When Riley was little, she watched Full House episodes whenever she got the chance. She would find herself so involved—as if she were Michelle, Stephanie, or DJ—solely because she wished her dad behaved like Danny Tanner. The way Danny responded to his daughters when they got upset, failed at something, felt any emotions at all, was exactly what Riley wished would happen in her house. She wished it so badly she would pray for her dad to respond like Danny during every episode where Riley could relate. Sometimes, she would even try to watch certain episodes at times when her dad might be in earshot.
Riley has been praying for a mom and dad that understand emotions and can respond with compassion, empathy, validation, and love for as long as she can remember.
When she started therapy, it felt like that prayer was answered. But Imagination Land swallowed Riley and she continued to create stories even when things were going well. No one is Riley’s mom and dad except her biological mom and dad. But she had begun to believe that one could create their own parents, non-biological, mentor-type humans that she chose, and when she did that she made the mistake of believing it was a mutual thing. Instead, she was writing a story that was only hers.
That’s what Imagination Land does—the stories keep going forever and ever to protect Riley and in the end, Riley is generally hurt. Who would want to be Riley’s mom?
No one gets it, Riley whispers in frustration to herself.
Tracy recommends a trauma program in the middle of Riley trying to convey the psychological crisis she thinks she is in.
God, she doesn’t get it. No one can. I can’t create the right sentences to explain what’s going on. Every time I try it comes out not quite as I meant and my heart sinks and burns up in the fire of my stomach.
“Trust your intuition, not the anxiety,” Tracy texts Riley after she tried one more time. God, I am so alone. Please help me. It’s like all of the grief I’ve been experiencing is holding me hostage in a burning shed and I cannot escape. I am going down with it. My brain is disintegrating. I can’t turn a corner or even feel a gust of wind without my body freaking out. None of this is normal or ok and it keeps escalating. My intuition doesn’t exist. It is completely gone, along with my confidence. I have to find a way out of this… on my own.
Tracy can’t hold the space that I need anymore. I have to be alone. For a very long time. I have to retreat inside myself to figure myself out. To heal myself. No one else can heal me.
The feeling to flee gives Riley important information.
A couple years ago, Riley and her husband were on a date. Seated at an Italian restaurant with red wine in their glasses and bruschetta on their plates, they talked about their dreams for the future. Riley remembered saying she wanted to move to Colorado so badly but couldn’t bear the thought of leaving her treatment team.
Riley’s eating disorder recovery put a pause on dreams. The guilt from that settled in her stomach and never left. This morning, she felt the ache from that. A wave of regret washed over her. She’d spent the last 4 years consumed with herself.
She’d spent the last 4 years building relationships with people who didn’t want her in their actual life (only professional) but to Riley, the intimacy felt real and forever. Suddenly, she regretted baring her soul to those people. She felt powerless with the information they held, information she could never get back even with all the record requests in the world, they were witnesses to Riley’s worst moments in the last 4 years and their memories held those moments. Suddenly, it felt threatening that someone who didn’t view Riley as an equal, Riley had given her world too.
It felt like the world was crashing down around Riley as she realized all of the people she invested in emotionally, beyond her immediate family, didn’t feel the same about her. Sure, they cared but not in the same way Riley cared. A part of her always knew this wasn’t quite right, but the other parts couldn’t see reality.
Coming to reality is harsh and feels unforgiving and cruel.
Riley wished they’d moved to Colorado and that she hadn’t been consumed and selfish all this time. She felt sick knowing she could have moved and Tracy and the other members of the treatment team wouldn’t have spent much, if any, time sad over the loss of the relationship. When just the thought of it felt absolutely devastating to Riley.
Reality set in and brought sorrow.
Imagination Land destroyed Riley in so many ways. Not that she wasn’t grateful and respectful of the jobs her treatment team did and the kindness they extended, but that Riley was subconsciously looking for a different relationship and is now irreparably hurt by her own doing: the burning ache of it all felt intolerable.
No direction felt right to Riley. How could she stay with someone she loved who didn’t love her on the same level? Tracy has been doing her job this whole time. Of course she has. Riley had been healing inside an imaginary relationship and it will no longer work.
Maybe a textbook, non-relational, psychodynamic intervention must finish this, so no more parts are hurt, and Riley can then let everyone go.
Riley felt broken as another harsh reality punched her in the gut: her eating disorder, over the last couple years, had served the purpose of meeting social-emotional needs and she wasn’t able to let go of her eating disorder fully because then there would be no legitimate reason to be in treatment. No reason to receive daily or weekly love. No reason for them to talk to her at all, no reason for any relationship to exist. Certainly no reason for mom to play the part of mom. Mom didn’t want to be mom anymore anyway, it’s all just your imagination, Riley, no one will ever care for you like that in real life, Riley thought as tears formed.
