Frank Talk about Post-Treatment: (1) Food: A Return to the Exquisite Privateness

What happens when you get out of treatment? First of all, you don't want any special attention as a result of where you've just been; especially, you don't want to appear to be making any special efforts around food. 
Do you?
I didn't. On reflection, actually, some of my fellow travelers took pride in the prospect of showing their loved ones that they were doing things differently, better. So perhaps I just speak for myself. What I do know is that nobody wants the "Oh, you've gained weight! You look great!" comment. I've had that one a few times on previous go-rounds and it is an enforced lesson in grace.

In view of this, I was lucky: the day after I left treatment I went to our MFA residency, at which the majority didn't know me well enough to know where I'd been for the previous ten weeks and probably hadn't noticed my food oddities the year before or remembered them if they had. I left the residency to a freewheeling crazed run of travel and family stuff, during which there were far greater priorities to attend to. My friends and family, most of whom didn't see me until a month or so after I got free anyway, are dazzlingly tactful.

Additionally, I don't talk about it. Not-talking, like talking, is powerful energy.
I'm choosing to talk about it now because I suspect it may be helpful for someone else, and possibly even useful information for people who know me. For this post, I'll talk mostly about the food aspect, but in a later post I'll talk about other aspects of life affected; not least among them, not-talking in a different context.

Being on the outside is not the same as being in treatment. The only reason I state something so obvious is because when you get out of treatment, the otherness is such a shock. Even stepping down from five weeks inpatient on a campus in the middle of nowhere to a day program in a city, with streets and cars and stuff, was overwhelming to the point that I was barely coherent at first. From there to 'total freedom' was another rush of adrenaline. In theory at least, they don't let you out the door of a treatment center without a multifaceted "plan," including an individualized meal-plan (considered the foundation of all growth both metaphorical and literal (!)), a therapist, a doctor, a dietitian and, if necessary, a psychiatrist (it usually is necessary), plus scheduled appointments with each of these. There are always people who fall through the cracks and get home without any of the support system, at which time the meal-plan is down to their discretion alone. Back home is where all the restricting and other 'disordered' habits are at home too. Without some kind of serious support--with it, even--it's easy for the meal-plan to fade from consideration. Last time I got out, I didn't have support and it was a big train-wreck. This time, you've all heard me talk about how much I love my naturopath and therapist. I don't know the psychiatrist as well, but she is formidably impressive.

Within this paradigm, the meal-plan makes a lot of sense. I have to admire it, even if I kick against it. The aim is to ensure you get enough food, while also eating a variety of food and avoiding calorie-counting or other ways to marshal food into controlled units. Most places use some variation on the "exchange" system, so that you should have a prescribed number of servings of carbs, protein, fat at each meal. Different food items in various quantities can be counted as a serving size for different macronutrients. The one many of us found crazymaking was that two teaspoons of nut butter counts as a fat serving, but two tablespoons of nut butter counts as a protein! And you're not allowed to double-count any one food item; in other words, you take nut butter as your protein and you still need your serving(s) of fat. Depending on what food items you chose, you could end up with a meal hundreds of calories more or less. But that's falling back into the regimented thinking, and since the meal plan's designed with the intent that exchanges are not exactly equal, and that you should pick different items at each meal, and that those items should go together: no beans and guacamole with your oatmeal, now!--the point is to relax and recognize that if you vary enough, it all evens out.

On top of this abandon-counting-but-commit-to-variation twister, depending on our weight, some of us leave treatment with supplements on our meal-plans still.

Three cups of coconut cream and three cups of either juice or full-calorie nondairy milk on top of all that food??
Could you do that?
I don't think anyone could make me get that all in in one day outside of treatment, myself included--often enough, it didn't happen in treatment unless a lot of the solid food was 'exchanged' for yet more coconut cream. But the point is, I don't think anyone really expects me to do all that: they are professionals, they recognize it's much tougher 'on the outside.' Most importantly, they recognize this recovery thing is a process. It's not a linear progression of physical and metaphysical growth to lasting happiness and total comfort around food.

I suspect their hope for all of us is that eventually we can eat enough, not too much or too little, in an intuitive way, listening to our bodies, gradually letting go of the 'exchanges' like training wheels, and that we can love our bodies at 'normal' sizes, and be comfortable eating in any situation.

So, where am I in all this? From what I've already said, I'm sure it's pretty clear that I'm not following my meal-plan 100%. But I have wonderful care providers and they're not worried, because they understand that it's a process.
I think of the meal-plan occasionally, and it helps me to evaluate how what I've been doing instead measures up. If I think I ate too much, running what I ate by my theoretical plan helps provide a reality check. Still how you'd express some of my smoothies in terms of carb/protein/fat exchanges is a question without an answer, and these can be quite substantial smoothies.
Some things slide around. I haven't had three cups of it on any day, but the coconut cream has morphed from 'supplement on top of everything else' to 'insurance,' making sure I got at least a certain amount of nutrition down, to not having it at all, to 'insurance' again. Once it's in the mix as insurance, I find it hard not to think that that's all I should have. This is a tricky dance. Right now, I'm committed to three quarter-cups of coconut cream per day. Three quarter-cups is not three cups, but this is a process, and having the commitment in place is like creating a rung on the ladder up to the trapdoor.

Pitfalls and Trapdoors. I mentioned having fallen through some trapdoors in my previous post. Here's some of what I meant. If you feel you may be triggered, please do not read on.

First big trapdoor: going too long without a snack, after an inadequate meal, hiking, and getting low-blood-sugared to that state of stare-eyed, whirly but still able to hold a conversation. This was a trapdoor because it reminded me of that feeling, that emptiness, that exquisite privateness to which I hadn't yet returned. In treatment, I was always so full that even half that amount of food in a day was still overly filling. Getting back to that reminds me of how easy it is to be in that place, how functional I seem to myself to be when I'm like that. If I feel like I'm functional, it's easy to say no need to eat more.
Second trapdoor: restricting/bipolar one-two punch. Letting dinnertime get too late, working too hard and too fast, paying too much attention to the monsters/hallucinations, and getting to the meltdown point. That nothing was smashed, nothing bigger than a piece of paper thrown, is testament to how much better things are now.
Pitfalls: -Counting calories and doing lots of math to determine portion sizes while preparing a meal.
-Poring over recipe books like novels and either making nothing or making lots and stashing it all in the freezer.
-Telling yourself "No"..."No"..."No"...over and over because you're too hungry to focus but have decreed you cannot have a snack.
-Deciding to eat only three (or four, or whatever, plus carrots) specified foods on a particular day.
-Throwing lots of good food away by various mechanisms.
HOWEVER--throwing some food away is actually a good sign for me because of this:
Danger Sign: -Intense fascination with food that's going bad, has fallen on the floor, is about to be thrown away, etc. Learning to feel ok about eating food that isn't about to be tossed--high-grading--was one of the biggest benefits of the enforced abundance of being in treatment.

There is so much more to write, but this is already long, and has taken me so long to write because I really want to be clear and nonjudgmental and as little triggering as possible. Another post soon with some more of the benefits of being 'inside.'