blog · Change · Mental Health · trauma

The Loss of the Living Part 2: Does Time Really Heal Us?

A few months ago, I sat down with a new client who had just been deeply traumatized and was in a state of crisis. “What do I do?” she asked. “How do I make the pain stop? Why did this happen? I’ll never get through this, I just know it!” Immediately the old adage “time heals all wounds” came to mind. I carefully chose to take that saying, open up the metaphorical garbage bin in my head, and throw it right the hell out. Lord knows, the last thing my grieving client needed at that moment was to hear me say “give it time.” She felt like her whole world was crumbling. A traumatized person doesn’t want to hear that things take time. They want to hear that they can get some type of relief to the seemingly endless agony that they feel. My heart broke for my client, who wished and begged for there to be a way to reverse what had happened to her. But I didn’t rush her agony. I didn’t try to find a bright side to it all, nor did I tell her that her feelings would change eventually. In that moment, it was important to meet her exactly where she was at. As we sat in my office with her grief and despair, I knew that over time she would have a different perspective on what had happened to her, and that new perspective would change her entire life.

As honored as I was/am to walk this journey with my client, I would be remiss if I did not acknowledge the fact that I knew what she was feeling all too well…

It has been about five months since I posted “The Loss of the Living” on my blog: and in case you didn’t read it, I’ll bring you up to speed: About six months ago I lost someone who is still very much alive, and at the time of my loss, I truly thought my world was ending. I was betrayed and violated by someone who I thought cared deeply for me. After the initial impact of the loss, a few people here and there would say “Give it time, you’ll feel better.” and I hated hearing it. I didn’t want time – I wanted ANSWERS. I wanted answers for the abandonment, for the vile words that were spoken about me, and for the completely unprompted betrayal. But I couldn’t find them because my pain was so blinding.

Time hasn’t healed my wound, nor do I believe it ever will. Pain doesn’t disappear over time, it transforms. So while myself and any other grieving person may not experience the same earth-shattering pain that we initially felt at the time of our loss, we still ache in other, more subtle ways. For example:

-Some people who go through breakups and initially feel that they cannot breathe without their ex-partner may realize over time that their partner was actually controlling, abusive, or perhaps the relationship as a whole was not healthy. Their pain can transform from “I can’t breathe without this person.” to “How dare this person abuse me.”

-Parents who lose children to an overdose often take their pain and use it to combat the stigma of addiction and help save others from being lost to drugs. Their pain can transform from “I’ll die without my child here on earth.” to “I’ll never stop missing my child, and I’ll take what time I have left on this planet to save other families from the same fate.”

My pain isn’t gone, but I understand so much more now than I did six months ago. Time has taken the myopic view I had on the situation and has allowed me to see that the woman who hurt me is the epitome of a wolf in sheep’s clothing. Time has revealed that, contrary to what I used to believe, this woman is wounded in ways she isn’t capable of accepting, going through life projecting her own insecurities and pain onto everyone she meets. I thank God that our relationship did not last, because I know she would have made me extremely sick.

With my new perspective, I realize that the downfall of our relationship was rooted in one thing: pure, unfiltered envy – envy over the flourishing parts of my life that reminded her of the places in her own life where she still has significant voids. And with every passing day, I learn new information of how I’m still being copied and stalked by this person, who used to make every effort to tear me down and tell me that my ideas and dreams were way too far out of my reach. In understanding this, I am no longer sad over the loss. If anything, I’m thankful she is gone, as my health and wellbeing have significantly improved without her narcissistic presence. The pain remains, but these days, that pain looks so much more like determination. In trying to tear me down, she has made me stronger and healthier than I’ve ever been before – what a shocking turn of events!

So does time truly heal all wounds? No, I wouldn’t say so, and I doubt many other trauma survivors would say so either. It’s how we treat our wounds that matter. Do we nurture them? Do we seek justice? Do we find new perspectives? The answer is different for everyone. Only time will tell. Thus, while time might not heal us, it certainly will tell us all that we need to know.

Oh, and I’d hate to end on a cliffhanger, so suffice it to say this: The client I referred to at the beginning of this post is now the happiest and most confident she has ever been. That is due to new perspectives, not the passing of time.

blog · depression · Mental Health · OCD · trauma

“I’m So OCD About It.”

**Trigger Warning**

I am quite guilty about having talked like this in the past: “I’m so OCD about it.” About what? How clean I like my house to be, how I organize my closet, etc. I can even recount many times at the gym where I would be in the middle of a fitness class – God forbid the instructor accidentally lost her place and we ended up doing 11 kettlebell swings with the right hand and 10 kettlebell swings with the left hand. I’d be the first to say out loud: “Oh my gosh, we’re uneven, we have to do one more one this side – I’m so OCD about it!”

A lot of us do this, but as I got older and started becoming more seasoned as a therapist, I realized how wrong those comments were. Obsessive Compulsive Disorder (OCD) can be a crippling mental health disorder in which we find ourselves having to act on certain impulses in order to quiet the thoughts in our head that just won’t seem to stop.

Yes, people can develop OCD symptoms around cleanliness, disorganization, and numbers, like I mentioned above, but the obsessive thoughts can also be much more than that. You see, when I would make those comments like the ones I mentioned above, I would laugh, my friends would laugh, and we would go about our day. But the truth is, I was joking about an issue that runs so much deeper and is more serious than most folks know. While many of us joke about having OCD, the truest form of the disorder is brutal.

