Home Sweet Hospital

living | My Life • close up

(published 7/14/05)

Home Sweet Hospital
Life Inside an Eating Disorder Treatment Center
by molly freedenberg

All client names have been changed to maintain anonymity.

BeforeI checked into an eating disorder treatment center in 2001, I had fantasies about what it would be like. First, I imagined it like a spa, serving fresh fruit smoothies and sandwiches with sprouts, providing massages and acupuncture, holding yoga and tai chi classes every morning. I also figured that a place like Pacific Shores, a co-ed facility for adults suffering from anorexia, bulimia, and compulsive overeating, would be full of people like me: motivated, dedicated grown-ups sick of obsessing about food. But within five minutes of entering the nondescript building on Ventura Road in Oxnard, both expectations were dashed.

The building looked more like a dentist’s office than a healing retreat, with brown carpet and stark white walls and low ceilings. I was given a daily schedule, which didn’t mention anything about pedicures or Reiki treatments, but did list multiple process groups, feelings check-ins, and educational seminars for every day.

My roommate, Nicole, was a 19-year-old anorexic/bulimic with blonde hair crowning a normal-sized head that was perched atop an unnaturally spindly frame.

“So how many treatment centers have you been to?” she asked, in greeting. I was stunned. How many? Wasn’t the whole point of this to go to one hospital, get over your eating disorder forever, and then go on with your life?

Apparently, the answer was “not necessarily.” It seemed Nicole had been in treatment centers, on and off, through all of her teenage years—and she wasn’t the exception to the rule.

Sarah, an 18-year-old bulimic/overeater from the South, had been to one center five years prior, for anorexia. Rick had been to several drug treatment centers near his home in New York City before ending up on the West Coast. Others, like Lara, had been to so many hospitals she dropped their names proudly into conversation the way some people would refer to Eton or Harvard. There were repeat visitors from England and Texas, men and women. And some, like spunky 23-year-old June and fake-fingernailed Lisa, had even been to Pacific Shores before.

This initially made no sense to me. I’d starved until I lost my period, binged until my stomach hurt, taken laxatives, tried crazy liquid diets, exercised compulsively, overdosed on diet pills, and just generally obsessed about my body for 10 years before going to the hospital. By the 10th year, I was so fed up with it, I fantasized about driving my car into the ocean—then quickly reasoned that getting help couldn’t be any worse than suicide. I hoped that the hospital could rid me of my disease forever, and naïvely believed it would happen in a few easy days. I couldn’t imagine doing this more than once—the humiliating removal of belts, shoelaces, and shampoo (a potential laxative) from our suitcases; the infantilizing way we were given monitors for everything from waking up to taking meds to going to the bathroom; the cultish 12-step speak injected into every conversation.

Ritual de lo Habitual
But after five weeks inpatient at Pacific Shores, and five weeks outpatient, I learned that the reasons for repeat hospital trips are complex. First, there is the fact that eating disorders are notoriously hard to kick. The Association of Anorexia Nervosa and Related Eating Disorders (ANRED) reports that only 60 percent of people with eating disorders with treatment recover, while 20 percent never improve. (One reason, suggest people in the eating-disorder-inclusive 12-step program Overeaters Anonymous, is that fighting an eating disorder, unlike kicking alcohol or cocaine, which you just stop ingesting, requires you to learn to moderate your “drug” of choice.) Even for those in the 60 percent, recovery might take 7 to 10 years.

Second, many clients at treatment centers don’t exactly go willingly. One bulimic soccer mom, for example, got an ultimatum from her worried husband: treatment or divorce. A concerned employer gave a similar choice to Ellie, a 50-ish anorexic from Northern California. Nicole’s parents didn’t even give her a choice. These were often the clients who hid their egg yolks (the part of the egg with the most fat) under broken shells to look like they’ve been eaten, who woke up at 4 a.m. to do sit-ups in the dark so nurses wouldn’t catch them, and who threw up in the showers we all shared (because they could be heard everywhere else). They either didn’t think they had a problem, or they didn’t want to give their problem up. Their purpose was to do their time, appease their captors, and gain as little weight as possible.

