Brave Girl Eating (18 page)

All last spring, as Kitty began to slide, her coaches never raised the issue of an eating disorder, not to her and not to us. When I called the head coach to tell her that Kitty was in the ICU, I asked if she'd ever known a gymnast with an eating disorder before.

“Of course,” she said. “Unfortunately, it's fairly common.”

“Did you know Kitty had a problem?”

The coach said cautiously, “I'm not surprised.”

“Why didn't you say anything to us?”

Did they think we'd dismiss their concerns, get defensive? Did they worry that we'd pull Kitty off the team? Or maybe they didn't consider it a big deal. Maybe eating disorders are so common in gymnastics, they're not even worth discussing.

I really wanted to know. But the coach said nothing. “She won't be coming back,” I said, and hung up.

“Just say you'll consider the high school team,” begs Kitty now. That night Jamie and I talk it over, going around and around. My gut tells me it would be a mistake to say yes. She's still way too thin, and emotionally fragile. We haven't seen as much of the demon in the last ten days or so, but we have seen a lot of tears and anxiety. Jamie argues that maybe gymnastics will motivate her to recover. Plus, it's hard for him to say no to something she cares about so passionately. It's hard for me, too; I don't want to be the killjoy. Maybe I'm overreacting. Maybe I'm letting my own fear get in the way of her recovery. Or maybe the emperor truly has no clothes.

Eventually we come to a compromise: the high school season doesn't start for another month. We'll let Kitty go to the gym once or twice a week to practice with her friend, as long as she keeps gaining weight. And we'll ask Ms. Susan what she thinks of the idea.

Over the next few days, Kitty's anxiety becomes palpable. At dinner one night, the demon digs in its heels over a plate of chicken Parmesan. Not-Kitty pushes the plate away so it skids into the middle of the table, chicken and buttered noodles flying everywhere. “Why are you doing this to
me
?” she shouts, her voice rising to an
eerie scream, dripping with rage and self-loathing. The demon's voice is relentless and reptilian, its vocabulary poorly developed but effective. I've heard this voice in my own head, though it's more like me talking to myself—a mean version of me, sometimes a downright cruel me, but still me. Whereas the demon in Kitty seems so
other,
so different from her.

This concept may not be as bizarre as it sounds. More than thirty years ago, psychologist Julian Jaynes suggested that consciousness is a function of neuroanatomy—specifically, of the corpus callosum, the fibrous band that connects the right and left hemispheres of the brain.
^*
His theory was that thousands of years earlier, before the two halves of the brain evolved a connection, they functioned independently. He pointed to the many biblical and literary references to earlier peoples hearing voices or seeing visions, which they interpreted as messages or visitations from God or the gods. In fact, Jaynes believed, they were communications from the other side of the brain.

Maybe there's something to Jaynes's theory. In people with schizophrenia, who often hear voices, the corpus callosum is typically smaller and narrower than in those without schizophrenia.
^†
I wonder if the demon might also be explained in terms of neuroanatomy. It certainly seems like Kitty's experiencing an altered state of consciousness when the demon is at its loudest. It would be fascinating to see what areas of her brain light up at those moments.

The next night we see a slightly different face of the demon.
Kitty goes to her first gymnastics practice and comes home upset because she's lost her skills. She's thrust into that altered state where she spins around and around—in this case, over the fact that she's lost her conditioning, she can't do gymnastics, she's no good, it was the only thing she's looked forward to, it was the only thing she was good at and now she's not. On and on she worries and obsesses. This time, maybe because I'm paying attention, I hear the moment when her distress over gymnastics flips into anxiety about eating. She goes from back handsprings to breakfast in one breath, worrying that if I make her have cereal the next morning, the milk will upset her stomach and then how can she possibly drink a milk shake tomorrow because that will also upset her stomach.

“I'm serving eggs tomorrow morning for breakfast,” I tell her, hoping to allay a bit of the anxiety.

“I'm afraid of eggs!”

“Why don't we talk about what's really upsetting you?” I say.

Out comes a gush of words. She says Jamie's mad at her because she needs him to sit in the kitchen with her at lunch, and now we all hate her, she's done nothing but cause us problems, she is stupid and fat and ugly. Oh, and why do I hate gymnastics when it means so much to her?

“I don't hate gymnastics,” I tell her. “I hate the anorexia.”

In a flash her tone turns from self-pity to rage. “Well, the anorexia is part of me,” she says furiously, “and you hate the anorexia, so you must hate me!”

“No, I don't hate you, I love you,” I say as calmly as I can, but it's like she's Helen Keller and I'm no miracle worker. She doesn't see me, she doesn't hear me, she's locked in, lost in her own terrible world, and I would give anything in my power right now to snap her out of it.

“Why do you hate gymnastics?” Kitty cries. Then she leaps from the table, grabs a pillow from the living room couch, and starts stuffing it into her mouth. I grab it and yank it out; I don't want her to make herself throw up.

“I don't hate gymnastics!” I yell. This is a lie. I do hate gymnastics, and gyms, and coaches, and leotards, and every last thing associated with the sport.

Kitty glares at me. “Gymnastics isn't to blame for my illness,” she yells. “I am! I'm stupid and fat and ugly! I'm a horrible person and everyone hates me!” She hits herself in the head, hard, with her open palm. I grab for her arm but miss. She hits herself two or three more times before I get hold of her. She's much stronger than she looks—much stronger than she should be, and despite her frailty she could get away from me if she really tried. But she's not trying.

After what feels like an hour, but is probably three or four minutes, she collapses in my lap. “You want to take away the only thing I care about,” she sobs.

“I don't,” I say, stroking her hair. “But right now the most important thing is your health. That's what I care about.”

