A Wasp in the Jar: a Medical Story about Bulimia

by Elizabeth Madden

I'm hunkered down in a corner of the kitchen, knees pulled up and pressed tightly against my obscenely bloated belly. The too-tight waistband of my skirt is cutting into it, the fabric taut against my skin. I feel nauseated and desperate. The remains of a white loaf lie abandoned on the table beside a half-full jar of strawberry jam. A spoon, perched on the rim, is slowly dripping red pulp on the white cloth. A large fruit cake has been torn into pieces, the yellow marzipan and thick, white icing strewn everywhere. A frantic wasp is buzzing around the food, now alighting on the crusty bread, now on the crumbs of cake. The table looks like a battlefield, the wasp scavenging amongst the fallen. Now it's hovering over the sticky, red stuff in the jar, preparing to plunge in and drown itself in cloying sweetness.

I wish that I was the wasp, plunging into oblivion.

I often feel like this, but never have the courage to act. I wish I did.

Instead,I drag myself up, go into the toilet and thrust two fingers down my throat, making myself vomit. It is vital to do this as quickly as possible after a binge, before the stuff starts the process of digestion that leads inexorably to the production of ugly, yellow fat. After vomiting, I force myself to drink a quantity of Epsom Salts, dissolved in tepid water. Epsom Salts: old fashioned they may be, but they're my laxative of choice. I could use other, gentler brands, of course, as there are plenty of such drugs available, but somehow the horrible, gritty taste of the salts and the painful wrenching and griping in my guts when they begin to take effect feels appropriate: a suitably agonising penance for my despicable lack of self-control.

The thought of doing penance jolts me back to my days at convent school, when all this started.

A plumpish eighteen year old, envious of my classmates, those effortless anorexics who managed to achieve the ideal of waif-like slenderness through the simple exercise of iron self control, I was still inexorably drawn to the homely comforts of "unacceptable" food: bread, potatoes, slabs of fruit cake and the sweets of a childhood spent at my grandparents' cosy, west country farmhouse.

I longed for the gazelle-like slimness of the other girls, whose boyish figures looked stylish in the tight jeans and even tighter tops that were so fashionable. I deplored my dumpy, bumpy shape, forever condemned to shapeless, frumpy clothes which made me feel so ugly and out of place, like a drab weed in a garden of roses. I thought that, if only I could lose weight, I would be more like them. I would be one of the gang, I'd be happy. But my sinful greed made it impossible. I tried and tried to starve myself, as they did, existing on black coffee and dry rice cakes with the occasional piece of grilled chicken as a special treat, but always ended up giving in to my loathsome weakness for food. In fact, it seemed the more I tried to deprive myself, the more excessive was my fall from grace when I finally gave in to my cravings and the more intense and unbearable were my shame and self-loathing as a consequence.

One day, when I was sitting alone (as usual!) in the common room, I heard some of the others whispering excitedly about bulimia: apparently, it was possible to consume large quantities of food, then evacuate them through vomiting, laxatives and the consumption of diuretics. It sounded like a fool-proof system for achieving the slim physique to which everyone aspired. Eavesdropping on their gossip, I felt excited, convinced I'd been given the key to finally gaining entrance to their magic circle.

Though I was successful academically, I was all too conscious of how different my background was from that of the other girls who excluded me from their circles. Most of them came from well-off families and possessed, almost as their birthright, the social ease and confidence conferred by their backgrounds. I was a scholarship girl whose father, a soldier, had died whilst serving in Bosnia and whose mother, shattered by the shock of my father's death, had become agoraphobic and chronically unhappy. I always felt painfully shy and inadequate in comparison with the other girls. My self esteem was non-existent: I had to do something.

So, I decided to try bulimia: in hindsight, the worst decision I could possibly have made!

I did get thinner. I did fit into smaller sized, more fashionable clothes. But I didn't become less shy, happier, more confident. In fact, as the years passed and I left school, went to university, got a job, I just kept getting more and more miserable. The alternate bingeing and purging persisted Sometimes, when I was under particular stress at work, I'd starve all day, using the excuse that I was too busy to leave my desk, but on the way home, ravenous, I'd buy highly calorific, stodgy food in the supermarket near my workplace, piling the trolley high with biscuits, cakes and instant puddings, telling cashiers I was shopping for a children's party when they expressed surprise over my purchases.

The constant dieting, interspersed with frequent bingeing and ever more desperate purging, meant that my weight remained fairly steady, just a little above average, and anyone viewing me objectively would say I had a curvy figure, but was certainly not obese, despite the thousands of "empty" calories I would consume when my binges were at their height. However, in my own eyes, I was gross: a target for ridicule who was rightfully shunned by those around her.

