Beating the Disorder

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A therapist helps a dangerously skinny patient.
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pacifist91w
pacifist91w
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Warning: Explicit sex, some offensive language, and a little self-destructive behavior within.

Note: While I wrote this, one of my favorite songs-which I've loved since childhood-kept popping into my head: "Respect Yourself" by the Staple Singers. If it's been a while since you've heard it, I recommend listening to it after you read this story.

As usual, this story is fiction.

*X*X*

Pain scorched the young man's esophagus. Pain burned the inside of his mouth. Good old pain. The young man welcomed the awful smell that accompanied the pain. "Pain is weakness leaving your body," several of his coaches had quoted to him. This time, pain was empty calories and disfiguring fat leaving his body. The pain and the scent were signals. He was fighting to maintain what mattered.

He'd been quiet tonight. No one knew what had happened. He went back to his room for some much-needed sleep.

...But the young man didn't see the light appear under his parents' door just a moment after he'd gotten back into his bed.

*X*X*

Dionna was calling me. At 1:42 a.m. "Hey, Dionna," I said, knowing my voice had to sound thick with sleep.

"Janice, please, please help us! He's going to die! My baby boy is going to die!"

She sounded like dozens of mothers I'd heard. She wasn't hysterical; she was reacting appropriately. "Stay calm, Dionna, please," I said. "Have you called an ambulance?"

"No, it hasn't come to that, thank God. But he was in there again, just now. I barely heard him, but I know he did it again. He's going to kill himself; please help him!" Dionna asked, struggling with tears.

"Stay calm; he will be all right," I said again. "I will help him, I promise.

"But if things are this serious, we don't have any options left, besides in-patient treatment. Terrison has to come live with me. Sessions haven't worked; medication hasn't worked; only personal support and instruction will save him now."

"Anything!" Dionna said. "I'll bring him to your house tomorrow."

"Listen closely, though," I said to her. "You must not let him believe that he's being punished. Make this move a change of scenery; try your best to assure him that nothing is going to change except for his address. Tell him that he will have all the freedom he has now; all the friends he has now; he won't have to change schools-try as hard as you can to make it seem like no big deal."

My best friend's daughter sounded a little calmer. "He won't want to go," she said.

"Tell him it's just for two days."

"Can you really counsel him in just-"

"-No, of course not, but tell him anyway. I can't help him unless I give him attention, rest, therapeutic information, and a new way of thinking about things. Don't worry, sugar. He'll know, deep down, that he'll be leaving for a while, but he'll also know that you're helping him. And he's a smart boy. Somewhere inside, he knows he needs help."

*X*X*

On the drive back from the counseling clinic where I work, I thought about the trust Dionna displayed. I had had many patients-and most of them were around her son's age-but her son was closer to me than any I'd ever taken. I believed I was capable of helping Terrison. But if I was wrong, how could I forgive myself? How would his family forgive me? Should I have told Dionna to get a doctor-ordered hospital stay for her son?

No, that was a last resort. I still had that card in my hand, if I needed it. I would use it if things turned for the worse.

I hadn't seen Terrison since my husband Gregor's funeral four years ago. Terrison had been a bright, quick, energetic young teenager then. He'd been thin, just as many boys his age were. I hadn't seen him run, but I'd heard that he played center field for his baseball team and that he sprinted for the track team.

My condo had three bedrooms. One of them I kept pretty empty, in case a guest wanted to stay on short notice. I was getting back from work at 5:45 and Dionna and Terrison would arrive at around 8:00. That meant I had a little time. Once I got into a comfortable sleeveless blouse and equally comfortable shorts, I set about straightening up my little place.

Keeping the condo in good shape had its advantages: I finished getting the spare room as ready as I could for the arrival of a teenage boy in about 20 minutes. Then I made some dinner and watched the news.

The phone buzzed eventually. I saw the number and smiled. It was Susette. I'd known she would call: Dionna was her only daughter. Susette still got protective of her sometimes.

"How are you, Susie?" I said.

"I'm just fine, but I hear my grandson isn't doing well at all. I just heard, from Dionna-and I had to know: are you sure you can handle it? Terrison can be hard to talk to, from what I'm told. I remember my Medgar and my Frederick when they were Terrison's age; they were real trouble!" Susette sounded a bit nervous.

"I'm great, thanks for asking," I said cheerfully.

There was a sigh on the other end. "I'm sorry. And I know I shouldn't panic," she said. "You treat people for a living. I just can't stop myself, Janice. Dionna's so scared and Terrison isn't scared at all. That's what I'm worried about."

"No matter what it takes, I'll help him. Even if he hates me for a few years afterward, he's going to get better. Do you believe me?"

"I do...but even you can only do so much! If you need help-"

"-I'll ask for it," I said. "You know, you can come visit us and see for yourself."

She said, "I'll take you up on that. A week or so from now."

"I'm glad to hear it; you know it's been too long since we've seen each other."

*X*X*

My laptop was temporarily set up in the living room and I was checking emails. I heard a car entering the condominium parking lot. Just after that, I heard a car door close and then another. I looked out the wide front window. That black-striped yellow ochre minivan was hard to miss. Dionna had arrived. She and Terrison were getting boxes and suitcases out of their van.

I automatically went outside to help them with Terrison's stuff.

