Andrea's Voice: Silenced by Bulimia

By Doris Smeltzer with Andrea Lynn Smeltzer

This heartbreaking story is told from the perspective of Andrea's mother. Scattered between these writings are excerpts from Andrea's diaries, including her poetry. Although I can acknowledge the beauty that others find within poetry, I am someone who doesn't really appreciate it myself. I wish I did, but I can't seem to help it. Although I like 'deep' prose, for me a poem has to be very clear in its meaning in order to hold my attention. I also find diaries hard to read, as diaries by their very nature are usually un-organised and rambling. Therefore merely personally, I found it difficult to keep reading through every word of poetry and diary at times, although I made sure to do so in respect for Andrea's memory and talent. Admittedly the diaries were needed to express Andrea's character and experience in her own words; as the title says, her 'voice'. Perhaps the very fact that diary form was the only way we could hear her voice, was testament to the fact that she didn't live long enough to carefully craft a book herself which maybe she would have done had she recovered.

Overall though, I learned a lot from this book regarding the reality of just how quickly an eating disorder can kill a sufferer, seeing it from a parent's point of view, and gaining some understanding as to how someone deals with grief in such a circumstance. Nowadays I seem to be more emotional anyway, perhaps due to therapy and no longer numbing every single thing, however it still takes me by surprise when a book manages to cut through my still often present detachment. Even though I knew from the start of the book that Andrea would not survive, reading the words describing her death hit me hard, and the tears flooded out even though I have no connection to this family. I was deeply touched, also by the solidity her family showed in trying to help her. 

 ‘All the “experts” agreed – Andrea would heal. We caught the behaviours early. Again, we heard that we had nothing to worry about.’

 ‘Andrea died in her sleep approximately six hours later [After the last phone-call with her mother]. Her body was found lying in bed with one leg on top of her down comforter, the right corner pulled down in a triangle, and one arm resting under her head. She never made it home to open her report card. She had earned straight A’s that semester.’

I think the ultimate message that I took is that with all the care, love and determination in the world, even with jumping in quick and paying out for therapy, an eating disorder sometimes still cannot be beaten. From this I don't think we can conclude that it isn't worth trying, quite the opposite; That professionals and society should take it seriously and treat the patient as soon as possible, because this is a killer disease with claws just as strong as a malignant tumor invading the body at a rapid pace. Not being hospitalized or able to function in every day life does not make you immune to sudden death from an eating disorder.

 

‘For those who survive, it can often take an average of four to seven years for a sufferer to begin the healing process in earnest' 

Again, the above quote is a fact which professionals mainly deny, if not in words, in action, by the fact they prescribe as little as 6 CBT sessions for treatment (or nothing at all), and then that is it; the message is you should be better after that, or rather they will twist it with the feeble justification 'you need to take responsibility for your own recovery'. You wouldn't justify refusing to continue giving chemotherapy to someone who is likely to die without it, with that sentence. I suspect that average of years to begin healing is true. At least, I can relate to that average almost exactly in my own recovery; After coming out of hospital I denied for 4 years that I had any problem at all. During the 5th year I sought treatment myself but still did not admit I was not recovered to my family until the 6th year, when my seeking of treatment from the government still hadn't gotten me any at all. It was finally time to ask for moral and financial support, and with that had to come the admittance that I was finally ready to start healing. Until I could admit that openly, even though I was no longer lying to myself, I still didn't have any real conviction that I was ready. Today, that conviction continues to go and come as the disorder gets stronger and weaker, sometimes by the hour.

‘‘In the treatment of Hodgkin’s Disease or Leukemia, waiting around for the individual to get sicker would be considered outrageous and unethical, yet it is done every day with anorexia (and bulimia)’- Marcia K. Ove, “The Evolution of Self-starvation Behaviours Into the Present Day Diagnosis of Anorexia Nervosa: A Critical Literature review’. 

 ‘I denied to myself that Andrea could lie to us as bold-faced as she lied to herself. I knew nothing of the manipulative nature of eating disorders, or of their deceptive, chameleon-like ways.’

