Because Tractors and Eating Disorders Don’t Seem to Mix

bootsAccording to the U.S. Census Bureau, less than 17% of Americans live in rural areas in towns of less than 50,000 people.  If you break the category of “rural areas” down and begin looking at the percentage of people who live in even smaller communities, say in towns that number less than 5,000, this figure dwindles dramatically.

This means that if you reside in a rural community and struggle with an eating disorder, you are a statistical anomaly.  To put it bluntly, there just aren’t that many of us out there.  Consequently, the challenges we face when attempting to access treatment, both acute and long term, can be formidable.

Get Ready to Drive
When I finally reached the point where I was amenable to the idea of participating in treatment, the closest facility I could find was a plane ride and a full state away.  Once I stepped down from full care to an intensive outpatient program, I then had to find lodging.  This lodging, as well as transportation to and from the facility, did not come without cost.  The financial burden that came with accessing treatment was nearly overwhelming.

Lonely, Lonelier, Loneliest
While in treatment I became intensely homesick.  Though I had dear friends who did their utmost to support me by phone, there was no one close enough to participate in group therapy sessions with me.  In addition, I was unable to ride my horse or hike with my dogs.  The acts of feeding them that had bookended my days had to be carried out by friends.  Everything that I loved, everything that served as inspiration for regaining my health, was hundreds of miles away.

 

But You Don’t Look Like…

Returning home was a jarring experience.  Friends and co-workers didn’t know how to integrate their experience of me with their understanding of what eating disorders and the people who struggle with them look like.  In their minds, anorexia is a disease that afflicts women and girls living in urban and suburban areas, not in rural communities.  This left many of them unable to quantify my experience and consequently made it difficult for them to support me.

How Can I Help You?
When you live in a rural area, finding support once you leave treatment can be incredibly challenging.  Even if you are lucky enough to live in a town with a nutritionist and a therapist, the odds of even one of these individuals having experience working with people with eating disorders is slim.  This means that in order to continue receiving care from highly qualified providers you either have to drive a long distance or relocate entirely in order to be closer to your treatment team.

If you are living in a rural area and are attempting to find support, know that you will need to be tenacious in your search.  Know that you may need to drive many hours to access services.  Know that after you leave treatment, you may need to relocate entirely in order to be near your outpatient team.  These are challenges you will encounter and choices you will have to make.  The process will be hard and, sometimes, it will be very lonely.  As someone who has made it to the other side though, I can now say this without reservation.  Recovery is worth it.  Which means so is the drive.

Graveyard Shift

snoopy-toothbrushes.jpgHe starts his story in the middle
With the night he stood on tiptoes in orange plastic sandals
Pressed his face against the window in the door of his cell To peer across the hall
Where a young man hung
From a twisted sheet noose

He didn’t see it happen
The actual act that is
Just got a glimpse of the end
But he’ll never forget that
His first night in hell

He grinds his palms together as he tells me this
Pushes his index fingers into a steeple
And talks a little more
About what came next
Days and months rolled into one
Another year
Gone

Nights were the worst
The lights never went out
Just slipped
Into shadows that made it safe
Enough to cry
That’s what he remembers now
The sound of tears

Daylight meant fights
A brick in a sock broke a boy’s skull
And then they were gone
No one got any socks
His sandals left blisters but he didn’t cry
About that

And then he was moved
Transferred clear across the state to a cell
Just the same
Men cried there too
When the light melted away

He closes his eyes as he tells me this
Laces his fingers together
And talks a little more
He loops back to the front of the story
The part he doesn’t like
Did you know – he asks – I turned twelveon my first night in hell

Which is the age I actually would have guessed, because he’s nineteen now
Sharing a Coke with me as he waits for his laundry to dry
Pretending that nights aren’t the worst anymore
He just likes to stay up
Looks forward to talking to me – his favorite shelter staff he says
And my dog
He really likes my dog
A yellow lab sprawled on the floor between our feet

But I was eleven when I did it – he says
This is the part I know
How he got jumped in
Was told to leave a mark
Just a mark
But the blade
It slid
Right through
That little boy’s heart

He’s wearing a new basketball jersey tonight
I comment on that
He smiles dimples
A buzzer rings – his laundry is done

He stands up
Thinks about bed in this homeless shelter called home
Remembers he doesn’t have a toothbrush
So I reach into my desk where I find four
Still in the package new with Joe Cool Snoopy on the handles

Awww, man!  You can’t give me this!
But I do
Because I remember his first night here – when he chose Snoopy sheets for his bed
And a nightlight
Turned out he needed two
That was when I realized that I’d need to watch out
For this little boy’s heart

Books Matter

homeless_teenI was staying in a hotel.  Not a nice hotel, just a hotel.  The kind where the lamps are bolted to the bedside tables and the glasses beside the bathroom sink are covered in Saran Wrap ripped from the roll.  It was a hotel in a town where I’d lived not too long ago.  I’d taught there and had met kids with more and less than I’d ever known.

