Substance Abuse: Choice or disease?  

Currently, I am taking a graduate course called Substance Abuse Counseling. Today we were asked to write a discussion post taking a stance on whether substance abuse is a choice or a disease. Although smoking crack, shooting heroin, snorting lines of coke or drinking liquor by the liter all sound much different than an eating disorder, to our brain they are much the same. An addiction, an addiction that grows from the time of initial use. There are all kinds of deeply-rooted emotional, personal and/or societal reasons onechooses to start abusing a substance. 
Although I think this may stir up some controversy, I believe that eating disorders are not much different… ultimately a choice. Below is my discussion post that defends my opinion:


   I believe that anyone who initially chooses to pick up a cigarette, a pipe, a joint, a bottle of beer, a shot glass, a needle, et cetera does so by matter of 50:50 choice. Its a rather simple choice if you think about the easy hand to mouth, or similar, movement they all involve. Either you say yes and grab the substance or, you don’t. Yes or No. Accept or decline. All are a choice on a dangerously polar scale.

   Once a person says yes and accepts a substance, this is where disease grows. We all are likely to know that some substances are more addicting than others due to their chemical make-ups. Because of this variance in addiction qualities, some substances are easier to say yes to only once or twice and then, never again. Others, not so much.
   When the more addicting substances are involved, disease grows quickly and inevitably. In order to rid yourself of the more addictive substance driven diseases, detox may be required. Once detox is completed in success, this leaves the substance abuser with another choice: to pick it up again or not. This is where the disease gets more complicated.
   Because of the reward center in our brains, some people may have a genetic disposition to crave and continue to seek, not the drug but, the previously experienced “high”. Can’t forget about one’s environment… if a drug user or abuser is located in an environment where substances are prevalent, they may be left with more of the same use-or-not-to-use choices than those who are in cleaner environments. Because of our brain’s stronger recollection of the pro’s rather than the con’s of previous substance use, the brain will urge a person to give in and just say yes again.
   By no means whatsoever am I saying this yes or no question is an easy 50:50 choice. No. However, ultimately, it is still what it always was, a choice.
As a recovering disordered eater, I will tell you that my substance abuse was NOT easy to say no to. However, I always had a choice. My acceptance of that fact, that it is MY CHOICE, has been one of my biggest saving graces. It never had to be catastrophic, I just had to make a different choice. Although my brain and mind might have urged me to binge and/or purge, it has always been my right and my ability to say yes or to say no, no more.

Gratefully, I can now say I have learned and adjusted and accepted… I choose no.

What’s the reward in Anorexia?  

In a discussion the other day, the topic of rewards in disordered eating behaviors came up. One of the questions I was asked is: “what is the reward in anorexia??”

The person asking me the question spoke about how they could understand the temporary rewards or pleasures from binge eating behaviors in disordered eaters but, could not grasp the reward in restrictive eating patterns found in anorexics. So, I pondered…

So… what IS the reward in the seriously restrictive eating patterns found in Anorexics?

Part I: –> Hunger Pangs

I battled anorexia here and there in my fight with disordered eating. Borderline Anorexia is how it all started for me… (I will make sure to remember to blog about my eating disordered start, soon). Basically, I had gone through months with horrid stomach pains due to eventually diagnosed gall bladder disease and pancreatitis; the mentioned caused me to undergo a cholecystectomy or, gall bladder removal surgery. I had an NPO order upon my hospital admission meaning: absolutely NO food or liquids, whatsoever, by mouth. And, when they said NPO, they really meant it; like, I was seriously instructed to spit out my spit. No saliva. No nothing. This, literally, taught me how to go weeks without food. It taught me that, if you let it go long enough, your stomach will just give up and stop growling. After 2-3 days, I didn’t even care to eat. And, after surgery, I really didn’t want to eat because, well, it hurt.

A natural bodily reaction to hunger is hunger pangs. According to Webster’s Dictionary:


Definition of Hunger Pangs: pains in the abdominal region which occur in the early stages of hunger or fasting and are correlated with contractions of the empty stomach or intestines.


Hunger pangs is your stomach’s verbal unhappiness with being hungry!

Part II: –> Hunger Pangs = Restrictive Game ON

The moment hunger pangs start is when the anorexics restrictive dieting game begins. Holding out until the stomach gets the hell over it and moves on is the goal.