There is a cruel irony in the fact that those with eating disorders often have a personality in which there is a relatively clean past record of lying. The eating disorder uses this to feed on; the trust that family and friends may have in what the sufferer claims to be the truth. But many also fail to realize that it isn't just they who are being deceived by the illness, but the sufferer themselves. The guilt the true person underneath the illness feels gives rise to a defense mechanism, being that of, in some dimension of the psyche, believing their own lies. How can a deluded person appear so sane and convincing to someone on the outside who thinks of themselves as rational? The very fact that people with eating disorders can sometimes appear so healthy and 'with-it', makes it all the more dangerous.

 

‘After patiently listening to me rant for over twenty minutes about how I could have saved my daughter if only I had tried harder, the wise counsellor had asked “Do you really believe you are that powerful, Doris?”... I could finally hear the words – that when we look back at the “should haves” and “if onlys” we tend to see them in a stagnant, one dimensional realm.’

Morphing Disorders

I have not updated for a while, I am struggling to read right now due to lack of concentration. I have set myself the challenge of working through a self-help book, even though I have not had much success with these in the past. Therefore it is proving difficult to keep motivated. The next ED book I plan to read is 'Fasting Girls: The History of Anorexia Nervosa.' But on a different note, here are some recent thoughts:

There is a theory that Anorexia and Bulimia are ‘two sides of the same coin.’ I think this has a lot of truth in it, but I would also add BED in there as well. There are so many people who have gone from one disorder to another, or picked up symptoms from all three and developed an atypical ED or EDNOS. I think it is wrong for professionals to see me as being recovered from anorexia, and that I developed Bulimia as a separate entity. I have talked to many others who have never lost their anorexic mindset even though their behaviours may suggest otherwise. I am now addicted to binge eating because as long as I don’t let it go, it guarantees that the anorexia cannot take over my body again. However, no amount of binge eating can drive the anorexia out of my mind. When professionals refuse to accept that my disorders have layered up rather than replaced each other, they are in danger of encouraging my anorexic thoughts. It is a balancing act; they need to treat the anorexia and bulimia/BED simultaneously until I finally meet balance. When I was a restricting anorexic I thought that Bulimia was the opposite. Now I know that they are the same monster which changes tactics in order to fool.

Happy Pancake day! Even though I don't celebrate this due to the food content ;)

xxx

The Passion of Alice

By Stephanie Grant.

Thanks to Elara for reccomending this :)

After reading the novel Wintergirls, I didn't expect to like The Passion of Alice. However, there was something about this book that made it intrigueing. Some of the reviews on Amazon* weren't impressed with the lesbian theme of the book, but I thought this gave an alternative view which is usually overlooked. I am not convinced of the accuracy regarding eating disorders, but as a novel it was good. It demonstrates how within inpatient treatment you can often learn more about yourself from other patients than you can from the therapists. The only problem is I feel that the story could have been built upon more, and I would have liked to find out what happened to Mauve (The protagonist's lover).

* Amazon.com. There are usually more reviews on the American site, so I check there before buying at .co.uk.

'...So I almost told him right then and there about the emptiness that the overeaters tried to fill with impossible amounts of food, again and again; the emptiness that the bulimics try to disgorge, as if it had been caught, a chicken bone or a fragile green fish’s gill in their quivering throats; the emptiness which we anorexics, in our superior knowledge and practice, tried to constrict, tried to compress by strangulation and deprivation...’

‘What seemed remarkable, finally, when I thought of it, was not that I loved women, but that I had loved a woman so imprecise. Maeve in all her chaos... That I loved her imperfection...’

Conversations with Anorexics

By Hilde Bruch, edited by Danita Czyzewski and Melanie A. Suhr.

Bruch passed away before this book was published, but before she went, she made sure that the content was essentially complete. The book is mostly made up of conversations with many of her patients during the therapy process.

‘While the binge-purge cycle may occur during the first or second year of the anorexic illness, often it appears later. When the simple starving becomes too strenuous or exhausting, then the idea of eating and vomiting looks like a solution, in order for the patients to give in to their desire for food and to stay slim at the same time.’

Anorexia often develops into Bulimia, and the above explanation for this makes sense. But what doesn't make sense is me; I moved onto the bingeing, but I never purge. Purgeing sounds awful, and don't get me wrong, I am glad I don't have this addiction. But people binge so that they can purge, or they purge so that they feel slimmer. If I have such a fear of getting fat, as is the case with anorexia and bulimia, then why don't I compensate? I fast, but I think I do that because I get sick of all the eating and I want a break, rather than doing it in an attempt to lose weight. This implies that I suffer from binge eating disorder or EDNOS, not bulimia as the doctors say. But there doesn't seem to be many books on BED, so I don't know...

