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Emerging from Anorexia

May 9, 2009 | by

My daughter's journey from starvation to salvation

My 21-year-old daughter descended into the abyss of anorexia six and a half years ago. For five years our family - my wife Sarah and Rachel's two brothers - agonized along with Rachel in a freefall of starvation and withdrawal into the hands of a strange and silent stalker that resisted all attempts to free his victim.

Rachel was hospitalized numerous times, and despite an ongoing barrage of eating disorder therapists, nutritionists, and parenting "support groups," she only got worse. Her Jewish identity ebbed into indifference. She lost her once vibrant joy of living, and her only solace was her dog Annie - that, and her fervent devotion to the "high" of a life without calories.

Finally, we heard about a program at Columbia Presbyterian Hospital in New York through my son's roommate in Israel, who had been treated for an addiction problem in a unit that also treated eating-disordered patients. The first time Rachel reluctantly agreed to an interview (which took weeks to arrange) she abruptly ran out of the building in the middle of her meeting with the doctor in charge of the program. A year later, having completed the follow-up research protocol, she told the doctor why she had run away: she was so weak that she thought she would faint, which she did after leaving the building.

(Read "Anorexia: Starving in the Land of Plenty" for the full account.)

After a rocky start, Rachel was released from Columbia three months later, eating up to 4500 calories a day to attain her "goal weight." We nervously held our breath as Rachel re-entered the "outside world". Could she survive outside of the highly structured unit, where she was required to be supervised for an hour after every meal to insure that she would digest her food and not self-induce herself to vomit? Would she once again skip meals, and substitute chewing gum for food when she was not under supervision? Why would this time be different?

As Rachel walked out of Columbia to freedom, I felt a wave of emotions: pride, relief, and most of all, total fear.

When an obsession is so ingrained that every waking hour revolves around it, thoughts of a balanced and healthy life seem as remote as a walk on the Moon. As Rabbi Yisrael Salanter said, "It is easier to learn the entire Talmud than to change one negative trait." Anorexia had robbed Rachel of her sunny personality, her ability to socialize, her killer sense of humor, her natural non-"Runway Model" beauty, her Jewish identity that she was raised with, her self confidence, even her will to live. Life became a day to day question of survival. As Rachel walked out of Columbia to freedom on that August morning, I felt a wave of emotions: pride, relief, and most of all, total fear. When she was locked up in her unit, at least I had the peace of mind knowing where her next meal was coming from. What glue would hold her together now?

Starbucks and Stability

The first weeks were a nerve-wracking trade-off between surreptitiously watching to see if she was eating, and giving her some space to adjust on her own. Finally she landed a job at Starbucks, a chance for stability and structure (and coffee - a food that was strictly controlled in the eating disorder world because it was a popular food substitute for anorexics). Rachel quickly mastered the art of the Starbucks barista, and her bubbly charm was a hit both with her co-workers and with customers. She did admit that sometimes she "didn't have enough time" to eat lunch, but otherwise, she liked being back in the world and restoring order to her life.

Starbucks was a bridge between breakdown and recovery. Rachel made friends with her co-workers, had a social life, and a daily routine. She must have been eating enough to maintain her job; previous jobs had collapsed under the exhaustion of malnutrition after a month or two, and now several months went by and the status quo was maintained. She still frequently expressed the need for a family member to sit with her while she ate her meals, but she gained a level of stability.

Rachel was now 20 and felt strong enough to risk seeking something that previously she had been too sick to attempt: finding a husband. Despite her alienation from anything overtly Jewish, Rachel wanted to find a Jewish husband. My wife and I were relieved that she still felt some connection to her Jewish upbringing.

Rachel signed up for a Jewish internet dating service, and was immediately deluged with emails from interested Jewish men. She spent hours on the computer sorting through prospects, and shocked us by setting up her first date with a man ten years her senior in a restaurant in Manhattan. The scary part, she admitted, was the prospect of eating real meals and not "safe" anorexic foods. She boldly decided to risk eating fattening and long-neglected foods, risking it all for love, I mused.

I had to embrace Rachel's risk-taking as the essence of a healing process.

The thought of Rachel driving to New York on her first date to meet a total stranger, older, undoubtedly suave and wise to the world, made me briefly long for the days when she was "safely" locked away in her room, eating her "safe" no-calorie food, tucked away where no danger existed. On the other hand, Rachel was now secure enough to start taking risks to move forward, on her terms, and I had to embrace that risk as the essence of a healing process. On the night of that first date I stayed up with my cell phone on until I heard her car pull up to the house. It turned out the man was no monster, bought her a fancy dinner, and treated her like a lady.

