Monday, January 27, 2014

The Hopeless

It's hard to begin a story when there is no definitive beginning. It's hard to give a brief snapshot summary of something deep and complicated. It's hard to remember events when you have tried to forget them.
That being said, I'm writing a summary of a confusing, horrible time in my life before I forget any more of it, and for reasons unknown to me, sharing it.

So where shall I start? I guess I'll start with the message of hope given to me before I knew I would need hope to cling to.
The summer of my 12th year I went to a really fun kid's camp with a friend for a week. That same week, my mom had a heart attack and was under a lot of stress when she got home from the hospital.
The night she got home from the hospital, she had an overwhelming thought that I was going to get very sick. She brushed it off.
She heard it again in her thoughts as if it were not her thoughts but planted there. She spoke out loud to her thoughts in rebuke, thinking it was in response to how low she was feeling and the impending stress coming down the pipe.
But a third time, the thought was there, "Dawnelle is going to get very sick," but she stopped and just waited quietly. "Dawnelle is going to get very sick, but it will not be unto death."
Weird.
My mom is a very spiritual person. So it wasn't very weird for her. This is a message from God, she thought.
Exhausted, she wrote it in her journal, and then settled in for the night, fell asleep, and completely forgot about it.

What she didn't know was that that week was the start of a quick decline in my spiritual, emotional, and physical health.
I was diagnosed with anorexia nervosa 1 & 1/2 months later. This message about me not dying resurfaced several years later when my parents were told anorexia had become a chronic condition in me that I most surely would die from. She was perusing her journal one day, when she stumbled across her encounter with the supernatural before I even showed signs of illness. And that was what we clung desperately to.

Now, if I had heard this story about anyone else, I would most certainly think that that person was being attacked with whatever evil, dark forces I believed in, and that that person was meant to live for some very good reason. People die all the time. For the supernatural to intercede, something big must be going on! But 2 decades after my recovery, nothing big has gone on or is going on. It is disappointing because I often still feel as though living is less a joy and more a burden, and *sometimes* I feel like I was cheated out of death...my right to be laid to rest.

I like to believe that all difficult, heart-wrenching, life-altering situations happen for a good reason.
I think this is common to want to try to make sense of pain and suffering, to try to find a silver lining, to somehow prove that you have gone to hell and clawed and fought your way back into life and are now a better person because of it, and other people benefit from your suffering. Sometimes, though, I think you can suffer with no real gift in the end, or perhaps the gift comes in such small increments that it is hardly noticeable.

I was diagnosed with anorexia when I was 12. It began innocently, a few months prior to the diagnosis, with exercise (think training to get excellence in the grade 7 phys-ed tests) and all the good endorphins that come with that. Then, it was like a switch in my brain went off. I lost a couple pounds and almost immediately felt a pull, an addiction for more. I would feel overwhelming anxiety around food, my body craved feeling empty and light.
I was at a kid's camp in July of 1987 when I realized that I didn't HAVE to eat, I could choose not to. I remember going to fill my breakfast bowl with Cheerios and thinking, "I don't have to fill it all the way. Maybe just half-way." And after eating half of what I served myself, I had another epiphany: "I don't have to finish this!"
It snowballed quickly from there. My mom had a heart attack that very same week and our summer was confusing and chaotic as we prepared to move back to the same city we had just moved from a year previous. With my dad working out of town, my mom recovering, packing, moving, and selling the house, my change of behaviour around food easily slipped in, unnoticed.
I began to eat a piece of dry toast for breakfast, another at lunch, and then pick at whatever was served at supper time, or pretend to feel sick and miss it completely.
In between packing, I would cram in three 2 hour walks / runs every day. I helped my mom pack with gusto, with this new realization that every step I took, I burned more calories. The whole onset and quick progression of this illness was and still is rather curious to me. I never really *wanted* to lose weight, I just loved the feeling of losing weight and somewhere in that month became immensely terrified of gaining weight! My mom noticed one evening when we were sitting, talking quietly in the living room about some great friendships I had made that year in grade 7, that I looked thinner. She asked me to go weigh myself. I weighed in at 60 lbs, but I lied and told her I was 65 lbs. A month and a half later, by my 13th birthday, I would be 47 lbs.

One warm summer night, my mom made me one of my favourite snacks - toast with melted cheese and tomato slices. This was the first time she was "making" me eat. I felt panic! I begged for just a plain piece of toast, but she wouldn't budge. I sat down in front of the welcoming plate with food lovingly prepared for me and I cried. I didn't think I could eat it. I blurted out, "I'm too scared to eat this!"
My mom gave me this look that was like an aha-I-knew-it kind of look and asked me why.
"I don't know!!" And that was the truth.
"Dawnelle, I think you have anorexia," she said surprisingly calmly.
I was dumbfounded. Wha? I had heard the word once, on the TV sitcom "Diff'rent Strokes". And then I felt worried. I could feel my head getting hot, my stomach churned and I was overcome with nausea. I looked at my big, scary snack and proceeded to eat it. I would eat this sickness away, I guessed. I had no understanding of anorexia, but the way that my thoughts were consumed by food, calories, exercise, input vs output, and how disgusting I felt when I ate, it made complete sense that something was "wrong".

Now, it was out there in the open that I was sick (informally). And I was quite happy to passively remain this way because when I ate I felt physically awful, unless I ate just tiny amounts. One orange for breakfast, one slice of bread (without the crust) for lunch, and small bits of food for supper. During our final week at our old home, the same week my mom took a guess as to what my problem was, she took me to the doctor and he told her to take me to the emergency room in our new town as soon as we got there. So she did, and that was when I was formally diagnosed, sometime those last few days of August 1987. I was sent home with instructions to check in with the family physician weekly and to start eating.
With a diagnosis, zero energy, and continued weight loss, I never recall denying that I was sick. It was apparent to me that I was. The anxiety I felt around food or at the idea of eating was undesirable, and had I had the ability to wish it away, I would have. Sometimes strongholds cannot be overcome by actions.

I started grade 8 and we all had high hopes that outpatient treatment would be successful and that once I got settled in school, made friends, and got a regular routine going, I would gain weight and health. I had honest hopes. But the task was pretty difficult. Impossible. The weight kept coming off. Kids at school called me "Bones". The guy who started it came to me once and apologized, then asked, in all seriousness, if I was okay. I knew I wasn't, but maybe I would be soon, so I just shrugged and said weakly, "I guess so."

But, 2 weeks into school and there was no improvement, so at my doctor's appointment, I was told to go straight to emergency, that I was going to be admitted through emergency, and my doctor would meet me there later that night.
My mom took me home to pack a few things. I recall saying good bye to my most loyal friend, my dog Sheba, telling her I was going to be gone a very long time...like a month...and when I came back I would be all better. I was excited with anticipation of this being behind me. Little did I know my battle for recovery would take me 7 years of intense treatment.

