Chapter 29
I got out of the car, stopped at a stone archway, and looked down at a seam in the concrete sidewalk. Across that line was the entrance to the Renfrew Center for Eating Disorders in Philadelphia. There was no missing the symbolism here. Ilana had dropped me off and kissed me goodbye and now I stood here all alone thinking, If I cross this threshold, this is genuinely my moment of truth. By the beginning of 1995, I had amassed all sorts of accomplishments and firsts. I’d been inducted into the International Tennis Hall of Fame. I’d invented myself not once, but twice—first as an athlete and activist, and again after Marilyn outed me. And yet, I knew that I had to face one more struggle, or I was finished.
I had recently turned fifty-one, I was at least forty pounds overweight, and I had hit bottom emotionally, physically, and spiritually. Ilana and I were still closeted to most people. After I stopped competing, I wasn’t working out regularly and my weight occasionally hit 200 pounds. I became detached, almost remote, which isn’t like me at all. I couldn’t stop overeating, no matter how hard I tried. I felt depressed and disconnected from myself and the people I loved. It became difficult for me to function.
Some days I would gobble up ten candy bars and a quart of ice cream, but it would only momentarily satisfy me. Sometimes I’d allow myself all the chips or Snickers bars I wanted, then I’d go on an extreme diet to lose the weight. During one diet I drank nothing but powdered shakes that I mixed in a blender and lost something like fifty pounds. Then I’d binge and my weight would balloon again. I was tormented that I hadn’t been able to live out my life or personal challenges the way I wanted. In my mind, I pictured myself standing in a circle of solid barriers and when I’d walk out from the center toward any place in that circle I would get stopped. It was as if I had no place to go, I couldn’t get out. I felt my soul was imprisoned; a battle was going on inside me. I wasn’t being truthful.
My therapist saw how desperate my behavior was, and suggested that it might be time for in-patient treatment. I called two clinical psychologist friends, Kay Loveland and Julie Anthony, and asked them to recommend a treatment center. Both independently suggested Renfrew. I believe taking their advice saved my life.
I was willing to stop everything and spend the recommended five weeks in residential treatment. In fact, I welcomed it, knowing that I had to put my workaholic drive aside for once and make my health my top priority. Ilana told me not to worry, she would take care of everything while I was away. The night before my admission, we drove from New York to Philadelphia and checked into a hotel on Rittenhouse Square. We ate dinner knowing that it would be our last meal together for a while. In the morning, Ilana and I were quiet as she drove me along the familiar leafy streets of Chestnut Hill where I had stayed when I was an amateur in the 1950s and ’60s. That was also where I first started binging on Bassetts Ice Cream. Talk about coming full circle.
Renfrew was just a few miles away. The facility sits in a neighborhood of horse farms and old stone mansions. The residential center I checked into is part of a cluster of colonial-style buildings surrounded by pastures and forests. I felt nervous anticipation, but also a readiness to face whatever came next. Ilana has always been skeptical about psychotherapy, but she promised to do anything I needed to support me and help me work through things, including attending couples therapy.
Renfrew was homey and welcoming, but it was by no means a resort. The residents, as we were called, lived in comfortable but spare double rooms. The sheets were a plastic blend, a sobering concession to the fact that some residents were tempted to purge once alone. Most of the residents had roommates, but my treatment team decided I needed my own space so I could be alone with my thoughts and have some peace. But other than when I slept, I was rarely by myself during the next thirty-five days. Unless we were in individual therapy, residents had some sort of group meeting most of the day, from eight in the morning until lights out at 10 p.m. We were encouraged to keep a daily journal. We were served three meals a day in a communal dining room, along with snacks and desserts.
To my initial dismay, I was told I was not there to lose weight. The philosophy at Renfrew was not to create a make-believe space where you had none of the temptations or choices you faced in the outside world; the object was to help you understand and manage the emotions behind your eating disorder and to start normalizing your relationship with food. Neither sugar nor caffeine was banned, and smokers could light up outside. Everyone was given an individualized meal plan based on their needs. We were simply asked to pay attention to our eating, an approach that would be called “mindfulness” today.
A lot of hospitals at the time treated the symptoms of eating disorders without looking for the underlying emotional issues or conflicts that were causing the problem. Renfrew was different. It used an integrated approach to treat the whole person, from medical, nutritional, social, and psychological perspectives. They delved into my relationships in my life as possible sources of dysfunction, as well as paths to healing.
As soon as I checked in, I was placed on a team with other residents. Each team had its own group of therapists. The individual therapist assigned to me was named Lynn, and she was so insightful I still keep in touch with her. We met three times weekly during my stay at Renfrew. Between Lynn and group sessions with my peers, I found out how little I knew about eating disorders.
Eating disorders can affect people of “every age, sex, gender, race, ethnicity, and socioeconomic group,” according to the National Eating Disorders Association website. You really can’t generalize about who is at risk, but EDs tend to show up in adolescence, most often among girls. Some people, including me, mask our disease well into middle age. Renfrew’s patients range in age from their teens to older adults. When I was there, most of my fellow residents were in either high school or college.
