I wrote about Anorexia and exercise last week and the case for cold turkey. This post is the follow up to that and it addresses lower-level, movement. If you read the last post and thought “well that doesn’t apply to me because I don’t exercise excessively,” this post is for you.
In last week’s post I explained my jump from an excessive six hours or more exercise a day into cold turkey. Now for the second half of that story.
Anorexia is like the shitty gift that keeps on giving. It seemed that as soon as I had conquered one mountain, another, steeper, one emerged behind it. Stopping exercise was one thing. Stopping compulsive movement was another — and even harder because one cannot use logic to argue as to why it is unhealthy or detrimental to participate in compulsive lower-level movement in the same way as for things like running and formal exercise.
I could see that the amount of exercise I did was unreasonable. I could see how it may have been doing damage to my body. I could see how doing it worked against my goal to gain weight and recover. The same could not be said of that not-exactly-optional dog walk every morning. The same could not be said about the frequent walks to the shops. I could not argue physical reasons as to why continuing to do these things were detrimental to my health. But I knew deep down they were.
These lower-level movement compulsions hide in plain sight and can be harder to uncover than the egregious abuses of excessive exercise.
Lower level movement is still Anorexia-generated, energy deficit orientated, OCD and should be taken seriously.
Examples of lower-level movement:
Walking
This one is a killer. Seems so innocent but can be the hardest Anorexia behaviour to overcome for many of us. I had walks that Anorexia demanded that I do every day. Below I outline some more of the specifics around these walks to give some illustration of the OCD element to them, however, some of us just walk for walking’s sake, so compulsive walking doesn’t have to have a rhyme or reason.
Walking the dog — Always a specific route without much variation, and if I did vary it was only to take a longer route. When I moved out of my parent’s house and no longer had a dog to walk, I still did the exact equivalent of this walk at the same time every day.
Walking to the store a specific long route every day — This often meant I had to invent something to go and buy, and then suddenly remember when I had reached the store that I already had enough of it at home so I could turn around and walk straight home. Initially this walk started with the most direct route to the shops. Over time, that route turned into a longer and very indirect path with add-ons and loops. At this point, should anyone else want to walk to the shops with me I would decline and insist on going alone, as I knew that any normal person would wonder why we were not taking the direct route. I’m putting this in there to show more reasons why isolation builds up for activities other than eating.
Walking to various “checkpoints” — E.g. I had to walk to the outside bins location for my block of flats every time I had some rubbish to throw away rather than put it in the rubbish bin under my sink in my kitchen and take it all at once at the end of the week like a normal sane person would. This was so bloody annoying too because I always had to do it immediately regardless of the time of day or night and it bloody rains a lot in England!
Situation-dependent walking rituals — On days when I worked at the pub, for example, I had walking rituals around going about my business at work. i.e. as soon a get there, rather than walking in the front door next to the parking lot, I would have to walk around to the back door. This was approximately a 20 meter difference. A stone throw of a distance. However, I had to do it. I think that it was things like this that broke me down mentally. So negligible. So pointless. Yet utterly unable to not do it. These such rituals existed to every place I visited on a regular basis. As you can imagine, it was pretty tiresome.
Housework
Vacuuming the house, cleaning the kitchen, organizing the fridge etc.
This cleaning compulsion was not something I did initally as much as things like walking, but I do get told about it a lot from clients. I see that it emerges more for people who are relatively house-bound, so people who have young kids, or people who live in places where it is raining a lot. When I moved to Manchester and the weather was worse, this cleaning emerged more as an excuse to move when unable to leave the house. In fact, if I am honest one of the reasons that I was keen on us buying the house that we did was because it had three flights of stairs in it. Of course, I developed all sorts of OCD elements to the housework such as having to keep all cleaning products on the bottom level and retrieving and replacing them one at a freaking time to ensure as much up and down trips as possible. Exhausts me to even think about it now!
I’ll include cooking in here. I have heard this from people who have children too, that they like the excuse of having to cook to be on their feet and while this tends to be a duty that falls on one parent more than another naturally anyway in any household. People report getting resistant to offers of help from spouse/partners and almost territorial about the cooking. While on the outside this looks like they simply enjoy cooking, the underlying reason is a perceived energy burn from chopping carrots etc.
I’m going to include running around after kids in this one too, as I recently had a woman email me telling me she is already dreading her toddlers getting older and more independent as her Anorexia likes it that she is on her feet running around after them and tidying up all day. And by the way, as far as her treatment team are concerned, this woman has been fully recovered for five years because she is weight restored. I would argue that weight restored or not, if she is still having to comply to movement compulsions, there is work to be done to get this person all the way to full recovery.
