Thin, Beautiful, and Out of Control, Part II

November, 2009

Not knowing where to go, I made an appointment with a woman at my university’s counseling center. She had bright, kind eyes and listened empathetically as I tearfully explained to her how I had lost control, binged nightly, and over-exercised. She put her hand over mine and suggested I see Dr. S., a well-known therapist at a special center for eating disorders nearby. At that point in time, I knew my situation was dire; I knew I wasn’t going to “get better” on my own. Each morning, for the last year, I had resolved to eat more regular meals, stop binging, and stop the over-exercising. Each night, upon waking, I made my way to the kitchen, binged, and deprived myself the next day. I was being whipped around on the fastest, scariest roller coaster around, with no one to stop it, and no emergency exit.

December, 2009

The clinic was modern, with chic couches and elegant lamps. I looked around at the people sitting in the waiting room. Some were young, some were middle-aged, and a few were elderly. Some people were large; some were “average,” and others looked fragile. A few people looked bored; some looked nervous. I was one of the nervous ones; I bounced my leg up and down, leafed through The Washington Post, and wondered how my first appointment, the “intake appointment” would go. A woman in a black pencil skirt, shiny high-heels, and a bright pink button-down shirt emerged from a hallway, called my name, and ushered me into a small, well-lit room. The woman pointed to an oversized chair, and asked me to sit. She asked me a series of questions about my eating, exercise, and purging habits. The appointment was quick, and relatively painless.  The woman scheduled my next, “real” appointment, with Dr. S., for the following week.

2010/Early 2011

I’m not sure what I expected therapy to be like. In the waiting room of the clinic, prior to my first appointment with Dr. S., I wondered what I would say. Would I tell her what I told the woman during my intake appointment? Would I lie on a couch and tell her about my childhood? Would I regale her with the details of my latest binge? I wondered if she would judge me. Would she think I was damaged goods, beyond repair?

Dr. S. turned out to be a very kind woman; she smiled and nodded encouragingly during every session. While parts of the treatment focused on building my coping skills and alleviating my fear of food, a large part of it involved learning to love myself. In order to do that, I had to come to terms with some aspects of my childhood. It isn’t that I had an awful, nightmarish childhood, but I wouldn’t call it idyllic either. I was always fed, clothed, and given a warm place to sleep at night; my parents told me they loved me. My mother and father divorced when I was three. My mother remarried when I was four, to a young man with no children of his own. I could be a challenging child, with a fiery temper, and distaste for authority. My parents, I think, didn’t know how to handle me. At times, they said some things that hurt me. Sometimes, my behavior led to arguments between my mother and step-father, which I overheard. My brother and I visited our father on the weekends. He loved us, but could be rough with us, both physically and emotionally. Even though I acted “tough,” I was a sensitive child, who internalized all of this. My perception, from a young age, was that something was wrong with me. I was stupid, and bad. Difficulty with some of my peers in elementary and middle school, and rejection from many of my high school peers only strengthened the beliefs I had about myself.

I hadn’t really talked about my childhood to anyone before going to therapy. Speaking about it to Dr. S., I became angry with my parents. My anger eventually turned to sadness, and slowly, that sadness turned to acceptance. My parents had us when they were young, and they did the best they could. I know there are some things they would do differently if given the chance. It took a little longer for me to come to terms with myself. Dr. S. encouraged me me to stand in front of a mirror and recite affirmations, daily; I was told to say: “I am a good person,” “I am worthy of love,” “I am good enough just the way I am,” etc. It seemed so silly, standing there, talking to myself. In the beginning, I couldn’t even bring myself to look at the girl in the mirror; she was ugly. After about three months, I was able to recite a few affirmations, and believe them. I was smart, I had nice eyes, and I was a kind person. About six months into treatment, I got two tattoos on my wrists, to remind myself to love and accept others for who they are, beginning with myself.

Another part of my treatment involved learning to “feel my feelings.” I know that may sound corny, but prior to going to therapy, I didn’t feel many of my feelings. To cover up my sadness, shame, and anger, I ate. It was a distraction, sometimes a short one, but one in which I felt something other than all of those negative feelings.  I had to learn to accept being sad, ashamed, and angry. It wasn’t easy, and was a process, but once I was able to deal with those feelings, my desire to cover them up with food decreased.

In addition to seeing Dr. S., I worked with a nutritionist, Ms. C., once a week. Ms. C.  asked me to record everything I ate and drank, rate my hunger before and after eating,  and log my emotional state before eating. She asked me not to count calories, and to surrender my scale. I continued to count calories, for about three months after I began seeing her, but I did give up my scale. Not knowing my weight was sometimes a source of intense anxiety. On a few occasions, I grew so concerned about my weight, I drove to the nearby Target store and weighed myself. I should note that while in treatment, I was instructed to stop exercising- no Elliptical, no treadmill, no work-out videos, and no grueling hikes. Because I participated in out-patient treatment, it was impossible for them to monitor this, so I continued to exercise.

