Exploring the roots of fear that feed an eating disorder

Exploring the roots of fear that feed an eating disorder

Tanya declares she and anorexia are irrevocably entwined. Fear is ever-present. Here, Tanya explores the roots of her fears.                                  

Editor, June Alexander

I have physical fears, emotional and psychological fears, and spiritual fears (in the guise of superstitious beliefs). Are my fears real or imagined? Are they innate or learned/acquired? Are they false or genuine? More pertinent to this task, which of my fears live inside my eating disorder, and which stand apart? Was I fearful before my anorexia? Or am I afraid because of it?

FEAR

Night. In a bed next to another bed in which my older sister, Katherine, sleeps.
My eyes are open, looking wildly about me in the thick darkness.
I settle myself, rearrange the covers, change sides of the pillow, and get my face and neck comfortable.
But I keep my eyes open.
Always.
You just don’t know what you might see,
or what might happen,
if you keep them open.
I am four years old.

Fast-forward 50-odd years.
Every night before I go to sleep,
and almost every time I wake up
(either in the middle of the night or the following morning),
I automatically place one of my arms around my torso and pat my side.
I tell myself: It’s okay. It’s okay. Everything is alright.

I draw up a list of my main ED fears and those I think are my ‘other’ fears (or, as one therapist categorises, the distinction: my false fears and my real fears). On the left-hand side (the ED-fears column), my fears are listed as weight gain and food anxiety, stomach aches, eating between meals, and loss of control. On the right-hand side (my ‘other’ fears) are abandonment and failure/imperfection.

Somewhat naively, I think this task can be simplified into two columns. But, no. I quickly realise that ALL  the fears I have listed intersect. Everything is interconnected, overlapping in a complex tapestry of knotted, tangled threads. The lines of my woven picture become blurred. Messy. From a distance, my artwork looks neat, with every thread where it needs to be, forming a visual completely and efficiently delineated as a tapestry woven in black and white. But when I burrow down and rummage through the complexities of each fear, I see that every thread is warped, creating a chaos of distortion in a type of colour blindness.

If I overeat, my tummy hurts

The earliest cognitively-processed fear I have originates from stomach trauma, a real reaction based on infancy compromised by feeding difficulties, colic, and myriad digestive issues. At the age of six, I developed a frighteningly mysterious stomach pain, the severity and acuteness of which caused my father to rush me to the Emergency Department. I instinctively knew that for Dad to drop everything and take me to the hospital, it must be bad. Dad always preferred the ‘wait and see’ approach to injuries or ailments that my siblings and I sustained during our childhood. Working in medicine, he was knowledgeable about causes, signs, symptoms, and treatment. However, lying across the back seat of our Falcon station wagon, I was terrified. What was wrong? Would I have a cramping belly for the rest of my life, forever gripping my tummy and curling in a tight fetal ball? I was irrationally catastrophising. I was six, and I never wanted to feel that pain again.

My diagnosis that afternoon was Rubella Fever. Since then, I have suffered from various gastrointestinal complaints. Some are the consequence of food intolerance, and others are caused by multiple parasitical infections acquired overseas. Nowadays, stomach aches persist, occurring when I overeat or when I am anxious about overeating. I tolerate these aches, but I fear them.

If I eat too much, nobody will love me

I was the result of an accidental pregnancy. I was supposed to be Gregorovich, a boy. Instead, unplanned, I was Tatyana, the third child, the third wheel. My father’s speech cemented the wound on my wedding day when he said, “We were blessed with our firstborn, our golden boy Nicholas. Our longed-for daughter, our beautiful middle child, Katherine, soon followed. And then … well, then there was Noddy.”

‘Noddy’ was me: the afterthought, the part belonging in the margins or parenthesis, the postscript or footnote. For as long as I can remember, I was categorised as the family’s black sheep. Quips about being the postman’s child or the milkman’s offspring were meant jokingly but taken seriously by me until a recent DNA test confirmed that I do indeed belong, genetically, to the Hayward family.

Somewhere in all of this lies a deep-seated fear. I asked my sister what she thought the roots of this fear were, and without pausing, her response was the following:

Fear of abandonment. You were abandoned in a way as a baby – you have an implicit memory of this.  This is where your perfectionism is a result of what happened to you when you had no choice. You have spent your life as a carer and a people pleaser, giving and giving so that you would be loved and never abandoned again due to that fear.

