This time, I’ve been watching the series as intended — week by week, with all 5 patients in a row. It’s interesting how much the viewing order has changed my perception of the show. Originally, I saw things more from the patient’s point of view, rather than Paul’s (the therapist). I had no idea what was really going in in Paul’s life (especially since I didn’t watch the one patient, Alex, at all).

Now that I’ve been watching straight through the week, I see things more from Paul’s perspective. He has a life and various patients — all kids of things happen during the week. His real life affects his mood/actions in therapy (though he’s pretty good at separating the two).

It’s interesting to experience therapy from that perspective, since I’m always the patient. I know that my therapist has other patients – not to mention a life outside of the treatment center – but I’m not really thinking about that during our sessions. I’m only there one day a week, so I guess I expect things to be kind of where we left them the previous week. Granted, things happen in my life between sessions, but therapy stands still. Meanwhile, life at the treatment center moves on.

Another good example of this I’d with email. If I email my dietitian and she doesn’t reply, I get kind of frustrated. Sometimes I’m annoyed, but often I’m thinking “I shouldn’t have emailed her, it was a stupid question, she’s too busy” etc. I forget that it’s a one-to-many relationship. She’s my one dietitian, but I am one of her many patients. For all I know, she could get 100 emails a day. My one email is far more significant to me than it is to her.

Interestingly, this treatment point-of-view changes with level of care. When I was in a 5-day program, there was no time lapse between therapy. We were on the same page. I was THERE for all the other stuff. I was still just one patient, but was in a sense creating a lower patient-to-professional relationship (by occupying a greater percentage of time).

Anyway, the moral of the story is: watch “In Treatment” in order!

Last night I watched all of the “In Treatment” Sophie episodes.  I am just engrossed in this show.  I feel so connected to the patients and to Paul.  I think that they discuss such intimate details that I feel like I am part of some deep relationship.  I can relate to a lot of what the patients say, so Paul’s responses are meaningful to me.  It’s also funny that I don’t feel comfortable ending therapy at the end of each season.  In episode nine of Sophie I was thinking, “No!  You can’t go!  There are so many things we still need to talk about.  I’m not ready to end therapy!  I’m still processing things.”

Anyway, one of the things that struck me about Sophie were all of times that she tested Paul.  “Testing” is a good word to describe the scenarios.  I probably would have looked at it differently had he not used that word.  But yes, “testing” is perfect.

I was trying to think if I’ve ever tested my treatment professionals.  I’ve definitely never overdosed, threatened to kill myself, or asked my therapist to change my clothing (I felt so awkward even watching that moment)… but the more that I think about it, the more aware I am of how many times I have tested professionals.

For example:
Nutritionist - With my most recent nutritionist, I’ve turned in a couple of really bad days worth of foods logs to see if she would say something (that wasn’t really the reason they were bad, but it’s the reason I turned them in instead of just not writing those days down).  If she didn’t say anything, then it meant that my following my meal plan didn’t matter.  She passed.  Another time when I felt like she was tired of dealing with me, I stopped making appointments.  I figured that when she decided that I needed an appointment, she would say something.  No such luck — failed that test.

Therapist - Sometimes my therapist assigns me homework.  I’ll do it, but don’t bring it up or turn it in during our next session unless she says something.  If she doesn’t, that means she doesn’t remember and it doesn’t really matter.  She usually fails this test.  It’s probably the only test that she fails, though.  For months I didn’t tell her much just because I didn’t trust her… I thought she would think I was ridiculous.  So, piece by piece I’d tell her little bits of information and watch how she responded.  She was concerned and validating and understanding — definitely passed.  Another big issue of mine is calling/emailing/anything outside of a session.  I just feel like it is not her responsibility to deal with me outside of that hour a week.  I am so afraid that I will be too needy or too much and that I will ruin the relationship.  She says that it’s impossible to ruin the relationship, but I don’t know.  Anyway, I called her one day when I was really upset, and she was there for me and she wasn’t at all annoyed that I called.  Pass.

I could go on, but that’s more than enough examples.  While I do like the word “testing,” I think that it has a negative connotation.  I think that to some degree, it’s a part of therapy — learning to trust the professional.  I hate feeling vulnerable and it takes me a long time to open up and trust someone.  I have to feel certain that the person isn’t going to hurt me, though.  It’s like testing the waters.  It’s hard to build trust.  I need to reassure myself somehow that this person is going to care and isn’t going to walk away when I actually need her.

Anyway, this past week I watched all seven weeks of April’s sessions.  I’m not going to summarize her whole story, but in the last episode she decides to discontinue treatment with Paul (therapist).  She says she can’t continue to see him because he saved her life.

