Once you label me, you negate me.
~ Soren Kierkegaard [Danish Philosopher]
An article in the New York Times grabbed my attention instantly. It appeared in the health section. The title, One Spoonful at a Time. This writing was heartfelt. Author, Harriet Brown tells a gripping tale. It took me to memories of my own struggle with anorexia and bulimia and how these affected my family. In this exposé, the dilemma of how to treat the condition was thoroughly discussed. I wish to share my response to this situation and story. My personal experience of this is vast. I hope my thoughts, realizations, and rejoinders on this topic will be helpful to those grappling with similar issues. I trust that the effects of anorexia and bulimia are trials and tribulations for all those afflicted by these.
The subject of weight alone is a sensitive probing. An individual need not starve, binge, or purge in wrestling with weight. On the same day another New York Times essay loomed large entitled “Big People on Campus.” This commentary contemplated the plight of being “fat.” I was once that too. Many may muse in this moment, all anorexics believe they are chubby, and while that may or may not be true, I actually was at times in my life. My weight rarely was stable; nor was I when reflecting upon it. However, my weight was never the issue; it was a distraction, a symptom of what was within.
As I read the articles mentioned above, when I turned on the television and saw a report on the increasing male bulimic and anorexic population, and as I listened to a discussion focusing on the media, and the message of being thin, I wondered. Why are Americans obsessed with their weight and avoiding the truer concern?
Americans spend billions of dollars on books, diet programs, professional weight trainers, and behavioral experts that might deliver them from “evil” otherwise known as “eating disorders.” Some recount, “I eat too much,” others muse, “I eat too little.” There are those that think they do not make healthy choices, those that believe themselves fine; their family worries about their physical condition.
I lived in a plump body; a buff body, a slender body, and one that was sickly thin. As a child I over ate. It was what most members of my family did. As an adolescent, I dieted. That is what teenagers do. However, weight was not the trepidation it appeared to be. My problems with body image were not pressing; nor did my peers influence me.
It was my life at home, in my heart. Much was disquieting. My parents were together; yet, they were not. My natural father was rarely home and when he was, it was not fun for me. My sisters were close in age and seemed to have a connection with me; however, it felt incomplete. For me, school began at an early age. I love learning and welcomed the opportunity; still, there were demands, those I placed on myself. Life progressed and it seemed perfect.
I had goals, visions, and dreams. In my late teens, I wanted to lose my virginity. That seemed the natural progression, at least in my neighborhood, or among my peers. Oddly enough, a young man began paying attention to me. This may not seem unusual; yet, it was. Those that are closely familiar with my ways and thoughts recognize that this was quite striking.
I was never “boy crazy.” I had no thoughts of marriage or even being in a relationship. I was and still am extremely comfortable with my own company. Perhaps, I am a little too independent. While I have always had very close friends, I was not one to seek physical intimacy. I did not need company or companionship. It could be imposing. I needed time to be me. Nevertheless, this gentleman delighted in my presence.
Yes, we did “connect;” we did the deed; still he wanted more! Imagine that! Eric wanted a real relationship, with all the bells and whistles. I later learned Eric wanted to marry me. Years, before realizing that his intention was to wed, I freaked. When confronted with the fact that he wanted us to spend all our time together I panicked.
Eric was and is an extraordinary man. Physically, he is quite the “looker,” not my type. I love brains; brawn does little to warm the cockles of my heart. He is kind, tender, and evenly tempered. Eric is infinitely considerate, and amazingly enough, he does love to learn.
Women fell for him, flocked to him, and fought for his attention, all but me. Initially, I just saw him as a vehicle for losing my virginity. I never expected he would fill my mind. I did not plan to take time and be with him beyond the bed. I never imagined he would enter my heart. Yet, he did and that scared me. I put on weight, lots, and lots of pounds. I did this as I do most things. I am exceptionally thorough. If I am to do a job, I will do it incredibly well. I grew fat! Perchance, obese might be a better word. Eric said nothing. He still wanted to be with me.
Now, what was I to do? All this weight, I wore poundage that poured over the edges of my clothing. I was uncomfortable in my body. I needed, no wanted to loose all this excess mass. I began dieting. I did it well depending on your standard, and not well, if health is a main concern. At first, I only wanted to lose what I had gained. I did this. Then as the pressures of life grew, my apprehension for food and what would follow were I to eat it grew.
