New Job Working with Traumatized Adolescents with ED

[Kintsugi]

... is maybe killing me? Maybe it’s helping me, which sometimes feels like I’m dying? I’m on the fence by the hour.

Something really bad happened my first day off. The whole day was a shitshow from the start.

But speaking of starting, I’m going to start from the beginning.

I don’t even remember how to save drafts so I’m posting prematurely to switch to my tablet. Must has keyboard. This feels like a long’un.

 

[hithere]

I'm listening...

 

[Kintsugi]

Okay. I was anorexic when I was a teenager, after getting out of an abusive relationship with my first boyfriend, which culminated in him raping me in my garage and doing what would today be called stealthing, although it wasn't stealthy, it was spiteful, and it resulted in an (obviously) unwanted pregnancy at 15, which then resulted in a very traumatic abortion.

So I'm 15, and I'm still living with my primary abuser, my brother, who has at this point confessed to sexually abusing me for years when I was about 3-6 years old along with about a dozen other young teen boys. I've just had an abortion, which I realize now was executed very poorly, probably thanks to the intervention of my mother. No one even gave me a tylenol. I had no information. I just laid back and tried not to scream. It felt like rape but worse. I was unprepared and young and scared. And that's what broke the spell with my boyfriend. I kicked him to the curb. Then the ED began.

I didn't realize I was anorexic until about a year later, as I didn't realize you could eat and be anorexic at the same time. I was eating between 200 and 600 calories a day while working at a rock climbing gym and basically living at the gym. When I wasn't rock climbing or helping other people rock climb, I was training at home. The only time I wasn't exercising is when I was doing homework. Oh yeah. I was taking a full load of college classes, because I started taking courses at the community college when I was 13, and by the time I was 16, I was up to a fulltime schedule there. So there's that.

What I'm trying to say is that I was stressed the f*ck out and anorexic. I also had a total breakdown around this time. I wouldn't sleep unless I was at my (new) boyfriend's house. I sipped on instant miso soup all day to keep my metabolism running as high as possible when I was in school. Half a banana for breakfast. A cup of miso for lunch. Two chocolate chip cookies for dinner. Starving is so euphoric. Dissociation was my best friend and drug of choice. Not eating helped. I developed hypoglycemia around then, too. And I was vegan, so when I went from 155# to 118, everyone just assumed it was because I was so "healthy." I drank so much water that when I went to see a doctor after feeling sick for weeks on end, and he asked me how much water I drank, he told me I should be dead from water poisoning. But my parents were thrilled. They're obsessed with body weight. So much so that 10 years later, after all of this, I saw them four days after suffering from the most violent stomach flu I've ever endured, which made me scared to eat for a week. I was pale and gaunt. They said I looked fantastic. Did I lose weight?

Ugh.

So yeah, I've got baggage. And now I'm working with adolescents with ED in an inpatient facility. PTSD is typical. Being an adoptee is typical. Families who aren't doing any of the work with their kids is typical.

On the one hand, everyone loves me, and I believe in the facility. I like it. I like how it's run. I like the medical team (except the super f*cking weirdo nurse who is bordering on harrassment, but that's another story). And the kids responded positively to me in record time by all accounts. They're opening up to me quickly. And that's great. It feels good. I've put enough of my time and energy into this forum that anyone who knows me here should know that working with trauma sufferers is one of my greatest passions, and helping others has always been a massive help to myself.

But I also never got treatment for my ED, and recently I went through about 18 months of anorexia brought on by graduate school and other stressors. I just recovered a couple of months ago. But I recovered to what I was before I began shrinking so fast my boss staged an intervention. And now that I work here, I'm realizing that what I was before wasn't normal. I've had disordered eating this whole time. It just wasn't bad enough for anyone to care, most of all for me to care or notice. I've eaten once at 6pm and then something around midnight for the past five years, and before that, I was too poor to eat that regularly. That was me at my best.

Now I have to eat with the kids, and after three days, it started seriously f*cking with me. I'd never heard about "EDBs" before (eating disorder behaviors). I never talked about ED in therapy. I never got treated for it. I got lucky. I went on a prolonged trip abroad that essentially cured the worst of it, but I never addressed it head-on aside from trying to recover last year because I was slipping into starvation so fast my pants weren't staying up after a month of owning them.

