Personal growth obsession

So, since I got third place in my West Coast Swing (WCS) dance competition over the weekend, I have been obsessed with dancing and improving my dancing. It’s a fun kind of energy, but I also feel like my brain is stuck in a loop.

For one, I have been searching all kinds of online websites to read dance technique tips and started taking notes on key points that I want to implement in my dancing. This has changed the way that I listen to music, including trying to pick out components in the music that I could not hear before so that I can dance to all of the layers in the songs. If no useful WCS songs are playing on the radio when I drive to and from work, I switch to my CD, which does have some danceable songs.

Next, I added dance events to my calendar for the rest of 2014, aiming for about one major dance event a month, with up to three in some months. There is no way I will be able to go to all of those scheduled dance events, but I want to consider all of them. Too bad I will not be able to attend another event until the middle of March. I nearly bought tickets for an event that is happening next weekend in Monterey but I instead booked a haircut appointment as an intervention. (Similarly, I bought and then promptly returned makeup products at Ulta this week. I usually only wear makeup at dance events and have enough already to get me through the year.)

Also, I have been looking again at all the classes and dance events that are offered locally in San Diego and Orange County, adding whatever possible to my calendar. Just like with the big dance events, I will probably skip most of these, but I really just want to keep dancing!

Finally, I am back to practicing dance as soon as I get into work. There is a microscope room that almost no one uses in the morning. That room is my favorite space for quiet work before anyone else arrives. I also love to use it to dance, which I did this morning. Even as I am typing this, I am doing triple steps under my desk.

Research Roundup #5 – CBT in Anorexia

Because the UCSD eating disorder treatment center used cognitive behavioral therapy (CBT) to help treat my eating disorder, the review “Cognitive Behavioural Therapy for anorexia nervosa: A systematic review” by Galsworthy-Francis and Allan (2014; Clinical Psychology Review) piqued my interest.

Introduction: A goal of CBT is to help patients identify and alter dysfunctional thinking, emotional responses, and behavior. Considering anorexic patients have distorted thinking about their body shape, food, and eating, 88 – 92% of clinicians attending eating disorder conferences recommend that eating disorder patients undergo CBT. While CBT is considered the treatment of choice for bulimia, with strong research support, evidence on the usefulness of CBT for treating anorexia is limited. This article reviewed recent literature on CBT for anorexia, examining randomized control trials as well as alternative studies.

Methods: Only studies from 1995 – present were assessed. All studies reported more than a single clinical case and utilized quantitative analysis as well as assessed patients before and after the treatment intervention. A total of 16 studies fulfilled the authors’ inclusion criteria (5 randomized control trials, 2 non-randomized controlled trials, and 9 individual clinical trials, including case series trials).

Results: For the randomized control trials, the average patient’s body mass index (BMI) was higher after CBT, which was only statistically significant in one trial. CBT trended towards decreases in eating disorder symptoms and improvement in mood, but it was not better than other treatments. There were similar findings for the non-randomized controlled trials. The results for the individual clinical trials were less conclusive but still suggested that CBT can contribute to weight gain and BMI improvements.

Discussion: CBT is not conclusively better than other treatments for anorexia, though it can be helpful. Dropout in CBT trended towards lower than for other treatments. CBT also improved depressive symptoms, self-esteem, and negative thinking in anorexia, but CBT has already been shown to be effective in individually treating these conditions. There were some limitations in the overall quality of the reviewed studies, including mixing adolescents and adults in the same sample (even though family treatment is the treatment of choice for adolescents); disproportionate number of female participants; absence of ethnic diversity; variations in the CBT approach; and substantial variability in the BMI status of the participants at the start of CBT. Still, CBT may improve treatment follow-through, which is important considering that anorexia treatment dropout is 50%.

Conclusion: There is inconsistent information on the usefulness of CBT in treating anorexia. Further research is necessary to determine the type of CBT that is most useful for treating anorexia. (So, this study really did not provide much of a clue about how CBT should be incorporated into the treatment of anorexia besides just recommending that more studies are needed…)

Appreciating my body

Last night, I watched videos of my West Coast Swing dancing from this past weekend and my body image definitely improved when I saw how well I am now able to move my new, fuller body. Yes, I am larger than I was before treatment, but I am finally appreciating my body as an enabler for activity instead of a prison. In full disclosure, I still do not necessarily like the way that I look when I am standing still. However, the graceful, flowing movements that my body allows me to execute when I am dancing are fun to watch.

First, I do not look nearly as large as I often think that I am. Thus, I definitely still suffer from a mismatch between my real-time perceptions and the reality.

Second, I finally look confident and grounded. I compared this weekend’s dancing with videos of myself from before I entered treatment and the thinner me looks fragile, willowy, and airy, which is the opposite of the desired West Coast Swing technique.

I am grateful for my new dance confidence and my progress towards body acceptance.

Prioritizing my needs = awesome!