Of all the issues I have been battling, one of the ones I talk about the least is my OCD, mostly because I know that my OCD is a result of my trauma and in treating the trauma, I am also treating the OCD.

But truth be told, OCD is an absolute beast, one that lives with you, follows you everywhere you go, and keeps you from sleeping at night. It’s the worst friend you’ve ever had, but cannot seem to get rid of. It’s counting how many times you chew your food before you swallow, it’s making sure you step on the scale 3 times just to make sure the scale is right. It’s this irresistible compulsion to say your prayers exactly the same way every night, fearing that something bad will happen to you if you don’t.

This elusive beast comes in many forms, and what I named above are only a few symptoms that people with OCD may struggle with. Looking back on my childhood, I know that my OCD began as early as 3rd grade, where I remember washing my hands so much and for so long that my skin would bleed. As I got older, my obsessions then became about people breaking into our home. I would have to check the doors at night, dis-arm the alarm that my mom already armed, check to ensure the garage door was shut, and then re-arm the alarm. After about 3-4 rounds of doing this each night, only then could I be assured that the doors were truly locked and the alarm was truly set.

My symptoms have come and gone throughout my life, worsening during times of extreme stress. COVID 19 of course sent my obsessions and compulsions through the roof. I would cry if anyone came too close to me, I refused to see anyone but David for months on end, and any time I needed to go anywhere, I would come home and strip at the front door, throwing my clothes immediately in the washer and jumping into the shower to scrub my skin raw. We even used disinfectant to wipe down every grocery item that we bought before allowing it into the house. It was exhausting, time consuming, and needless to say, very rough on my skin.

And have I mentioned intrusive thoughts? I could write an entire blog post on intrusive thoughts so I won’t dive too deeply into this, but they often couple with OCD. For example, if you’ve ever been driving your car on a highway and suddenly thought to yourself: “What if the car next to me runs me off the road and I crash into a tree and die?”, this is an intrusive thought. Or maybe worse, you’ve even pictured the entire event taking place in your head. This is also an intrusive thought, and you are not alone if you have them.

Often times we develop compulsions to quell our obsessive and intrusive thoughts. Over the last few years, my obsessions and compulsions have come back in more crippling waves, likely due to extreme stress. Back in 2018 when my mom was severely ill and in the ICU, I believed that I caused her sickness. I recall sitting in the spiritual room of the hospital, feeling the urge to pray the same exact prayer, in the same way, for the same amount of time, because somehow, I believed that would save my mother. I remember those dreadful times when I would have to leave the hospital after spending a day with her in the ICU, I would make sure I didn’t step on a single crack on the floor as I walked down the hallways, because I thought that if I stepped on a crack it would be the reason why my mom didn’t survive.

In more recent months, I have been battling health issues, including an autoimmune disease that is – to put it lightly – excruciatingly painful, rendering me, at times, incapable of even breathing without severe, nauseating pain. I have also had multiple tests done on my eyes, as doctors were concerned that I had inflammation in my optic nerves that were being cause by a brain tumor. I was referred to one of the best neuro-opthamologists in the country, but had to wait nearly two months for an appointment. (I just had my appointment this week – no brain tumor!) Naturally, these last two months have been wrought with compulsion after compulsion to try to quell the obsessive thoughts about dying. Some examples:

-Driving to work: Did I check the stove to make sure the gas isn’t on? (after having checked it 20 times before leaving) Am I sure my dogs are safely in their crates? What if there is a fire and my house burns down? My dogs will die. Oh god, I can’t go to work. What if David dies? Let me call him to make sure he and the dogs are okay. NO, don’t call him. Don’t give into the compulsion.

-Driving home from work: Did I really blow that candle out in my office or did I just imagine it? Let me turn around, I have to check, I can’t be responsible for burning down the building. *drives back to office, confirms that the candle is blown out, starts driving home again* Okay but what if I imagined that? Did I really blow out that candle? *Gets home from work 45-60 min later than expected because I have to act on my compulsions*

-Getting ready for bed: *Hears David cough* He must have COVID. Oh God I probably gave it to him. He’s going to die and it’s going to be my fault. He can’t die, because I’m going to die because I probably have a brain tumor. He has to live because someone needs to take care of the dogs. Speaking of dogs, are mine safe? I know I checked earlier but let me check on them again to make sure they are breathing. While I’m at it, let me check the locks on the doors again. If I don’t, something bad will happen and everyone I love will die and it will be my fault.

It’s terrible. It’s exhausting. And sometimes I so desperately want out of this head of mine. This is the case for so many folks with OCD. It’s not just about wanting your house to be neat and orderly. It’s about needing to do certain things to avoid horrible things from happening and to quiet the brain.

I understand things so much differently now. I used to have the attitude of “I’m not changing the way I speak just to save other’s feelings” but the older I get, the more I realize how much of an impact words have on myself and others (I am a therapist, after all!). Intent does not equal impact – and even if I was just joking all those times when I said “I am so OCD about it”, I realize that it is nothing to joke about.

1. If you have been diagnosed with OCD, know you’re not alone and there is no shame in sharing the thoughts and compulsions you are having. In fact, speaking them out loud takes the power away from them.