So yeah, apparently I have a bunch of these classic ED behaviors I didn't even know about, and when I eat with the kids, all those things are no-nos. So I just had to, like, get over myself without warning, pronto, and after three days of pretending to be normal I started feeling extremely panicked about it. Like some kind of whiplash.

So I work my first week. I have a day off. It's a shitshow from the time I get up, because the reason I have this job is that a close friend of mine from my alma mater, which is in the city I just relocated back to (as did she last year), is a therapist there and recommended it to me and me to them. And she'd left her meds in her (unlocked) office, which included her adderall. Well, idfk what happened, but I got the bag out, locked it in my car, and then it f*cking disappeared. Me and my fiance looked everywhere for it. The only place it seemed it could be was in the dumpster where he'd thrown away our trash the day before. Which was in another state.

So we took a road trip and went dumpster diving. Needless to say, things were not hunky-dory between us. Oh yeah, by the way, because of the financial stress of moving and getting new jobs, I had to reschedule my psychiatrist appointment and decide which meds to refill and which ones to put off. So I was withdrawing from a medication during this fiasco, which was a fire I was trying to put out by taking about 3X as much of my PRN clonopin. I usually take such a lose dose that it didn't even pop positive on my recent pre-employment drug screen. Sunday I took the highest amount recommended by my P. Maybe .25 more. I don't even remember. I was freaking the f*ck out about losing my friend's medications after she just got me a job.

So it turned out that the adderall wasn't even in that bag, which by the way wasn't in the dumpster either. We had a long f*cking day. We were supposed to go out and eat a fancy lunch, catch up with my therapist college coworker buddy for some live music that night.

Instead we bought some whiskey and fast food. Did I mention I hadn't eaten all day? Yeah. I was finally not being compelled to eat, and I didn't until around 9pm, at which time I decided it was a great idea to eat a bunch of french fries (so... sugar) and drive home.

We get home. I take more clonopin, because I am still in a total shit mood from the withdrawal. I drink. And drink. And drink. I didn't drink more than I usually do, but still, I had at least three drinks before I took a shower. I never did eat the rest of my food.

I get out of the shower and start picking a fight with my fiancé. Why? Idfk. I'm about to start my period. I'm trying to process this extremely emotionally draining job, which is confronting me not only with my ongoing issues with food but forcing me to see these young kids who are the same age I was when MY life was going to hell just like theirs, and it's all just dredging up so much shit for me, and then I'm withdrawing, and withdrawal from this medication always makes me angry and temperamental. I'm wearing something between a nightgown and a negligee while getting pissed over nothing. I grab my keys to go sit out on my car to cool off.

Well. My fiance has a history with a longtime ex who also had a trauma history, except that ex used to get drunk, get mad, and then go out and try to f*ck as many people as possible before she sobered up. I'm not thinking about this when I go out to sit in my car. I'm thinking about turning on the AC and listening to a f*cking podcast. But the next thing I know, my fiancé is in my car yanking away the keys and storming off back to our house.

So I get pissed off and go back inside to demand the return of my keys. He thinks I'm going to leave. I'm not going to leave. At this point, things get blurry, because the benzo-whiskey-no food combo is kicking my ass. I call my mom, because now I feel trapped and upset, and I just want to talk to someone who isn't treating me like I'm a psycho, which is how I'm interpreting the taking of my keys.

For reasons that are still completely unclear to me, after I get off the phone with my mother, he takes my phone away. That's when everything goes really south.

I tried to get my phone back. He restrained me. He's way, way, way bigger than I am. He doesn't know he's crushing me. And me, I'm having a f*cking flashback, because I have a history with this shit, and I start screaming bloody murder. And this is when shit really goes dark in my memory.

The next thing I clearly remember is getting away from him and running out of the house, barefoot, screaming for help. I flag down the first car I see. I don't know what I was thinking, but I do know I felt like someone was going to try to kill me. I'm not in touch with reality at all at this point. I'm just completely terrified. Oh yeah, and I look like someone beat the f*ck out of me because of the struggle over my phone, during which I was knocked into a bunch of shit, because we live in a tiny house.

