Reviving Ophelia (28 page)

Therapy must be a kind of reverse brainwashing. I attacked the anorexia, but not Samantha. As she finished her meager lunch, I asked her questions that I learned to ask from psychologist David Epston. “If anorexia is your friend, why is he making you so tired and weak? Why is he encouraging you to do something that has made your periods stop and your hair fall out?”

These questions surprised her and were not easy to dismiss. She said, “I don’t know what you mean.”

I asked her to take home questions to think about, to write about. “We will continue to explore the lies that anorexia has told you, the lies that are costing you your life.” I also told her I would work with her only if she agreed to stop her long-distance runs for now. I explained that these runs might trigger a heart attack. She resented my limits, but agreed.

Work with Samantha proceeded laboriously. I assigned her consciousness-raising work. She was to look at models and movie stars and ask, Who picked this thin, passive type as our standard of beauty? I asked her to think about women she really respected. Were they weight- and appearance-conscious?

With Samantha, as with most anorexic women, the biggest step was realizing that anorexia was not her friend but her enemy, even her potential executioner. After that, she resisted its claims on her soul. One day Samantha came in and said that she realized that anorexia had lied to her. She said, “He promised I would be happy when I was thin, and I’m miserable. He promised I would accomplish great things and I’m too tired to even do what I used to do. He promised I’d be healthy if I ran, and instead my bones ache from the pressure of my body. He promised me friends, and everyone is mad at me. Anorexia has stolen all the fun out of my life.” That day I felt Samantha would recover.

In this culture we are all socialized to love food. Rich, sweet foods are connected to love, nurturance and warmth. We associate grandmothers and parties with cookies and cakes, not carrot sticks. Emotional nourishment is linked with physical nourishment. Many of our words for those we love are food words, such as sweetie, sugar and honey.

In addition to the emotional power of food, it has a chemical power that’s addictive as well. We all have experienced that sedating effect after Thanksgiving dinner. We feel sleepy and mildly euphoric. Sugar has particular power, and many women use sugary foods as a way to calm themselves and medicate away pain and anxiety.

In my experience, certain populations of women are most at risk for compulsive overeating. These are the women who are caretakers, whose life work is nurturing others. Nurses, for example, are notorious for having goodies in their nursing stations and eating when they are overworked and tired. Many develop into compulsive eaters.

Young women who eat compulsively have learned to use food as a drug that medicates away their emotional pain. This is harmful because they do not learn to deal with emotional pain and because they become obese, which sets them up for much more pain and rejection. It’s virtually impossible in America to be heavy and feel good about oneself. A vicious cycle has begun.

Compulsive overeaters are often young women with a history of dieting. They diet and feel miserable, then they eat and feel better, but meanwhile their dieting makes their metabolism grow more and more sluggish. Over time weight loss becomes associated with control, and weight gain with out-of-control behavior. They become more obsessed with calories and weight. Soon it’s not just their eating but their lives that are out of control.

Writer Susie Orbach distinguished between “stomach hungry,” which is genuine physical hunger, and “mouth hungry,” which is a hunger for something other than food—for attention, rest, stimulation, comfort or love. Compulsive eaters are mouth-hungry eaters. All feelings are labeled as hunger. Eating becomes the way to deal with feelings. Compulsive eaters eat when they are tired, anxious, angry, lonely, bored, hurt or confused.

Treatment for compulsive eating is similar to the treatment for bulimia. Young women need to identify their real needs and not label all need as hunger. If they are restless, they need stimulation; if they are tired, they need rest; if they are angry, they need to change or escape the situation that angers them. Of course, compulsive eaters need to learn controlled eating. Often they can benefit from a support group such as Overeaters Anonymous.

It’s difficult to be a healthy eater in this country. Unhealthful food is everywhere, and we are encouraged to consume without thinking of the consequences. Support groups help women stay focused on long-term goals, not immediate gratification. They also give women a new way to deal with painful experiences: They can talk about them.