She had been so desperate for connection, for love, for care, that the eating disorder manipulated Riley. When she unconsciously felt this happening she created Imagination Land, where she could find ways to connect with people and give and receive love forever outside of the eating disorder.
Oh God, Riley thought. I’m in such a massive emotional mess that I created and the grief of losing so much time and energy and relationships is outstanding. It feels as if I did something to myself I can never recover from.
She hates me, Riley thinks as tears flow and she holds back panic that will come anyway—it always does. It used to be with Tracy, now as real life events pan out Riley is failing at managing emotions on her own during every waking moment she has an opportunity to think. It’s completely devastating.
How do I get through this? She wonders. Panic tells her this is the end. Of what, she’s not sure. But the impending doom is ever-present and all-consuming.
Riley’s mental health is rampant. Sudden panic attacks, mood swings: deep-end-questioning-worth depression mixed with straight up fear.
Riley briefly finds reality, the edges of her body, her breath. Before it’s gone again hours later and she sets out to protect herself from further damage by canceling things, isolating, deleting and taking away coping mechanisms like journals, and worst of all: creating stories about everyone she loves and how they hate her and she is never allowed to be vulnerable with them again.
I need a hug, and my mom. This is so awful, Riley cries out to God. Please hear me.
It was 3:02pm on Friday, and the outside corner of Riley’s eyes stung. Salty tears rubbed her skin raw and drained her eyes of lubrication. It hurt to keep her eyes open.
It hurt to keep her heart open.
Earlier in the day, Tracy had come. Riley had waited all week to recieve a hug from Tracy, only to find herself feeling resistant to the comfort Tracy extended. Riley’s little-self tears came as soon as she was pulled in, but then an overwhelming sense of shutdown came. A different part of her lead her emotions and did the talking. The tears stopped. Anger flooded her system. Her hands were shaky. Maybe the teenager part, coming in to protect because safety wasn’t quite established. Riley felt misunderstood and confused and nervous Tracy was judging her emotional state as completely irrational.
Riley wanted nothing more than to feel loved and cared for. To experience Tracy in the way that was the most helpful and healing. Instead, her walls were too tall and her body felt filled with acid. No one should touch acid, acid should touch no one. Riley felt worthless, filled with shame, and trapped.
I need her to pull me back in. I need to be held, Riley thought, faced away from Tracy and unable to make much eye contact. What came out of her mouth was “you can just leave. This is all pointless.” Riley’s heart sank as the words left her mouth feeling like she’d lost all control over possibly breaking through whatever part was the most present and letting the rest of her find some calm in this storm.
It’s like I want to destroy myself and I’m watching it happen without being able to stop it, Riley thought hours later after Tracy left.
None of the triggers are my fault, but I still have to help myself find homeostasis and I feel despair knowing that coregulation could work but I can’t let it. Tears streamed down Riley’s face as she processed alone the missed opportunity that morning with Tracy, and the shutdown that has to take place in order to wait all the way until next Friday to try again.
Something is trapped and I can’t let it go. I don’t know what it is, but I’ll never know until I find safety and start truly trusting Tracy–or even just the process–again.
Tracy is better off without me, Riley’s depression took over after one last huge hit of panic on Saturday night.
“I lost my mom. I mean, it feels like I lost my mom,” Riley says as the tears she tried to wish away drifted down her cheeks.
“Is that the first time you’ve said that?” Blair asks.
“Out loud? No. No, I’ve said it before, with Tracy.”
“I can see how much she means to you,” Blair tries to validate, while Riley continues failing at holding back tears. “If it feels ok, we can stay here for a little bit.”
Blair continues the intake, with permission to shift a bit. Riley held herself with her arms as she described the panic and anxiety that has taken over the last couple weeks. Blair is empathetic and peaceful. She is knowledgeable about trauma, the nervous system, and somatic experiencing. She understands trauma responses and the vagus nerve, and seamlessly inserts herself into Riley’s “parts” language.
But she is not Tracy.
Riley scans the room. Her heart aching for her mom to reach out to her. To check in, to ask her how she’s doing, to make sure she’s ok after her dad was physically aggressive Saturday night. She scans the room for safety, wondering how this could work, how her little parts could be safe here, and wondering if she could ask for help and touch and co-regulation from anyone else besides Tracy. Riley’s eyes dart around the room, fear rising, looking for shelter, like the closet in Tracy’s room, noting no options save for maybe wedging herself between a bookcase and the couch and the wall. I can’t do this, Riley thinks and then reality sinks in as she remembers how devastated she has felt and how alone and abandoned parts of her have struggled with through the recent shifts from Tracy.
