Sep 12, 2015

How I Beat Bulimia, One Therapist At A Time

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Trigger warning: This article and pages it links to contain information about eating disorders which may be triggering to survivors. If you are currently suffering from an eating disorder, please call the National Eating Disorder Information Centre (NEDIC.ca) for North America, the Netzwerk Esstörungen for Switzerland, Germany and Austria, or a similar service in your area. In case of emergency, please call the National Suicide Prevention Lifeline (or any similar helpline in your area).
Disclaimer: I am not a mental health professional. All opinions expressed are personal, my own and do not represent the views of my employer. No statement made in this article should be considered official or sanctioned by Sheena's Place
tldr: I suffered from bulimia for eleven years, and have been fully recovered for ten. Therapy, Yoga, food management and feminism helped. There is hope! 

Falling Ill

The first time I threw up on purpose, I was still a child. It was the fall before my twelfth birthday. My parents were at work and I was home alone, watching TV and eating my late lunch of choice: a doner kebab and a pack of toffees. A program came on about eating disorders. A woman explained that she hated the feeling of food in her tummy. She said that she made herself sick after meals: "Like that, I get to eat whatever and however much I want, without a hint of guilt." I sensed that her logic was flawed, but figured her method was worth a try. I, too, liked my food, and I, too, hated feeling guilty. 

It was 1995, Kate Moss had just risen to fame and I was very much concerned with admiring her. I thought if I looked more like her, I would be cooler, more popular, and, paradoxically, better able to express my true self. I was convinced that with just a few kilograms less on my bones, life would be better. The only time that I was happy when I was alone was when I ate. Sugar made me feel sharp and alive - a pleasant change from my familiar depressed state. 
At that point in time, of course, I had never heard of our cerebral reward system or dopamine levels. I had no idea that sugar has similar - if not quite as strong - addictive effects on the brain like heroin. Sticking a finger or two down my throat seemed like a fair compromise. Eat what you want, feel a little uncomfortable - because really, who would waste all this food and money, you don't deserve any better! - lose some weight while you're at it... Little did I know I was embarking on an eleven year long journey that would land me in hospital, damage my teeth, esophagus, stomach, cardiovascular system, and memory, and that I would require nine years of therapy before abusing myself was no longer a necessary coping strategy. And while there was no magic trick that did away with my agony, I found the following factors crucial to my getting better:

Recovery

In 2015, I have been symptom free for a decade. I am writing this article from a place of mental health that I thought I would never reach. I was certain that bulimia would always be there, waiting to take the edge off a stressful day, just like a drink. That puking was a bad habit that I was to keep, because it was mine, and mine only, and because in all likelihood I would be dead before thirty, and what did it matter? Eating disorders are the deadliest mental illness indeed; if sudden heart attacks, multiple organ failure or other consequences of malnutrition won't kill you, suicide will
Therapy
Until I hit my late twenties, I was never much of a team player. I was under the impression that I knew exactly how the land lies, or, if not, then that I would be best equipped to figure it out. And yet, surrounded by a family of mental health practitioners, it wasn't long before I clued in on the fact that my eating disorder was nothing I could fix myself. My ability to concentrate was lacking, and my parents' divorce didn't help. I asked for my first therapist at age thirteen. I saw her once a week for two years, but we didn't make too much progress. Surely, part of the problem was that I spent entire sessions just staring at her, like the kids in the movies, without saying a word.
Before I moved away for university at eighteen, my mother and I made an attempt at seeing a family therapist. While I found those sessions utterly nerve wrecking, they were helping. I didn't need to throw up after every meal anymore, and I went weeks without purging after I had settled into my program of study. A compulsory year abroad was bad news, though. A classmate and I shared a flat in a city a twelve hour plane ride from home, and while she fell head-first into the hellhole that is anorexia, my depression returned with full force. Soon enough, I was drinking too much, restricting my food intake, exercising, and barfing again. According to Ann Kerr, a Toronto-based eating disorder specialist at the WaterStone Clinic and the Founding Program Director at Sheena's Place at the time, 40% of bulimics will abuse alcohol at some point in their lives (source). Something needed to happen, and fast. 
Right upon my return, I found myself a new therapist and a support group for girls affected by eating disorders. I still had no interest in planning a future, but I urgently needed someone to talk to, if just to get through the day. It is impossible to say what happened exactly, but by the time I finished university, I was excited enough about life to pursue my writing and apply for a master's program in the UK. I enjoyed meeting people who shared my interests - war and terror, of all things - and I was looking forward to returning to a heady literary scene back in Berlin.
Nevertheless, there was no denying that my depression was severe, and that I was in need of serious treatment. I found my psychoanalyst by looking at a list of recommended names and calling the funniest one. We clicked right away. I credit my psychoanalysis with much of my ability to want a future. It taught me how to set boundaries in a respectable way. It helped me leave constrictive environments and experience what people call emotions.

