At 4:32 a.m., I awoke to the crackle of radio static.
Still half asleep, I searched for my white paper gown.
It was crumpled in the corner next to my black Adidas sports bag.
The Adidas sports bag--plus two smaller ones--contained a month's
worth of wrinkled clothing. All
of my belongings had been searched the day before, leaving me with a
disheveled mess. The room was
cold and drab. There were no
pictures, just sterile uncomfortable beds and imitation furniture.
I did not look forward to replacing my oversized sweatshirt and
cotton shorts with a scratchy thin gown every morning.
Careful not to wake my sleeping roommate, I tiptoed out of the room
into the activity area. The
poems, quotes, and therapy regulated affirmations covering the walls and
the window frames caught my attention before I
preceded downstairs for vitals. Two
of the quotes, written by patients, read, "Above all else love
yourself" and "I can live without my disorder."
Love myself? I still had to learn to accept myself.
And, living without my disorder would require learning to live a
whole different life. That is
why I was standing on the second floor of Renfrew, the top eating disorder
facility in the nation. Overcoming
bulimia nervosa was something I could not do alone.
My disorder began four
years ago in the summer of 1996. I
was on a cruise with my family and for months I had been restricting my
food. I
wanted to lose weight to look
better and to run faster. I
was the captain of my high school cross-country team.
At first, I just stopped eating snacks, then I skipped meals.
By the time we went on the cruise, I was counting calories and
increasing my workouts. I was
obsessing over food. I felt
empowered when I refrained from eating and guilty when I did eat.
On cruise ships there is an abundance of food.
Every time I turned around there was food staring me down,
tempting me. I hadn't been
eating much of anything, and one night hunger got the best of me.
At first, I ate a small plate of vegetables and roasted chicken.
Then, I started eating everything I could get my hands on: cake,
cookies, and other "bad" foods.
I was acting on impulse. I
let my feelings take over. After
my binge I was panicky. I
could not believe the amount of food I'd eaten.
Ashamed and angry, I decided to try and purge my food. I went to
the cramped bathroom in my room and shoved my fingers down my throat, successfully purging the food I had just eaten.
And I said to myself, "Just this once, and I'll never do it
again."
The bulimia continued well into the school year and into my
cross-country season. I
figured I had everything under control--my grades, my athletic
performance, my family relationships, and my future.
In reality I was letting everything external control me.
I wanted to be "up to par."
My appearance was something I could control, and controlling it
became addictive. Every time I
walked into a room I felt like all eyes were on me, picking out all of my
flaws. I never looked in the
mirror and was completely happy with what I saw.
The bulimia began with my dissatisfaction of my body, but it turned
into a habit and then a life-threatening addiction.
The decision to become
a patient at Renfrew was difficult. I
was nineteen and in the middle of my first semester at the University
of Maryland. My
bulimia had taken control of my life.
I stopped going to classes in order to accommodate my binge-purge
patterns. Consistent
binge-purge cycles made me dehydrated and weak.
But, I needed the euphoric feeling they gave me.
Bulimia separated me from reality.
It numbed my feelings and, at the same time, gave me a rush.
Girls I met in treatment gave similar descriptions of their own
bulimic experience. My
episodes were roller coaster rides, anxiety filled and thrilling.
Once the thrill passed, I wanted to do it
again and again until I became too exhausted
to continue.
Bulimia became me. If I
was not binging or purging, I was sleeping or thinking about binging and
purging. I was running away
from life, I was escaping. I
had lost all interest in school. I
had transferred from
North Carolina
State
with a 3.9 grade point average.
And, at Maryland
I was close to failing all of my classes.
One morning I woke up and felt nothing.
I wasn't sad, worried, hostile, afraid, confused, bored, desperate,
or lonely. I was nothing.
It was as if all emotion had been pushed to a place I couldn't
reach. I called my mom and
said, "help me." Less
than a week later I was on my way to Renfrew.
When I first arrived, I was
given packets of rules and regulations.
I
was put on the purple team,
which meant that I would share the same psychologist and psychiatrist as
the other members of the purple team. The purple team would also meet
after every meal together in MST--mealtime support therapy.
There we discussed how we felt before, during, and after the meals.
Renfrew was structured. Every
morning the routine was the same. First,
I sat against the wall waiting behind those unfortunate girls whose vital
check times were even earlier than mine.
Next, one of the night nurses would call my name, take my weight,
my blood pressure, and a blood sample.
