Malign obsessions: On health as a whole organism phenomena

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“she goes to the gym seven times a week, doesn’t drink and watches what she eats. She is so healthy!”

How many times am I going to hear this or its ilk and still manage to keep my volatile opinions to myself. The surface is fraying, I’m losing my composure over this.

The media would have us believe that to be healthy, you must subscribe to a set of rules: you must go to the gym multiple times a week, you must control your weight and diet, cutting out ‘bad’ foods and drinks, and you must drink enough water to detoxify the bad stuff out of yourself.

Exercise, water and a good diet are nothing new as far as ideas go, but what is new, anthropologically speaking, is the attitude that some have towards health.

It’s no secret that a lot of people suffer from mental health problems. It’s all over the news, raising awareness largely of depression, but what there is still a general lack of recognition for less well publicised phenomenon like orthorexia, obsessions, paranoia, dysmorphia and anxiety, and I really think they are creeping up on people without them or their loved ones knowing. What is worse is that others look up to those with such problems as role models.

There is nothing wrong with wanting to live a healthier life and keep your body strong, but there is a line at which the compromise to ones mental state no longer justifies such control over ones thoughts and actions.

Take sarah, she’s in her mid-twenties and to an unenlightened onlooker, she appears to live a healthy lifestyle. She has a normal BMI, goes to the gym seven times a week, she plays squash, she drinks only water eats a healthy diet and gets plenty of sleep. Physically she is in good shape, so all good right? A paragon on virtue. Don’t you wish you could be like Sarah?

Well let me tell you a little more. Sarah gets up at exactly your same time every day and weighs herself, she has each minute scheduled in her daily calendar so that she can eat, sleep and exercise at the times of day that she read are the most beneficial.  All her meals are weighed and measured out and every calorie and gram of fat tabulated. Sarah won’t go out in the sun and only drinks water from a glass bottle because she knows that plasticides in plastic cups are bad for you. Every label is scrutinised for nasty additives and preservatives. She eats alone because she thinks that a late lunch is better for the metabolism, and she eats the same thing every day because she read that they are the healthiest foods. Sarah spends a lot of time reading about new health news about what extra things to avoid, and refuses to take medication that she thinks is bad for her. She has never had caffeine, alcoholic drinks or smoked a cigarette in her life because she considers them too dangerous. Sarah is constantly checking her feelings and measuring her words so that she can stay in control of her mind as well as her body. Occasionally the control is lost and Sarah binges on treats and then compensates by making herself do a commensurate amount of additional gym work.

Do you still aspire to be like Sarah ? Or do you feel sorry for the way she needs to obsessively control her body to feel in control of her life?

Let’s take a step back.

Exercise:
Someone told me the other day that I didn’t exercise because I didn’t go to the gym. Where did this idea come from? Why the hell do I need to go to a small petri-dish of a box room with a bunch of sweaty people to be considered to be exercising. The 1 hour of medium impact cycling that I do each day counts for nothing? What about the fact that I have gym equipment at home should I feel the need, and a half a ton horse that I wrangle at the weekends? Well you can discuss your concerns with my body fat percentage because I’m not buying such a blinkered view, and yes, of course I can lift that 10 litre water butt for you because you aren’t strong enough…. Exercise can be walking, cycling, shopping, cleaning, gardening, dancing or having sex. You don’t need to be in that mirrored box with onlookers to make the exertion count, nor do the calories burnt need to be emblazoned on an lcd for them to be real. Personally I think that if you can get a decent quota of exercise without resorting to the gym, then you’ve proven self-sufficient in your ability to keep yourself active. Hurrah! If you happen to like going to the gym then good for you, but I don’t see the point. Bottom line, moving your body and using your muscles are good things, obsessing over reps, times, steps, times etc, not so much.

Diet:
There are huge debates over dietary recommendations. Each week there is another article telling you to eat this but not that, and scaremongering about how terrible some foods are for you, for the story to be reversed months or years later. Keeping up with those articles is not only exhausting but also damaging if you start cutting out food groups willy-nilly. The keys to a healthy relationship with food involve a balanced and varied diet that includes snacks and treats, and not ignoring the social aspects of meal times; cooking for a loved one, or sharing and enjoying food and drink together. I really feel like enjoyment and savouring what you nourish your body with is important, as is including a variety of foods, and including fruit, veg and fibre in with your fats carbs and protein. If you only imbibe things that you dislike and deny yourself the things you enjoy then you might get a certain ascetic kick out of being so controlled, but really, what are you doing? You are strictly denying things that you enjoy, to what end? So that the numbers add up right? so you get to feel virtuous? So you get other people’s approval? Think about what you are doing and why.

