Body Image and Self-Punishment

I’ve been trying to lose weight for as long as I can remember. Perhaps it’s one of those neurotic things I inherited from my mother. Even when I was thin, I thought I was fat — because I wasn’t emaciated. I’ve never been super-model thin. It’s not how my body is built. I imagine I’d have to develop anorexia or undergo chemotherapy to be that thin.

I was bulimic from 11 until 17. I spontaneously recovered (i.e., without any treatment) at 17, a typical course of development for bulimia, as I would later learn in my college clinical psychology class. I had a few purge-free years after 17. I’m not sure exactly when I started purging occasionally again, but it was sometime in my early 20s. It wasn’t bad. It was fairly infrequent, and sometimes I’d go weeks and even months without purging at all. This pattern persisted until three-and-a-half years ago when a combination of life events caused me to gain 20 pounds in a short time. The extra weight made me hate my body more than I had in a long time, and I started purging more frequently. But, even then, it was no more than once every week or two.

A little over two months ago, I saw a therapist and developed intense transference. I wrote about that experience in a series of blog posts here on Medium. I (the adult me) eventually decided that that particular therapist would not be good for me in the long run so I terminated therapy with him. But my inner child was very attached to him, and I think she decided to throw a prolonged temper tantrum. Soon after terminating therapy with Steven, I experienced a serious recurrence of my eating disorder. I started binging and purging almost every day, sometimes more than once a day.

The binging and purging feel like punishment. After mostly emptying my stomach, I would often drink more water and make myself throw up again, just to make sure that there was nothing left in there. The acid — and sometimes bile — would burn my throat, and I’d wonder if I’d end up with throat cancer because of this.

Some nights I would binge, make myself throw up, drink a bunch of water, then go out and run six miles. I laughed at myself.

In Creatures of a Day: And Other Tales of Psychotherapy, psychiatrist Irvin Yalom writes about a patient named Ellie who had terminal cancer. At one point, Ellie wrote to Irv:

My work is to love my body, all of it. Whole and entire. The whole aging mortal troublesome failing miraculous intricate breathing doomed cancerous warm mortifying unreliable hard-working imperfect beautiful appalling living struggling tender frightened frightening living dying living breathing temporary wondrous mystifying afflicted mortally-ill assemblage of the atoms of the universe that is my self, is me, for this space of time.

Ellie, whose body was riddled with cancer, strove to love her body, “so that, from that stable core, [she]can reach out with strength and generosity.”

But I, whose body is healthy and strong, hate my body and can’t find the resolve to try to love it. How sad. How sad and pathetic.

I don’t always hate my body. There are moments when I marvel at all the things it can do. I realize that I’m getting stronger and more fit in certain ways even as I age. And that’s pretty cool. There are even moments, rare moments, when I see my body as beautiful. Even though I’m not skinny and even though I don’t have the full breasts I’ve always admired on other women, every once in a while I can see that my strong thighs and firm hips are beautiful. Sometimes I run my hand over my upper arm and admire the rock-hard muscle I can feel under the layer of fat. But, most of the time, especially when I’m shopping for new clothes or trying to squeeze into old ones, I think I’m ugly and fat and wonder how I even manage to live with myself.

This is my dark secret — the one secret I’ve told almost no one else. So few people know about it that I can count them on one hand: my mother because I lived with her during my worst bulimic years, a girl from high school who was also bulimic (I don’t remember how we first disclosed to each other; we weren’t even friends), and my ex-therapist Steven. I think that’s it. That’s all the people in the world who know. It’s my best-kept secret.

I’ve refrained from telling people because I don’t want them to become suspicious whenever I spend too much time in the bathroom. Sometimes I’ll realize I’ve eaten too much while hanging out with friends, and I’ll tell them that I’ve had too much to drink and needed to puke. People are very understanding — it’s totally normal to puke from drinking too much. But I think that excuse only works if they don’t know I’m bulimic. So I keep my mouth shut and carry on with life.

** Irv Yalom’s story about Ellie, “Get Your Own Damn Fatal Illness,” is available in its entirety here. **