The night of my first admission I was brought 2 pieces of toast with honey that had sort of soaked into the toast. I refused it. My mom reminded me I was there to gain weight because I was dying, so I succumbed, and let me tell you...that one piece of toast I ate was the most glorious thing I had EVER eaten. I savoured every morsel of it. It took me half an hour to eat it, partly because it frightened me, and partly because it was so dang good I just couldn't rush it.

In the hospital, my weight kept slowly dropping. I was transferred to an isolation room in the Paediatric Special Care Unit soon after as a result. The nurses had made a chart for me and with every one-hundred grams I gained, I could put a star on the chart. At first I laughed. Then I was angry. I was aware of the entrenching trap I was in, and obviously they weren't. Stars and stickers and charts and pats on the back would not help. I wasn't 3. And I couldn't be bribed from the grip of my Offender. It was much more serious than that.
After a week of getting nowhere, my psychiatrist described to me the next step in treatment and I was completely horrified. They were going to put a tube UP MY NOSE to tube feed me. I had never heard of such a horrible procedure in my life! So that day I ran away from the hospital, not because I was going to be force fed, but because they were going to shove tubing UP MY NOSE!

It was the first of many AWOL's.
I started walking home, with moments of complete vision loss due to malnutrition, and tripping and falling due to muscle failure. I walked for about 2 hours and less than 10 blocks from home, my mommy picked me up. I was so glad to see her! I was exhausted and freezing.
She started heading back to the hospital and I was dumbfounded. I had just escaped from there! I had just crafted a great plan to escape the Special Care Unit where the ratio of staffing and patients were 1:2! I had worked hard to get home, and just like that I was headed back to the hospital? It was my 13th birthday in a couple days! Come on!!
I convinced my mom to take me home. She was very reluctant, but I made promises and we had a little hope that perhaps I could get better at home. Maybe the hospital had scared me just enough. For supper I heartily ate an entire hamburger. I couldn't keep that up for long, though. The next couple of days before my birthday I just slept. I tried to eat, but that hamburger was still sitting like a load of bricks in my stomach.

My mom invited 2 of my friends over for my birthday. I think my parents were disappointed that I wouldn't eat any cake. I appreciated them letting me stay home for a birthday that marked the start of the teens and was supposed to signify more freedom. For me, I was too trapped by something I understood nothing about to experience any freedom.

My 13th birthday:




The day after my birthday, when my mom said, "I think you need to go back," I readily agreed. I was no match for this Beast.

Because I was now a flight risk, I had a "sitter" watching me 24/7. It so happened that my regular "sitter" was my friend's mom and went to our church. We didn't talk much. She was instructed to sit outside my closed door. There were so many things wrong with that policy, I can't begin to point them out.
Anyways, I was tube fed. If you know anything about NG (nasogastric) tubes, they inserted a size French 12 into my nose, which is just way to big and incredibly painful for someone with teeny tiny nostrils. I was heavily sedated by just a small dose of lorazepam, but when you are 47 pounds, a little goes a long ways. I was alert enough to be aware of the shuffling going on around me and the incredible pain, but sedated to the point where I couldn't cooperate or make complete sense of what was happening, and I couldn't respond in a coherent way. I remember the frustrated nurse scolding me and accusing me of making her task difficult, but I couldn't do any different.
I was pumped all night with liquid nutrition and in the morning the tube was removed, which was unpleasant. I spent that day in so much pain. My gut was reeling, distended beyond belief. I honestly thought if I could just poke a hole with a needle to relieve some pressure....
And then that night they shoved another fucking tube up my nose!! I was so confused! I just did this last night, and they ripped it out in the morning! Couldn't they just keep it in? The answer is yes, but for reasons unknown to me, they took it out every morning. To top it off, with every insertion the hospital policy was to give an X-ray to ensure the tube had entered my stomach instead of my lungs, and until the X-Ray was performed (sometimes hours later) the stupid guide wire had to remain in place. Even my 13-year-old malnourished brain could figure out how to ensure it was in my stomach without this procedure, but I learned that policy is policy, regardless of common sense.
This went on for maybe a week or so until we struck an agreement that I would drink Ensure instead of getting it pumped through a tube.

Sometime in November I was transferred 2 floors down to Psychiatry with my sitter. I spent about 6 months there. I met some of the most sanest people there...people who were honest, open, vulnerable, and real.
I also met some people who were not "all there" and felt such sadness and empathy when their basic rights were stripped away. One huge Jewish Native American had been diagnosed with schizophrenia and had fingers and toes blackened by frostbite. One day he stood stone still in the hallway for hours. I asked him if he was okay. He said he couldn't move but he was fine with it. Eventually he was chased back to his room by some very aggressive staff and sedated despite his screaming that his religion prevented him from having IM sedatives. He wasn't eloquent in his speech, but if I could make out his plea, so could the staff. At that moment I realized exactly how trapped I was, not just by anorexia, but by a whole other entity...the medical system. They could do whatever the heck they wanted to do, and because I was 'crazy' I could easily have no say. Panic!
Another little East Indian woman would follow me around. She actually scared me a little as she was always trying to hug me and call me her daughter. If I had met her 5 years later I would have welcomed her delusion because by then I was so isolated and starved from any nurturing human contact, but at the time she sort of scared me.
The guy who wouldn't speak because he was convinced he had a microphone in his tooth fascinated me. I wanted to know more, but, he wouldn't talk. I remember a nurse saying to me, "You really are lucky. All you have to do is eat. But so-and-so...he is convinced he has a microphone in his mouth and is being spied on."
What. The. Hell. She obviously knew nothing about my torment. She obviously thought I had at least an iota of control in my mind. Not so. I had no control.

Christmas was on the psych ward. The only thing I remember is that my entire family came to visit me that day (the one and only time that ever happened), and they brought our dog, Sheba. Best Christmas gift ever!!

Anyways, on the psych ward I was put on calorie counts and the dietician made sure I had enough calories going in. This meant I picked the most calorie dense foods because the fuller I was, the more miserable I was. So I ate all the desserts, slathered 4 pats of butter and 4 pats of jam on 1 piece of toast, drank milkshakes made with whipping cream and Caloreen. My nutrition was so out of whack, but the only concern was my weight so the fact that I ate no fruits or vegetables did not phase anyone on my "team".
My time on this ward was a waste of time. I didn't gain much weight, I didn't come to any understanding, and the longer I lived with my fear and the lies repeating over and over in my head, the more hopeless I became. I paced in my room because the activity and movement calmed me down. I also hid food in my socks, my pants, and my sleeves even though someone was watching me to make sure I didn't. Invention comes about out of necessity, and I was pretty innovative. This is not specific to me though. It happens to all people with anorexia.

