Anorexia Nervosa and the Girl Who Wouldn’t Grow Up
By JOSEPH P. BLANK.
Nobody, neither family nor friends nor
doctors, recognized the onset of Stephanie’s disturbance. But Stephanie knew, two years before the
crisis, at the age of 13, that something overwhelming, confusing and mysterious
had taken hold of her.
(*) I had a problem that I was afraid of getting
fat, so I decided to exercise more but still eat the same amount. I didn’t tell anyone and no one knew; they
would have laughed anyway because I was underweight at the time. This went on for two years, getting worse
and worse inside. Each day I ate a
little less and a little less, and then we went to England for our summer
holidays and I told them [her mother and father] my worry and they said how
ridicules it was and so I shut up and ate less.
Stephanie’s
father, Timothy Parsons, a professor at the University of British Columbia,
finally did notice her thinness. At the
beach that summer in England, he looked around for Stephanie and saw a girl in
a bathing suit standing some distance away with her back to him. ‘That can’t be Stephanie,” he remarked to
his younger daughter Allison. “She’s
far too thin.” Them the figure turned
and it was Stephanie.
That
evening—although Stephanie had had a normal medical checkup a few months
earlier—Tim and his wife, Anne, dedicated to have her checked again on their
return to Canada. Because of
professional duties, Tim made a trip ahead of his family. At home, he happened upon an article in Time
entitled “The self-starves.” It
described an emotional disorder called anorexia nervosa that is
especially prevalent among teen age girls form middle-and upper-income
families. The physiological source of
the problem is fear. Unable to control
this fear, the victim demonstrates another kind of control by dieting to the
point of starvation.
Tim
grew alarmed. Was it possible that his
lovely, sensitive child, with her ash-blond hair and deep-blue eyes, had
‘anorexia nervosa?’ According to the
article, early attention to the disorder was important; unless the anorexic can
work out her emotional problems, or obtain effective psychiatric treatment, the
strange malady can be fatal.
When
the Parsons family returned from England, it was clear to Tim that Stephanie’s
troubles had intensified, and he and Anne decided to seek the help of a
psychiatrist. Their daughter was
thinner than ever, and grew more so each day.
She skipped meals of ate only a few mouthfuls of food. Exercise became an obsession. She bicycled for miles, ran, did pushups and
sit-ups. She couldn’t relax. At the movies, she incessantly rattled her
heels and jigged her knees. It was
difficult for her to fall asleep, and look of fear haunted her eyes. She wrote:
I
lost 30 pounds in two years and I had dizzy spells. I felt guilty if I sat down for just a minute. I had to keep on exercising.
One
reason for Stephanie’s unhappiness was that life was not nice and lovely the
way she wanted it to be. She worried
about starving children in underdeveloped countries, and about the killing of
whales. She became upset when a friend
or relative fell ill. After snowstorms,
she shoveled the walks of elderly neighbors.
She loved to do things for people, to see others happy.
Another
love was nature. She tramped through
the woods tape-recording birdcalls. One
winter day she brought home pine cones because “they were sitting in the snow
and terribly cold.” She enjoyed
drowning and spent many solitary hours each week working on cartoon stories for
which she invented characters and created stories. Tim says, “In her drawings she created a place in which people
were kinder and nicer than they are in the real world.”
(*) I draw to express my feelings. When I’m mad I’ll go to my room and draw
till I’ve quieted down. Drawing cheers
me up. There are few words with my
drawings; the words are in my head. I
tell the figures what to do. It’s like
a king ruling a country.
As
Stephanie enjoyed some aspects of life, so did she intensely fear much of it?
I wonder if the world will last
Or will it all go to war
We’ll all kill each other
Then there will be no one left
To see the end
She
read about deranged person who had imbedded razor blades in Halloween
apples—and thereafter she always cut up her own apples to check for
blades. News of a car accident made her
fear that her mother would be hurt in one.
She worried about her father dying in an airliner crash. She cut out scores of newspaper headlines and
assembled them into a montage of horror: “Four Die in Freezer!” “Three Perish
in Student Mobbing!” “Sex Slaying!” “Murder” And so on.
One
night when she and Allison were in their beds, Stephanie asked her sister, “Why
am I so afraid of things and you’re not?”
“I
don’t see a reason to be afraid.”
“Oh,
I do, I do.”
I
don’t want to grow up. I don’t like the
idea of college and handling big affairs.
I would like to remain young because you have someone to protect
you. I’m so afraid of getting old and
stiff and not being able to run around and fly kites.
At
times Stephanie felt as bad about herself as about life.
To
tell the truth, I hate myself. I want
to be somebody I like. I want to like
myself most of the time but I don’t at all.
That’s probably why I’m starving myself—because I hate myself.
Paradoxically,
Stephanie enjoyed everything about food except eating it. It was fun to bake, to help prepare meals
and shop. “You talk about food is such
an enjoyable way,” Allison said. “Why
don’t you eat?”
“I
know it’s wrong” Stephanie admitted.
“But one part of me says, ‘Eat’ and the other part says, ‘don’t eat!”
and the “Don’t!’ is the one I have to listen to.”
