When food becomes a lethal weapon.
Where is your soul now, my friend? Were you given a chance to explain why you did it?
It's been 16 years since they discovered the crushed remains of your broken body on the cold, concrete platform near the building that was just too tall. And I have not forgotten you. Your memory enters my consciousness at unexpected moments -- while watching yet another goofy, delighted grin flash across my baby boy’s cherubic face; while standing outside, drenched in a sudden downpour, watching furious splatters of rain. I think of you in these ordinary moments and wonder about the moments you might have experienced had you not cut your life short.
I know you spent most of your last year in a locked institution for the severely disturbed. And I know how awful an experience that was. The stench of urine filled the stairwells and the only place you could call your own was a bed with rusted iron rails, a thin, stiff mattress, and faded, stained sheets with the words “Talbieh Hospital” printed in a repetitive patterns all across them, so that you could never forget where you were, not even in your sleep. The unmistakable marks of madness were everywhere. They were etched into the dark, soulful depths of youthful eyes that had seen too much and crackled constantly with flickering flames of sadness that would not die. I know it well, Aliza. I was right there with you.
I had befriended you in a tenuous effort to reach out from a dark spinning whirlpool of incessant agitation, panic and despair.
As far as I know, I was your only friend in the last year of your life. You had little contact with others outside of myself and your dad. (Sadly, you longed for your mom, but she had cut you out of her life some time ago.) I was angry at you for a long time after you ended your life. In fact, I was often enraged. It took quite some time for the rage to subside enough for the underlying sadness to seep into my heart. I thought I understood you better than most. We did not exhibit the same symptoms, but I was no stranger to protracted mental illness or despair.
My own mind was a dark spinning whirlpool of incessant agitation, panic and despair and I had befriended you in a tenuous effort to reach out from behind my fiery curtain of pain and touch someone outside of myself. I was so desperately depressed that I barely got out of bed for a good part of the year that we spent together on that decrepit, gloomy adolescent ward.
You wanted to be beautiful, Aliza. You were 19 years old and locked up or not, looking pretty was important to you. But did you really think you looked pretty after continual bouts of self starvation? To me, you looked like an emaciated concentration camp survivor. You were so frail and gaunt that it sometimes frightened me to look at you. Your collar bones jutted out so sharply that I had to look twice to assure myself that I was not, in fact, gazing at a skeleton. Your face could have been pretty. But your features protruded unnaturally; hallowed impressions took the place of your cheeks. I remember you circling in front of a full length mirror in your Dad’s place where we went on rare passes to the outside world. You examined yourself critically from every angle, pulling anxiously at fat that was perceptible only to the distorted mirrors of your inner eye.
“I must lose more weight,” you’d inevitably conclude in a determined, forceful way while attempting to hide the rising panic that crept into your tone.
“But you’re already so thin!” I’d protest weakly. “You’re the skinniest person I know. How can you possibly think you need to lose more weight?”
“You’re the skinniest person I know. How can you possibly think you need to lose more weight?”
“Look at this,” you’d say in vexation, pulling at yet another piece of imaginary flesh in noticeable agitation. “I must get rid of this.”
I was young and ill and certainly had no formal knowledge of eating disorders. But I understood enough to realize that these conversations were pointless; it was as if we were speaking different languages. I would then fall silent, wishing there were some magic words I could say that would make it all go away for you. But I didn't have any magic. If I did, I would have used it for myself as well.
Bulimia. A perplexing and agonizing illness. Especially as seen through my dark, 20-year-old eyes. The binge-and-starve cycle raged on ferociously, and your thin body and wavering spirit trembled in its repeated destructive winds like a sapling in the epicenter of a tornado.
During one particular brief pass, you informed your dad that we were going shopping, and returned with your frail frame weighed down by several super-sized shopping bags. You then proceeded to unload box after box of sufganiyot, the special type of donuts sold in large quantities in Israel around Chanukah time. They were round, jolly looking things, balls of soft fried dough stuffed with jelly, glistening with oil.
I had never seen so many donuts all at once outside of a bakery or supermarket. The bags were full of other junk food as well. When the donuts were all unpacked, you began stuffing your face, one after the other. You did not seem to care what you were eating, only that you were eating. And you seemed to be in a rush. It was as if you were in a race against time, trying to consume as much of the stuff as possible before your mind could process the insanity of your actions.
Eventually, you seemed to notice my presence amidst a frenzied fog of carelessly scattered confection sugar. “Do you want some donuts too, Shani?” you asked, in a burst of sudden politeness. “I have lots.”
