I’m feeling really discouraged. I just did six weeks of IOP. I want so badly to get better. I’ve struggled with my eating disorder for 10 years. I just want to get better. So I did the six weeks of IOP and I am still not doing better. I struggled through all of IOP. I didn’t make it more than three days of following my meal plan. I did the best I could, but I was still purging and cutting. I was honest about all that was going on with my treatment team, but they don’t believe me! The second to last day of IOP my therapist for group told me, “We need to talk about honesty.” Then she cornered me and told me that I wasn’t being honest with the team and that I’ve not lost any weight so obviously I’ve been eating, even if I was telling the RD that I wasn’t. They decided that I was doing all this for attention. For aftercare, my therapist told me that I was wasting her time and space in treatment when another girl who is sicker could need it more. I just sat in her office and sobbed for the rest of the time. She told me that if I got any sicker she doesn’t want to see me at all. I haven’t bothered to go back to my therapist since that. I would hate to “waste her time” and “waste space.” I want so badly to get better. Right now it’s hard for me to believe I deserve help. I’m EDNOS, so I’m not “sick enough.” How can a therapist say something like that? And what is the point of trying to recover now? Obviously, I don’t deserve the help. I just feel really down and don’t know where to go from here. Part of me feels like I just want to die. Not take up any more space in the world. Sorry for a long pointless email and that I’ve wasted space in your inbox. I could just use any encouragement you could give me. Please. – Bethany
Bethany,
You are a valuable and important person made in the image of God. Part of you likely believes this is true, but another part isn’t so sure. You likely have a very strong need to feel special. Before you jump to conclusions and think that this last comment is a criticism, let me assure you that it is not. God put within all of us a desire to be special. Your desire to be special is simply a manifestation of a truth that lives within you: that you are special.
From your email, I believe that you have some severe emotional wounding that started long before you went to the IOP. Most likely in your childhood and/or your teen years. You didn’t feel special and irreplaceable. The wounding may involve one or more parents and/or peers. Early painful relationships can create a template or map inside of you that sets the stage for all relationships that follow. You may find yourself dealing with the same basic problem over and over: not being listened to, not being trusted, not being good enough and not important enough to even take up space.
This doesn’t mean that you created or caused the situation in your IOP and with your therapist. However, all of us tend to find ourselves in circumstances where the patterns of our unresolved wounds are repeated. It would take too long to explain how this happens, but the important part is for you to hear clearly that it doesn’t mean you are making things up or being too sensitive and it does not excuse anyone, either in the past or now, saying hurtful things to you.
I do not know the details of what happened with your treatment team/therapist and so I don’t want to comment directly on it, but I do know that when people want someone else to change – and that person isn’t changing in their perception – they try to elicit emotions in the person they want to change. The hope is the emotion (fear, shame, etc.) will cause them to finally change. Take the “e” off of emotion and you have motion. People try to get you to move by saying things that increase your emotions. Sometimes this strategy works, but it is very seldom a good thing to do.
WOUND-INSULT-PROTECTIVE RESPONSE
Looking at this chain you can see the word wound on the left side. This means people who have been significantly wounded on a relational/emotional level in the past. The insult is when someone hurts the wounded person in ways that are similar to the ways she was hurt in the past. The protective response, as you might imagine, is a way to try to express anger from the pain and to prevent further pain.
Different people develop many different ways of protecting themselves. Here are just a few:
- Attacking the person who hurt them (sometimes physically, sometimes verbally, sometimes passive aggressively such as spreading untrue rumors about them, sometimes by trying to turn other people against them, etc.)
- Diminishing the importance of the person who hurt them. “She’s an idiot, who cares what she thinks.”
- Acting out (drinking, drugs, self-harm, sexual promiscuity, eating disordered behavior). This can tie into the next one.
- Attacking themselves. Some people do this for more than one reason, often because the wounds from the past cause them to hate themselves “If I wasn’t so ______, my parents/peers would not have hurt me or rejected me. I wish I were someone else.”
- To show the person who hurt them how badly that person has made them feel, with a subconscious hope that the person will see what she has done to the wounded person, stop hurting them, say that she is sorry and even begin to give them the love and nurturing they crave. Almost always the wounded person craves love and nurturing because she didn’t receive it very well in childhood. It is not a character flaw – it is a wound!
These ways of protecting ourselves are just ways we learn throughout our lives to cope. It is normal to protect ourselves. We develop these protection strategies earlier in life. We use a specific protective measures – for two simple reasons: 1) Because it works to an extent and 2) because there wasn’t anything better we could do at the time.
When you talk about “taking up space” and apologizing for the “pointless email,” you are doing two things. First, you are expressing the pain you feel from being hurt very badly. Again that’s normal. It is normal to yell OUCH when we stub our toe or to cry when we’ve been hurt.
Painful feelings don’t automatically come with just the right words to express them – so we often choose words that describe the wounds we experience years ago. “I am not important. I just take up space.” My guess is that you have felt this way many times in the past. It isn’t your fault, but there is significant hope for change.
