Interview: Elena Vanishing

Seventeen-year-old Elena is vanishing. Every day means renewed determination, so every dayElena Vanishing jacket means fewer calories. This is the story of a girl whose armor against anxiety becomes artillery against herself as she battles on both sides of a lose-lose war in a struggle with anorexia. Told entirely from Elena’s perspective over a five-year period and cowritten with her mother, award-winning author Clare B. Dunkle, Elena’s memoir is a fascinating and intimate look at a deadly disease, and a must read for anyone who knows someone suffering from an eating disorder. In an interview style format, I had the opportunity to chat with Elena about her story and published memoir.

Question 1: The way you describe it, anorexia nervosa doesn’t seem to be all about ‘being skinny’ but rather, on a deeper level, it’s more of an issue of needing to feel in control at all times, extending far beyond just the person’s relationship with food. Do you think this is a correct assessment? 

That’s a very good way of describing a lot of the motivation driving many people who suffer from eating disorders. It isn’t about being skinny, it’s about the control. There is a significant link between traumatic experiences and eating disorders, and much of the pain of trauma comes from a loss of control. This causes many victims to engage in a negative relationship with food because it is something that can be controlled when everything around them seems to be in a complete spiral.

Many anorexics I have had the honor to meet have been very open about the fact that they know severe eating disorders make a person look unattractive. Rather than equate anorexia to dieting to achieve a look or a size, I would equate it to another addiction, like alcohol or drugs. Both anorexia and those addictions allow a person to disconnect from how he or she is really feeling and separate himself or herself from the terror and grief that comes from being a trauma victim.

This is why eating disorders need to be taken seriously and caught early. People need to realize there is no perfect weight or goal in the minds of those suffering from anorexia. Rather, they restrict food to feel the numbing effect that starvation brings, and the complete focus on food distracts them from the real source of their pain. Unless help is given, the end result often is death.

Question 2: While in therapy, you formed friendships with several different young women who also suffered from eating disorders. How would you say those friendships have affected your recovery?

Anyone who is going through an unusual experience benefits from relationships with people who are able to relate. I was very lucky to have a group I call on for advice and comfort; it helped to break through the anorexic mentality, which is very isolating and frightening.

The friendships in the treatment centers were closely monitored by the staff. There were many points when I allowed myself to sabotage my recovery to stay on an equal footing with anorexic friends I had made, and eventually, I had to learn to distance myself from those who were in a negative place.

It was a beautiful thing to meet people who were like me, but at the same time it was very hard to see some of them slip back and ultimately pass away from the disorder. The most important thing was to learn how to separate friendship from care-taking, to allow each woman to walk her own path, and to seek out the ones who had reached a place of being fully dedicated to recovery.

Question 3: You experienced several grim life events that combined to escalate the severity of your anorexia. How have you learned to deal with the memories of those events in a healthy way?

I realize the best way I have learned to deal with those memories is to be open and have a group of supportive people who are there to listen and help me work through those moments.

I think the best advice I have come to accept and can also give is this: there is no time limit on how long those memories will affect you. It could be years or even decades, and they will be as painful as the day the trauma happened. Never feel that you should have moved on by now or that you are just repeating yourself again and again.

I have a specific journal where I write down how I am feeling while recalling a traumatic event, and many times I write the same entry over and over. That is ok. Trauma stays fresh, and learning how to cope in the moments as they come to the surface is what is important. My therapist has never told me to move on, but instead to learn how to live with those moments and memories. For years, I would try to push them down and deny the effect they had on my life. Allowing moments of grief and staying in the present has been incredibly helpful.

Question 4: What do you believe was the turning point on your road to recovery? What has been your proudest moment?

I think it was a culmination of many years of therapy and an open relationship with my family and friends. It took a long time for the physical effects to really improve and an even longer time to allow myself to be open and trusting in therapy.