2. If you have never been diagnosed with OCD, but resonate with some of what I’m saying in this post, please reach out for help. You don’t have to live like this forever and managing the symptoms truly does get much easier.

3. If you have no experience battling OCD, but often say phrases like “I’m really OCD about it”, maybe consider trying to change your words. What else could you say instead? “It makes me feel frazzled and disorganized when my house is a mess” or “I prefer my closet to be organized by color because it makes me happy” are just a few examples. The beautiful thing about language is that there are millions of ways to say something without using words that might minimize the beast that is OCD.

To learn more about obsessive compulsive disorder, please visit https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

*All information about OCD is derived from my training as a clinician. No articles or websites were used to create this post.*

blog · health care · self care · trauma

You’re Not Listening!

No one likes it when they feel as though they aren’t being heard. For me, over the years, not being heard has become a debilitating trigger. Sometimes it feels like all I do is scream at the top of my lungs and people don’t seem to hear me – especially when it comes to my health.

I have known for months, if not years, that something is wrong with me. But because of my history of trauma and because of my weight, I typically get one of two responses from doctors, therapists, etc.:

  1. “It’s the trauma! Your body is holding so much pain.”
  2. “It’s your weight. You’d feel better if you worked out a little bit.”

I mean, I typically would say “don’t even get me started” when it comes to healthcare providers saying this type of stuff, but who am I kidding? We all know I’m about to get started!

  1. Perhaps this is shocking coming from a trauma therapist, but I truly don’t believe that every single sickness is a manifestation of trauma. Sometimes people are, in fact, sick. I don’t know how many times I tried to tell my therapist “my body hurts, I’m so tired. I cant function” only for him/her/them to go “Well of course! It’s the trauma!” This therapist believed that people get illnesses due to undigested trauma, and while I do absolutely agree with that, I don’t think that means that trauma therapy is the be-all, end-all cure. I think I needed a medical doctor, stat, but never got one because I was told the trauma therapy would cure it all.
  2. Ah, the “It’s your weight” comment – a personal favorite. Here’s my truth: You could put me in a boxing ring with a man ten times my size, and STILL, the strength of my right hook alone would knock him off his feet. So what is it that these doctors want me to do when they tell me to exercise more? Push-ups? Not a problem. Deadlifts? Child’s play. Planks? Sure! Triathalon? Let’s go!

    And the most dysfunctional thing of all about doctors telling me to move my body more is that they incorrectly assume that exercise is a weight-management tool (it’s not!!!). Doctors are taking one look at me, observing that I’m fat, and assuming I’m lazy (not true for anyone, fat does not equal lazy). Therefore, in their minds, the solution must be that I need more exercise.

Thus, because of my weight, because of my trauma history, I am stigmatized. I am not heard. And quite frankly, I’ve been getting downright disgusted by it. A few weeks ago after being told by yet another doctor that nothing is wrong, I was ready to quit and live the rest of my life only maybe 40-50% of the type of person I knew I could be if I were feeling better. But thankfully I have a supportive partner at home who reminded me that I have never been one to give up or take “no” for an answer.

And so I continued to fight. And over the last few weeks, my fighting is starting to pay off. I have seen multiple doctors who have run tests on me that have never been run. I went back to a doctors office for the second time in a month and requested a new doctor because I didnt’ like the answers I got from the previous doctor. And this time, I got a few more answers. I was HEARD. This doctor, bless her sweet soul, sat down next to me and handed me tissues as I cried and told her how horrible I felt. She validated me, listened to me, comforted me, and after an examination she gave me a diagnosis. She confirmed that what is going on with me is NOT my fault and that my weight gain, fatigue, and chronic pain is a result of this diagnosis, NOT a result of being lazy.

I am now being referred to a doctor who specializes in this specific autoimmune disease, as my doctor suspects that I have multiple autoimmune diseases that are contributing to my symptoms. All in all, I still don’t have all the answers. I have a few different doctors that have varying concerns ranging from issues in my brain, potential loss of vision, multiple autoimmune diseases, etc.

But low and behold, people are finally listening to me. I have no idea what will come of the journey ahead, but I am so much more hopeful knowing that people are hearing me, believing me, and truly wanting to see me feel better.

It’s so easy for us to fall into silence and not question anything when a doctor is not giving you the proper time and attention that you deserve. But it’s so important to push through your triggers and never stop fighting for your right to be heard. You know your body better than anyone else, so if you feel as though something is wrong and you are not getting the answers you want, use your voice! Use it one time, ten times, or a hundred thousand times if need be and I promise you that someday, someone will hear you and someone will provide you with the answers for which you’ve been searching.

blog · COVID-19 · depression · Mental Health · trauma

Missing Those ~Precedented Times~

If I hear the phrase “unprecedented times” one more time…..

Now let me just preface the remainder of this post by saying that I am eternally grateful that my loved ones have not yet lost their lives to coronavirus, and therefore, my intention is not to come off as inconsiderate or selfish when I say the following:

UGH! I miss going out to eat. Especially Zahavs (to die for) in Philly. My husband and I went on our first date there, celebrated our engagement there, and continue to go there every year on our anniversary, with the exception of last year and most likely this year due to Covid. What I wouldn’t give to be able to hop on a train and head into the city, where I can stroll carefree from one historic monument to the next, enjoying the sights and sounds and, most importantly, the delectable cuisine!

