Loose ends

I expected this week to be difficult, because it is the last week of the first semester of my graduate program: papers were due, exams were taken, loose ends were tied up before the holidays, and I have been running around trying to get everything done, trying to be a model student.

I still have moments of doubt about this whole enterprise of getting a Ph.D. in clinical psychology. Doubt in myself, about what it means to have had a serious mental illness, and to place myself in the situation of wanting to help other people in distress. The thought dogs me: Am I well enough?, followed by: Am I good enough for this? Will I be able to do all that is required of me?

The way that I have dealt with my insecurities this semester has been to apply myself whole-heartedly to my studies, as if by knowing enough about statistics, IQ tests, neuroscience and the Diagnostic and Statistical Manual, I would somehow proove to myself and others that I was worthy of being in a Ph.D. program. The voice in my head presented a clear rationale: Even if they found out about my eating disorder, no one can say that I am a bad scientist. I have been objective to a fault: clear-headed, perspicacious, and critically-minded in my classes, my research job, and my encounters with faculty.

What I didn't know was that I was coming across as arrogant.

My faculty adviser and my research supervisor broke the news to me earlier this week, in two of the hardest conversations that I have ever had. I was so worried about doing something wrong in school, about failing to be brilliant or thoughtful or punctilious enough, but now it turns out that I was barking up the wrong tree altogether. I am a first year graduate student. There is no need to take so much responsibility on myself. I just need to study moderately hard, plan a second-year thesis, and do whatever my supervisor tells me to do at the research site. No need for intellectual pyrotechnics, no need to take on additional activities to impress my superiors, no need to rush ahead when I am fine just where I am.

My adviser reminded me, in breaking this news to me, that there are two main reasons why people come across as arrogant: either they are insecure, or they are very smart.

While I would like to believe that mine is the latter case, I know that I feel insecure about being in my Ph.D. program, but for reasons that he would probably never imagine.

I fear that I will never be able to help other people unless I am completely healed.

I fear that I will fail to help a patient because I have missed some critical piece of research or treatment technique that might be appropriate for them.

I fear that I will commit some act of negligency, like the psychiatrist whose inattention led to my father's hospitalization last winter.

I fear that I will let down my patients as I have been let down by doctors and therapists in the past.

So many fears! And yet it does me good to get them out on paper, and to own them as my own. I don't think of myself as arrogant, but as afraid and anxious. And, even before the eating disorder, my way to allay my anxieties has always been to learn more, as if knowledge itself was protection against my own fallibility, my own humanity. I believe that intellectual achievement would act as a talisman against all of the boogey men and long-legged beasties that lurk in corners. I made sure that, whatever else happened in my life, my academic accomplishments were seal-tight, and so I have been safe for a while. Just as I wrote in a previous post, Whatever else happened, at least I was thin, I have been operating by the assumption that Whatever else happens, at least I am smart. At least I had that much, when so many other things seemed beyond me grasp.

Chuan and I are about to go to China for two weeks, and I will have time to think about all of this there. There couldn't be a better time for me to step outside of my regular patterns and let the rhythm of travel carry me forward.

Butter is better

I just can't get over the fact that I now, on a regular basis, make my own butter. Out of the freshest, richest, yellowest cream, to boot! My butter turns the bright yellow that most dairies have to use dye to obtain, and it's all because the happy cows at Milk Thistle Dairy are getting enough carotenoids in their diet.

I started to add butter back to my diet a few summers ago, when I read Nina Planck's Real Food and decided that it was time for me to seriously consider incorporating real (i.e., good quality) animal products into my diet. No to insipid soy milk from a box; no to olive-oil on everything; yes to whole milk, good bacon and beef broth, chicken thighs with skin on them and butter, oh yes, yes to butter.

Why butter? Because butter is better; at least my grandmother always said so. She grew up on a dairy farm in Wisconsin during the height of the Great Depression, and even when margarine became more fashionable in the post-war years, she refused to have anything other than butter at her table. When margarine was largely discredited as a "healthy" alternative to butter some years back, my grandmother was smug: butter was better. And now I believe the same thing.

Loss/gain

This afternoon, as I was cooking lunch, I had a phone conversation with my sister about, among other things, weight gain and how it makes us feel.

