Reviving Ophelia - Mary Bray Pipher [92]
Of course, Prudence wasn’t always successful. But gradually she was able to reduce her binges to once a day. After four months in therapy she had a binge-free day. Some of her energy was returning and her skin and hair looked healthier. She reported that there were days she didn’t even think about weight.
Prudence was a good talker, more sensitive to her own and others’ feelings than the average teenager. Slowly she battled her addiction. She made a commitment to live an examined life. Recently she said to me, “Greg would like who I am now.”
STARVATION IN THE LAND OF PLENTY
Anorexia is a problem of Western civilization, a problem for the prosperous. It is, to quote Peter Rowen, a question of “being thirsty in the rain.” Anorexia is both the result of and a protest against the cultural rule that young women must be beautiful. In the beginning, a young woman strives to be thin and beautiful, but after a time, anorexia takes on a life of its own. By her behavior an anorexic girl tells the world: “Look, see how thin I am, even thinner than you wanted me to be. You can’t make me eat more. I am in control of my fate, even if my fate is starving.” Once entrenched, anorexia is among the most difficult disorders to treat. Of all the psychiatric illnesses, it has the highest fatality rate.
Its victims are often the brightest and best young women. In my experience, it is the good girls, the dutiful daughters and high achievers who are at the greatest risk for anorexia. Anorexia often begins in early adolescence with ordinary teenage dieting. But instead of stopping the diet, perfectionist young women continue. They become progressively obsessed with weight and increasingly rigid in their thinking about food. They see themselves in a competition to be the thinnest girl around, the fairest of the fair.
The word “anorexia” implies an absence of hunger, but in fact anorexic girls are constantly hungry. They are as obsessed with food as any starving people. They have many of the physical symptoms of starvation—their bellies are distended, their hair dull and brittle, their periods stop and they are weak and vulnerable to infections. They also have the psychological characteristics of the starving. They are depressed, irritable, pessimistic, apathetic and preoccupied with food. They dream of feasts.
Anorexic girls are great at self-denial. They are obsessed with weight, which becomes their one important and all-defining attribute. They feel confident if they are losing weight and worthless and guilty if they are not.
By the time the anorexia is full-blown, family members are terrified. They try everything to make their daughters eat—pleading, threatening, reasoning and tricking. But they fail because the one thing in life that anorexic girls can control is their eating. No one can make them gain weight. Their thinness has become a source of pride, a badge of honor.
Anorexic young women tend to be popular with the opposite sex. They epitomize our cultural definitions of feminine: thin, passive, weak and eager to please. Oftentimes young women report that they are complimented on their appearance right up until they are admitted to hospitals for emergency feeding.
I think anorexia is a metaphor. It is a young woman’s statement that she will become what the culture asks of its women, which is that they be thin and nonthreatening. Anorexia signifies that a young woman is so delicate that, like the women of China with their tiny broken feet, she needs a man to shelter and protect her from a world she cannot handle. Anorexic women signal with their bodies “I will take up only a small amount of space. I won’t get in the way.” They signal “I won’t be intimidating or threatening.” (Who is afraid of a seventy-pound adult?)
SAMANTHA (16)
Against her will Samantha was brought to my office by her German-Lutheran mother. Wilma kept her coat on and her arms folded across her ample chest as she explained that her husband wanted