I won’t sit here and go through all of the things that I miss, because it’s not news to anybody. I know we are all on the same boat when it comes to missing our pre-covid lives. But what I will say is this: Being stuck inside has forced me to re-evaluate what I’m doing to take care of myself. If you had asked me a few years ago, I would tell you that self care was going out for an expensive date or a pricey spa day. I would tell you that self care is being able to hop on a plane and go to your favorite vacation spot whenever you want. Or I might tell you that self-care is forcing yourself to wake up at 5 AM so you can get to the gym even though you only got three hours of sleep the entire night.  

Some part of me always believed that self care should have an emphasis on spending money or looking a certain way. But I didn’t have an opportunity to do any of that this past year. I had to actually stay in my house and figure out how I was going to take care of myself, because going on vacations or strolling the mall or hitting the gym excessively was not an option for me. Looking back, I see now that those things weren’t truly self care at all. The only purpose that all of those things served was to be a giant distraction for the painful feelings that were surfacing as a result of my PTSD.

With all of that being said, I thought I might take a moment to share on the blog some of what I’ve been doing to keep myself sane over the last year. It has nothing to do with spending big bucks or trying to make my body meet some impossible standard. Ready? Let’s go!

1. Puzzles. Don’t you roll your eyes at me! I hated puzzles up until this year. You know why I hated them? They forced me to be still and process all of the intense feelings that were coming up. Since quarantine, I have completed about ten 1000-piece puzzles. When I’m having some big feelings, I shut all of my technology down and I work on my puzzle. It keeps my hands busy, and keeps my brain distracted while allowing space to process my emotions at the same time. I highly recommend!

2. Painting. Again with the eye rolls?! I’m telling you, it works! I have zero artistic talent, and that’s putting it nicely. But a few months ago, one of my clients introduced me to “Canvas by Numbers”, which has been so satisfying to work on! Not only do all of the colors soothe my soul, but just like with puzzles, it keeps my hands busy and keeps me focused, while also allowing me to process other things.

3. Epsom salt. People who struggle with anxiety and depression tend to have lower magnesium levels, which can be found in Epsom salt. Magnesium is best absorbed through the skin, and there are now different types of Epsom salts that are infused with essential oils (which is really the icing on the cake if you ask me). If you are not a person who enjoys taking baths, I have also found it to be extremely soothing to put some Epsom salt in a cup and bring it in the shower with you. You can scoop it out with your hands and rub it into your body, using it as an exfoliant. It certainly helps with aches and sore muscles, but also with anxiety and depression. It’s one of those instant fixes for me when I’m really depressed or dissociated.

4. Essential oil diffuser. When I am dissociated or anxious, I need all of my senses on deck to pull me out of the funk that I am in. So my diffuser doesn’t just give off incredible scents, but it’s also a 3-D light-up diffuser. I found it on Amazon! Between the amazing smells from the essential oils and the pretty lights, I find this to be a very grounding tool for me. 

5. Movement. And I don’t mean exercise, although this can include exercise if you would like it to. If you have a yoga mat, roll it out and sit on it. Do some light stretches, some neck rolls, some lower back stretches, and even give yourself a foot massage. There are parts of the feet that are directly connected to your organs (more on that later), which is partially why some spots on your feet are more tender than other spots. There are a million free videos on the internet with guided stretches if you need a bit of assistance. The goal here is not to lose weight or change your body. It is simply to allow the emotions that are stuck inside of you to start moving through you.

6. Animals. Do you have a fish? A cat? A dog? A bearded dragon? Whatever you may have, interact with him/her/them. Yes, even your fish. Feed your fish, clean the tank, walk your dog, etc. When I force myself to put my phone down and play with my dogs, it often pulls me out of my depression and brings some laughter into my days.

This self-care list is drastically different from the list I would have given you two years ago. One of the most important differences between what I did back then and what I do now is that my current self care tools are all about moving through the feelings instead of trying to avoid the feelings. If you’re struggling in these (dare I say it?!) ~unprecedented times~, I hope that this list can help you make a giant leap towards taking better care of yourself. You one thousand percent deserve it!

blog · depression · Mental Health · trauma

Depression Stole 28, But It Won’t Steal 29

My birthday (January 6th) always falls during a weird time of the year. The madness of the holidays has just passed and everyone is trying to get back into their work/school flow. Growing up I’ve had countless people mention that it must be tough having a birthday right after the holidays because people are always so tired of parties and presents and celebrations by the time my special day rolls around. Luckily for me, my parents never made me feel like my birthday was any less important because it falls just after the holiday season. My parents have always encouraged me to celebrate myself on my special day.

But last year was different. Depression reared its ugly head and I simply couldn’t celebrate my birthday. It was all I could do just to breathe. I dreaded the days leading up to my birthday, so much so that I actually changed the settings on my social media so that no one would be able to see it was my birthday and thus, wouldn’t reach out to me. And to those who did wish me a happy birthday, I could barely muster up the strength to text them back and thank them.

When I look back at my birthday last year, I feel so much sadness for myself. I wish I could tell my newly-turned-28 year old self that I deserve to be loved by others. If I could change things, I wouldn’t have shut my phone off that day. I would have packed on all the self-care instead of all of the self destruction and isolation. While my year on earth as a 28 year old woman was the most difficult year to date, it has turned me into a self-care warrior, which made my 29th birthday so much more enjoyable.

