Wasted: A Memoir of Anorexia and Bulimia (31 page)

She said to me finally, in a low voice, “They're going to make you eat eventually, you know.” I said nothing. Staff said to her, “Sarah, you are only responsible for yourself,” and he smiled at her. She looked at her plate.

The nurse arrived with a tray of small paper cups, like those taster cups at yogurt shops, only they were full of pills. Everyone said, Hi Shawn, and Shawn, a woman in her fifties with a pleasant face, said good morning to everyone, and passed out meds. She got to me, set a cup full of Prozac and multivitamins in the center of my empty plate. I swallowed them with the smallest possible sip of milk. I tried to picture the size of the sip: a tablespoon? Twenty calories, maybe?

Maybe just ten? One-eighth of a gram of fat? More?

I liked this business of having the freedom to serve myself. It seemed just right to me. It had the desired effect of empowering me to make my

own choices, and I thought to myself in a grandiose voice: I choose not to eat at all. I suppose, in retrospect, that only a rather disturbed person could find a locked institution liberating, which I did, for just under a day. They weren't making me eat. They were waiting to see what I did, but I didn't know that. I found that out after breakfast, when Shawn took me upstairs to her office, put me on the scale, and found me hovering at about eighty pounds. Then I got a treatment plan.

It entailed this: Either eat, and stay here at Lowe House, or don't eat, and go back to the hospital, where you will be forced to eat, and then return to Lowe House.

No exit.

Can't I just go back to the hospital and then go home? No. But all the food here is fettening! That's not a very accurate perception. Yes it is! Well, the food we have is the food we have. I won't eat it! Then you'll go back to the hospital. Fine, at least the food there isn't DRIPPING WITH FAT! That's all right, but then you'll come back to Lowe House. Are you telling me I'm STUCK HERE? Yes.

Stuck there, yes. But I still had my laxatives, therefore I still had my eating disorder, and therefore I still had myself. In a little satin jewelry bag in the back of my closet, I kept the laxatives between two sweaters folded neatly on their shelf. I would never, during my stay,
consume
the laxatives. I would, however, keep them in a corner of my mind as they were kept in the corner of the closet, picture them there, picture reaching between the sweaters, taking them out, tipping my head back, swallowing them all, should the need arise.

I would hold on to this small comfort, a pharmaceutical security blanket, calming myself with their mere presence, my modicum of control over me.

Think back to the fact that children, in their early years, teach themselves how to regulate moods, slow the careening train of anxiety as it clatters through the brain. It's not so uncommon for a person to simply teach themselves the wrong thing. Like me.

By the time I got to Lowe House, a horrible paradox was running my life, and to some extent runs it still: My only means of self-regulation was self-destruction. To give up a long-standing eating disorder, one that has developed at precisely the same pace as your personality, your intellect, your body, your identity itself, you have to give up all vestiges of it; and in doing so, you have to surrender some behaviors so old that they are almost primal instincts.2 I had to give up the only tried-and-true way of handling the world that I knew, turning instead to things untested, unproven, uncertain. I am a suspicious person by nature. I could not simply take as gospel that I would “someday”

learn to live without the eating disorder. I was not absolutely certain that I could do it: I had no “normal” life to return to, no prior experience of eating “normally,” being “healthy.” So I kept the eating disorder—small reminders, the uneaten laxatives, the patterns that organized my eating of carrots and peas, the little thoughts that got me to sleep (I can always go back, I can always do it again when I get out)—as backup, just in case. That was a mistake.