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New Habits

Yoga
Before Yoga, I perceived my body as unnecessary ballast that my mind was forced to schlep around. I found no joy in movement, as it usually gave me migraines. My limbs were without purpose. For the longest time, I had been preoccupied with negative thinking. I got into Yoga because I craved stillness. I just wanted my thoughts to shut up. Moving through a random set of poses was the only way I knew to be at peace with myself. Over the years, I tried a bunch of different styles and even had a daily practice of Ashtanga Yoga. Currently, I mix gentle Vinyasa Flow with relaxing Restorative. Through Yoga I learned that my body doesn't need to be looked at, it needs to be purposeful. My body needs to be sensed. I no longer perceive it as a prison, but rather a vehicle.

Nutrition
For most addictions, the crucial part of recovery is eliminating the drug of choice. Unfortunately, those of us suffering from an eating disorder can't not eat. Instead, we have to form a new relationship with food. Since the advent of the iPhone, apps like Recovery Record can help log meals and teach coping skills. When I was recovering in 2006, smartphones weren't around. Contrary to the common idea of how bulimics go about their business, I rarely bought large quantities of food to have in one sitting. Rather, I would randomly throw up whatever I had to eat as soon as I could. And then return to eat more. One day, exhausted and in pain, I stopped counting after fourteen times. I was lost in space, and without a plan or structure. In order to get better, I needed to pay more attention to my physical needs, and to set priorities. I looked into the relation of food and mood, and for the first time understood that a well nourished brain makes for happier times. Nowadays, I make homemade meals a priority (which, by the way, saves a ton of money!) and I ensure that I won't go too long without having a healthy-ish snack. 

Sleep
For many years, insomnia added to my distress. When I was still sick, I had trouble falling asleep every night. In one particularly bad week abroad, I didn't sleep at all in five nights. Recovery from my depression led to improved sleep almost immediately. Likewise, treating insomnia may result in improvements in mental health. This is because the brain systems involved in sleep and psychiatric disorders tend to overlap. Insomnia, like depression, is a female disorder. The prime risk factor for it is being a woman. 

nedic.ca ad for #NOdietday
Feminism
I had to turn twenty-six before I first paid attention to feminism - I really wish I would have done so sooner. Grasping the extent of the constant exploitation of women's minds and bodies helped me make better choices in life. As Naomi Klein writes in The Beauty Myth
"A culture fixated on female thinness is not an obsession about female beauty, but an obsession about female obedience. Dieting is the most potent political sedative in women’s history; a quietly mad population is a tractable one.” 
And as Dr. Blake Woodside says in the clip I added below:

"If this were an illness of middle aged men, like prostate cancer, there would be a treatment centre in every hospital in this country." 

It suddenly dawned on me that wasting my mental and physical energy on bulimia had effects not only on myself, but the society I was a part of. Every minute I spent with my head in a toilet bowl was a minute I missed making a difference. I didn't want to live my life like that. Feminism taught me that my throat is good for more than throwing up and blowing men: I have a voice I get to use in any way I please. 
Owning Bulimia
Eating disorders are hard to talk about. I had all sorts of ideas about what would happen if I would tell someone. Nothing much ever did, but I also didn't quite tell anyone. In fact, most of my friends and family probably don't know that this is something I struggled with, and over so many years. But I am no longer ashamed. Eating disorders are not a choice, and they are not about food. It's ok to let people in.

6 comments:

  1. "There is a crack in everything, that's how the light gets in" - Leonard Cohen

    xo

    ReplyDelete
  2. Powerful story. Much love to you, sweetie.

    ReplyDelete
  3. "Every minute I spent with my head in a toilet bowl was a minute I missed making a difference." Love it. Let's make that difference.

    ReplyDelete