When I was disappointed, I tended to withdrawal and kept to myself. That was a common practice among all of the patients and so when we were all not having a good day, group therapy sessions were not as helpful as they could have been. It was hard to have a group session when none of the group wanted to talk. It was easy for us to get lost in our heads and completely ignore everything else that was going on around us.
The goal that my treatment providers set for me was to gain about a pound or two every week. That was not much at all for anyone who was not too concerned about weight, but for someone who made it her life to lose weight, it was a huge amount. I fought so hard and put my body through hell in order to lose those pounds and they were going to come back even faster than I lost them. My work was to be reversed and the monster inside scolded me for letting me put the weight back on. I did not like my doctors very much for making me gain the extra pounds. In comparison, it was extremely easy for me to have enough willpower to starve myself and it was extremely difficult to give it the nutrients it needed in order to get to a healthier weight.
My rationale was toyed with and I often convinced myself that the whole program was a set-up and that they were all only trying to make me obese, not healthy. Obviously, that was not the case, but irrational thoughts appeared out of nowhere. Many other patients believed the same thing. We often joked that our doctors probably were not at healthy weights themselves, and we doubted that they followed our meal plan. We were convinced that the people who were giving us advice were secretly a bit disordered themselves. Discussions were held at dinner and the conversations made our meals a bit more bearable.
Sara, an older woman in her 40's, started the debate one evening.
"I'm sure they don't even follow what they're telling us! They're skinny, there's no way they eat everything that we have to eat."
We laughed and agreed, not sure whether it was true or not. But Sara was not happy with her theory; she wanted to know for sure. During a group discussion about our meal plans and how food was important for our bodies, she chimed in and began to speak directly to Dr. Serrano.
"Do you even eat what you tell us to eat? Do you do what you tell us to do?"
She stunned us all with her bold bravery.
Dr. Serrano thought for a minute, taken aback by the very honest but very candid question.
"I wouldn't be teaching what I don't practice myself."
Her short answer sounded legitimate, although we still were not fully convinced. In our heads, any woman who was thin had to have some sort of eating problem. Because of the culture and the media, we were sure that about 98% of all females in the United States had some sort of disordered eating, and we were quick to judge and tried to point them all out. We made a game of picking out unhealthy coping skills in others, laughing and snickering as we bragged about what we had learned in therapy. We had become well versed on many different topics and knew much more about therapeutic techniques than most people.
We discussed many things in different therapy groups and on our own free time while waiting for groups to start, but we were not allowed to say any specific numbers. Weights, calories, and all numbers were off limits in order not to trigger anyone else and their symptoms. I am glad the rule was in place, as I would probably feel jealous if another girl bragged about her caloric intake.
Eating disorders were notorious for being very competitive between two parties. One aspect of eating disorders was being the best, pushing the furthest, losing the most weight, eating the least amount of calories. The lack of numbers within our talks was very helpful in all of our progress.
Trying to gain weight was not as easy as I originally thought it would be. I thought that eating more normally would automatically add the pounds, only it was not that simple. Even when I did follow my meal plan and was pulling in quite a few more calories than I had previously eaten, my body did not respond in the way that I had imagined. I first gained some weight from the lack of water in my body. The first meals hydrated my body again and it showed on the scale. I was secretly happy about not gaining the weight, but in order to be discharged from the program, I needed to get to my goal weight first.
Eventually, a supplement was added to my meal plan. The supplement, Ensure, was a high calorie nutritional aid, and many people supposedly drank it on a regular basis. To me, Ensure was a creation of the Devil. The caloric and fat content was equivalent to a milkshake in my mind. I would have rather had a milkshake. The Ensure was a stamp that screamed, “I’m here for you to gain weight!” I did not see it as a healthy nutritional supplement but as fat and weight in a bottle. Ordinarily, it probably would have tasted good. But drinking it for the sole purpose for gaining weight tainted the taste and it was not enjoyable. I dreaded drinking my 350-calorie drink every night. It was a chore, and for once, I wanted to gain weight so I did not have to continue the torture of drinking the thick liquid.
The supplements did not take too long to add the extra pounds and I soon reached my goal weight. On one hand, I was excited and relieved that I did not need to gain any more weight. On the other hand, I gained weight! I was terrified that the number would keep increasing, no matter what I did. I imagined my body getting back at me for the constant beatings I had put it through, storing every single calorie and saving it for my future, adding extra pounds for no other reason than to mess with my head.
Being at my goal weight meant that I was no longer sick, I no longer needed help, I thought. Everything I had seen in the media was so focused on low weights and so I assumed no one would take me seriously if I did not look sick. I was worried enough when I was underweight and even more worried when I reached my healthy weight. I assumed that people would ask me what was wrong, and they heard my answer, they would respond, "But you don't look anorexic!"
