#Worksheet Time! What can you offer that other people cant? What makes you worth it to choose over others? Whats the most marketable thing--

[trainingdummyrabbit]

me, experiencing the horrors: >:( art shouldnt just be whats most consumable!!! we should do what makes us happy, its an expression of who we are as people and nobody should judge us or our value for that!!!

also me, drawing what i want: Oh God My Art Isnt Marketable Enough :(

[letsdiscoverkitty]

Therapy summary: 20/02/19

Today’s session has left me feeling utterly exhausted (even more so than usual, and that is saying something!). I find it quite helpful to write down the things we talked about so that I can remind myself/look back if I need to, so I will give this a whirl, it might be a bit of a ramble, which I am going to blame on the tiredness... NOTE: This will be long as we talked about quite a lot to, including my depression (for the first time). Also, TW because, well, you know why.

- Okay so to get it out the way, my weight was down slightly. Which yeah, it’s not great but it’s been fairly stable recently and is within a certain range...so we kind of moved on as lingering talking about it wouldn’t have necessarily helped as we both know the severity of the situation/I have been reminded about it enough already. - In general things have been rather messy and hard, my intake has been stable, maybe a bit more than it was but I know it is not where it should/needs to be. I’ve been wanting to make changes but feeling utterly paralysed day after day. - Today was the first time in therapy that we have openly talked about my depression....which I did not realise until T pointed it out. A lot of the focus was on how the depression/anorexia cycles keep each other going. This came about as I have kind of realised that one of the things that has been holding me back in terms of committing to change is that I was “allowing” my depression to dictate major parts of my routine. - For a long time this has meant not setting an alarm for the mornings and trying to sleep in as long as possible (one reason is because I am always tired but also to put off having to face the day), thus putting off breakfast as late as possible as I did not/do not see the point in getting up...Anorexia then jumps on the bandwagon saying it is then too late to make changes/increases to breakfast, that I can do it later. Then lunch gets pushed back further and further because I ate breakfast late (it has not been uncommon for me to have lunch past 3pm recently)...Again, when lunch would finally come around, the excuses of it being “too late” in the day to change things/increase would come in, with anorexia also reminding me that I would be having a snack in x time, so I should just wait until later... - I was always vowing that I would make changes “later” and that “tomorrow” things would be different but they never were... - This cycle has been going on for weeks/months and I have been beating myself up over it time and time again. I’ve been telling myself that I am a failure/need to pull myself together/talking to myself in very negative ways (that I would not say to anyone else) and dragging myself down a lot by feeding into these negative spirals. - Another example of depression getting in the way of things is that I have gotten stuck in the habit of not showering until gone midday and just sort of sitting around not really doing anything (unless I had to be somewhere) as I didn’t feel like there was any point in getting up and ready for the day as I had no purpose...this then feeds into the whole “what’s the point?” “why even bother trying? there is no reason to eat more” and anorexia jumps on it all dragging timings out and manipulating anything it can get its hands on. - These two ‘main’ things have both then been exasperated by the effects of starvation/malnourishment and ensured that I have stayed trapped in the same cycles day in and day out. We spent quite a while talking through some of the side effects of starvation/malnutrition (and the science behind it) which helped to get my head around it a bit more (I know the facts, it is just so hard to apply to myself) as it can be so easy to brush it off and forget how intertwined depression and anorexia can be and how they affect one another. - For example, I find my mood drops quite a lot in the afternoon, usually after lunch until well into the evening. This, we came to agree, is likely because my lunches are quite messy/not enough, as well as there being quite a bit of time between breakfast and lunch. There is a lot of science behind it that actually explains quite a lot (e.g. blood sugars and the importance of having all macronutrients at each meal as they each have their own role to help sustain energy, hormones, absorption of vitamins etc)