This year, I took the time to celebrate myself on my birthday. When I opened my eyes on January 6th, I wasn’t filled with dread. Instead, I was filled with excitement! I ate a great breakfast, did some neurofeedback (more on that later), and cozied up in a fresh pair of my favorite pjs. I sat on the couch under a pile of blankets and worked on a giant puzzle. I ended the night with an awesome boxing session, a healing epsom salt bath, and of course, dessert!!! I truly enjoyed every second of my day, wrapping myself in love and self care and appreciation for who I am and the resiliency I have shown over the last year.

It has taken so much sadness, anxiety, anger, grief, rage, and pain to be able to get to a place where I could celebrate myself on my birthday. Time after time this past year, I had to take a leap without knowing where I’d land, hoping for the best. I quit my job in the middle of a global pandemic, praying I’d be able to make it on my own. I stopped making myself so readily available for people to keep myself from burning out, not knowing if in doing so, I would end up being abandoned by everyone (spoiler alert: I wasn’t!). I gave up chronic dieting and put my faith in a nutritionist who had me eating ice cream every night to start normalizing “bad foods” (again, there are no bad foods). In my 28th year, I found the balance between letting go and holding on, between surrendering to the things I truly can’t/don’t want to control and fighting like hell for my voice to be heard. And most healing of all, I walked away from a cancerous relationship that was sucking the life out of me (not my husband, Dave’s a good guy!).

And here I am at 29, happy. Of course I have bad days. Horrendous days. Days where I want to rip my hair out and scream at the top of my lungs. Days where the tears don’t stop coming and I blow through an entire tissue box in 6 hours. But that’s what living is. It’s showing up for your emotions – all of them. It’s allowing yourself to feel all of it instead of numbing out with drugs/food/sex and self-destruction.

A few days before my birthday, I had a long talk with one of my best friends. God blessed me with her beautiful friendship over ten years ago. I believe wholeheartedly that she was hand-picked to come into my life at the exact moment that she did, because I’m not too sure where I would be without her unconditional love and support. This Wonder Woman has been with me my through my highest of highs and my lowest of lows, even though there were periods of time where we spent years living on different continents, in different states, etc. While we were on the phone recently, I found myself expressing how I am feeling about turning 29. I told her that these days, even in my worst moments, I still love myself. I’m still thankful for the very air that I breathe (even if I have to breathe it through a damn mask).

Days later, I received a birthday gift from her in the mail. It was a subscription to Vellabox, which is a candle company (my days are incomplete unless I have a candle lit somewhere nearby). In the box, there happened to be this card with a quote on it, which is randomly selected and placed in each box before it ships out. Tears filled my eyes as I read it, because it so beautifully sums up the lesson that I’ve learned over the last year. The card read:

“Our memories are gifts that show us life, even through the toughest times, is worth living.” – Chrissie Pinney

So cheers to 29, for I am far more alive than I’ve ever been before.

blog · Change · eating disorders · Mental Health · shame · trauma

Why Trauma Survivors Don’t Go To The Doctor

I have not been feeling well for months. -low energy, aches and pains everywhere, chills, and chronic fatigue. I’m so exhausted that I can barely make it from my bed to the couch downstairs without feeling drained. At first I thought maybe it was depression, but as the months went on, I started to get this feeling that there is something deeper going on with me aside from depression. I have a history of thyroid issues in my family, and I’ve been told by a few doctors that I should keep an eye on my thyroid levels, as they have historically been on the lower end of the spectrum.

Thus, after months of feeling like total crap, I picked up the phone and made an appointment with an endocrinologist, hopeful that this doctor will give me the answers I am looking for. I scheduled my appointment for the end of December – and what did I do immediately after I hang up the phone?

I agonized over the appointment. Every day that it got closer to me having to go to the doctor, I felt my anxiety increasing. I loathe going to the doctor. In fact, I’m petrified. And here is a little glimpse as to why doctors appointments, for myself and many others, are often traumatic:

My recent appointment with the endocrinologist went as follows:

I arrived, checked myself in for my appointment, got my temperature taken, and was called back by one of the techs.

“Step on the scale please,” she says. I respond “Oh, no, I am in recovery from an eating disorder and I cant – ” She cuts of me off. “Ma’am, we really do need your weight if you’re going to be a patient here.” I feel myself starting to shut down. “Ok dont be a big baby, just get on the scale” I think to myself. As I step on the scale, I say to her “Okay but it’s triggering to weigh myself so can you please not tell me what my weight -” She cuts me off again to say my weight out loud in front of multiple other people in the office so that someone else can write it down.

And then the shame starts. I start sweating. “Oh my god oh my god that bitch yelled my weight out to the whole office everyone is going to know my weight oh god I cant breathe.” I walk into the room to wait for the doctor. Soon enough the doctor barges in the door and says hello without making eye contact. She sits down at her computer and asks me deeply personal questions without looking back at me one single time.

“You wrote down that you have PTSD?”

“Yes.”

“From….?????”

My heart sinks right into my gut. I stammer on my words as I try to give a 15 second elevator speech about my trauma to a woman who isn’t even looking at me. As I finish speaking I start to cry into my mask. “Why couldn’t I just tell her I wasn’t comfortable discussing it?” I think to myself. But I cant help it. I’m with an “authority figure”. I’m playing out my trauma – giving my all to a person who promises to help me but doesn’t actually care about me.