My sister rowed crew in college, and as she only graduated in May, she still misses the daily exercise routine that defined her life as an undergraduate. Women's rowing -- like gymnastics, running, and dance -- is notorious for breeding eating disorders, especially among women who row in the "light-weight" category. If you row light-weight, you have to weigh at or under 135 pounds at every race, or you cannot race that day. Given the penalty for being overweight, you can expect that there are a lot of women who go to extreme efforts to shed a few extra pounds before weigh-in. I consider it somewhat miraculous that my sister did not develop an eating disorder in the course of her college career, given my (and our family's) history of eating problems. The misgivings that she has about food and her body fall into the "normal" realm more often than not, and she is a comforting source of reassurance that what I am going through, right now, is thoroughly normal.

I am referring, of course, to my recent weight gain. Although I am more bummed about the fact that my favorite jeans no longer fit me than upset by the notion of "gaining weight," it does disturb me in more ways than I would like to admit. As my sister pointed out, it is especially hard for me because, during recovery from bulimia, I actually lost weight -- which makes sense, as I stopped binging and developed some serious food sensitivities and digestive problems, which limited the amount and types of food that I could have. Thus I associate recovery and being healthy with having a lower weight than what I had when I was fully symptomatic, and now that I am creeping back towards the weight that I had as a bulimic, I am not sure what to make of it. I remember, when I realized that I was actually losing weight and not gaining weight in recovery, thinking that I must have been victim to a divine prank: as soon as I stopped hating my body, as soon as I stopped hurting myself, I lost weight! It seemed so contrary to what I had believed about needing to purge and exercise relentlessly to remain even moderately slim, and it ran counter to everything that I had heard about recovering from eating disorders (which mostly emphasized the fact that people with anorexia need to restore their weight in order to get better). At the time, my weight loss also seemed like a gift, in the sense that I really was much thinner than I had been during the eating disorder, and because I knew that I was thinner, I didn't worry about my weight for the first few years of recovery. It became a non-issue, because I was thin enough.

Which makes me wonder now: what would recovery have been like for me if I had gained 15 pounds instead of lost 15 pounds? Would it have taken me longer to feel better psychologically, or to develop normal eating habits, if I weighed more than I was comfortable with? Was this period of low weight a sort of "grace period," or did it set me up for unrealistic expectations of recovery? (As in -- "Things are hunky-dory: I am recovered from an eating disorder and thinner than I ever was!") I am not sure, but as my body is now undeniably changing in that direction, it has given me more to ponder about the nature of recovery, and the depth (or sincerity) of my love for my own (post-ED) body.

This I do know: my weight is fine right now. More than fine: completely within the realm of normal for a 26-year-old woman. If anything, as my sister was so kind as to remind me, this is just a normal fluctuation in weight accompanying the winter season, and might reverse itself as soon as the warm weather comes around. Or, as I think, it could be the fact that I am in my mid-twenties, and my body has finally decided to shape itself according to its evolutionary purpose (i.e. reproduction).

I also know that I am at a total loss to account for the recent weight gain -- I can't see any real changes in the amount or type of food that I have been eating in recent months, or in the quantity of exercise that I get. I think that this failure to pinpoint a cause to the weight gain is actually a good thing, because it means that I am not tempted to "fix" anything that I am doing. I eat healthily and abundantly, and I indulge in sweets and goodies almost every day. No change from this time last year. I don't get as much exercise as makes me happy (in the endorphin sense), but still, that's no change from last year.

My plans for dealing with this recent blip are to continue on the same path that I have been on: a combination of good home cooking, moderate exercise, and lots of self-love. These are the habits that steared me out of my eating disorders, and in these I place my trust as my body changes in unexpected ways. These are the things that I don't want to lose by gaining.

