Baby Steps... Oh, Baby- Rip Off The Band-Aid and Start Striding

Tonight was the long-awaited phone call with my therapist in New York. I had emailed him a couple of weeks ago, before I had been offered a place at the supported housing project, to inquire about reapplying to do the dialectical behavioural therapy program I left prematurely in 07. The program is pretty demanding emotionally, and requires a certain level of stability with symptoms- I was starting to spiral downwards and had to leave- the recommendation was that I entered an eating disorder specific residential program, but I didn't have insurance coverage for that so was left with no option but to return to the UK.

I don't know why I have such high hopes for this program, or why I so desperately want to return to New York and complete the 6 months. I think that I am becoming increasingly frustrated with how slow my progress has been and want something more intensive to really propel me forward.

I've written about the difference between the two health care systems before- the high hopes of my team in the US for a full recovery (like ripping off a band-aid) and the s...l...o...w... way of working here. I am under the eating disorders team and I am giving my therapy sessions my all, but I find it really hard to hold onto much hope when the expectations seem so low. I want to be FREE from this completely- to suddenly be "okay" with food, health, life. To have a job, be living independently, to not be controlled by rules and rituals and compulsions. When I was receiving treatment in the US, I was really thrown in at the deep end. Quite a challenge for someone who hasn't been in full-time education since the age of 12 and pretty much grew up in hospital. I suddenly found myself being discharged from inpatient at a healthy weight, working at Starbucks, living by myself and taking college classes. It was weird. In a GOOD way. It gave me a taste of what life COULD be like. But in a lot of ways, it's made things so much harder for me- to have that all, and lose it all.

My team now want me to take this one class for 2 hours a week and not take on anything else (work, study, etc). We set small goals each week around socialising, food, etc. It's working for me- as in, it's sustainable. I'm not rushing into things, taking on too much only to have it crashing down around me. My team seem to have learned from my past history- so why is it so hard for me to do the same?

I guess I am just angry with myself for still being so stuck in this dysfunctional state when I know there is so much more out there, and having tasted it, want it more than ever.

I can't figure out why New York represents "health" so much for me. Or why I cling to the idea that I can only truly recover if I am in America. It doesn't make sense, certainly isn't based on evidence and is only further fueling my frustration. I have been working really hard at just accepting where I am right now- both with my recovery, and the more concrete facts of where I am living, the treatment I have available to me here and what that involves.

It's really hard for me to NOT compare myself to other people. I know I am not alone in my struggles with food and weight, but I feel so inadequate to others who somehow manage to go to school, work, etc. I don't know if I am just lazy? I don't know if I need to just somehow Nike-style "DO IT" or if for me, baby-steps are the only way. I should know by now that for whatever reason, just "doing it" doesn't quite work out. It's just painfully difficult for me to accept that *this* is how things are. Not that I won't keep working towards my goals, I'm just frustrated with how long and drawn out this all seems, and whether I am making things worse for myself. I feel like I can DO all these things- I can work, go to school, eat in a restaurant, deal with whatever stress life throws my way. But only for a very short space of time. Days, weeks, months- it doesn't matter. I just haven't been able to sustain things for any significant period of time without falling to pieces. Again and again.

Anyway... Back on topic. The outcome of the phone call was that the program doesn't think I am stable enough to return at this point for various reasons. This is just bizarre to me because my team here are perfectly happy with how I am doing/the way things are going. I WANT to try things here with moving into my apartment, carrying on with the small goals, and if TIME wasn't an issue, I'd be happy to do this and reapply for the program when I can stand up and say, "that was where I WAS, this is where I AM and I am ready to take it to the next level". BUT, I only have insurance in the US until October so it DOES feel like a "now or never" thing. Because it IS. I know that I am working towards that place where I can proudly say, "this is where I am NOW" but it doesn't feel like progress because I'm not there yet.

Valentine's Day, Thanksgiving.... It's All The Same To Me!