But, what’s the motive?

Part II (cont.): –> CONTROL meets COPING mechanism


From the research I’ve done and the experience I’ve had, establishing and maintaining control and/or coping via disordered eating mechanisms are almostalways the motivating factor in restricting. And, by restricting, I surely don’t mean just not eating that extra dinner roll or that cookie after dinner. No, no. This is a much more seriously-restricting matter.

Once an anorexic has passed the point of hunger and their hunger pangs cease to pang, they have (for now) won the hold-out, restricting game. If you ask an anorexic, they will more than likely tell you, this is not a fun-and-games type-a deal. Nah… this is a terrifying, anxiety-laden, life-or-death-matter type-a deal. They must restrict and they must beat the pangs and win the game, or… well…

Disaster in Part III: Euphoria meets Failure

Euphoria is to restricting just as catatonic states of binging is to a binge eater or bulimic.

…Euphoria turned Failure.

Failure like minutes-pre-binging to a bulimic. Guilt like minutes-before-purge to that same bulimic. Shame like minutes-post-purge. Anxiety like minutes after moments of revelation to any disordered eater. Revelation. Disordered eaters are well aware at some revolutionary moments in time that what they are doing is nothing short of disastrous. But, sadly, the devastating and irrational cyclical game usually wins and continues to spin… and, spin… and, spin…

And, Repeat:

Part I…
…Part II…
……Part III…

So, what’s the “reward” in Anorexia. Well, I guess the (sad) answer is:

To continue, and, to continue & continue to WIN

The goal and the reward is to continue to win a quite literally, continuously losing, restrictive game.

Incredibly humbled, post-OA meeting…  

As part of my master’s degree program and substance abuse counseling class, I was asked to attend two 12-step meetings of my choice. Naturally, what do you suppose I chose?

Overeaters Anonymous.

OA, like AA or NA or et cetera, is based on a spiritual plan of 12-steps. Each step, completed in order and in successive completion, until you reach the ultimate goal. Abstinence. In the case of OA, abstinence entails refraining from all types of disordered eating. Compulsive overeating, binge eating, bulimia, anorexia…all so different but all the same = disordered eating.

Tonight I attended my first Overeaters Anonymous meeting. From the moment I walked in the door, I was greeted with acceptance and with cheer. I introduced myself as a student from my mental health counseling graduate program coming here not only to complete a class assignment but, to learn. And, learn, I did.

I learned a lot tonight. I learned a lot and it was overwhelmingly humbling. I listened to those who suffer speak of moments of hopelessness and moments of grieving with guilt and with shame. I listened to those who are abstinent all the time, some of the time, and, sadly, some that are abstinent almost none or absolutely none of the time. I listened as they defined Freedom as Abstinence; Acceptance as thee way; recovery as indescribable gratefulness; Surrendering as a way to peace.

They, as an OA group, described themselves as self-contributing. As they readied to pass around a basket for monetary donations, they asked the circle to give as they could and, as one did, to recall their last binge. This, I assume, to be a way to substantiate your donation to a cause whose purpose is to promote your future abstinence.

As I sat there swallowing my tears, I donated the lone $5 bill I had in my wallet, and I tried to think of my last binge and my last purge. It was then that I was overwhelmed with an unbelievable sense of grateful humbleness. I really had to think back; I had to think 5 months back. I haven’t binged in months. This, I realized, as I sat in that circle, was a huge and meaningful, hard to come by, total victory. I sat there victorious amongst others who may not have ever been quite so victorious. Joyous, proud humbleness…

My heart beat steady but staccato as I listened to a middle aged woman introduce herself and describe herself as a bulimic. Everyone said hi to her name, but I sat there silently and vastly intrigued. She spoke of her very long-time battle with bulimia, how she swore to change after marriage, after childbirth, after relocations. She swore she would not do it again. Everytime she did it again, she swore the same thing again. “With bulimia, there is no end. I can empty myself and start over.” This is raw, unedited, sad truth.

As the meeting began to come to it’s close, they began their coining ceremony. One chip denoting newly committed membership and 1 day of abstinence; another chip denoting a month or multiple months of abstinence; another chip denoting a year or multiple years of abstinence. As my heart beat almost out of the walls of my chest, I raised my hand for the month-chip. I raised my hand and as I was handed a chip I followed the 12-step lead: “Hi, my name is Jessica, and I am a grateful 5-month recovered bulimic.” Everyone said hi to my name and I was changed.