The biology of social justice

I am not one to religiously follow the latest in nutrition or obesity research -- I take these kinds of things with a very large grain of salt -- but I was pleasantly surprised to find a great podcast produced by Yale University's Rudd Center for Food Policy and Obesity. Today I listened to an interview with Elizabeth Goodman, a pediatrician who studies the social factors surrounding obesity, such as poverty, social exclusion, racism, and chronic stress. What I loved about her approach was her recognition that weight goes much further than mere biology: it is not only what you put into your body, or how you use it, but the environment that you grow up in that influences your ability to make choices about your body. Dr. Goodman talked about obesity and the "biology of social justice," meaning that behind the fact that obesity is rising in the U.S., obesity tends to happen to people in position of social exclusion and stress -- that is, to the poor, the less-educated, the oppressed. Conventional approaches to obesity prevention, she says, focus on "educating" the public -- and especially those at risk -- with the assumption that knowledge is sufficient to lead to behavioral change. In the case of people who are at risk for obesity because of social factors, however (e.g. having no money for high-quality foods; having no leisure time because of working multiple jobs; living in neighbors where recreational space is limited or where it is dangerous to be outdoors; etc.), such messages can lead to feelings of guilt and further stress. That is, if you are already leading a life of poverty and stress, being told that you need to eat better is probably not enough: you also need to be in a situation that allows you to eat better, such as being able to afford produce, living near a well-stocked supermarket, having access to green spaces, etc. Without such conditions, telling someone to "eat less fat" or "eat more whole grains" is laughable, and may even be counterproductive in that it is likely to induce feelings of guilt and stress.

I liked this podcast because, in my quest to understand my own experience with an eating disorder, I often find it useful to approach food and eating from other perspectives. The current crisis in food prices interests me, as do environmental issues surrounding agricultural practices. I like putting food in a larger context, because by doing so I am able to make connections that I would not normally see. For example: although I am not a disadvantaged American struggling to put food on the table, I can appreciate the importance of our surroundings on the food choices that we make. I remember how overwhelming it was in college to have to eat in a cafeteria every day, where food was poor in quality and (too) abundant: every meal was a test for me of whether or not I would eat "well" (i.e. restrict what I ate) or binge (i.e. have one of each kind of dessert offered). Once I got away from the cafeteria environment, however, I had a much easier time eating appropriate portions. Similarly, soon after I developed a gluten sensitivity, I moved to China for several months, and found it much less effort to plan meals in a culture that ate so much rice, and so little wheat. These are example of the environment playing a role in what I ate, and I am sure that I could come up with more examples, as you probably could as well.

When I listen to researchers like Dr. Goodman, I am heartened to learn that there are scientists who are very conscientiously engaging in research related to eating disorders without falling into some of the traps that the nutrition world often unknowingly sets out for us, such as instilling in us a fear of obesity without a recognition of the role that fats play in a healthy diet, or failing to mention that the psychological impacts of an eating disorder can be far more devastating than carrying an extra BMI point or two.

Where do you get your sources of nutritional or health information? How do you feel about the sources that you turn to? Do they make you anxious, smug, or merely curious? I'd like to know.

Keeping the faith

So even this happy chica has her days of feeling that nothing is right with her body, that all of this good eating and good food have put unpleasant pounds right where she doesn't want them -- in short, today I am experiencing a rebellion against all that it means to be well fed and to be a rounder person than I was at the same time last year.

It is harder, in some ways, to gain weight in recovery and know that I will not do anything intentional to take it off, than to let myself go down that old path of restriction and exercise -- I am done with that. And still -- and still. It dies hard.

I am in the middle of my finals for the semester; I have been battling a sore throat for nearly a week; and the weather has turned lousy here in New York. So I know that it is not just my extra weight that is making me feel down, and I have tried to stay positive in the midst of it all, even though I don't like optimistic jingles and Pollyanna tunes. I have tried to will my mind's attention away from my weight, to replace those punishing thoughts with messages of love and comfort -- but I feel, tonight, as if I had reached my limit with that particular ruse. The mind-game just isn't working right now, and I am not sure what to do if I can't make it work again.

Every day I tell myself that weight doesn't matter, that the person I really am inside will stay the same regardless of my pant size. But that feels like a lie, because it still is important to me -- and there's the rub. On the one hand, I ask myself, What kind of woman are you that you value your looks above your heart and your brain? What kind of feminist do you call yourself? while another part of me asks How can you stand to look this way? What if you gain more weight? What then? What then?

Today, more than most days, it is hard to reconcile the two voices, both of which have nothing pleasant to say to me. Nagging, relentless harpies, stuck round and round in my head. This is what it means to revisit the eating disorder, for an evening. And because this is such an unpleasant reminder of what things used to be like for me, I am quite ready to call it a night, crawl into bed, and wait for another day to look better than this one.

And, maybe tomorrow, there will even be a recipe to coax me out of my glum, to remind me that food can nourish me even as I am uncertain about how to nurture myself. At the very least, I can put my faith into the simple act of cutting a carrot -- only that much. The rest will follow.

Fast, Filling, Foreign -- and Fried!