Her
parents implored her to eat. “We love
you,” her mother said plaintively. “Please eat!” When pleading failed, Tim became stern. “You sit there until you’ve eaten half of what’s on your plate!”
he ordered. After an hour she did eat a
few mouthfuls, the went immediately to her room to do push-ups.
Stephanie
knew that she was destroying herself and causing her parents terrible pain and
despair. She did not want to do
this. “Daddy, can’t you help me?” she
pleaded.
“If
only I could,” Tim said with a breaking heart. “You know what you have to do to
help yourself. Eat Stop exercising!”
“I
try. I can’t.”
In
her despair Stephanie told a friend, “I
don’t know what’s happening to me. I
want to please the people who love me, but I can’t. Oh, why don’t we end this and let me die.”
When
school opened, Stephanie’s teachers talked with her and tried to persuade her
to eat, but it was futile. “You could
feel the child’s tension,” says teacher Kathryn Hurwitz. “Day by day I could
see her slipping away.” The family
physician tried to reason with Stephanie.
Her response: “it’s my body, and I can do what I want with it.”
Stephanie’s
psychiatrist, recognizing that his patient had reached a critical stage,
undertook intensive treatment directed at getting her to understand her fears
and put them into perspective. He also
gave her tranquilizer, hoping to reduce her frenzied compulsion to exercise.
But
therapy takes time. Stephanie did not
immediately eat more or exercise less.
In less than a month the psychiatrist realized that, under existing
conditions, Stephanie’s survival was at stake.
She had to take food, had to stop exercising. He recommended that she be hospitalized.
A
few days later, Stephanie told her friend Leila Christensen, “I’m going to the
hospital. It’s all over with me.”
“Don’t
talk like that, Leila objected.
‘They’re going to help you get better.”
“No,
it’s all over with me.”
On
October 8, Tim and Anne drove Stephanie to the hospital.
Today
was the worst day of my life. Ma and I
had breakfast together in bed. I felt
happy with ma’s arm around me. At the
hospital I pledged with Ma and Pa for another chance. They left, and I cried bitterly.
I feel like a cone without ice cream, a human without a heart.
At
this point Stephanie weighed just 67 pounds.
Eight days after entering the hospital she suffered abdominal
pains. A gastric ulcer (which can
develop very quickly) had perforated, and she required immediate surgery. Ulcer-related infections then set in, and
she did not have the strength to fight them.
Tow days later, Stephanie Parsons was dead.
Friends
of the Parsons’ in Japan sent money to he used for a remembrance. Tim arranged to have a Katsura tree planted
in a beautiful garden on the campus of the University of British Columbia. In the fall, a time when Stephanie loved to
tramp through woods, the Astsura’s bluish-green heart-shaped leaves turn red,
orange, pale yellow, mauve and pink.
Then they drop to the earth and partially obscure plaque that reads:
STEPHANIE
PARSONS, 1959-1975.
(The
italicized excerpts are taken from Stephanie’s diary and other writings.)
What is Anorexia nervosa?
In
the following interview, Dr. Hilde Brush, professor emeritus of psychiatry at
the Baylor College of Medicine and author of The Golden Cage: The Enigma of
Anorexia Nervosa (Harvard University press, 1978.), answers some basic
questions about the strange malady that took the life of Stephanie Parsons.
What
is anorexia nervosa? A psychosomatic
illness that selectively befalls the daughters, and extremely rarely the sons,
of well-to-do and educated families.
The families tend to be success, achievement and
appearance-oriented. The chief symptom
of the condition is a devastating weight loss from self-inflicted starvation.
What
is the incidence of the disorder? In
the risk populating of high school and college girls, the incidence may be as
high as one in 200. And it is
definitely on the increase.
Why? For one thing, our society places enormous
and unrelenting emphasis on slimness.
Also, these girls tend not to see the new freedom for women to use their
talents and abilities as “lineation.”
To them, it represents a frightening obligation to be special and
outstanding.
What
have you found at the root of this problem?
In general, these youngsters have struggled in childhood to appear
“perfect” in the eyes of others. When
adolescence arrives, with its heed for independence and self-assertion, these
girls cannot break out of dependency and submissiveness. They don’t have the necessary control, and
this lack of control is the basic psychological issue. But they can control their own bodies, and
the exercise this control through self-starvation.
What
other symptoms can alert a family?
Interest in food combined with a denial of hunger. Excessive exercising. Eating binges, them removal of food through
self-induced vomiting, laxatives and other means. Failure to menstruate or cessation of menstruation. Excessive devotion to school work. Sleep problems.
What
treatment should be sought?
Psychotherapy aimed at resolving the underlying psychological problems,
and restoration of normal nutrition. If
at all possible, professional help should be sought before the crisis
stage. As soon as the family or
physician recognizes the symptoms of anorexia nervosa, treatment by and
experienced psychiatrist should be insisted on. Therapy must encourage the patient to become more aware of and to
act on the impulses. Feelings and needs
originating within herself. She then
becomes capable of living as a self-directed, competent individual who can
enjoy what life has to offer.