Years passed, as did my obsession with weight and food. After a time, apprehension for my impending graduation from college consumed me. The more I thought about this the more I struggled. Careers, professions, being more a part of the “real” world, more responsible for my self, it all seemed a sacrifice. What was I to do or be now?
While attending the University, I never hesitated. I chose my majors and pursued each discipline with zeal. My course of study never changed. However, I never expected to graduate. That was not part of my plan. I had no desire to leave the sanctuary of school. I first enrolled in classes at the age of two. Academia was the world I knew. What next?
Next, or soon, I would become a statistic. Not unlike the “Kitty” in the tale her author mother, Harriet Brown tells. I was anorexic. Ultimately, that lifestyle was too difficult. Starving my self was such a struggle. I chose bulimia instead. I “thought” that would be an easier avenue to pursue. It was not. I had no control over my life, my weight, my worries, my ways. A person such as myself that prefers infinite tranquility, found herself in a world of chaos, chaos I created!
For decades my family deliberated, what would they do? What could they do? Some pondered what had they done. Who was at fault and would the circumstances ever change? There was much guilt, theirs, mine, and ours!
I share this revealing story with reason. Harriet Brown, the parents, the professionals in her tale all do as people customarily do. They look for facts, quick fixes, simple solutions, thirty-second spots, immediate gratification, and spontaneous change. I acknowledge the year or more this family invested in re-parenting and feeding their child; one spoonful at a time was overwhelming. Yet, in the end, wonderment still fills the void of not knowing.
Ms. Brown discusses in depth the niche, a role, the pondering, the play, the place, and the label each person holds. Yet, for me, she misses the nuances. The world within will determine whether Kitty again chooses an addiction with food or the lack of it. I believe and experience that our compulsions cannot be broadcast through numbers. I understand the fascination with facts, the need to look for answers. Nevertheless . . .
Programs may not be profound no matter what they cost or what their supposed success.
we asked Kitty’s pediatrician where her other anorexic patients went for treatment. “When they’re this sick, they go away,” she said, referring to inpatient eating-disorder clinics, where people often stay for two or three months. The nearest was an hour away and cost $1,000 a day, most of which would not be covered by our HMO.
There is ample reason for alarm.
Anorexia is one of the deadliest psychiatric diseases; it’s estimated that up to 15 percent of anorexics die, from suicide or complications related to starvation. About a third may make some improvement but are still dominated by their obsession with food. Many become depressed or anxious, and some develop substance-abuse problems, like alcoholism. Almost half never marry. It is thought that if anorexia is not treated early on, during adolescence, it tends to take an average of five to seven years for the person to recover – if it happens at all.
There are behavioral modification plans and they tout great success.
Among the few studies done on anorexia treatment, I came across one from 1997, a follow-up to an earlier study on adolescents that assessed a method developed in England and was still relatively unknown in the United States: family- based treatment, often called the Maudsley approach. This treatment was created by a team of therapists led by Christopher Dare and Ivan Eisler at the Maudsley Hospital in London, in the mid-1980s, as an alternative to hospitalization. In a hospital setting, nurses sit with anorexic patients at meals, encouraging and calming them; they create a culture in which patients have to eat. The Maudsley approach urges families to essentially take on the nurses’ role. Parents become primary caretakers, working with a Maudsley therapist. Their job: Finding ways to insist that their children eat.
The two studies showed that 90 percent of the adolescents recovered or made significant gains; five years later, 90 percent had fully recovered. (Two other studies confirmed these results.) In the world of eating disorders, I was coming to understand, this was a phenomenally high success rate.
Yet, I think it is essential to consider what works for one person may be the kiss of death for another. I personally, would have rebelled and reacted more overtly had my parents spent their every waking hour with me, as the Brown’s did.
I would not have felt loved, quite the contrary. I would have felt as though they did not trust me. I grew up in a family whose primary principle was “No one has the right to tell you what you “should,” think, say, do, feel, or be!” Granted coupled with this was the belief, “Do whatever makes you happy, as long as it does not hurt anyone” and of course, my reactions were hurting everyone; nonetheless, they were mine to choose. In my mind and in the family I was raised in, it was accepted, in order to learn we must error. It is part of our evolution. To force another to be, as we believe is best gives them no room to grow and discover for themselves.
