I went through five years of treatment for the treatment of anorexia that added to the negative transference I have for psychotherapy. This included three therapeutic relationships, three hospitalizations, and three therapeutic trends that were utilized back in the early nineties. I participated in mandatory family therapy, behavioral inpatient eating disorder therapy, and addressing the problem through a twelve step tradition.
As a result of these relationships I learned four additional lessons:
- lesson four, it is important to set reasonable expectations;
- lesson five, it is not helpful to make negative predictions;
- lesson six, it is important not to ignore signs of abuse in relationships; and
- lesson seven, it is important not to attack a spiritual tradition.
Again, although I am glad that this treatment helped me survive a life-threatening condition, reflecting on these experiences has always led me down a path of madness. I am left wondering if I am safe in therapy.
“Of course, you are safe in therapy,” I can hear the choir sing!
“Stay on the streets of this town, and they’ll be carving you up alright . . .” I hear Bruce Springsteen retort.
Oh, how I hate choir music, but what do you think?
Structural Family Therapy:
I instantly liked my second therapist just like I liked my first therapist. He was affiliated with Salvador Minuchin’s reputable Child Guidance Clinic. It would be intensive Structural Family Therapy for me.
My parents tried to drop me off with my suitcase and he said, “Wow, that suitcase is very heavy!” Then, he ordered my family to have daily sessions to save my life.
There were a lot of tense family sessions in which my father bullied me to eat and I hated myself for acquiescing. In fact, this made it harder to swallow my pride and eat even though part of me was hungry and wanted to do better. Instead, I learned to throw-up in trash cans to object to my father and the family drama that unfurled.
I was expected to gain a half pound a day or we were failures. I researched an article in academic journals in the hospital library that suggested that this was not a good plan for the long-term needs of eating disorder patients. My therapist did not respond to my effort to self-advocate.
Indeed, when I would fail treatment at this facility and get transferred, I would learn that six thousand calories a day would not enable me to gain so rapidly.
It was true this therapist that I had for one month was good at calling my parents on their shit. At the same time, he also would punish me for not gaining enough weight by not letting me speak in the session. He really liked my sister, he said.
It may not be fair to blame the next ten years of family cutoff on the distress caused in those intense sessions. The therapist told my parents that I would run from home. This was often thrown in my direction. My mother sounded good in therapy and clearly felt my struggles were my fault and let me know it a great deal over the years. My sister always made it onto the folklore of the family Christmas cards, but not me. My room would be converted into a study and I moved in with a high school friend.
There was ongoing contact, but I did what I could to divorce myself from my family. Particularly when I reconnected with them ten years later, they chose to listen to the negative prognosis of the psychology tests, called the police, supported, and in one case openly prayed for longer-term hospitalization. Up until then, my psychotherapists functioned as my parents.
Inpatient Behavioral Treatment:
It took me a while to get my next therapist because the hospital assigned someone who was incompetent. He was not an eating disorder specialist and didn’t get it, even though he wanted to work with me. The new hospital made me fire this man to get the specialist that all the women on the unit loved and recommended. If it were not for some assertive anorexic females who were appalled that my family was paying out of pocket and I wasn’t working with a specialist, I wouldn’t have had the pleasure.
I could tell this man was curious to work with a male and that felt good. However, his strategy seemed familiar: he encouraged me to be corrupt by talking about how bad his sons were. I tried to be influenced by this gender manipulation technique. “Be a man, be bad,” he seemed to say. “And continue eating through the night.” These quotes seemed to be his mantras.
I did manage to gain weight and cheat at my diet. I was clearly addicted to starving but locking me up and forcing me to eat by changing my environment worked. Oh, I suffered. I kicked and screamed more than most. But I changed. One day I objected to eating Brussel sprouts and pulled out the blue chair and the tube that was to go up my nose and I listened. Fucking Brussel sprouts, how stupid! When I gained privileges I cheated frequently, but I was prescribed so many calories I still made gains.
