I love Catherine's blog as she is honest during the difficult times and also has a desire to help others who are suffering. Before I mention Eating Disorder treatment in the UK and other parts of the word I want to say that I am a huge fan of the NHS and it's staff having worked for them as a nurse for many years. The areas that are lacking however are ED treatment, addiction treatment and the treatment of many mental health issues in combination with the two (dual-diagnosis). They simply don't have the resources or finances available to deal correctly with what are hugely complex and difficult conditions to treat. People often don't get the support until they are admitted as an emergency and by that time it is too late. People die because of lack of knowledge about treatment and of course the cost of treating these conditions can be vast so they are often brushed under the carpet and forgotten about. Private treatment in the UK is costly and often the same rules apply about lack of knowledge and specialty staff and treatments. Eating Disorder clients often need a minimum of three to six months in treatment and people simply cannot afford it. That's why we have UK clients coming to South Africa for quality Eating Disorder Treatment at about a tenth of the cost of private treatment in other countries. The support here in Cape Town is incredible and that's why I love working with our specialist ED treatment centre here in Cape Town. There is hope and people do recover despite blips and problems along the way and Cathy is a living, breathing example of that so over to her!
News of the death of 19yr old Averil Hart hit me hard at the end of last week. I felt so angry that it was allowed to happen - that in the 21st Century in a First World country, a young woman could starve to death. But the reality is, this happens. I have known people this has happened to. An adult with an eating disorder in this country waits on average 5mths for treatment. A child or adolescent 4wks. This is not acceptable. But what is worse is that Averil was known to services yet still slipped through the net. My first crisis happened nearly 13yrs ago. I collapsed like Averil and was admitted to hospital where I was left to my own devices and lost even more weight. As with Averil, no ED specialist came to see me for several days. It got to the point where I could no longer walk, I had no control over my bowels and was slipping in and out of consciousness before they even thought to place an NG tube and administer IV fluids. Basic surely? I nearly died. Averil did die. I was lucky.
I am lucky. And today I am really feeling it. It was my birthday yesterday and what change a year has brought about. I spent yesterday with my family at my parents' house. As I watched my little nieces play I was very aware of what I so nearly lost. A year ago I was in hospital recovering from a broken spine amongst other injuries. I was in nappies. I was in pain. I was starving. I wasn't physically strong enough due to my anorexia to do the physio I needed. Yet somehow I still found the strength to pace the corridors, ignoring the agony. I was refusing my pain medication, believing I deserved to suffer. I was broken and I thought I was beyond repair. I refused to see my family - I was too ashamed. They were hurt, angry and pretty much devastated. But just the other day my mother told me she is proud of what I have achieved this year. How my heart sang to hear those words from her! I can't take away what I did last year. I can't undo it. But I am determined to lead the best life I can. For now that is taking things one day at a time, sometimes one hour at a time. I can't erase the past and I don't know what the future holds for me so the best thing I can do is cherish the present.
I had a bit of a wobble this last week but I didn't write because it made my recovery 'messy' (for want of a better word). My perfectionism didn't allow for this blip. I want to recover but, as with everything else, I want to do it perfectly. Mainly because I want to show other sufferers that it is possible but also because I am in a desperate hurry to 'catch up' with my peers from treatment who have substantial clean time and are living life. Of course, the reality is that recovery is never a straight line on a graph, but rather a zig-zag with a general trend upward. It's two steps forward, one step back. It is going to be different for everyone. I was in recovery for three years before relapsing. Some won't relapse at all. Some will relapse several times before 'getting' it. We're all individuals so our journeys will be unique to each of us. The important thing is a forward momentum. It is certainly not a race. It's okay not to be okay.