- I don’t know why or how but after months of knowing it, something has begun to actually shift over the past few days in terms of facing up to the depression cycles. I think a lot of it has been pure exhaustion/frustration of going around and around and around time and time again, but also because I have been a lot more open with mum and she pointed out a number of things that I was not necessarily thinking about/aware of before... - T and I were able to talk about how important it is for me to have a more positive/healthy morning routine as those are the hardest times for me. This is something that I have begun addressing over the past few days in a CBT style - I have begun setting an alarm for the mornings (the first day was roughly half an hour before I was ‘usually’ getting up, then the next few days have been 10minutes earlier). I force myself to get up and out of bed, and then get in the shower straight away. For me this is so important as even just the simple act of getting in the shower and starting the day off can put my mind in a much more stable place. I also find the routine of “get up, shower, get ready for the day” makes me feel a lot more, idk, purposeful? and again with a slightly clearer headspace. - It has not been easy, so far from it. I have been an anxious ball of mess and I am only a few days into the shift, but I know deep down it is what needs to happen and actually, this is evidence to myself that I CAN make changes. That I can go against these routined patterns and nothing terrible happens. - T emphasised how important it is to keep working on this and that in order to do so it might be worth trying to factor in at least one “thing” in each day to give myself that feeling of “purpose” as otherwise my depression clouds over and drags me down v easily. Whether it be going to a coffee shop, the library, a little walk, a specific craft thing etc. I agreed to aim to think about things one week at a time and try to schedule some things in, which is apparently a CBT depression worksheet (which I think I have used before and I did find helpful as it gave me more structure/feeling of purpose). She said that it is important that even if I don’t want to leave the house and I have down to say take my nan for coffee, that I stick with the plan like I would a prescription and not allow my depression to dictate when/if I follow it.  - Anyway, what came from all of this, in the end, was that I need to try to approach the eating side of things just like I am with the mood/depression/sleep....so much easier said than done but it is the truth. - Again, it helped to talk through some of the side effects of starvation that I have been really struggling with, as anorexia has been very very loud. This included: constant food thoughts (seriously so sick of this), irritability, low mood, feeling of needing to hoard and buy more food in case it runs out/the supermarkets stop offers/run out, I AM SO BEYOND COLD all the time and can’t warm up, tiredness, sleep never being restful, and the sheer constant exhaustion. - We then tried to talk about lunches but ahh my head got so messy that I could hardly think straight :(  - I’ve been worrying A LOT about getting things ‘wrong’. Whether it be the speed of increasing, the foods I use, the timings etc etc. I feel like I should just be able to do it by now and keep beating myself up, but as T pointed out, this is not helpful in any way/shape/form. My mind gets so caught up in the “what if’s” that I forget that there is no evidence behind those fears/worries... - As ever, the only way to find out is to collect “the data” and see what happens. To do the actions. Follow through. COMMIT. Actually make changes. Because, as we said for the millionth time, talking doesn’t change anything, action is where it lies.  - I will have to admit that one big fear is gaining on less calories...I am so scared to increase incase I start gaining on an amount that is “less than maintenance” or I “should” maintain on. I know the science. I know why I MIGHT gain weight at first. Yet applying it to my own situation feels so alien/wrong/doesn’t make sense. AN comes up with all the excuses and reasons under the sun as to why to put things off and wait...why today is not quite right, or perfect, or whatever it is. It is so incredibly frustrating and I am so tired of the bullshit that goes around my head 24/7. I also know from the past that it does take a lot more than you think to gain, but again anorexia has managed to “convince” me that this time I have definitely broken my metabolism and that my weight will skyrocket and I will always have to restrict just to keep it stable and I will forever me trapped in the hell of disordered rules and actions.....blergh. - The thing is that I KNOW that I need to gain weight (heck right now I actually HATE so much of what being like this has done/is doing to me and how I feel. I genuinely hate leaving the house and seeing people because I am ashamed/embarrassed of how I look :( ) yet it’s like I can’t allow myself to have this chance. That I believe so strongly that I don’t deserve to get better. That it isn’t possible. That this is all there is....So many thoughts start swirling and excuses firing.  - My lack of mental clarity at the moment due to malnutrition is such a huge hindering block. I can’t concentrate. I cant think straight. I can’t be “present” in conversations. My mind constantly wandering. I literally feel like I am floating, barely even existing in this space. Just trying to keep going is so exhausting that it often feels so much “easier” to listen to those disordered thoughts (which in the moment i believe are what is “right”) as they are so automatic. I let them guide me, make decisions, dictate my days....but in doing so that is exactly what is/has been keeping me trapped and stuck for months on end....

Wow, gosh, if you got to this point in this post then I really do want to give you the biggest hug in the world (and a sticker) because this has been quite the ramble. Right, so, summary...below are the goals we set out for the next two weeks (T is off next week and training as well so we can only have a text check in  :( which is so not ideal but these things happen):

I need to continue to set alarms to get up in the mornings, shifting it a little earlier each day if I can (this will hopefully help get my eating into a bit more of a ‘normal structure’)

Have a shower when I wake up

Try to factor in one thing each day to “focus” on/give me a little purpose/reason (no matter how big or small it may feel, it matters)

Continue to work on the “little acts of defiance” that I have been trying out the past few weeks to help build my confidence

LUNCH NEEDS TO BE LUNCH. (I am so bloody stuck with this one though :( we talked about maybe trying to buy some premade lunches? but ah I dont know)

Increase meal plan by 300 calories minimum

Make sure lunches have all necessary components (as well as dinners and nothing gets cut out or compensated for)

Be kind to myself (in many ways e.g. take care of my hands (using hand cream but also things like keeping food as SIMPLE as it can be so I don’t get trapped in the internal tossle with anorexia over decisions/options/calories as it becomes a form of torture)

Try to speak to myself in a kinder way/try to stop myself when I find the negativity beginning to ruminate

Weigh myself ONCE a week and check in with T next week. I need to give this experiment a proper go, not keep putting it off and waiting. I need to collect the evidence for myself. Increase my meal plan and ride out the wave. 

Gosh, it all feels like A LOT and thinking back on it now, it is!!! And there is no wonder why I am tired after that session. There is so much I have to focus on/do over the next two weeks but I think writing it down like this has helped put it more simplistically/focused, especially with the bullet pointed goals at the end. The review with my consultant is coming up too so I really really need to continue to take this turn in the road that has just started and show that I can do this and that want to (because I do, I do I do). Okay come on Kitty, time to ride out this messy and shitty pathway. God I am terrified. Scared. Apprehensive. Worried. Anxious. amongst all the other emotions flying around. I am already finding myself questioning every single thing I have written/thought/talked about but I am trying to stay grounded. I can’t let anorexia win. I can’t. I need to trust the process. Trust my T. Trust that it will be okay in the end (short term pain for long term gain, REPEAT) and as simple as it is I just have to give this a go.  If I never try, I will never know, and I will always wonder.