Immediately after my birth, Mum had postnatal depression and was having to manage three children under the age of three, alone and unsupported. Dad was working hard, often over part of the weekend, as there were financial pressures. My mother, therefore, found it difficult to cope with the third child, and because that early attachment was a problem, as a baby, I cried constantly. Perhaps this was because my needs were not fulfilled. I became a fussy eater, playing with my food and consuming less than my siblings.

My sister told me about the similarities between my infancy and John Bowlby’s Attachment Theory, the ‘circle of security’, and I agree with her perspective. Her theory also concurs with some of what I have spoken about with my treatment team. This theory proposes that an infant’s emotional and social development is profoundly shaped by their relationship with their primary caregivers (in my case, my parents). The theory is rooted in the belief that infants are biologically wired to form attachments, a mechanism that serves as a survival strategy (John Bowlby, The Origins of Attachment Theory, 2012). Without that link, the consequences can do life-long harm. Is this, then, where my eating disorder comes from – the fear of not being wanted, of not being loved and cared for? Of being abandoned?

If I eat too much, I have failed; I am imperfect

I fear failure, which has led to an acquired trait of perfectionism. I am averse to doing the wrong thing, morally and spiritually. Something bad will happen to me if I do something ‘wrong’. Consequently, I have developed a strict code of discipline and a fierce sense of righteousness.

I write copious lists, indulge in numerous obsessive-compulsive behaviours, and must have every component in my life ordered and organised (I don’t like that disorderly tapestry), or my world will collapse around me. So, I do what I was raised to do—I strive for perfectionism in ALL things. An A grade at school would never be as good as an A+. Second place was most definitely not first place.

My upbringing inadvertently reinforced the pressure I placed on myself to excel: Our parents expected we would complete university studies, preferably at a ‘prestigious’ institution (hence, Melbourne University for my older brother and me, staying at Queen’s College). There was a constant battle cry of ‘Do your very best’. Punishment was meted out, not for academic or sporting disappointments but for telling a fib or breaking something.

Accidentally breaking a tall red glass vase when I was seven led to the humiliation of being placed across Dad’s knee on the bench on our street-facing front veranda and being spanked. I developed the belief that if I did not behave or perform perfectly, something bad would happen.

More than this, I never, never wanted to let Dad down. He cannot, must not, be disappointed in his Noddy, or I will lose his love and attention. From my infancy, when Mum could not cope with me, Dad and I formed a deep, everlasting bond. In my mind, Dad was God. I hoped never to disappoint him. Having gained his love and affection, I had to keep it, no matter the cost.

Dad never played sports or games, openly admitting that to come second place (or, heaven forbid, lower) was to fail. If we went out with friends, he would ask, not, “Did you have a good time?” But, “Was your outing a ‘success’?” Until the day he died, a meal at a restaurant was qualified by whether or not the dinner was a “success” rather than whether the evening was pleasant.

If translating that fear into the context of my eating disorder, I strive for perfectionism, my motto being:

I am a good anorexic – I do it well, and I do it properly.

Even in this, I do “my very best”, striving for precision and excellence. In my approach to eating, I am fiercely rigid and consistent, and I am proud of this. I feel ‘good’, ‘ pure’, and ‘right’ each time I restrict myself. Related to this is another intense fear: the fear of losing control.

If I eat too much, I will lose control

If I eat more than what I think I should, I get berated (spanked?) by the voice inside my head (me?) telling me I have failed. I am imperfect and inadequate. I am BAD. I’ve done WRONG. If I lose control over what I do and do not eat, everything else in my life will – like a contagion – become flawed and break down. My life will disintegrate. This happened after Dad’s unexpected death at the end of 2018. My life fell apart. My entire world had been Dad-centric, and I did not know how to survive without that framework. My trusty ED helped me out, and the rules tightened to regain the control I had worked hard for before Dad’s death: as long as I stayed in control, nothing else bad could happen.

Connected to the fear of losing control is the fear of uncertainty. I know this when I receive an invitation that requires spontaneity: I cannot do it. I need thinking time with my lists to see how I can rearrange all the other components of my life (and in my mind) to accommodate and justify the change(s) necessitated to oblige, to switch from what I had previously scheduled to what must or might now be. This might be a change in the food, a change in sleeping arrangements, a change in my social calendar, or a change to my work schedule, each requiring an enormous amount of time, energy, and courage.

