Down to the Bones
One Woman's Story of Anorexia

By Cat Saunders

      Anorexia kept me alive. That was its biggest gift to me.
--Sarah

       Author's note (January 2002): When this interview was first published in 1995, the interview subject (my former client) courageously allowed me to use her real name and picture. "Coming out" publicly about her anorexia was an important step in her healing process at the time. It's several years later now, and the woman has graciously granted me permission to reprint her interview on my Web site, provided a pseudonym is used to protect her privacy in cyberspace.

Healing anorexia is about breaking rules: family rules and societal rules about how to look, act, speak, feel, eat, work, love, and just plain be. Years ago, I broke a major family rule--"Don't talk about the family outside the family"--when I wrote a New Times article about family issues related to my own past years of anorexia and bulimia. Now I'm breaking another family rule--not to mention professional rules--by making a client relationship public, though of course I'm doing it with the client's full knowledge and participation.

       For years, my father warned me about becoming "emotionally involved" with clients. Most of my traditional therapeutic training--though not my alternative ones--also cautioned against emotional involvement. Though I understand and respect the need for clear boundaries in therapy, I personally believe that rigid rules against emotional involvement are based on fear.

       As painful as it is sometimes to lay my own heart on the line with clients, I believe that true healing can only happen through love. As Ram Dass says, "If you let down the boundaries between you and your patient or client, that's the gift." Nonetheless, it's still scary for me to break the rules of therapeutic convention and risk the criticism of my peers. In the end, however, I think it's only fair that I do something scary by exposing my work to public scrutiny, since my client is doing something even scarier, namely, exposing her own soul.

       Before I go any further, let me tell you a few things about Sarah (not her real name). At the time of this interview, Sarah has been anorexic for thirteen years. For nine of those years, she subsisted on whatever her body could retain from daily rituals of eating and throwing up. About a year a half ago, after working with me since early 1991, Sarah was finally able to start taking in tiny amounts of food and water. This is still excruciatingly difficult for her. In addition, she has only recently begun to be able to use language that refers to the body without "leaving" psychologically.

       When you read Sarah's story, please understand that she is afraid she will die for speaking her truth. But her fear of dying for not speaking her truth is now greater. As you read her words, I invite you to join me in receiving her truth with all the tenderness and respect her remarkable story deserves.

       Cat: What does it mean to you to be anorexic?

       Sarah: Anorexia feels like a desperate means of survival. From the outside, it can look like a slow form of suicide, but it doesn't feel that way to me. It has been, and is, an attempt to feel safe in a world which does not feel safe to me.

       The two words that come up most strongly are restriction and conflict. I restrict food and water, my body, my voice, my experiences, even my breath. When I think of conflict, I think of my struggle to be seen, while being afraid to be seen--for fear of being hurt. There is also conflict about wanting to act powerfully, but being afraid to feel power in my body. Also, I want to live a life of kindness, yet part of me tries to brutally annihilate another part: my body.

       Being anorexic means being so terrified of nourishment that I need a signed contract with myself to take in even the smallest amounts of food or water. It means running miles every day, even when I'm sick or exhausted or injured. It means wearing clothes that are three sizes too big, so I don't feel my body, so I can hide. It means being obsessed with food, eating, weight, and body size.

       For me, anorexia includes eating and throwing up many times over to try to purge the pain I feel inside me. It means constantly lying to myself and others about whatever I feel the need to hide. It means being terrified of having monthly cycles, of having breasts, of experiencing womanhood.

       Cat: Numerous books already exist that document the family's role in anorexia. My bias, which I know you share, is that there is no blame. It feels more helpful to see families as complex systems of roles and responsibilities, which together create varied experiences for each member.

       I know it's scary for you to tell your perspective about your family, but if you could wave a magic wand to change a few things in your family system--either in terms of how they are with you, or how you are with them--what would you change?

       Sarah: I would change both how they are with me, and how I am with them. First, I would ask that their hearts be open to see me, hear me, and believe me when I speak my truths. I would like to be seen for who I am, not as an extension of them. I would like to have a relationship with them, in which we all give and receive unconditional love, respect, and mutual support.

       Even though this is my ideal, I feel some confusion about how much I want my family in my life. I have not experienced safety with them, except for one sister, so I don't know if my ideal is possible. Ultimately, I want to make choices about this which take care of myself. I feel bad to say this, but one part of me wants to send them far, far away.

       Cat: What are you afraid might happen if your family knows that?

       Sarah: I'm afraid they'll see me as being only hateful. I'm afraid they won't love me. I'm afraid they'll only hear the part about me wanting them to go away, and not the part about how I need to take care of myself. I'm afraid they won't believe I love them. I know I love them. I love them very much.

       Cat: In my own healing work and in my research professionally, I've noticed a profound correlation between the way anorexics were treated by others and the way anorexics treat their own bodies later.

       Sarah: I've come to see anorexia as a perpetuation of abuse: I took on the role of abuser by continuing to hurt myself. Also, I experienced growing up as having been denied my needs, and now I deny my own needs. However, I think my family would have a hard time understanding how I could say these things about my upbringing.

Cat: For the next few questions, I wonder if you would answer yes or no, without disclosing who or what, in order to give some sense of your experience with abuse. Do you consider yourself to have been emotionally neglected or abused?

       Sarah: Yes, I believe I was both emotionally neglected and abused.

