Thank you to those following along. As I chatted about in my last snippet into recovery, I discussed the importance of acceptance we are ill (and how damn hard and shameful this can be), and motivation to change and become a better, healthier version of ourselves. These are the very first steps to overcoming an eating disorder. If we cannot accept and be willing to change, then we have no hope. If you haven’t had a read – have a squizz here.
After accepting and seeking out help, it’s an enormous weight lifted off our shoulders, that someone knows you’re struggling, and someone is about to enter your life (or already has) with the purpose to simple help you overcome this battle.
Number 2 of my little blog series giving you an insight to what eating disorder recovery and therapy might look like is all about a little model called R.A.V.E.S.
After meeting my psych for the first session, she got to know me quite well – things close people in your life should. Things like she knew the name of my brother (one of my best supports – and my housemate), what he did for work, she got to know the name of my close family members and my best friends and what they all did. She knew my hometown and what I enjoy on weekends and during the week, she knew I hated winter and fancied a red wine. I felt extremely comfortable with her, I felt like she really, really cared about me and my health – it is really special. In saying this, please don’t hesitate to find the right person for you, you need to feel comfortable enough to open right up, with no shame.
She eventually introduced me to the model of RAVES, and suggested this is something we need to work through first and foremost. Although a lot of time things that drive and underpin eating disorders are issues relating to body image, shame and dissatisfaction, we could not tackle this problem yet – I found this pretty odd to be honest, why wouldn’t you FIRST tackle the root cause of behaviours?
The way she explained it was this:
To begin with, I am very much underweight, I am not providing my body enough energy to function optimally. For example, my heart slowed down, my circulation was compromised (reducing flow to extremities to save for my organs), my menstruation had stopped to save energy. A lot of body systems were working sub-optimally, to save energy to live. This also included my brain and cognition – which would not be working optimally either. Therefore, how can we heal and work on a deep insecurity in our mind when it isn’t stabilized?
This also explains why some of us are moody, sad, depressed and anxious, often “not the Carla I know”, it’s because our brain isn’t working the same as it should, or would being well nourished. The idea of RAVES first, is to stabilise health first.
This was quite tricky (and still is) hard to work through. Because it’s the body image issues that are stopping us from eating regularly, eating enough, going out socially – however remember if we don’t do what is expected of us from our psych then we won’t get much better?
REGULAR EATING:
3 meals and 3 snacks each day – no less. ‘Fasting’ can fuck off. She didn’t care if I wasn’t hungry – or was too full. We need to eat that damn snack, we neglect our hunger cues for a long time and our connection between mind and body has been switched off, therefore we can’t trust our bodie’s cues. This was seriously uncomfortable.
ADEQUATE EATING:
Although I didn’t get an exact meal plan, we get provided a plan of how many servings (and what a serving is) of food groups: carbs, fats, calcium, protein, nuts/oils, fruit, veg and ‘fun’ foods. No mention of the word ‘calories’ because this can be distorted and controlling.
Start baseline was something like this:
Brekkie: 1 servings of carbs (ie 1 serve of oats = 1 cup of oats, 1 crumpet, 1 english muffin), 1 serve of calcium (1 serve = 1 cup of milk) and 1 fruit
snacks: had to include a serves of carbs, fats and fun food and calcium (1 fun food = 2 scoops of icecream, 1 big chocolate bar, 4 lindt balls, 3 tim tams).
Lunch: 2 carbs, a protein, 1 fruit, 1 veg
Tea: 1 protein, 2 veg, 1 nut/oils, 1 carbs
Along the way, if I was not restoring weight well enough, I would have to increase the amount of servings I ate. It’s pretty expected to do this. Often, we need to add in liquid energy as we already are eating heaps. So additons of Up & Go, sustagen, or juice is also expected (I do not recommend Sustagen – tastes a bit sandy HAHA).
This does seem like a lot of food, yeah its frightening. But hunny, the faster you stabilise your health and weight, the faster you can return to things you love (ie netball). Also remember, the purpose of this phase is to RESTORE weight, so naturally, it is always going to be more than you are used to.
VARIETY:
“Write down a list of foods that provoke some feelings of anxiety and foods you avoid” (ie ‘fear foods’). Okay, now eat that fear food every day.
Learning to learn foods are not good or bad. Different foods have different purposes and nutrition and we are humans. We learn that food should not have the power to cause us anxiety, if they do – we simply need to challenge this until they no longer ruin our day.
For example – One fear food am currently working through is a bowl of pasta. Italian roots, I was a sucker for a bowl of pasta with some nice tomato sauce. However I haven’t been able to eat a full meal of pasta since pre-eating disorder. So, I have had the challenge of eating a bowl of pasta 3 times a week for 4 weeks. I have to change which days and times I eat it – this is so my brain does not cling to making more rules around this food fear – otherwise yes I will allow myself to eat pasta, however then I would ONLY be allowed to eat it Saturday night.
Other ones I have worked through include: Peanut butter (I had to eat MORE than I would have each day), a phat steak (I had to have this 3x a week), a big chocolate bar (1 x each day) – The idea is to basically eat it more than your previous self would have so you can learn nothing bad really happens. Kind of like exposure therapy.
Going from never eating this to having to do this is extremely scary and overwhelming. However, doing it and learning that nothing bad actually happens is part of the process.
There are still a few on this list to work through – It’s best to work through 1 or 2 at a time, and then when they are no longer fear foods, keep them in your diet regularly. Remember food is just food.
EATING SOCIALLY:
It was a ground rule to eat out socially at least 2 times a week. Its best to find someone who you’re really comfortable with to do this with, so they can help you though it – it’s really scary, but you can do it. Also it is best to write down which days and meals you are going out (if you have too much lack of control then it is more likely you won’t follow through, there needs to be a fine line of control and accountability) – but let your friend decide where you are going, mainly so you don’t fret about which menu can cater for the lowest calorie option. It also adds a bit of fun too.
P.S – thank you to those girls who help me out with this one – you know who you are xx
SPONTANEITY:
Okay, to be honest. I don’t know when this will ever come easier to me. It’s hard to contemplate the idea of being able to just eat a random, unplanned food at a random time of day – like I used to. I’m getting better at being able to eat what I feel like. However I feel like this spontaneity comes with me expanding my variety, eating more types of foods and re-learning what food I feel like, when I feel like it.
Now, again, as you can see, it’s really up to me, up to us to actually do these things. The psychologist cannot make us- we own our behaviours. However, to keep accountability, I needed to fill in a food diary each day (what food, how much, what time, my emotions, where I was and who I was with) and bring it to each appointment to go through. We would highlight and discuss challenges ie if I missed a snack or if I couldn’t bring myself to go out for a meal. We broke down my thoughts and formulated a plan for next week.
Either way, if the scale wasn’t going up despite food plan increases then the psych would know something is not equating, and I would probably be sent to inpatient.
This is a chunky blog. There’s heaps more detail I can go into about working through RAVES. However, I hope you get a bit of a rough idea on the process of this. I am still working through a lot of these things, going out to eat socially still gives me anxiety – however I can manage it a lot better. I still feel fear around some foods, however I am working through these and don’t feel the need to compensate anymore. It’s a long process, but stabilising health and first and foremost important in early days of recovery.
Stay tuned for my next blog inside the life of recovery.