Riley takes a deep breath. And another.
I was so burdensome to my mom that her life is better without me in it.
“I… don’t want to be a burden. It’s 3:50, do you need me to go now?”
Blair jots down probably the word “burden” on her intake note and looks at Riley softly. “Burden?” She says.
“I just don’t want to go over the time and I’m not sure…”
“I appreciate your attention to the time and I am watching it, you don’t need to.”
Riley left 10 minutes later, 100 degree heat scorching her face and began to plead to God. Blair will be helpful but Riley felt suffocated by Tracy’s absence and wished she had been telling Tracy about Saturday and receiving a hug from Tracy for the entire hour. For the entire last 5 days.
God, please, help me fix this. Please, I need my mom.
Grief swept over Riley as she recounted the very first day and then the countless days after over the last almost four years that she sat in Tracy’s office. Sometimes looking back brings rose-colored glasses to the memories that make it through but the fact is, this journey has been taxing on Riley’s system and the memories came with a burning pang as each one entered her mind.
The moment she made the decision to begin therapy with Tracy, she held onto a new sense of hope. Hope that she wouldn’t hate herself so much that she wanted to die, because life had almost lost purpose. Three reasons to live remained: her husband, her 10-month-old, and her 2-year-old and she couldn’t keep living like this, feeling constantly like they deserved someone better.
Riley’s eyes filled with tears as the struggle with the eating disorder from those days—years—felt just as real today as ever.
In the fight to end her eating disorder behaviors, Riley latched on to Tracy. She wasn’t ready or even able to let anyone else into all of the parts of her that needed healing—the parts that began to show themselves when the eating disorder began to loosen its reign. But she began to trust Tracy, allowing her to care for each part, sorted out in Riley’s mind by ages, marked by significant traumas: 3, 5, 10, 13, 15, 19. The times when she needed her mom, Tracy began to fill the need for love and care over the course of an entire childhood and beyond. In Riley’s mind, Tracy became her mom.
And then, an incident inside the therapy office timed just perfectly with a childhood memory, ruptured some of the safety. Over the last year, Riley struggled with safety and regulating emotions, along with her nervous system, when safety felt threatened, taking all of it out on Tracy who remained steadfastly supportive.
But this wore both Riley and Tracy down.
In an unconscious effort to heal herself and her inner child wounds, Riley got lost in an imaginary world she’d created. A world she frequently went to survive pain. A world where Tracy’s relationship to Riley was akin to mom-daughter, like the kind where an aunt or church member might become someone’s “adopted” mother. Riley never believed she was actually Tracy’s daughter, but she did believe somehow there could be a way where the relationship could survive beyond the therapeutic relationship, in the same way an aunt would continue to be in their neices life, as a supportive older female.
Riley’s reliance on this belief allowed her to trust Tracy to the extent of letting in the love and care Riley needed to heal her trauma. That healing wouldn’t have happened without that piece. Riley knew she began to feel truly and deeply connected, as well as safe, with Tracy correlated to feeling like there was mutual mother-daughter love. Riley tested it over and over to make sure it felt mutual, some parts needing extensive reassurance, and in the end, Riley felt incredibly loved and ready to let Tracy hold her so she could move through complex trauma healing.
Last week, Tracy reminded Riley her world wasn’t real. While Tracy maintained she loved Riley, she emphasized the goal to end eventually. The goal of a healthy therapeutic relationship, and the goal of Riley not needing Tracy anymore.
Riley could feel her inner child retreating as the words “therapeutic relationship” “boundaries” and “negotiation” crushed her idea of her relationship with her mom and cemented that what she had dreamed up to survive and heal was fabricated and not possible.
How could she keep going now?
Riley’s stomach turned every day over the last week, agonizing over the emotional interpersonal struggle she created. How did she manage to do this to herself? Riley had been so afraid of the “moving forward” Tracy continued to refer to, panic attacks had been consistent parts of Riley’s days. Moving forward, the words pierced Riley’s intestines as acid made it’s way to her throat. She means we are not allowed to continue in my world, she means we can only continue within clear bounds of how Tracy wants to move forward. She means no more mom. No more little-me, no more surviving intense emotions through the kind of love only a mom can give.
Riley nodded, tears streaming. “You didn’t do anything wrong,” Tracy insisted. But Riley knew where she went wrong. She knew it was wrong to let herself drop so many walls and show so much of herself. She knew she was wrong to love Tracy like her mom and believe she’d always be her mom. That there would always be a supportive relationship.
