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February 15, 2011

What Really Happens Inside an Anorexia Clinic

When Meg Haston checked herself into an Arizona eating disorder clinic, groundbreaking therapy forced her to confront her worst fears.

meg haston anorexia recovery true story

Photo Credit: Gillian Laub

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"Tell me a bit about what brings you here." The psychiatrist across the table has an interested, if professionally detached, demeanor. Points for this, as I know he spends his days asking the exact same question of a population of women largely similar to me: white. Privileged. Angry.

It's an absurdly simplistic question. He knows it, and I—a therapist myself and now a patient—know it, too. There is no elevator pitch to explain why I've checked myself into this treatment center in the Arizona desert. No single explanation as to why I've opted to be stripped of every coping mechanism I have. Not to mention my books, bobby pins, and flatiron. (On the bright side, they tell me Arizona heat is a dry heat. I might not even need the flatiron.)

I answer as simply as I can: "I'm anorexic." I have accomplished something that no one can take from me: I am Thin. I am Sick. And still, I am not as accomplished as many of the other women around the lodge, these students, professionals, mothers—largely middle or upper-middle class, given the astronomical cost of treatment. (Inpatient treatment can cost upwards of $3,000 per day; we are all here for 45 days minimum.) In and around the lodge, these women spend their hours between individual and group therapy sessions, equine and art therapy, and meals and snacks. I watch them. Crossing the lawn, reading and journaling beneath the sparse palm trees that border the lodge, are women thinner than me.

Frantic, I categorize my competitors. There are the walking-dead women, with feeding tubes snaking from their nostrils and the hunched walk that says they want to disappear. They are Better Than Me. Stronger. There are women with bodies similar to mine: painfully thin but without feeding tubes or wheelchairs. Our worth is equal. And there are women who take up more space than me, who are not disciplined enough to be anorexic. They are Less Than. I recognize bulimia and half-assed anorexia when I see them: bodies that might seem "normal" to others but are actually fat. (I consider myself an excellent judge of reality, of course.)

"Tell me about your family." While the psychiatrist takes notes, I rattle off my personal history. Eldest, perfectionist child of high-achieving parents. Genetic predisposition to anxiety, depression, and addiction. Tortured romantic relationship with a man I love desperately but will never have. It's the perfect storm. Genetics has loaded the gun; environment has pulled the trigger.

"And can you talk a little bit about your symptoms?"

This is my time to shine. I tell him that I have been restricting myself to around 300 calories a day, but that I don't generally go more than a day without eating. (There are women here who could boast up to three days on water and cigarettes alone. I've never been more envious of anything in my life.) I tell him that I purge all regular meals and most restricted meals. And then, ashamed, I mention the occasional binge episode: periods of time in which I eat everything around me, induce vomiting, go out to buy more food, and repeat the cycle. I don't know how long these episodes last or how much I consume. I know only this: For a fleeting moment after I purge, I feel calm. Relaxed. I can best describe it as a brief, sweet release from my life. It's what everyone here is looking for.

"All right." The psychiatrist takes a few more notes, then releases his pen to the notepad. I lean forward, waiting for The Verdict. The confirmation that I am good enough.

"Considering your history and symptoms, I'm diagnosing you with bulimia nervosa."

No. This is a mistake. "Bulimia?" I choke. It's the bad diagnosis, the label that means I am impulsive, weak. I want my old identity back. In less than five seconds, this man has erased me.

"You don't meet the diagnostic criteria for anorexia nervosa, given that you're still menstruating," he explains. Right. I know this. I make a few quick mental calculations: It will probably take only a few more pounds for me to lose my period. I've been fighting to do that anyway, to rid myself of the one final reminder that I am a woman and that I am alive.

He tells me that it is time to choose. That every moment I am making a choice for Recovery—for health—or for my eating disorder. He tells me that there are no other choices. He is right. I can opt for health, for life. Or I can continue to find my identity in my illness, can work for the diagnosis for which I am literally dying. It's the ultimate choice: life or death.

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