Archive for August, 2015

posted by Amy on Aug 20

Attachment disordered people often have eating disorders. Some of them are sugar addicts. Some are overweight. Some work out obsessively. Some become fixated on the “purity” of what they ingest. Some hoard food. Many keep trying reducing diets and regaining all the weight they lost after the diets inevitably fail. Some either overeat or forget to eat when they are under additional stress. Many, including me, cycle through some combination of those and other food addictions.

I am attachment disordered. I have been healing from it, slowly, for about thirty years. But I periodically seek counseling to help me overcome plateaus or roadblocks. In my most recent counseling relationship, I figured out that I simply can’t tolerate feeling hungry, and I connected that to my insecure attachment. Once I had that insight, I began to play, gently, with not doing anything right away when I notice hunger pangs. It’s not an emergency. There is no tiger. I also started experimenting with whether my hunger can be satisfied with less food: one slice of toast and one egg instead of two of each; half as much cereal; smaller portions (in smaller dishes.) And, when I remember to do it, I try to be more mindful when I eat–saying grace, deliberately slowing down my chewing and noticing how the food looks, tastes, and smells.

There’s no “discipline” in this. I didn’t tell myself I “have” to eat smaller portions, or wait awhile to eat after I notice I’m hungry, or eat mindfully. I have no “forbidden” foods. The key was noticing that for me, hunger triggers a gut-level and largely unconscious sense of impending disaster. Once I became aware of that, I could deliberately choose to tell myself new stories about what’s going on. It was never a “weight loss plan.” It was an effort to shore up a weak spot in my development. It’s the only change I made, yet over a period of four or five months I began to shed some excess body fat.

People heal from attachment disorder through “corrective emotional experiences.” I believe that Twelve Step recovery programs heal attachment disorder (which I believe is the cause of addictive behaviors) by helping people become attached to a Higher Power and to their sponsors. Over time, this builds Basic Trust and helps one come to have compassion and empathy, for oneself and for others. My food issues come from insecurity and distrust. I don’t know specifically what caused that, but I don’t need to know.

Part of the inspiration for this post was a question raised by a clergy colleague. He said a women’s group in his church wants to do a book study on a “Christian weight loss” book that he thought was problematic. I did a quick search on Google and again on a religious book website. I found many health, fitness, and weight control books, but they all seemed to be in the “What Would Jesus Eat” or “Pray Away All Your Problems” categories, which I find theologically and psychologically suspect.

But I do think small groups and spirituality can help people become healthier. Humans are inescapably social. Our self-concept and our behavior are formed in relation to others. Further, the human mind is not separate from the body. What we eat, how we eat, and when or why we eat is part of complex feedback loops influenced by our hormones, our body chemistry, and our personal (social) history. Whatever the current state of your mind and body, it is a system in homeostasis. The way you are right now “functions” in some sense. For example, the vast majority of morbidly obese people have a history of childhood incest. What better way to protect one’s body from unwanted attention and touch than to encase it in a protective layer of fat? Simply eliminating the excess weight, such as through bariatric surgery, doesn’t do anything to heal that, so it will fail.

It could be argued that the way to motivate people to heal is for them to have an easily quantifiable objective: Get married within a year; lose four pounds a month for a year; run a marathon. I have gotten a lot done with setting goals and planning ways to meet them. But since that approach didn’t get at the reasons I was judging myself and punishing myself, there was no happiness or satisfaction in attaining a goal. Obsessive, compulsive, and/or addictive behaviors took over in all the areas of my life that I wanted to improve.

Christianity teaches that the highest law is to love God and neighbor. If I were evaluating a small group curriculum, I think that would be my main criterion. If I could find a “Christian” weight loss book that helped people love God, themselves, and other people more or better, I’d probably approve it. But I might focus more on how the group itself functions. Do the members get to know one another intimately? Do the things they do together in their group help them feel more connected with God and with one another? Does the group help its members experience a more abundant life?

 

posted by Amy on Aug 16

In mid-July my oncologist and I agreed I should stop taking the oral chemo I had been on since the preceding December and go back on Abraxane, which I took when I was first diagnosed, and which, along with an antibody drug, cured my liver metastases. We made this decision hoping that the small amount of active cancer in my body can be cleared away in three to six months. If that happens, then I can stay stable and healthy for a long time with just two antibody drugs, which I tolerate very well and which have few side effects. We are acting from a position of strength. Arguably, I was sufficiently stable on the oral chemo that I could have stayed on it.

Abraxane causes hair loss. This time around my hair loss was quite rapid. One day after the second infusion (three weeks and one day after the first infusion) I had my head shaved because I was tired of molting clumps of hair wherever I went.

People tend to think you’re “in remission” if you have hair and you’re “back on chemo” if you suddenly go bald. I overheard a cousin telling someone my cancer had come back. In fact, it never went away. I’ve been under treatment constantly since June, 2011. I have been on at least one antibody drug the whole time and on some other kind of medication in addition to antibodies for all but six months. I get infusions every three weeks, and PET scans about every three months.

Most likely, I will continue to be under treatment until my cancer becomes uncontrollable (or until I die from some other cause.) Stage IV cancer is (still) incurable. The goal of treatment is to control it as well as possible for as long as possible with the best quality of life possible. I’ve had this “incurable but treatable” illness for over four years, and so far I’m a poster child for the new “cancer as a chronic illness” phenomenon.

Maybe there should be another term for it. At the moment “Stage IV” is synonymous with “terminal,” “end stage,” and “advanced.” Once a solid tumor cancer spreads to other parts of the body that’s the end of the line. There’s no “Stage V.” But there’s an obvious difference between someone like me, who’s still basically healthy (except for the cancer. . . ) and someone in hospice a few weeks or months before she dies.

Although I’m doing well physically right now, I’ve seen a lot of people with breast cancer go from “doing well” to “it’s all over” in relatively short order. There is no way to predict when and how I’ll make that transition. Just don’t make any assumptions about my health from how I look or how much hair I have. Right now I have the colorful headscarves and knitted chemo caps, but I’m doing much better than those “traditional” signifiers of cancer might indicate. Some time in the future I might have a full head of hair and look fine, but be close to the end.

Come to think of it, since all humans are mortal, that actually applies to everyone. Life is short and uncertain, so go ahead and be more kind than you absolutely have to be. Because you never know.

 

 

 

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