On Anorexia And Resiliency

I would not understand the real immensity and insidiousness of anorexia nervosa until it left me, unequivocally, powerless. I would not realize, for instance, that the same sense of security so seductive to me at sixteen, would lead to repeated attempts on my life six years later. It would have been confounding just in taking stock of a disorder continuing to hijack my life so many years down the road, but most emphatically, that despite anorexia delivering me into emergent care at Weill Cornell/New York Presbyterian on three occasions, I would still cling to it more terrified and tightly than ever.

The first time through the massive sliding glass doors, it was a beautiful spring afternoon: the kind in New York that empties buildings out, and creates a lightness in the air of unencumbered delight. I arrived limply seizing from a cascade of nutritional deficiencies, having ultimately been unable to escape a series of unwilled public displays on subway platforms and Manhattan sidewalks.

The second time resulted in a mandatory enteral nasogastric tube that I named Daisy. Daisy’s machine was decorated in cut-out flowers made by the other girls on the ward, and for twenty four days I lay on partial bedrest; oedemic, emaciated, and sucking on lozenges to numb the chafing in my throat. On the days I did not jolt with a thrill of impulse and slip into the bathroom to unscrew the cap off the unit of liquid, dilute the feed in the sink, and return to my room in deeply paranoid shame, 4,000 calories were administered through a tube taped to my cheek.

The third time I found myself in that emergency department, nestled in the crook of the Upper East Side and another planet, I simply couldn’t come to terms with the reality of another relapse. I had spent the last year (not that I was counting) in twenty four days of acute inpatient care, ninety-six days of residential treatment, fifty one days of partial hospitalization day treatment, and twenty nine days of intensive outpatient treatment, in addition to the hundreds of hours of nutrition therapy, psychotherapy, psychiatry, and outpatient group therapy I attended.

I was treated at some of the oldest and the most renowned treatment centers in the country, and in the relapse after, I thought I would maybe just cut to the point and murder myself in a more direct fashion.

This starvation-high sixteen year old could not have believed that after all of it; after being admitted once again, and once again spending the next couple months in inpatient and residential care, I would relapse… again. And again. And again. And whether it was the beating this took on my self-esteem, or the nature of the beast itself, each relapse was worse. At sixteen, anorexia had been an answer to something, and I had felt invincible as hell.

The intoxication deteriorated around the same time my body did. Previous to that, my body had been young, unmarred, and resilient to the abuse I railed. It was adolescent, and convenient, to hold my nose high to my parents and doctors and deny any of the serious medical complications they worried over. My blood tests had always come back normal, my electrocardiograms showed normal cardiac rhythms- It wasn’t that bad; I was fine… It’s an anomaly that many people with anorexia nervosa experience- sparklingly clean bills of health, contrary to any appearances, until they quite suddenly are not. And predictably to anyone thinking linearly, I was no exception. The resiliency fell, and I was swept under a tide, never having anticipated what it would be to swim against.

“They” become worried about my health, as my labs began to rickashay up and down, the indications ominous for several of my organ systems. “They” became worried about my heart, which had begun not to beat normally, and I was soon stuck to a twenty-four hour heart monitor. It is only in retrospect now that I can consider how terrifying this must have looked- wires taped to my chest, hooked up to the monitor, a tube taped to my cheek filled with the almond-beige of the feed dangling from the IV stand next to my bed, an IV in my arm. At the time, I was embarrassed- how overblown, what a drag to have all these tubes and wires in the way, my parents must be so confused.

My mental health had taken a deep dive into a place so scared and alone, that the only thing I knew to desperately grasp to was the disorder that drove me there. Regardless what support was around me, calling out through the anorexic fog, there was a point in which I could not hear anymore, could not see anymore, my gaze turned entirely inwards to my racing and skipping thoughts of food eaten, and not. It was the most secure, familiar, and controllable thing in my life, and it self-perpetuated this belief.

I was unreachable: entrenched in the anorexia, and dissociated to the chaos erupting around me.

This was not supposed to happen like this… was a thought I used to have a lot. I was not supposed to be in Philadelphia that spring, when I first entered residential treatment, standing in medication lines, and taking monitored showers and bathroom breaks. I was supposed to be starting my sixth semester at a college in a city I loved, swept up in school, and interning, and the glamour and excitement of New York City. But this only scratched the surface of what anorexia robbed me of, and it would be months before I would be able to face this, and for the first time, become angry.

I was back in residential treatment, in a victorian house outside of Boston (that would have been more charming had I not been confined behind its property lines with seven other women, discussing our food and feelings on a continuum basis) when I realized this. My situation was beginning to appear rather helpless, and I had nearly lost all will of motivation. No one really had much left to say, and least of all myself. It had all been said before; whether through patient and carefully measured tones in family therapy sessions, or hysterical and crying ones over phone calls and visits. The treatment team began to look at me with something that bordered pity.

In it’s simplest, resiliency is the ability to become strong, healthy, or successful again, after something bad happens. The suggestion-whether it was real, or something I had imagined- that I was incapable of this, after enduring so much adversity and illness, enraged me. And this rage, which could be directed at no one but the disorder that put me there, was the key that led to the freedom from it.

To me, resiliency means getting out of bed on the days the anorexia feels I’m unbearably unacceptable, and unworthy of life. It has meant grounding myself in the face of life’s intensities, instead of flailing back, or reaching for a cigarette, a pill, a line, a drink. It has meant learning to lean on those around me, while it is also careful not to mean reliance. Resiliency means believing in life, and not loss, and knowing it is a choice.