Violet was living on the streets when we first met, but soon after she moved into a shelter for homeless young women. She had a more difficult life than many compulsive eaters, but she shared essentially the same issues. Compulsive eating, unlike anorexia, is not primarily a problem of the middle class, but an equal-opportunity problem. Violet associated food with love and nurturance. Like many compulsive eaters, she was a good-natured, hard-working people pleaser. Violet was good at caring for others, but when she needed care, no one was around. Food was her pain medicine.

I met Violet when I worked at our local homeless center. During the day homeless people and transients came there to shower, use the phones, pick up mail, escape the weather and play cards. As a volunteer, my job was to make coffee and put out trays of day-old donuts and rolls. I was to enforce the rules—no swearing, no alcohol, no obscenities and no weapons.

When I wasn’t busy, I played cards and gave advice about local jobs and services. Most of our customers were men, but increasingly in the last few years women and families have come to the center. Cigarette smoke fills the room with a blue haze by midmorning. I’m struck by how many of the homeless are hooked on caffeine, sugar, cigarettes and alcohol.

I noticed Violet right away because she was an unusual age for a shelter visitor. She looked about eighteen, maybe even younger. She was chubby and dressed in jeans, a T-shirt and plastic thongs. Like most of the people at the center, she had bad teeth. When I first saw her she was playing cards at a table of regulars. She laughed easily and was popular and accepted by the group. They joked with her, offered her smokes and advice on survival in our town.

Later, when the men hit the streets, I visited with Violet. She had just run from what she said would be her last foster-care placement. She’d had six and that was plenty. She’d also lived on the reservation with her mother, who was sick and alcoholic, and she’d lived in an institution for difficult kids with no place else to go. She was ready to be on her own and said, “I’d rather live on the streets than have anyone tell me what to do.”

I worried aloud that she might get raped being on her own, and she looked at me strangely. “Do you think that hasn’t happened to me before?”

Before she left that day she pulled out a picture of her mother’s home on the reservation. It was a trailer surrounded by squalor—old tires and car engines, even a toilet. But Violet looked longingly at it. “I miss my own place, but Mom’s just too hard to live with.”

Violet came in for several months. Like many of our local homeless, she sold her blood and “volunteered” for drug studies at a pharmaceutical company. She wove leather armbands that she sold on the streets. Violet made enough money to buy herself and her friends food. She bought presents for children whenever they turned up at the center. Soon I was busy answering the question “Where’s Violet?”

In fact, Violet had lots of friends. She wasn’t a complainer and had a way of laughing about troubles that made them seem less serious. She was big on hugging others when they were down and had nicknames for everyone.

One morning she showed me all the scars on her arms and leg—from a knife fight with her mother’s ex-boyfriend, from her mother when she was drunk, from a foster father who believed in physical discipline. Another day she said, “You’re a shrink. I wonder what I should do about this tendency I have to eat everything that isn’t nailed down.”

She told me how she always associated food with comfort. Her fondest memories were of her childhood visits to her grandmother’s. There she’d had a calm, clean place to play and rest. She said her grandmother was a good cook and always had oatmeal cookies and angel food cake for her to enjoy. “Mom never had food around, only booze. Grandma’s place had good food.”

She lit a cigarette. “I had lots of bad homes. Food was the one thing I could count on. No matter how wrecked I was, eating helped me feel better. But there was never enough food. That’s what worries me now. I can’t get enough. I eat until my stomach hurts, and then I’ll keep on eating.”

I said, “It sounds like you’ve got things pretty well figured out.”

She smiled. “I know what’s wrong, but how do I fix it?”

Eating filled a deep need that Violet didn’t know how to fill in other ways. I knew she could learn healthy ways to take care of herself. Because she was such a good worker, I was sure she could work her way into a decent job and a more stable life. I started to tell her this, but Violet waved her hands. “Whoa. Don’t get too deep on me.”