Happy Sunday- everyone ready for a new week? ;)

Today's been kind of up and down. As I've talked about before, I really want to move back to New York. I've been looking into options and trying to see if I can make it work (I've moved back and forth 3 times in the last few years). There isn't a single fibre in my body that would rather be in the UK, but there are a lot of practical things to consider so it's not straightforward.

In the spirit of Jenny's post a few days ago, I realised that I am spending a HUGE amount of my time and energy thinking about where I would rather be and what I'd rather be doing. A good thing in that it gives me some focus and inspiration, but it's taking away from the things I could be appreciating right here, right now.

Soooooooo... I decided to make a list of the things I am grateful for in this moment.

- somewhere safe and comfortable to stay
- the city I live in is beautiful- this is right in the middle of the city (Starbucks gives a great view!)



- the progress I have made in recovery (I still have a lot of work to do, but I have come a long way from the darkest moments)
- living in a relatively civilised country (apparently in some cultures, you face criminal charges if you have an eating disorder?)
- my health (yes, I have a lot of consequences of my eating disorder, but things could be a LOT worse)
- having enough food, enough heat, enough of the essentials to LIVE
- having access to doctors, dentists, medication, etc if I need it
- the amazing people I have met over the last few months/years
- the friends who have stuck by me through all of this
- my family (definitely issues there, but again, could be worse!)
- my education (I haven't been in full-time school since I was 12, but that is a lot more than lots of people ever get access to)
- luxuries like internet access, phone, etc...never mind things like clean water


I don't know. I feel like I spend a lot of time thinking about other people, what they do, how they live and being insanely jealous. There is a whole world out there and so many people never get the chance to learn to read and write, never know where there next meal is coming from, have never had freedom to even play outside... Kind of makes you think, right?

Point I am trying to make is that it's easy to fall into the trap of comparing, striving, always pushing to go that extra mile/get that bit ahead, and life isn't about reaching some kind of destination: it's about enjoying the ride. Goals are important and I am a firm-believer in continuously assessing and reassessing where you are/where you want to be, but I'm also starting to see that this way of thinking means I am missing out on the moments that I have right now before they pass me by.

Question: what are you grateful for right here, right now?

Everything's Changed (Back To What It Was?..)

I last posted over a week ago. Things haven't really changed from a physical point of view. I'm still sleeping insane amounts, still feeling horribly unwell and still no clue what is actually going on with my body right now. Different people have different theories- adrenal fatigue, food intolerance's, depression, thyroid problem. It's all being investigated.

Meanwhile, on Tuesday night I started exchanging emails with a really good friend of mine in New York. Turned out, she is moving into a new apartment this week and looking for a roommate. Within 24 hours, I had booked flights, made appointments with a psychiatrist and therapist and am all set to go.

How do you know if you are doing the right thing?..

The reasons I left New York remain pretty much unchanged. The reasons why I want to leave Edinburgh so badly are accumulating by the day. I *need* to get out of Edinburgh and New York is the "easiest" option (as in, I know the city, have somewhere to live, etc). I don't know if it's going to work out this time. I pretty much stopped caring about ANYTHING somewhere amidst my move to London, and that also remains unchanged. I don't want to go back, but honestly? I don't want to be anywhere right now. I am NOT (for the record) suicidal. Hell, I don't want to be dead anymore than I want to be alive right now.

Something in the emails sparked *something* in me, and maybe now that the initial excitement has worn off, am just overwhelmed by moving, yet again, and the increasing frustration with the situation in Edinburgh.

I don't know what to do, and I don't know what my options are right now. There are so many "pros" to moving, and far less for staying. Lots of cons on either side. Nothing feels quite right about this, and I can't think straight enough to figure it all out myself. But I don't actually have anyone in real life to talk this over with...(and yes, I am aware how pathetic this is).

Digging For A Cause

I really have nothing to say right now. I still have the feeling that I have been run over by a bus, still feeling like curling up in bed for the next 6 months, still having no desire to do anything/see anyone. Hell, I haven't switched on my phone for 3 days, never mind actually called anyone.

I don't know where this came from. A week ago things were really starting to look up, then all of a sudden, "BAM". A couple of things did contribute, looking back...

