Therese’s Story

For a long time, I used to wish that I had never developed an eating disorder. I felt angry, pathologized and stuck. I used to imagine how things might have been different for me if my family was different, if I weren’t so driven or if I wasn’t a woman.  As I began to understand myself more clearly, I accepted that the development of the eating disorder was part of my life history. It is a mental illness that I work to keep in remission. I don’t blame myself for its having existed much like one would not blame oneself for having had cancer or asthma. There are certainly biological, psychological and social factors that can impact whether an eating disorder manifests itself. What I am in charge of is whether or not I indulge in the eating disordered thinking and behaviors.

In the beginning, the function of the eating disorder was to comfort and soothe myself. It relieved a lot of the stress and anxiety in my life. For me, the eating disorder was a compass giving me direction while bypassing the difficulties of the present. It also gave me a false sense of success. My behaviors became my automatic “go-to” anytime I experienced a difficult emotion and needed to retreat. They were coping mechanisms that I assisted in crafting for myself.

I grew up as the youngest of four children in Milwaukee, Wisconsin. My father was a physician. My mother was a homemaker who cared for my siblings and I while almost always maintaining a warm and loving disposition. We could always go to Mom for hugs, playfulness and comfort. Dad, although he loved us in his own way, was much less approachable and a harsh critic. When you really wanted to feel like “something,” you would try to win his approval.

I had two sisters who were 10 and 8 years older than me and one brother who was 5 years older than me. We all had special gifts and we relished our accomplishments. Sadly, it is hard to tease apart what motivated us more: attaining my dad’s approval or merely avoiding his criticism.  While I don’t think we would compete with one another, as the youngest, I always felt like I was trying to catch up. From my perspective, my own skills and talents seemed subordinate. We were a very closely-knit bunch and I idealized my siblings. I aspired to be like them. Developmentally, my siblings and I were on really different planes but I placed an enormous amount of pressure on myself to close the gap.

There was an interesting food culture in home.  My mother had a Masters Degree in Nutrition and had worked for years as a high school Home Economics teacher. There was always more than enough food and a variety of it.  Friends would flock to our house to eat “sugary” cereal and “junk” food.  I was given a lot of permission around food and tasty, balanced meals were regularly served.  However, my mother was usually on a diet or “watching it.”  She fed herself on smaller plates than the rest of us and would eat non-appetizing food from time to time: cottage cheese, cans of tuna, rye crackers and diet shakes.  My father ate pretty erratically and would spend a lot of time eating snacks while standing in front of our pantry after dinner.  He had a larger body and believed strongly in fasting. So there was this idea that children had permission to be normal eaters but all bets were off for adults.  They needed to control what they ate.

The summer before I began high school, I experienced my first episode of depression. At fourteen, I spent the bulk of my summer vacation isolated, tearful, panic stricken and preoccupied with death. Most of all, I felt so ashamed of my depression; I was embarrassed of my tearfulness and the extreme anxiety I felt around beginning high school. I felt so different and so separate as I saw my friends bubbling with excitement around starting the school year.  In 1990, childhood depression was not really on the mental health map.  My parents were at a loss to help me.

With the depression, my interests began to dissolve and my appetite became poor. Around this time, I began to restrict my eating. I am not sure why I chose to control my eating specifically but I did. It was such a welcome distraction. I could spend time thinking about food rather than how sad, lonely and frightened I felt. I felt like I was back in charge of something in my brain again. And, now, I could take on the newness of high school by completely stepping out of the present! During a time when everything was changing, I wanted and needed something to be constant and predictable. Rigidity around food and, later, exercise provided that constancy and sense of control for me. As I found more and more comfort in the eating disorder, my depressive symptoms seemed to disappear and I found a place into which I could channel my difficult emotions.

During that freshman year of high school, my eating disorder also gave form to my self-concept. As my weight changed, it gave me more gratification. I was becoming a skinny girl not only at school but also at home! This was something new I could be good at! I was now basing the bulk of my self-esteem on my size.

At this point, my family had not become overly concerned. My weight had not dropped to a dangerous level and, frankly, I think they were relieved that my depression had seemingly abated. I can imagine they did not want to “rock the boat.” I think that my parents normalized my restrictive behavior as a “phase girls go through” or just normal initiation into womanhood. One of my sisters struggled with bulimia in her late teens. She sought counseling independently in college and this was not something that was discussed at home. In my family as in many, a slender body was admirable and preferred. It was a reflection of our social culture.

By spring my body continued to noticeably change and it became my primary focus. It was now apparent to the few friends I had that I was not just dieting. I became reluctant to socialize because I did not want to be pressured to eat or for my behaviors around food to be scrutinized. I grew more irritable and sensitive. I needed my behaviors; I relied on them to assure me of my attractiveness, likeability and success, essentially my worth as a person. They defined me.

