Reviving Ophelia - Mary Bray Pipher [93]
Wilma said that Samantha used to be a cheerful and peppy girl. Now she rarely smiled, and she was irritable and lethargic. Once she’d been a strong worker on the farm, now she could do only the lightest of chores. When she was home, she hardly spoke to the family and spent all her time exercising or studying in her room. Samantha was a straight A student, a cheerleader, and she was popular with her classmates, but Wilma said, “She doesn’t enjoy those things like she used to. She does everything like it’s one more job to complete.”
As her mother talked about her health problems and behavior changes, Samantha listened without emotion. She was 5 feet 6 inches tall and weighed ninety-nine pounds. Her head clearly showed the outline of her skull, and her eyes were watery and sunken. Her light brown hair, though attractively arranged, was dull and brittle. She dressed in a blouse and heavy sweater to disguise her thinness. She had the furry arms that often come with anorexia. It’s called lanugo—the soft, woolly body hair that grows to compensate for the loss of fat cells so the body can hold in heat.
I asked Samantha what she thought of her mother’s description of her. She said, “She’s exaggerating. I eat plenty. Just last night I had pizza and ice cream.”
Wilma looked doubtful and said, “Only a spoonful of ice cream and less than one piece of pizza. You took off all the cheese first.”
“I don’t like cheese,” Samantha said. “You know that.”
Wilma said, “She plays tricks on us with food. She pretends to eat but really just rearranges things on her plate. She says she ate at school, but we’ll find out from her friends that she didn’t.”
“Has your personality changed in the last year?” I asked.
“I am different now, I admit it. I don’t have as much fun, and I get stressed out. I have trouble sleeping.”
“When did you begin to lose weight?”
Samantha said, “I went on a diet.” She pointed at her mom. “You encouraged me.”
Wilma shook her head sorrowfully. “Yes, and I tried to lose weight with her. Only I stopped after a week of misery and Samantha never stopped.”
We spent the rest of the first session talking about treatment. I told Wilma to throw the scales away. Once a month Samantha could be weighed at her doctor’s office. Samantha was to keep track of her eating and exercising so that we could talk about patterns. I stressed that Samantha couldn’t get well unless she decided that anorexia was her enemy and made a conscious decision to fight back. Otherwise, she’d perceive me and her family as her enemies, trying to make her do something she didn’t want to do. She’d fight us and she could win.
Wilma agreed with me. “It is so painful to watch Samantha eat a dinner of lettuce and a few grapes when I know she’s starving. But we’ve learned that we can’t make her eat. We tried and it was awful. Samantha lost weight even quicker.”
Samantha said she was scared to lose the scales. “I can’t get fat. If I can’t weigh myself I’ll be too nervous to sleep.”
I gave her a list of books to read and scheduled an appointment for over the lunch hour. I wanted to see Samantha alone with a sack lunch.
Samantha arrived wearing a blue sweatshirt with white kittens on the front and blue jeans that looked ironed. I pulled out my cheese sandwich and apple and suggested we eat as we talked. Samantha showed me her lunch—two crackers, celery and carrot sticks and a small bunch of grapes. She explained that she had had a big breakfast and wasn’t hungry.
I asked what triggered her anorexia. “I broke up with Brad,” Samantha said. “We dated all through junior high. I thought I could trust him and that we’d be together forever.”
I put down my sandwich. “Why do you think he dated someone else?”
“He teased me about my thunder thighs. He wanted someone thinner.