Shopping
Arguably this ties in with walking but disguises under another excuse. One very interesting entwinement of behaviours here, is for those of us who have a fear-based reaction to spending money (a common side-effect of Anorexia). What I used to do was if I really did need to buy an item, say tea bags, I would have to walk to every store in town and compare prices. Now as one can imagine, the cost of 40 bags of Tetley doesn’t differ much between Safeway, Tescos, and Wilco, but I had to visit every single one of them. Even worse, if I knew that Tesco sold them 1p cheaper than the rest, I would have to start at Tesco, then walk around all the other stores, then end up back at Tesco.
I know. Exhausting. And all for a cup of tea (which was probably awful anyway because I was only allowed to use skimmed milk).
The reason that shopping crops up for so many of us and turns into an energy-deficit OCD behaviour is, again, because we can hide it in plain sight. Shopping for grocery items is normal. Nobody is going to tell you not to go shopping for food — especially if you are underweight.
Shopping for food is fine. Take the car, and go to one store. No walking between stores.
Standing
Well done for spotting that this is not strictly movement. I’m going to tell you about it anyway. It is still a compulsive behaviour for many of us and needs to be outed.
So many of us have twisted rules and regulations about how long we are allowed to sit down during the day. I have lost count of how many clients have told me that the reason that they cannot go on holiday is because they cannot sit down long enough for the plane trip. Of course, they don’t tell their family, friends, and partners this, they make up other excuses.
If you have read any of my blogs you will probably know that I had a standing problem. Or a sitting problem, in that I couldn’t sit. Whichever way you look at it, it was a problem! When one cannot sit, one cannot be very social. When one cannot sit, one’s job options are limited to bartending, waiting, and manual labour. When one cannot sit, it is very hard to be flexible as one has to limit one’s activities to those that will not demand spontaneous sitting.
I cannot tell you how much it opened my world to be able to sit for as long as I liked. It meant I could emigrate to the USA for one. Even more deliciously, it means I can cuddle up with hubby midday on a Sunday and watch a film — these small things make all the difference and spell out true freedom.
Fidgeting and pacing
I’m thrilled to say fidgeting never bothered me. But I know plenty of people for whom it is an absolute thorn. Leg jigging, foot tapping etc. Having to get up and down a lot. Like most of these low-level movements it really irritates the person who has to do it, but they are engulfed in fear at the thought of not doing it. This one also gets overlooked as some people to jig naturally.
Pacing should be included here, as I think in a way it is a form of fidgeting. More anxiety ridden, so rather like an escalated form. I know some people are driven to pace when they eat, and this can be another reason that they insist that any eating they do is done in private. For those of you who live alone and are enable to enlist the support of other people to make sure you sit and eat your meals, there are peer support options for this online. This sort of thing was another motivation behind AEDRA, the meal support nonprofit org. that I founded. Sometimes we can eat, just about, but we cannot eat without weirdness. Having someone there to inhibit the weirdness helps.
Favoring occupations that allow for movement
This one makes me very sad as it can mean a person’s entire working career is dictated by Anorexia. e.g choosing a lower paid waiting career even when you have the grades/qualifications for a much higher paid desk job.
This was me, fresh out of university, deciding that I wanted to work in the pub serving beers and running plates of steak and chips out to the beer garden all day and night instead of continuing and getting my masters degree. Why did I make that decision? Because one can move more when serving in a pub than when sitting in a lecture hall. It was that simple.
I don’t like working in the service industry. I am also incredibly bad at it. I don’t have the right attitude. Or, as one of my ex-bosses put it, I have a bad attitude. He told me that when he fired me. Apparently telling customers to “fuck off to McDonalds” if they wanted fast service is not good for customer relations. Regardless of how very terrible I was at waiting tables, Anorexia insisted that I torture myself and other people by choosing this occupation.
Not only has my recovery done me a favor, it has saved the rest of the world from enduring me serving them at the pub.
All of these lower-level movement compulsions, and any other that you might identify in yourself, serve the same purpose as exercise and higher level movement: they put conditions on eating.
I was floored when post-recovery and talking to other adults with Anorexia I learned that this sort of madness was not unique to me. We don’t tend to talk about this stuff. It is embarrassing to admit. It is bloody insane. I firmly believed that if anyone knew these things I would be locked in a lunatic asylum. I was scared to talk about these things. Now I am glad that I do because it allows other people to out them too.
The best part is that once we “out” them, we have the ability to stop. If they are secret and hidden even to ourselves, we don’t.
When these compulsions exist as our little secrets, trying to overcome them is much harder. Naming them and talking about them is uncomfortable, but in the right environment can be empowering rather than embarrassing. For example, if you are surrounded with other people in recovery in a supportive environment, you know that nobody is going to judge you. You know that everybody in there “gets it” and is working on breaking their very own madcap eating disorder rituals. That is what our recovery Slack group is for.
You don’t need a shrink to stop these compulsions. You don’t need to work up to the right time. You don’t need to spend years talking about them and trying to figure out some hidden meaning. It is an eating disorder generated form of OCD and you can stop. Now.