The summer following my freshman year, I found myself with even more time and energy to structure according to my behaviors. My days became a series of rigid eating and exercise rituals. I became so myopic. Only food and exercise interested me. My skills, passions and dreams dwindled in favor of my behaviors. It was just me, my behaviors and my obsessions…and my parents who vacillated between denial and alarm. My father insisted that I was merely “athletic” and had remarked that it was better for me “to be underweight than the alternative.”  My mother, on the other hand, expressed genuine concern over my body which was now “clinically” anorexic. In fact,  she took me to the pediatrician who commented, “she’s just too small for germs to find her.” On the one hand, I felt that I had safely slipped under the radar. Another part of me, however, desperately wanted someone else to take over and rescue me.

In July, my mother and I took a trip to New York to visit one of my sisters who had now lived there for a few years. I felt so ill over the course of this trip, I was fearful that I might die. I checked my weight once on my sister’s scale and saw a number much lower than what I had anticipated. On the one hand, I felt a rush and, on the other, I was terrified by how far this had gone.

That evening my sister confronted me about my behaviors as well as the state of my health.  I slowly gave into tears out of shame, fear and a sense of having failed. The tears also came easily because I felt utterly exhausted by my behaviors. I was at a point of surrender. She shared her own experience of having had an eating disorder with me. While it was comforting and it gave me hope to know that I wouldn’t have to carry this around forever, I wondered who I would be without the eating disorder. It gave me such a strong and definitive identity and so much security. She offered to talk with my mom about my eating disorder since I was not ready to do so. She did and, later that month, I received outpatient therapy and nutritional counseling for the following nine months. While

I was relieved by all the encouragement to end the misery, I had some ambivalence about recovery. What would it look like? Who would I become? What on earth would I do without my behaviors?

Over the course of this initial recovery period, I began to binge. When I entered therapy, what I craved most was the permission to eat. I felt exhausted and depleted; I desperately wanted and needed to “give” to myself. This need seemed so bottomless. I was not yet thinking beyond food or my body and, so, I nurtured myself through habitual overeating. Biologically and psychologically, this made some real sense. My body and brain were starved. However, it was extremely difficult for me to move beyond this behavior once my body was nourished. I couldn’t establish more normal eating patterns because my thinking around food hadn’t yet changed.

Because I had been so underweight, my family, therapist and dietician were overjoyed that I was eating again. This time in my life was both thrilling and frightening. I was in charge but without an instruction manual. For so long, I had clung to something precise and external to dictate my actions.

As my body changed again, I felt extremely uneasy about myself and my eating. My therapist and dietician viewed my eating andweight gain as progress and my own experimentation with the refeeding process. At the time, I viewed it as a loss of control. Certainly, in some ways, I felt invigorated by this “experimentation” and my rebellion against restrictive eating. I had begun to take risks and break rules. While that was good, I got stuck there. Eating felt “rebellious” and “irresponsible.” And it certainly did not yet mesh positively with my ideas around beauty, goodness and worth. Food was still a moral issue.

Because my family and I viewed my eating disorder as largely a weight- and food-based illness, I terminated with my therapist and dietician after my weight had stabilized in a healthy range for a few months. I had not yet begun to look at the deeper meaning of my eating disorder: the purpose it served, the assurance it provided me and how it helped me to escape.

For the next several years, my weight fluctuated greatly and much of my eating remained compulsive albeit at a less severe level. What remained constant and unresolved was the sense that I was deprived and could never get enough. I felt positively insatiable. At the time, I did not realize that this hunger was not entirely about food. It was about all the other restrictions in my life. That is why I romanticized my binges; they were a reaction to and rejection of my restrictiveness. The eating disorder served a larger purpose in my life and now there was a void. And, so, I began my search….

While away at college in Chicago, I became fascinated by the psychology of eating disorders. Just as I had once dove into diet books, I now buried my nose in books by therapists, physicians and assorted eating disorders specialists. I looked toward these experts for permission, once again, to liberate myself. I wanted some authority to trust; in a way, I wanted to cling to a new structure. I felt that my own judgment was flawed and untrustworthy. Feeling empowered by my new gurus, I began a peer-led eating disorders support group on campus. I didn’t really know what I was doing. I just didn’t want to be alone in trying to get better; I felt like I was a rebel against the disorder and I wanted some comrades. I wanted to feel vindicated in “letting myself go.”

Among the three group members, we all yearned to be “normal.” We hoped to recover the untainted relationships we once had with our bodies and food before the onset of our respective disorders. We all felt the solution to our problems lay in being able to change how we viewed and used food or how we felt about our bodies. What we didn’t consider was the why in the equation. Why did we maintain our behaviors? How did they serve us and what did they represent?