You giddily boasted that you could make yourself vomit on a whim, but I thought I heard tears in your easy tone.
You looked pretty loony to me, shoving all that food into your mouth, and something about the whole scene frightened me deeply. Yet your binge also perversely appealed to me. I did not have an eating disorder but I was incredibly self destructive and this activity fell decidedly into that category. Besides, I had nothing else to do. I decided to give it a whirl and joined your attack on the fried dough.
No, I did not develop bulimia from this experience, but it did result in a massive stomach ache, the severity of which I would remember for a long time. But you had a solution to that. You calmly explained, like a professor with confident mastery over her teaching material, that this was an expected part of the experience and there were two basic ways to deal with it. I could either vomit or use laxatives. You giddily boasted that you could make yourself vomit on a whim, but I thought I heard tears in your easy tone. I chose the laxatives. Perhaps in the spirit of camaraderie, so did you. It was an experience I'll never forget, and one I vowed not to repeat.
It's taken years, Aliza, but I have forgiven you. I understand that you were suffering intensely. You may have thought you had no options at the time. You were obviously at the depths of despair. I do not -- and cannot -- judge. But I most certainly do not agree with what you did. I suspect you still had, on some level, a choice. There is a God who runs this world and He helps those who reach out to Him in earnest.
After you killed yourself, I went on to battle severe mental illness for many long years. I walked down the road that led you to take your life too many times and almost joined you in that mysterious place where humans do not tread. I must learn to forgive myself for this, as I have worked to forgive you, because I firmly believe that neither you nor I had the right to attempt to take our own lives.
Ultimately, I learned to fight against my own destructive tendencies with tears, prayers and sheer willpower. I waged an ongoing battle in my own private inner terrain of darkness against light, and good against evil. I raged against the forces within my personality that threatened to destroy me from within with focused determination and ferocity. It seemed like the battle of David and Goliath at times, when the darkness became so powerful and my desperate attempts to fight against it seemed impossibly weak and feeble. And that's when I knew there was a God. When I experienced repeated bursts of healing that were not any more feasible than David's victory over the formidable giant with his slingshot and small stones, I understood that I had felt the hand of God, and I could not but thank Him. I welcomed His angels in human form that had a mysterious way of appearing time and again to help guide me through the ravaged, war torn landscape of a diseased mind.
Although I probably understand why you took your own life better than many, I want you to know that I believe it was a tragic mistake. You may not have had many opportunities to grow in the hole of misery where we then lived. But why didn't you wait? I firmly believe you would have eventually found an opening, a place from which you could begin to fight your way out of your own inner darkness, a place where God's grace might have entered.
I still wonder where you are. Where is your soul? I want you to know, my dear friend, that I hope you are at peace, that you have been forgiven. And I hope your soul basks in God's gentle light for all of eternity.
* * *
An endnote by Hudy Neuman, MSSA, LISW
Bulimia is unfortunately an all too common eating disorder affecting four to seven percent of women with the typical age of onset being during the teenage years. It is characterized by recurrent episodes of binge eating followed by compensatory behaviors such as vomiting, laxative use, excessive exercise or starving.
Eating disorders such as bulimia and anorexia are often comorbid with depression, anxiety, post traumatic stress disorder and / or substance abuse. In this case, Aliza was clearly depressed as well as struggling greatly with her eating disorder. I was most concerned by what appeared to be a lack of treatment – other than some psychiatric medication. A responsible treatment approach for a severe eating disorder should include a multi-disciplinary effort. This would typically involve a physician, psychiatrist, individual therapist, nutritionist, group therapy and family counseling.
Although eating disorders are often considered the most deadly form of mental illness, patients more typically succumb to medical complications related to the disorder rather than suicide. Some of these medical issues are cardiac arrhythmia, esophageal tears, electrolyte imbalance, digestive problems and dental problems. Fortunately, there is time from the onset of symptoms to the point where it is life-threatening during which effective treatment can be implemented.
If you or someone you know is struggling with this disorder, please get help immediately. Following are some resources with more information about eating disorders and treatment options.
Magen Avrohom – education, guidance and support for families dealing with eating disorders in the observant Jewish community. (718)222-4321 or (877) HELP- EAT.
National Eating Disorders Association - www.nationaleatingdisorders.org
Eating disorder information and online support - www.pale-reflections.com
Eating disorder referral and information center - www.edreferral.com
Hudy Neuman is a clinical social worker specializing in adolescent mental health in Cleveland, OH. She works at Yavne High School and in private practice.