It was nearly 1:00 a.m.by the time I pulled into the parking lot.  I went into the lobby and rang the buzzer to get a key to the room where dogs are allowed.  That is who I was with, my German Shepherd.  He’d needed to go out.

I was standing, admiring the moon, waiting for my dog to finish sniffing around the base of a tree, when I heard my name.  I knew the voice, but couldn’t place it.

The shadow of a young woman bounded down the stairs from the second floor of the hotel.  It wasn’t until she stepped into the puddle of streetlamp light that I recognized her.  This young woman had once been a girl who sat at a table at the back of my class, she and her younger brother, always side by side in jeans that hadn’t made the acquaintance of a washing machine even once.

Her life between then and now hadn’t been good.  Her father still hit.  Her mother had gotten better at forgetting how to cry.  Her brother wasn’t so quiet anymore.  He’d learned to yell.  Just like Dad.

For this student, it had been heroin that made ashes of her life, leaving her here, in this hotel. She could stay as long as she cleaned the parking lot.  That’s what the manager had said.

She bent down to stroke my dog’s ears and asked, “Do you remember that book?  The first one we read?”

I did.  We’d gotten a classroom set.  Brand new for the kids who swore they never read.

“I got sent to GED after you left.  I could see the library from my desk.  One day, I just went in and checked that book out.  You know, the one we read?”  She smiled.  Embarrassed.  “I guess I didn’t really check it out.  I kind of took it.  I’ve still got it.  Sometimes I sit down and read it.  Did you know it was the first book I ever read all the way through?”  She paused.  “I guess I should take it back.  Do you think I should?

“No,” I said.  “Keep it.  That book is exactly where it should be.”

Food Stamps Saved my Life

Recovery is expensive. There are appointments with counselors, dieticians and primary care physicians, all of which require co-pays.  There are the monthly bills that come from the treatment center where your recovery received a jump start.  On top of that you have your welcome-back-to-the-land-of-the-living-bills like rent, utilities, and student loans.  We never talked about how expensive recovery was going to be while I was in treatment.  I wish we had.

Before I went to treatment, I had a good job. It was the kind of job that came with a title, a salary, and an arduous schedule.  It was a job that I could have never sustained while putting in the work that maintaining recovery, specifically recovery in the earliest stages, requires.  Consequently, after I left treatment I decided to take a full time job that paid significantly less but offered both a comprehensive health insurance package and a schedule that allowed me to maintain my appointments with my outpatient team.

I had been out of treatment for several weeks when the first round of bills came in. I paid my electric and water bills.  I received my first full paycheck and was able to cover rent.  For a brief period, my financial situation seemed manageable.  Things began to slip however and I soon found myself struggling to keep the number in my checking account above zero.

Confused as to why this was the case, I sat down with my receipts and came to a shocking realization. I had not budgeted for groceries.  As odd as this may seem to someone who has not struggled with anorexia, it never occurred to me that I needed to create a line item for food in my monthly budget.

This oversight left me in an ironic position. I could either pay to see my dietician or pay for groceries.  Things were literally that tight.  Going to treatment and moving into recovery was supposed to help me put my life together, but the financial vulnerability I encountered in the months following my discharge left me asking myself if it all been for naught.

Prior to leaving for treatment I began attending 12 step meetings. It was a practice I continued after my discharge.  As I sat in meetings I would hear the same question posed again and again.  The question was, “Are you willing to go to any length to obtain a life in recovery?”  As I was sitting in a meeting one night, it occurred to me that, if food was the cornerstone of my recovery, then I would need to go to any length in order to ensure access to it.

I had never been on public assistance of any kind before, but I knew what I had to do. The following day I filled out an application for food stamps.  The application was accepted and I was handed an Oregon Trail card.

There are a lot of stereotypes about people who rely on food stamps. Few are flattering.  People on food stamps are lazy and uneducated.  They should work more and buy less expensive food.  I heard all of these things.  They were said by people I know.  People I love.  People who had no idea that I had an Oregon Trail card in my wallet.  I never said this to them then, but I’d like to say it now.  I was sick.  I needed help and I’m grateful it was there.