The person I flag down is my landlord, but I don't know that until my fiancé, who has pulled up in his car, tells me so. I don't really remember any of this. I got in my landlord's car. My landlord comes into the house. He tells me to put on some clothes. He tells my fiance to give me my phone. These things happen. My landlord walks me out to the driveway so I can get in my car and be alone. I beg for his forgiveness the whole time, because now all I can think about is that I look f*cking insane and this man is going to evict me because he thinks I'm a liability.

I wake up the next morning with a total PTSD hangover. Not even a whiskey one. It wasn't really the whiskey that did me in. It was the confluence of whiskey and clonopin with a sugar crash. And all I can think about is how this job really pushed me over the f*cking edge. Nothing like this has ever happened to me before. Nothing near this magnitude.

Oh yeah, I also remember I called RAINN after I got my phone back, because I didn't know what to do. I still wasn't thinking clearly, and I felt like I had been in a car accident. And the next morning, I realized why I felt like that. I look like I've been in a car accident.

I work in a facility full of therapists and, y'know, mandatory reporters, and I look like a battered woman. I feel like shit. I'm totally embarrassed. I'm scared to leave the house because I know the next door neighbors, who are also my landlord's tenants, heard me screaming bloody murder for about 20 minutes straight like a raving lunatic.

I don't even know what I'm getting at with this post. I might not be at the "getting at" stage. I realize this could and maybe should go into dysregulation, but my main concern is this whole job thing. My mother thinks they're taking advantage of me, because I have a master's degree, and this is "beneath" me. But I'm so passionate about it. But also it kind of feels like it's going to kill me. But then other times it feels like it's a way for me to help myself while helping others.

I just needed to write everything down. And I hope that someone out there has some words of advice.

I know the whole battered woman thing is going to come up in the comments. I always hated it when people wrote "don't respond if it's about X," because people writing threads really shouldn't try to dictate the feedback they get unless it's truly totally irrelevant, but I'm probably going to ignore anything suggesting my relationship is abusive. He's already agreed to premarital counseling and said it was reactive and dumb to take my phone away, and he's promised not to do it again, and in the 2.5 years I've known him, he's never broken a single promise to me, even when I was sure he would for one reason or another.

That is all. Thank you for reading.

 

[Sideways]

Very long. Probably mostly completely not helpful...

So, I know you probably want advice about whether this job is a good fit (clearly not at the moment...maybe sometime in the future), how to make it work...

That can wait. You’re a hot mess. Gotta get your head straight first, yeah?

I’m gonna put it out there that I don’t think your partner should be dragged over coals for this. In the state you were in, any responsible adult should have done almost anything necessary to get your keys off you.

I get your flashback issue, and the car is my safe space too, and I’m really sorry it worked out the way it did.

But when we aren’t sober? We aren’t allowed to sit behind the wheel of a car with the keys. Period. Regardless of our intentions, you were not sober (and not just due to alcohol), and your behaviour was unpredictable (even to you)...I’m sorry, but that shit is really unsafe (for you and the people in your neighbourhood).

If you need to sit in your car in that state in the future? You don’t get to do that with your car keys. No one does. That shit ends with good intentions and dead pedestrians too often.

Could have been handled better? Sure. With the benefit of hindsight, your partner could have done a lot of things differently. But sometimes, you step in and keep someone safe, regardless of whether they like it. Which is what he did. So, maybe go easy on him...??

He actually sounds like a keeper this one. Things got tough for you, and it turned into a shit storm. You’re the first one to own that you could’ve done a fair few things better as well.


Right now? You are not okay. Your pdoc didn’t get the chance to say it (or hospitalise you), so I will: you are not okay.

You are using a whole list of dangerous coping strategies to keep your head above water. What advice would you give if this was one of your patients, who had just got out of treatment, doing great, then hits a wall? You absolutely wouldn’t tell them to cope using dangerous eating habits, misuse of prescribed meds, throw in alcohol for the trifecta.

That’s not gonna work. That’s a disaster in the making. That’s gonna cost you this job, and more, if you don’t find another way forward.

But being real with your employer? Might work.

