Purge

by Nicole Johns

  Dietitian Caroline calls gaining up to eleven pounds while at the EDC “maintaining.” As the numbers creep up, I grow uncomfortable thinking about the burgeoning fat cells expanding my thighs. My body is growing soft and fleshy. I am Rubenesque. I am taking up too much space. My favorite jeans grow tighter, until one day in early June I simply can’t wear them anymore.

  After one week at the EDC, I lie down in the hall and writhe around on the floor because anger is coursing through my body and I need to manifest my pain physically. Eliza asks what I am doing, and I tell her my jeans are too tight. RC Julia watches this scene unfold from her chair in the office.

  “You are really crawling out of your skin, Nicole.”

  “That’s a really astute observation, Julia.”

  “You have to fight that eating disorder voice in your head.”

  “I’m fucking tired of fighting; I just want to fit into my jeans again.”

  1 A nasogastric feeding tube is a thin plastic tube inserted through the nose, past the throat, and down into the stomach, and through which Ensure can be pumped slowly into the patient over a course of a night. This helps speed the weight-gaining process and is usually used if a patient is severely underweight or medically unstable, or refuses to eat.

  Snack Time

  Unlike meals, snack time at the EDC is held in the dayroom. At promptly 10:30 AM, 2:30 PM, and 8:30 PM, an RC comes out of the office, armed with meal cards and keys to the cupboards and the fridge. We are supposed to arrange ourselves in an orderly line, but more often than not we storm the cupboards in a frenzy of indecision.

  “Should I get an apple or string cheese?”

  It is never a question for me after I eat my first Cheerios bar. Prior to coming to the EDC, I had indulged in drinking maple syrup straight from the bottle, eating spoonful after spoonful of granulated sugar that I crunched gleefully between my molars because I loved the texture, and eating entire jars of jam (preferably strawberry). I also relished drinking half a bottle of soy sauce. I’ve had this flair for condiments since my preteen years. Brown sugar used to be a favorite, as were uncooked oats and the occasional chug of apple cider vinegar, straight from the bottle.

  No one at the EDC will permit me to eat a jar of jam for snack or drink a bottle of soy sauce (and I am too mortified to ask), so instead I eat a Cheerios bar at every snack because it is the most sugar-filled food I can find at the EDC. Eventually my Cheerios bar consumption is outlawed, as staff thinks the bars are a “safe food ” for me, meaning I am not “challenging” myself by trying different foods. They don’t know I am simply enjoying a mini-sugar binge during snack time.

  To make my Cheerios bar last, I dissect it. First, I separate the two layers that hold it together. Next, I eat the layer without icing. Then I pick the icing off the remaining layer, relishing the grit of sugar on my teeth. Last, I pluck at the denuded remainder of the bar.

  While I am performing microscopic dissection on my Cheerios bar, Holly wolfs down her pretzels at lightning speed, then goes out on the deck for a postsnack cigarette, Danielle furtively stashes her Oreos in between the sofa cushions when she thinks no one is looking, and Sandra refuses to eat anything other than fruit because carbohydrates are “ junk food.” Laura eats her yogurt like a normal person and joins Holly on the deck, while Eliza is granted the privilege of choosing whether she wants to eat a snack, because she follows her meal plan and doesn’t purge.

  Occasionally, someone will flat-out refuse a snack or have a breakdown because no one has restocked the oyster crackers in the snack cupboard, and oyster crackers are their “safe food.”

  Even though we know the snack list by heart, we stare at it when we pass by. Food, our addiction and our fear, fascinates us. As much as we feign disinterest, we secretly all know the truth.

  One day, at 1:30 PM, Holly attempts to break into the snack cupboard while yelling that she wants food—now. RC Allison tells her it is one thirty and she has to wait until snack time. Is Holly hungry?

  We are always hungry.

  Scenes from the Dining Room

  OF THE EATING-DISORDERED

  Elise is from Oregon, but there is something inherently Californian about her—perhaps it’s her dark tan and bleached hair. Later, we find out that she lived in California and then moved to Oregon to go to college. She is competition. Her hip bones jut out and her arms look breakable. Elise has been bulimic for a long time. During her first breakfast, she shocks us by nonchalantly taking three (not one, but three) pieces of bacon.

  We watch her eat the bacon, then discuss it during our postbreakfast cigarette (I’m not a smoker, but I occasionally filch a cigarette). Laura is laying bets on when Elise will sneak down the hall and purge; Danielle is too busy bouncing up and down on her tiptoes, trying to burn off the butter she put on her toast this morning. She says she can’t remember what bacon tastes like. I haven’t allowed myself to eat bacon in a long time.

  During dinner I place two peas on my spoon and flick them in the direction of RC Evan. The peas whiz by him and bounce off the wall.

  “Are you kidding me?” he says.

  The whole table starts laughing.

  Danielle is having a hard time finishing her Mexican tofu casserole. To distract her, I launch a cherry tomato at Sandra, who wipes off the tomato and eats it.

