Why I still struggle with factors like perfectionism and obsessive-compulsive disorder that contributed to my eating disorder three decades ago
By Vanessa Nirode
When I graduated from high school in 1988, I weighed 89 pounds. Currently, I haven’t weighed myself or obsessively counted calories for 30 years. Echoes of that girl I once was, though, live in my brain.
My disordered eating was wrapped up in not feeling as if I belonged, an overwhelming quest to be perfect, and struggling to control my own narrative.
Recently, during my weekend group cycling ride, I grew agitated and uncomfortable after one too many comments on what I was eating (or not eating) at lunch. I angrily asked my friends to stop talking about food for just one meal. It didn’t go over very well and I only really succeeded in making everything awkward.
Annoyed with myself, I wished I had remained silent. Usually, I do; usually, the anorexic girl in my brain stays dormant. But not that day. For some reason, I was reminded of dodging my mother’s questions and accusations when I was 15. My mini-meltdown didn’t necessarily surprise me. I believe that while you can take the girl out of the anorexic, you can’t (completely) take the anorexic out of the girl. What fueled my anorexia will always be in me. Some truths persist: I don’t eat when I’m upset; I still struggle with perfection; I’m not always great at dealing with my emotions. Yet, I am no longer anorexic.
While you can take the girl of the anorexic, you can’t (completely) take the anorexic out of the girl.
What fueled my anorexia will always be in me.
Rachel Woodson Goode, a clinical social worker and researcher who develops behavioral interventions to treat binge eating and chronic disease, says that in recent years, eating disorders have increased.
“We know more about them,” she explains. “For one, [people with eating disorders] hide.” In the past, there was an accepted image or idea of a person with an eating disorder. Now, medical professionals recognize that anyone can develop one. Most people don’t know where or how to seek treatment. So, they hide.
Hiding Behavior
As a teenager, I hid. I wore baggy clothes, ate every meal alone, and, when home, hid in my room with my books and music. I recorded everything I ate with its calorie content (two graham crackers: 120; apple: 60; plain bagel: 150), the information copied from small diet books I found in a kitchen cupboard. At 13, I read about Karen Carpenter’s death, which was attributed to a heart dysfunction that was a consequence of anorexia nervosa. I was struck by how steadfast she was in not eating.
Despite all that, I did recover and, in the past 30 years, have not relapsed. I wish I possessed a clear set of instructions on how I went from barely eating, counting calories, and weighing myself daily to consuming food in a “normal” way. But I do not.
I remember that I once lived my life like that, but I’m unsure how — or even exactly when — I altered my behavior. I do know, though, that my disordered eating was wrapped up in not feeling as if I belonged, an overwhelming quest to be perfect, and struggling to control my own narrative. Which, when you look at the science, makes sense.
According to research, many people with disordered eating struggle with perfectionism, have a difficult time regulating emotions and often experience rigidity cognitively and psychologically. Some people have a history of bullying, physical or sexual abuse or psychological disorders in their family.
“Eating disorders are a lot about a lack of power,”
says Ann Kearney-Cooke, Ph.D., author and licensed psychologist.
The reality is, real power isn’t trying to make your body look like somebody else’s. Real power is defining yourself by the choices you make each day, whether that’s around your body or other things, such as choosing to listen to a friend when they are down.
For instance, people may realize they can’t control their partner’s infidelity or workplace dynamics, but they can control the number on a scale. This inner monologue is likely not a conscious one. It definitely wasn’t in my case.
OCD Connection
To say I was unhappy as a teenager is to greatly underplay what I felt. Not that I would have described what I was as unhappy.
Nothing was blatantly wrong; my parents were wonderful people … I got straight A’s; I had a boyfriend. And yet.
Anna Marcolin, clinical coach and psychotherapist, says that disordered eating diagnosis and causes are always incredibly nuanced.
Anorexia nervosa can be defined as “a restriction of food which leads to low body weight along with an intense fear of gaining weight and distorted body perception which greatly influences self-esteem,” Kearney-Cooke says.
While this definition makes sense to me, my understanding of my anorexia remains cemented in control/power, emotion regulation and a tendency toward obsessive compulsive behavior. Scientific studies support connections between OCD and anorexia as they often share symptoms and present simultaneously. Recent research shows that common structural brain “abnormalities” overlap in both and, while scientists do not yet fully understand the underlying mechanisms that may lead to anorexia, numerous studies show that there is a genetic component. I think what all of this means is that some people, as Goode would say, “have a leaning.”
“Many people learn enough so they don’t lean fully in that direction,” Goode continues. “They gather their tools, learn how to cope and how to navigate challenges to make sure they’re eating regularly.” I put myself in this camp.
After talking with Marcolin, I think I utilized something called dialectical behavioral therapy (DBT) to spur my recovery, as well as making an unexpected (to everyone else) sharp exit from the life path that everyone assumed I would follow. After graduating valedictorian of my high school class, being accepted into the Honors Tutorial College at Ohio University and attending for a month, I abruptly decided to double major in theatre and English. After completing my first year. I made the even more impulsive decision to not go back. Instead, I took a job in costumes at a regional theatre which turned into a 35-year (and counting) career as a tailor and pattern maker for film and TV (while also working as a journalist). There are many things I regret, but leaving university when I did is not one of them.
Marcolin explains that DBT, a kind of emotion regulation therapy, involves accessing your wise mind to work through emotions. The premise of DBT is that everyone has three minds: the emotional mind, the rational and the wise, which sits between the two. When you find yourself deep in your emotional mind, identify and record your intense emotions. Then, factually evaluate the situation: what happened to cause your emotions; what exactly did someone say or do? Are you interpreting what someone said or did in a way that perhaps they didn’t mean or intend?
Using your wise mind is not easy, especially when you’re deep in your emotions. For me, there’s usually a lag time of a few hours or more until I’m able to examine my emotions and the situation. Occasionally, I wish I had someone to talk things out with.
Recovery Steps
Marcolin says that any time a person ruminates toward the point of obsession about how and what they eat, they need to be careful. There’s the potential for rigidity and experiencing guilt or shame when “messing up” and consuming something they think they shouldn’t. Marcolin works with clients to find flexibility and moderation and guides them through the deeper dive issues related to control. Her first step is always cognitive behavioral therapy.
Anorexics, generally, she points out, are overachievers.
“Everybody needs to learn thought distortion and unhelpful thought patterns,” she says. As she develops deeper relationships with her clients, she may introduce emotion regulation or guidance around self-love and self-acceptance. Some may struggle with rigidity and not knowing how to relax. Anorexics, generally, she points out, are overachievers.
All the experts I spoke to believe that recovery is completely possible. It’s also normal to notice, as I do, remnants left behind by disordered eating.
“It reflects your journey,” Goode says. “Where you’ve been, where you lean.” But these remnants also remind me to not lose sight of things I need to maintain, watch and guard my mental health the best I can.
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