You have a shittonne of insight into exactly what’s happening here, and what’s caused this issue. And you are an incredible asset to this team. If this is your passion? It’s too early to quit. But this, as it is? Isn’t working.

So maybe work with your boss to find a work regime that’s going to work for both of you. Hours, tasks, put everything on the table. Brainstorm. How can we do this differently?

It is okay to work around these issues, find a way for flexibility in the workplace. It doesn’t have to be all or nothing, 100 mph or sedentary.

If sitting with the patients during mealtime is too confronting for you, for example? Too hard? Haven’t worked through those issues yourself yet so it’s not a strength? Talk to your boss about it. You’re one of a kind employee for them, so go in with ideas, strategies. Work smarter, work differently.

We have mental health issues. Doesn’t mean we can’t work. Sometimes, it actually makes us better employees. Like you, here, with this employer, doing this job. But we do, often, have to work differently to what the norm might be for other employees.

 

[scout86]

I like your landlord, I think.

Your employers know about your ED history, right? If they do, my thought is you have a serious talk with them where you mention that you just realized you never really worked through all your stuff, and there's stuff that needs to be worked though. "What can we do about that?" By doing so, you'll not only be able to do that work that needs to be done, you'll be a good example for the kids you're working with.

The rest of it....... You know, in every relationship worth having, once in awhile a do over is a good thing. You weren't really thinking with what my T likes to call "the rational part of your brain that we'd all like to think is usually running the show." And, for totally understandable reasons. He probably wasn't either, also for understandable reasons. There's stuff there you each probably regret and wish you'd done differently. You've talked about him before and he sounds like a potential keeper. Can you guys talk theough what happened and agree to do a reset? And, maybe, come up with some predetermined ways of calling it when things start to go sideways and a time out is called for?

 

[theshadowoftheliving]

It's always amazing to me how sometimes things get assimilated into normal accidentally for those of us with long-standing struggles. I feel you on the eating thing - I was also treated for an eating disorder as a teenager, but became convinced that it was a problem I had solved.

I started to wonder about that just tonight. I'm taking a language course, and we were asked to describe our favorite meals. I literally couldn't come up with any. I don't eat meals .... I eat things. Sometimes. And when I eat things, they aren't usually assembled or presented, or really anything other than a means to an end.

I left wondering if I have more trouble with food than I thought. And maybe, the other problems are just so big that this one has seemed like the least of my worries (and the least of the worries of the people who are treating me).

 

[Justmehere]

Damn. It’s been one heck of a week for you. I’m so sorry no one had really been there for you except kind of the landlord.

Here’s the thing about “looking like a battered woman”... Most people won’t say anything at all. I have been there and looked like it, and found that my own doctor didn’t even say anything. There were social workers and counselors on staff at the agency that I work for, none of them said anything either. A stranger on the train asked if I was ok, and I told her I tripped. She shrugged. People will blow it off in unbelievable ways. The closer people are to a person, and the more that person is like themselves (like they are a co-worker) the less likely they are to speak up about suspected abuse. Yes, even trained pros. Unless they are super healthy and super on top of their own stuff.

ED treatment centers and other facilities like the one you are working at tend to have very high turnover rates for people who don’t have histories of mental illness and ED, even higher for those that do. Can it work even when someone has an ED? Yes, in fact I know someone who did make it work while actively anorexic and it was helpful for them and the process for their clients... but it didn’t work at the first few places they worked at. They told me about how it generally takes a few things including: 1.) Staff have support on the job or in their lives outside the job for how they might struggle with the job. 2.) It’s ok to have limits. Self care is highly valued.

Instead of you describing having solid support on or off the job, or saying no to taking on too much all at once, you described a lot of taking on responsibility for solving other’s serious safety related mistakes (Adderall in an unlocked office? Ugh.) and a variety of other things that are not your own to take on.

If the support is there, I hope you consider using it. If you can say no to eating with the kids or etc, or managing other staff’s issues right now, do it and take it off your list of things to you need to manage. Even if they are a friend. I know that in the past, go-go-going means you could keep avoiding but with everything in your face, now is the time and space to find support and become a self care expert, just like your clients will need to do.

I hope you heal up fast and things settle out very soon.