The most commonly treated types of ED are anorexia nervosa, bulimia, and binge-eating disorder. The definitions can be tricky, but NEDA describes anorexia nervosa as a disorder characterized by “weight loss (or lack of appropriate weight gain in growing children); difficulties maintaining an appropriate body weight for height, age, and stature; and, in many individuals, a distorted body image.”
Bulimia nervosa is “binge eating and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating.”
Binge-eating disorder, which is what I have, is now the most commonly diagnosed ED in the United States, but it wasn’t recognized in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-4) when I went in for treatment. Whatever didn’t fit neatly into the other two categories was lumped into “Eating Disorder Not Otherwise Specified.” That was my initial diagnosis.
The updated DSM-5 now recognizes binge eating as “a severe, life-threatening, and treatable eating disorder characterized by recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); a feeling of a loss of control during the binge; experiencing shame, distress or guilt afterwards; and not regularly using unhealthy compensatory measures (e.g., purging) to counter the binge eating.”
Elton has talked candidly about how he struggled with bulimia, and addictions to drugs, alcohol, and sex in the 1970s and ’80s. I never knew; I only suspected. He cut me out of his life for five years after I asked him directly if he was using drugs—“Of course not!” he said, turning red. He only got back in touch, out of the blue, after he entered a treatment center near Chicago in early 1991. He called from there and asked Ilana and me to come see him. I had always told him no matter how tough life got, I would love him unconditionally. We were there the next morning.
I overate, too, but unlike Elton, I never threw up. Studies summarized on the NEDA website have shown that athletes are particularly prone to eating disorders because we are constantly monitoring our weight. Our need to control our bodies can become an obsession. I
’m a perfectionist by nature, which is another risk factor. The Olympic gymnasts Cathy Rigby and Nadia Comaneci both nearly died from self-starvation. As I would soon find out, the great young tennis star Monica Seles was also suffering from a binge-eating disorder after she was stabbed by a deranged fan of Stephanie Graf in 1993, and her father died of cancer not long afterward.
Starting as a teenager, Ilana often struggled with food issues. Eventually she experienced large swings in her weight as she went on a series of diets starting in 1972, after she had gained twenty-five pounds on her first trip to Europe and the United Kingdom. She told me if she won she ate because she was happy, and if she lost she ate because she was depressed. What turned her around was training for, and completing, the 1981 New York City Marathon. Ilana says running changed her life because it was something that was totally self-driven and empowering. The outcome wasn’t clouded for her by, say, a tennis opponent having a bad day or some other variable.
Through talking to Lynn and listening to others in group therapy, I started to understand that eating disorders are an unhealthy relationship with food that stems from what Renfrew calls a “dysfunctional relationship with the self.” For me, having an ED is a daily fight, much like being an alcoholic. I know I’m in trouble when I start to get two voices going in my head. I wake up in the morning thinking I might want a quart of ice cream and start obsessing about it. One voice will say, No. You need to take care of yourself and eat properly and exercise. All the rational stuff. The other voice goes, Forget it. I want it. There can be this tug-of-war all day long, and it’s exhausting. I have to pay attention because it’s not really about the food or hunger—something emotional is going on.
One of the most pivotal questions Lynn asked me after we began working on my eating disorder was “What’s in it for you to be overweight?” I had never thought about it before. “Relief,” I said. “Comfort. Protection from being harassed, especially over my sexuality.”
Just being asked to describe it brought up feelings I had suppressed for years. I tore through a lot of Kleenex, crying—and I’m not a crier. I realized the gut pain I so often felt was caused by emotions I tamped down. When I overate, it was about trying to numb the hurt. I learned that another of my issues is deflection. When a subject matter is painful or anxiety producing, it’s hard for me to keep my mind from going off on tangents. Even in treatment at Renfrew, it was much easier for me to delve into the science of EDs—I was fascinated to learn that brain scans show how sugar activates the same neurological pathways as nicotine or cocaine—rather than focus on addressing my own food addiction. There were so many people in pain at Renfrew, my immediate impulse was to help them fix their problems, which is another thing I’ve been doing my whole life. When the staff at Renfrew saw me behaving that way, they stopped me and said I had to take care of myself first.
We were offered a range of therapy models—talk therapy, art and movement therapy, and psychodrama sessions where residents and staff acted out scenes from our childhoods to revisit and resolve past traumas. There was a lot of visualization involved, and I threw myself into that. I was shocked by the things that came up, and also what I couldn’t remember. It was agonizing. In one exercise, we were told to visualize a safe space.
I couldn’t find one.
* * *
—
When I tried to figure out where the unsafe feelings first came from, it made me look back at a childhood spent coping with my fear of my father’s unpredictable anger and my very capable mother’s tendency to silence or subjugate herself. Both dynamics affected me. I was always on edge, ready for the switch to flip, trying to please everybody. So I grew up restless and hypervigilant. I compartmentalized. Then I had to hide my sexuality. Then I was constantly worrying about being exposed.