My psychiatrist was so frustrated that she couldn't get to the bottom of the cause of onset of anorexia, and I wouldn't talk because I knew nothing myself. She eventually resorted to calling me names (Hey, Skinny!) and trying to fill my mind with rubbish. She told me I had repressed memories and was very specific as to what they were. My heart told me that she thought if she fed these lies to my mind 5 times a week, I would finally start believing them and then say what she wanted me to say, but logically I know she was just at a loss of how to help. At the time I felt so betrayed by this woman who was supposed to be helping me but was just making everything worse

I was put on a reward system and every 200 grams I gained I was allowed a "privilege", like having a visit from my mom, or being able to have my own clothes, being allowed out of my room, etc. I manipulated this system by drinking a measured amount of water each morning before weigh-in, and just slowly increased it over time. Eventually I got to a point where I couldn't drink that amount of water without feeling incredibly nauseous. So, when I stopped, it became apparent any indication of progress was lost.
Communication with my parents had been compromised. They often were not allowed to visit and when they would phone the nursing station to see how I was doing, they usually got the "it's none of your business" brush-off from staff. Imagine that....none of their business. Hm. At one point the staff called the police claiming my dad was a threat to them, was harassing them, etc. The police showed up at my parent's house in the middle of the night with handcuffs, ready to take him into custody. But after they heard my parent's side, they left.

It was around Easter they started talking about tube feelings again, I ran away on Good Friday, but I actually didn't run away, I just ran to an empty ward and locked myself in a bathroom for the day. Again, it was my mom who found me.

My mom never stopped advocating for me in the BC health system. I had the feeling that I would have to live in the hospital forever. I had lost hope because no one I had met had offered me any. My original expectation was that a "long" treatment would be a month, and when the months passed with no trace of recovery, I had lost hope.
My mom (or someone...I don't know...) eventually found the program in BC Children's Hospital in an actual eating disorder program, with people who actually knew about anorexia and had helped many people recover. I was so excited! Finally!! I think it was in April when she drove me to Vancouver and I was immediately admitted to BC Children's Hospital. There, I had actual tests performed (blood work, ECG's, heart monitoring, bone density, etc) to determine my physical health, and the results showed damage but nothing that couldn't be reversed at my age. I don't know the ins and outs of it all, but my mom mentioned liver and heart damage and osteoporosis. 
When the time came for NG tube placement, I was thankful to learn the size was French 8, and that it was kept in instead of put in and out and in and out, and the guide wire came out right away and there was no need for an X-ray. The dietician actually cared about balanced nutrition but was also sensitive to safe vs unsafe foods. She pushed a little, but also knew when to back off. Nutrition was slowly restored as my body tolerated it, so there was not as much pain, though lots of discomfort.
I remember my new paediatrician asking me if I felt as though I would never get better, never even get out of the hospital. I nodded. When he said he could have me out in 2 months, I didn't believe him, but I had renewed hope. I broke. I cried in both disbelief and relief. I did not think I would ever talk to anyone who understood how horrible and terrifying anorexia was, but how horrible and terrifying recovery was. Now that I had a team who understood this, there was some hope.
I followed procedure and policy to a T most of the time, and sometime in June my weight was 75 pounds, which was my given "goal weight". It felt disgusting. I could hardly stand the presence of so much of me. I was told it would get easier and easier, to just give it time. I was discharged in June on the agreement that I would return in 3 weeks for a 6-week camp for people with anorexia on Gabriola Island. We all agreed as we believed it was integral to relearning how to live and gain more health and strength in a non-institution as I had been institutionalized for about 10 months.


Me at my "goal weight" at BC Children's Hospital. My social worker, who was also my art therapist, took this picture. Although I was smiling, it was just pretending. I couldn't stand all the weight. I felt like I wanted to tear it off. My body ached with what felt like tender bruises from all the weight gain:

So, I returned home for 3 weeks with both reluctance and hope. I lost 5 pounds in those 3 weeks, so it was clear I needed more treatment.
The hope was that camp would do it. It turned out that camp was just one fight after another. I ran away a lot, I refused to eat often, I lied a lot, hid my food...typical anorexic behaviour. I felt like everyone was mad at me and / or hated me. Here I was on this beautiful island, and I was missing out because I was so entrenched in this stupid disorder.

Me at Camp Elsewhere...always standing and moving. Never sitting. My mind would not permit it:

I went home the end of August with cautions and warnings. I was not feeling compliant and I could not stand this new weight. It was too much. My senses felt overloaded.

My best bud and I. I had to plug a picture of us in here. She loved me no matter my weight or health:


My physician in northern BC was actually an excellent doctor. He admitted to having no experience with anorexia, but he would do what he could. I went there three times a week to be weighed. Each time in September my weight had dropped. By the end of the month, my paediatrician in Vancouver recommended I go back to Children's Hospital because my weight loss was drastic. My mom took me down right away.

I was there for my 14th birthday, alone and lonely. I was put on a very strict behaviour modification program. Everything was taken away and I was left with a hospital gown sitting in my bed all day with nothing to do but lay there, stare at the striped curtains and blank TV I couldn't watch, and think. Oh...how those thoughts circled around and around and around in my head and nearly drive me to insanity. Everyone hates me. Why wouldn't they? I'm a brat. I'm a pain in the ass. I'm a burden. I'm ugly. I'm fat. I'm disgusting. I should never have been born. I hate myself. I'm worthless. I have no talents. I have no gifts. I have nothing to give to anyone. No one cares about me. I'm a product, not a person. I hate life. Everyone would be better off without me.
I don't remember much about that time, but by Christmas my weight was restored to 75 pounds and I went home for Christmas, but with no plans on keeping that weight.

This is where things start to get very blurry. In order to keep me out of the hospital full-time, I started going in every weekend to get pumped up with tube feeds in Prince George. So during the week I would lose weight and every Friday-Monday great effort was made to bump my weight up. That "worked" for several months from a weight stand point, but not well. I was miserable. My whole family was suffering. Imagine you weigh 500 pounds and can hardly move yourself because you are so heavy. Now imagine every weekend other people trying to inject you with 100 more pounds. This is how I felt. The whole situation left me feeling rejected, helpless, angry, hostile, suicidal. Treatment had become worse than the disease. I fought back with everything I had. Bring. It. On. I ended up back in the Prince George hospital full-time, but somehow I ended up on the General Surgical Ward. Either there was no room on the paeds ward, or they were just sick of me.

I went back to camp that summer. I was supposed to go for 4 weeks, but after 3 weeks I was kicked out and shipped back to Children's Hospital. My parents were not yet notified when they came to pick me up, but they had a feeling they should call Children's Hospital to check if I was there instead of going to the ferry or to the island or wherever they were meant to go. I didn't see my parents for many months after that.
I was treated with utmost suspicion and mistrust now. My room was directly in front of the nursing station so they could see me clearly at all times. When tube feedings resumed, I got so HOT! Incredibly hot, which was very abnormal for someone so cold. My weight stopped increasing despite a very high caloric intake, and though I was not lying when I claimed it was not my fault, no one believed me. Out of any place, I was the most compliant at BC Children's Hospital because for the most part it was a safe place. It made no matter, though, I was suspected of deceit (I don't blame them) so a surveillance camera was put into my room and wired to a monitor in the nursing station. I felt like a convict.