It took Staff a few days to get the idea that I wasn't going to serve myself. They revamped my treatment plan. At breakfast the next day, there were eleven blank plates and one plate full of food, covered with cellophane. It was lukewarm, the plastic steamed up with what I was sure was straight fat. A glass filled too full of milk sat next to it. I was informed that if I chose not to finish my food, I would be given a can of

2“The root of masochistic conflict,” Zerbe writes, “probably stems from the earliest time
in development when the establishment of a body self is disrupted” (167). The equation of
self-protection with self-destruction—or of pleasure with pain—can be viewed as a psychological fissure in the psycho-physical boundary previously discussed. It has been speculated
that many eating disorders have at least some basis in an early childhood trauma, however
minor, usually occurring in the first year of life. This is why I use the term “primal” in
describing the depth of conflict that an anoretic may experience, and to highlight the profound
difficulty she may have in giving up her behaviors. It is primal not in the sense that it is
innate, but in the sense that it may be experienced as innate. Lacking language, an infant
can only express her needs through physical behavior; later in life, this developmental gap
may manifest itself in an eating disorder, wherein needs and emotional states are both expressed and regulated by a physical “language.” It is notable that well over half of all eating-disorder patients are considered to be “alexithymic,” that is, unable to effectively verbalize
emotional states, even as they are often exceptionally verbal (in my case, diagnostically

“hyperverbal”) in expressing intellectual concepts. Even now, during my hours of therapy,
my articulations are limited to the intellectual. I will intellectually inform my therapist
that I have, for example, sliced up my arms with a razor blade (see afterword) and then
quote medical textbooks as an explanation for why such behavior might arise in a theoretical
person. “How do you feel about this?” my therapist will ask. “Well, I think it has its primary
etiology in blah blah blah—” “But how do you feel?” I stare at her blankly. “I don't know.”

Ensure after the meal (a whole can? Yes. But that's WAY more calories than the food! Then finish the food, Marya) and another can at snack time in the afternoon. They tried this for a while, but I was still losing weight. The cans of Ensure became mandatory, whether I finished my food or not. Nothing was fair. Everything was falling apart. There was nowhere I could go.

And so there was really nothing to do but try to get well.

Except that I didn't really know what was wrong. At Lowe House, the focus was not on food, or body image, or anything of the sort.

They treated you as a person whose life and emotions had somehow made you very sad, and this was an approach I did not know how to handle at all. It was an approach that seemed entirely reasonable for the rest of the Clients, whose problems were, in all objective reality, far more serious than mine; some were victims of unspeak-able cruelty at the hands of their own families, abandoned by parents, shuffled from foster home to foster home for years, like my roommate and Duane. Some were victims of rape or childhood sexual exploitation. Some had severe personality or thought disorders, from depression so severe it was mitigated only by a battalion of hard-core antidepressants, to multiple personality disorder or possible schizophrenia. Some had deep and probably chemical emotional disorders that had gone completely out of control, leading them to multiple suicide attempts, massive sexual promiscuity, and drug use. A few were, as far as I could tell, just plain old criminals who had somehow ducked into treatment instead of jail, and probably wound up in jail anyway later on.3

Whereas I was a big question mark. A victim, primarily, of myself, which makes victim status very uneasy and ultimately ridiculous.

My family messy, but hardly psychotic. The specifics of my diagnos-able disorder, beyond the obvious eating, unclear. I appeared to be some form of

3It is notable that there were no black patients at Lowe House. Several years later, working
on an article about the racial imbalance in juvenile detention centers and residential treatment centers, I would return to Lowe House on assignment and find myself talking to a
number of administrative brick walls. Ultimately, the article would question the judicial
pattern of “referring” young white criminals to treatment while “referring” young criminals
of color to the penal system.

depressive, though this would later turn out to be inaccurate (I'm manic). I showed, noted my shrink in his notes on our meetings, no signs of a personality or thought disorder. I seemed, he also noted, a relatively well-adjusted, if emotionally blank, severely eating-disordered young woman exhibiting “the ideas and behaviors of a person ten years older than her chronological age.…She is pleasant but condescending and intimidating. She makes the examiner feel as if he is asking stupid questions that he should know the answer to or that certain [questions] have foregone conclusions that anyone would understand.”

