Sunday, January 29, 2012

Respecting and Facing Fear

In the television series "Buffy, the Vampire Slayer", one of the characters is Willow, a formerly mousy nerd turned witch who spends most of her time on the show doing good things to help people. When her lover is killed as collateral damage by a murderer intent on killer Buffy, she goes crazy and turns bad. In her fury to exact revenge on the man who shot her girlfriend, she kills other people and eventually skins her prey alive.

By the end of the small arc in which Willow's character goes bad, she returns to her true self, but is afraid to use magic again for fear that she'll lose control and her sense of self again. In one of the follow-up scenes in a subsequent season, Willow is seen causing a small candle in a ball-shaped holder to hover over her hand with magic and repeats, "I'm facing my fear." Over the past two and a half years, I can't tell you how many times that scene has popped into my head and I have actually used that phrase.

Part of being fat is living in constant fear. Since I've spent the vast majority of my adult life between 300-400 lbs., I've lived with that fear more than without it. That fear is of both small and big things that diminish quality of life from fear of seats that are too small and not traveling to eating in restaurants to going to movies to the fear of social censure and ridicule to the fear of medical treatment. It extends into every nook and cranny of life. It keeps you off of scales and away from shops with narrow aisles. It keeps you from changing jobs and finding a significant other. It keeps you from getting regular testing like pap tests and mammograms. 

For quite some time, my sister has had anemia. My sister also weighs slightly more than I did at my highest weight and is two inches shorter than me. I'd guess that she weighs around 420 lbs. at 5' 2" (157.5 cm). The problem (her anemia) got so bad several years ago that she was put through a large battery of tests including copious testing for bowel and stomach cancer. The thing she did not get, however, was a pelvic exam or pap smear. Though she did not say it, I'm pretty sure that part of the reason she avoided those tests was her weight. 

Very fat people avoid medical intervention unless their circumstances are dire because there is so much fear involved. Will the doctor weight shame you? Will they complain about tests they cannot do or difficulties treating you due to weight? I know this fear because I avoided such tests for over a decade due to such fears. Mine were based on experiences in which I was treated horribly during one exam in particular. I didn't have a pap test for over a decade and had never had a mammogram. However, I was lucky. I gambled by not getting tested for a long time, and I won. I had no problems. 

My sister has not been so lucky. She has an enormous tumor which fills her entire uterus and her OB/GYN believes it is cancer. The test results won't be in for awhile, but all signs point to malignancy at this stage. I can't help but wonder if this wouldn't be happening if my sister had not been afraid of such tests because of her weight. I can't help but think that fear of fat shaming may result in her death, but I can't blame her for avoiding what she was afraid of. After all, I did it, too. Though I don't "blame" her at all, I'm deeply, deeply afraid of losing her. I'm very close to my sister, and this news has been extremely hard for me, though not nearly as hard as it has been for her. 

Fear is supposed to be an extremely potent as a motivator. You hear a lot of people try to push themselves to lose weight through fear of possible health problems. You also often hear about people who already have health problems, but can't lose weight despite dire consequences like having limbs amputated due to Type 2 diabetes complications and uncontrolled eating. The thing about fear is that it can motivate, but, in my experience, more often than not, it paralyzes.

Understanding that fear is more likely to cause inaction rather than action is the first step in dealing with it. If you realize it is holding you in place rather than pushing you forward, you can stop berating yourself for not moving and explore how to break out of the ice that holds you in place. This is what I started to do in 2009. I had lots of fears, and I started facing them one by one. It was horrible and overwhelming. Sometimes I felt like I was tied to the back of a moving car and being dragged along at a pace just a little faster than I was capable of running. Dealing with my fears constantly wore me out and made me want to slow down or just stop

The truth is that, had I not been on a concrete timeline, I'm not sure if my pace would have been as fast. I knew I'd move someplace in which I wouldn't have health insurance to pay for testing by the end of March of this year. I knew I had to be ready and face testing at least by the end of 2011 or possibly end up with a health condition and no insurance for treatment. Maybe I would have done it all anyway after losing enough weight, but I can't say for sure. The only thing I can say is that I faced those fears, but first, I regarded them with the respect they warranted.