"Nice guy, treated me really well, but not my type," Rachel told me the next day. She always knew exactly what she wanted, whether it was buying earrings, choosing friends or changing her hair color. Some people are born with self-confidence, and after being out of action for a few years, I could see that Rachel's swagger was back. She quickly moved on to the next date, and the next. Rachel was always attracted to a glamorous lifestyle, and she located some potential husbands who seemed to fit the mold. But none of these Jewish Princes, in their mid to late twenties, were in any great rush to get married. And even though Rachel was no longer "religious," she started to comment that something intangible was missing. "The dates are fun, but they're not going anywhere."

"Could I go out with guys that are religious, even if I'm not?" Rachel asked me one day, after another relationship fizzled out, with no hope for marriage on the horizon.

I was caught off guard. "No you can't - it won't work," I answered. "You need to have some common ground." It reminded me of something I'd heard years ago, about a person defining himself by the synagogue he doesn't go to. Rachel still found meaning in the religion she didn't practice - and that made her different from the men she was seeing.

Rachel's Decision

The next day, Rachel proclaimed her decision to keep Shabbat and kashrut and all that went along with it. No dramatics. Just a decision, from a girl who always knew what she wanted (but retained the right to change her mind!). Friday night came and Rachel joined us for kiddush straight through to benching. My wife and I pretended like all was normal. In fact, we felt like a time tunnel had dropped us off six years in the past, as if nothing had happened.

"Show them unconditional love. Avoid confrontation and yelling." Easy to say, hard to do.

Having become religious ourselves 30 years ago, we always assumed that our children would eagerly embrace our Jewish lifestyle. The first stirring of teenage rebellion in Rachel's older brother caught us by surprise. At first, I instinctively tried to head off this insubordination, only to find that direct confrontation was making things worse. I then received some invaluable advice from a rabbi whom I respected and trusted: "Keep your connection with your children," he emphasized. "Show them unconditional love. Avoid confrontation and yelling." Easy to say, hard to do. I had to re-examine my role as a father and my desire to get "nachas" from my kids. I had plenty of practice in building a connection by the time Rachel slowly abandoned her observance.

The rabbi also told me that these days a child or teenager leaves the fold because something doesn't feel good, not because of intellectual reasons. Your child is a real person with thoughts and feelings, not a "nachas machine." My focus became "I want my children to feel good" to be with me, without sacrificing my own principles. Whatever contribution my wife and I made to Rachel's return to Jewish observance, it was primarily a result of keeping the "big picture" in the relationship and not gunning for immediate results.

With two Shabbats under her belt, Rachel once again returned to the internet dating scene, but this time, on, looking for a husband who shared her revived religious lifestyle.

Rachel scoured hundreds of profiles, like a gold prospector knee-deep in a promising stream. After some false positives, something caught her eye. "It was his warm, friendly smile that made me want to know more. His name was Avi, and something about him sat well with me," she explained. Three weeks later, Avi responded, telling Rachel that he had joined the service just to respond to her. They made a date the next day, and if any doubts remained over the next six months until they formalized their engagement, I'll show you Rachel's share of my mobile phone bill!

Believe in Miracles

Rachel and Avi's engagement was a landmark for Frumster - their 500th couple to become engaged (including a free wedding photographer and videographer)! Somehow, it felt like God Himself was putting His exclamation point on this joyful event, as if He was winking at us, saying, "Didn't you believe in miracles all along?"

With only a few weeks left until the Big Day, life is consumed with invitations, gowns, seating arrangements and a thousand other details.

My mind drifts and I can see us standing under the chuppah, Rachel, Avi, Sarah and I. The music is playing and a chazzan is singing, white gowns and rabbis and women with tissues drying their eyes swirl around me. Suddenly, everything is silent and the hall is still.

My feet are on the ground but I feel myself soaring, up and beyond the wedding hall. A rush of white clouds and suddenly the sky is blue, and I'm surrounded by faces, surreal and filled with love. A blue-eyed man, radiating wisdom and compassion, begins to speak in the calmest voice, sounding like the distant roar of the ocean that has come to life: "We've been waiting for this chuppah, don't you know? You think it was easy to arrange?"

The faces, tens, hundreds, stretching into thousands, are serene, frozen in time, deep wells of eyes that reflect an endless expanse of time. The blue-eyed man continues:

"We're your family, of course, spanning the generations... Now go back to the wedding. Everyone is waiting for you!"

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