My paediatrician proposed I get a G-tube surgically implanted into my stomach. It was obvious to everyone I could not eat enough to stay out of danger. He also proposed I be transferred to another hospital, SunnyHill, which was more of a long-term care facility. So, we did that.
I had a G-tube inserted and was released from the pressure or need to put anything into my mouth. I was bolus fed 4 times a day.
I was at SunnyHill Hospital for my 15th birthday, alone and lonely. I was put on behaviour modification programs and if I was found outside my guidelines I was punished with loss of privileges, things like being allowed out of my room, going to the bathroom alone, having my own clothes, being allowed paper or crafts or books or personal belongings. I was really ambivalent, and quite often anorexia won out and so I was punished. This was the way anorexia was treated in adolescence. It worked for many kids and saw great success, but it did not work for me. I learned to fight with all my might, but I was on the wrong team.
One time my parents were coming down to see me (a full day's drive one way), and when they arrived they were told they weren't allowed to see me because that was my consequence for being caught doing something I wasn't allowed to do. I can't even remember what it was I did. The things I needed most at that time were some hugs from my mom and dad, some distraction from my prison (my mind), for another human present with me for a short time. I tried to catch a glimpse of them through my window as they were walking down the path to the clinic across the property, but I missed even a visual connection from a distance.

I had to be transferred back to Children's Hospital for a time because my weight was dropping at SunnyHill. I was at Children's Hospital for the autumn time change. (It's funny what you remember sometimes, eh.) I spent a lot of the time here causing trouble, fighting, and being drugged so I was easier to control.
I returned to SunnyHill about a month later.
For Christmas I was allowed home on a pass. My mom drove the 9 hour drive to pick me up, bring me home, bring me back to the hospital and return home. That Christmas was tolerable for my family. There were no fights around eating as I was bolus fed at home just like in the hospital. I went back after Christmas and stayed there until that summer. I don't remember what happened next besides in and out hospital admissions back at the hospital at home. I remember my 16th birthday was at home and our neighbours came over and we watched a movie while they ate pizza and I was bolus tube-fed.

Even with tube feeds at home, I could not maintain good health:

My mom and I were invited to appear on a local TV talk show on CKPG. I think it was called "This Morning" or something like that. I had become slightly infamous in Prince George, and it would be a good opportunity to provide awareness and more help for others in the future, as our hospital and medical community had not encountered anorexia "this bad" before. It was a horrible interview. I just sat there like an idiot looking at my fingers, nodding, shaking my head, or replying with a weak "yes" or "no". I expected no different, but I had wished my swirling thoughts would have magically been translated into words I could speak. 

Soon thereafter, I went back to SunnyHill hospital for another long stint. I can't remember much about it other than I ran away because I had gone against the rules for passing a note to another fellow anorexic who had befriended me and I had been caught. I had run away many other times and always came back. I often needed space, time, and freedom to think, to walk, to get away from my overwhelming anorexia thoughts, to put new thoughts of health in my head. So, My paediatrician made certain, uncharacteristic allowances for me with reasonable guidelines and boundaries, and I had agreed that if I "ran away" outside those guidelines, I would be kicked out of the program. So...I ran away in a panic because I knew I was going to punished anyways.

Without my tube feedings, my stomach contracted in such a way that my G-tube site would pull, hurt, and bleed. The day that I ran away, a young couple noticed me sitting outside their apartment building several times that day, with bleeding bare feet and blood on my shirt.( I was waiting for a friend of mine. I thought she lived there. It turns out she didn't.) This young couple showed concern for me and "lured" me into their apartment that evening. They weren't creepy or anything, but they offered to let me wash up and use their phone call call my friend. When I agreed to go into their apartment, I prayed that they would turn out to be sociopaths and that they would kill me. To my disappointment, they were so very kind and caring. I called my friend, and she came to pick me up, but in the meantime had called the hospital, who had called the police, who came to get me.
I returned to the hospital in the middle of the night and was immediately transferred to Vancouver General Hospital...to Psych Emerg.

Psych Emerg is the place were really crazy people go before they are sent to the Psych Evaluation Ward and evaluated as to where they should go from there.
I was locked in a rubber room. It was not rubber, but rather a big concrete cell with a mattress on a block of concrete and a toilet/sink combo. There was a little itty bitty window in the heavy auto-locking door that the psych nursed covered up when I cried. It would come down when I had stopped crying for several hours. It was provided as an incentive for me to not cry. The window was usually covered. They had no idea how to use a G-tube to do tube feedings. I ate a little here and there, mostly things I could sip on. A few days had gone by. One afternoon when one of the nurses came into my room to take my vitals, I tried to get past him and run out. When he blocked me, I slid out of my room between his legs and ran and ran and ran and ran. I had no idea how to get out of the ward, let alone the hospital, but somehow I did! When I got outside, with this nurse close on my heels, I was confronted with a very high chain link fence. I climbed over it and jumped off it and completely collapsed on the other side. If he had had the guts to climb over, he would have captured me, because I had such a hard time getting my wasted muscles to pick myself back up, but he didn't pursue me past that fence. I ended up finding a quiet alley and sitting behind a bush for a while.
A police car came to pick me up astonishingly quickly. Less than an hour. I should have hid better. The cop was trying to coax me into his car peacefully. "Let's go back to the hospital to get your shoes." (My feet were torn up and bleeding from that chain link fence. It actually took over 3 years for those wounds to properly heal, and I had scars there for another decade). I was stunned. This cop was an idiot. I guess he didn't know how to respond to a 16 year old kid who was starving herself and had just run away from psych emerg. He was treating me like I was an idiot. I tried to tell him I was locked up wrongfully, I tried to tell him I was being emotionally abused, but he kept on about my shoes and clothes (I was happy I had strategically chosen the hospital pj's over the hospital gown. Haha). Eventually an ambulance came. I had 6 strong, uniformed adult males surrounding me with the purpose of getting me back to my prison, so I surrendered.

Several days later I was allowed out of my cell. I actually made it over to the psych evaluation ward but was sent back 2 hours later when I refused to drink the Ensure they had brought me. I was back in my cell. (they actually called them cells...and I have seen the inside of the Edmonton Remand Centre, and the prisoners cells are a thousand times more humane than psych emerg's cells.) A couple days later I was told I could come out for half an hour 2 times a day if I was "good". I think what they meant was if I was quiet and didn't cry, because they didn't seem to care at all what, if anything, I ate. So...I guess I was "good" because they let me out. I met a guy in the common area who was covered in recent tattoos that were infected, and he asked me if I wanted to touch the oozing scabs (???!). He told me he loved me and that when we "got out of there" he would marry me. I asked him why he was there, but he wouldn't give me a straight answer, just that he had done some bad things. He laughed when I told him I was there because I wouldn't eat, then he told me to eat. I traded him my entire dinner for his jello. I could slowly choke down the jello and it didn't sit like a brick in my stomach.