The following bits do describe the way I think, or used to think:

‘” I could have a peaceful mind only when I went to bed and couldn’t do any more, when I was physically and mentally exhausted. Then I could think, ‘Yes, I have a right to sleep and I have a right to eat,’ but only then. When I went to bed without being really exhausted and tired, that meant there was still more I could do and wasn’t doing..."'

'"...when I weighed a lot less than I do now I had so much energy. I mean, I could do fifty projects at once and I didn’t have to work so hard at my grades. I don’t have that energy and the drive that I had when I was thin. That’s really scary for me to cope with."'

Sensing the Self: Women's recovery from Bulimia

By Sheila M. Reindl

Okay, I reviewed this before I deleted everything from my blog and started afresh, but this time I will try and summarise it with less waffle.

It is a very long-winded read, but, if you collected together all the good bits that are scattered eveywhere, and made the book a fraction of the size, then it would be very useful.

A comment it makes on Bruch, who wrote 'The Golden Cage' (reviewed the other week):

‘(Bruch) relied upon what she called “the constructive use of ignorance” – that is, her willingness to learn from and with patients...’

‘Susan Sands points out that “many bulimic patients are expert at dissociation” and that bulimics “portray their bingeing episodes as one might describe a trance state, drug trip, or delirium...”

A patient - ‘”It is pretty angry... an angry thing to do, to make yourself vomit, or with force expel things that are inside your body...”’

To recover, Reindl states that the person must come to a point where she accepts that:

'...she was sick enough...had suffered long enough... had tried hard enough to recover alone, and that she mattered enough to be worthy of care.’

The Monster Within

Facing an eating disorder: A Bulimic's journey of hope and healing By Cynthia Rowland McCure

I would not reccomend this book to anyone wanting to read specifically about eating disorders. However, for someone looking for a general memoir about overcoming inner conflicts through inpatient, group, and one-to-one therapy, it would probably make a good read. The points made by Cynthia and her therapist at the very end of the book were more directed towards eating disorders, but most of the book was not (not that this was a bad thing, just not what I wanted nor expected!)

Mike Moore (Cynthia's therapist): ‘Each individual has unique rituals and perceptions as part of their symptomatic patterns, and it is the individual person’s patterns being addressed, not the abstract diagnosis.’

P203 Cynthia ‘People with eating disorders always harbour intense inner pain or locked-up secrets. Often they don’t realise the depths of their pain because of the numbing effects of their eating disorder.’

Anorexia nervosa and bulimia: How to help

By Marilyn Duker and Roger Slade

The best literature I have read on the subject. Most of the book is worth quoting, and has very little waffle. I read it a while ago but one thing I remember it covering is the theory of Anorexia and Bulimia being 'two sides of the same coin.' I will have to re-read it sometime...

‘Few people appreciate the extent to which anorexia nervosa and bulimia can wreck family life, either by the way it erupts into physical violence to people or property, or by the suffocating tension it creates.’

‘So well in fact does she hide her feelings that the way her later bulimia or compulsive eating is related to her former anorexia nervosa is also hidden. Because the episodes appear to be discontinuous, few theoreticians perceive that there is a clear relationship between the two problems...’

‘...Moral rules... it is starvation that pushes these familiar values to almost unrecognizable extremes...’

And hence:

‘There is a cruel irony in the frequent assertion that anorexia nervosa is a mysterious illness...’

3. Wasted

By Marya Hornbacher

Probably the most reccomended and referred to memoir on the ED shelf. I find the first half a bit tedias, as is more like an autobiography of her life in general which led to her ED. It is the second half which really touched me, the way she articulated things in my mind, and I dare say many other's minds, which I never thought could be put onto paper. She is astonishingly accurate in her description of bulimia and especially anorexia, and she describes the consequences in their blunt, devastating reality. She manages to communicate the paradox of both pride and destruction that the illness simultaneously gives.

‘I wanted to get caught to be seen as something, to have a claim to greatness, to have the sick admiration that comes to those of us who destroy ourselves particularly well.’

‘When she leaves you alone, there’s a silence and a solitude that will take some getting used to... There is a profound grief. And there is, in the end, after a long time and more work than you ever thought possible, a time when it gets easier... There is, in the end, the letting go.’