I was living in London with a friend's family a few years ago. I was working with a treatment team, had my friends nearby. I wasn't doing "well", but there were concrete plans in place to help me move forward. My dad (who has always been opposed to "treatment" and thinks I should just sit in a garden and be healed by nature) persuaded me to move to Scotland and live with him. I knew that there were/are VERY limited treatment resources in Scotland but he assured me that *he* would take care of me, that his wife was a dietitian who would stay at home with me, that we would eat together, do things together- set up our own "care plan" to avoid another inpatient admission. I stupidly agreed. Packed my bags and left. It became obvious pretty early on that things weren't going to work out for lots of reasons. My dad worked long hours so was never home, his wife and I didn't get on so the atmosphere in the apartment was horrible, never mind "healing". I didn't know anybody, didn't connect with the therapist I was assigned to and regretted moving, but going back to London at that point wasn't an option. So I stayed. Within a few months, I NEEDED to get away and focus on my recovery which was when I went to New York for treatment. Whilst I was there, it became apparent that I would be there longer than the anticipated 3-4 weeks. I couldn't give a date for WHEN I would be back, and my dad, out of the blue, called me in the hospital to say he was selling his apartment, moving abroad and putting all my stuff in storage. His reasoning was that he was retiring and needed the money from the sale of the apartment to live off. I understood this. I wasn't happy about it, knowing that if/when I returned, I had nowhere to GO, but it was his apartment/his money/his choice.

Fast forward to now. I am staying with my mom, in the storage room of her apartment. It's also my brother's room. He is away at college so doesn't need a big space since he's never here, but the room is filled with his and my mom's stuff (I have 2 small suitcases in the sitting room behind the sofa and have gotten rid of most of my things because there was nowhere to put it). I am in the process of registering as "homeless" and applying for "supported housing" (ie, a shared house with 7-8 people who struggle with mental health problems, mainly psychotic illnesses- been in one before and they are SCARY places to live). On Friday night, my older brother came for dinner and just happened to mention that my dad is coming at Christmas, having bought an apartment in the city. The plan is for my older brother and his girlfriend to live there and pay rent to cover the mortgage until my dad moves back.

I am so angry and hurt about this. I don't understand why my dad sold his place with such urgency, making out like he desperately needed the money, and now less than 2 years later has bought another property (which I am 99% sure was more expensive). I am angry that I gave up EVERYTHING I had in London to live with him and believed his lies. I'm angry that he has put me in this situation of being "homeless" without accepting any responsibility for that.

Most of all, I'm angry with myself. I'm 26. I should be working full-time, living with friends/by myself and not relying on my parents at this point. But I am. I'm just angry and hurt by the situation, and there are so many unanswered questions. None which I feel I have the right to even ask, never mind get answers to.

Wow, that was long.

So yeah, that was on Friday. Saturday morning was when I woke up and things had "changed".

Coincidence?..

And Just Like That...

...everything crumbles again.

I've been doing better the last couple of days. Feeling brighter, more hopeful, more determined to get my life back on track. I've called insurance companies, treatment centres. Reached out for help, dusted off my old DBT manuals, prayed (for those that know me, this one may be a surprise- I'm not exactly religious!) I've been eating better, sleeping better, looking forward to things again.

One of the things that has been occupying my time has been trying to find a treatment program that is either free, or accepts my insurance. I finally found one, after several long conversations with the insurance company. The logistics are tricky. It's in New York, but nowhere near anything- in itself, that wouldn't be a problem, but the program runs from 4pm - 8pm 5 days a week, and is about a 2-hour commute each way. I don't think it's going to be an option. Actually, that's not true. It COULD be an option. But nobody else thinks it is. My mom walked into my room tonight and said, "I think you should just try to see if what's on offer in Edinburgh is enough".

I don't know quite why this has shattered my positivity the way it has. I'd RATHER stay here and improve things at my pace. I'd RATHER settle somewhere for a few months and focus on voluntary work, etc. But I don't know how well it's going to work out. I only seem able to sustain my motivation for a few days at a time, if that. Throw in the recent suicide attempts and I think I'm in over my head at this point in terms of putting things back together on my own.

