The trauma of having an eating disorder
It wasn’t long after I returned home to Michigan that the nightmares started. They weren’t overtly frightening or threatening- no boogeymen, no one chasing me. Instead, I found myself back at the treatment facility where I had spent the previous seven months. I was returning a failure. I had relapsed somehow, although I couldn’t tell you how or why. I was just back there, with people telling me what to eat and when, flushing my toilet, having me hop on a scale, and telling me, a 26-year-old, when to go to bed. All within the same dream, night after night, I found myself inexplicably being discharged and readmitted, a breathless, whirring motion of walking around the facility’s wrap-around porch.
They talk about the revolving door of eating disorder treatment, but they probably never thought it could happen half a dozen times in a few short hours of REM sleep.
My time at the program did not end well- I had discovered that about half of the 10-12 women in the program had been reading my journals out loud to each other every night while I was asleep. After denting a wall with my fist, I walked out and didn’t really look back. Except in my dreams. Then, I looked back. My mind had become stuck in that scenario, in that place and time.
It wasn’t a Trauma-with-a-big-T. After a while (and a few other unlucky walls), I got over it, inasmuch as someone ever gets over that much of an invasion of privacy. I wasn’t housebound or losing vast quantities of sleep. I didn’t have flashbacks, though those would come later, with another event. I was angry and bitter, sure, but I never thought of myself as traumatized.
Except I was. No, it didn’t give me PTSD, but that didn’t mean I hadn’t experienced trauma.
Talk about the intersection of trauma and eating disorders, and the entire body of literature focuses on PTSD and the traumatic events that can help trigger an eating disorder. All of which is very real and very much worth studying, but it doesn’t address a separate but related question: how much are eating disorders themselves a traumatic event?
You have to eat when you’d rather not and/or not eat when you’d really like to. You have people poking and prodding and weighing you. There are the hospital admissions, the inane comments from friends, family, and total strangers (“You have anorexia? I’d like a little of that, tee-hee.”). The loss of school and jobs. The list goes on. For some people, these become Trauma-with-a-big-T, creating full-blown PTSD. For others of us, it’s a trauma-with-a-little-t. They scar, they haunt, even if they don’t completely incapacitate.
Even parents can join the fun. Many parents I’ve spoken with have PTSD symptoms from the yelling and screaming, the food refusal, the torment of watching your child turn into a haunted spectre of his or her former self. So many have written to say, “My house has become a war zone.”
Earlier this week, a psychiatrist published an essay in the New York Times about The Trauma of Being Alive. “While we are accustomed to thinking of trauma as the inevitable result of a major cataclysm,” writes Mark Epstein, “daily life is filled with endless little traumas. Things break. People hurt our feelings. Ticks carry Lyme disease. Pets die. Friends get sick and even die.”
Trauma is not just the result of major disasters. It does not happen to only some people. An undercurrent of trauma runs through ordinary life, shot through as it is with the poignancy of impermanence. I like to say that if we are not suffering from post-traumatic stress disorder, we are suffering from pre-traumatic stress disorder. There is no way to be alive without being conscious of the potential for disaster. One way or another, death (and its cousins: old age, illness, accidents, separation and loss) hangs over all of us. Nobody is immune. Our world is unstable and unpredictable, and operates, to a great degree and despite incredible scientific advancement, outside our ability to control it.
Understanding that an ED, in and of itself, can be deeply traumatic didn’t occur to me until years later, long after I stopped trying to kick unoffensive walls into a pulp. It didn’t feel big enough or significant enough to be called, ipso facto, a trauma. I felt like a baby, making a big deal out of nothing. My experiences weren’t nearly as scarring or awful as others I’ve talked to, but that doesn’t mean they didn’t leave scars.
Having an eating disorder and getting treatment for it is deeply traumatizing, and there’s not much of a way around it. It’s not like the traumas we’re conditioned to think of as traumas (rape, torture, abuse), so we don’t acknowledge it as such. But the facts remain that many people, even those for whom the ED is part of a distant past, have these traumatic memories. They’re real, and they deserve help.