During all this time, I managed to keep my guilty secrets; for once, my lack of a close social circle had been a positive advantage. Living alone, I kept my behaviour under wraps and there were no outward signs, apart from frequent visits to the dentist necessitated by erosion of the enamel in my teeth following years of self-induced vomiting. I also found I was having to take laxatives even on days when I hadn't binged because I felt "bunged up" all the time. As a result, I was dehydrated and my skin felt dry and itchy. Physically, I had not spent long enough in the binge/purge cycle to have irreparably damaged my body, but mentally, I knew I was in a dangerous place.

Everything was finally brought to a head when a workplace romance went pear-shaped! For several months, I had been going out with a colleague: nothing serious, just drinks and the occasional meal or visit to the cinema. For once, I'd been enjoying the experience of having pleasant, congenial company and things to look foward to doing outside of work. I suppose, if I'm honest, I'd started falling in love. One evening, though, on the way to a concert hall where we'd planned to meet, I got a call on my mobile from an hysterical woman who claimed to be my boyfriend's fiancée! She ranted at me, stating in no uncertain terms what she thought of me. I did try to explain that I hadn't known, but the woman refused to listen and hung up on me.

Once again, I felt awful about myself.

I hated myself not only for being stupid enough to fall for a man who'd deceived me so blatantly; I was also deeply ashamed of causing his fiancée such pain. No wonder I was so disgustingly fat and ugly and unloveable: my outward appearance reflected my horrible, sinful character. I didn't deserve any happiness, not ever.

I'd been "doing well" in sticking to my diet during our brief romance: happy, the yawning gap inside me had had things other than food to fill it. Now, though, I felt it gnawing at me even as I trudged home from the concert hall. A small 24 hour grocery was open, so I went in and began to stock up on forbidden foods. There was a longish queue at the desk and so, tense and not really thinking straight, I crammed several jumbo sized chocolate bars into my shoulder bag and hurried out without paying.

I knew immediately that I'd committed a crime, but at that moment,I didn't care. I was desperate - not just for the temporarily soothing taste of the chocolate but also, subconsciously, I was hoping I had been seen and would be arrested. I wanted, in fact, I needed to be punished for the sin of being myself.

Looking back, I realise that the theft was a cry for help. I knew that I could no longer cope with all the problems in my life on my own.

I had been bingeing and purging continuously throughout the last seven years and I knew that, unless I took decisive action, bulimia would continue to dominate my life for as long as it lasted. I thought of my mother's miserable life, which had ended when she took a fatal overdose of sleeping pills just before my twenty-first birthday. My mother and I had never been close, and so at the time I thought of mother's suicide as a betrayal: a weak, selfish act which was pathetic in its futility.

Yet here I was, drowning in self-pity and despair, just like my mother. I remembered the face of my father, familiar from a photograph I always keep by my bedside. My brave, decisive, heroic father looked steadily back at me, and, suddenly, I knew what I had to do. I wouldn't let go of life without at least trying to make some changes. I had to fight back against the bulimia and my all other problems, too, before they had the chance to destroy me.

I sought and obtained treatment for bulimia.

The first step was speaking honestly about my problems to my GP who then referred me to specialists in the field of eating disorders and other related problems like anxiety, depression and various forms of addiction. I was soon having regular meetings with a very helpful, friendly psychologist who explained to me that my problems with food derived from my early life experiences and the inappropriate strategies I'd adopted for coping with my understandable loneliness and unhappiness.

Food, the therapist explained, was something I instinctively associated with love and contentment, because of the way my grandparents had treated me in my early childhood. Gradually, though, the very source of comfort had become the enemy and I'd battled with my body for years, instinctively both attracted to and repelled by the thing which, temporarily, filled the yawning hole in my emotional life.

With the help and counsel of my therapist, using cognitive behavioural therapy (CBT), aimed at recognising thoughts and events prompting cycles of bingeing and purging and finding more appropriate, healthy ways of dealing with them, and high doses of Fluoxetine medication to supplement the talking therapy, I am slowly beginning to achieve a more comfortable relationship with myself, my body and the food which nourishes it.

I've also received counselling which has helped me to deal with the deaths of my parents, as a result of which I'd been showing symptoms of post traumatic stress disorder, which were exacerabating the anxiety and depression which go along with addictive behaviour; in addition, my shyness, or social phobia, is being addressed through CBT and psychotherapy. It's hard work, after all these years, but as I slowly begin to feel more confident around other people, I am finding that my social life is improving, along with my self esteem.

I now have a partner. At last, I've found someone I trust enough to confide in. He's aware of my background and the problems I failed to cope with alone and in secret. The chasm in my emotional life which I'd tried in vain to fill is, thankfully, becoming narrower and some of the mental scars are beginning to heal. I've even begun to believe I've inherited some of my soldier father's courage and no longer think of myself as contemptible and unloveable. Happiness isn't achieved through cosmetic changes to the body and outward appearance, I now know.

Instead, it's something that comes from accepting and being kind to oneself and adopting the same attitude towards other people, however different they may seem to be.