I don't think 4 hours a day, 5 days a week for a month or so is going to do a great deal in terms of my mental OR physical state, but it might be a jump-start and is at least *something*.

I don't know. I could rent a room for the few weeks, or stay in Edinburgh, or...just flail wildly until someone sees I'm struggling. I WANT so desperately to be able to do this myself. I seem to have lost all concept of what's NORMAL though- how people spend their days, what they eat, what they think about, what they do for fun, how they just get on with "life".

I feel so lost. I want to move forward, I just don't know how at this point.

Less Choice, More Choice...Whaaat?

Some of my decisions have been made for me- for now at least.

Things in London aren't going to work out. So my choices are staying in Edinburgh, or returning to the US. I have a lot to consider. This afternoon has been spent on the phone to insurance companies and programs in the US, and various organizations in the UK.

I like the attitude of providers in the US. Health care is not easily accessible, but the treatment I got, for the most part, was worth fighting for. Sure, some of it was crappy beyond belief, but they all hold the same basic idea that EVERYONE can make a full recovery. I'm looking into various types of programs. I don't know if I want to commit to a long-term program right now- I have nothing stopping me, but I guess...well, I'm scared. I don't know if 3-5 weeks of 4 hours a day is going to make much of a dent in my behaviours/mindset and may make things worse? I don't know.

IF I stay in Edinburgh, the plan is to see my therapist weekly and be monitored by my GP. I've hated the place I go for therapy since I started there. Something about it just really rubs me the wrong way- perhaps the stark contrast between the attitudes there and the attitudes of that in the US. Being written off as a lost cause/hopeless case at the ripe age of 23 when I first went didn't sit well with me.

Staying in Edinburgh means I don't have to get well. I don't have to fight my eating disorder, don't have to face up to my demons and *gasp* move on with my life. I can drift from one low-key job to another, occasionally be admitted to hospital to stabilise, maintain the bare minimum "safe" weight. Forever. And that is what my life would look like- therapy, blood tests, meaningless/boring jobs, the social isolation that anorexia brings. It's a pretty bleak prospect.

The US is somewhere I HAVE to be healthy. It's just not negotiable. And that is what has appealed from day 1- I want to be there? I have to be doing well. No "maintaining the bare minimum weight", no staying in bed for 3 days or walking for 12 hours a day. I have to be eating properly, have to be working, have to be healthy. It works for me because I have so much social support and love the lifestyle/culture/family I have there so much that I desperately WANT to be a part of LIFE. Not like here where I honestly don't give a rat's a** about anything.

I am trying to think of ways of bringing what I love about NY to the UK...it's hard. Things are different. People are different. Life is different. I know that peace/happiness/whatever starts from within, but I also believe that environment is where it breeds.

So many things to think about right now.

Meanwhile, I need to figure out how the hell I am going to add in a tablespoon of peanut butter to tomorrow's meal plan...(and yes, I am aware of the fact that eating 90 calories worth of peanut butter should be the LAST thing on a 26 year old's mind).

Uncertainty Breeds Opportunity?

I'm still swinging wildly between highs and lows, and still have no idea what is going on.

I've realised a few things over the years- the main one being that without a definite plan, I tend to go a little crazy. Also that even when I have a definite plan, I'm looking for the *next* thing which results in me being crazy. This knowledge is all fine and well- doing something with it is a whole different story.

The current plan is...there is none. I still have the option of going to London I think. I'll find out more on that front on Wednesday. Honestly? I hope that the day program says they are only offering OP initially because then I can cross London off my list without having to make a decision myself. I know that I want to be in New York, and I know that in order to get there, I need to be stable enough to work full-time without having some kind of breakdown/relapse. Struggling with anorexia and dealing with the US health care system is difficult. Struggling with suicidal ideation and dealing with the US health care system is NOT something I want to face (leather restraints and visions of "One Flew Over The Cuckoo's Nest" anyone?)