I had never gone to OA. I had never really gone to counseling. I had never seeked inpatient or outpatient treatment. Yet, I was months in recovery. Why me? Wow… what a blessing… a blessing I have no other choice at this present time or any future present time but to give myself undeniable, insurmountable credit for. I did it… and I am doing it.

After the meeting was called to an end, the woman sitting next to me asked how I did it. In short, I told her I relabeled my suffering as divine destiny. I told her with complete and real conviction that I believe I suffered for a reason. And that reason is now my passion and my purpose. It is my passion in Eating to Live, Not the Alternative. It is my passion in future counseling and inspiring. It is my passion in speaking, writing and promoting.

This is my passion and I know it has been given to me by something greater than myself. I am humbled and I am certain; I have undoubtedly found, via blessing, my ultimate and divine purpose in life.

Eating to Live, Not the Alternative… this cause, this passion, this purpose, it proudly and humbly defines me.

My first speech… feedback, please!  

On September 18th, I have scheduled my first public speaking engagement. This will take place in the ballroom at the University of South Florida for Kappa Delta’s National Women’s Friendship Day celebration. I would love any and all feedback from my readers 🙂
 
My very first Eating to Live, Not the Alternative speech:
 
 
Did you know that approx 8 million people suffer from eating disorders? Did you know that 86% of women who suffer from an eating disorder claim it’s onset by age 20. Did you know that as many as 20% of college women suffer from bulimia? Did you know that eating disorders are the deadliest of ALL psychiatric illnesses?
-How many people in this room know of someone who suffers or has suffered from an eating disorder?
The fact is that everyone in this room is highly likely to personally know of someone who suffers or has suffered from an eating disorder. The purpose of my project, Eating to Live, Not the Alternative, is to promote positive body image and the prevention of eating disorders through education and awareness. 
The societal based thin-ideal has taken it’s toll on our standard of existence. In media, a woman’s worth is portrayed as being dependent on their appearance. The standard of appearance lies in the perfection-seeking ideal that achieving and maintaining thin is the only way to be in. Little do women and girls growing up today know, the images they see in media are a facade. Media images are photo-shopped and airbrushed. Without an educated awareness of media’s unrealistic body-perfect ideals, women in our Western society are likely to determine themselves as unworthy and not good enough unless they achieve this thin-ideal.
As women in today’s perfection-seeking society, I urge every one of you to take serious note of the prevalence of such disorders. The sad but true fact is that your fellow peer or sorority sister may be suffering in silence. This silent suffering is all too common and is what I find to be the scariest element of eating disorders. Even at the worst of times, a disordered eater can fake it to make it. During the lowest and shameful of days, a disordered eater can put on a show and fool a crowd. All the while, they will be suffering in silence.
During my tenure as a Delta Eta KD lady, I, too, suffered in silence. There were less than a handful of my sisters who truly knew anything about my battle with poor body image and disordered eating.  My suffering led me into a trail of depression. I was depressed and full of shame. All I wanted to do was isolate myself. If it wasn’t for my membership in Kappa Delta, I probably would have done so… Without the love and undying acceptance of my sisters, I don’t know if I would have made it. I am certain I wouldn’t be here to speak with you today.
Because of my involvement in KD, I had to face the world and face my sisters. Coming to chapter meetings and socials, being involved with the executive board and just simply coming to hang out and bond with my sisters was, at times, the only thing that motivated me to get up and get dressed, go out and face the world. At any time, on any day–good or bad–I could come into the company of my sisters and feel acceptance through love and true unfailing friendship. This friendship and sisterhood kept my head above water. Being a member of the Delta Eta chapter of Kappa Delta saved my life.
The presence of my sorority sister’s truly saved my life. I know that the love and influence of my Kappa Delta sisters is the one thing I can honestly say put a smile on my face or pride in my heart at a time where I may have otherwise felt hopeless and numb. Today I can stand here and proclaim that, without my sisters, I do not know where I would be. 
Because we are here in celebration of Kappa Delta’s National Women’s Friendship day, I want to encourage every woman to be mindfully aware of what their mere presence in another woman’s life can truly mean. Because you, too, could be unknowingly saving another woman’s life. Never underestimate the power of friendship and sisterhood.
It took me years to change my irrational thoughts and beliefs regarding my body. I am standing here in front of you today as a recovered disordered eater. Today I can stand proud and say, I am a phenomenal woman. I am a woman who is in acceptance of myself and my body. Recovery from eating disorders is possible. As a woman,always remember, your weight is NOT your worth. As a woman, you are entirely too intricate and incredible and unique to be judged, labeled or defined by a number on a scale or an image in a mirror. Your worth goes way beyond what man-made items can measure or reflect. Your worth is beyond that… you are beyond that.