The other stuff:
As I have described above with respect to meal times, social interactions are important and isolation can be very damaging to someone in the throes of monomania; with noone to argue against their floored logic, it becomes cemented as truth and then paranoia slips in that others are trying to make them unhealthy or fat by sabotaging their strict regime. It’s a very delicate insular experience to be so absorbed in one aspect of your life that you obsess over it, and it has all manner of costs to you. It may feel like you are controlling your world from the calorie control room, but all you are doing is feeding the anxiety fire with more fuel so that everything outside of your safe boundaries becomes some kind of threat. Can you imagine pulling up the drawbridge like that?

I can. The reason why I have such a strong opinion and feel that I have a right to thrust this tirade internetwards is that I have had a serious eating disorder and a fixation with my health for most of my adult life. When I was sick I got so many compliments about how disciplined I was and how they wished they could be like me, how lucky I was to be thin etc. This kind of attitude was very unhelpful because it reinforced the idea that the way I was living my life was good and something to be admired. It fucking wasn’t, I was constantly exhausted, medicated up to my eyeballs, and every single thing in my life revolved around making sure I could eat ‘safe’ foods. I missed out on so many experiences in those years because I was too busy sat at home weighing and reweighing myself and my food and trying desperately to make the calories balance out. That is not a way to live, it’s barely an existence and if you genuinely admire those who live like that then maybe you aught to try some meds too. It has taken very many years but now I can exercise and eat without a thought for numbers of the energetic kind, and I can finally concentrate on the things that matter in life and every day is another day to try and maintain a healthy weight. I enjoy food and drink, and try new unknown dishes sometimes. For this gargantuan effort I receive the opinion that other people think I am not as fit or healthy any more. Health is not as superficial and the glossy magazines would have us believe. It encompasses the physical and the psychological, and people should not underestimate the physical impacts of a psychological problem. Unsatisfied as you may be with aspects of your physical form, if you had the opportunity to swap with Sarah to have a fitter, more muscular body and also take on her insecurities and necroticisms, would you do it? No, neither would I.

By the way “Sarah” in real life could just as easily be a man.

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Facing the dragon and staring at it for a few seconds before running away

As you know. A few weeks back I proferred some uninvited information for my therapist…it was three major incidents that have affected my health anxiety, a list of health problems that I am terrified that I have or will get, and a list of things that anxiety stops me from doing. The final list was pretty depressing, spanning from driving to dining out to exercising to travelling and maintaining relationships. We are talking some pretty major areas of one’s life there.
Have I told you I didn’t used to be this boring? When I didn’t think I was dying the whole time I could even be a bit fun every now and then. Imagine that!

Anyway enough about that. I want to talk about how cbt is shaping up. Having given this information, my therapist made a formulation… That is a flow diagram showing the vicious cycles that involve being triggered until automatic negative thoughts, having inappropriate cognative and behavioral responses as well as extreme emotional responses, that all feed back into the negative thoughts. You don’t need to know what weird shit I do when I get panicky, but what you should know is that the idea is to gradually stop relying on those unhelpful or inappropriate coping mechanisms by considering an alternative to the doom and gloom, end of the universe, deadly premonition that happens with every sniffle. For me, the downside are that you have to replace the negative responses with something else and therefore I have to be less harsh with myself, which feels unnatural and frankly trite after years of constantly telling myself that I’m a worthless piece of crap and that everything is my fault. I’ve got to the point where I’m so damned negative that I complain about everything and find it quite uncomfortable to even compliment someone else, let alone myself! That’s fucked up because people can be awesome and they deserve to know it.

Anyway, now I have to try and stop doing so much weird shit when I get worried, and focus on something else, cos I spend about 99% of my time thinking about me me me and as I’m not even that interesting, I think you’ll agree that’s a tragic waste of my time. I could be thinking about something more productive like banjo-playing unicorns.