This last weekend, I attended Swing’n New Years Dance Camp in Palm Springs and had a fantastic time–one of the best times I have had at a dance event in awhile. There were multiple key ingredients that made this weekend an awesome dance experience for me.

(1) Committing to staying overnight and booking a hotel room for myself. Last time I competed in West Coast Swing at Palm Springs (in August), I drove from San Diego, danced in prelims, and then left as soon as I learned that I did not make it into the next level (semi-finals). At the time, I was so glad that I had not committed to staying overnight because I was too disappointed to want to be stuck in Palm Springs for the night. I skipped out on all of the “fun”, evening social dancing (that follows the competitions) because I felt worthless about my own dancing and not being able to progress to the next level in the competition. This year, I reserved a hotel room in advance and planned on staying at the event whether or not I progressed to semi-finals or, even better, finals. I committed to sticking it out and trying to have a good time no matter what the competition results. And, guess what? I made finals this time!

(2) Sticking to my meal plan. I ate my breakfast, lunch, dinner, and snacks throughout the day, which is the first time I have ever strictly stuck to my full meal plan, without cutting corners, at a dance competition event. Somehow, I managed to accomplish this in spite of having body image issues…competition pants weren’t fitting exactly as I would have liked them to fit. Normally, I have a lot of anxiety at dance competitions, but having food in my belly definitely helped to ease my nerves. I think starvation put me into a hyper fight-or-flight mode beyond what normal competition adrenaline can accomplish. I was still nervous for my competitions but was not shaky on top of it.

(3) Projecting confidence. My dance instructor, Brandi, tells me that if you walk and dance like you are trying to hide in a turtle shell, the judges are likely to respect your wishes and ignore you. So, I tried playing the game of acting like I am awesome and my dancing definitely was more awesome as a result. Not only was I more consistently asked to dance in social dancing (for almost every song!), I got third place in my Jack and Jill competition, which gave me enough points to move up to the next level in West Coast Swing (from Novice to Intermediate).

(4) Letting myself have fun. Even before I made it into finals or found out that I got third place, I was having a blast. My dancing was feeling and looking good and I really felt like I was in the moment of just dancing and existing and smiling. Even on my drive home, I was singing and jamming in the car to some fun hip hop music, still happy from the weekend dance high.

I am grateful for this past weekend and for all the progress I have made since I went into treatment. I am thankful I persisted and continued dancing through my dance lows and that I am reaping the benefits of all my hard work 🙂

Proud of Ke$ha

I am proud of Ke$ha for entering eating disorder treatment and being so open about it as she starts the process, as quoted in People Magazine and Us Weekly. Eating disorder therapy is not easy and I wish her the best of luck as she faces the dark side of the disorder. I was not able to be open about the process until after I felt grounded in therapy, and some people never want to share, but I am thankful that celebrities like Demi Lovato and Ke$ha are showing in a very public way that it is ok to seek out help for eating disorders.

Mixed responses

I have been doing really well recently with recovery, except that I came down with a little bit of a cold (complete with nausea) the last couple of days that has severely decreased my appetite and made it more difficult for me to follow a strict meal plan. However, when I do have an appetite, I am continuing to enjoy food more and more, including the yummy dinner my mother made for Christmas, consisting of prime rib, my favorite potatoes au gratin, my favorite vegetables long green beans and red cabbage, and sweet potatoes…with creme brulee as the finishing touch, which I caramelized myself with a blow torch.

I have so much been enjoying the holidays. First, I submitted my first first-author research paper, and the editor-in-chief personally thanked my boss for the submission, which is promising. Submitting the paper has really made my holiday break feel like a break; in the old days, I would take finals and then be free until after the new year started. This year, I submitted my big paper and again am free until after the new year.

I also have enjoyed spending a ton of time with Ben and my family, including my wonderful nephews, so much so that I cried a couple times after I said goodbye to my nephews at the end of the visit. We had fun playing at multiple parks, the dog beach, the pool, and at my parents’ house with all of their awesome new toys, and now that I am doing better in recovery, my relationships are all more meaningful to me.

Second Chances

The program I attended to treat my eating disorder runs a group called after care for former patients to support each other under the guidance of a therapist. Some months ago, I had a really difficult time going to after care. Hearing stories of people relapsing made me afraid I would do the same and I discounted my own struggles to the point that I never let myself have a chance to process (share what I’ve been up to/struggling with) with the rest of the group; I was falling into my old patterns of catastrophizing and minimizing my problems, respectively.

Last night, on a whim, I gave after care a second chance. I had not attended the group for awhile, but I had some extra time yesterday and thought it would be nice to reconnect with others in recovery. I am so thankful that I attended group last night…and I participated. I rated my own need to share as high enough that I got to share first, and it was really nice to get some support on an issue that has been bothering me in recovery. The new me is sometimes difficult for my friends and family to embrace compared to their concept of the old me. So, I asked for some help from the group on setting boundaries in relationships in order to preserve my new sense of self and not fall into my old patterns. The group reminded me to validate the people around me when they voice concerns about the changes in my personality and I appreciate the reminder that everyone needs some validation. I love being validated, and I can understand that when a close friend or family member is concerned about a change in me, it would be nice for me to validate that concern before asserting that I am happy with my new changes.