The act of “going to any lengths” takes many forms. Though it has been inactive for a very long time, I keep my Oregon Trail card in my wallet as a reminder that, in order to maintain recovery, I need to reach out and ask for help when I need it.  Doing this will require humility.  Doing this may make me insanely uncomfortable.  Doing this may very well save my life.

I am Enough

I am enough. These three words appear in memes on social media.  We fling them around in the recovery community and silk screen them onto shirts.  While in treatment, therapists shared them, fellow patients repeated them and encouraged me to apply them to myself.  With a flip of a pronoun they altered the phrase and turned it into a mirror, one directed squarely at me.  You are enough, they said.  You are enough.

The fact is, when I was sick, these words made absolutely no sense to me. Anorexia had whittled away my body, yes, but it had done something far more insidious.  It had whittled away my sense of self worth.  It did this by isolating me from friends, destroying romantic relationships and even incinerating my career.  How could I, someone who could not hold a job down or a relationship together, be enough?

When I stepped out of treatment and back into the vestiges of my life, I looked inward to find a sense of self-worth. These words became my mantra.  I am enough. I am enough.  I reasoned that, if I repeated them enough times, perhaps I would come to believe them and when I did, they, and the sentiment they reflected, would sustain me in recovery.

The results of this exercise were abysmal and I ended up returning to treatment not once, not twice but three times. After my third and final go, I realized that I needed to do something dramatically different.  Relying upon myself and looking inward simply wasn’t working.  I decided to turn my gaze elsewhere.  I began looking at the world around me and began asking myself, how do I fit in?  How can I contribute?

I would like to be able to insert a dramatic story here, one in which I went overseas and was part of an international relief effort or perhaps selflessly leapt in front of a large, swiftly moving vehicle and saved a three legged, one-eyed kitten from certain death and, in the process come to understand that I have the ability to affect positive change in the world around me. Sadly, I don’t have that story to tell.  Sadly because such a story would be a good one, and if there’s one thing I love, it’s a good story.

The tale I have for is this. I was walking down the street and saw a flyer on the window of a coffee shop.  It advertised a writing workshop, one that took place deep in the heart of the Eagle Cap wilderness in Eastern Oregon, where I was living at the time.  It was a workshop for individuals interested in writing for children and young adults.  I enrolled in the workshop and spent two days doing nothing but writing.  I wrote in pen and pencil.  I even wrote in crayon that weekend.  I wrote and I wrote and I didn’t stop, not even after I returned home.

I began attending a critique group and volunteered to read with a kindergartener at the local grade school once a week as a part of the Start Making a Reader Today program. When I was at the grade school, I listened as children told me why stories mattered to them.  When I participated in my critique group and eventually began attending conferences, I listened to authors as they talked about why they wrote.  What they shared made me laugh and sometimes, it made me cry.  It made me do something I hadn’t done while I was sick.  It made me feel.

It made me feel more connected to the individuals and to the community around me and, in the process, I began to feel more connected to myself. It became easier to smile, easier to laugh and the space that used to be consumed with thoughts of calories and numbers and the 101 reasons I didn’t deserve to take up a single inch of space in this world were replaced with my own poetry and original stories.

It was through a sense of connection to other people and to my community that I began to realize my worth as an individual. Alone, I am not enough.  But as a mother, as a teacher, as a writer and an activist, I can see myself as a person of value. I can see myself as someone who is part of a greater whole.

Burnside Bridge Redemption

You might mistake him for Ziggy Marley
Jesus that is
At least I did
When I saw him walking up the sidewalk in Low top Cons
Soles the color of erasers

He stopped when he got to us
Three girls
Backs to the wall
Inhaling clove cigarettes

He asks how we are
We say fine
Which is a lie
But he doesn’t mind

He sits down on the sidewalk
Because we are
And looks
But it doesn’t feel bad
At the tattoos and belly rings our too small shirts show

I offer him a smoke
He shakes his head no
Coffee, he suggests
And nods in the direction of the convenience store
Across the street with windows painted black
And bars
On the door

There was a rainbow painted there
Before the black and the bars before
Ray
Got shot
And the store changed hands

It isn’t his fault
Jesus’
I hope he knows that

But the thing is
I’m hung over
And my head
It hurts when I talk
So I’ll just have to hope
He knows

I close my eyes to the too bright sun
Open them
To a man in loose
Loose coveralls and a tie
He switches the black plastic trash bag holding
His life
From one shoulder to the other

Pancakes? he asks
An invitation to breakfast at Sisters of the Road Café
And then socks
Socks because it’s Saturday and the church ladies give them away in the park
In front of the fountain
Still-in-the-package-new socks on Saturdays

I notice Jesus doesn’t have any socks when he stands up
And takes the trash bag from the man to carry like it’s his own

Come too, Jesus says
But we can’t
Or don’t
Which is fine

Because it is enough just to know that five minutes from now
They’ll be eating
Jesus and his friend
Eating pancakes with sweet cream butter and drinking coffee from thick white mugs

It’s enough that I know that after the pancakes
There will be socks
On the feet
In the shoes
With eraser colored soles.

