When Love Comes To Town
You guys ever have that moment when you hear something and, all of a sudden, finally understand a concept you have never really grasped before? It happened to me recently at a TBT-S (Temperament Based Treatment, with Supports) workshop for carers of kids with ED run by Drs Laura Hill, Stephanie Knatz Peck and (I forgot the other name – doh). Dr Hill was talking about why CW purging is so compelling. As she talked, I suddenly had complete clarity about my own history with purging. I suffered with AN/BP for nine years from before I was a teenager to age 20; I don’t have to describe the struggle. I know that you who have it, or have had it, or have cared for someone who has it, understand already. It is hell, isn’t it? No matter how many times I promised myself I would “stop”, no matter how many times I begged the God of my childhood to forgive me and to help me not do this to myself any more, I was unable to break the habit. I would suppress my intake for as long as I could and then bust out into a spree; or it would just happen over and over again every day for weeks – no rhyme nor reason – and no way out that I knew. I had breaks of being behaviour free – but they were few and far between. Plus, I lost my ability to function well at those moments. The behaviours worsened when I was involved in a relationship of any kind with a boy. They became the way I managed distress about expectations; on one hand, the expectations of the religion in which I was raised, and which was all consuming, about physical behaviour between “the opposite sexes”; on the other, the expectations of boys and men about physical behaviour. And somewhere in the middle of those, me myself, and my absolute hatred of being “groped” competing with an all-consuming craving for being “loved”. I would find myself in a relationship (which was really just one big struggle to feel validated while repeatedly peeling some guy’s fingers off my body?) and enjoy the euphoria that came with feeling wanted, and with being held, and being touched in a non-sexual manner. Trouble is, non-sexual touch was never enough for most guys; cue the usual battle, hands from no-go zones, while trying to avoid rejection.
My craving, above all, was to be wanted.
I remember sitting in a car with a guy friend once and telling him that I just wanted someone to want to marry me. He just about died on the spot. I didn’t understand why he was so nervous. But he misunderstood the words. I wasn’t saying I wanted him (or anyone else) to marry me, just that I wanted to be WANTED. Poor guy probably shat himself.
Given that I was raised in a misogynistic religion, where women were seen as temptresses, leading men to sin, and sex outside of marriage was about the worst thing anyone could do, it was natural that I struggled with overwhelming guilt. Hell, when I was a pre-teen, I used to tickle my own arms as a means of soothing myself. I know now that it was stimming, and it is not a big deal. Back then I felt as guilty as hell because I believed it was “masturbation”, which was right up there with some of the worst things as mentioned. I had no concept of physical pleasure being “allowed” or that I was ok to bring it to myself. To complicate things further, I had been sexually abused as a small child by a family member. My response in that situation had been to “freeze” (my default fear response), and later to shame myself for it having happened, a pattern that would play out many times in my later years. The worst part of that experience was losing the innate response to say no and resist, and not ever having that response validated or reinforced by someone else. It was only as an adult that I began the difficult task of validating my own responses to that situation.
Add to this the rhetoric in my family religion around “gluttony”. Hoo boy. Can of worms anyone? Gluttony was a “huge” sin, and as a child I listened to many bible-based talks (given by the same men in suits that roundly condemned all things sexual) condemning “desires of the flesh”…. Overindulgence in food and sexual pleasure – an incredibly damning combination. Add in my father’s eating disordered behaviours and personality, and his incessant discussions about fat people – linking body size to weakness and lack of discipline, greed and “not really being spiritual people” as he himself struggled against his own hunger and deep sense of self-loathing, and his rigid control over the clothing his daughters wore, and his constant attempts to supress any signs of blooming sexuality in our actions or dress.
It was a shitstorm that enabled my ED to flourish. The only way of managing my anxiety was, of course, practicing ED behaviours; either severe restriction (usually fasting on vegetable juices, something our family had done since I was 9), or reactive eating followed by purging.
And then love came to town. Someone wanted to marry me. A manboy of 20, same age as me. He had the same urges as all the other boys, of course, but it was a little more permissable in the context of “getting married”. Sex was all good in a married state (until misogyny and patriarchy reared their ugly heads, along with our complete ignorance about adulting, and my trauma history came home to roost). And, because the religious constraints around “going too far” were in place, I was getting all of the physical affection I had been craving, without being pressured overly much for more.
I “confessed” to him about the purging. He “confessed” a “great sin” of his own. And, naively and hopefully, we promised that that was the end of those behaviours. Which, of course, it wasn’t. But we thought it would be. I did stop purging. Only had a couple of lapses after that. It was like switching off a light. One moment the purge was there, and the next it was gone. (What I didn’t know was that I was not “cured” of ED, and that it was still running the show behind the scenes, and that it would overwhelm me in the future any time I faced an anxiety-inducing situation.)
In my mind I had always tied it up with “being in love”. I used to jokingly say that I had “traded addictions”. Turns out, I was partially right. Partially.
Back to Dr Hill. In her discussion about purging, she mentioned the huge rush of a nine-amino acid peptide, vasopressin, at that moment, which has a euphoric, heady, calming effect (it also affects fluid balance in the body). Vasopressin is one of the reasons that purging is so compelling. I registered with a shock that I had taken a photo of a newspaper article that mentioned vasopressin, and that it was still stored in my phone. I flicked through my gallery until I found this.
And there it was.
Dr Hill’s words completed and validated my understanding of how I had been able to stop purging at the time. I replaced one source of vasopressin with another, and added in high levels of oxytocin (which has been used to some success in treating AN) to boot. I knew back then the purging was problematic. But I didn’t have a name for it until a few years later. And, the fact that I had been able to stop the behaviour fooled me into thinking that I had been cured at that moment. As more became known about ED, I used to believe that I had “had” an ED in my younger years; I used to believe purging was an addiction; and I used to think that my eating was an addiction as well, and that all I had to do was to get the same control over it that I had gained over purging. Which I endeavoured to do for most of my adult life, and came closest to perfecting, between the ages of 46-52, before realising that I had a very long term relationship indeed with ED, and that my seeming “perfect control” was classically typical AN.
ED and anxiety are bosom buddies. All too often we focus on the behaviours, or on our current weight, or on the foods we are eating, or on how are clothes might fit. Practising remission isn’t about “what “ we do or how much we weigh, but hinges on whether or not we are using ED modalities to manage our anxiety. Stopping purging was great. But I STILL had an active ED. If I map out my life from that moment, there is a clear pattern. I resorted to getting into, or staying in, an overall calorie deficit whenever things got stressful. And until I interrupted THAT pattern, I was unable to practise remission.
Deal to the anxiety; and you deal to the ED.
