Most people are dismissive of their fears and encourage "bucking up", "growing up", and "grabbing ahold of those bootstraps" and "bullying through". I didn't do that. I considered my fears and how they were based in real concerns and consequences. There were elements of irrationality, of course. With all medical tests, for instance, fear of a bad outcome is somewhat irrational because knowing the result doesn't change the underlying issue. Most of my fears, however, were related to very plausible circumstances - fat shaming, censure, humiliation, physical difficulty, and pain. All of these are absolutely rational fears based on personal history. 

A lot of people advise those wanting to lose weight to just ignore such things and get on with it. If you think that those feelings are not potent motivation for remaining stuck like a fly in amber due to fear, then I will kindly ask you to mail me a picture of yourself in a bikini or thong with your real name attached so that I can post it and strangers can pick you apart for your body flaws. It matters. It is real and painful and frightening, so respect your fears and validate them as absolutely justifiable.

Once you validate them, you are then ready to face them. For me, this started with going outside more to walk. I hated going out when I was in the range of 230-380 lbs. in weight. People stared, pointed, laughed and said unkind things. What was worse was that I had to stop and sit down every few minutes because of my back pain so people would see me walk a short distance and sit to rest. I'm sure a flood of judgment went through them as I stopped so often (like I'm so fat I don't have the stamina to walk far before I need to rest). Since I couldn't go far, they could gawk and make fun of me while I rested and there was no real escaping them because I had to wait for the pain to fade and the muscles to relax. I had to face the real fear of physical pain as well as the humiliation again and again, day in and day out.

When I was out walking, I would tell myself that I was facing the fear so that I could do things I wanted to do in life (like the relatively mundane pleasure of walking out the front door without fear of being in agony). I had to remind myself that I could only get from where I was frozen by moving through fear. Yes, it was incredibly stressful and tiring, especially at first when I was thinking so much about it. I repeated the mantra, "I'm facing my fear", and told myself that this hard and scary road was one that I had to pass through in order to get to where I wanted to be. 

In the end, I learned to just say that I was worth enough to continue on despite the difficulties and that the actions of the people that acted to make my progress difficult had to be something which I would have to regard as not mattering to me. My progress mattered. Moving on with my life rather than held in place by fear would be the thing I'd ultimately end up living with, not the words and actions of those people. Facing the fear eventually made it disappear. The more I acted in spite of it, the less I felt it.

The same applied to every situation that I had to deal with that I feared. I feared going to the doctor, the gynecologist, a restaurant, unpredictable social situations, and getting interviewed for a new job then starting that job. Every time, I validated then faced my fears and they slowly diminished. It's a little easier for me to talk about this now because I've both lost the weight that inspired many of my fears and have already faced so many of them down. However, I remember many times in the past several years when I told my husband that I was exhausted by going out every day and facing my fears. I felt like all was doing everyday all day was battle psychological demons.

Losing weight was supposed to make my life easier, but it very much felt like one challenge after another was being put in front of me because there was a domino effect of new fears to face once I faced the first few. It felt like a treadmill of stress and difficulty and that I was actually happier when I was 380 lbs. (and in some ways, I was... but that's a topic for another post). Losing weight was making my life harder and harder because it kept opening doors to things I was afraid of rather than keeping them firmly shut. This is a reality of weight loss and one reason that it is so hard. It is actually de-motivating "in the short run", where "short" means years and years of changes. 

It's important to note that I only lost weight because I faced my fears. Some of those fears were of being hungry, failing to lose weight, and loss of something (food) that was a huge comfort to me. Losing weight didn't make most of my fears vanish, not by a long shot. Most of them were faced as part of that process. There was no shortcut and being lighter didn't solve problems. I still had a tumor in my neck and needed surgery after facing a doctor's examination. Ultimately though, I was lucky. Nothing was cancerous and the surgery wasn't incredibly serious. I hid for years due to my fears and didn't pay a price.

My sister, on the other hand, is going to pay some sort of bigger price than me. The question isn't "whether" she will, but "how high". Even if the tumor she has is benign (my greatest hope), she will need at least a partial hysterectomy. If it is cancer, it will mean a far more complex and life threatening course. I'm hoping that she gets lucky, like I did, and doesn't pay the ultimate price for living in fear for so long. 


Princess Dieter said...

I so hope it's benign. Hey, I spent 10 years without seeing an ob-gyn because I was so large and my acanthosis between my legs was so embarrassing, that I could not make myself go. The times I did go before that, still obese, but smaller, I took my own robe, cause no doctor I ever visited had robes big enough for a size 22+ person. That was humilating in itself.

