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I don’t know how it started

By Alf

I don’t know how it started. I don’t know when it started. There was no event that I could point to that made me do it the first time. I don’t even remember the first time I did it. It was just a gradual realisation that I was doing it. And even then, alarm bells didn’t go off straight away. It was a long, long time before I admitted what it was and that it had to stop. The one thing I do know is that it started sometime after my mother died. We were very close. I got on really well with both my parents and the diagnosis hit me hard. But that wasn’t directly responsible for the onset of the eating disorder. More than 40 years together, my Mam still made my Dad’s eyes sparkle. When she died, he was heartbroken. He still is.

That’s what eventually precipitated my journey down that road…my Dad being broken.

He was a hero of mine. He’d always been this Herculean figure. Big and strong and could do anything. He taught me to play sport and here he was – broken. And I couldn’t help. There was nothing I could do to ease the pain. I lived away and could only make it home at weekends. I called every day. I could hear it in his voice. I felt so helpless to help my Dad and I later learned my coping mechanism manifested itself in throwing up food. I could control that.

The word ‘purge’ is used a lot for the act of throwing up. I used to think of it as just another euphemism but it’s actually the perfect word for it. When I threw up, I was purging myself of the anxiety, of the unease. Sure, it was temporary but that didn’t matter.

Or so I thought.

When I was about 3 months old, I’d had an operation on my stomach. I’m not sure of the details but one of the results was that I was able to throw up relatively easy. Not that I did all that often and I only ever used it to my advantage in school once to get out of something. But the ease with which I could throw up enabled me to excuse/rationalise/make light of what I was doing when I was doing it because I had an eating disorder.

Somewhere along the line I knew I was getting thinner and I had become aware of comments from family. A couple of incidents spring to mind. My brother mentioning that they had speculated I was bulimic. I didn’t bat an eyelid at that. I ‘knew’ I wasn’t bulimic. For a long time I ‘knew’ I wasn’t.

Another time he told me his daughter asked if I was going to die like Mam (because I was getting thinner). But the one that really hit me was when he said my Dad had broken down in tears one day because he was worried about me.

I had been doing it a lot by then and it had begun to creep more and more into my consciousness and the more it did, the harder I worked to explain it away to myself.

I made attempts to rectify matters but because I’d told myself it was everything but what it was, they were pointless. I had ruled out so many things so I went to a personal trainer nearby to try and build myself up a bit. In the assessment the first day, he said I had a high BMR. So basically I burned food quickly. That gave me something else to point the finger at and I carried on with my finger on the self-destruct button.

I actually put on a little bit of weight over time because I stopped running as much and stopped cycling to work. I had become more aware that what I was doing wasn’t right….but it was easy (no fingers down the throat or anything like that) so it couldn’t be that bad. But I knew it wasn’t right. One weekend I was down visiting my Dad and he was out cleaning up the leaves out the back. He came in after he’d been cleaning the drain outside the bathroom and found remnants of food that had been washed down the sink plughole.

I ‘admitted’ it to him. It was emotional. I said I was trying to address it, that I’d been trying to but had lapses.

I said this like I meant it. But I hadn’t actually admitted it to myself. It was almost like I was talking about someone else.

People must think “How did no one cop it?” or “How was it not obvious?”.

I had convinced myself for so long and had been adamant that I didn’t have a problem. When you truly believe what you’re saying, it’s more believable to others.

A couple of times when my brother had made comments about me losing weight, I was almost offended. I wasn’t doing anything wrong. In fact, I was trying my hardest to address it. So I told myself.

The symptoms of my Mam’s cancer only manifested when it was too late – a feature of the particular type of cancer. So I decided I should have a blood test every 12-18 months just to make sure things were in order. To cut a long story short, there was a big red flag in my blood test. I had dangerously low potassium and was sent for different blood tests and a couple of ECGs – potassium regulates the heart – and ended up hospitalised for 3 days on a drip for it. They couldn’t figure out the reason for it though – I hadn’t been entirely truthful answering their questions.

The next morning when the doctor was doing the rounds, I started to tell him about the throwing up, that it was a problem, that it had been going on for a few years. A weight started to lift. An hour later, the senior doctor spoke with me and told me I would be referred to a consultant who specialised in eating disorders.

I started to feel better.