This struck me as a little odd.  I was reading a blog post about it, and the author had a really good point:

“I think this is her way of preserving the feelings and experiences she has had with him, preserving them against the destructive urges she is still experiencing — in leaving school, in believing she cannot have love and a normal life. Leaving now allows her to continue to hold him as her savior…”

Now that makes a lot of sense to me.  She’s been through a lot of pain in her life that makes it hard for her to trust anyone.  She’s always taken are of herself because her parents are preoccupied taking care of her brother.  She probably thinks it’s not okay to have needs or to not be self-sufficient, because she has seen how her brother’s dependency has changed her mother’s life.  She has a pretty tough facade.

I think that on a deeper level, though, she really wishes that someone would really understand her and be able to reach her.  She needs someone to take care of her.  I don’t think that she put off chemo because she really wanted to die, but because she wanted someone else to be the adult and take care of her.

I can relate to that with the eating disorder.  I didn’t want to ask for help — I felt that if I really needed help, that someone would notice that I wasn’t okay and make sure I got help.  i knew that I was hurting my body and didn’t care.  Well, half of me didn’t care and the other half couldn’t understand the severity of the illness.  Never for a second did I think I was going to have a heart attack or end up with osteoporosis or anything.  But, that is like April — she was really sick with cancer and she was still waiting for someone to take care of her.  For someone to tell her that treatment mattered — that SHE mattered and that her health was important.  That she was worth taking care of.

Not only did she not want to have to ask for help, but I think that she felt guilty for needing help.  Not really guilty for having cancer, but that the cancer and her treatment were going to affect other people.  She cared more about not burdening her mother than saving her own life.  Again, I understand that — it’s easier for me to suffer than to hurt someone else.  I hate that my eating disorder affects other people.  I try to minimize the significance of it… not because I’m lying or trying to be manipulative, but because I don’t want to be a burden to my fiance, friends, or family.

I also know the feeling of your therapist being your “savior.” I don’t think I would have ever personally chosen that word, but when someone really does understand and connect to you on that deeper level… when they do just know that you’re okay and take care of you when you don’t ask… that’s valuable!  You have spent forever believing that it would never happen.  And now that there is someone in the world who can connect with you in that way, you’re afraid to lose it.  The thought of being let down by that person is too much to bear.  Or, even worse… what if you drove that person away?  You could ruin the relationship.

I have two theories on why April decided to discontinue treatment with Paul.

1. I think that sometimes when you get what you need, you can move on with your life.  April needed someone to take care of her in that moment and to show her that she mattered.  Paul repeatedly showed concern over her not taking care of herself and eventually even drove her to chemo.  She felt that loved — and that’s what she needed.
2. She wanted to think of Paul as her savior or caregiver, and not just her therapist.  He told her in the previous session that he couldn’t play both roles, and I think that she would rather pretend that he could than continue a relationship where he was just her therapist.  It’s less painful.

I know that I have jumped all around in this post, but basically — I could relate to a lot of the issues that April was dealing with (minus the very real threat of death… and losing my hair).  The therapeutic relationship between her and Paul was familiar to me.  I question her ending treatment with him, however, and am very suspicious that her decision was motivated by the fear of losing someone important.

1. You must abide by “ED recovery etiquette” – By this I mean, no matter how crappy you are doing, when you go out with a friend that you know has an ED or whom you know from treatment, you better suck it up and act as normal as possible… because triggering a friend is not okay.

2. If I can’t get a salad for dinner, neither can you – And I can’t, because then it would be considered eating disordered. So order something else.

3. It’s not fair for you to skip breakfast and skimp on lunch, and then give me crap when dinner isn’t my largest meal of the day – While you were sleeping, I was enjoying the most important meal of the day (breakfast). All meals being equal, your skipping 1.5 of them doesn’t put you in a position to be criticizing my dinner.

4. Please please please don’t order the same thing as me at a restaurant – Because restaurants are challenging enough, and I don’t want to be comparing how much I ate to how much you ate.

5. Don’t eat my yogurt – I’m sure this is unique to me… but there are 100 kinds of yogurt in the world — why eat mine? I think it’s more the switch from a different yogurt to my yogurt that bothers me…

6. Things you can’t say: You’ve lost weight. You haven’t had an appetite lately. Wow grey, you’re always cold — you must have no metabolism. You’ve doubled your workout plan lately. You’re not eating ____ food anymore. Our friend has lost so much weight. Our friend needs to gain weight — she’s too thin.

,,, I could go on, but I’ll stop. feel free to add your own

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