In addition, I’ve been told I need to start exposing myself to things that make me anxious, like to start with, cleaning chemicals, and more strenuous exercise. That’s this week’s task. So far I cycled to and from work a bit faster than usual and I have to say I do feel like I achieved something. My heartrate increased, I sweated a bit and I got a bit of a sore throat, I got that weird pulsing in my eyes (does anyone else get that or is it just my bizarro physiology?) but I didn’t pass out when I stopped and I didn’t wake up the next day having dropped a stone of weight. Triumph. Unfortunately another source of anxiety popped up from under the rocks when my boss told me in no uncertain terms that I was NOT to make mistakes in the future (regarding a minor typo in an email). Because I am a robot without fat fingers, yes? Ugh. No pressure then!

I’m beginning to warm to this therapist after our rocky start. Possibly because she chose to work with what I voulenteered as I thought it was the most important stuff. She’s offered to give some information for my partner to read about my erm condition, so he knows how best to support me (I.e. constantly telling me I’m lazy and to just get on with things like a normal person may not be the best tact)…lets see how that goes down. I’m already worrying about the approaching therapist abandonment.

Laboring through the inevitable fear

The end started its approach on Monday, it didn’t take long to pick up momentum, waves of sticky and infectious anticipation slamming relentlessly into me. That was when I first realised that I’m dying.

I feel my heart atrophy, burning into ischaemia after every cup of coffee, every sip of wine,
Each faltering beat convulsed with another gripping stab in my chest that is far too severe and rhythmic to be heartburn.

A narrow escape lets me see Tuesday.

Just when I think the coast is clear, I feel my chest implode and I can’t breathe, some heavy cinch has grasped me tight, and the blood rushes faster as I struggle to inhale, shoulders to my ears but lowering won’t help me, aren’t you listening to me? I can’t damned well breathe!!!

A fluke recovery meant Wednesday rose to met me.

But in Wednesday’s maw is a terrible fate. Into a small cut that I obtained, leapt staphylococcus and streptococcus. They swim from that cut right up to my brain! Lending headaches and feverish ranting as my grey matter becomes violently colonised.

I don’t know how I survived that meningococcal experience, but Thursday knocked on my door nonetheless.

The sun rises with a stab in my thigh, a throbbing ache that portents of a clot. Perhaps I didn’t move all night, and as I rub to test if it’s muscular, the clot detaches and heads for my lungs.  shortness of breath is quick to follow, accompanied by dizziness and all things severe, but once the worst of the embolism is passed, I get out of bed and cycle my weary self to work.

Friday approaches with a rash in tow and infact on my toe, but I’ve had enough. I’ve already had two strokes, five ulcers, two brain haemorrhages, pneumonia and toxic shock this month, No-one can be expected to die every day of the working week. I’ll resign from the Billy Witch council, I’ll join health anxiety anonymous, I’ll write poems in strawberry shampoo, paint a platypus on my knee, whatever you want, just fucking get me off this adrenalin-sapping horror show!

Maybe let me Google that rash first though first, just in case…..

Parrots with bad attitudes and Dragons with razor teeth

I’m going at this new course of CBT (cognative behavioural therapy) all wrong.

I know it.

I don’t like my new therapist much, and I’m increasingly reminded about why I hated CBT before and why it was so unhelpful.

What it boils down to is that I’m not stupid, in fact I have a higher than average intelligence (not my opinion, this is evidence-based) and find it intolerable to be patronised or condescended.

In principle, the theory of CBT aught to work in many cases, but only if the therapist can intuit when the patient wants to punch them in the face, and take the therapy a bit off the beaten track.

This week I was asked if I knew what the diaphragm was. Erm Biology doctorate? Then had diaphragmatic breathing demonstrated. Honestly, I expected more. I can only imagine that my face exhibited the single raised eyebrow of derision.

I can be such a bitch but unfortunately it slips out when my tolerance threshold gets approached. Maybe I should explain.

As an ex-flautist, my natural way of breathing is deeply from the diaphragm, I would like to know breathing exercises, eg how many seconds to breathe in/out/hold, some visualisation or mantra or something but no, I got told to breathe like I do anyway. I’m not convinced she knows anything further than that. I was promised muscle relaxation techniques too but I suspect that involves ‘just relax your muscles and you will feel relaxed’, in the simplistic style of delivery I am coming to expect from CBT.

I was given a handout that came complete with cartoons – perfect for your children who have anxiety problems. Apparently I have a toxic bullying parrot in my head and if I ignore it I will be calm and happy.

Cheers for that. I’m not pissing myself with laughter at this idea at all. Nope. Not one bit.

What she doesn’t realise is I don’t have a parrot, I have a dragon (see blog header for a portrait of the beast), and it doesn’t bully me, it messes my personality about and makes quite compelling and intelligent conversation.

