Disclaimer: While the reason behind this post may not seem like "a big deal", please know that anything involving food can be extremely distressing to those suffering from eating disorders. My experience was really real and very anxiety-provoking but ultimately led me to understanding my thoughts a little bit more.
Since I am Level 3 now, I get the privilege of participating in the menu planning group here on the unit, which essentially gives me a little bit more freedom in choosing the foods I eat. This past week, though, I showed up to snack on Tuesday night only to find out that an item had been added to the snack I had chosen for that day. I panicked. An extra apple.
Please don't say: "it's only a fruit". That was not the point. I was upset that the dietitians had added something to my diet without my knowledge. I knew in the moment that the snack I had chosen maybe wasn't caloric enough, which might explain why they had taken action and made an adjustment. But the fact that it was a SURPRISE really threw me off guard.
Surprises involving food to someone with an eating disorder are probably the worst kind of surprises. We like to know exactly what goes into cooking our food, exactly how many calories are in our food, and exactly what we will be consuming and when. So when I sat down and looked at a snack that was not what I was expecting, panic ensued.
I was mad and upset for a bunch of reasons, and initially let my doctor know that I no longer trusted the dietitians. Trusting the people who "control" my food is one of my biggest hurdles and goes back to a long-standing distrust towards all the dietitians I have crossed paths with throughout the past nine years of this illness. I thought I could trust the ones here (which took awhile, but nevertheless, I eventually got there), but after this incident, I revoked my trust.
Here is the letter I wrote to the two dietitians following my exit from snack:
"I just wanted to let you know how upset I am that you changed my snack on Tuesday night. I have huge trust issues with dietitians and it takes me a LONG time to place my trust in one. I felt like despite my strong eating disorder telling me otherwise, I could trust you. But changing (or ADDING) food to someone's diet without telling them is a big deal and I am angry that even though we had a conversation earlier that day, you failed to mention anything to me. I am angry that I was not made aware of the change and please know that "surprises" like this are not appreciated given my difficulty to trust the people who control my food. I hope you will consider this in the future".
While my letter may seem like an over-exaggeration to some, this issue with dietitians goes back to my first inpatient treatment in Montreal where my calories were increased without anyone notifying me, so I showed up to lunch faced with a much bigger (and unexpected) plate of food. Since then, I have always had difficult relationships with these members of my treatment team.
I had many, many therapy sessions about the snack "incident" this week. I became frustrated because I felt like the others were failing to see my point. I kept repeating: "I don't trust her" but my message was not really received in an understanding way. Finally, though, my problem with what happened became a little bit clearer. It's not like the dietitian had told me: "I will never change your snacks". If she had said that, and THEN changed something, I could label that as no longer trusting someone because they went back on their word.
Instead, what I was really frustrated about was the fact that she had added an apple to my snack like it was no big deal. Like I wouldn't mind. But I DID mind. Even something as "simple" as an extra apple can wreak havoc in the mind of someone with severe anorexia nervosa. And at the end of the day, I didn't appreciate that my feelings, difficulties, challenges, and the severity of my illness was not really considered.
So it's not that I don't trust dietitians. I think they do the best that they can, most of the time. And we, as eating disorder patients, are not an easy population to work with. I realize now that I do trust my treatment team. But I think what happened here was a wake up call to me: my thoughts are still very loud and very strong. And also, just as important, I think sometimes people forget what a nasty illness this can be. I think that they do care for our well-being but I also think that sometimes they underestimate the complexity of the illness.
At the end of the day, though, I don't blame them. It's impossible to get inside the head of someone with an eating disorder. But for any of you dietitians out there, please know that even the "simple" things can be challenging and upsetting to us.
This is a ugly, ugly disease.