I am a week away from turning sixty-one. For about forty-three years, I have held a vice-like grip and awareness of even the tiniest changes in my body, as a bird noticing a feather out of place, or a bumble bee who notices one too many pollen grains on her hind leg. This awareness isn’t necessarily a gift, nor is it rooted entirely in the practical need to make my flight feathers work properly, or to rid myself of weight that might impede my journey. While it is a practical concern to move with grace and efficiency, the more formidable psychic predators have been shame and fear.

In my teen years, actually starting at the age of twelve, my father made a crude remark about my body. “Pretty soon you’re going to start sprouting tits.” He was a doctor; he was my dad, the man who had seen me naked hundreds of times as he bathed me, or checked me over when I had the chicken pox. My mother was too sick, too addicted, too depressed to notice when my longing for womanhood enveloped me like a chrysalis. When she recovered, she scoffed at my longing, and told me it was silly to want to develop breasts and hips, and even more ridiculous to want my menstrual cycle to start.

By the time I was seventeen, shame invaded every cell and bone, and was so powerful that I could not bear the feel of clothing touching my skin, or allow the tiny bites of food to saturate my taste buds. I ate only enough to stay alive. There was not a single friendly mirror or plate glass window, none gave back to me what I hoped to see, and I avoided all reflections, unable to see myself with adoration or even a small measure of approval. Like Wendy in the story of Peter Pan, I stepped on the fearsome scale like Wendy stepped on the plank, hands bound behind her to walk off the edge and plunge to her death. The terror of becoming fleshed out and full, of developing the hips and breasts my mother warned me not to develop began when I was twelve and has been a constant shadow even since. It has taken many years of tender self-mothering to cultivate a more loving and affirming voice to displace the once omnipresent and relentless internal dictator, the punisher and persecutor who caught every bite of food and screamed at me not to swallow, and would not let me see my reflection in the mirror in a way that one might greet a beloved companion. This massively ominous presence appears when I am anxious, tired or in any way vulnerable, and it is a daily practice to rise up as my own best mother and feed myself.

The issue of eating and body image is very difficult for me to write about. I am a therapist, and I have to be mindful of what I reveal about myself, fearing what people would think of me or worse, being ostracized by my colleagues and the licensing bureau. But I’m just going to do it anyway.

I am now six weeks along in my recovery from bilateral knee replacement surgery. Prior to this surgery, I kept a punishing schedule of endurance exercise. I do love to be outdoors for long periods of time, in solitude, and letting my imagination wander, but I have been in the grip of an internal critic, so menacing, and so punitive that I have been powerless in silencing it even with all of my tools and experience. Stilled by the surgery and recovery, the memories of trauma and the rawness of my vulnerability have the space to surface. I can’t escape by going Nordic skiing for several hours, which I did despite excruciating pain in my knees, or go for bike rides where I would push myself to exhaustion. It was only after these kinds of outings that I would feel comfortable allowing myself to eat. If my activity was light, or if I took a day off, I would restrict my food intake such that I would barely meet my basic caloric needs.

When I look in the mirror, I don’t see what other people see. To me, I look fine. I like to be lean and muscular, but I couldn’t see the emaciated body that my husband saw. He knew not to say anything; anything he said would usually be the wrong thing, but he would find ways to gently tell me how he felt. “Sweetheart, could you bring yourself to have a protein smoothie if I made it for you?” I would reluctantly agree, and then take a few sips, pouring the rest down the sink when he wasn’t looking. It was only when I saw photographs of myself that I wept at what I was seeing. I saw a woman with skin so thin that even the smallest impact would cause bruising and hematomas. I saw my legs and arms, so emaciated that I could not believe this was really an image of me. The thing is, I know I need protein and fat and carbohydrates to rebuild after hard workouts. I’ve been an athlete all my adult life, and I actually felt okay about meeting my nutritional needs for a while when I was competing at a high level. So what happened to me? Where did I go?