She types on the computer in complete silence for what feels like 15 minutes. She gets up, touches my hands, my ankles, my neck, my chest, and says “There doesn’t seem to be anything wrong.”

I finally start to get angry. “That can’t be right. I’m telling you, I don’t feel well. I know when something is wrong with my body. I am in recovery from my eating disorder and eat better now than I ever have in my life and somehow have put on an excessive amount of weight in the last few months that has me extremely concerned about my health.”

She says “Well, I’ll send you for more bloodwork but in the meantime, you should exercise, 20 minutes a day. Sound good?”

NO THIS DOES NOT SOUND GOOD, DOC. If exercise was the f&%$*@! answer, I wouldn’t be here talking to you, now would I? The problem is that I do exercise, perhaps not as much as I would like because I’m so exhausted I can barely function but I do my damn best. I’m not here because I needed you to tell me to exercise. I’m not here to talk about how to lose weight – I’m here because everything in my body is screaming “SOMETHING IS WRONG.”

But I dont say any of that to her. Instead, I nod through my tears “Yes, I’ll exercise.” and I am sent to the front desk to check out. The woman hands me a piece of paper with the summary of my appointment, in which it says that the doctor discussed BMI with me and I agreed that I was going to exercise every day for 20 minutes.

And I sobbed. The discharge summary said nothing other than that I am overweight and need to exercise. I threw it in the garbage because IT IS garbage. Why why why can we be so obsessed with someone’s weight but be completely oblivious about the trauma that is often behind the number on the scale? Why are we still even talking about BMI? There is a plethora of research negating its validity as a tool for determining health.

How differently could that appointment have gone if she had asked me what is going on in my life aside from exercising? If she had looked me in the eye when she walked in the door and made me feel seen and heard? Would I have been so horribly triggered if they had respected my right not to step on the scale? I guess I’ll never know, but I do know one thing:

This sort of stuff happens in doctors appointments over and over and over again. Folks who are struggling with eating disorders are often masking trauma. When you get to the root of the trauma, you mitigate the eating disordered symptoms. The person then learns how to listen to their bodies and eat intuitively, and their weight becomes whatever it is meant to be.

WEIGHT WILL TAKE CARE OF ITSELF. It is not necessary for doctors to be discussing BMI when 90% of the time, we don’t show up to the doctors to discuss BMI. Weight isn’t, despite what so many people think in this fat-phobic society, the root of all evil. Unprocessed emotions, underlying autoimmune diseases, irregular metabolic functioning, and suppressed trauma, are just a few of the many, many things that are more important than BMI.

I wasn’t given the time of day by this doctor, as has been the case with dozens of other doctors. Instead of leaving with answers for what is going on with me when I know something is wrong, I left full of shame and rage that no one will listen to me when I am doing everything short of screaming at the top of my lungs “SOMETHING FEELS OFF WITH MY BODY PLEASE HELP.”

I’ve been in recovery from my eating disorder for awhile now. I’m more in tune with my body than ever before, but because my BMI labels me as being overweight, everyone jumps to the conclusion that it must be my diet and exercise that are off.

We need to do better. We need to get rid of the BMI are start assessing people’s ACE scores (see https://alyssascolari.com/understanding-adverse-childhood-experiences/ for more info on ACE scores) because this is ultimately what’s going to kill people, not their BMI. You can put someone on the biggest, best diet in the whole world and they will still continue to have health issues until you get to the core of their wounds.

“Trauma-informed” is not just some training that we need to get in order to check off another box on our “to-do” list. It’s a crucial part of the work that all healthcare professionals do. When we start to shift our focus towards a truly trauma-informed practice, I can guarantee that we’ll start saving more lives than the BMI chart ever has.

blog · Mental Health · self care · trauma

Boundaries vs. Threats

Of all of the pain I have endured over the last few months as a result of a significant loss in my life, I have to say, both time and space have given me the ability to see this person for exactly who he/she/they really are. I have had some time to reflect on the recent years filled with scenarios that left me feeling full of guilt and shame. This person, who happens to be the ultimate gaslighter, loved to tell me that he/she/they were setting boundaries with me. The thing about being in toxic relationships is that when you’re in one, you inherently believe that this person is speaking the truth. You don’t question whether or not this person actually knows what he/she/they are talking about. And when you start to feel angry and offended by what this person says, instead of blaming that person, you automatically blame yourself!

Thank God I know so much better now. The fog has cleared and although this person is nowhere to be found in any aspect of my life any longer, I feel as though I can see this person for who she/he/they truly are for the first time in years.

As I am processing the depths of my relationship with this person, I have realized that if this has happened to me, it is likely happening to so many other people, so I want to provide a little bit of clarity on a rather fuzzy topic. There is a significant difference between someone setting a boundary with you and someone threatening you, but sometimes the lines can be blurred and what we think are healthy limits are actually threats.

So let’s break it down, shall we?

BOUNDARIES

Boundaries are limits that we set with other people or sometimes, even ourselves. The point of setting a boundary is to protect our own physical, social, and emotional health. Setting boundaries with others can look like:

-“Thank you for the invitation, but I can’t go out this weekend.”
-“I won’t be joining you for the holidays this year due to the pandemic.”
-“I have let you know repeatedly that I do not want to speak about this topic. If you continue to bring it up, I am going to leave the party.”
-“I have told you that I am not comfortable meeting up without masks. If you are not able to wear a mask, let’s wait to meet up until it’s safer to do so.”