So somehow I need to get back onto my feet and figure out how this time in New York will be different.

AHA!

Back to the drawing board.

Wednesday is the day I find out about London and what the eating disorders service there are recommending. I also meet with my therapist in Edinburgh (lovely woman who told me I am a waste of NHS resources...quite a self-esteem boost). I also have an interview for a part-time job which sounds interesting/cool/fun/useful (in terms of something concrete on my resume/experience and all that jazz...)

Life Isn't A Game. There Are No Winners.

Wow...it feels like a long time since my last post, and it feels almost foreign right now as I read it back. A lot happened after writing my previous entry. I ended up back in hospital for a few days. It was decided that I could be discharged on the understanding that I return to Scotland and live with my mom. The alternative was to stay in the acute psychiatric unit until the eating disorders team picked up my treatment (they were offering 10 outpatient sessions, starting in January). None of the options appealed much, but I decided that moving back to Scotland would be the best bet for now. For a few reasons. All of which I seem to have forgotten since my plane landed last night.

BUT, as unhappy as I am about living with my mom again, I am feeling a strange sense of optimism. London felt almost as New York did last summer- one knock-back after another, doors closed in my face, everything just crumbling.

I did have some amazing conversations whilst I was in the hospital and in the day following my discharge. Not with psychiatric patients, not with mental health professionals, not with my family. But with people my age who I happened to meet (where they worked- in Starbucks, at the airport, or on the bus). I don't know quite what it was about these conversations that touched me so deeply. Perhaps how peaceful they felt. They didn't have high-flying jobs. They didn't live in great apartments, struggle to get through each day. They seemed content with what they had. They were a pleasure to talk to, to be with. Just to have NORMAL conversations about random stuff. I don't know if it was just the stark contrast between the thoughts tumbling around my head at the time and the mundaneness of everyday life, but it really did make me think about my situation and how I am NEVER content with what I have. I put a tremendous amount of pressure on myself in any given situation to be the best, to strive harder, to push further. Inevitably my standards become completely unattainable and I shrink back into the shadows of my eating disorder because I *know* I am good at that.

So, yes. Being around for the last week has introduced me to a world that was (and still mostly is) alien to me. A world of contentment, acceptance, recognising what is REALLY important, what life is REALLY about. No, our conversations didn't get to that level ;) BUT just interacting with these people has opened my eyes a little and given me lots of food for thought...

And So It Goes...

I left hospital on Friday after my assessment with the eating disorders team. I don't know yet what treatment they will offer me, or whether or not I have the motivation/energy to keep pushing through with treatment and trying to make a life here in London. I am finding it so difficult to function on a day-to-day basis, that it's impossible to think further down the line than the next few minutes/hours.

I, rather impulsively, booked a trip to New York as soon as I arrived at my friend's house. I leave in less than 72 hours. I am too caught up in depression and anxiety to feel anything but dread about this. I am GLAD that I am getting a break. It's been a long time since I have gone to New York for a "holiday" and if I can manage to relax, it will no doubt do me the world of good. So far my thoughts are swinging wildly between trying to land a job whilst I am there and staying, seeking treatment there, coming back and moving back to Scotland, coming back and engaging in treatment in London, then the back-up plan of just calling it quits and repeating the recent incident. I don't know what I want right now, never mind the steps involved to get there.

At least in New York I will feel safe, be spending time with family and friends and not surrounded by the temptations and negativity pulsing through my veins right now.

My plan is to have no plan- see if going with the flow for a week helps. Danger of that is that I then romanticise New York. Everything is good there. I don't worry about the same things, I have family and social support. I feel safe, loved. Not like the UK where I have support out of NHS guidelines dictating "duty of care", or Edinburgh where I don't even have that.

I feel like I do nothing but whine and complain in this blog. I originally started it as a journal of my recovery, my progress, my unfolding LIFE. Instead it logs my peaks and falls, my slow declines, my rapid mood swings and impulsive choices.