The second thing you are doing is expressing your anger at your team and therapist. Expressing anger at people who have hurt us that badly is also normal. However, the way you are doing it isn’t the best way to do it. More than likely, when people first started hurting you, you didn’t have any other ways to express anger. So you did what you could at the time: becoming angry with people who hurt us.
Let’s look at what happened in IOP. “My team and therapist is saying I am a liar. They are saying I am worthless and not worth treating.” I believe that this is the same kind of wound you felt in the past, so you felt an understandable need to express your anger and protect yourself.
But now lets look at how you express the anger and try to protect yourself. You are expressing your pain and anger about what your team said by agreeing with them. “I am wasting Constance’s inbox space.” I believe that is exactly how you feel, but you can learn a better way to express it and deal with it.
Although therapists play a powerful role in people’s lives, look how much you’ve given your therapist: “How can a therapist say something like that?” “What is the point of trying to recover now?”
The point of recovering is YOU. The point of recovery has nothing to do with what a therapist says or believes. What you are saying is that your therapist has the power to decide whether or not recovery has a point: no therapist has that much power. You have to be careful. People who were hurt in the past often have dependency issues and they give a lot of power to other people. They do so because they feel very fragile inside and want someone to help them and protect them. Often wounded people transfer that power over time from a parent to a friend to a boyfriend to a therapist, etc. They are looking to receive what they needed earlier in life, but didn’t get – a sense of worth, value, identity and love.
Somewhere along the line (again, likely with one or both parents) you felt rejected, like you were just taking up space in their home. The person/people who were supposed to have cared for you made you feel worthless. Now people who are supposed to be taking care of you are doing the same thing. I may be wrong. Your parents, both of them, may have been wonderful to you. If so, I believe you were likely wounded by someone else. In some ways it doesn’t matter who wounded you – just that you were wounded.
So where do you go from here?
First – You need to be validated that you have been wounded (not so much in your experience in the IOP, although that is hurtful), but in your past by someone important to you. The wounds you suffered are likely very real and anyone would have been hurt.
Second – Look for and recognize patterns in your life that go back to when you were much younger. Examine how those patterns continue to occur in your life.
Third – With the help of a therapist, develop skills to regulate your emotions and your impulses. You have learned to protect yourself in certain ways and those ways have become second nature, but you can learn better ways. You have to consciously decide to do something different.
For example, in your IOP, instead of hating yourself and making extremely negative statements about yourself, you can learn to speak the truth in love.
You might say to your therapist: “I understand why you might think I am not being truthful. I cannot prove that I have been truthful, but I know in my heart that I have been. If you choose to think I haven’t been honest, I cannot change that. When you say those things, I feel hurt inside and I feel tempted to fall back into a victim role because of my past. However, I am choosing not to do that to the best of my ability. As my therapist I want you to speak the truth to me as you see it, but I need for you to do so in a manner that respects me. If you cannot do so, then we have a problem and we need to figure out how to best deal with that problem. You have a choice in how we resolve this and so do I.”
In this example, you are setting boundaries and establishing responsibilities. You are stating that the therapist is making a choice in how she responds and admitting that you cannot control what she does. You are also stating that you have a choice in how you respond to take care of yourself. Then you tell her what your expectations are, what you need from her. If she is unable or unwilling to do so, something will need to change.
The next step is responsibility, which is very different from blame. Responsibility has to do with the issue of who is going to take care of something. Blame is about who messed it up. Blame looks for someone to punish, but responsibility looks for a plan and is supposed to carry it out. Although other people may be to blame for your wounds and issues, you have to decide that you are responsible to make the changes, with the help of others.
Developmental psychology can be summed up in the following statements: A brand new baby you cannot really do anything for himself. Someone has to feed him, change him, etc (usually parents). As he grows he can do more and more for himself. When he is a child his parents likely tell him when to go to bed and when to get up. But as an adult, he will be the one to decide when it is time to go to bed and when to get up. What’s happened? He has taken over his parents’ job, not just in when he goes to bed and when he wakes up, but in pretty much everything. You have to become your own parent. You wouldn’t tell your child she is just taking up space. Learn to treat yourself as you would a child that you love dearly. Even if it doesn’t feel right, feelings change; don’t let them dictate what is good or bad, right or wrong.
You do need help. Whether that is with your recent therapist or someone else. You need a place to heal. Continue to work on your eating and cutting. But again, the way you would if you were helping a child you loved. If a child binged, a good parent would not shame her or hurt her – she’d speak the truth: “This isn’t a good thing to do. Let’s work to figure out what happened that set up the binge and see if we can figure out something to differently the next time.” Shaming leads to shameful behaviors. Speak the truth to yourself in love.
I would recommend that you read a book called Changes that Heal by Henry Cloud.
God loves you. The space you take up is space He planned for you to take up from before the beginning of the universe. Be patient with yourself, rejoice in progress and let setbacks only serve to make you more determined to succeed. God Bless you richly, Bethany.
David Wall, PhD