Starting to hook up with all the women on the unit took a second hospitalization because I was extremely sexually repressed. I guess having a girlfriend or two wasn’t so bad, really.
While I experienced an influx of polyamorous flirtations on the unit during my second hospitalization, I also met a twenty-five-year-old newspaper reporter on the outside who didn’t mind robbing the cradle. I think she liked me because she hated her father who was an alcoholic. I was basically discharged to her care. “Loose the raincoat,” was the professional advice to me with my inability to copulate.
Right before I was discharged, I had a female social worker acknowledge my situation and warn me not to fall for any women when I was in such a vulnerable position. I was stunned. My parents and my MD didn’t care to warn me in such a manner!
According to the MD, the treatment worked! He would discharge me a year and a half later as a success. However, in the process, the MD stopped validating me and supporting me. He didn’t seem to care about what I was going through with the solution to my problems, the relation with my girlfriend.
You see, my girlfriend got extremely controlling. I was not allowed to have external friends. He just didn’t seem to acknowledge the pain her silence treatment and abuse caused. My first family had failed me, but certainly this new solution had to work. He was proud of me for gaining weight, but he knew nothing of the world I entered living in Camden, New Jersey at a commuter campus.
Through it all, real disassociated trauma went unexplored. When I finally after two years got so fed up that I had to cut ties with the older woman, I started violently binging and purging in the roach infested apartment I managed to afford on my own.
The Twelve Step Traditions:
My mother saw my fourth therapist for a while and said she was, “really good.” She was like my first therapist in that she was less credentialed and saw paying middle-class clients. My Mom paid for the sessions.
This therapist liked John Bradshaw who was a lot like me in terms of rage and shame. I saw him speak in a video clip and saw he also had been through eating problems. Still, I just thought he was fat and sloppy looking. Still, when I was told that families were like water torture dripping on your forehead, it did make sense. As such, she seemed to understand and care about my suffering.
Once a week, I took the train from the inner-city to the wealthy town of Haddenfield, New Jersey. I’d buy a weeks-worth of groceries most of which would only get vomited down the sturdy old sink pipes back amid the roaches.
Additionally, this therapist would occasionally challenge my spiritual beliefs in ways that seemed inappropriate. “Some things are worth dying for . . .” she would say with sudden rageful intensity. She once told me that she was attacked by a psychotic woman when she worked in community mental health and her primal response was violence, and that was okay.
She also clearly didn’t trust my mother and often asked me if I was sure my mother didn’t sexually abuse me. “I shouldn’t be telling you this, but I really don’t trust your mother,” she would say.
To her credit, she did see me outside my eating disorder. She encouraged me to pursue one of my interests outside the confines of the blocks on which I was immersed in work and school.
I was smart enough to make friends with the good people from the crack house, the ones who did not call me “Where’s Waldo.” I learned there are many respectful people who get caught up in that lifestyle. I also made friends with many of the local youth. I even made a friend with a fellow student who was in recovery from drugs and alcohol. Who else on the working-class campus would befriend a anorexic dude who had an attitude, who outlined everything he read, who was the only person willing of able to answer professors questions, and who tried to act like his weight and food didn’t matter?
It was the summer of my junior year and I quit my job and hiked six hundred miles of the Appalachian Trail. Even though I barely had enough weight on me, I binge ate a lot that summer and burned it hiking mountains. I was proud of myself for making the trek though it was a lot of alone time.
When I got back and started binging and purging again, I made the mistake of feeling the therapist had written me off. I guess I blamed her for the new-found fury in my binging behavior.
I found a new therapist with better credentials. I chose not to accept this therapists’ line of inquiry and views of the impact of sexual abuse. In fact, it became toxic to me. It would take twenty years and writing a memoir to recapture memories that helped me start to understand myself.
If it wasn’t for the fact she attacked my culture, she might have really helped me understand myself better. Instead, I sought refuge in the the medication craze . . .