I have more coping skills than I let myself use. I honestly forget they are there in those moments of "oh my god!!!!!" then regret it once I am face with the consequences of my actions. I'm not used to consequences anymore...in the US, my actions had repercussions which I ignored (didn't like what the doctor said? pfft...go to a different doctor) and in Scotland, there were no consequences ("you want to lose xlbs/take x pills/do xyz...go ahead!") There is a part of me that KNOWS, full well, that any consequences are felt most harshly by ME. I hurt myself, impact MY life when I do these things, yet I can justify it to myself time and time again, because honestly? I don't care enough about *me* to stop most of the time.

It's Really Happening (what is?)

"Overwhelmed" doesn't even begin to cover it. I am moving this week- most of my stuff sits in an apartment 500 miles away, and I'll be joining my possessions on Friday. I want to say that I am excited, happy, relieved...but this feels oh-so-wrong. I moved away from London for very valid reasons at the time, and moved to somewhere I believed would offer some different opportunity. To summarise, it's been a disaster from the word "go". My original reasons for moving, in hindsight, stemmed purely from fear. I was running. Not *to*, but *from*. I've been running ever since, and now am going back where potentially, I could be forced to face those demons once again if I don't tread carefully.

I know how the system works. Scotland has been a bit of a minefield for me, New York even more so. I've been out of my depth when it comes to certain areas, and it's shown. The stress eats away at me, little by little, until it has eroded half my body and half my brain and what's left is a vacant shell where my soul once lived.

London NOW feels threatening. I know it too well. I know where the obstacles are, and am a "pro" at avoiding them. I'm talking in terms of medical treatment here. I know the system better than I know the streets. Where to live, where not to live. When to show up to appointments, when to cancel. This could well work in my favour, unless my negativity is running the show, and knowing me/my patterns/my eating disorder, it's oh-so-easy to become a statistic when 1) stress from moving and college starts to become consuming, and 2) I know how to avoid doctors/treatment if I choose to.

I'm scared.

Scared because I know that things aren't going well. I eat my oatmeal, smile, say "good morning" to my family and go off on my adventures for the day. I pretend everything is fine. I want to go to college, I want to see my friends, I want to go back to dancing, I want to be healthy, I want LOTS of things.

But really, I don't. I don't want it ENOUGH. I am scared of eating, scared of breaking my rituals, scared of giving up my obsessions. My heart thumps erratically in my chest, my heart pounding against what feels like a boa constrictor around it. Every breath hurts. I'm tired, I'm dizzy, everything hurts. It's hard to think straight because I'm so exhausted, cold, confused.

I feel like a wimp for 1) feeling like this, and 2) verbalising it. I have said it on my blog, but I would never say it out loud. How weak of me to not be able to take the blows I throw myself. How pathetic of me to complain about something purely self-inflicted.

And yet I don't know if it IS self-inflicted. I'm not doing anything overly disordered. My body is perhaps just weakened, or maybe everyone feels like this and it's normal after all?

It's been a draining last 24 hours. I'm sure I'll feel differently tomorrow. If not, I can mention it to my therapist, who will confirm that yes, I am indeed, absolutely fine and should shut the hell up and get over myself.

Home, and Homesick

I feel like I should update. Or rather, I feel like I should have something to say. Anything to say. The truth is that things feel pretty strange and foreign right now. I am back in the UK and struggling to adapt to the weather, my treatment team's polar opposite approach to what I had in the US, different foods, living with my mom again.

It's hard. It's tiring. I am homesick, and yet have no desire to return to New York right now. I am not unhappy *here* per se, just overwhelmed by the differences between my life here and my life there.

I thought I would miss it more than I have- maybe I am still a little jet-lagged, maybe it's a kind of "honeymoon" period, maybe I have just accepted that NY isn't an option for me right now, but I feel relieved to be back. I am sleeping a lot and grappling with ideas about where/when/how to move out of my mom's place. Not sure where I fit in, or what I want to be doing in 3/6/9 months. Wondering if things are going to get wildly out of control, or if my rather tenuous grip on reality will grow stronger.