In terms of the food, Ms. C. encouraged me to eat whatever I wanted. I know it may sound counter-intuitive, but she explained that only when I gave myself permission to eat what I wanted, whenever I wanted, would I begin to regain control over my eating habits. Each week, Ms. C. would issue a challenge: go out for an ice cream sundae, order Chinese food, or buy a loaf of bread at Panera (GASP! Something that wasn’t “low-calorie”!) Sometimes I complied with the challenges, and other times, I didn’t and told Ms. C. I did. I was reluctant to go along with the “eating whatever you want” idea. I fought it for the first few months of treatment. Slowly, I began eating the foods I had denied myself for months: Olive Garden’s Chicken Scampi, brownies, frozen yogurt, and Vegetable Lo-Mein. The more I ate the foods I desired, the less I binged.

During all of this, I was enrolled in a rigorous, full-time graduate program, worked a 20-hour assistantship with the university, worked a part-time job at a retail store, and completed a school psychology practicum experience (I worked in a school one to two days per week). There were days I sat in class, didn’t speak to anyone, and didn’t hear a word the professor said. I missed two classes over the first two years of the program; those were days following significant nighttime binges. I felt so ashamed of myself after those binges that I couldn’t bring myself to get out of bed. Thankfully, I have always been a great independent learner, so I made it through the program with a 3.86 grade point average. Most days, I’m amazed I made it through.

Summer, 2010

Six months into therapy, I had made some progress. I was becoming less critical of myself, attempting to feel my feelings, and eating more regularly, but I was still struggling. I just felt sad; I didn’t want to get out of bed on some days, I didn’t want to go anywhere, and I didn’t want to see anyone. Dr. S. encouraged me to see a psychiatrist, who suggested I try an antidepressant. While I wouldn’t describe myself as “anti-meds,” I usually tried to manage illnesses and sicknesses without them. The psychiatrist assured me that if I didn’t like the way it made me feel, I did not have to continue taking it. Hesitantly, I agreed, and began taking the medication. It was awful; it made me incredibly lethargic, I had difficulty attending, and I swear I started seeing “things.” After five days on the medication, I was taken off of it. I was asked to try one more medication. It turned out to be divine. For the first time in about two years, I felt light, and happy. I was able to put more energy into my therapy, and I began sleeping better.

Fall, 2011

I had landed a full-time psychology internship about an hour and a half away from the university I attended. My husband and I moved, and I stopped going to therapy. Dr. S. and Ms. C. offered their well-wishes, and assured me they would be there if I needed them. The binge episodes had all but ceased. On occasion, I would wake in the middle of the night and wander into the kitchen, but I was able to “talk myself down” from eating. A few times, I did eat, but it was typically a granola bar, or a scoop of peanut My eating was no longer out of control. In November, I found out I was pregnant. Knowing that a little life was growing inside of me gave me incentive to work even harder on the things I had learned in therapy.

Fall, 2013

I have not had a binge episode since September, 2011. Prior to becoming pregnant, I stopped taking my antidepressant, with the approval of my doctor. I have not been on any medication since. I eat the foods I love, with no restrictions. I have a difficult time “working out,” at least in the formal sense. I think the hours upon hours of gliding on the Elliptical and walking/running on the treadmill left a bad taste in my mouth. I dance, go for walks, and play with my sweet baby P; that is my “work out.” I don’t weigh myself routinely, but I am wearing the same size I did in high school, and my doctor says my health is great.

My experience with an eating disorder, and the recovery, taught me so many things I want to share, especially with P. Chad and I are already taking steps in hopes of preventing her from developing an eating disorder. First, in our home food is not “good” or “bad,” it’s just food. Some provides more nutrients than others, but when you break it down, food does not have any moral value. Second, we eat dessert in this house. Brownies, cookies, and donuts are fine by us. What Ms. C. taught me in treatment was so true; once you give yourself permission to eat whatever you want, when you want it, the desire to do so decreases (trust me on this one). Third, we’re working on banishing the “negative food and body talk.” I still struggle with this one, but the goal is: no more “I feel so fat today,” “I shouldn’t have eaten that donut,” or “I hate the way my butt looks in these pants.” We do not want P to view her body as something that needs to be criticized. Fourth, we will stress being active because it makes you feel good, and keeps you strong, not so you can look good in a certain article of clothing, or have a “six-pack.” Next, we will monitor and limit, if necessary, P’s exposure to media. There are unhealthy images everywhere; young women parading around in music videos with their bones jutting out, “diet food” commercials, and advertisements for extreme weight loss products. When P sees these images, we hope to be there, and have a discussion about what is healthy and realistic, and what is not. And last, we hope to teach and model for P how to “feel your feelings.” Negative feelings are painful, and unpleasant, but if you don’t let yourself feel them, they will show up somewhere else.

Living with an eating disorder and working through treatment was an experience I don’t wish upon anyone. It was physically and emotionally painful, lonely, and frightening, for me, and those closest to me. There are no guarantees, but I’m hopeful that something positive can come from my experience. I remind myself often that above the clouds, the sun is always shining.