I also don’t think that I like the idea that you have no control over your thoughts. For example, let’s say that you keep thinking about killing yourself. Then magically by the power of CBT you start ignoring that thought… I mean, that seems a bit off-piste to me…aren’t you better off dealing with why you feel like that and changing your thought patterns rather than accepting you will repeatedly have those thoughts forever?

The therapist seems baffled by some of my problematic anxious thoughts because she sees them as relatively realistic – as in – there is  a historical reason why I think those thoughts, so they aren’t disordered. Erm, so…that means I don’t have health anxiety? I’m really not convinced about that. I have stomach pains (from suspected gastritis) so I avoid loads of things (foods / drinks/ medications/travelling/social meals/drinks) to avoid the prospect of stomach pains that will most likely not happen but could and she thinks that’s ok? I’ll wager she doesn’t know enough about these physical conditions (gastritis / ibs) and how they relate to anxiety so just tells me that they might not get any better after therapy. So….what exactly am I doing here if you keep telling me that this doesn’t work for everyone and physical symptoms that perpetuate anxiety will not be improved?

I came out with what I consider to be a highly relevant and important statement. That I suspect that I allow myself to get very anxious because I want an excuse to be imperfect. I have had something ‘wrong’ with me since 15 and it’s been touted as why my exam grades slipped, why I got a 2:1, why I struggled so much during my PhD. Maybe I’m just not the best at stuff after all – and I cannot accept failure. Hence I do not try to control my anxiety as it gives me a nice get-out clause. What about that then Ms therapist lady?

Well. She wasn’t interested in that theory at all. She just thinks I’m too harsh on myself and that self-criticism is bad. The ONLY thing she wrote down this session was when I said that I felt self-criticism could be a good thing. A concept utterly alien to her – that the inability to see and accept one’s own flaws turns one into an arrogant narcissistic douche. The ability to self-criticise is inbuilt in any half decent scientist (or artist, or y’know… human being) – you judge what you have done, your level of ability, your qualities and you think about how it can be improved (or ruminate of how it cannot if you so choose)- that is the instigator of progress and understanding of the shortfalls of others- realisation that things are not perfect. Am I getting through here???

I’m trying to stick with it – but I feel  I am being asked the wrong questions. I’ll fill out the inane homework things I’ve been asked to complete but in addition I will write something about the stuff that I think is relevant.

Chronic anxiety for me is not all about a single thought or situation that happens every week- I may not have a panic attack during the whole course of treatment – but the problem comes from big overwhelming thoughts that rarely specifically get triggered but are always lurking in the wings, hovering and ruminating and  stopping you from living your life. And that is what I will write about.

Does anyone know the trick of getting off one’s high horse and trying to accept that very simplistic and superficial things might be helpful?

 

 

Blah mental ouch blah

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Now I wait.
I wait to discover whether the miasmic pain and fatigue of late are from a source physical or psychological. Bets are still being taken. My money is split between anxiety-provoked organ dysfunction and wholesale pancreatitus.  Thanks Dr Google. You always know just what to say at times like this. GPs money is on gastritis (again?Oh come on that’s just not fair!)

I wonder how the psychological asessment process designed for grossly normal people who are stressed or depressed, will cope with all of this (gestures to ludicrous potentially staph infected face). It doesn’t bode particularly well that they didn’t want to see me initially because of my eating disorder history, but I’m certainly not going to go knocking on ED services’ door for health anxiety help!
To be honest I’m a bit nervous about this whole thing. Nervous in an uncharacteristically rational way.
I haven’t had a psychiatric or psychological assessment like this for quite a few years and the last one didn’t go so well. I fell into the gap between two services that wouldn’t help me and so wound up going private. The contradictory stories were that I was too complicated for one department buy not sick enough for the other. Sigh. I’ll have to get the balance right this time.