Step One: Identifying Anorexia movement OCD behaviours
These lower-level movement compulsions had been with me to some extent when I had been taking part in excessive formal exercise too. However, when I went cold turkey on the exercise, more movement compulsions flooded in to fill the space left. That was when I worked out that the Anorexia movement compulsion wasn’t limited to “exercise” as such, and it would take any form of movement it could get.
I was determined to put an end to them all, but it was not as cut and dry as stopping exercise as the lines are so blurry with lower-level compulsive movement. Some compulsions were easier to label as “Anorexia OCD” than others. For example the one where I had to walk the 20 meters extra to go to the back door of the pub served no purpose other than movement OCD so that one was easy to label as such. Other ones such as walking the dog are harder, as arguably the dog needs a walk.
Here is what I worked out to help me sift though the movement and separate the innocent from the compulsive:
If the thought of not doing it causes anxiety and stress, then it is a compulsion and you have to stop.
If the thought of not doing an action made me feel anxious, stressed, cranky, irritable, pissed off, etc, then it was safe to say that my relationship with that movement was contaminated with OCD urges and I had to stop it. Regardless of how “normal” the movement was — walking the dog — no arguments. It had to stop at least long enough for the habit to be broken.
How to do you stop?
As mentioned above, bringing the rituals out of the shadows and into the open is a good step. You can use other people to help you stay accountable in a good way.
The strategy that I used was this: do nothing or as little as possible
When my eating disorder told me it was time to do the dog walk: do nothing — let someone else do it, or drive to the dog park and sit on the fence.
When my eating disorder told me to walk to Tesco to compare the price of tea bags: do nothing — buy the ones under my nose and don’t listen to the thoughts telling me that doing so was both a waste of money and lazy. If you cannot trust yourself not to walk around the shops like a nutter then get your groceries delivered.
When my eating disorder told me to be the first person to jump at the sound of the service bell in the pub: do nothing —Let someone else go. As soon as I did this, working at the pub was no longer attractive and I started having thoughts about wanting to be writer.
Basically. Stop jumping though the hoops. Do nothing when the urges call you. If some action is required do as little as possible. The urges pass. If you do nothing the urge to do the compulsion will pass.
Whatever you do, don’t fall into the trap of not taking these lower-level movement compulsions seriously. They will stay with you until you make a determined effort to stop. Of course, you can weight restore while doing these compulsive movements, but that means you are weight restoring under the conditions of the eating disorder. They will keep you on a tightrope weight restored or not.
And … don’t get emotionally involved
Easy to say “do nothing,” right? What about the flood of anxiety that hits when you disobey?
Do nothing there too. You do not have to participate in your emotions. You don’t have to get involved. Emotions, like urges, come and go, and they only stay if you step into them and empower them. If you step out of the way, emotions will pass by. This is what meditation taught me, and while I am not really into meditation as a spiritual practice, as an eating disorder recovery tool it rocks!
One of the most powerful things I ever learned was that my emotions are optional. I don’t have to step in. I don’t have to get involved. I get to make a choice. Learning this made me feel like Neo in the Matrix. I could take control.
For example, the emotion of guilt and panic at the thought of not following though with my standing compulsion. To be able to not participate in that was huge. Powerful. Sit down and shut up.
What was the one thought that helped me step out of the emotions that I knew were not helpful?
Talk to the hand cos the face ain’t listening.
Mediation doesn’t have to be elegant to work.
Eating disorder treatment has to recognize these OCD-like behaviors
I got an email yesterday from a woman who quit uni because attending classes was interfering with her daily walk that she still has to take. This person has been considered “recovered” from Anorexia for 3 years. Nobody looked past her weight restoration and at her behaviors during her treatment, and she is still having to comply with Anorexia-driven OCD behaviors such as walking to this day. Treatment has to start looking past weight restoration and addressing both exercise and low-level movement compulsions and helping people fully recover.
Treatment needs to inquire. While we are still embarrassed and secretive about low-level movement compulsions, don’t expect us to volunteer them. Don’t even expect us to be honest if asked all the time. Treatment needs to ask. Treatment needs to observe. Treatment needs to use family members and other friends and take feedback and observations from these vital sources too. Treatment needs to take all the help it can get in order to get a complete picture of an individual rather than discard the opinions of family and friends.
I stopped, and so can you
Your eating disorder will tell you that the world is going to end if you don’t participate in all these lower-level OCD like behaviors. You will feel in your body as if the world is going to end when you try and resist the urge to participate in them. I broke into a cold sweat the first time I made myself do in the front door at the pub. I remember it well because it was so bloody hard. But it simultaneously felt like freedom. Freedom to do what I wanted to do and not jump though Anorexia’s hoops all day long.
The front door of the pub was a tiny 20 meter difference that enabled me a couple of years later to fly thousands of miles in a plane without feelings of dread or guilt about having to sit for ten hours straight. It all matters. Every inch you take back from Anorexia counts towards freedom.