Becoming more in tune with my body’s abilities and realizing the limitations I was placing on myself through my relationship with food was eye-opening. And it was not, and still is not, a linear path. As a very dear friend said to me, “I am always three days away from loving starvation again.” That is the mantra I live by right now. I stay hyper-vigilant about my current mental state, and I put in a lot of work to create checks and balances for myself. I keep a food diary for every meal, and I have meal plans in place to prevent myself from sabotaging my own recovery.

My proudest moment came last year, when my five-year-old niece started hugging and cuddling up to me all the time. When I asked her why, she said, “Because, Aunt Lanie, you are softer now. You feel good to hug.” I cried and hugged her as hard as I could. I want to be there as an active part of the beautiful lives around me, and that was a lovely affirmation that I was on the right path. I still hold that memory very close to me and use it to help me on days that are tougher than others.

Question 5: Throughout your memoir, your relationship with your mother was rocky and tense. How has writing this book with her affected your relationship and your healing process?

Writing the book was one of the best things we could have done for our relationship. We decided we would be completely open and honest during the writing process, and that allowed us to revisit moments that had been hurtful and painful and talk those out in a way that brought us to a healthy place. We joke that it was the best form of therapy we could have ever had, but no joking, it was wonderful. Even though the process of writing was very hard, it was worth it to come together and work through a lot of that pain in a safe way.

I learned how strong my mother was in her ability to walk with me through very painful parts of my life, and how non-judgmental she truly is when learning about mistakes I had made. It gave me a new respect for her and helped me to appreciate her part in my recovery. I am very proud of the success of both of us.

Question 6: Around the world, the number of ‘body positive’ campaigns is growing. These campaigns encourage young women to embrace their own unique beauty, regardless of their shape or size. How do you think you would have reacted to these campaigns while in therapy and how do you feel about these campaigns today?

I think I would have reacted the same way as I do right now. The campaigns make me very uneasy. There is a very strong medical link between weight and health. I would not have benefited if anyone had come to me and told me, at my lowest weight and very near death, that I was perfect the way I was.

I reached a point where I was so close to death my parents were afraid to come wake me up in the morning. They were afraid they would find I had died in my sleep. And yet, it was when I was most comfortable and happy in my own skin. So, even though it sounds very empowering, it can be a very dangerous to say everyone deserves the right to decide what his or her body should look like. If that right had been given to me, I would be dead.

I believe there should be less pressure to conform to generic beauty stereotypes. Factors such as stress, trauma, or being raised with an unhealthy relationship to food can be very detrimental to health. We should have more education campaigns that stress the need for both health and happiness. Praising beauty at any size can be a very short-sighted solution to a very serious problem.

My parents and doctors all showed a great amount of tough love to me. While they didn’t humiliate me, they certainly didn’t affirm that I was beautiful when I was an unrecovered anorexic. That tough love was hurtful at the time, but it saved my life, without a doubt. I have never been more thankful for their honesty and their concern of my wellbeing.

I think it is important to be body-positive while also understanding how fragile and sensitive one’s body is.

Question 7: In your book, you share scathing thoughts from your ‘critical voice’ Elena Dunkle. Is this voice something that many people with eating disorders struggle to control? How did you finally learn to ignore and/or stop it?

I remember my therapist telling me never to expect the critical voice to go away, but to focus on living my life in spite of it. The voice is still there, and I think it is something many people with eating disorders and other addictions struggle with for their entire lives.

Just as long-term recovering alcoholics still refer to themselves as alcoholics, I still refer to myself as an anorexic. I am always in the process of recovery, and some days are as bad as they were when I was in the worst stage of my eating disorder. I have learned many coping skills to work around the negativity. I let those thoughts and criticism speak and then sit down and logically work through those thoughts to find their source. It is very difficult, and it is still a step-by-step process. I have been able to build up a good support network that lets me turn to others when I need help.

Question 8: Today, you work as a nurse in a hospital. How does it feel to know you’ve reached your career goals? Where do you see yourself in 10 years? What else do you hope to accomplish?

The biggest thing I have learned through my process of recovery is not to focus solely on goals but to live in the present. For a very long time, I was so afraid of the past that I missed my present by focusing on the future.