Harriet Brown acknowledges that
The idea that parents should be intimately involved in the re-feeding of their children can be quite controversial, a departure from the conventional notion that the dynamic between parent and child causes or contributes to the anorexia. Many therapists advocate a “parentectomy,” insisting that parents stay out of the treatment to preserve the child’s privacy and autonomy. They say that a child must “choose” to eat in order to truly recover.
However, she chose to believe as Maudsley advocates “no one else knows the child as well or has the same investment in the child’s well-being. She states, “That felt right to us.”
As I read Ms. Brown’s re-counting, I was continually struck by the specifics of the feeding process and the lack of luminosity. There was so little of Kitty’s feelings expressed. While I trust that her parents spoke to her of her fears, apprehensions, and worries, the details of these discussions were not shared with the reader.
As I reflected on Kitty’s approaching entrance into high school, my own memories flooded my mind. I knew while living through anorexia and bulimia, it was never about the weight. It was the wait, the anticipation of the unexpected, unknown, unidentified, and unfamiliar. It was the strange, the strain, the mysterious, and the mystifying musings that strangled my soul!
I do understand the dynamic; the habit becomes the pattern etched into the brain and physical memory. I comprehend the ever-present question, which comes first the chicken or the egg. I recognize the theories
Over the last few years, most eating-disorders researchers have begun to think that there is no single cause of anorexia, that maybe it’s more like a recipe, where several ingredients – genetics, personality type, hormones, stressful life events – come together in just the wrong way.
What I think is in error is the prospect presented by
Maudsley practitioners say that focusing on the cause is secondary, ultimately, because once the physiological process of starvation kicks in, the disease takes on a life of its own, unfolding with predictable symptoms, intensity and long-term consequences. Anorexics become almost uniformly depressed, withdrawn, enraged, anxious, irritable or suicidal, and their thinking about food and eating is distorted, in part because the brain runs on glucose, and when it has been deprived over a long period of time, when it’s starved, it goes haywire. It’s important to get the patient’s weight up, fast, because the less time spent in starvation, the better the outcome. Adult anorexics who have been chronically ill for years have much poorer prognoses than teenagers.
In my own life and search for a cure, I found professionals that believed as these do. I contend, the obsessions of medical professional almost killed me. Killing with the kindness of tough-love, prescribed by parents or physicians has the potential of doing a person in. It certainly would have taken a toll on me.
Thankfully, I located others, those that treat with love, just as my parents did and do. I discovered “experts” that acknowledge they are not. They understood the notion that a person that has never experienced an illness cannot fully understand it. Thus, they turned to me. My parents and physicians reflected on who they knew me to be as a person. They thought me wise.
I was trusted to resolve the situation for myself. I was given only potassium and talk therapy to keep me alive. Those in my life trusted my intelligence, my reflective nature, and my ability to be introspective. The professionals, my parents, and my peers believed in me when I did not. This was confusing, though extremely meaningful to me.
Those close to me knew of the tens of hours I devoted daily to eating, isolation, and purging. They hoped, based on their history and knowledge of me that I was not simply doing binging and purging, but that I was also thinking. I was working through my concerns and circumstances. Indeed, I was. When I finally, she says with great exasperation, found myself, discovered what Harriet Brown might refer to as my demons, I met them with delight. I no longer; nor did my family or friends need to contemplate the possible impending doom. I would not, will not return to those trying days of old anorexic or bulimic beckoning.
Four months after the “change of life” [no, not menopause] giving up my ways, I was thrown into a situation that truly tested my will. I was in a serious accident. Unexpectedly, my life went topsy-turvy. I was badly injured and unable to walk. The prognosis was grim. It would be half a year before I could again return to a standing position. I had perfected the bulimia process through many a situation, and in the past, I would have found a way to again engage. I had the will and there was always a way. However, on this occasion I did not return or resort to my decades old pattern. I did not consider the option.
Ms. Brown, I share this with you for you are questioning, anxious, what might the future bring. I myself think behavior modification programs such as the Maudsley plan may be nice. Their success rate may seem comforting; however, I caution, it is my experience that unless or until the cause is addressed, the emotional effects are evaluated the likelihood that there is true resolution is “slim.” Many experts say anorexia and bulimia are chronic conditions. Years after my coming of age, I still do not experience sweaty palms. I do not white knuckle my way through stressful situations. I think the emotional, intellectual work is essential. Kitty may have done the work that you did not speak of. I know not. Nonetheless, I worry. I think “cures” and certainty come with more than one spoonful at a time.