Blood work was needed to monitor my body’s adjustment to a proper
diet. Then, I would walk to
the distribution
counter and take five pills.
The little white ones were each a 100mg dose of Zoloft.
Originally, I was put on the drug Paxil.
But, after a few severe headaches attributed to the drug I was
switched to Zoloft. Both Paxil
and Zoloft are anti-depressant/anti-anxiety drugs.
The little green one was the drug Trazidone, used to help me sleep.
The big green one was a multi-vitamin, and the big orange one was a
calcium supplement. Nutritional
supplements helped my body re-establish and maintain an electrolyte
balance. In high school I had frequently passed out in the middle of a race.
My doctor at Renfrew told me that electrolyte imbalances were most
likely a partial cause to my black outs and that if I had been taking
better care of myself I would have been a more
proficient athlete.
For
breakfast all of the patients filed into the dining room.
The most important rules during mealtime were: No talking about
food or looking at your menus. No
substitutions. You may not
wear jackets or sweatshirts with pockets into the dining hall.
All food and drinks must remain
in the dining hall.
You must remain seated during mealtime until you are checked off.
You will be supplemented after each meal for any missed exchanges.
The rules went unbroken most of the time, except for people not
finishing all of their food. All
patients went by a menu that broke food up into exchanges.
For example, a girl on a 2,200-calories-per-day diet would have nine
protein/dairy exchanges, four fat exchanges, ten carbohydrate
exchanges, three fruit exchanges, and three vegetable exchanges.
Some girls were on plans that required over 5,000 calories a day.
We had seventy-five minutes to eat and then all patients broke off
into mealtime support groups.
During the day I attended all kinds of
groups. My schedule that
listed the group and its time and place reminded me of a college class
schedule. I participated in
Adult Psychodrama, Handling Difficult Feelings, Journal, Separation
Issues, Understanding Body Image, After-care Group, Relapse Prevention,
Interpersonal Group, Assertiveness, Nutrition, Menu Writing, Grief and
Loss, Movement Therapy, Relaxation, Art Therapy, Embodiment, and
Understanding Relationships. Groups
helped me focus on things other than my eating
disorder. I also had a
psychiatry appointment three times a week and daily forty-minute sessions
with a psychologist.
The
doctors were there to monitor medication and health problems.
The counselors were there to listen, the nutritionists to monitor
individual diets, the psychiatrists to medicate, the psychologists to
analyze and organize, the movement therapists to provide relaxation, the
massage therapists to provide a sense of one’s own body, and the art therapists
to provide a non-verbal expression of emotion.
I was a
perfect patient that followed
all of the rules. I did not
purge any of my
food during my treatment, but
that did not mean I would be able to easily continue my non-bulimic
behavior when released back into the real world.
In-patient treatment is just the
beginning of the struggle to come. Treatment provides a base to build
from. Concerned and confused
parents send their daughters to Renfrew with the hope that their little
girl will return home and lead a happy healthy life.
Unfortunately, relapses are common.
Going in and out of treatment becomes a difficult pattern to break.
Some of the girls I have talked to in treatment are convinced that
they'll be patients for life. Knowing the problem exists does not
necessarily make it any easier to solve.
My mom only caught on to my bulimia after months of its
progression. She began
noticing how much I ate or restricted my food and my frequent trips to the
bathroom after a meal. When
she confronted me with it I agreed to see a therapist, but I did not want
to let my problem go. Eating
disorder patients are different from most other patients because they
typically don’t want help, and don’t seek treatment
until after they’ve had the disorder for many years.
My first therapist was not experienced with eating disorder
patients, and she had a difficult time understanding why my fear of
rejection was so strong and from where that fear originated.
Studies have shown that therapists who had a greater number of
eating disorder patients in their caseloads reported feeling more
frustrated, angry, tired, and manipulated than those with fewer eating
disorder patients.
At
Renfrew, my therapist was incredible.
Like most bulimics, I used words to hide rather than reveal an
emotional experience. But, my
therapist at Renfrew knew how to dig up past experiences and explain them in relation to my eating
disorder. I made more progress
in my six week stay at Renfrew, than I had in years of therapy.
But, therapy was all I had to concentrate on.
My real test would be leaving Renfrew and confronting real life.
My
last night at Renfrew was on Halloween.
In celebration of my departure the following morning, some of the
girls suggested we go out for the night.