So what did my wobble look like? Well, I think I had been getting a bit ahead of myself, putting pressure on myself, and I experienced some very bad anxiety (tears, the works). I started to freak out over the weight-gain, the latest increases to my meal plan, the going cold turkey with my OCD. It all felt too much. But, hey, I'm here to tell the tale. Nothing terrible happened, I just felt terrible. I am so grateful to be living where I do as I had people to talk to and it was that simple act - talking - that got me out of my panic. (I say simple but I still don't find expressing my fallibility, my vulnerability, easy). I just needed to put the brakes on for a bit and take it easy. I have needed more sleep these past few days so I have allowed myself to rest. I have been for gentle walks in the park (yesterday accompanied by my mum's dog!). Today I took myself on a coffee date and spent a good hour nursing my americano and working on my novel. I popped into the supermarket and bought myself some chocolate on the way home. It's the little things that make a difference. This being kind to myself is new to me. Today I am feeling much more me and it's just such a relief.
In my work with eating disordered clients, I have met many individuals who have been plagued for years, and who are recovered today. I have worked with clients who have been treated in various institutions across the world, and who themselves had given up their fight, who are recovered today.
How your treatment team understand and treat eating disorders is vital, as not only does it affect the type of treatment you receive, but also the actual outcome itself.
We believe it is a myth that eating disorders are about food or weight.
We believe that it is a myth that eating disorders are about control.
These are symptoms of the disease.
Can someone have full recovery from their eating disorder. The answer is yes, but much like the answer, it depends on where and how it is understood and treated.
One thing that is commonly agreed upon is that it takes time to recover from an eating disorder. In fact it is recommended that those seeking treatment for eating disorders should look at a minimum of three to nine months residential care.
Although a contributing factor, this is not due to the complexity of physical consequences or the weight restoration and stabilization required. The length required in treating eating disorders is due to the decoding of the eating disorder language of food, weight, and body image into real emotions.
It is in finding a new way of expressing oneself, finding a new way of defining oneself that recovery is achieved. And this takes time.
Even though there are no accurate South African statistics on the prevalence of eating disorders at this point, the annual mortality rate has increased by 93.3% since 1990. This is a serious and life-threatening illness that requires serious attention and expert treatment.
What we do know, is that eating disorders affect many people. Not determined by race, age or sex, eating disorders not only destroy the lives of the individual suffering, but the lives of those around them too. Family, friends and colleagues watch their loved one be ruled and condemned to a life valued only by the calories consumed. This is not life.
When dealing with addicts, it is commonly believed that recovery is lifelong. With eating disorders, the debate stands to whether a person can recover fully or will be in recovery for the rest of their life. If someone doesn’t believe that full recovery is possible or that they’ll always struggle to some extent, then fighting for recovery and finding recovery is far less likely.
Many people suffering with eating disorders give up in their search for recovery, losing hope in treatment, professionals, help, and their own ability to overcome this illness.
Many people suffering with eating disorders run out of funds, don't get the right help, or don't get the help they need.
Many people suffering with eating disorders have co-morbid conditions that negate the treatment process, making it longer and harder.
Many people suffering with eating disorders, don't believe they need help.
One of my clients said to me once, "recovery is a process", my question to her was "are you ready to give that process up?". If recovery from an eating disorder meant living life through your body, through your fears, through the food you eat, through the size you are, then I wouldn't do what I do. Recovery is no longer being defined by these things. It can be done, but it depends on what level of freedom each client wants.
Many people suffering with eating disorders are satisfied with better, with no longer engaging in overt destructive behaviours.
Safety measures need to be in place to keep you from relapse, but life in recovery is not meant to be an aftermath of the illness or a prison of new constraints. Recovery is not determined by weight, body, size but is defined by a new way of living, without obsession and compulsion.
Recovery is a journey of self-discovery and self-healing that perhaps the rest of the population should work towards achieving.
Is full recovery from an eating disorder possible. The answer is highly dependent on who you ask. But, I want to tell you with absolute certainty that there is more, there is freedom.