Please weigh your options. Read the references. Reflect who you are, more than your mass.
Dear reader, you may wish to peruse Chapters One through Six, of my life as an anorexic, bulimic, a person. Please do.
Or Similar Discussions . . .
Betsy L. Angert
BeThink.org or Be-Think
the plague. I just don’t feel like talking about it today I guess. I’m Tracy, I’m an anorexic….not bulimic (sick anorexics think they are better than the pukers because we have the courage and fortitude to STARVE to death and it’s less yucky in some ways more gross in others though). All my “stuff” was attached to having to deal with losing my family and not being able to control what happened and having nobody to blame and having few family members who wanted to talk about it. I was told many times to just forget about it….like a person can do that! A person has to find a BIG GOD when you have a day like that and sadly only perhaps one distant family member had that size of spirituality to share and I wasn’t sure if it was okay to own such a large spirituality until I had to get help for my anorexia. I have been a HUGE success story considering that I dealt with it finally in the year 1988 and we knew considerably less then than we do now. My healthy weight is around 140, I’m over 5’7″ and my body type is very densely muscled so I can weigh quite a bit more than other people but my body isn’t taking up that much space. I once weighed 95 lbs….ew! I have not relapsed since I was 23 and as the years go by I can even lose a close family member and still eat once that first day. Under big stress I used to forget to eat for about two days. I am actually a little overweight right now but the only word I ask myself to live by now is healthy. My goal is to be healthy. I can never have the goal of being thin ever again because thin is sort of without end, you can get thinner and thinner and thinner but there isn’t a standard measure for thin and it’s not a good goal. Lots of good endorphins when you starve too, can help a lot with those self esteem issues you have as a teen and then everybody congratulates you on your thinself……it’s a baaaaad mix in America.
Oh Dear Militarytracy . . .
I wish I had seen this earlier. My heart breaks! Oh, I know starving, which I did for years is quite an accomplishment, not in a profound sense. I decided it was too challenging for me. However, it was years before I made that decision. I caused much anguish for my family and for me.
I am so sooooorry, if you would, please share. How did you lose members of your family. Did no one recognize what that does to a person. Be it by death or emotional separation, I know the pain is devastating and does not die or dwindle.
Militarytracy, I wish I could reach out to you, touch your tender heart. As I wrote to another comment, when my father read the New York Times article, it took him back. When he read my words, his heart hurt. The memories, the fears have never left him.
I understand that there is always the possibility of being thinner. I can only share my own story and assure you, the “condition” need not be chronic, though I thought I was doomed with that diagnosis.
Once you work through what is within, an achievement that still fascinates me and truthfully occurred through a life experience not attached to therapy, you will not white knuckle your way through life. Perhaps you have already done this. I too now choose health. Happiness is far easier to find than I imagined. At times, I think it is the joy that scares us.
in an accident in 1972. It really wasn’t the fault of anyone either where the trauma was concerned. It was more a societal thing where grief was concerned back then. People who could suck it up were doing the “right thing” and people who wanted to talk about the bad things were picking at scabs. I had been monitored by social services when I was smaller, they wanted to make sure that stayed involved in my school activities and things like that. I became a huge over achiever and hid there, they had no reason to suspect I needed anything because I just couldn’t be anymore perfect. I also had a court ordered shrink, God, what a putz sitting on his arse collecting his paycheck. I think that all the work that went into AA and helping alcoholics paved the way for understanding that everybody must process ALL of their emotions and not just the ones that everybody likes. It was a time of giant learning for me and once my emotions and feelings were respected by another human being I began a rapid healing. I never used to cry though….never….just wouldn’t by the time I reached about 16. Crying was a worthless useless experience I had been taught by society as a whole back then and nobody even wanted to think about how much crying someone like me might have in them. When I finally was able to cry again I swear, I cried for four days. I called my counselor a little bit frantic because I needed to go work yet I couldn’t stop crying. Knowing that if he gave me one reason to stop I would latch onto it ferociously like a dying woman he told me I would stop crying when I was finished and hung up on me. I went to work full of sorrow but oddly no one said anything to me, it was sort of like maybe it was okay to not always have a happy face every single damn day. I went home after work and cried for another 24 hours when I was awake and then finally, just as my counselor predicted I guess I was done and I stopped. I remember looking around my home that day after I was finished and it looked like the whole world had been washed clean and I sort of felt a little hungry too…..then began my return to a life a bit more reality based and allowing things back into my feeling reality again that I may not be able to control and trusting that it would be okay and listen to my gut feelings about what is happening in my surroundings. After my own experiences I became very interested in psychology. I have taken lots of classes and workshops on different things. It’s a fascinating area of living but I would never want to be a therapist.