The form I had to pre-complete scores me as moderately severely depressed and moderately severely blighted with general anxiety disorder.
How weird. I don’t feel that depressed. I haven’t thought about killing myself or anything equally dire for ages, I can still get out of bed of a morning and haven’t gone into the weird slow motion utter braindead phase, so I figure I’m just fine on that front. Adequately functional thank you. Hopefully they won’t try to focus on that shit because this level of depressed or non- is actually perfectly tolerable. What is not tolerable is freaking out at stupid illnesses that I will never get, and about going somewhere where I will have to interact with actual people in a social setting. I really want to be able to do that…to be able to go to a party and not spend the whole time nauseously shaking and clenching my every muscle for fear of falling apart, and double thinking every damned word and movement for fear of rejection or inadvertently falling dreadfully ill. I’m such a shit person to go to the pub with. Seriously. That 1 in 100 times I actually go and don’t make some lame excuse, it’s really not worth it for everyone else’s comfort and conversation! It would be easier if I could have a few drinks and be less of a corner-hugging wide-eyed weirdo but sadly my current internal organ rebellion refuses to allow even than concession. If anxiety is to blame I’ll be pissed off. Bastard self-preserving anxiety stopping me from tolerating cns depressants.

Checking my grades for the phobias and social adjustment mcq it says I have severe social functional impairment (no shit) and who knows what the phobia questions say.

Yuck. All those categories. I know how the game works though. I’m supposed to have lower scores at the end of whatever course they give me. If they even so much as suggest I also still have an eating disorder, I’m likely to punch them in the face. Ok maybe not but at the very least I won’t be impressed.

Creativity has taken a hiatus while I try to figure this mess out. The prize for most unremarkable post of the day goes to me and my tireless fear of life and death.

I know what you said, but that doesn’t mean that I understand which hat to wear

You sit me down to watch a TV show about health anxiety that makes me uncomfortable (due to being comparably mildly inflicted, and finding their behaviors grotesquely inspiring) and tell me in less than eloquent ways, that this stomach-churning anxiety I allegedly feel coursing through me on a daily and irrational basis is simply a fictitious product of what would, if it were real, be munchausen syndrome. That I’m not happy unless there is something wrong with me, and implying that I haven’t really achieved anything in overcoming a 15-year eating disorder because I’ve just replaced it with something else to fixate on. You seem to think that you understand exactly what is going on, that I’m copying someone else, and that I don’t need comforting or therapy or medication because there is nothing wrong with me and I just need to grow up and get on with things. At times like this, I just want to cry.

(Before I continue, I put on the hat of honesty with baubles of self-doubt)
I am in the referral process for CBT for anxiety. I recognised that this issue is infringing too much on my life and needs to be tackled (preferably without meds). I’ve had anxiety (mostly health and social-related) since I was about 5. I had my first panic attack at that age not long after I cut my hand on a broken mirror and realised that I was actually mortal, and not magical after all. It’s been downhill from there. It didn’t occur to me before now, before those suggestions of fake illness, that I might not be deemed ‘sick enough’ to be helped, but now I wonder. Do I really have anxiety? (puts in analytical hat) Well I have the physical symptoms, racing heart, chest pains, tension headaches, ibs, nausea, sweating, shaking, numb extremities, dizziness, the familiar racing thoughts, sleep disturbance, exhaustion, and terrible waves of nauseating fear, and I’ve been diagnosed and medicated for it before, but (puts on elaborate self-doubt hat) what if I’m making myself feel all that now so I can basically get attention? That would be so messed up. If that were true then surely THAT would need some psychological straightening out?

I was feeling positive about the prospect of new therapy and another bright shiny door towards freedom opening, but voices all too real and present, seem determined to tell me what I am and what I am not.(dons wizard’s hat) Few things upset and piss me off more than being told what I am, who I am, what I represent. I detest being defined as a portrait of a person that I don’t identify with. You think I haven’t changed? Well I’ve got news for you buddy…

So why, if I’m so worried about my health, can I let a dog lick my face, and cuddle a muddy horse? Why can I drink from a hosepipe but not take the last cup at the water dispenser or use a fork with any suspect marks on it? Well (balances analytical hat ontop of wizards hat) that, my darling, is a lesson in inconsistent and irrational thoughts.

“If you were my head
I would be heard”~K’s choice, my head

A veteran of things I don’t much want to be

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Sometimes the mirror is ripe with vines of shadows, circling my shoulders, pressing all too urgently and familiar.

The air suddenly slices through to my bones.

Weeping skies and hollowed heartbeats threaten to pull me back to the tornado of disjointed memories. The taste of fever and hatred is in my mouth and I wonder for a second, if I can breathe in these mirrored shards before they perforate my mind.

One eye still on the future, I swallow the bilious threats and smile because this is me looking the hypnotising past straight in the eye, and chosing to look away.

“Calculate what we will or will not tolerate”~Tool, the grudge