Over-compensatory behaviours will surface if I take detours or face roadblocks in my path to perfectionism. OCD behaviours step up, and avoidance behaviours, socially, emotionally, and food-wise, increase. My psychologist has long maintained I am emotionally numb, that I suppress my emotions rather than expressing and releasing them. Perhaps if I were to open the lid on my feelings, I would lose control.

If I eat between meals, I am piggy

Related to the above fear of losing control is my fear of eating between meals. I was raised in a household where morning and afternoon tea were considered unnecessary indulgences that meant one was piggy. Dad would berate excessiveness of this kind, openly warning, “You’ll get fat.”

Perhaps this restriction and rigidity on Dad’s part had its genesis in his childhood. An impoverished single mother raised him; his education was hard won through gaining a scholarship at a distant private boy’s grammar school, to which he rode his bicycle 12 miles a day, regardless of sun, wind, rain, and snow. Food was sparse. He often recounted the story of not finishing his porridge one morning. His mother put the bowl aside and, unrefrigerated, kept it to serve him again the following morning: he was violently sick for days because the porridge had turned rancid. He had not been able to eat porridge since.

At four foot 11 inches, my mother was short, contrasting with my father, who was over six feet tall. Dad described Mum as “as wide as she was short”. She was obese. Subconsciously, from a young age, I may have vowed not to be like her. I know Dad loved Mum deeply, but his humour and knack for wordplay would get him into trouble, particularly with friends and work colleagues. He was too honest and blunt, albeit his joviality disguised his words. I have wondered if Mum took offence. In my young mind, I reasoned that I had to avoid becoming as wide as I was short. Perhaps this was another seed sprouting an additional branch of roots, entwining itself in the complexities of a severe and enduring ED.

If I eat too much, I will gain weight

The overriding fear, the king of all fears, is the fear of weight gain. Dad was a disciplined, regimented navy man, having served 12 consecutive years in the Royal British Navy from the age of 17. His cups of tea and meals were kept to a strict timeline every day of his life: anything outside of that framework was letting yourself go. He maintained his slim frame throughout his 89 years, removing the tradition of Mum serving pudding at the end of the evening meal when I was pre-teen and ever striving for the next hole down on his belt. His weekly system of weighing himself always resulted in a family announcement as to whether he gained or lost as much as half a kilogram.

As children, we were lined up and weighed weekly, right before the Sunday evening ritual of clipping our nails on his knee.

In my teenage years and early twenties, my sister and I spent most of our time dieting, swinging from one diet to the next in our bid to lose the excess weight we were carrying. For two years in my college days, when living away from home, I gained a substantial amount of weight and truly, deeply despised myself. My saviour came disguised as four intestinal parasites on an extended trip to India after my tertiary studies. The usual story followed – comments from every friend and family member:

You look so good, Tanya, having lost all that weight. How did you do it?

The fear of weight gain is so severely entrenched in my psyche that the recent suggestion by my dietician to change the timings of my meals (without adjusting the portion size of the food) has instilled a deep, unshakeable fear that doing so will lead to weight gain. Of course, the rational side of my brain knows that this is impossible – and yet, I cannot do it. I have been trying to adhere to this edict for more than three months, to no avail. Too hard. Any change in my routine might lead to weight gain. And weight gain is, of course, the number one enemy.

Weight gain is akin to asking me to kill myself. I would rather kill myself than gain even 10 grams of weight.

My fears are tangled.
There are cross-overs between every one of them to the extent that I cannot tell which are real and which are false,
which are ridiculous and which are justified,
nor which are innate and which are learned.
There is no distinction between my ED fears and my ‘other’ fear
the environment in which I was raised, or from circumstance,
it matters not to me.
They are there, I have them,
and they are REAL to me.

Fear is typically thought of in negative terms:
Fear is dark, bad, ugly, unhealthy, and harmful.
Fear is something to squash, avoid, negate, and destroy at all costs.
The question morphs into a different form for me:
Do my fears rob me of my life?
Or do they give me my life?

I will not risk poking at them to find out.