Dear Militarytracy . . .
How interesting. I thank you for sharing. At the age of eight, my life changed. My Mom returned to school and re-married. Both my parents, the, were psychotherapist. I had much permission to be, even to feel; however, the earlier years of my life left me thinking feeling was not a worthy pursuit. I lived in logic and I was indeed happy, though hurt and wounded.
Food temporarily took away the feelings, or at least I hoped it would. Actually, purging for hours on end gave me sooooooo much time to think. I never intended to love intimately. I worked hard to be sure that I stayed safe. While I unknowingly had many excellent and lasting relationships, I did not understand them or even acknowledge what I created.
My deliverance did not come from drugs to treat on therapy, though the talk therapy was helpful. What helped me was experiencing pain fully.
If you read the Gary missive I wrote and wondered why I would stay, it was because very early on I realized he was my mirror. I learned from experience, reading, and discussions with others that we are all insecure, we act it out or hide it differently.
I saw myself in a man that others thought was the black to my white. Introspection, reflection, and accidentally allowing myself to truly feel helped me more than any therapy or drugs had. Plunging deeper into the pain, rather than numbing myself, avoiding what really hurt helped to heal me.
Then there were the lovelies in my life . . . I send hugs and kisses to you all. Your trust in me when I could not and would not trust myself, smooches!!!!!!!!
Wondering if you saw “Thin”, the HBO documentary, if you’re interested in seeing it, or if you think it’s safer not seen.
I know every person is different, but I’ve a friend who’s kicking around the idea of seeing it, and as she’s been in recovery for 5 or 6 years, I’d rather be able to discuss it with her intelligently. What effect it might have on her, that sort of thing.
I’ve talked to her, I’ve read stuff, but only when I saw Thin did I really understand how much courage it takes just to say “I’m an anorexic, bulimic, a person.”
So my hat’s off to you, for fighting, for posting this diary here, and for giving hope. Thanks for this.
My take on watching it is that someone who has some recovery behind them can witness how far they have come. I can still relate to much of what those in the documentary were going through and I can sort of remember being that “crazy” but it is a long way down the road now. The documentary didn’t trigger me or anything like that. It was just sad knowing that struggle still continues. I found myself angry at the mother battling her eating disorder and eating with her daughter at the treatment center and picking apart a salad and trying to bite parts of lettuce that didn’t have any dressing on them. If we don’t get into some sort of recovery with this garbage we just pass it on to our kids in some form, and here’s this woman’s daughter in treatment and dying and she’s acting it out right in front of her during a family visit. I did sort of want to reach through the television and give her small throttling.
It amazes me, the sheer level of ignorance out there–which can’t help people in recovery one bit. The idea that anyone would choose anorexia or bulimia is so incredibly ignorant there isn’t a good enough word for it. I think one of the biggest positives about that movie is that it makes ‘not a choice’ so utterly clear.
It ought to be criminal, IMO, for insurance companies to turn people in need out of programs like the one in the documentary. I mean, given what (and WHO) that poor 15-year old girl has to go home to, where else can she get help?
It was an eye-opener in so many ways. I hope my friend decides to watch it and gets something good out of it. The sheer amount of hope I felt–that there is good help out there for people suffering from those diseases, that it’s possible to make such enormous strides in weeks (even if that doesn’t fix it, it’s a start)…it was good to see.
It hurt to watch, too. And that was good, I think. Because it brings it all home–those are women like you and me, and we have to have each others’ backs.
But what really ran through my mind at the end?
Universal healthcare needs to be SUCH a huge priority. Having the chance to yank your life back from a disease like that shouldn’t be dependent on income.
Thanks for replying. I’m glad you’re in a better place now, and I’d give you a hug, but my monitor gets in the way. So, consider this (( )) a virtual hug, I guess. 😉
Dear thoughtcr1me . . .
I thank you for your kind words and thoughts, for caring to understand you friend.
I would love to see “Thin”; however, I do not have HBO.