Then there’s another group of people with a subtler motivation: They want to stay inside. Some get well, leave the hospital, and then immediately relapse, leading to another hospitalization. Others hover carefully on a precipice—well enough not to get kicked out for insubordination, ill enough not to get discharged. A few (like me) do everything in their power to get better, and then panic when it’s time to move on.

It may be hard to imagine that anyone would want to stay in a hospital—where everything is regulated, confined, and contained—any longer than they have to. For example, the only time we went outside was for the morning walk (during which we had to wait at every street corner like

preschool children) or between sessions, when we were allowed onto an enclosed 10-by-10-foot patio. We ate out of plastic trays with pink covers, and spent our days listening to lectures or exploring past traumas. Television-watching was limited. There was no coffee.

However, for people whose issue is control—and the fear of being out of it—this kind of world is comforting. The structure, the lack of responsibility. The ability to ignore real world concerns like money, kids, jobs, car maintenance. The mandate to focus on yourself.

I grew to love the predictable ritual of choosing my meals for the week, of enumerating my goals for the day and announcing my feelings at the moment. I felt drunk with success when I cried reading a letter to my emotionally absent dad, and vicariously so when a 700-pound New Yorker took her first unassisted steps in two years. I wrote in my journal religiously. And I made friends.

Though some might refer to the hospital as a prison, I found it more like summer camp. Nicole and I would put on our jammies and giggle before bed. One night, we had a condiment fight at our table, launching packets of ketchup and Sweet’N Low through the air. We wore slippers and cuddled on couches; we met in each other’s rooms to apply face masks (even, sometimes, the men); we developed self-deprecating inside jokes (e.g., “You make me want to puke. Literally.”). We were a Girl Scout troop, giving each other patches for eating a whole lunch, or appropriately expressing anger.

When the doctors said it was time for me to leave, I didn’t want to go; I was scared to be on my own. Lucky for me, my desire to get better was stronger than my drive to stay safe. I soon got a job as a reporter at a daily newspaper and moved to a house on the beach with another alumnus from Pacific Shores. I went to 12-step meetings religiously, then grew out of them. I started dating again. I moved on.

But not everyone did. My roommate at the beach house relapsed a few months later and went back to Pacific Shores and struggled for another year before finally recovering. Others, like a girl from Davis so bulimic she’d been declared dead in the emergency room three times, disappeared, presumably slipping again into her illnesses.

And then there are those like Nicole, who have probably gone back and forth, in and out of hospitals for the past four years the way they did before I met them, asking each other, “So how many treatment centers have you been to?”

Now I understand. Of course, I can’t say I’d ever want to be back there again. I love my life now too much to give it up. But there are days I long for the safety and comfort of those rooms, of that daily structure, of having a team of people taking care of me. And in many ways, all I’ve done since leaving is recreate the friendship and safety I felt at Pacific Shores. Luckily, I no longer need my eating disorder to do it.

Comments

[Joanna Poppink]

Dear Molly,

Thank you and congratulations for writing the best, most accurate, honest and clear description of being in an eating disorder in-patient program.

So many people have misinformation and fantasies that have little to do with the genuine experience of first stage recovery in a residential eating disorder recovery situation.

Your descriptions may help to "dash" other people's fantasies and help them make a realistic decision to go into recovery.

You also clarify a point many people with or without eating disorders do not understand. With vivid examples and heartfelt emotion you show readers that in-patient treatment in the beginning of recovery.

Yes, realistic and solid recovery requires dedication, committment, time and arduous effort. Despite all that, the actual experience of knowing you are getting better is wonderful and sometimes even joyous.

Thank you for this post. I am putting this url on my blog and hope readers will find you.

I hope you are still in recovery and doing well.

warm regards,

Joanna Poppink, MFT, psychotherapist, eating
disorder recovery specialist, Los Angeles, CA
www.poppink.com

[Acupuncture Santa Barbara]

This seems like a pretty open article, thank you. I don't have any experience really with these kind of situations but this article gave me some good ideas on how to deal with one of my suspicions. Thanks again.

[Lindsay]

Thank you