A couple days later I met with several psychiatrists (finally) who deemed that I did not belong there and so they prepared to fly me back home. My first plane ride! I really enjoyed it.
I could tell when I got off the plane my parents were not happy to see me. Their response surprised me, but they knew what would happen. They were right.

My weight plummeted. I tried to maintain it through tube feeds and drinking Ensure and Boost, but somehow I managed to sabotage nearly everything, including boring teeny tiny holes in the supplement cans and emptying half of it out and using a syringe and needle I had stolen from the hospital to replace it with water. I also discovered if I stuck a q-tip into my G-tube, I could flip open the 1-way valve and empty my stomach. That was as close to purging as I ever got, thank God.
I faked my weight by water loading and strapping a 5 pound weight around my waist during my weekly weigh-ins at the doctors, even though I was weighed in a hospital gown.

Soon though, I ended up back in PG Hospital on the Step-Down Unit, a place for post heart attack victims to recover. I had a sitter and my entire bathroom boarded up with plywood. (Everyone assumed I threw up, which I attempted to do twice so far, with no success. That was not part of my illness, and my gosh, I am so thankful it wasn't!!) My sister's friend's dad actually put the plywood up as per his orders (he worked on the maintenance crew in the hospital), and later he told my sister that he felt so sorry for me and had the opinion that what I needed was not more loss of control, but a hug, and some love. Funny how the insight of a regular guy can surpass the professionals.

The day before admission to St. Paul's:

I was soon after accepted into the eating disorder program at St. Paul's Hospital in downtown Vancouver. At first I was put on a medical ward to get me into a safer zone. My weight was around 50 pounds. I had a nurse with me 24/7. My tube feeds were increased to 3200 calories per day, and once again I had no weight gain even though I was on bedrest, and I was incredibly hot all the time. Normally I was not allowed to know my weight, but here I told them straight up if I wasn't involved 100% in knowing what was going on, and if I had no say in my treatment, it would just be a big waste of time. So, not seeing my weight increase was both a relief and a huge panic. How many calories would it take? I worried I'd have to maintain thousands and thousands of calories every day, and the thought of more was painful. My whole digestive system was in a state of shock and if I put my hand on my stomach I could feel huge, hard, painful air bubbles moving around. And I was so damn hot! A hyper metabolic rate...everything coming in was being burned off. After about a week, my metabolism settled down, my weight crept up, and I felt like shit. As I was allowed to move around more, my tube feeds were changed to bolus feeds during the day and a continuous pump at night. I asked for my clothes and to be able to go onto the roof garden at will. My wish was granted and I was greatly surprised. I got in big trouble once for running away, but I didn't actually run away. I called my best friend who lived in the Lower Mainland and she hopped on the bus to visit me, and we planned to go walk down to the beach. I was so close to the ocean. I had to go! I was only gone 3 hours, but it was too long and so I was put back on bedrest. It was so worth it. The ocean is such a healing place to be.
At some point I was transferred to psychiatry. My tube feeds were stopped and I was drinking Ensure. I was unable to bring myself to eat food. It had been so long and I had a paralyzingly fear of food. I was even afraid of the smell of food. When I was watching TV and food commercials came on, I would look away. Not because I was afraid of temptation, not because it would make me want to eat food, but because I was actually afraid of the picture on the TV. I was sure I could absorb nutrients and calories through watching food commercials.

The team at St. Paul's was huge. Many different people were actively involved in my treatment. I had many nurses at my disposal any time of the day that I wanted to talk. We had group therapy, individual psychotherapy, cognitive therapy, and whatever else I don't remember. The ward had a resident cat, and I was on "cat duty", feeding him, changing his litter, buying his food and litter and whatever else that entailed. I found a pet to be very therapeutic. Nurturing something else made it easier to see how I could eventually, possibly nurture myself again.
The treatment team felt as though my PEG-tube has served its purpose and now it was time to move forward, ditch the crutch, and not look back. They recommended it be removed, and because it never really healed completely and always grew a thick stoma which had to burned off with silver nitrate, and it would push and pull and hurt my gut and often bleed, I was in agreement. It was always tender. I had to be careful how I moved, sneezing or coughing was dreaded, bumping it accidentally caused pain, it was a constant source of discomfort. So, it was removed. I was heavily sedated but still awake. It's removal was an awful experience, but it seemed pretty quick.
It was not long afterwards that with a natural increase of activity, my weight started to drop, and they said if I was not going to increase my intake they were going to recommend tube feeds! I was livid! There was no way another nasogastric tube would enter my nose! I refused for a couple weeks, but then I was vetoed and the choice was not mine anymore.
So, I ran away. I went down to English Bay and just sat and stared at the ocean and cried. I was approached by a man who asked if I was okay and then apologized for intruding, but that I reminded him of his niece who had Crohn's disease and was painfully thin. I told him I was okay.
I contemplated living out the rest of my days there on the beach, in front of the massive beached piece of driftwood. I realized that wasn't realistic. I contemplated getting on the skytrain and trying to make my way to my friend's home. That sounded more feasible. So I approached the man who had approached me an hour earlier to ask if he could point me towards the sky train. He gave me instructions as if I knew which streets were where and it seemed so overwhelming to me that I just broke down and cried. When he saw this, he asked where I was trying to go ("I don't even know...to my friend's...but I don't know where she lives.") and then he suggested I go with him to his apartment to call my friend. I had nothing to lose. I went with him, and I'm just lucky that God sent a gentleman with a good heart to me that day. I found my friend's phone number through 411 and called. No answer. I tried again in half an hour. No answer. Another half an hour. No answer. Dang! I fell asleep on his couch by accident. When I awoke, he was gone. Weird. I didn't move until he returned, which probably wasn't long. I felt like a trespasser, like I had accidentally stumbled into a comfortable, safe place uninvited, and now this poor man was stuck with me because I had no place to go and he couldn't just boot me out.
I tried calling my friend again. She answered! I asked if I could come stay with her...hide in her room. She gave me her address and my rescuer insisted on driving me to her place. It was a 45 minute drive one way. I was so grateful, but felt a great amount of guilt. I had basically stolen an entire day from this man.
When I got to my dear friend's house, her mom accidentally saw me. That wasn't part of the plan. About an hour later she came to gently inform me that a police officer would be there in about 5 minutes to take me back to the hospital.
All that for nothing!

My friend rode with me back to the hospital. She stayed with me for several hours, until quite late at night, and held my hand while the NG tube was being inserted. I needed her bravery and strength.