  Danielle and Sandra jostle each other at the dining room door before every meal. As soon as the RC unlocks it, they sprint to the fruit basket. They are both in search of the coveted green apple. Sandra gets the apple, takes one bite out of it, and offers it to Danielle, who eats the whole thing, core included.

  The fire alarm goes off in the middle of breakfast one morning in June and we shuffle outside, the bottoms of our pajama pants wet with dew. We shiver and smoke cigarettes until the all-clear signal is given and we can return to our food.

  “Someone stole my toast!” exclaims Sandra.

  “Some fuckstick probably binged on it,” says Holly.

  Eliza and I laugh as Sandra repeatedly voices her concern over her lack of toast, waving her skinny arms in the air, her voice edging on panic.

  “Go ahead and get another piece and calm down,” says RC Allison.

  Sandra talks about her toast for the rest of the day, bringing it up in Group Therapy and during evening check-in. She twirls her hair with her index finger while recounting the story for the third time.

  “No one cares about your motherfucking toast,” Laura says in a calm voice.

  Individual Therapy

  WITH THERAPIST ELAINE

  I’ve had ten therapists, most of them ignorant about how to treat eating disorders. Over the years I have been told I don’t have an eating disorder; it’s perfectly normal for a teenage girl to diet; I’m merely engaging in adolescent rebellion; this isn’t serious; this is a phase I will outgrow like last year’s pants; if I wait fifteen minutes, the urge to purge will pass; I just need to make a meal plan; I don’t want to get better; this is all my parents’ fault; I need to have my chakras balanced; I need to learn the fine art of forgiveness; I’m not thin enough for treatment, I’m not sick enough for treatment, I’m obviously not trying hard enough to recover.

  I have also been told I do have an eating disorder, this is not a normal teenage diet, this is more than adolescent rebellion, this is a serious illness, I’m slowly killing myself, I do want to get better, this is not anyone’s fault, I need to stop numbing myself out and let myself feel anger without guilt, eating disorders are not about thinness, I need intensive treatment immediately.

  At the EDC, Elaine is my therapist. She is our floor’s Group Therapy leader and the person who conducts individual therapy sessions with each of us. Because I am so quiet at first, Elaine often forgets my name. Compared with the vocal bulimics and shockingly thin anorexics, I fade into the background, a silent observer, recording the scenes before me in my journal.

  During our second session (our first session involved filling out the required paperwork), I tell The
rapist Elaine about how I ended up at the EDC, about the events of the last year, about how desperate I was.

  Therapist Elaine listens to this information with what I assume is an emotionless face. We play the therapy staring game. I know that I’m supposed to be crying, or at least showing some emotion, but I feel none. I am blank, and that is what I tell Elaine when she asks me how I feel. She tells me we will work on getting in touch with my emotions.

  Emotions scare me. Emotions signal a loss of control, and I have tried so hard and for so long to be in control of as many things as possible in my life. Yet I sense that I am missing out on something, that my blank existence is no way to live. By engaging in eating-disordered activities, I am numbing my feelings.

  Instead of feeling my anger, I throw it up; instead of feeling my sadness, I attempt to starve it away.

  I’ve substituted school for intimacy, particularly as an undergraduate. Focusing on school to the extent that I did left me no time for intimate relationships, and that seemed like a good idea at the time, since the vulnerability an intimate relationship requires was something I sought to avoid.

  As I sit here with Therapist Elaine, I’m dressed in pajama pants and a sweatshirt, with my blanket wrapped around me, and I begin to think that I am watching my life hurtle onward without me. I tell Elaine I want to work on my perfectionism, get in touch with my emotions, and learn how to live my life. And she tells me we will work on all of that.

  Group Therapy

  WITH THERAPIST ELAINE

  The chairs and sofas in the dayroom are arranged in a circle, to facilitate a feeling of closeness. The furniture is comfortable but worn and makes obscene noises when its occupants stand up. We fight over the lighting. Half of us like the dayroom dim and murky; it is easier to nap in the semilight of late afternoon. The other half want all the lights blazing and can’t stand the gloom when the room is poorly lit.

  Therapist Elaine sits in the therapist chair in front of the fireplace that we are not allowed to use. Whatever RCs are on duty sometimes sit in on Group Therapy and offer feedback. Therapist Elaine asks someone to start, and we go around the circle and talk about how we’re doing today, what we’re struggling with, and whether we need to take time to talk. We read assignments from Therapist Elaine that we have completed. This is called processing. At the end of Group Therapy, we all stand up and form a circle. Then we clasp hands and recite the Serenity Prayer.

  There are perpetual sleepers in Group Therapy. Laura snuggles under her tie-dyed fleece blanket and curls up against whomever she is sitting on the sofa with. Danielle falls into such a deep sleep that she snores and has to be prodded awake. Those of us who aren’t sleeping play Tetris or knit. Anything to occupy our hands. All of us have trouble sitting still. This time for contemplation makes us nervous.

  Group Therapy is uneventful unless someone has a rape flashback or a breakdown brought on by the stress of telling the story of their trauma. We watch as other residents leave this reality and enter the past. Their eyes glaze over and they don’t respond to anything, except when they jump or scream when touched. We watch, curled into ourselves, wrapped in blankets, as our peers relive trauma so unbearable that their minds overload. We grow educated about the signs of a flashback; we learn how to ground each other in the present.