I have never been one for fried food -- in fact, around my house growing up, we took it as a matter of gospel that fried food is bad for you. Right? I never knew a family who had a deep-fryer at home until I spent my last year of high school in Chile, and saw my friend's mother fry up batch after batch of fresh empanadas de queso from a mysterios aparato that she stored under her countertop. Since then, I have not given much thought to fried foods, other than to join in the general American sentiment that such things are bad for you: fritters and hushpuppies and codcakes and french fries and schnitzel and corndogs have an almost immoral air about them in this age of glorified food frugality.

Last night we had tonkatsu for dinner, those Japanese breaded pork cutlets that are often seen at run-of-the-mill Japanese restaurants and, I have learned, are a Japanized version of Western food (Yes, they take our food and make it theirs too, just like we fusion this and fusion that.). Tonkatsu seemed like the perfect addition to our repertoire of rice bowl meals. Rice bowls are simple, hearty dishes where rice is scooped into a large bowl and the rest of the ingredients (meats, sides, vegetables) are piled on top. There is nothing so comforting, after a long day at work or studying, than digging one's chopsticks into a rice bowl piled high with fragrant meats and delicate greens, the juices leaking down into the rice below.

The recipe for tonkatsu came courtesy of Maki at Just Hungry, the best website that I have found on Japanese cooking for home chefs. I bought the pork rounds at an Asian grocery store earlier this week; they were labeled expressly for this dish, and I couldn't resist the opportunity to try yet another Japanese meal-in-a-bowl. I prepared the recipe exactly as indicated on Maki's site, down to the last panko breadcrumb, and the result was just what you would want from a pork cutlet: crispy, flaky crust on the outside surrounding a juicy, tender interior.

So, the question that I keep asking myself: why haven't I fried foods earlier? Unknowingly I have stumbled upon another category of food that had been prohibido and now, quite suddenly, has added a whole new dimension to what I can make in my kitchen. Tomorrow or the next day I have plans to make vegetable tempura with my finds from today's farmer's market: pumpkins, turnips, sweet potatoes, and apples (to be really daring). I'll slice them into rounds, dip them in batter, and fry away! Or I could make Indian samosas, or Brazilian cod-balls (bolinhos de bacalhau), Chinese morning fry bread, or even bring back the Chilean empanadas. There's a reason that fried foods appear across cultures: they are easy to make (just be careful with the hot oil!), filling, and delicious (fat makes everything better, I think).

Oh, and a note about the frying itself: I am pretty careful about which oils I use for cooking, what with hydrogenated-this and trans-that creeping up everywhere. I use olive oil and butter for sauteed and searing, but for higher heat I prefer coconut oil or grapeseed oil. For the tonkatsu I filled a small, high sauce pan with about two inches deep of grapeseed oil. The small pot was just large enough in diameter to hold one cutlet at a time, and its small size allowed me to scrimp on the precious oil, while the walls were high enough that the oil didn't splatter on my hand or the stovetop.

South American study drugs

Several weeks ago, I wrote about the need to eliminate coffee from my diet due to health concerns. In the meanwhile, I have had a lot of fun trying alternatives to coffee, some of which were suggested to me by the readers of this blog.

Yerba mate (Argentine pronunciation: shair-bah mah-tey) has emerged as my number one substitute for coffee, at least while I am at home studying on Friday afternoons. The first time you drink yerba mate it feels a bit like engaging in a exotic and intricate ritual from a foreign land, which indeed it is. But living in Argentina, where mate is drunk daily, took away a bit of the strangeness of the drink, so that now drinking mate at home feels more like nostalgia than fetishism.

Last year we bought a mate gourd, at a Brazilian supermarket no less, and I have found some good sources of yerba at McNulty's Tea & Coffee in the West Village. Brewing mate is a tricky business, and it has been five years since I was in Argentina, so I resorted to asking an Argentine classmate of my husband to explain how it's done.

In brief:

1. Fill the mate gourd about a third full, or half-way, with yerba.
2. Arrange your mate bombilla (metal drinking straw -- see the pilfered image to your left), poaking it down into the yerba.
   
3. Saturate the yerba with cold water, just a little bit. This is done to prepare the yerba so that the hot water doesn't "burn" (quemar) it when it is first poured. Add a teaspoon or two of sugar to the top.
   