I don't know how long I kept that NG tube in for, but I pulled it out the morning of my 17th birthday. No one said anything to me about it. A couple days later I told the team I was done gaining weight. I could not safely go any higher right now. I had to get used to being 68 pounds first. They respected that.

The next 2 months I worked hard at finding the right balance of intake vs output with nutritional supplements. I worked hard on cognitive therapy. I worked hard to change my self talk, to nourish myself with kindness. My weight and attitude stabilized. I developed a sense of ownership over my recovery. I saw huge leaps and bounds that I had made, I was starting to find my voice, be honest with myself, push myself beyond my comfort zone, yet develop patience with myself. I came to a point where my progress plateaued. When I boldly told my team I was done for now, I needed to sit here for a while, let it all sink in, and practice my new skills, they agreed a rest or a break was not unreasonable. So my discharge date was set for just before Christmas. I went home a few days before Christmas, armed with Resource Plus (like Ensure only higher in fat and energy), and a plan. The only things I really didn't account for was the loss of constant support and encouragement from my friends and team that I had come to be so reliant on, and an increase in energy expenditure that would set my weight into a slow but steady descent.

Back at home, things were pretty good for a few weeks. My parents bought me a dog, a whippet. My dad thought my very own dog would provide a sense of cause, constant friendship, a distraction from my infliction, an incentive to work hard at staying home. My brother joked that I wanted a whippet because they are skinny dogs and their bones stuck out, and so I would have someone to identify with. They are a beautiful dog, very gentle, very snuggly, and very loyal. I had encountered one a year or so earlier when I was out for a walk in the pouring rain. The dog was lost, shivering, and soaking wet. So, I brought him home and he stayed with us for the night before my mom tracked down his owner.
So my parents gave me Cassie. Cassie helped me stay out of the hospital for 5 months. That was the longest stretch I had been out of the hospital since this whole ordeal began. We became attached to each other. As my weight slowly dropped, I was so incredibly tired that I spent most of the day on my bed or on the couch, so she just sat with me, patiently waiting for me to muster up some energy to pet her or possibly take her for a walk.
My dad also started taking me out on daddy-daughter dates almost every single night. I can't remember how it started, but we would go to a gas station that had an eating area (classy, I know...but I liked it). I started taking risks like drinking a can of diet soda, not healthy, but a big step for me at that time. I would confess to him all my irrational thoughts that I was trying to change. Talking about them logically helped me work through them.
Some of them were things like being afraid of diet coke because it added 5 calories to my intake, or what if it was really 1000 calories in that can? What if they lied, or there was a mistake in the processing plant? And then I'd walk myself through it, explaining to my dad (but ultimately giving myself a pep talk and introducing logic to fight my fears) why those scenarios wouldn't be so terrible, even if they were true, which they logically wouldn't be anyways. I explained how I was afraid to breathe...I bet there were calories in the air, especially where the scent of food was. I bet the cilia in my lungs could absorb calories. I was afraid to use soap and lotions. I still washed with soap, but my fear was that since skin is a semi permeable membrane, I could absorb things through it that could possibly be converted into weight. I always came back to the fact that I was emaciated anyways, so why should I care? Even if I gained weight....if I didn't like it it knew I could always lose it again. I had proved that a zillion times.

Cassie and I:


Three major things happened during the time I was getting this intensive therapy during our daddy-daughter dates. My dad had a new video camera and he wanted to test it out. He video taped me playing with Cassie and played it back on the TV to check the quality and figure out how it all worked. I sat there completely stunned as I looked at myself on the TV. I looked scary. I sat in silence while my dad fiddled with the camera and the manual, then asked him, "Dad, is that picture distorted?" I knew the answer....Cassie looked the same, our furniture looked the same, but I did not look the same. "I mean, is that actually what I look like?"
He said, "Yes...that is what you look like." He looked at the TV, then back at me. "Actually, you look a little healthier on the video for some reason."
That made me cry. Oh my gosh. I was going to drop dead any moment.

The second thing happened one night while I was lying in bed, 3 in the morning. I had a hard time staying asleep at night and staying awake in the day, so I'd often listen to the "Superman" stories that came on the radio at 2am. This particular night I could not sleep at all, and my head felt like it was physically swirling inside. I felt an odd, spooky floating sensation, and I felt partly like I was lying in bed and partly like I was in the corner of my room where the walls met the ceiling, looking down on myself. I cried for a short while. My mom came into my room and asked what was wrong. "I'm going to die!" I said.
She looked at me as if to say, "Did you JUST figure this out?" But she didn't say anything.
"Can you help me out of bed and sit with me while I eat a Sustacal pudding?" I asked.
So there we sat in the kitchen, at 3am....all of us tearful while I slowly ate my pudding cup.

The third thing? My mom found her journal entry from that night years ago. She believed it to be a message from God, a message of hope given years before and promptly forgotten until the time when it was meant to be found, the time when it was needed.



Soon thereafter I confessed I couldn't do this anymore. I needed to be back in the hospital. The problem was that St. Paul's had no room for me, Children's Hospital and SunnyHill Hospital had sort of washed their hands of me since I was kicked out of the program due to non compliance. Prince George Hospital couldn't help me because they had no experience, let alone experience with a chronic case of anorexia. UCLA and Sick Kids in Toronto had programs, but until BC a medical agreed to pay for my treatment, I had no way to go there.
I ended up going to the Prince George Hospital on the Surgical Ward. I remember I ate a lot of ice from the ice machine and I couldn't understand why I craved it so much. I thought about ice all the time. My family doctor said, "Well, if you actually allowed yourself to eat food, it would be food you were craving. But since you won't allow food into your mouth, you think you crave ice."
And that got me thinking.
I thought a lot. I finally said to my parents, "I've not always wanted to get better. I've wanted to cling to what I know and now there is nothing to me except anorexia. Take that away and I am nothing. But, I don't want it anymore. I want to get better. I am sick of this." I realized I couldn't live with anorexia anymore. I had the choice to die or to recover. I just wasn't entirely sure I was up to the challenge. And with each day that I saw my weight drop, my fear increased. I lived to see the day that my weight dropped to 19-point-something kg's, and I was unsure how to stop the continuous weight loss. Dropping from the 20 kg's into the 19 kg's was a big deal for me.