 

[hithere]

Thank you for writing this all out. I followed it. I completely can relate and it felt like a scene(s) out of my own life--Putting it out there in writing and looking at it I hope helps. I really, really, really feel for you. You ask for advice and this is the only advice I can give: "Believe that you will be ok, and you will be ok. you will get through all of this. this isn't the end of the world, nor is it the end of anything." I hope that your boyfriend may be a source of comfort even though it is a "wild ride" between you two. You will get there. You already know and see what has happened.

May I ask for clarification? Do you mean that you just recently had an abortion that your mother intervened with, or are you referring to the abortion at age 15? Abortions are traumatic and taking the time to grieve is often denied and overlooked and blocked out and can be one underlying source of pain leading to ED. I wish you so much peace that you deserve and I honestly think you are doing a great job at your recovery.

Edited to add: You MUST address the alcohol. Yes it was the whisky. even without all else you say. I was in total deny about the alcohol and your writing that it wasn't the whisky, but the combo: NO NO NO-- It was the whiskey. Yes--there's everything else. But Whiskey or any alcohol at all including lite beer screws up EVERYTHING EVERYTIME. I beg you to believe this for your own sake. You cannot address everything else if you don't address the alcohol first. Sorry. But I can't let that one slip by.

 

[The Albatross]

Too bad you can't hook up with Spock anymore by PC.. you guys could mutually benefit each other Simon.

 

[The Albatross]

Here's the thing Simon. Open spots are disproportionally open for a reason... most always shit shows with high turnover. The trick is to endure and hang round enough to scope out better positions.

 

[Kintsugi]

Firstly, thanks for all of the listening and nonjudgmental responses. Nothing like this (alcohol + benzo + trigger = f*cked) has happened since I posted about an emotional flashback I had at a party over two years ago.

I wasn’t worried or blaming my partner for taking my keys. It was when he took my phone that things got way out of control. He’s promised never to do that again, and he agreed immediately to premarital counseling so that we can both stop reacting to each other out of fear that’s borne out of our respective pasts. We’re also quitting alcohol; it’s never been a priority so much as a thing we intermittently have, like grapes or popcorn.

Here's the thing Simon. Open spots are disproportionally open for a reason... most always shit shows with high turnover. The trick is to endure and hang round enough to scope out better positions.

I completely agree with you on that.

I was wishing you were here today while a fifteen-year-old lectured me about how I need to be more sensitive to potential triggers. :roflmao:

It’s okay. She forgave my negligence, because I’m inexperienced at ED and mental health struggles... :whistling:

 

[Kintsugi]

I’m just going to keep on going here as I evaluate this position.

When I worked for the government, everyone was always terrified of privatization, and I never really understood their mortification. This job is private sector, and at first, I thought—this isn’t so bad. It’s much more lax. Things are less regimented and paranoid-making.

Wrong.

I’ve come to see how maddeningly disorganized it is. At my previous job, everyone knew what policy was and what practice was. When I trained someone, and they asked a question, I could say, “This is what you need to know about our policy. This is how we do it in real life. You decide when to deploy which strategy.” Corners were cut and policy snubbed out of necessity and practicality (I once did the math—there were literally not enough hours in the day to follow every single rule and scheduled step). But at least we had rules, and everyone knew what they were.

It feels very much like the lunatics are running the asylum here (forgive the idiom, my fellow diagnosed denizens). The people who should know best undermine their subordinates by not following the policies that they don’t know. And the leadership tends to be volatile when questioned about direct contradictions created by their mandates, then blame it on being overworked. You know who are overworked and unable to afford the fallout of any whiff of volatility? Hmm... we the people on the floor.

Chasing the idea of consistency around here is like chasing a dragon. It sucks when you’re there to help and everyone else just wants to avoid being fired or chastised. I give zero f*cks about that, because I’m in this magical place these days where I don’t have to work. My pay is just gravy, my work a hobby that I’m using as a steppingstone and networking opportunity. But man it’s f*cking annoying to work in a place where no one can agree on the most basic ideas. I’m trying to focus on helping kids save their own lives, yet I’m constantly sidetracked or stonewalled by the accidental conspiracy of those at the top making me chase my own tail.

Tutoring rich kids at an obscene rate is starting to look pretty f*cking appealing.