I am glad I gave after care another chance, and I look forward to receiving more support from the group in the future as well as providing support for my fellow recovery friends.

Cookie Decorating Party

Last night, Ben and I went to a cookie decorating party, and I actually enjoyed eating cookies and other snacks at the party. When I was deep in my disorder, I had such a strong aversive reaction to cookies, especially because if I let myself be near cookies, I might cave in and…goodness forbid…eat one. But, when I was a child, long before I developed an eating disorder, I loved making and decorating cookies for the holidays, including shooing away my parents, grandparents, and sisters from trying to steal unbaked cookie dough from the bowl. I am enjoying discovering all the ways that I am returning to my more natural responses to foods and activities and how much more being free from my eating disorder allows me to interact with the world around me.

The cookie decorating party was additionally fun because it was adult-themed, and all the things that were taboo to talk about when I was growing up were things that we were drawing on cookies and laughing about. So, I can be more grown up (or less, if you count laughing at adult jokes as less mature) while still enjoying activities that were fun when I was a kid. And, it was awesome to have Ben with me last night…as it has been awesome to have him with me since the day I met him.

Snapshot Stress Response

As a result of seeking ways to minimize my stress levels, mostly because I now see how stress triggers my eating disorder behaviors, I am more aware of how I handle stress.

I have been working quite a bit recently on my 1st first-author paper on my asthma research, which has definitely been stressful. I contribute to that stress by first creating unreasonable deadlines for myself, trying to use added pressure as a way to motivate me to work. Then, when I do sit down to work, I browse online, “wasting time” before finally starting on the main task at hand. Often, I then take a food break, during which I am usually more interested in unhealthy foods than healthy foods, much to the chagrin of my quieted eating disorder. When I finally do start working, I get stuck in a bubble of obsession about the work and do not want to stop to eat or do anything besides work. I deny myself time for fun activities throughout the day, like going to the dog park or dancing, because I feel guilty about having wasted time earlier in the day and I do not want to lose my newfound work flow.

I was in the middle of this cycle yesterday, when Ben helped me break it by encouraging me to go run a couple errands with him and stop by at the gym. As a result, I was able to tackle that stressful paper task at a leisurely pace this morning and send a new draft off to my collaborators before the afternoon rolled around.

Distracted by Life

Again, it has been awhile since I have updated my blog. I used to delay starting my work in lab by writing blog entries every morning, but I have recently been starting my lab work nearly as soon as I arrive in lab. Also, when I was avoiding reading research papers for my asthma research, I was reading and commenting on eating disorder papers. I hope to continue posting on my blog and commenting on eating disorder papers in addition to, instead of in place of, doing my work and reading asthma research papers, respectively.

Some recent progress in my recovery has been that I enjoy food more now. Last weekend, I really enjoyed a couple meals. One was a buffet at the Wynn hotel in Vegas where I finished my meal by trying at least a bite of nearly all the desserts available there. (It was also nice that we stayed in an amazing, amazing room at Encore.) My favorite was the creme brulee. Ben and I also went to Firefly tapas restaurant with one of his friends while we were in Vegas, and I realized that I no longer think about how the food is going to end up on my body while I am eating. When I wanted more bites of the tapas food, I took more bites, and I was not worried about extra cheese or grease on my food. I really just enjoyed the flavors, and that was refreshing. Additionally, it has been a lot easier for me to eat meals in general, which may be confounded by the fact that I stopped needing a weight gain diet awhile ago.

I have learned a new approach to working out at the gym. I used to use the machines for isolated muscle work, but Ben recently encouraged me to try working multiple muscle groups at a time with deadlifts, lunges, squats and situps on a yoga ball, among other exercises. The transition to working multiple muscle groups at a time has made my gym time so much more efficient. It takes me much less time to work up a sweat and start to feel sore the next day or so later, which is helping me stay within healthy limits on gym activity.

I am freer without my dance team commitments and I am finally going to go out social dancing tonight at Cheers! My dance instructor and I are both excited for the new transition for me, and I had an awesome dance lesson this afternoon.

I have been way more emotional than I had been for a long time. I feel intense happiness and sadness and everything in between, all of which often inspires tears for me. But, when I have had a chance to express my emotions to their fullest, I feel freer. I even felt safe enough last night, when Ben and I were having an intense, awesome conversation, to cry a little at Panda Express. Normally, crying in public would have been super taboo for me and way too vulnerable, but it felt amazing to express my emotions as I felt them.

Finally, I have not been as rigid about saving my normal, pre-determined amount of money each month the way I had been doing in the past. I would love to be able to save the same amount of money each month, or more, but I am also generally learning to be more flexible and less restrictive with myself and that feels nice too.