I'm going to write about a pretty taboo subject. A few people know about this but it is something I tend to keep to myself. Why? I am ashamed and I am scared about the reaction I might get. People generally don't know how to respond and that's because it is such a taboo. People get angry, they get upset, they turn it into a joke but they also judge. It's natural, it's what people do, but because of this I keep silent and that's not always helpful for me because sometimes I need to talk about it. So what is it? Suicide. Ten months ago I tried to end it all. I was desperate. I couldn't see any other option. Was I a coward? Was I selfish? I guess yes is probably the answer but, more importantly, I wasn't well and I was suffering. I nearly wrote "but that's no excuse" but I'm not going to. No one could feel worse than I do about it. No one could beat me up about it more than I do myself. I feel like a criminal, indeed, not that long ago suicide was a crime. Many still consider it a sin (I was helpfully informed not long after the incident that I had sinned against God). The guilt is immense but I need to learn to forgive myself because I 'use' on guilt - perhaps leading eventually to another attempt on my life, me being such a terrible person etc. How do I move on? Will others let me move on? I read somewhere online about 'Survivors of Suicide' and I thought it might be an article about people like me and thus helpful, but it was about the people left behind after someone has opted out of life and reading it made me cry. I am not going to talk about what I did, (a) because it's not very nice, and (b) because someone vulnerable could be reading this and get triggered. What I will say is that I regret it every day and every day I am reminded of it because my body is different and I am in pain a lot of the time. (Nearly wrote, "serves me right - I deserve to suffer"). Anorexia has the highest mortality rate of any psychiatric disorder - this includes medical complications of starvation but also suicide. According to one paper I read, sufferers of anorexia have been found to be 31 times more likely to make a fatal suicide attempt than the general population. I didn't know this until recently. I thought it was just me who felt that way. I am incredibly lucky to be alive after everything I have put my body through. Something out there wants me to live. Do I feel lucky? On the whole, yes. Life isn't easy but I am trying to take things slowly with baby steps. I am trying to be kind and gentle with myself (which really goes against the grain). Suicide is a terrible, terrible thing. For everyone involved, and that includes the person making the attempt. I wish I could do something to help my fellow sufferers but for now, all I can do is write and be open and maybe others will be able to follow suit. I would hate for anyone else to be in that dark place I was in last year but sadly, many people are.
Since we began at CapeRecovery three years ago, we are increasingly seeing more and more people coming to Cape Town because it is the home of some of the best Eating Disorder treatment in the world. We work with the wider recovery community but I see everyone who comes here for any addiction, behavioural addiction, dual diagnosis issue, co-dependency issue or indeed, eating disorder, as an integral part of that community. The complexity of treating any eating related issue is so great that it is a highly specialist and ever evolving part of what we do.
So, why have a dedicated site for eating disorder treatment?
Well, I personally know many people here in Cape Town who are enjoying life free from the pain and confusion that they been subjected to because of their eating disorder but also because of being given the wrong advice and directed to inappropriate places for treatment. Inappropriate placement and inadequate aftercare and follow up is keeping people sick and ultimately leading to fatalities that could otherwise be avoided. I don't profess to be an expert on eating disorders but I do understand the complexity of them and the need for planning treatment and never treating in mainstream rehabs that cannot fully support the needs of the person. I never want to lose touch of our original goal of always putting the client first in any decisions and we stick by that.
As a result, we have partnered with the best eating disorder clinic in Cape Town and we have plans for more focussed aftercare and sober living just for these clients. In terms of continued care, eating disorder clients require a special level of support, very different from that of our clients who are being supported through their addiction issues. Monitoring people who are dealing with the behaviours related to their eating disorder is more difficult as they are subtle and less easily detectable. With an alcoholic or addict we can simply do a test. We need to implement support with the things that most people take for granted like cooking, mealtimes and eating plans. Though the continued care facilities and re-integration homes that I work with are incredible, we need to provide more re-integration support where eating disorders are concerned so that is what we are doing!
I love what I do today with CapeRecovery and I am truly blessed to do it! I want all our clients to experience all the gifts that recovery can offer and that includes our eating disorder clients, they are a huge part of this incredible and vibrant recovery community in Cape Town! Let's continue to make Cape Town the recovery capital of the world!