By my forties, I also developed the first serious health challenge of my life. I noticed one day that my heart was racing. When I lay on my left side it felt like my heart was flopping around in my chest. I was scared and smart enough to get it treated right away, and I was diagnosed with atrial fibrillation, or A-fib. My cardiologist told me the condition occurs when the upper heart chambers fire out of sync with the two lower chambers and cause arrythmia. If left untreated, it can lead to stroke, heart failure, and other complications. I’m lucky that I’ve been able to control it for the most part with medication. But there have been several occasions when doctors had to admit me to the hospital, sedate me, and use defibrillator paddles to shock my speeding heart back into place. I’ve had two cardiac ablations.
There were so many confusing and painful emotions that I tried to numb with food and denial. When Frank Deford and I were collaborating on the book that was rushed into print after I was outed, I wanted the title to be Misfit because I felt like I was always on the outside looking in, walled off from the rest of the world because of what I was hiding. I was still battling those thoughts a decade later when Life magazine included me on its 1990 list of “The 100 Most Important Americans of the 20th Century” along with Eleanor Roosevelt, Dr. Martin Luther King Jr., Albert Einstein, Bob Dylan, Jackie Robinson, and Muhammad Ali. It was a huge honor. But I kept asking myself, If they think I’m so great, why am I so miserable? What’s wrong?
At Renfrew I learned that isolation is another symptom of an eating disorder. That’s why the group therapy experience and participation of family members was considered so important. Ilana, true to her word, dropped her aversion to therapy, telling me early on, “I’ll do anything that is going to help you get through this.” My parents were not as easy to get onboard the treatment train. Convincing them to allow me to fly them to Philadelphia for family therapy was difficult. They couldn’t understand why I needed therapy in the first place. They didn’t want to discuss my sexuality or the possibility that I might have an eating disorder. They were in almost total denial, which made me think: That’s exactly where I was.
We did get Mom and Dad on conference calls a couple times for sessions with the family therapist. When I begged and pleaded for them to come to Renfrew—I was starting to get upset about their refusal to buy in—they finally agreed to one weekend. They were unhappy about it. But it was crucial to my recovery.
I had to come out to them once and for all, to their faces, and tell them how miserable it made me when I couldn’t be totally honest, especially with the people I loved most. I was weary of being so cautious and measured, dancing around the truth, cauterizing my feelings. Dealing with my sexuality has been the hardest, longest-lasting challenge of my life.
My parents joined us on a Friday night when residents, former residents, and their families all gathered in a large room for an open group meeting. We all introduced ourselves and some shared our stories about how our eating disorders had wrecked our health and relationships. I felt my dad stiffen in the chair next to me. At one point he leaned over and whispered, “Sis, you’re not like these girls.”
I said, “Dad, I am. I’m just like them.”
My dad heard me, and he was terrific for the rest of the weekend even after we went through some extremely painful sessions as a family. Mom was a mess. She kept trying to take all the responsibility and saying, “Where did I go wrong?”
“Mom, you didn’t—you were and are great,” I assured her.
After a difficult afternoon on Saturday, my dad was walking down a hallway with me and said, “Be patient with your mother. She’ll come around. She just takes longer.” It was such a sweet moment, and the beginning of a profound change in us all.
In individual therapy, I was dumbstruck when Lynn uttered one of the most important things anyone has ever said to me: “Do you realize you’ve given all your power away to your parents? What does it feel like, always trying to take care of their feelings instead of your own? When are you going to take your power back?”
She was right. Realizing that was the turning point. I now knew what had to change.
I can see now how I was making accommodations for everyone, not just my parents, by concealing my true sexuality, even after I was outed. I was driven so far underground, some of the aftereffects took me decades to unwind and created one of the great paradoxes of my life. In tennis I was among those out front catching blowback and credit, shouldering enormous responsibility and blame in constantly shifting amounts. Whether it happened by circumstance or conscious choice is hardly the point. There were mountains to scale, setbacks to absorb, secrets I dared not utter. Some days—including that night I played Bobby—I felt as if nothing could stop me. Sometimes our achievements tore along at such a breakneck pace that to this day when people ask what I remember about the seventies, I answer, “I remember always being tired.”
And yet, while people saw me joust fearlessly in public and even called me a militant, they had little idea how much I privately struggled for clarity, for honesty. I had my first committed lesbian relationship in my twenties, but I was fifty-one before I could finally look at my mother and father and say the words, “I am gay.” It took Ilana’s assertion of her place in my life to prod me to finally allow what I wanted to supplant my avoidance of divorcing Larry. Had it been gratitude, affection, duty, guilt, self-preservation, an aversion to more pain that caused the delay? Yes. It took my time at Renfrew to show me how my eating disorder was symptomatic of so many things. Social conditioning is a powerful, powerful thing.
So is love.
Chapter 30
I think everything we go through is a process of self-discovery, but tennis can accelerate what you learn because it engages all of your senses. As a singles player, you go it alone. You have to summon whatever it takes—energy, self-awareness, determination, ambition—to drive yourself to the finish. You have to have the sensitivity to take in everything and yet a certain obstinacy when it comes to ignoring your fears and advancing fatigue, calculating the risks and then going for broke sometimes anyway. You make decisions in nanoseconds, often under duress, and you can find out about yourself really quickly.
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