A Reflection; No Mirror Required

Sometimes it's surprising how much we change. Sometimes it's surprising how little we do.
Either way, it's important to look back and see where we've been, where we've gone, and how far we've come.
Sometimes the person I've been is someone I barely recognize as myself, and yet I know her all too well. It's as though I've changed so much that my previous self is an entirely different person from who I am now, and while I can understand and relate to the deepest feelings and experiences of that person, it is no longer who I am.
Most of the time.

When I was 15, I developed Anorexia Nervosa. Classically defined as "the refusal to maintain body weight at or above a minimally normal weight for age and height (generally less than 85% of expected weight) accompanied with an intense fear of gaining weight or becoming fat, disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight. Additionally, in women who have not yet gone through menopause, the absence or loss of the menstrual cycle is a key indicator." (www.something-fishy.org) It is a disease perceived of in this culture as a lifestyle choice or confused with vanity, obsession and conceit. But what most people don't see is that the illness is a coping mechanism in which internal pain or frustration is manifested in physical terms on the body and in preoccupation with weight and physical appearance. It is the cognitive process of masking personal issues with physical ideas of perfection and transforming life problems into bodily dissatisfaction.

"It is important to remember that there is not one single simple thing that causes a person to develop an Eating Disorder. It usually lies in some combination of the social, environment, and biological attributes, and/or the family dysfunction of each individual." www.something-fishy.org

There are a number of reasons I've explored for why I personally developed this disorder. Part of it can be attributed to the panic felt by an adolescent to control my life and to create an identity for myself- I fell back on the identity of the "little one"- the youngest grandchild in my family, the little sister, the smallest in my class etc. I was craving love and feeling worthless but because these were too painful for me to recognize and deal with, my I subconsciously converted them and any other less-than-pleasant feeling into "feeling fat." I did everything I could think of to avoid this feeling, from dieting, exercising, restricting calories and eventually food groups, self-induced vomiting, purging by laxatives and abusing diet pills. The feeling of accomplishment when I lost a pound, while exhilarating, was nonetheless fleeting and the "fat feeling" would return only momentarily.

I did not know that this was not normal. I was convinced by the little Eating Disorder (ED) voice in my head that this was how I was to live; this was all there was. I did not think there was anything wrong with me, and I most certainly did not think I had a disease. My first therapist explained to me:

"an eating disorder is like standing in a room, and deciding you don't like the color of the wall to your left, so you paint the one on your right. Now you still don't like the color of the left wall, and you again, paint the right one. What happens is, there is something within yourself that is causing some stress, but you don't feel like you can deal with it, so instead you change something on your outside (i.e. your weight etc.) but, like the walls, it doesn't satisfy your discomfort, so you keep changing your external, until you finally pay attention to the internal."

A few quintessential memories of this time in my life come to mind:

One afternoon, after an exhausting day of school, I came crashing into my mom's office (she worked at my high school) and told her I couldn't go to play rehearsal (I was cast as Alice in Alice in Wonderland). I kind of collapsed on the floor, crying, as my muscles ached and I approached one of my own breaking points, sort of beginning to realize that my behavior was taking a toll on me. I leaned against the wall and my skirt fell above my knee. This allowed my mother to see the multiple straight-line scars on my thigh. I saw her eyes dart to them and a millisecond of fear and sadness flashed in her eyes before I pulled my skirt down and ran out of her office and to her car where I waited for her to take me home. I think this was when my mom realized that something was really wrong. After this incident, I told my parents, in a rare state of mental clarity, that I needed help, that I was hurting myself in multiple ways, and that I was scared. I remember my dad's response: "Want to go for a bike ride?" He wasn't treating me differently, he didn't pin my identity with this disease- I was still his daughter, and he wasn't treating me like a porcelain doll. I smiled- YES, I wanna go for a bike ride. This was the most perfect thing he could have done in that moment.

One evening, kneeling in front of the toilet like a throne, crying, breaking down and realizing that I was no longer in control- my "dieting" was controlling me, and I was powerless. My mother opened the bathroom door, saw me, and calmly shut the toilet seat, pulled my close to her and told me "It's going to be okay, we're going to get through this," as she stroked my head. This was the most perfect thing she could have done in that moment.

Arguing in the kitchen with my mother because I wouldn't eat dinner again. I was getting ready to go out and was waiting for her to drive me, but she wanted me to eat something before I left. She didn't push hard, but I refused, over and over, and eventually erupted, lifting my shirt up and asked her if she could see my ribs. "If you can't see my ribs, I'm not thin enough!" I shouted. I can just remember the look on my mother's face; a look of sheer sadness and hopelessness, with a plea in her eyes for me to get healthy.