Again, boundaries are put in place to honor ourselves and protect all aspects of our well-being.

THREATS

Threats are designed for us to get the things we want and/or need, often at the expense of someone else. Threats typically come in the form of a warning that someone or something might be harmed if we don’t get what we want. Some examples of threats might be:

– “If you are going to continue dating that guy, then I’m going to stop asking you how you’re doing since you’re only going to get hurt.”
-“If you don’t spend the holidays with us this year, then I’m not buying you those shoes you have been asking for.”
-“We aren’t having sex at night anymore since you clearly can’t even have the laundry done by the time I get home from work.”
-“I’m paying for this wedding so I think I should have some say in where you have it.”

Threats are about securing our wants and needs by taking something away from someone if things do not go our way.

THE THIN LINE

As you’ll notice in the section on boundaries, none of the examples I provided were about doing harm to the other person in any way. The only thing a boundary should do is help us to protect ourselves without doing harm to others. The line between threats and boundaries starts to blur when we start punishing other people for not getting our way. There is no punishment happening when we tell others, for example, that we aren’t comfortable meeting up with them unless they are wearing a mask. There is punishment happening, however, when we withhold sex, threaten emotional neglect, or hold money over people’s heads in order to get what we want. Sometimes it can be quite difficult to tell the difference between a threat and a boundary. Many people feel that they are one in the same, but that could not be further from the truth; and it is important to suss out the difference so that we are taking good care of both ourselves and our loved ones.

Now with all of this being said, I’d like to shift gears and speak directly to YOU – the one who is the epitome of the thin line. I know you lurk in the shadows of my life, reading every blog post, listening to every podcast episode, watching me rise from the ashes like the goddamn phoenix that I am. You are the thin line between threats and boundaries, the one who has been threatening me for years under the guise of being “great at setting boundaries”. I know your eyes will scan every word of this page, hoping to find evidence that you broke me but knowing deep down that you never had that kind of power. Let me take a moment to thank you for teaching me the difference between a healthy boundary and an insidious threat. You have allowed me to be able to share this critical information with others so that they can recognize a threat from a mile away and learn how to set appropriate limits with others. Allow me to express my gratitude for the blinding pain you caused me. While I would have preferred to live without your subtle threats, manipulations, and abrupt abandonment, I am proud to say that I am taking what you put me through and will use it to help others for the rest of my days.

blog · eating disorders · Mental Health · self care · trauma

The Pain Will Come Again

As somebody who is rarely ever short on words, I find myself struggling to speak lately. I am quiet these days, possibly because I’m not too sure how to put words to the things that I have experienced over the last couple of months that have culminated in me being re-traumatized on multiple levels.

I will never tire of the way in which I feel so alive when I sit with my patients. It feels so natural for me to enter their worlds and help them to make connections, process pain, and heal what hurts. But sometimes I don’t do so well when the roles are reversed. When I become the patient, looking back at my therapist, I am speechless. Perhaps this is because words simply do not feel like enough to describe what has recently transpired in my life.

I suppose I am doing as well as any one person could be doing after being re-traumatized. There have been moments, especially this past week, when I have wanted to crawl right back into the cold, icy arms of my eating disorder -anything to take the edge off and make me feel like I have some sort of control. I’ve had to fight like hell to maintain my connections with safe, supportive people instead of isolating. And once or twice this week, I even had to take the risk of reaching out to my treatment team to help get myself grounded.

The flashbacks have become more frequent and I am finding that the way in which I talk to myself or about myself has become increasingly negative. I’m having to focus nearly all of my efforts into the self-care department. It would be so much easier for me to constantly work so that I don’t allow time or space to process all that has happened, but I’m trying to be intentional about slowing down. My boundaries in both my professional and personal lives have gotten tighter (i.e., avoiding contact with potentially triggering people, setting limits on how many hours I am working a day, etc.). While this process has required an exhausting amount of introspection, I have become much more aware of the things that I can and cannot hold space for right now.

So what does this all mean? Does it mean I’m too sick to do my job? Does it mean I am unraveling and cannot function? Does my pain make me any less competent in my profession?

No. Not at all. If anything, being fully in touch with my emotions and having awareness of my limits right now makes me more competent in my profession than I’ve ever been. I am completely aware of how much I am hurting right now, and I am fully aware that I have more on my plate than I bargained for. 

Therapists are humans too, and as a human, being in recovery from PTSD does not mean that I will never have bad days again. It does not mean that I am immune to being traumatized in the future, nor does it mean that I am immune to a relapse in my eating disorder. Relapse is not only possible, but is also probably given my circumstances right now. Healing is not linear. None of us will ever wake up one day and be 1000% cured. The simple act of being alive means we will most likely experience pain multiple times throughout our lives.

But the exciting news is that with every breath I take, I have become more aware and more empowered to take my healing into my own hands instead of self-destructing, which is what I would have done in the past. As distraught as I have been, I have turned away from self-destruction and instead, I have made every effort to take better care of myself than ever before. This is what healing looks like. Healing doesn’t mean that we never hurt again! Healing means that, when the pain creeps back in, we feel more equipped to cope and to persevere.  I am healing because although I will never be okay with what has happened to me, I am choosing to love myself through it in every way that I can.