Commenting on the appearance and weight of a person with an eating disorder was probably the worst thing anyone could do. No matter what that person says, the sick one will take it the wrong way. I never wanted to hear that I looked healthy; that meant I looked fat. I did not want to hear that I looked good; that, too, meant that I was fat. Everything and anything could be misconstrued and interpreted as being fat.
The program kept track of my weight and even though I knew my "official" weight on the hospital scale, I still struggled with the scale at home. I continued to use it quite frequently and it was not helping any. The outcome was slightly different from the hospital scale and that constantly played with my head. I wondered if I really gained or lost weight, and how much the scales were off. I used my scale at home more often than I should have. I did not need to step on the platform to find out what I weighed. I already knew how much I weighed, only seeing the number gave me a sense of control. If I felt anxious, it calmed me. I knew then exactly how I was doing in that exact moment and I did not have to worry about it any longer. At least, I did not have to worry about it for a while. The worry never really went away.
My treatment team urged me to get rid of the scale that had been sitting in the kitchen. It was the instrument that first started the obsession. My parents did not understand the impact that it had on my life. Seeing the scale every day, especially where it was sitting (next to my chair at the kitchen table), reminded me of my weight. Dr. Serrano compared it to a drug addict trying to stay sober.
"It's like sitting a syringe on the table in front of a heroin addict. They do not want to stick it in their arm, but they are very tempted to do so. As long as it is there staring them in the face, they will be tempted. It is the same with your scale. You will be tempted unless you get rid of it."
She explained clearly to my dad one night during a family group. Before the discussion, he had no idea how it made me feel. After her comparison, the light bulb lit up in his head.
"Oh. I get it now. I can see how that would be hard."
He finally understood something that I could not put into words myself. I was not good at explaining how I felt or why things affected me and hearing from some
one other than me made him understand.
The night the discussion took place, he took action. I came home half-expecting the scale to be gone, although, I hoped that it would still be there for old time’s sake. I walked into the kitchen and looked to the left. The scale was no longer sitting against the wall.
"Where's the scale?" I asked.
"I got rid of it."
"Oh...ok." I was not happy about the decision but I knew it was a step in the right direction for letting go of the control the scale. It had been holding too much power and its power had been taken away.
13
Family Dysfunction
One aspect of eating disorders and treatment that frustrated me was families. Family members just did not seem to get how eating disorders work or why they were used as a coping skill to deal with life. Sometimes, they said the most inappropriate comments to the one who was suffering. Yet, they did not know that what they said was hurtful. Communication between families and patients was a difficult battle in the lives of most of the patients, including mine.
My parents did not understand why I was putting myself through such torture and they often wondered what they did wrong in order to cause it. My mom especially worried about what she might have done in the past to contribute to my self-starvation; and despite my insistence that it was not her fault, she continued to ask what she did.
“What did I do wrong?“ she’d ask in frustration.
She did nothing, and most parents did no one specific thing. Certain personalities had a pre-disposition to developing eating disorders and I just happened to have some of those traits. Technically, I guess you could say it was my parents' fault, since I am made up of their genes, but that really stretches the truth.
In the program, we were allowed to bring our parents, family members, or friends to eat dinner with us once a week. After dinner, we all sat around in a circle and talked about various topics. Family members asked questions to help them understand better and it was our job to let them in on our little world. It was still hard for them to piece together how our minds worked and they probably will never know completely.
During dinner, we were required to eat everything on our tray, and our guests had to follow the same rule. My mom and dad had no problem eating the meal - my dad actually liked getting some free food - but there were others who were stubborn and hesitant to comply.
I was lucky enough to have a couple support people in my life that may not have understood, but tried to learn more about what was going on inside my head. They did not question the rules of the program and they happily obliged to finish their dinners. Others did not have the same support and it tended to trigger some patients, myself included sometimes. In order for a patient to grow healthier, those surrounding the one in need must not necessarily understand, but be supportive in any way.
There were quite a few instances when a parent would leave part of their meal on their tray, or start with less food than everyone else. We were challenged to eat what was labeled as a normal sized meal, so when support people did not do the same, it made us question why we had to do it. We were taught from an early age to follow what our parents did, and if they did not eat the full meal, why did we?
It was very frustrating to me when I would finish my meal and look over at the thin mother at the other side of the table. Her napkin was scrunched up on her plate, signaling that she was finished with her meal. Only, her meal was not complete. There were still bites of chicken and spoonfuls of mashed potatoes lying on her plate. I looked down at my clean plate and wondered why I needed to eat it all. It was not fair, although, through the process of treatment, I was soon learning that there were many things in recovery that were not fair. If I wanted fair, I would only end up in a worse place.