I hope to see myself in ten years still being as open and vocal about my experiences with trauma and anorexia. I do hope to spread more understanding and awareness of the long-term devastation anorexia can cause. I hope to look at each day as a gift. I am very happy with the person. I hope to continue to pay back those around me who supported me during difficult years through being a stable and trustworthy person whom they can turn to in difficult life circumstances. I hope that in 10 years, I have not taken a single day for granted.

Question 9: What advice would you give to young girls who suffer from eating disorders?

Whenever I am asked this question, I close my eyes and picture myself as a little girl. Geeky, big glasses, scared, defiant, and utterly unprepared to take on anorexia. I wish I would have had someone say to me: Get help. Reach out. Nothing you have done, no matter how ashamed or how scared you are, is worth closing yourself off. Find a way to start battling your eating disorder now so you have a better chance of not damaging your body too drastically.

Eating disorders are traumatizing, isolating, and utterly terrifying. There are many of us suffering from eating disorders, and many of us who have survived trauma and pulled ourselves out of that darkness and paralyzing fear. You are not alone, even if you think you are.

In the last six years, I have met and loved and lost twenty-four beautiful friends to their eating disorders—through suicides, comas, heart attacks, ruptured esophaguses, their bodies gave up the fight. Twenty-four souls from the ages of nine years old to sixty-seven, men and women, boys and girls, with families, careers, talents, and a lot to give the world that now will never be given.

Eating disorders are incredibly dangerous. Even though in the short term, they seem to bring relief, they will bring a tsunami of pain to you and those around you. It is so vital to realize that you cannot have a little bit of an eating disorder in your life. It will take over and not stop growing until it is too big to extinguish.

Please, do whatever you need to do to get help.

Mental health and women’s health: Eyeing the ‘treatment gap’

Originally published on Devex

Mental health has attracted little attention considering the huge size of the problem. Ranging from mild depression to major psychosis, it is estimated that one in four people suffer from a mental illness, and estimates from the World Health Organization state that around 400-500 million people worldwide are affected.

Among sufferers, many go undiagnosed and untreated. In developed countries, the “treatment gap” can be as high as 50 percent, while in developing countries it can skyrocket to 90 percent. The dearth of medical attention can be traced to a lack of awareness, a fear of the stigma attached to mental illness, or barriers to treatment such as access or finances.

Within these astonishing figures, another little-discussed fact is that women are at greater risk for certain mental health issues. Partly attributed to biological factors, but also partly because of sociocultural factors — including a lower social status than men and different cultural expectations — women suffer from a higher risk of anxiety, depression and eating disorders.

In addition, women are at risk of gender-specific afflictions such as post-partum depression. Intimate partner violence, sexual assault or sexual abuse, which women experience more frequently than men, are also risk factors for developing mental illness later in life.

Image c/o Adi Sujiwo
Image c/o Adi Sujiwo

The ramifications of mental illness extend beyond the individual. Women — often having a greater role in child rearing — suffer additional stress and the responsibilities of parenting can take its toll on mothers. While some studies have found that parenthood can act as a balancing force for individuals, others show that adding mental illness on top of the stress of parenting presents unique challenges.

One case worker described the difficulty of balancing treatment with child care, saying, “I’ve seen a lot of mothers go into crisis, needing hospitalizations and debating which should come first, their mental health or child care, because they had no one in the community that could help them.” Another described the guilt mothers go through when feeling stressed by parental duties, or by witnessing behaviors in their children that they worry is hereditary mental illness, or a sign of failure in their own parenting.

Further compounding the issue is that many — on some level — assume that mental illness is a condition that can be willed away or cured by logical thinking. This fallacy shames sufferers into silence — often with fatal results.

Suicide, often the tragic final outcome of these diseases, is one of the leading causes of death globally: more than 800,000 people a year die by suicide, or one every 40 seconds. Women are two to three times more likely than men to attempt suicide, though men are four times as likely to die from it. Among suicides, a disproportionate number of the victims are found to have a mental illness, most commonly depression or a mood disorder.