I have been having the thoughts of "symptoms" the last few days, which I hadn't had for a while. First I was focused on getting/keeping a job, then life kind of took over, then it seemed pointless to ruin my last few weeks in New York. Now I have a huge blank future lying ahead of me and I want to sink into what's familiar and predictable. I am trying to ride out the urges, let the thoughts be little more than thoughts, and just take things day by day, minute by minute.

Recovery Is A State Of Mind?..

I am suddenly panicking about returning to the UK. New York has, and always will, represent health to me. A place where I am happy and stable. Despite recent years when I have spent time here, getting sicker and sicker, something about this city holds hope for me. A life. A life with a future. I think of the UK and I think about the hospitals, the sleepless nights, the crying, the pleading, the ambulances at 3am, the doctors, the needles, the tubes. What's strange is that all of this has happened in New York too, and yet somehow I feel like recovery is only an option in the US. It's a childish way of thinking, yet I struggle to grasp the concept that both recovery and sickness lie within ME, and my surroundings bear little weight on how healthy/unwell I become.

I don't want to leave because, in my mind, that means giving up on recovery. It means a license to throw myself head-first into my eating disorder. An inevitable crumbling under the ever-pressing urges to self-destruct. Every time I return, I feel like I am going "home" to die. I feel like I have permission here to be well, to be healthy. To keep striving for something more in my life than anorexia. Back in the UK, it's the complete opposite and it feels acceptable, expected, that I will stay trapped. I'm not ready to give up and leave this behind.

It makes no sense. I have had periods of doing well in both countries. I have had periods of pure hell in both countries. The difference I think is that I look at New York through rose-tinted lenses. I am different here. I don't quite know how- maybe it's just the way that the health care system works. Or maybe it's the mindset I have started off on when I have arrived each time, or maybe it's the simple fact that I believe recovery is possible here...and that I have people around me who believe in that for me too. And that when I am flailing, there are people here who still hold onto that hope for me. Back in the UK, I feel like I have been written off as a lost-cause, a "terminal" case. Why do I care so much what other people think? What happened to the 'old me', that would have turned around and just RECOVERED as a "screw you- I'll prove you all wrong!"? Where did that fire GO?.. I'm starting to feel like the character in "One Flew Over The Cuckoo's Nest" who was so worn down by the end, he gave up completely. And I hate that. That's not me. I am a fighter, a survivor, someone who laughs in the face of diversity and stands up for what I, at my core, believe to be right.

What happened? Where did I go?..

The differences between the US and UK health care systems

I have experienced health care on both sides of the pond, so whilst some may disagree with my opinions, I believe them to be valid.

In the UK, it's all about maximising resources, saving money, damage control/harm reduction. I've been shunted from program to program, deemed "unresponsive"/chronic and had several years of "treatment" where the primary focus was on living with my eating disorder. I was taught how to maintain a low weight in as stable a way as possible. I was taught how to minimise the damage I was doing to my body. This, to me, was great. I was tired of living in psychiatric units. I was tired of being held down and force-fed, tired of my body being controlled by others. Once I turned 21, the focus changed and in order to prevent wasting more money on treatment I wasn't making use of*, it was all about helping me to avoid medical crisis after medical crisis, and manage my condition in the community. This is fine and well. Everybody knows that eating disorders can kill people. What people don't know is that if it doesn't kill you straightaway, you live, day in and day out, within a vacuum- nothing is as important as food and weight. You think of nothing else. You have no social life because your malnourished state is causing such obsessive thinking that you cannot hold a conversation, never mind relax over drinks with friends (friends? oh- did nobody tell you that you lose them all? They have lives to live that DON'T revolve around calories/numbers). Anyway. Back to my point. I was being taught how to stay entrenched in my illness without really realising the impact this would have. It wasn't just a case of being a normal functioning human being who happens to be rather thin. It was more a case of being left to my own devices knowing that there would be some intervention only if and when I should happen to collapse in the street and somebody calls an ambulance. Fair enough. The National Health Service has spent a fortune on my treatment- money that maybe could have been better spent elsewhere. Maybe on something other than just refeeding. Or on a program better suited to an anorexic 15 year old than a juvenile detention centre (after one doctor washed his hands of me and nobody knew quite what to do with this child who would just not be normal dammit)

