2011-02-23

Not Exactly Binging

When I was hospitalized, for a few weeks, a couple of years ago, I participated in daily group therapy. A range of mental difficulties were represented, from the depressed, like I, to manics, so wired they could barely be contained in the room, to the severely eating disordered.

The latter group was overrepresented, and at the time their strife seemed irrelevant and their problems inapplicable. Many of them were there as part of a very structured outpatient program. They had to take all their meals, except the "1 starch snack", in the hospital. Because they saw each other so often and had so much in common they displayed an intimidating, unified front, much like the cool kids in school.

They brought stories of intense self-flagellation: binging then purging with laxatives and vomiting, endless workouts, one girl have caused so much damage to herself that she had destroyed her bladder.

Bladder-Girl made the strongest impression on me. Despite her self-abuse she was strong, independent and intelligent. She was clearly exasperated by our and her carers' stupidity and poor logic. At one time she shared that she had been binging and purging. Amid the group's exclamations she scoffed and said it was an improvement. She was met with incomprehension, but it was clear to me and I earned an acknowledging nod when I said so, that she had successfully resisted the more damaging impulse of buying several packs of Tylenol and chugging them.

In Dialectical Behavior Therapy you learn alternate, non-harmful behaviors to use instead of cutting, binging, substance abuse, or sexually risky stuff. The idea is that rather than relieving tension by cutting long gashes in your arms with a piece of glass you hold ice cubes against your skin, snap rubber bands against your wrists, take a walk, a bath, anything to deflect your attention until the moment passes.

Binging and purging was in Bladder-Girl's eyes an infinitely more constructive action than the alternative. She deserved some validation.

Because everything is a contest and I wanted to participate, but had no equally self-desteuctive stuff to share, I talked about sexual humiliation. This earned my some horrified empathy. Nothing is ever clear-cut though: as I told my story of being black-mailed, "I'll stay with you if you do what I want sexually', and anally assaulted while filmed, I was ashamed it wasn't technically rape. And another part observed myself basking in the warm glow of the group's attention.

I wasn't able to break into the tightly knit group of eating disordered, despite my attempts to provide interesting fodder for group. They, on the other hand, shared endless tales of food, their relationships with their scales, bodies, toilet bowls, pantries and gyms. It irritated me; it drove me a little nuts.

But I can relate better now. Every weekend I buy two bags of cheese curls, a pound of gummy candy and a long baguette and cheese. After I have eaten the baguette smeared with a thick layer of I Can't Believe It's Not Butter and several layers of Fontina, I start eating the gummy worms. Once I am full I start I eating mechanically and fast, as if somehow I must finish the bag. When I can't eat any more, or I make myself stop, I start in on the cheese curls. I don't stop until I feel overwhelmingly full and I spend most of the night on my side hugging my swelled up stomach.

Thirst in an issue at this point but each glass I chug adds to the sense of fullness. Many hours of discomfort follows. Thoroughly disgusted with myself I throw away the left-overs of my meal. But, although I historically have had a resistance toward taking stuff out of the trash, I have now gotten over that. The next day I can take the bag of cheese curls back out and have it for breakfast.

Most every day I go to an Indian buffet close to where I work. I eat the deep fried veggies, the naan, and the dessert, several plates full. When I leave I am inevitable uncomfortably full.

Last night I ate two thirds of a 8 inch quiche. Again, after a few slices worth, the eating became mechanical. I ate as if the goal was to empty the pie form. It wasn't even good. The texture and flavor were reminiscent of raw egg yolk.

Although purging technically seems like a way to deal with this I have found it practically difficult. The effect of laxatives is unpredictable and inducing vomiting is not straightforward. Even if I can make myself retch with some effort, it's almost impossible to affect an efficient emptying of the stomach. I throw up a few mouthfuls and that's it. I usually don't even bother trying.

So, I am gaining weight. It is particularly noticeable around my waist. Even my largest jeans have become snug. I think that's the most worrisome part, the swells and dips that make out my body shape seem the same, but the jeans and the way I almost burst out of my blouses are objective measures that those swells are getting more pronounced.

I don't know how to fix it. There is a switch that flips in my brain and I walk to the store like a robot and pick out those bags of highly refined, calorie-loaded foods, and then I walk home and eat until all I can do I lie on my bed and feel sorry for myself.

I have stopped cutting, and ramped up on the food. Like Bladder-Girl my thinking is fundamentally broken. One self-destructive behaviour is not better than another, one may not be immediately lethal but it will be long term. Last time I was at the doctor I was told my blood pressure is getting high. My weight is creeping closer to the definition of obese (BMI 30), I am hardly eating a balanced diet and no amount of vitamins are going to make up for this kind of malnourishment. It has occurred to me to start cutting again.


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