With such a profound effect, mental health in both men and women deserves greater attention and resources. More urgently, it requires an eradication of the stigma that prevents most people from seeking help. A greater focus on raising awareness and channeling resources could have a profound positive effect for men as well as women, as well as the families who rely on them.

Join Girl’s Globe’s #HealthyMeans Twitter chat today, November 13th at 11:00 EST to discuss how neurological and psychiatric disorders impact women and girls. To learn more about mental illness or how to help a loved one who suffers, please visit the National Alliance on Mental Illness. Read more on how gender disparities impact mental health at the World Health Organization.

Want to learn more? Check out the Healthy Means campaign site and tweet using #HealthyMeans.

Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.

On Skinny-Shaming: Not all real women have curves!

Recently, the world witnessed a surge of criticism on fat-shaming, with many plus-sized women coming out to flaunt their bodies and starting “Love Your Body” campaigns. Size zero went from an ideal body size to something women started looking at as unnecessarily and disgustingly unattainable. Marilyn Monroe became the new ‘ideal’ of a woman. Today, more women want to be like her. More runway designers are showcasing plus-size models in their shows and designing clothes for bigger-sized women. There is a new-found conception that ‘real women have curves.’

Photo credit: Stephanie London
Photo credit: Stephanie London

Though I do believe that women with curves are beautiful and that they should prize their body shapes, I do not believe that all real women should have curves. In the midst of the movement to build self-esteem for plus-size women, we often forget that we might be demeaning women who are naturally thin or have size-zero bodies.  While the world has become more body-positive, the movement to help bolster self-worth can sometimes inadvertently happen at the expense of someone or something else. In the light of body-acceptance and fighting the body ideal, it is a myth that thin women have it easy.

For those of you unfamiliar with the term, “skinny-shaming” is the act of demeaning someone on the basis of being ‘skinny’ or ‘too thin.’ Skinny-shaming often takes the form of a negative connotation and places guilt on one’s body, for being a certain shape and size.

“Fat-shaming” is often given the privilege of a negative act, while skinny-shaming is seen by most as essentially positive, or a phrase used to ‘compliment’ those who are thin. The truth is that skinny-shaming is just as negative as fat-shaming is.

Thin women constantly face criticism on their body sizes, and are often faced with comments such as:

“How do you manage to be so thin?”

“You could use some weight.”

“Be careful, the wind might blow you away.”

“You’re so thin, you look anorexic.”

“Why do you even need to work out?”

And worst of all:

You’re too thin to breastfeed.

If you wouldn’t call a fat woman fat, why would you want to call a thin woman thin? 

Photo credit: Allison Shaaff
Photo credit: Allison Shaaff

While skinny-shaming usually centers around female bodies, it is a fact that even men face this societal evil. A masculine body is often described to be lean, muscular and broader in structure to a female body. Thin men are called out for their weight and often told that they are “too thin for a man” or “not manly enough.” It is important that we recognize that not all men have broader frames and bodies cannot be judged relatively. Our bodies, both male and female, are our own, and shouldn’t be subject to anyone’s approval.

Personally, I have faced more criticism than appreciation on my size-zero figure. As someone who was born thin, I grew up listening to my friends complain about how “anorexic” I was. No one ever took into account that I was perfectly healthy and strong. I had relatives bring me food and friends occasionally buy me food at the mall. People constantly told me I could quit visiting the gym or keeping count of my calories. My size-zero figure became a burden on my living,  forcing me to eat more than I could. I desperately sought to attain those curves that made one a “real woman.”

After facing skinny-shaming for 19 years of my life, I now realize that I should be happy with what I have. I realize that as long as I am a fit and healthy person, no one can ask me to justify my size. I realize that I should take offense at someone passing a derogatory remark on my size. I realize that I am beautiful and that I should love my body.

Body acceptance starts from within.

We must learn to love our body, shape and size.

We need not justify our body size to anyone.

Not everything that is beautiful or feminine is curvy.

I do not need curves to be called a real woman.

For more information about skinny shaming, check out these additional links:

* Featured image credit: Flickr user Charlotte Astrid. Image listed under Creative Commons license.