My Other Birthday

Today is my birthday. It’s not the kind of birthday that comes with gifts and a cake ablaze with candles, it’s the bittersweet kind.  It’s a day that catalyzes a deep sense of gratitude for all the people who took risks on my behalf when I was sick.  It’s a day when I look back on the years I lost to anorexia and allow myself to grieve.  It’s a day when I take an inventory of my life and am overwhelmed with awe at all it has become.  Today is my recovery birthday.

Recovery birthdays are tricky things for people with eating disorders. Unlike individuals struggling to overcome substance abuse, there is no single moment when we decide to put down our drug of choice.  Instead, our recovery is a journey comprised of steps that bring us closer and closer to doing something that most people do every day without a second thought.  Eating.  Rather than abstaining, our recovery involves partaking.

It is for this reason that the act of choosing the date for a recovery birthday for someone with an eating disorder is personal. I chose the day I left treatment for the third and final time.  Since then I have discovered a great many truths and, each year, on this day, I reflect on them.

  • I still spend a lot of time at the doctor’s office. 
    I really thought this part would end after I left treatment, but my struggle with anorexia had medical consequences that I will have to deal with for the rest of my life. For example, every year I have a DEXA scan done. This entails sitting in a waiting room populated by individuals much older than I am. It means that a technician will look at me, and then at my file, trying to make sense of the number that is my age in relation to my last T-score. These appointments serve as reminders as to why I need to remain vigilant in my recovery.
  • Life is triggering.
    I can attempt to insulate myself from triggers, but they are everywhere. They come in the form of comments, photos, films and even songs. Rather than avoiding them, I now gather whatever support I can find and confront that trigger head on. If I don’t, it will surface again and again.
  • Self-care can be wonky.
    The things I do to protect myself don’t make sense to everyone. For example, for a long time, I did not have any mirrors in my house. I did not even have one in the bathroom. This is something people commented on when they came over. Sometimes I explained my lack of a mirror, other times I didn’t. Recovery is worth it and I must be willing to do whatever it takes to maintain it, no matter what anyone else thinks.
  • Think outside the box.
    Nearly two years passed after I left treatment before I wore a swimming suit in public for the first time. When I did, it was at a pool during a lap swimming session. Everyone, with the exception of me, was 55 years of age or older. No one in the pool cared what I looked like in my suit. This was liberating. I have had the most success overcoming challenges in unlikely places. Consequently, I now push myself to be creative as I think of ways to move forward in my recovery.
  • Do not rule anything out.
    Recovery has been nothing like I thought it would be. It has been more challenging and more fulfilling than I ever thought possible. I hope to celebrate many more recovery birthdays and will embrace the truths that each one brings.  After having been sick for as long as I was, I didn’t think I would ever have a child. My daughter turned four last spring. She is the love of my life. Last February she sat in the audience as I celebrated the launch of my first book. She has since traveled with me as I have given recovery talks, led workshops and done readings. I am now a writer, a mother and a teacher, three things I would never have become had I remained sick.Recovery has been nothing like I thought it would be. It has been more challenging and more fulfilling than I ever thought possible.  I hope to celebrate many more recovery birthdays and will embrace the truths that each one brings.

Body Politic

Some girls
Cut
One drank
Bleach
They (we) disassembled drains
Shared lies
Over teaspoons
Of air

I wasn’t like
Them
I just preferred
Thin
Mine was a protest
Against the body
Politic

But they didn’t
Understand

You’re not
Eating
Listening
Committing to the belief
That you need to
Can
Change
He said

My doctor
A psychologist
He clarified
(not that it mattered)
As he set the yellow poster board
On the table
Between
Us

“Wall of Death”
Was written across the top
In black felt tip pen
Pictures of smiling girls
With Sparknote epitaphs
Glue sticked
Beneath

Their families cried
He said
I nodded
(which was right)
As I sat
And looked
At these girls

Who looked everything
And nothing
Like
Me