I was condescending because I felt like a serious idiot, a royal fuck-up, and a general lost cause. It became apparent very quickly that I was light-years away from understanding my Issues. I understood that what I was doing was not, by any objective standards, healthy, and I understood that there were reasons I was doing it. It was not my opinion, however, that those reasons were anything serious, anything complex at all. I assumed, though I did say this, that there was something innately wrong with me, that I was a
priori
flawed in some way. I was not sad, I was not angry, I was not depressed, I was not bipolar or schizophrenic, I did not have a personality disorder, there were no events in my life that were overly traumatic, nothing external was wrong. What was wrong was me, therefore no amount of therapy would make me well.

All of us have theories about the world and about ourselves. We will go to great lengths to prove ourselves right because it keeps the world in our head coherent and understandable. My theory was simple: I was a screwed-up person. The phrase “self-fulfilling prophecy” comes to mind.

Eating disorders are different, in some ways, from most forms of depression or other “mental illness.” It is important to note that many people who get eating disorders have a preexisting chemical depression or other biological predispositions that lead to eating-disordered behavior, but then there are also many people who get eating disorders without that predisposition. I was, to the best of anyone's knowledge, of the latter set. Furthermore, the chemical imbalance that malnutrition induces may lead to depression, which in turn is dealt with through eating-disordered behavior, which is what probably happened in my case. The point I'm getting at here is that while depression may play a

role in eating disorders, either as cause or effect, it cannot always be pinpointed directly, and therefore you never know quite what you're dealing with. Are you trying to treat depression as a cause, as the thing that has screwed up your life and altered your behaviors, or as an effect? Or are you dealing with a screwed-up life and disordered behaviors that are simply
depressing
? Will drug therapy help, or is that a Band-Aid cure? How big a role do your upbringing and family play? Does the culture have anything to do with it? Is your personality just problematic by nature, or is there, in fact, a faulty chemical pathway in your brain? If so, was it there before you started starving yourself, or did the starving put it there?

All of the above?

I was not, the month before my seventeenth birthday, dealing with any of this. I was sitting at the little table in the main room, reading schoolbooks. We had school every day from just after breakfast to just before lunch. We sat in three tiny rooms, grade levels abolished altogether, doing whatever assignments the three harried teachers figured were appropriate for our age, using whatever ancient schoolbooks the Minneapolis Public Schools threw our way. They just fed me books, at first. I developed an academic plan for myself to lessen the manic anxiety I felt about being out of school, which was a great hindrance to my Future. I had a book of Trigonometry, a book of history, and several books of American literature. I read voraciously as much Whitman and Emerson and Thoreau as I could get my hands on, swooped through trigonometry (and promptly forgot it), read all of ancient history, Greek, Roman, Chinese, then into the Middle Ages, then started in on the early American short story, wrote paper after paper for a teacher who just wrote “Excellent!” at the end of every one. Hair pulled back in a bandanna, glasses propped on my nose, no shoes, cozy as a bug in a rug, reading. No one to bother me, “No deeds to do, no promises to keep,” I began to compulsively take down my favorite quotes. I have four fat three-ring binders full of spiral notebook paper, scribbled over with quotes from e.e. cummings. Whitman I thought a bit mushy, very fond of the Modernist approach. This was my favorite: “What's madness but nobility of soul/At odds with circumstance?”

What's madness but nobility of soul

At odds with circumstance? The day's on fire!

I know the purity of pure despair,

My shadow pinned against a sweating wall.

That place among the rocks—is it a cave,

Or winding path? The edge is what I have.

—THEODORE ROETHKE, “IN A DARK TIME,” 1964

Give me a break, I was sixteen. At sixteen, locked in a mental ward, who would not want to believe in some level of nobility? In all truth, I thought I
did
know the purity of pure despair. I firmly believed that I was
living
pure despair, wronged by fate and at odds with circumstance, the innocent man falsely accused and incarcerated for life, the martyrdom of the misunderstood. I felt
terribly
misunderstood. It was simply not
fair
, this cruel punishment. I was not mad!