Now, the grief spilling out and the panic ensuing from feeling as though she had lost her mom was making Riley sick. Hope seemed to be lost in the struggle—Riley fighting to find it but not able to fully hold on to it.
I’ve lost my way to survive, Riley thought as acid churned in her stomach and tears filled her eyes as she tried to go to sleep.
The last time Riley committed to starting over was August 8, 2018, at 3:48pm. Riley’s very first e-mail to Tracy. Hours of staring at the e-mail and putting Tracy’s phone number in her cell phone to dial but never hitting send as she felt her heart beat faster and faster. Her brain shouting yes and no at the same time; the sick and wise parts fighting. The wise part won at 3:48pm.
It’s Going to Get Worse Before it Gets Better
Riley knew before she walked into the office that this was going to be the case for her. She knew before she made the initial phone call seeking help that she would not – no, could not – get better until she reached her goal weight first. She had yelled at herself for far too long to give it up so quickly. But something in her whispered, seek help. She needed a witness.
Riley arrived at Tracy’s office. Deeply entrenched in the numbers game. How many calories did I eat? Check. Check again. How many calories did I burn? Check. Check again. How much space am I taking up? Step on the scale. Again. Again. Again. Again.
It’s only ten pounds and ten pounds is not enough to be sick. I’m not sick enough. Definitely not sick enough, Riley thought. Everybody wants to lose ten pounds. And nobody else is spiraling down Eating Disorder Alley. I just need to lose five more pounds. Well, seven. I just need to lose seven more pounds. And then I’ll be done. Then, I will be fine. Negotiating even as she parked and walked in fear into the therapist’s lobby.
This is why she made the phone call, she reminded herself, taking a deep breath and trying to prepare for whoever opened the door to the office. Riley sat on the couch nervously and mindlessly scrolling through apps on her iPhone waiting for the therapist to open her office door. She was so nervous at this point she could barely breathe. The room felt like it was closing in on her and she became suddenly nauseous. This would be the third time in six weeks she admitted her problem to a professional, a new stranger each time. A primary care doctor during an annual physical. Then the in-office counselor the doctor referred her to. Finally, she found herself here, in the office of an eating disorder specialist.
Tracy opened the door to her office, “Riley?” she said as she entered the lobby with a smile, and introduced herself. Riley barely managed to confirm her name with a quiet, “yup, hi.” and worried she didn’t belong there. She wanted to run out the door, but instead chose the middle chair, crossed her legs and arms, and anxiously pressed her lips together as if it would stop her from talking. Her hands squeezed the sides of her arms so tight, that when she finally released them, her skin bore her fingerprints. She felt like a teenager. But she was decades older. Too old to be here, she thought. Too fat to be here.
Riley answered questions about her family, history of disordered eating, height, and weight.
“You meet the criteria for anorexia. You actually meet the criteria to be admitted to the hospital, though I am not recommending that by any means.” Tracy said.
Riley froze. The words repeated in her head, and reality seemed distant. She cannot possibly see what I see. There is no way I am anywhere near the criteria for anorexia. I have not lost enough weight, Riley thought.
The room began to get darker and Riley could barely see. Feeling as though she was about to pass out, she grasped for every trick she knew to attempt to focus and avoid something embarrassing. Deep breath. I am fine. I am fine. I am fine, she repeated.
And then Tracy says, “it might get worse before it gets better.”
Chapter one seems like an odd place to start, but Riley is starting over. Again.
The storm she created abruptly ended today. What slowly came to be over the last four years disintegrated in less than a week and the last pieces left with a final gust of wind as Tracy’s words punctured the heart held by the little girl in her soul.
Imagination as a source of survival is a curious phenomenon.
“I need you to slow down.” Tracy says, Riley’s therapist of three years and nine months.
Riley stared just left of the laptop screen, seeing nothing and everything at once as reality began to steal the last bits of the magical land her brain invented, trying to hold on.
Tracy broke the silence. “What’s happening in your head, I know it’s not quiet right now?”
I can’t possibly explain. You won’t get it, Riley thought, as her heart twisted and the world she’d created crumbled, exposing reality.
Cement bricks piled up in her stomach as she searched for words and tried to make sense of what was happening. No one will ever understand this. Heartbroken, she said goodbye to a screen that used to be a physical person she loved with the fury only a child gives.
Riley wasn’t going to ever be allowed to use the land she escaped to to survive, because it only worked when she believed it was real.
Nothing she knew was real, and everything real was nothing she knew.