I needed reassurance that people would still love me and support me if I began to change and transform. Primarily, I was terrified of losing my boyfriend who I was certain, loved me because of my physical appearance and over all self-restraint. To the outsider, my needs and requests were so small. I was so agreeable and mild natured. I worked so hard to whittle more than just my body down. I intensely needed people to like me so that I could feel OK about myself. I imagined that if I would put an end to my restricting, my eating and body shape would spin out of control thereby jeopardizing my most likeable and special qualities.

During my senior year of college, I sought the help of a therapist and a dietician again. This time, I was more motivated to understand why I had this relationship with food and my body. I had made efforts to “normalize” my eating and maintain a healthy weight. I was no longer clinically ill but I still didn’t exactly feel comfortable in my own skin and eating would, at times, cause me to feel guilt, shame or self-reproach. Although I only spent a few months in therapy, I continued to progress in my recovery and self-awareness. I had changed by stepping out of my confines a little bit and becoming a little more “messy” and real. I revealed my needs, wants and insecurities to those close to me; I argued and cried. I ever so slowly broke out of my shell.

At this time, I decided that I wanted to continue learning about the treatment of eating disorders, women’s mental health and different models of therapy. I wanted to keep growing and understanding eating disorders while helping others. After two years, I completed my Masters degree in Social Work in Boston.

My first year out of graduate school, I suffered from my second episode of depression.  A family member referred me to a wonderful psychiatrist in the Boston area. Over a period of several years, I saw her regularly for individual therapy which focused on depression and psychopharmacology visits. This was the first time that I had truly begun to investigate my struggles with depression under the guidance and care of a really compassionate provider. I started to understand more of the why in my eating disorder. I began to understand the strong connection between depression and my eating disorder. I discovered that I used my behaviors to manage my stress and anxiety as well as frustration and sadness. When circumstances or emotions became seemingly unmanageable, my eating disorder provided constancy and refuge. It was repetitive, formulaic and predictable. Through therapy, I slowly started to see myself as much more than a jumble of pathology and failures. I came to witness my strength, competence and value as a human being. I started to trust myself again. I was also able to acknowledge the progress I had made, just on my own. At the same time, I began to accept that my recovery would not be linear or “perfect.”

And I stayed well through the pregnancy and birth of my son 2 years later. I began to volunteer at MEDA, Inc, as an outpatient eating disorder support group co-leader.  And I even stayed well following the birth of my daughter 3 years after that. A few months after my daughter was born, however, I slipped back into some of my old behaviors. I was alternating bingeing with fasting. This retreat into the eating disorder happened when my son was diagnosed with autism. Once again, I felt terrified, powerless and as though I had failed in life. This time, though, I was not only dealing with my own pain; I had a newborn to take care of and a little boy who was now diagnosed as having “special needs.” For me, eating or not eating was a simple solution…I did not need to hire a babysitter or ask my husband to watch the kids. I could multi-task and take on everything and manage by channeling all of my pain and exhaustion into destructive eating patterns. This went on for about 6 months.

I was miserable and was aware that I was not the person, the woman, the mother I wanted to be. Although my psychiatrist was wonderful with helping me manage depression, I knew that I needed to work with someone who had experience treating eating disorders. I began to see a psychologist and registered dietitian that specialized in eating disorders.  They encouraged me to uncover my faulty thinking and challenge it. They helped me to find my voice again: to state my needs, to ask for help and establish my boundaries.  Mostly, they taught me the incredible value of self-care. I cannot nourish and nurture others if my own well is depleted.

Today, I own my process as a continuing journey. For a long time, I strove to be “cured” because I was so ashamed of ever having had an eating disorder. After acknowledging the past presence of an eating disorder in my life, I felt so flawed and self-conscious that my recovery was not immediate, like somehow, I had messed up at getting well. It was difficult, furthermore, to feel positive about moving through recovery while continually judging the recovery. The idea of treating myself more gently and less critically has absolutely helped me to maintain a more forward momentum.

My recovery is a priority for me. The loving support of my husband, my family and my very closest friends truly help me to remain grounded.  My two children are my main reason to be well. I strive to have energy and a love of life that I can share with them. I want to be a well mother and adult role model for them. Those two people have really redefined “perfect” for me and I will be forever grateful to them. I have discovered joyful movement in a variety of way: walks, yoga, swimming, dancing and lifting weights. I do not abide by any exercise routine or schedule, though.  I fully embrace intuitive eating.  I take medication to treat my mood disorder and I still see a psychiatrist and therapist in addition to my general practitioner. I also make a lot of irreverent and fun artwork which you can view on Instagram @healingcrayons.

Over the years, I have discovered that recovery, for me, is not summed up in being completely “cured.” Negative feelings and thoughts have and will flit in and out. It is not solely about the presence or absence of behaviors. That eclipses too much of the process and experience of attaining wellness. Recovery, for me, is about trying my best to stay truly engaged in life, all the while learning more about myself.

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