Your worth is beyond that…You are beyond that…  

As many of you know, I am a graduate student at the University of South Florida (GO BULLS!)
My Master’s program is called Rehabilitation and Mental Health Counseling (RMHC). The Rehabilitation side never seemed like much of an interest to me…in fact, I didn’t even realize what the “R” in RMHC really stood for when I started the program. I was thinking Rehabilitation as in trauma-rehab, not vocational and lifestyle rehabilitation. 
Anyhow, one of the classes I am currently taking is called Career and Lifestyle Assessment. The reason I give you the background is because, as we were learning career development theories, one of the perspectives in particular stood out to me. It is called Happenstance Theory. This perspective suggests that, over one’s life span, chance events can create and/or turn into opportunities for learning and exploring one’s true passion. These revolutionary sparks of opportunity are said to provide momentum for and clarity of one’s true career and lifestyle purposes.
 
Curiosity, persistence, flexibility, optimism and risk taking. There are the five critical skills involved in allowing this perspective to become a reality. Hmmm…


I was always curious, so to speak, why I suffered the way I did. I was always curious why I had to go through the things I did. My curiosity was saying, Why me? My curiosity wanted to find out first hand what life was like when you lived in acceptance, personal acceptance.


I was persistent in my disorder for a long while. Lately, I have been persistent in finding and maintaining acceptance of my physical, emotional and cognitive attributes. Now, I am persistently pursuing a new way to label and think about my previous suffering. My persistence has allowed me to accept my suffering as meant to be because it just so happened to lead me to discovering my passion-driven purpose…


I have learned to be flexible with myself. I have learned to be flexible with my ideals of my physical, emotional and cognitive attributes. I have learned to be flexible with my life and career goals in order to adjust them to mold around my life’s experiences. I am flexibly looking at the opportunities my previous suffering has provided me with in order to think outside of the career box.


I am so optimistic. I am certain that this idea of happenstance is not without an element of fate and divinity. I am optimistic about my previous sufferings now. I am optimistic and proud of what I have been through and overcome. I am SO optimistic that I can and I WILL make a difference. I am optimistic that I will continue to touch lives as I have been told I already have. I am completely positively optimistic and excited.


I am a risk-taker, so I’ve learned… I take risks by speaking up and speaking out; it is risky speaking personally and sharing my stories and testimonies. I took that risk and here I am. I am speaking; well, I am writing and you are reading (Thank you, readers!). I am ready to take more risks. I want to take the risk of dedicating myself to writing a book. I want to take the risk and attempt to start a nation-wide speaking campaign to promote positive body image and an awareness of eating disorders. I want to take the risk as an activist against faux-media advertisements. I want to take the risk of dedicating a part of myself and my life to rid society of thee thin-ideal.


I have been curious, persistent, flexible, optimistic and a risk-taker


But, was it ever happenstance that I suffered from eating disorders and poor body image? Was it happenstance that I suffered and recovered and relapsed to recover again. Was it happenstance that I have, over the last 8-10 years discovered that, with acceptance and faith in myself, I could change. My (irrational) thoughts could change therefore my behaviors and emotions could change. 


I could change…and, change I did. This change, this growth, this self-acceptance and self-love…it could all be yours, too.


Wouldn’t you rather know the world in optimism and pride? Self-acceptance and confidence are yours for the taking. No one but you…no one but YOU can make it happen. No one but YOU can make YOUR recovery happen and stick around. 


Just remember, your weight is NOT your worth. You are entirely too intricate and dignified, transcendent and incredible, mystic and unique to be judged, labeled or defined by a number on a scale or an image in a mirror. Your worth goes way beyond what man-made items can measure or reflect. 


Your worth is beyond that… 


YOU ARE BEYOND THAT!