I remember being so angry that they had diagnosed me. It felt like an unnecessary limitation; the obligation the therapists and nutritionists put on me to gain weight seemed like a misapplication of their expertise. I was a waste of a patient because there was nothing wrong with me, they should spend their time helping people who actually are sick. I particularly remember seeing a girl from my middle school in the mall. She was part of the 'popular kid' crowd when I knew her, but we had gone to different high schools and I hadn't seen her in two years. When I saw her in Forever21, she was very thin, probably at a similar weight to me at the time, and I thought, "I know that girl, and she doesn't have an eating disorder, why can't I look like her, and not have this stupid diagnosis?!" A few weeks later, I saw her sitting in the Office of my Eating Disorder-specialized therapist/nutritionist.

Anorexia Nervosa is a disease most commonly mistaken as a lifestyle choice or confused with vanity, obsession and conceit. During the time I spent engrossed in anorexia, my mind and my body were metaphysically at war. My mind, once a close ally, betrayed my body. I became caught in the battle and was forced to choose sides. Anorexia double crossed me, turned me against my own body and vice versa. As my body begged for respect and nourishment, my mind attacked it as an enemy crossing the border. My mind became the territory of my eating illness and my body was intruding. Eating illnesses are blood thirsty and merciless. Except, those struggling with them generally believe they've got a friend, not a life-threatening illness.

Beginning in October of my sophomore year, my parents had me seeing an Eating Disorder specialized nutritionist regularly, and I had had a few consults with therapists in the same field. They came to the same conclusion and diagnosed me with Anorexia Nervosa, and warned me that if I didn't gain weight soon, I'd be in the hospital in no time. I was of course deluded by my conviction that continuing on this path (destructive as it was) would bring me happiness, and did not believe their threats.

By Halloween, I had successfully isolated myself from most of my friends, was rapidly losing weight and was all-the-more dedicated to my disease. An average day consisted of a piece of fruit and 3 pieces of gum throughout the day, constant obsessive thoughts about my body, losing weight, what to eat or not to eat, and setting weight loss goals for myself. Any binges I had as a result of a starving body would be purged because of the intense guilt I felt after eating- as though I didn't deserve it. I remember thinking that my body's needs were less than others, and while others needed to eat three balanced, nutritious meals a day, I did not, and if I did, it would in fact destroy me and everything I was working for. I felt that I had a "higher standard of beauty," one which I would never hold any of my friends to, but that was the bare minimum for myself.

A few weeks later, on a Wednesday, I had an appointment with a therapist at the same office of the nutritionist I had been seeing, and ignoring. They weighed me, brought my family in, and talked for some time about the possibility of hospitalization- a conversation I had heard with distant ears several times and it never worried me. I had tickets to go with a friend to see my favorite band of the time in two days and I was more concerned about that. Two days later, Friday, I was in Honors U.S. History class, taking notes and using the margins of my notebook to count calories and doodle as my mind wandered due to lack of nutrition. My mother's face unexpectedly came to the window of the classroom door, and she cautiously beckoned my history teacher over, whispered something, and then motioned me to come with her. I walked out of the classroom and had a conversation that would change my life. I was told I was being taken to the hospital. She would drive us back to the house, I would pack a bag of clothes for about a week and then I'd be taken to the hospital for an evaluation. I stormed back into my classroom, grabbed my notebook, made no eye contact and left.

I was furious, but I was not worried. I was certain that I would not be deemed "sick" and would not be admitted, my mother would be made into a fool and I would return to my "life," having only wasted a few hours. We drove to the hospital in total silence. After measuring my blood pressure, heart rate, taking an EEG, and asking me questions about how I saw myself in the mirror and inquiring about scars on my wrists and thighs, they weighed me.
this. terrified. me.

The average, healthy 15 year old female weighs between 120-140 pounds. I weighed in at 78 pounds. Hello, hospitalization.
I asked the nurse if I could go to the concert that night and come back on Monday, or something. The answer, obviously was no- but that just goes to show the value I had placed on my health.
The next 2 and a half months of hospitalization, Intensive Outpatient and Partial Hospitalization Therapy were some of the hardest times in my life. I had to face fears of food and gaining weight, but also even more intense fears of losing control, inadequacy, and dependence. I had to come to terms with issues that I had masked with body preoccupation, and I had to learn to be assertive- to use my voice to tell people how I feel, rather than to express it with my body. I had previously expressed my pain through starvation- through making my body sick, and now I was learning to express myself healthily.

Since being discharged from the hospital almost four years ago, I've come a long way. My path on recovery has been far from straight and narrow, it's been more akin to a roller-coaster ridden backwards and blindfolded most of the way. Its an issue that I face every day, a battle I fight from sun-up to sun-down, but some times are easier than others. There are moments when I feel like I've got this down, settled, under control, and there are times when it feels like I'll never stop hurting, never stop fighting. Relapses have come and gone, and every time I have to fight, it feels just as hard but every time I fight, I'm stronger for it. And while I may not ever be completely "over" this, life is about doing the work, so I'll keep working, getting better, learning and never quitting. Because it's just not me anymore. Most of the time.

peace, love and strength to all who are fighting, have fought or support those struggling with anorexia, bulimia and EDNOS.

If any of this sounds like you, or someone you love, please seek help:
Www.something-fishy.org
Www.edap.org
Feel free to comment or contact me- this is nota joke, we are in this together.
:-D