So, yes. I've had my fair share of NHS treatment and quite frankly, would not be alive today without it. But...there's always a but. Maybe I am being a little too 'Pollyanna'-ish about it, but I still believe that there is a better life out there for me. I don't think I have to settle for what I currently have. I don't want the life that the NHS has mapped out for me- several more years of outpatient weigh-ins/check-ins, doped up on psychiatric medications, too stuck in my own world to hold down a job/live independently/have a *gasp* life.

This train of thought was what prompted me to try a different approach. The NHS was (and remains) a closed door in terms of actual help with a true recovery for me. I looked elsewhere and was very fortunate to qualify for a research study in America. I do consider myself VERY lucky to be offered a place on this program. The treatment was free because I participated in research. From the word "go", it was clear that they KNEW recovery was possible. They weren't even going to entertain the idea that living with an eating disorder was an option. No sir-ee. This was a whole-hog "refeed/fix the brain/eat like a normal person/you can do it" program. I got to a healthy weight for the first time in about 6 years. I ate pizza and French toast. I started a part-time job, a part-time class at university, met new people...got a life. Things were starting to take on a new and exciting form for me.

I graduated from the program, and for follow-up, attended a world-renowned treatment centre's day program. Don't let the name fool you kids- you don't always get exactly what it says on the label. This was a "wham bam thank you ma'am" program. You paid a rather disgusting amount of money just to be scrutinised as you cut your sandwich into quarters, and sat in endless hours of silence as the groups were facilitated by robotic clones who seemed brainwashed into saying little more than, "that is inappropriate conversation" should we even dare to utter the slightest reference to food/weight/body image/celebrities/men/media/fashion (hence the silence- you can only talk about the weather for so long!). The first signs of struggling, you were issued a "contract"- break the contract and you go to a higher level of care (oh, and what do you know? they even OFFER a higher level of care, at...what a surprise! An even higher cost!) I didn't technically break my contract, but it came to a point where I had "saturated my time on the program". Their explanation was that I would not get more benefit from the delights they offered. The reality was that I was paying the sliding-scale fee, and after a certain length of time, they wanted to give my space to somebody paying the full cost. Fair play. Business is business.

WAIT! NO!

Business should not be *just* business when it comes to health care. What about the patient? Where do they come in? Isn't their health a priority? Nope. Not if they don't have the money or the potential to sue at some point. You have enough to pay for treatment but not for a lawyer? You're home free. You have semi-decent insurance? They'll take you, all concerned and caring, then 3 days later kick you out when insurance pulls out. All of a sudden you go from being "in desperate need of help/support/observation", to "there's no more money- pack your bags". Seriously. I've seen it happen.

Americans may read this and not bat an eyelid- it's the system they know. I was shocked. The system, in both countries, is fatally flawed. No, I am not being melodramatic here. I don't even want to imagine how many people die each year as a result of the US money-making machine that they (almost laughably) call "Health care", and the British system, whilst free, is almost as bad with the "postcode lottery" and "care in the community at any/all costs" approach they take.

Either way, it's not your illness or symptoms that determine what kind of treatment you get. Whether it's an eating disorder or something completely different (cancer, diabetes, a broken bone), in the UK it's about spending as little money as possible to stop you racking up a huge bill to the Government. In the US it's about what insurance you have and whether that person sitting at the admin desk in the insurance office decides whether or not today is your lucky day (I wonder if they use some kind of magic-8 ball system? Or a spin-the-bottle type game each time a claim comes through?..)

Don't get me wrong. There are huge benefits to both systems too. I have seen some excellent doctors in both the UK and US. I've had some superb treatment both sides of the pond. I've met genuinely caring and compassionate people who really DO want to help patients. But they sadly seem to be few and far between.

Just my $0.02. feel free to disagree.


* quite how you make use of being held down and having someone stick a tube up your nose, I don't know