The doctors asked me if I wanted to tell anyone, i.e. my wife. I didn’t. I thought it better to protect her from the truth to spare her the worrying. I would tell her when I’d beaten this. I certainly didn’t want to be a burden to her. Whether by accident or design, a nurse let it slip to her that evening.

That conversation was much harder. I felt so guilty. She didn’t deserve this. She didn’t deserve the lies – for all my excuses, to her it must have seemed like so many lies. I still don’t think I will ever fully appreciate just how hard it was for her.

I told her everything. I told her as much as I could understand. I told her the things I did to hide what I was doing, the things I did to facilitate throwing up. Whatever I thought would help. I just wanted to be 100% open. The more transparent I could be, the better for both of us.

I got out of hospital the next day and was back in work the day after with a believable story. Strangely, work was easier to get through even though it was the place that was easiest to throw up. It was a distraction from 9-5.

The first weekend was hard though. All that free time. All that time to think. I felt on edge. It was harder than I thought it would be. I felt like a drug addict trying to go clean.

The first session in the hospital with the eating disorder consultant was about 2 weeks later. By that stage, I had managed maybe 2 days in a row without throwing up. I went in and told him as much as I could. I was relieved to hear he didn’t think I needed to be an in-patient. In hindsight, I can only think that my openness about having a problem and my desire to beat it came through.

I met with the Cognitive behavioural Therapist (CBT) a week or so later. She was lovely and I felt comfortable talking openly to her. This was important.

I didn’t fit the classic case of bulimia nervosa primarily because I didn’t have an overriding body image issue but the eating disorder manifested itself as a coping mechanism. This is common enough, it turns out.

Initially, we went through identifying triggers and strategies for avoiding or dealing with triggers. I kept a ‘food and feelings’ diary to record what I ate, how I felt when I had eaten and rated my feeling of fullness. This helped identify triggers and we would discuss how I had felt at the following week’s session.

I discussed every session with my wife. She’d want to know how it went and I felt it was important to involve her as much as I could so that she could feel like she was playing an active role in helping me recover (and not feel helpless, looking on) and also so that she would be able to help me through those times when I struggled and needed her help to get past a tough moment.

I brought her along to one of the early sessions after the CBT asked if it might be ok. I thought it would be. But it was hard. Several things were brought up and I felt like everything I did was being questioned and that if I justified it, I was just rationalising something that wasn’t healthy. But it made me look at everything I was doing and figure out why I was doing it.

The next step was to try and get to the bottom of why the coping mechanism had manifested itself the way it had. In my first couple of years in secondary school, I had been on the heavy side. I was made fun of at times. Not to the point where I felt victimised or hate school but enough to make me feel bad at times. It made me conscious of my weight then and though I started to lose weight as time went on and didn’t feel like I was carrying any weight-related baggage with me, it stayed deep in the dark recesses of my brain.

Christmas came during the middle of my time with the CBT. It wasn’t ideal but in a way it gave me the chance to make some big steps. The first being a family dinner with my wife’s family and extended family. The thought of it scared me…trying to get through it without throwing up my food. How it would make me feel. But I did. And at one point, I felt great as I went to the bathroom and knew I wasn’t going to throw up.

There were times over the Christmas where I did get sick but the successes were what I focussed on – progress.

All along, I had been setting little targets. If I went 2 days without throwing up last week, I had to at least match that this week and try to go one better. It was slow but I was recovering from years of an ED so it was going to be.

But I was moving in the right direction and after maybe 4 months of weekly sessions, the CBT asked me how I felt about finishing up or if I felt like I needed more time. By then I felt like I had learned so much and had been given all the tools to deal with it, I said I would be ok to finish and I meant it. It took a long time for all of those conscious things I was doing to reinforce what I learned through the sessions. How to judge what was enough food for me, to eat a bit slower and know when I was full; to accept that feeling full as normal; that sometimes you might overindulge, e.g. at a special occasion but that’s normal.

It’s a year since my last session of CBT. I still remind myself to consciously do certain things – more so to make sure that I’m doing them but more and more they’re just becoming sub-conscious and I do them without thinking.

My relationship with food is moving towards normal. It will take some time and I know there will be times that will test me but I’m confident I can deal with those.

I’m in a good place now. Having admitted where I was, having gone through treatment, I feel so much more comfortable in myself. I’m happier because of it and the people around me are happier. I’m in a really good place and learned a lot about myself.