  Certain group members are prone to dramatic breakdowns. Sandra is known for bursting out of her seat in an explosion of bony limbs and wailing inconsolably. We question the authenticity of her episodes. She throws herself onto the floor, wiry arms sprawling in all directions. When Sandra has a breakdown, Group Therapy ends because it is impossible to concentrate with her wailing in the background.

  When Therapist Elaine goes on vacation in Siberia for two weeks, we get Arlene as a substitute therapist. We dub her Fuckstick Arlene because we like the sound of “fuckstick,” a word that we believe we have created, and it seems to fit Arlene well. Fuckstick Arlene stares at us through large wire-frame glasses that emphasize her owlish appearance. She is a proponent of worksheets. We all fall asleep in Group Therapy, and after the first week most of us boycott it altogether because it has become Worksheet Therapy. In an effort to liven up Group Therapy and minimize the rate of attrition, Fuckstick Arlene announces that we will be going outside for Play Therapy. Intrigued, we follow her outside, where we find sidewalk chalk and balls. Fuckstick Arlene wants us to play Assertiveness Hopscotch, which involves stating a need every time you hop from square to square. None of us will play except for Laura, whose sarcasm goes undetected by Fuckstick Arlene. When Therapist Elaine returns from Siberia, I have to rein in the impulse to hug her and beg her to never leave us with Fuckstick Arlene again.

  One afternoon in late June, Eliza and I are sitting on the coveted blue leather sofa during Group Therapy, wrapped in our blankets and watching as Laura comes down from a rape flashback, that glazed, faraway look in her eyes dissipating as she clenches an ice pack, concentrating on feeling the cold and staying present. Danielle is shaking her head back and forth, back and forth, her fluffy tufts of thin hair swaying methodically. Meanwhile, Sandra is gesturing wildly with her scrawny arms, telling Therapist Elaine and the rest of the group how she purged in a Tupperware container, wrapped it in paper, and gave it to her mother for Christmas.

  The Vibrator Policy

  AT THE EDC

  Before a Group Therapy session, we talk about how long it’s been since we had sex. Someone wonders whether we’re allowed to have vibrators. Sandra says she’ll ask Therapist Elaine during Group Therapy. None of us believe she will do it.

  After checking in, Sandra says she has a question. Therapist Elaine tells her to ask it.

  “I was curious about what the vibrator policy is.”

  Silence. Therapist Elaine blushes. All the residents stare at each other, then collapse into fits of immature giggles. This is the most we’ve laughed in a long time. Our sides hurt and our eyes tear up from laughing. We are all in our early twenties, but we find this hilarious.

  “I’m not sure. I don’t think they’re allowed, because it would violate your roommate’s privacy. And we’d have to keep them in the office, in your personal bin, which means you would have to request to use them. Then, when you were done, you’d have to return them to the office, and that would be gross,” says Therapist Elaine.

  “Don’t you want us to love our bodies and have positive sexual experiences?” asks Holly.

  “Residential treatment is not the place for vibrators,” says Therapist Elaine.

  Confession

  The first assignment Therapis Elaine gives me is to identify my eating disorder behaviors and the negative consequences of those behaviors. I sit in the conference room at the end of the hall and listen to the Tori Amos Little Earthquakes CD as I complete my first assignment. It takes me hours to compile my list of behaviors and consequences, and when I finish, I am appalled at how long the list is. I know I will read it in Group Therapy the next day, as that is what we do at the EDC—we all confess our sins and then talk about how we feel. I’ve heard other people read their lists and I am not nervous, as most everything has been mentioned before. And so the next day, I read.

  Therapeutic Exercise: EATING DISORDER BEHAVIORS

  Bingeing and purging

  Purging after eating something with a high caloric or fat content

  Taking diet pills with ephedrine even though I knew they were worsening my heart problems

  Not getting dinner or drinks with friends after class because I couldn’t deal with the food and eating in front of people

  Not drinking alcohol because it has too many calories

  Lying to friends about having eaten

  Lying to friends about purging

  Weighing myself multiple times a day

  Restricting to only “safe” foods

  Restricting my water intake

  Running compulsively to burn calories or as punishment for bingeing

  Fasting

  Skipping meals

>   Not wearing a jacket when it was cold in an attempt to burn more calories

  Spending hours in front of a full-length mirror, convinced I could actually see myself getting fatter

  Obsessively fantasizing about liposuction

  Bingeing and purging instead of dealing with what was upsetting me

  Drinking large amounts of coffee and diet soda to mute my hunger and trick myself into feeling full

  Counting out precise serving sizes

  Eating one meal over the course of a day

  Claiming I wasn’t feeling well so I didn’t have to eat

  Avoiding friends so I could binge and purge

  Only eating even numbers of things because odd numbers felt wrong

  Therapeutic Exercise: THE NEGATIVE CONSEQUENCES OF MY EATING DISORDER

  (Physical Health Problems)

  Heart problems (PVCs, PACs, and bradycardia)