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Wednesday, May 12, 2010

Inside a Residential Eating Disorder Facility


The first thing you notice about The Anna Westin House in rural Minnesota, named for one of the saddest stories in eating disorder lore, is that you don't notice it at all. Two light brick townhouses joined at the kitchen, it blends seamlessly in with the surrounding upper middle class neighborhood. From the green and white porch chairs to the single car in the driveway, nothing sets it apart. There is nothing to tell you that this is where girls who are actively courting death come to live. For many it is their last grab at life.

Passing the unobtrusive shrubbery, I step through the door to find myself standing in an open great room. This is how it must be for the girls who live here, I think. No transition. One moment you are in your own life and then you walk through a door and everything's changed. This is a house of rules, you see.

Rule number one: You cannot come and go as you please. Nor can your friends and family. A soft-spoken older woman, the house matron, smiles and asks me to sign in. I do so, the only person on the fresh sheet. My friend Emily, whom I have come to see, stands awkwardly in front of me, hugging a thick sweatshirt around her despite the moderate 74 degrees the thermostat is set to.

Rule number two: There is a time for everything. And I have come at the end of Seminar Time, just before Visiting Time. As the guest speaker for the evening talks about being "recovered" - a word that causes almost unanimous eye rolling; one girl tells me that her highest hope is to be "recovering" for the rest of her life - I glance around the homey living room. The walls are painted in Model Home colors accented with tasteful furnishings and wall hangings. Flowing uninterrupted from the living room, the kitchen carries on the same post-modern Pottery Barn feeling. The most prominent decoration in the kitchen however is a wall-size antique looking chalkboard. White lines split it into a calendar of sorts. I squint and realize I'm looking at a menu complete with chore assignments. Tonight's dinner was apparently seafood salad with lemon bars for dessert although it smells like spaghetti.

Nobody seems to think it strange that the dominant feature of the first room you see in a house for eating disordered girls is a wall-sized menu. Daily Special: Anxiety on a plate.

"I didn't know how much food they were going to make me eat," Emily says plaintively, her knees tucked up under her chin. We're now sitting outside, on the porch, to let Emily warm up. As she readjusts, I notice how much thinner she is even though I just saw her 2 days ago. Her eyes narrow as she notices the gum in my mouth. "If you have gum, you have to give me a piece."

I hem and haw. Rule number three: Caffeine and gum are specifically banned at the beginning of the program and thereafter meted out on an earned basis only. It makes sense as anorexics typically abuse both. (How does one abuse gum? When you use it to occupy your mouth so you don't eat.) I look down at Emily's cute shoes. "Don't you think your first day is a little early to be breaking the rules? I mean, if you're going to be here you should try and be committed..."

"Oh, I'm committed all right," she says wryly and after a pause we both giggle.

We move on to discuss other things, mostly light-hearted gossipy banter, and my hour passes quickly. The flash in her eyes returns as I sigh and stand. Don't go. She doesn't say it but I can see it in her eyes. She is scared. And alone. And so so tiny. Her fragility overwhelms me. I am loathe to leave her like this.

"Here," I whisper, holding out the pack of gum. "You can have one piece." She takes two, pocketing one and chewing the other. I silently curse myself for not remembering to spit out my gum before coming. For not being strong enough to resist her anorexia-fueled manipulations.

We join the rest of the girls out in front of the house. They are watching a Midwestern thunder storm roll in with all its fury - a row of upturned faces searching for funnel clouds. I notice they are all wearing sweatshirts and pants to ward off the chill of a perfect summer night. I feel fat. A small swell of panic rises in my throat as I look down at my adult-sized jeans completing the row of childish denim. I am not immune. Rule number four: Do not talk about body size. Not yours. Not theirs. Not Angelina Jolie's. I swallow my fear.

An attractive young man sans shirt jogs by. I smile and comment, "Well you guys certainly have nice scenery!" The girls glance briefly at him, confusion playing across their faces.

"What I wouldn't give to run," Emily sighs.

"No cardio until you earn it back," a brunette says curtly and then adds, "You'd better hide that gum too." Emily nods, the shirtless man remembered only in the context of lost exercise.

I don't know how to end this. It seems too abrupt to just toss a casual wave over my shoulder as I head down the driveway, as I would at another friend's house. I know it will get easier after future visits but for now it is awkward. Stepping lightly, I hug Emily - so careful, she is so breakable - but she doesn't hug me back.

"What?" I say urgently. "Are you going to be okay?" What a stupid question.

She shrugs and chews at her nails. "Just something you said..."

"What??" I demand. "What did I say?"

"It's nothing," she turns away, trying to draw me back in.

I won't be played this time. "You'll be fine. Really. I'm proud of you for doing this. I know you can do this."

My resolution affects her. She stands straighter. "Can I?"

"Yes. You are a survivor." I don't add that it's her last chance. Her parents have said if she fails this round of therapy - her third in so many years - then she can't come home again. Meaningless threat? Tough love? Parents simply unable to watch their daughter kill herself by inches as they watch? I don't know.

Emily's eyes cloud over and she chews her lip as if she too is considering her alternatives. Or lack thereof.

I walk away to my car and drive into the night, keenly aware of my freedom. Keenly aware of how very little separates us.

Have you ever had a friend or loved one with an eating disorder? How did you support them? How did it change your relationship?

This post sound familiar? It originally ran in August 2008. Copyrighted by Charlotte Hilton Andersen and The Great Fitness Experiment. Not to be used or republished without permission.

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