I apologized. “We shrinks have a tendency to do that.” Then someone asked me to make some more coffee.

I bought Violet a copy of Orbach’s book
Fat Is a Feminist Issue
and told her about a free support group near the center. She didn’t like to hang out with people with money (it made her self-conscious), but she did read the book.

One day she told me that she thought her eating was related to her fears about sex. She said, “I figure that if I’m fat enough maybe guys will leave me alone. It’s a kind of armor, soft armor, but it works pretty well.”

Another day I said, “Everyone counts on you to cheer them up.” She was pleased by my observation. I continued. “I wouldn’t want you to change, except maybe to follow some of that sensible advice that you give other people.”

She looked at me. “Like what?”

I answered, “Like getting off the street. I’ll help you when you’re ready.”

I wish I could say that Violet’s story had a happy ending, but after a few months she left for California to pick fruit with a man she met at the center. She sent me a postcard from the Central Valley. It said: “The weather’s great and there’s work. But I miss my shrink. I’ll be back. Don’t worry.”

Violet comes from an extreme situation, but in terms of dynamics, she’s similar to most compulsive eaters. She learned to associate love with food and to use food to comfort and nurture herself. She’s good at caring for others, but relatively poor at meeting her own needs. She’s good at burying her pain.

Her sexual fears are quite typical of compulsive eaters. Many date the start of their compulsive eating to an incident involving sexual abuse. Others are fearful of men or their own sexual appetites and see their weight as a form of protection. Many have had the experience of being pursued by men when they lose weight. Often they gain to avoid the choices and dangers that pursuit causes in their lives.

If I could have seen Violet in therapy, I would have encouraged her to examine her feelings carefully at the times when she felt tempted to gorge. No doubt she had pain from her past life, with its foster homes and institutions. She had abandonment issues and physical and sexual abuse issues to deal with. She learned that while people let her down, food was an ever-faithful friend.

I would have taught her to respect rather than run from her feelings. I would have encouraged exercise as a way to fight depression, manage stress and feel better about her body. I would have taught her to set limits with others and even to ask for help. I would have encouraged her to stay in our town and work her way through problems. We could have found money for her to go back to school or get some technical training so that she’d be employable. I would have found her a good dentist.

 

Beauty is the defining characteristic for American women. It’s the necessary and often sufficient condition for social success. It is important for women of all ages, but the pressure to be beautiful is most intense in early adolescence. Girls worry about their clothes, makeup, skin and hair. But most of all they worry about their weight. Peers place an enormous value on thinness.

This emphasis on appearance was present when I was a girl. Our high school had a “gauntlet” that we girls walked through every morning. It consisted of all the boys lined up by their cars along the sidewalk that led into the front doors. We walked past them to catcalls and remarks about our breasts and legs. I wore a girdle made of thick rubber to flatten my stomach on days I dressed in straight skirts.

But appearance is even more important today. Three things account for the increased pressure to be thin in the 1990s. We have moved from communities of primary relationships in which people know each other to cities full of secondary relationships. In a community of primary relationships, appearance is only one of many dimensions that define people. Everyone knows everyone else in different ways over time. In a city of strangers, appearance is the only dimension available for the rapid assessment of others. Thus it becomes incredibly important in defining value.

Secondly, the omnipresent media consistently portrays desirable women as thin. Thirdly, even as real women grow heavier, models and beautiful women are portrayed as thinner. In the last two decades we have developed a national cult of thinness. What is considered beautiful has become slimmer and slimmer. For example, in 1950 the White Rock mineral water girl was 5 feet 4 inches tall and weighed 140 pounds. Today she is 5 feet 10 inches and weighs 110 pounds.

Girls compare their own bodies to our cultural ideals and find them wanting. Dieting and dissatisfaction with bodies have become normal reactions to puberty. Girls developed eating disorders when our culture developed a standard of beauty that they couldn’t obtain by being healthy. When unnatural thinness became attractive, girls did unnatural things to be thin.