I was so relieved when I finally went and she did comprehensive tests and it was all clear...and now, I am less embarrassed. I have the saggy/crinkly skin, but I remember how good it felt to be "clear". And she was great. I even told her I was embarrassed by the acanthosis and she said, "You know, it's not that bad." was amazing to hear that. I felt like such a pariah.

It's still hard to disrobe with a stranger--though I prace nude about the house and sleep nude, hubby versus strangers is a different kettle of fish.

I hope big gals just say, "My survival and health is more important than the embarssement, the trial, of tat half hour or less in an office, legs spread." Find a good lady doctor (I love female ob=gyns) and take your own robe and socks to be comfy, and just tell yourself it will be over soon. It WILL be over soon. :)

Now, if I can just get myself to set up the colonoscopy. Oddly, in this case, it's not the nudity. It's the "evacuation" and that crap you have to drink. I dread that. Ah,w ell, one exam hurdle at a time...

God bless your sis. I hope you get good news...

screaming fatgirl said...

Thank you, Princess Dieter, for commenting and for hoping along with me that it is benign.

I had never heard of acanthosis before, but I looked it up and I'm pretty sure I've had it (or something like it) on my thighs for most of my life (possibly no longer, but I haven't actually looked, oddly enough).

I wish my sister could say, "my life and health is more important," but fear is so potent that I believe we can convince ourselves that it's going to be okay and we don't need to be tested.

I'll be posting when we know the results. Thanks again!

anastasia said...

So sorry to hear about your sister. You've written about her and her life so poignantly in the past that I've often thought about her and her circumscribed life. I've lived the last few decades morbidly obese so I can truly and completely understand her fear of disrobing in front of a doctor--or anyone for that matter. It's amazing how that fear of humiliation can even thwart a desire to lengthen life. I've not had a pap test in a decade nor have I had a colonoscopy despite having a strong family history. Simply, I find it too shaming. I fear that feeling of shame so intensely. I will try to take your message of feeling and overcoming the fear to heart.

I hope that your sister's tumour is benign and that she can go on to live a happier life.

Jan said...

Another great post. Of course much of what you wrote resonated with me as some of my fears are similar to yours. I avoided medical treatment for years and it is only in the past couple of years that I have found a doctor who I felt could help me. Although there is a limit to what tests I can have due to my size, it feels good to be treatment, almost normal.
I really hope your sister gets some positive news.

LHA said...

I am so sorry about your sister, and will hope for her speedy recovery! I thank you for such an interesting and thought provoking blog. I read you frequently and always learn something. It usually give me something to search myself about too.

Fear is a powerful emotion and it does express itself in complex ways. You have made me think about what fears I need to face thoughts are coming to me even as I write this. I appreciate the mental nudge!

I'll be thinking about you and your sister and hoping for the best possible outcome.

screaming fatgirl said...

anastasia: Thank you for commenting. I would not blame you a bit for avoiding those tests nor for your feelings of apprehension. I have nothing but the deepest empathy for you. I lived in the mental space you're living in for as long or longer as you have. I don't want to give you any false pep talks or tell you what you "should" do or whatever people tend to say. I just want to say that your feelings matter and your fear and any pain you feel as a result of it are legitimate.

Jan: Thank you for coming by and commenting. I'm really thinking of you a lot these days since your harrowing hospital experience. I'm happy for you that you found a doctor and that you may be on a path to better health, but I feel for you so deeply about the hardship you are facing and will face. I wish there was more I could do to help other than say I understand and am here to talk.

LHA: Thank you also for reading and commenting. I think we all have our unique fears, though morbidly obese folks (which I was and my sister is) have similar fears due to size. Sometimes it helps to know that your fears are shared by others in the same boat. Sometimes it really doesn't matter. I'm glad that you find yourself thinking about things in a new light after reading some of my posts. It makes sharing my thoughts worthwhile even when sometimes it's wrenching to talk about them.

And thank everyone who reads, whether they comment or not, for any good wishes they send my sister's way. She needs them and I appreciate them. Bless you all.

karen said...

I'm sorry about your sister. I can't imagine the worry you feel especially so far away!

The thoughts you shared about facing fears were excellent. Acting in spite of fear until it goes away - good advice!