Only eight of the girls, including me, were permitted to leave the
facility. Renfrew had levels
of progress, and only those individuals on the highest level were granted
the privilege of leaving unaccompanied by a counselor.
I was excited and nervous for myself and the other girls, two of
whom I had become close with over the past few weeks. We went to a local
mall sporting our plastic identification bracelets. The eight of us
excited and scared walked into Friday’s restaurant to eat.
It took thirty anxiety-filled minutes to order.
Each one of us counted our exchanges in our heads.
It was important, not too little, not too much, and not too exact.
The drinks were easy: water, water,
water, and water.
The goal was not to be too picky and to make sure the meal met food
exchange requirements. The
task went fairly well. The trips to the bathroom were together, the
unfinished food was eventually finished with encouragement, and the
anxious moments were discussed with compassionate understanding.
The meal was a success. We
shopped and bought matching black-beaded bracelets that stood for
strength. We laughed, and we
wore honest smiles. We called
ourselves the “Frew Crew.” We were happy, carefree, and content with
life at that very moment. For
at least a few hours we were triumphant.
I was triumphant and ready to live a life free of bulimia.
The next
day my mom came to pick me up. "Hey,
kiddo, how do you feel?" she said.
"I am pretty good. But
ready to go home." I replied. I
wanted to tell her that, I've been symptom free for six weeks, but I
didn't. If I told her she
might have had higher expectations for me, and I did not want to
disappoint her if I relapsed within the next few days.
The girls at Renfrew had faith in me and even told me I was an
inspiration since I did so well in treatment.
The Renfrew staff decided to release me because they believed I
had made sufficient progress and the next best step for me would be to try
and stay symptom-free at home.
Living
at home was not easy. I
focused on positive things like my love
for running and spending time
with Docker, my new black lab puppy. I
began binging and purging again two months after leaving treatment, but
not to the same severity as when I entered treatment.
My next challenge was going back to school.
I decided the best way for me to meet people would be by joining a
sorority. So I did join and I
love sorority life. But living in a sorority with an eating disorder is difficult. There is the
constant sound of girls whining about their bodies.
The girls chant, “I am ugly, I am too fat, my arms are too big,
my legs are too big, my stomach is too big, everything is too big.”
Then they say, “I wish I looked like that (not her, but that), I
want those abs, I want that body, I wish I could trade my thighs for
hers.” It doesn’t end
there; they feed off one another’s comments: “I’m going on a diet,
I’m disgusting, what I would give for those legs, I would kill for that
body."
Surprisingly, all
of these girls are well informed of the treatment centers I’ve attended,
and yet they persist, even going to the extent of saying, “Ugh, I am so
full I just want to throw up this food.”
“Go ahead,” I think. I
just loved blacking out in public bathrooms, hiding my food, lying to
people, constantly feeling anxious, attacking my brother in bursts of
rage, being so dehydrated that I often had to crawl to the sink for water.
Flirting with an eating disorder is dangerous--I found out the hard
way.
Now, I try not to think about my body in a negative way.
Renfrew helped me change the way I look at things.
When I was a baby my parents called me “thunder thighs.”
As a bulimic this message is horrifying.
But as a bulimic slowly progressing toward recovery and acceptance
of my body, I find the comment complimentary.
Physically speaking, of all my body parts, my thighs have gone
above and beyond their call of duty. They toughed it out through
years of horse-back riding, four seasons of cross-country, four seasons of
indoor track, and four seasons of outdoor track.
In addition, every year they run the half marathon without
complaint. While my other
muscles cramp, pull, and ache my thighs remain un-phased.
To my thighs I owe a long awaited thank-you for carrying me across
the finish lines.
Today, I have a new therapist,
Yvonne. I see a psychiatrist
once in awhile and I have symptom-free weeks.
Most importantly when Yvonne says, "Amber, you have to try and
focus on today and worry about tomorrow when it comes," I actually
listen. I know I have
developed an improved "sense of self," but I still have the
addiction part to struggle with. My
impulses are compelling, especially when I am angry, stressed, or upset.
I know that with effort and practice my alternative coping methods
will become familiar and take place of the bulimia.
Walking the dog, writing in a journal, talking to someone, or
listening to all the tracks on a favorite CD don't seem that difficult.
But, as a bulimic doing
one of those things instead of binging and purging is a monumental event.
Renfrew showed me that it is possible to be completely
symptom-free one day, but that it takes hard work and persistence.
Renfrew helped me start the road to recovery.
It is up to me to finish it.