There was a writer for the Vancouver Sun who wanted to come and interview me and write a story on me. I was fine with that. She came and talked with me and that particular day I was feeling very positive and hopeful. It was a short interview and she was very kind to me.
I spent the rest of the day feeling fairly uplifted. Then at 10pm, I saw a beefy security guard come and stand at the door to the room (I was currently sharing a room with 3 sweet old ladies), and I knew he was there for me....something was about to happen. The thoughts that rushed through my head were that they were going to drug me into a coma and put me in a straitjacket and tube feed me until I weighed hundreds of pounds. Then my mom entered my room. I relaxed. Knowing she was involved signalled I would be safe.
"I'm sorry I didn't tell you sooner, but it couldn't because we didn't know if you'd try to run away."
Oh dear...it must be bad.
"You are going back to Children's Hospital," she said.
I sighed with relief, "But under whose care?"
"Dr. T's"
"I'm allowed back?" I was surprised. After breaking our contract I had written and mailed a letter of apology to him, and it had come back to me as 'Return to Sender'. I was sure he wanted nothing to do with me ever again.
"Yeah, and you're going right now," she said unapologetically.
"Now? It's....late!"
"You're going now...you have 10 minutes to be ready to go. You're going by air ambulance."
"What about you?" I pressed.
"I'm staying here. I can't go with you."

So there I had it. I got packed up quickly and the old ladies in my room who could get up came and gave me a hug, wished me good luck, and gave me an encouraging send off.
Getting on the ambulance, I was worried they were going to strap me down on the bed since I was a flight risk. I was thankful I could just sit on it. A baby was supposed to be coming with us too, but s/he did not show up. I thought sadly about what that might mean.
So it was myself, 2 pilots, and 2 attendants on the helicopter. It took forever to take off, and it took forever to get to Vancouver. It was the middle of the night, so I couldn't see anything out the window, and the ambulance attendants weren't as chatty as I had hoped.

At Children's Hospital, it was the same familiar feel of the "old days". I was wheeled in a wheelchair to my room. It was after midnight. I was expecting a cold, icy welcome from the nursing staff who had seen me admitted over and over. But they were decent and nurturing.
When my doctor arrived a few minutes later I was pretty stunned that he'd come in so late.
"Sooooo??" He said. We just sort of stared at each other for what seemed minutes. "I guess we're going to give this another go?"
Those words sucked all my hope out of me. I saw how long this battle had been, how I followed a very predictable pattern, and how things would probably never change. I shrugged.
Silence. For a long time. "What do you want to do?" He asked.
Those words took me back. I had not been asked for input like that ever. I had no answers. There really didn't feel like any hope, but I requested he ordered I needed to drink a can of Ensure before I changed my mind. If it wasn't written in the orders, I could back out of it, which I knew I would do. Once it was written in the orders, the choice was out of my hands. I had begun to recognize I could manipulate myself against anorexia. We talked a while longer. He said at this point their main goal was to make sure I remained comfortable. No one had ever seemed concerned about my level of comfort in treatment. He would be back around 6am (like 5 hours later), and said he didn't have high hopes I'd still be alive then. That's not the prognosis I was expecting. But, if that were true, I couldn't do much about it now. I wondered what it would feel like to die. I hoped it wouldn't hurt. My doctor gave me a sad hug that felt like a goodbye hug.

A couple weeks later I felt quite proud I was still alive. The newspaper article had been published and I finally got to see it.

Front page of the Vancouver Sun:

I'm not sure where I heard about the political motivation for it all (funding, etc.), but I recall feeling like a tool. I also had lots of letters come to the hospital for me. "Don't give up", "You can do this", blah, blah, blah. I knew they meant well, but they didn't even know me, let alone know I could do this.
But, my despair had lessened. I recall that they were trying to get funding for me, either to send me to Toronto or LA. But as a chronic case, no one really wants to take you on. I had heard that other doctors said I had a zero chance of recovery. I didn't belong anywhere. With my 18th birthday approaching, I was technically not even allowed to be in Children's Hospital.
I only remember bits and pieces of that last admission. I avoided all NG tube feeds. My doctor decided that doing anything outside my comfort zone was a waste of resources, so he was very patient in figuring out the next steps. I wasn't put on the usual behavior modification program. I wasn't told how things were going to be, but was part of the planning of it all. I'm not sure if that's because the usual methods always backfired, or if it's because I was older, or a combination of both...but I do know that this process helped me to see my value beyond what I did. I started to give myself permission to be okay with myself simply because of who I was, and it had nothing to do with what I did or did not do.
It is funny that I don't remember the tangible steps taken along this part of the journey, seeing as they were the life-changing steps. I remember having freedom to walk the hospital as long as I signed out with the time I'd be back and where I was going. I also remember being happy and comfortable with gaining weight into the 50 pounds. I recall eating 4 vanilla Magic Moments Pudding Cups a day. One for breakfast, one for lunch, one for snack, and one at bedtime. I kept that pattern for many months. I maintained my weight for quite a while on that. I spent my 18th birthday in the hospital, and that Christmas as well. My parents couldn't come for Christmas, but they came a few weeks earlier, and I said to them, "I may be anorexic in my body, but it am not anorexic in my mind anymore." For them, that was the turning point. But for me, the turning point had started years earlier.
I spent my entire days talking to myself. Not out loud like a crazy person...but just self-talk in my head. I wrote and wrote and wrote in journals. I wished I had kept them. But I threw them all away the following year. My entire life had become talking sense into my mind, feeding my mind with truths to replace all the lies.
I started eating food besides just pudding. I was maintaining my weight, but needed to gain, so we started discussing how that would happen. I was terrified to eat enough to gain, but I was good to eat enough to maintain. I asked for no tube feeds. The temptation to tamper with them was too much, and it would just take me back into old habits as my new thoughts were so fresh and incredibly fragile.
The solution we came up with was TPN. Although that would involve surgery and the insertion of a Vascular Access Device (VAD) into my chest. The concern was my health was too poor to attempt this and have my body heal properly without infection. We talked about it for a long time and eventually I had the surgery performed. It felt like it took a long time to heal. But after several weeks, the TPN made me feel so great! The only problem was that because I felt great getting all the nutrients I needed, I stopped eating altogether. I had no need to eat, so I simply didn't. The TPN was my maintenance intake, and I was supposed to eat and that would be my gain. But it was so nice to not have to deal with food. I asked them to increase the TPN to help me gain. I don't think they did. I can't remember though.