I truly don’t know what the days will bring given my current circumstances, but I do know that with every decision to love myself instead of hate myself, I heal a tiny bit more. I have the tools, the love, and the support I need right now. And when all else fails and I simply cannot turn down the intensity of the pain, the anger, or the worry, I turn back to one of my favorite fictional characters who, I believe, said it best:

“No good sittin’ worryin’ abou’ it. What’s comin’ will come, and we’ll meet it when it does.” – Rubeus Hagrid, Harry Potter and the Goblet of Fire

blog · eating disorders · Mental Health · trauma

Have Mercy

Today, the day after Thanksgiving, is my favorite day of the year! Yet, it’s also one of the hardest days of the year for those of us who struggle with being elbow deep in diet culture and eating disorders.

The day after Thanksgiving leaves so many of us feeling guilt and shame over our bodies as a result of what we consumed yesterday. Eating disorders and diet culture, at their core, are really all about having control; and in a world that feels more out of control than ever before, I am sure that the urge to over-exercise and restrict food intake as a way to make up for the the calories consumed yesterday is extremely strong.

So I’m here to ask you one thing, and that is to have mercy on yourself. 

When you find yourself opening your eyes in the morning and immediately thinking about what you ate yesterday, have mercy on yourself.

When you tell yourself that you need to work out as a form of damage control for the food you consumed, please have mercy on yourself.

If you feel as though the only way you deserve to get through the day today is by eating lettuce that you later end up purging, please have mercy on yourself.

If you find yourself staring in the mirror and pinching and poking the softness on your body, wondering if your stomach is more doughy today than it was yesterday, have mercy on yourself.

When you find yourself starting to feel hungry, but do not feel as though you deserve to eat because you enjoyed yourself yesterday, have mercy on yourself.

And finally, if you find that you cannot stop chastising, telling yourself that you were out of control yesterday, and calling yourself names that are shame and guilt inducing, I beg of you, please have mercy on yourself.

You do not have to spend the day obsessing over how to reverse what you ate yesterday because you did absolutely nothing wrong. One huge meal will not, I repeat, will not have any effect on your weight. You deserve to nourish your body today, whether that means having three full meals with snacks, or snacking throughout the entire day.

Try to check in with your body and listen to what it needs. If we tune out the noise of diet culture, we will discover that our bodies already have the answers to the questions that we have been asking our entire lives. So be extra kind to the body parts that you hate, for those body parts have kept you healthy, safe, and alive far before your brain developed enough to allow diet culture and eating disorders get in the way.

When the guilt and the shame and the urges to restrict, purge, over-exercise, or body check start to creep in, please remember to have mercy on yourself. Not just today, but always.

blog · COVID-19 · suicide · trauma

You Just Want Attention

I don’t know how many times I have said this in the past, nor do I know for how many more months I’ll continue to say this, but damn, times are tough. I have more clients than usual who are in a state of suicidal crisis. While I am by no means negating the prevalence of the coronavirus, I do think it is important to point out that the number of suicide attempts and suicide completions far outweigh the number of covid cases in our world. Again, I say this not to take attention away from the seriousness of the pandemic, but to also point out the suicide pandemic that receives little attention.

As a therapist, I am frequently in contact with other care providers who work with my clients, such as doctors, school counselors, and parents. Lately, when suicidal urges increase among my patients, I find more and more doctors, school counselors, and parents having the same response: “I really think he/she/they is just doing this for attention. I don’t think there is any real threat here.”

This statement really hits me like a ton of bricks….not because I feel judgment towards the people who are saying it, but more or less because I find it to be so sad that we have quite literally shamed, chastised, and ignored people for wanting and needing attention from others. When people tell me that they don’t think suicidal urges are anything to be concerned about because it’s just a plea for attention, my response is usually
“Yes, this very well could be for attention, but that doesn’t make those urges any less real. And why risk it? At the end of the day, if you’re child/patient/student/spouse/parent is saying this for attention, then that means something is very wrong and we do need to give this person the appropriate level of attention and care.”

Why do we do this? Why do we condemn people for wanting and needing attention? Why is it such a bad thing to want attention from someone else.? I’ll be the first one to admit it: I love attention. I need it. I crave it. And most of all, I deserve it. I deserve to have others know when I am hurting so that they can help me. When my pain isn’t heard or validated, my suicidal thoughts and urges only become louder.

Now with this being said, I do acknowledge that there are people who can be manipulative with their words or are seeking attention in dangerous or unacceptable ways. I’m not suggesting we should be okay with this. What I’m suggesting is that we stop writing folks off when they say they feel suicidal. Sure, it could be an attempt at getting attention, but often enough, the attention that people happen to be seeking is much needed, even if it’s not necessarily needed in the form of crisis intervention. And besides, why risk it? Why label a suicidal person as ‘attention-seeking’ and then just wait and see if he/she/they really mean it? 

I’ll say it once more – life is hard right now. Like, really friggin hard. And the more I speak to doctors and school staff and parents and other providers, the more I see how hardened we have become to the needs of others. All I ask is this: let’s stop shaming and criminalizing others for being “attention-seeking”. Instead, let’s ask ourselves what kind of attention this person might need and how/if we might be able to help. Let’s all do our best support each other through this so we can all make it out on the other side of this pandemic happy, healthy, and most importantly, alive.