4. Boil a pot of water. Once the cold water has soaked into the yerba, add a slow stream of hot water to the yerba. Only moisten the yerba, do not pour past the top of the yerba, as the point is to brew it very thickly and strongly. Pouring on more water may make the yerba lose its flavor much more quickly than it should.
5. Let it brew for a few minutes, then drink your brewed potion through the bombilla.
   
6. The yerba can (and should) be brewed again, as you only get about 1/2 cup of liquid per brewing. Often, Argentines put the rest of the the hot water into a thermos at this point, so that it remains hot for future brews; you may add sugar directly to the thermos water or continue to put it on top of the yerba as you pour hot water over it.
   
7. Brew yerba a second time, a third time, a fourth.
   
8. Now, the rule: if you're drinking with another person, one of you should drink all of the brewed drink the first time, then brew it again and pass the mate to the other person to have the second serving, and then so on and so forth, alternating between people. That's what makes mate such a social drink.

Drinking mate alone also has its charms. I find that the whole ritual of preparing it gives me just enough of a distraction while I am writing my papers to actually be useful; I am the kind of person that works best when there is something else to attend to at the same time. Also, mate is well-known for its energizing effects; like coffee is to caffeine, so mate is to mateine, a chemical substance that some hold to be among the most potent and healthy antioxidants out there. When I lived in Argentina, I was often told that in the old days, the Argentine cowboys survived and thrived on a diet of cow meat and yerba mate alone -- apparently, the mate provided so many vitamins and minerals that the cowboys didn't die of scurvy or develop goiter. More recent studies suggest that yerba mate may protect against DNA damage while also lowering cholesterol, acting a diuretic, and improving cardiovascular health. These are great things, but what I love most about mate is the memories that it brings back of studying with classmates in Argentina over a gourd of yerba mate, nibbling on sweet crackers as the afternoon passed us by.

Running to run

I am learning to run again like I have learned how to eat again.

If you're like I am, you may have spent too many years on the treadmill or on the roads, in the pool or in the weight room, trying to shape your body into something different from what it is. In high school I was a runner, a swimmer, a lacrosse player, and a skier; exercise started out as an excuse to spend time with friends and compete with other teams, but became a full-blown obsession once I entered college. I kept an exercise log during my freshman year, where I wrote down every minute that I spent in exercise, chiding myself if I missed a day. I rarely did. Thirty-day streaks of exercise were the rule rather than the exception, and if I felt tired or injured, well, I just ran right through it.

About four years ago, when I was midway through my recovery, I came down with a case of mononucleosis that had me out of commission for months. No more "I'm training for a marathon," no more gym workouts at 10 p.m., no more books read on the elliptical machine. Just rest, and more rest, and some yoga now and then.

It took me about two years of recovery -- from both mono and my eating disorder -- before I began to consider running again. I was living in Brazil, and found that I was spending far too much of my time indoors. Running gave me an excuse to get out and see the city and its parks, and it put an order to my week and structure to my time. But since I returned from the U.S. in 2006, I haven't pursued running seriously. Part of me knows how easy it is for me to go overboard when it comes to exercise: a few workouts a week easily turns into a mandatory schedule of one a day, plus stretching, plus cool-downs. I can't afford to follow this kind of regimen right now, what with my studies and my job, and so I mostly don't. Besides, there is little joy in such practice, and these days I try to fill my free time with things that I like to do.

But this laissez-faire attitude towards running (or other forms of hard exercise) doesn't suit me, either. I like routine, but not obsession. I like seeing myself improve over time, something that doesn't happen if I just run "when I feel like it." And there's much to be said about mood and exercise: I just feel better, all around, when I get some exercise. Tentatively, I have created a schedule for myself: three brief runs (or rides) during the week, and one or two longer runs on the weekends, depending on how I feel. I love rising early to exercise, and find that it makes the rest of the day feel so much better, knowing that I have already seen some beauty in the world, used my body to creative ends, and have given myself time that is all mine.

Strangely, this must be the first time that I am running without the expectation of perfecting my body from exercise. In fact, I seem to finally accept that fact that my body, when it changes, rarely follows the rules that I would expect it to. So this time, I am running for other things. I am running to feel the cold air in my chest; running to see the sun rise; running to keep up with my husband; running to remind myself that I am fast, strong, and resilient; running because I don't need to, but I can.

Why are you running (or not)? Why or why not do you exercise, and what does exercise mean for you these days?