       Cat: Physically neglected or abused?

       Sarah: I believe I was physically abused.

       Cat: Do you feel you were sexually abused, either overtly or covertly?

       Sarah: I would be lying if I said no. I believe I was sexually abused.

       Cat: What do you see as the roots of your anorexia?

       Sarah: The first thing that comes up is trauma, specifically abuse, resulting in a deep sense of shame. Shame is the feeling that I am a bad person--that if someone were to split me open, I would be black inside.        Another root for me is total terror about being in a female body. Another is to have grown up in a family and a culture that did not encourage individuation. I grew up feeling like I was an extension of my family. I lack a sense of self.

       Cat: You mentioned the culture. What's your sense of society's role in anorexia?

       Sarah: For one thing, I don't believe our culture values children. All the abuse that happens definitely contributes to eating disorders. I also believe that our culture fears and denies the feminine; thus, we dishonor women. I feel that our society emphasizes appearances at the expense of inner truth.

       Cat: What kind of healing work have you done in regard to anorexia?

       Sarah: At times, the content of the work has not been as important as my willingness to act on my own behalf. I'll list some of the helpful things. Individual and group therapy--both traditional and process work; Developmental Movement Therapy (neurological repatterning); dream work; homeopathy; journaling (both writing and art journaling); prayer work; shamanism. These have been helpful because they acknowledge all parts of me.

       Straight medical care--which looked at one part of me to the exclusion of other parts--has not been helpful. It also has not been helpful to work with individuals who have their own agenda about how I should heal.

       Cat: That last point is really important. Most people are so scared of death--and so scared of the anorexic dying--that they try to force the anorexic to change in order to alleviate their own fears. If you could tell someone how to support you as an anorexic, what would you say?

       Sarah: I would ask you to take ownership of your own feelings, conflicts, and issues. This would give me a healthy model for self-care, and it would help me break my unhealthy pattern of carrying other people's pain at my expense. In the same way, I would ask you to find the line between your own ability to be supportive, versus giving yourself away. I value support, but not at your expense.

       I would ask that you respect my choices and let me take responsibility for them. See me as whole, powerful, and capable of choosing well for myself. This encourages the part of me that does know how to care for myself.

       Help me remember that there is more to me than this obsession. Don't engage in discussions about weight, body size, food, eating, calories, and exercise.

       Ask me what I need and how you can help. I may not always know, but when you ask, it shows me that you respect my right to find my own way. And it validates that it's okay to have needs and ask for help.

       Listen to me. Understand that my truths are statements about me, not you. Last of all, respect and honor my requests for time and space when I ask for it.

       Cat: Earlier in our interview, you mentioned that neurological repatterning work has been helpful for you. I know you've been working with a trained professional on this neurological piece for years, but I don't think the general public knows much, if anything, about it.

       It's important for people to realize that anorexics are neurologically unable to feel and appropriately respond to hunger, pain, cold, and other inner or outer stimuli. If people understood this, it would help put an end to the "talk show mentality" of seeing anorexics as pathetic creatures who willfully starve themselves in order to be thin. Such a view is limited and cruel. The truth is much more complex.

       I appreciate that you mentioned the neurological piece, in terms of letting people know that this physiological component of anorexia can be successfully addressed with repatterning work (see http://www.developmentalmovement.org for more information).

       Aside from this and all the other therapies you mentioned with regard to your healing work, what do you think is the most important thing you need to heal anorexia?

       Sarah: I used to think it was safety. I thought that if the people and places in my life felt safe enough, I would be able to take steps toward self-care. I still believe that safety is vital, but I don't feel safe in my own body. Now I think the most important thing I need to heal is that I need to want something different for myself. I need to want that difference badly enough to face my fears, act on my own behalf, and let go of something that has been, and is, precious to me: my anorexia.

       Cat: Would you tell me what is precious for you about your anorexia?

       Sarah: It feels like it's mine. It was the first time in my life that I lived with passion. I've only experienced passion through anorexia, so I'm afraid to let it go.

Cat: For you, what is anorexia about spiritually?

       Sarah: I think that anorexia grew out of a real hunger for spirituality. I used to think that in order to develop spiritually, I needed to eliminate my physical self, even to the extent of living on thin air. I don't believe that anymore.

       Cat: What have you learned from taking the anorexic path?

Sarah: I've learned that I am a survivor. I've also learned that it is important for me to live passionately and fully. Anorexia has given me a tremendous opportunity to reclaim myself. There's something very powerful about taking my body all the way down to the bones, and then rebuilding, choosing every step of the way.

       Cat: Do you see anorexia ending in your future?

       Sarah: I don't feel that it will end in the sense that I'll put it in a box and hide it away somewhere. I do want to live my life differently. But I always want to remember, and I want to do so in a very loving, gentle way. Anorexia kept me alive. That was its biggest gift to me.

       

       This interview was originally published in The New Times (October 1995).

        The symbolic drawings included with this interview are from a series of more than 1,300 daily drawings that Cat did during the final period of her own 15-year voyage through anorexia, which ended in 1985.

       Currently, Cat is working on a "Healing Deck" of cards (for use by individuals and helping professionals) that will include 60-70 images selected from the original 1,300 drawings.

       If you are a publisher, agent, or investor interested in helping with the Healing Deck project, please contact Cat.