There have been a few traumas over the past ten years and after each one, my body reacted in a way that bodies in survival mode do. The constant flood of cortisol flattened me, and my body’s ability to regulate its systems was compromised. After the suicide of a young client in 2011, I was ostracized by some of my colleagues and people in my community who held me responsible in some way or other. I was interrogated, misunderstood, and considered unfit as a therapist by some, which left me with a mantle of depression so heavy that every move literally hurt. I lived my life feeling like an animal that had been run over, every gesture of love rejected with a growl, and a need to hide, tail tucked, fear of being seen, tears frozen in my throat, and my voice silenced by the fog of severe depression. Every therapist’s worst fear is losing a client by suicide, but when it’s a young person, the pain is unspeakable. I could not bring any comfort to the family, and I couldn’t reason it out for myself. I spent weeks ruminating over what I had missed, and despite all the teaching and intellectual knowing about not blaming myself, I did anyway. I felt I did not deserve to enjoy anything, and medicated myself with wine and withdrawal from friends and any social activities.

I began to feel a little glimmer of myself again in 2013, and decided I needed to get out of this community and be somewhere else. I took a job as the director of mental health in a rural county not far away, and Jon and I packed up and moved. I will not go into detail, but I went into the job with so much joy, so much enthusiasm and confidence that I could make the changes the board of supervisors asked of me, that I was completely devastated when they fired me eight months later. Again, my body went into survival mode. The inflammatory response caused pain and swelling in every joint and muscle, the bloating and weight gain seemed a betrayal, the cause of which I could not understand or fix, the mood swings and depression so severe that I considered suicide thinking I would be doing everyone a favor. Thanks to very high doses of anti-depressants and Jon’s unwavering love, I pulled out of it after about six months. From that point, I was on a rampage. I would never let my body get out of control, I would not allow myself to gain weight and in fact, lost weight by the week, delighting in watching the digits on the scale go lower, and lower, and lower still.

I knew going into this surgery, weighing in at ninety-eight pounds, which on my five and a half-foot frame means I was consuming my own body’s muscle to survive, that I would not be able to exercise fiendishly so that I could feel I deserved to eat. I would gain weight, and I would eat because I actually do enjoy food, although I eat in very small amounts. Seriously. If I buy a cookie, it will last a week. And I knew that I would have to confront the predator that never leaves me alone. I hear it speak when I make my weird little breakfast; a cup of a mix of one rice cake, some multi-grain cereal, and some seaweed snacks. “You shouldn’t eat anything, you’re just sitting on your ass all day.” I eat it anyway. “Fuck you,” I say to this relentless critic. I began to go running in the pool ten days after the surgery, just twenty minutes with my AquaJogger, floating pain free in the amniotic water. “It’s not enough that you deserve to eat,” said my Inner Cruella. “Fuck you,” I said, each time with a little more vigor.

I’m gaining weight and I’m scared to death, but I know I cannot heal without feeding myself really good food. I take bites, and worry. The worry fades as I tell myself that it’s all going to be okay. Another voice has emerged, one that is softer and more loving that speaks to me as I wished my mother had. “Go ahead, eat and enjoy your food. Have a little more.” Having an eating/body dysmorphic disorder is a vicious predator, an addiction that likes to keep itself secret. No woman likes to admit she starves herself. She is likely to say that she is naturally thin, or make up some lie about her thyroid like I did, which is true, I do have a thyroid that doesn’t function, also an outcome of trauma, or she will say she has stomach problems, as I did, which is true, but it was because I drank too much wine, which as an interesting paradox. I drank chardonnay, and was fairly rigid about the intake. I was also good at lying to myself about how much I was actually drinking. I had a glass I used with two dogs facing each other, and I would pour the wine just about half way up to where the dogs butt was, about five ounces. But then I’d tale a pull from the bottle and tell myself it didn’t count. I fretted about the calories but would tell myself I’d just go out for a six-hour bike ride the next day and not eat.

I quit drinking in August of 2018, after the stomach problems got so bad that I had some tests done, one of which was a CT scan that revealed the beginnings of liver disease. That was a wake-up call. I stopped immediately, and have remained sober since. At least those calories are not haunting me anymore. I am noticing that I am a nicer person in this recovery time. I’m not constantly exhausted and overwhelmed, and I’m easier to live with when I’m not listening to Cruella criticize me non-stop every day. Or even if she does, I have another psychic presence that overrides her cruelty and criticism.

“It’s okay, Kimball. It’s all going to be okay. Just eat your food, love your husband and your dogs, go for gentle pool runs. An hour is all you need. It is good to rest.”