A Letter to My Disease

Dear Liar,

So many, many broken promises. So many nights lying awake, hungry, head pounding, pinching fat and feeling bones. So many dollars flushed down the toilet. So many people deceived. So much hurt.

You walked in with a James Dean swagger, all bravado and empty promises. You told me I'd be free. You told me I'd be strong. You told me I'd be happy. You knew all along.

I hate you for robbing me of myself. I hate you for convincing me, time and again and year after year, that I'm not worth anything. I hate you for what you've done to my body. I hate you for making me manipulate the people I love. I hate you for everything.

Now go. Leave me alone. Let me pick up the shattered pieces of my soul and attempt to reconstruct them into something meaningful. Don't come back again. You are unwelcome. You are a liar and a cheater and a thief. I can get by without you. I WILL get by without you.

Ungratefully Yours,
Cassie

Asking For Help

A lot of people have trouble asking for help. I'd venture to guess that most people have a hard time with it. Humans are a proud bunch (probably some evolutionary adaptation). In addition to pride, shame and guilt play a big role. I can't count the number of times I've begun a request with, "I'm so sorry to ask this, but..." or, "Please don't hate me, but could you..." We are supposed to be able to fix our own problems. We are supposed to be independent. We are supposed to be self-sufficient. Above all, we are supposed to be strong.

Ha. When you find that perfect, needless person, call her a liar right to her face. There IS no such person. We ALL need help sometimes. The ability to ask for it is absolutely necessary to survival (physical AND emotional). I go to school with a nice but very insecure girl. We get out of class late at night, and she has no car. She walks home, in a sketchy neighborhood, by herself. She will not ask for help. Think of the dangers: she could fall and injure herself. She could become the victim of a crime. She could be struck by a vehicle. This girl knows there are plenty of us from whom she could get a ride, but is afraid to ask for help. (Luckily there are enough of us who recognize her risk to talk her into one of our cars most nights.)

Let's take that example, and apply it to an eating disorder. We'll call our subject Leah. Leah is sick, has been for some time. She restricts, binges and purges, exercises too much. She's worked very hard to hide her behaviors from the people around her. Now, though, Leah is starting to have health complications. Her hair is falling out, she's frequently dizzy, she's cold all the time. Leah knows she needs help before it gets worse, but she's afraid to ask. Let's explore the danger Leah could be in: she could pass out while driving. She could have a heart attack. She could choke while binging. She could have a gastric or esophageal rupture while purging. She could develop osteoporosis and fracture a bone while exercising. She could fall into a deep depression and be at risk for self-injury or suicide.

Does Leah need help? Absolutely. Is Leah scared? Extremely. Is Leah ashamed, embarrassed, guilt-ridden? Without a doubt. Is it more important that Leah keeps her secret, or that she reaches out for help? We all know the answer to that.

Every person in this world needs help at one time or another, and we usually need to ask for it in order to get it. If you need help right now, please put your health and safety first and ASK for it. If someone needs help from you, please extend your arms in gratitude, for it is a great gift to be needed.

There is no "try?"

I was out for drinks with a dear friend last night. For most of the evening we laughed so hard we nearly fell off our chairs, but occasionally the conversation turned to more serious issues. She asked about my recovery. My response was that I continue to "try to be well." She quoted Yoda (told you she was awesome) and said, "Do or do not. There is no 'try.'"

Now, had anyone else said that to me, I would likely have slapped them. But since this gal is who she is, I tried to take the comment as constructive criticism. Do we - people who have struggled with eating disorders for years - have the power to simply CHOOSE to be well? Does it boil down to deciding to be healthy or sick? Is it that easy?

A few years ago much was made about the book "The Secret." For those who aren't familiar with it, the premise is that you can accomplish anything simply by thinking positively. While I agree with this idea in certain situations - careers, personal relationships, financial goals - I don't believe it can be applied to disease. A person with cancer can have the most positive outlook in the world and still die.

Maybe the real issue is whether mental illness is viewed as an actual disease or just an excuse for bad behavior. There has been extensive controversy on this topic. Knowing what I do about neuropsychology, I count myself among the group that believes in genetic, biochemical, and physiological causes of genuine organic illness. There are a fair bunch of folks out there, though, who believe mood, anxiety, and personality disorders, eating disorders, chemical dependencies, etc. are simply manifestations of weakness, laziness, defiance, confusion, and lack of will.

If mental illness falls into the latter category, then it stands to reason that people should quite easily be able to choose between sickness and health. If, however, the causes of psychological disorders are much more complex and largely neurobiological, "The Secret" method doesn't hold water.

So let's turn this into a discussion. Do you believe mental illnesses - eating disorders in particular - can be "willed" away? Do you have any thoughts you'd like to share on the origins of psychological disorders?

How Many Lies?

"I ate a late lunch." "I'm not feeling very well." "I had a friend over, and she ate all the ice cream." "I don't know why the bathroom smells funny; maybe the plumbing isn't working right."

How many lies have you told in the name of your eating disorder? I lost count of mine about 10 years ago. I have lied to so many people about so many things for so many years. I have to add, I'm a terrible liar. I have an overactive conscience. Even "little white lies" make me queasy. But I would tell anybody anything to protect my disease. Even as the words sting like bile when they come out of my mouth.

There's that saying, "The truth hurts." Maybe we need to acknowledge that for once. Lies protect our disease because our disease masks our feelings. The truth exposes our feelings, in all their raw, painful, ugly glory. It's no surprise that we'd do anything to make those feelings go away. But we have to realize that we're not helping ourselves at all. For every lie we tell, for every meal we skip, for every binge and every purge, we lose a little of ourselves.

Hold my hand, and we will tell the truth together. The truth is, life hurts sometimes. But if we're honest about it, we can help each other through it.

The Selfishness Conundrum

There's a rather vicious dichotomy to eating disorders. They are at once both a hatred of self, and a complete obsession with self. Where the narcissist obsesses about her own value, prestige, and vanity, the eating disordered person obsesses about her own inadequacy, failure, and imperfection. As different as their perceptions of themselves may be, both people are completely preoccupied with themselves.

I have a very hard time with this notion. I have always been motivated to help others; to reach out, volunteer, donate to causes I support, be active in service. Self-centered people irritate me to no end. I think to myself, "Does this person not realize how many billions of people there are in this world who need help, love, outreach? Maybe if she was a little less focused on herself, she could actually do some good for humanity." I find it exceptionally difficult to count my self-deprecation as its own form of self-centeredness. It is, though. As much time as the narcissist spends puffing herself up, I spend beating myself down. Neither of us are able to contribute much to the universe at large.

It's a tricky balance, though. To consider my anorexic/bulimic behaviors as self-obsessed is to feed into the notion that I am "bad." "Good people" don't spend so much time thinking about themselves. Since I'm already "bad," I may as well go on punishing myself. Nasty cycle, isn't it?

I have found that the most constructive solution to this problem is to simply spend as much time in service to others as possible. If I surround myself with positive people and fill my schedule with worthwhile activities, I squeeze out any time or energy for self-destruction. In addition, there's such a beautiful gratification that comes with reaching out to another person. Knowing that you've done good can be more powerful - and more healing - than years of therapy and dozens of medications. And when you see that you CAN do good, it makes you want to do MORE good. It's wonderful self-perpetuation.

Don't fret about who you are or who you're not. Go and do good. It will come back to you in spades.