- Borderline Personality Disorder, Trisha Paytas, Empathy and Accountability - June 11, 2021
- A brief thought on Scott Stringer, Andrew Cuomo, and others - April 28, 2021
- Internalized Ableism and the Dichotomy of Valuable Disability - April 15, 2021
I’m so OCD is a recurring theme. Obsessive Compulsive Disorder is my primary diagnosis and I’ve noticed that there are many circulating misconceptions and misunderstandings of the disorder. I’ll be writing about different compulsions and areas within OCD’s jurisdiction, in the hopes that discussion of it will help foster understanding and compassion.
Warning: some of the anecdotes included in my story might be upsetting/triggering to folks who are in the earliest stages of eating disorder recovery. I have tried to be objective in my telling but there is always the possibility of triggering. Tread carefully!
Throughout the months when my eating disorder was in its more severe, untreated stages, it served as a catch-all outlet for my OCD obsessions and compulsions. My brain was already modeled to obsess and perform compulsions, and the overlap between that and Anorexia’s symptomatology made it the perfect quick fix. Once I entered into treatment, the frequency of comorbidity of Anorexia (or behaviors present in other eating disorders) and OCD among my housemates was noteworthy, and hearing about that comorbidity in particular was soothing to me at the time. I wasn’t the only one who needed, who couldn’t stop!
Studies have shown that the diagnoses of OCD and eating disorders have a stronger relationship than most. Intrusive/obsessive thoughts are key characteristics of both disorders, and compulsive actions to alleviate those thoughts are as well. The key distinction between an eating disorder and OCD is that the latter is typically experienced ego-dystonically, meaning the sufferer does not want to be engaging in it and sees their thoughts and actions as repulsive, which stands in opposition to an eating disorder, usually experienced ego-syntonically, or in agreement with the inner self. Folks with eating disorders often don’t want to be rid of the disorder; diagnostic criteria for Anorexia include denial of the seriousness of the disorder and intense fear of gaining weight (often a key element of recovery). I certainly didn’t want to recover for the vast majority of the duration of my disorder’s worst acuity.
In fact, similarly to how one is still considered an addict when sober due to the ease with which one could slip back and the degree to which the addict is forever changed, I don’t know if/when I’ll ever be fully committed to recovery. Eating disorder recovery is notoriously long term. Most likely, it will take years for the way that my brain conceptualized eating and weight for so many months to fully morph into that of how a healthy brain would see those things (such is the nature of the drastic alteration in brain chemistry that comes with an eating disorder). What I am sure of today, however, is that converting my OCD into food and body focussed obsessions and compulsions is no longer an option.
In the thick of my Anorexia, my average week was comprised of my daily rituals and rituals that would add up to a “just right” weekly composition. I weighed myself twice a day, morning and night. I’d record my weight once every two days in an app called My Fitness Pal. My scale showed me my weight down to tenths of a pound, and if on any given day my weight stagnated (it never did rise), I would double down my efforts. I had to see a lower number every time I was on the scale.
There existed a small range of foods that were “acceptable” in my Anorexia-fraught world. I would dread being expected to eat in front of other people, for I might then be forced to eat unacceptable foods, which was essentially everything but the same meal I’d have once every two or three nights; half a slice of bread with half an avocado, mashed. Every so often- whenever I decided I needed it just to maintain functionality- I’d place a sunny-side-up egg atop the concoction.
I would eat nothing else.
More specifically, I couldn’t eat anything else. Physically I needed the food, of course. I was technically capable of eating it. I just couldn’t bring myself to do it. I decided that if I wasn’t seeing a lower number on every weigh-in then I wasn’t trying hard enough, I wasn’t dedicated enough, and the amount of food needed to maintain that loss was pittance: half a slice and some avocado every other day. If I ate any more than that, even by a little, surely I’d balloon in size! That was the obsessive/intrusive fear, and it was powerful; if I ate any more than a pitiably small predetermined amount I would become morbidly obese, and at the time my Anorexia-ridden brain could think of nothing more terrifying. I had to stick to my rituals to avoid the worst.
The other side of my eating disorder is, of course, the compulsive exercise. About two minutes’ walk from my house is a local trail that extends for a few miles. It also branches off into a few wooded hiking trails. Every single day, save for one weekend day, I would put on the same outfit, same shoes, wear my hair the same way, and set off for hours. I’d have to be out for more than two hours, but after that my goal was to be out as long as my body could take it.
I would walk until a specific point in the trail’s entrance, at which point I would start lightly running. At certain intervals, marked by telephone poles and distinctive bushes, I would sprint. I entered the woods at the same trail every time, went the exact same route (there were several trail-blazed options). I would navigate specific fallen trees, muddied pits, rock clusters, messy streams in the same way, every time. At certain rocks I would stop, step onto them, and survey my surroundings for the same amount of time (six minutes). This would generally occupy around two hours’ time, although I’d sometimes push for more, and it would have to be spent constantly running. Once I meandered my way back to the main trail, I’d slow to a walking pace. This was the time of night I reserved for experiencing PTSD (a common source of eating disorders). I’d put miserable music on in my earbuds and watch the last of the orange sky melt into the trees.
Nothing could stop me from performing this ritual. Whether it be rain, lightning, hail, snow, blizzard, or anything in between, my running was indefatigable. Anything less than two hours was unacceptable, and there was never a good enough reason to cut a run short. Snow would remain on the trail some days, two feet tall and frozen solid. I would run in prior footsteps or dance atop the cracking, frozen snow on those occasions, slipping and/or falling through the cracks every so often. I thought I was a superhero.
The word superhero implies strength, control, power. My rituals had strength, control and power over me, not I over them. There is nothing controlled about needing something, as objectively trivial as a lower weight, so badly that you’re willing to put your body and mind at severe risk to get it. Osteoporosis, bruised legs, lost menstruation, injuries from falls, and incredible mental anguish are what I had to show for the illusion of power.
Since I intellectually understood, thanks to treatment, that my eating disorder was doing me no favors, I have been able to treat it like I do my other obsessions and compulsions. My desires to restrict and over-exercise are self sabotaging and unreasonable, I remind myself, and following through with them will only send me down a path of pain and difficulty. As with my other obsessions, I allow myself to fully experience my fear of not: not restricting, not exercising, not losing weight. Of course I’m terrified, I have an eating disorder! What recovery really is is making the active choice to do the right thing for your body and mind despite predictably persisting urges to do otherwise. In time, as my brain grows to understand that it can expect to be eating a normal amount, I’ll be less afraid and doing the right thing will become easier and easier.
As with everything I write on this blog, with my story comes a lesson I hope you glean from it. You are going to experience thoughts, feelings, desires that you are uncomfortable with, that you intellectually understand are wrong or unreasonable. You needn’t judge yourself for this; brains are enormously complex and judging yourself for thinking incorrectly will only lead to increased suffering. What is truly essential is separating your thoughts/feelings from your actions. If I let the two remain linked, I would be in a perpetual state of compulsion performance to rid myself of constant obsessions. I’ve been in that state before, and it also leads to a high degree of suffering. If you can create separation, you will wield true power over yourself and your life.
Or, as Dumbledore so sagely put it, “It is our choices, Harry, that show what we truly are, far more than our abilities.”