My sister visiting me in the hospital after gaining some weight:


I can't even remember the incident that stressed me out so severely that I was driven to cut my TPN tubing. A nurse was in my room and we were having an argument. I was doing some sort of craft, and without much thinking I picked up the scissors and cut through both TPN lines. The nurse FREAKED out, grabbed and pinched the tubing and instructed me to hold my breath. Her reaction was so startling that I knew I had done something dangerous and was going to get into big trouble. Regret.
My VAD was hep-locked and it was explained to me that with several deep breaths and pumps of my heart and the air that was in the tubing could have entered my circulatory system right by my heart and caused a heart attack. Yep, I was in big trouble. And it was the start of a long weekend. I did not want to starve myself. I wanted to make sure I was still being nourished. But now I had no crutch, it was up to me and only me. So, I started eating. Chocolate milk, carrots, corn, and blueberry muffins with butter became my staples. I can't even remember why those foods. And I can't remember much else about the end of my admission.
There was talk of sending me to a group home once I got up to 60 or 65 pounds, but that did not come to fruition. I was discharged in April 1993. I stayed with my mom at the Easter Seals house for weeks. Then we found a room for me to rent near my friend, and I started taking a course at a Highschool. It was so tiring, but I was proud of myself and enjoying my new freedom of relative normalcy. (I started attending a church and the first time I went there I met the guy who is now my husband.)
I had weekly outpatient appointments and my weight started to drop again. My doctor said we were looking at re-admission to the hospital, and I was surprised because for me, that was it. I wasn't going to keep going with this fight, I was either going to overcome this time, or just give up and die.
I dove right in, faced all fears, ate horribly fear-inducing foods, and I ate. I ate and I ate and I ate and I ate.
The problem I faced but didn't realize was that I didn't have a meal plan to keep me on track. It was basically recovery done in the worst way possible. I ate huge amounts of food. Once I started eating, I couldn't stop. Not because I was insatiable, but because as soon as I stopped eating I would become aware of how horribly I felt, so I just kept on eating until I was so stuffed that I couldn't stand up straight. Then I would go to bed. My relationship with food was far from healthy. I was either binging or sleeping. But with each bite I took I felt like I was saying, "Fuck you, anorexia!" And after being squeezed in that pit for 7 years, I was ready to do anything to pack that hole up tight so I'd never fall in again.
That summer my weight crept up to 100 pounds. 100 pounds!! I grew in height. I did not feel healthy in my body, but I was so done with anorexia.

The newspaper reporter who had interviewed me the previous year interviewed me again, a year later almost to the day. A success story for the people. We all love success stories.

Front page again:

The National Examiner republished the article on me sans permission. It was weird to walk into 7-eleven and see this on the racks, especially the first time. Charles Manson, Burt and Loni Anderson, and....me:


But my battle wasn't quite over yet. It took a long time for me to not be obsessed with food and to not always be eating. I had to relearn how to listen to my body cues that I had ignored for so many years. I remember telling a friend that I couldn't tell if I was thirsty or if I was cold, but I knew that something wasn't comfortable. Eventually I got it, but I did it the hard way without a sensible meal plan to follow, and consuming too many "unsafe" foods (junk food) just to practice kicking anorexia's butt over and over and over again. But years later I am very intune to what my body needs and my relationship with food is very healthy. And I eat. A lot. My weight is so stable. If I have periods of stress I do lose my appetite, and when I notice I have lost weight I become terrified. I am terrified of losing weight at the same time as desiring to be thinner. I am also terrified of being hungry, but I also love the feeling and energy I get from it.
I am lucky to have 2 healthy boys now. They are the most important thing. They keep me focused on the lasting, good things in life. I still struggle with overwhelming depression. I have not found any effective way of treating it except through exercise, so I work my body to help my mind. And....I eat. A lot.

I have not shared much of my story with people. I find that when I have said, "I had anorexia as a teenager," people give me the up-and-down-body-scan and either shove food into my face or judge me, or they say really stupid things and act different around me.
But at some point, I feel there has to be sharing. People need to know that even the hopeless cases still have hope. 

I spent so many years in torment of my own mind. I was told I was borderline psychotic (aren't we all though?), I did strange things...pulled out all my eyebrows and eyelashes and 3/4 of the hair on my head (comorbidity with trichotillomania - another story -haha- and something I still have to overcome.), and chronic depression with a high degree of suicidal thoughts (yet I surrendered bottles of Tylenol and stashed medication more than once).
It was severe. And I was a hopeless case.
Yet, somehow, I came through it. The summer before my 19th birthday I was double the weight I was the previous year. I was called a miracle. My body healed over the next several years.
The therapy I received to try to uncover the triggers of my self-destruction was never something I willingly participated in. Because of this, there was some pretty horrible speculation that went on among my treatment team. I denied them all, because they were false. My family suffered greatly as fingers were pointed and the professionals had themselves convinced I was harbouring repressed memories or suffering to keep family secrets safe. But there were no secrets! 
But I was never willing to explore anything outside of my crazy cognitive behaviour. I worked on restoring healthy cognition in regards to my body and food, but never anything outside of that. I would just shut down.
If I could go back, though, I wish I had participated in the scribble drawings, the ink blots, the family therapy sessions, the seemingly idle chatter with this psychiatrist and that psychologist. At some point we have to work through our demons to master them and be rid of them.

My teenage experience has definitely shaped the way I parent. No star charts or privileges given for good behaviour. No behaviour modification of any sort. I despise reward systems. If my kids act poorly, I don't point out how they failed, I hug them and love on them which appears as though I am rewarding bad behaviour. I intrinsically know I am not but am unable to point out what exactly I aim to achieve by my permissiveness. I just know that to be healthy, one needs to know they are loved no matter how bad they act, and that "bad behavior" is a term we give when we don't understand what is behind the behaviour. Usually, it is simply feelings that are too strong to comfortably handle, and they dissipate when other people are not threatened or scared or overwhelmed by them. I always felt during my dark times that no one cared about me, only about my response and how I behaved. My actions were paramount; my self, not so much, which went a long way in shaping my self-esteem into something even more unhealthy.

While I no longer have food issues out of the ordinary, I do carry with me some things that I don't understand and am not fully aware of. I just recently realized I react alarmingly strong to any sort of perceived criticism. I also carry an "I don't care what anyone thinks about me so I'll be bitchy if I want to" attitude that I'm convinced has come about as a protective mechanism to the years of people trying to change me without trying to understand me or empathize with me. And I respond to rejection with a vengeance. Cause or effect? I'm not sure.

About 12 years ago I participated in a study that was exploring genetics and eating disorders. I recently read that there has been a link found in chromosome 1 and anorexia. There have also been studies showing a link between neurotransmitters and anorexia, suggestions that too much serotonin causes high levels of anxiety, and when a person starts to eat less and drop weight, serotonin levels drop and reduce anxiety. The problem with these studies that show a probable link to neurotransmitter dysfunction and anorexia is that it is unknown if it is a cause, or an effect. Regardless, there are definite physical and neurological differences in people with eating disorders than in people without, and there are definitely genetic factors that predispose one to an eating disorder. There are also behavior characteristics that are similar among people with anorexia, such as perfectionism, low self esteem, and a host of others that I'm sure everyone has heard of. It is interesting that there is no known history of anorexia in my family, but I am convinced my encounter with self starvation had more to do with hormones, physiological changes in my brain, and the way I metabolize food more than my psyche. And I am convinced that the complex nature of addiction and self-destruction can best be combatted through unconditional love....as in no conditions. As in "You do what you want, and it will love you and make sure you feel that love until you come around, and my timeline has nothing to do with it because you are not a project, but a person I love and will always love no matter what." Tough love is as helpful as no love.