Not only did parents sometimes refuse to eat the same meal as us, inappropriate talk was also brought up during our family meetings after dinner. I assumed that parents would be intelligent enough and take the liberty of bringing up more triggering conversation in private. I guess I should not have counted on my assumptions because they proved me wrong several times.
"Why do we need to eat all of that food at dinner? And why are their meal plans so big? That's a lot of food!" One mother asked after a particularly hard meal for quite a few patients.
Sitting in a giant circle, everyone looked at each other as eyes widened and whispers started traveling between the seats. I was baffled at the lack of education the parent had concerning treatment and proper conversation. I was also surprised at the ballsy question. The mother seemed oblivious to her horribly triggering question and looked around trying to find an answer. When dealing with patients with eating disorders, it was never okay to comment on the amount of food, especially directly after a meal. Especially directly after a meal in a room with very vulnerable patients.
Dr. Serrano took a breath and tried to tackle the question with the dietician's help. They, too, were thrown off by the mother's inquiry.
"Well...." she said, as she tucked her hair behind her ear, "...the meal plans here are designed following the food pyramid guide. The meal plans and each individual meal are no more than what a normal person should be eating every day. Because our patients only eat three meals and a snack, sometimes it seems like a lot because there are no snacks in between. Also, this country has been bombarded with so much information that it's hard for a lot of people to tell what a normal meal should be."
The mother was not buying her answer and for some reason felt the need to challenge the trained professional.
"Why do they need to have a dessert every day, though? No one eats dessert every day, or at least they shouldn't!"
The whispers grew louder and Sara was unable to keep herself silent.
"It's fine to have a dessert every day, they wouldn't lie to us. Everything in moderation is ok."
"Eating dessert makes us feel like it's more normal so we won't want to avoid it as much. Or it makes it seem like less of a forbidden food so we won't have the desire to binge."
I agreed with both of the women and wanted to add in my two cents.
"It's not like I want to have dessert. I do it because my doctors tell me to do it! We have to trust them since we can't trust ourselves yet."
"But..." The mother obviously did not understand the logic between meals, our requirements, our feelings, or anything else for that matter. She was caught up in her distorted views of eating and could not see clearly enough to know what was right to help her daughter. Her stubborn refusal to take in the comments by all of us made it difficult for her daughter to be around her. She could not get the support she needed in order to take steps forward in her process. Luckily, thoughts can be changed, and sometimes it took a while to reprogram.
It often made me upset that it was so hard for others to see what we all saw. In our world, things were turned upside down and inside out. Right was wrong and everything that we had been taught was turning into a lie. I had stepped into my own little distorted world of depression and self-hate many years before. That world was dark with little hope, with little chance of ever escaping. When I was trapped, I could not see outside of the misery. My brain had been rewired to believe that what I was doing was right, that it would fix everything and I would be happy. The lies that ran through my head eventually seared into my memory so that I could not forget. The fog was so dense that I could not even see the reality of the outside world. What others failed to see was that world of suffering. They could not know how difficult it was unless they had visited themselves.
Those who supported individuals who suffer from an eating disorder had a difficult task before them. Many times, communication between the support and the patient was so broken that it was nearly impossible for the two parties to get a message across. Communication with my parents was not the best and my mom often told me that talking to me was like walking on eggshells. I did not know how to express myself with words. She never knew how I would react to one of her questions, and so there wer
e many times when she just avoided it altogether.
Then there were others who got too involved and crossed personal boundaries. Those that got too involved felt personally responsible for everything regarding the patients' treatment, only it really was not their problem. It was the patients' problem and no one else’s. Others could help but it was a one man journey. It was hard for some to comprehend the complexity of such a disorder and so they tried to fix everything. It was not something that could be easily fixed and there was no easy solution and no easy way out.
The media and public opinions on eating disorders did not help situations, either. I realized that many families imagined that their daughter's story should have been like that famous-celebrity-who-had-an-eating-disorder-but-went-to-rehab-for-a-month-and-is-perfectly-okay-now.
Sure, sometimes there were those who were lucky enough to move past the demon within a month. But that was rare. It had been glamorized in society and it did not work that way. For some of the patients in the program, it was their way of life. Going in and out of treatment, year after year, was normal.
Doctor's suggestions were also challenged. Seeing things from a parents' point of view, I suppose that it would be hard to accept that the doctor's advice was more important at that time. In treatment, since family was not very well educated, some of their suggestions and comments had to be taken with a grain of salt. The professionals, on the other hand, knew what they were talking about.
Relationships with family could be a stressful situation and could even prompt symptoms. When I was walking through my dark world and looking for a way out, the last thing that I wanted to hear was my parents questioning anything I was doing. They did not necessarily need to understand, but they needed to be a little empathetic. Eventually, that empathy became an echo to follow and I started to follow the dim path out of the dark world. Without it, it would have been easy to stay lost and discouraged.
Restricted: A novel of half-truths Page 9