When she is finally asleep, I sit in the living room, lights off, feeling like a failure. I said all the wrong things tonight. I made things worse, not better. I yelled at my daughter. I couldn't help her.

Now I understand what the Maudsley people mean when they say it's not helpful to cast blame. Blame makes you sit alone in the dark and feel like your skin has been flayed. Blame takes away your power and makes you into a small scolded child, when what you need is to get bigger. So big that you can reach down and swat away what plagues you. Big enough to stare down the demon no matter what form it takes.

It's self-indulgent to sit in the dark and feel sorry for myself when Kitty's the one who's got the demon inside her, who can't get away from it. Who feels, as she said tonight, like it's part of her, a notion that makes me sick to my stomach.

That's what most “experts” in this field seem to believe: once an anorexic, always an anorexic. That it's like alcoholism, something you have to manage, actively or not, for the rest of your life. The day she diagnosed Kitty, Dr. Beth told us Kitty would feel much better in a year. She said she knows people who had anorexia in their teens and twenties, got better, and left it behind. Who didn't feel it always lurking somewhere inside them. That was what I wanted to hear. But I wonder, now, if it was true.

 

I'm relieved when Kitty
decides not to go to the gym later in the week. She says she's sore from the earlier practice. Instead, she volunteers with the Latin Club after school, and when I pick her up she's smiling.
This
is what I want for her—this kind of social and emotional connection with the rest of the world.

The next week the three of us meet with Ms. Susan to talk about the gymnastics team. I love this woman: after listening to Kitty talk about why she wants to join the team, she says, “There's a lot of stress that comes from competing. I don't think it's a good choice for you right now.”

“But I love competing!” says Kitty. “It's not stressful!”

“You love it, but maybe it's not so good for you,” says Ms. Susan. She points out that any sport where you have to be in a leotard or bathing suit isn't a good one for someone in recovery from an eating disorder, because it puts a lot of emphasis on the body, which is the last thing Kitty needs.

“You want me to sit around and do nothing!” Kitty snaps. I'm glad she's venting her frustration here instead of saving it for when we get home.

Ms. Susan talks about the need to find a sense of flow in life, about the intersection between what you're good at and what's good for you. She tells Kitty this is her chance to explore other interests, to think about what makes her feel calm and centered. She tells Jamie and me that our instincts are good and that we should trust them. I think I want to marry her. Or at least get this on tape so I can play it every day.

Ms. Susan speaks about using the anorexia as an opportunity for Kitty to go deeper, to look beyond the surface. For the rest of the session she talks to Kitty, and I really do wish I'd brought a tape recorder, because what she's saying feels true and right, and I don't think Kitty can hear it now. She's still too impaired, too much under the spell of the demon and its distractions. Daniel le Grange told me about a mentor of his who used to say that if you do intensive psychotherapy with someone with anorexia, you wind up with an insightful corpse, because without enough glucose the brain can't process or think properly.

Sitting in Ms. Susan's office, I can see that Kitty is on a path, as we all are, and that as much as I wish otherwise, anorexia is part of that path. I don't believe it has to define her, now or later. But I realize I've been thinking about the eating disorder as something to get through and leave behind, and it may not be that simple. Even if Kitty gains the weight, gets well, and moves forward, this will always be part of her history and her journey.

I can't see the future and I don't know what part anorexia will play in Kitty's life. If all goes well, if we're lucky, this will be it. But I also know from my own life how long-lasting the experiences of
childhood and adolescence can be. The events of these years shape our lives in powerful ways. For better and for worse.

Anorexia will be one of those events for Kitty, even if she's never actively ill again. I think that's part of what Ms. Susan is getting at: Kitty will have to integrate the whole of this experience—all the feelings and events, the terrors and the lessons—into the rest of her life. It's a process that will take years.

After the session, when the decision about gymnastics has been made once and for all, Kitty
says
she's upset and angry. But she
seems
relieved. As if what she wanted all along was for us to simply say no.
Remember this,
I tell myself. Remember to look past what Kitty says and into what she feels. Because clearly, they're not always the same.

 

In the third week
of October, Kitty gains another two pounds. She's now within eight or nine pounds of her target weight. Around the same time we also get the first bills for her treatment.

The state we live in does not have mental health parity, and the federal parity bill is still several years in the future. Which means that our insurance company covers only $1,800 a year of mental health expenses. Back in June, when I started looking for a therapist, I paged through our plan's provider list and wondered why I didn't see any mental health listings. It took a while to realize that they were listed under “behavioral health,” a term that suggests that good mental health is merely a function of changing your behavior. It would be funny except for the deeper implication: that mental health is a matter of choice, and if you make the right choices, if you choose the “right” behaviors, presto! You'll be healthy.

This linguistic sleight of hand infuriates me, especially as I come to understand that we blew through our $1,800 “allowance” in the first month of Kitty's treatment.

Kitty's visits to Dr. Beth are covered—with the usual copay, of course—because she's a pediatrician, not a mental health provider. (Later I find out that Dr. Beth gets the same amount of money from the insurance company whether Kitty sees her once a year or every day, meaning that our weekly two-hour sessions are essentially freebies.) But everything else goes on the behavioral health balance sheet:

Apparently we've been on our own, financially speaking, since mid-August.

On the other hand, Kitty's five-day hospital admission, including two days in the ICU, was nearly all covered, all $12,000 of it. I suppose I should be grateful we don't have to pay for that, too, but I'm pissed. Because I really don't understand: Why is mental health care not covered the way physical health care is? We're creatures of body and breath, blood and bone, not disconnected minds in jars. The brain is an organ, same as the liver or the heart. Your heart takes care of getting oxygen to your cells; your brain takes care of how you move, feel, and think. When it comes down to it, what's the difference? Why does one bodily function deserve care while another doesn't?