I got a good look at the kid. He had changed.

Terrison was definitely a young man now. He was his dad's height; he looked 5'11" or 6' even. His shoulders had broadened quite a bit. His arms and legs looked skinny, but the muscles were very well-toned. I was used to seeing underweight people, so I was pretty confident in my estimate of his weight. He was 120 lbs., 125 at the very most. He should have been at least 155 lbs., judging by his build. His curly dark brown hair was cut very short. He was wearing long shorts, a Spurs tank-top-style jersey, and clunky-looking high-top basketball shoes. There was a thin gold chain around his neck.

He noticed me looking at him while I approached. For an instant, his eyes widened.

"It's nice to see you, Terrison," I said. "I hope you'll have fun living here. Dionna, can I help with something?"

Dionna had turned to look at me as soon as she'd heard my voice. "I think we can handle it," she said politely.

"Come on, there's too much for just you two. I don't mind helping!" I picked up the cardboard box that was sitting on the edge of the van's rear end, under the open tailgate. "Follow me; we'll put these things in Terrison's room."

*X*X*

Right after we'd gotten Terrison's clothes and belongings into his room, Dionna took off, as I'd instructed. Terrison and I went to the living room. He sat on the sofa and I sat in my favorite chair, to his right.

"You know I'm your grandmama's best friend," I said to him. "But do you know anything else about me? For example, did you know that I used to be a clothing and makeup artist for a major agency? I also did some post-capture work on the images."

"I don't know almost anything about you, Aunt Janice," he said. His voice was raw and throaty. I hated that kind of voice; it meant needless suffering.

"Just call me Janice, sugar. Now that I've got you here, I want to show you some of my work from the '80s and '90s." I got one of my super-sized portfolios.

"Here. This woman was one of our best models. Carolyn Ruth Collins-this is how she looked with a little makeup, as photographed by a professional on an ordinary day, in an unscripted moment. Take a look at the lower part of her face. Take a look at her torso. And now-" I opened the next fold in the page. "-this is Carolyn with professionally done makeup and wardrobe. See the differences?"

Terrison looked up at me and nodded.

"She's wearing a bathing suit in this shot, but you see how opaque it is? She had a thin nylon corset under that," I said. I opened the next fold. "Now what do you see?"

"Her waist looks thinner," said Terrison. "Her cheeks stand out more, too. Did they change her makeup to get that?"

"The photographer used his lights and his reflectors to get these effects," I said. "He put a filter on the lens too, to soften the light. And the finished image comes last." I revealed the final picture on the page. I looked for Terrison's reaction while I opened the fold.

His eyebrows rose. His lips drew a little tighter. This picture had a lot of impact.

"No one has ever looked like this," I said.

Terrison turned to me. "What?"

"Carolyn never looked like this. I 'finished' this photo; I used an airbrush very carefully, one millimeter at a time.

"Today, they do that kind of thing more subtly and more skillfully. They've got software for it.

"Remember, she was a beautiful girl to start with! The client wants what the client wants. The process was simple: find a slim, pretty model; exaggerate with makeup and wardrobe to make her look slimmer and 'more glamorous'; shape the lights and shadows to amplify the illusion; finish with bald-faced deception wherever necessary."

I slid the finished picture next to the most natural photo of the model.

"I heard about airbrushing," Terrison said. "Damn, though-sorry!-"

"-It's okay. I'm not here to judge you," I said. "But what were you about to say?"

The skinny young man looked a little relieved. "I was saying that I didn't get it until I saw it for myself. This is more than just airbrushing."

"You're right. Take a look at this one: Miles Tucker. He was the hottest male model we ever signed; he had commercials and ads all across the country." I showed Terrison the progression of images, just as I had shown him Carolyn's images. After Miles's sequence, I showed Terrison three other models I'd put in my portfolio.

We talked for a few minutes about each example. Finally, Terrison looked up at me and asked an important question. "Why did you do makeup and wardrobe and photo-finishing, then?"

"It was kind of glamorous. It didn't take a college degree back then. Plus, I didn't know about bulimia or anorexia or other eating disorders. They were the dirty secrets of the industry.

"But if I had known, I still would have done it."

"You would?" said Terrison. His soft hazel eyes fastened on me.

I put my hand on his hand. "Listen, sugar; there's a chance that someone will be hurt no matter what you do with your life. I hope you don't think that I've been showing you these pictures to condemn the 'evil people in the modeling industry.' I had a lot of great friends in there. I still have a few!

"I want you to know how this works. You needed to see for yourself that these pictures are fiction. Smoke and mirrors! You could think of them like a magician's act.

"These pictures are harmless to most people. Here's another thing you need to know: different people have different reactions. If you see pictures like these and you worry because you don't look like the models, that doesn't make you weak. It means you have a chance to learn more about yourself. You have a chance to grow as a person.

"You know why you're here. I'm asking for your hard work."

Terrison looked doubtful. "You're asking me to work? What do you mean?"

"I mean I want your mom and your grandma to sleep easier at night, but that's secondary. I want you to feel good about yourself. I can't do anything but help a little; if you're going to rise above bulimia, you'll have to do it from within. I'm here to support you."

"You mean you aren't going to weigh me?"

I smiled at the youth. He'd been through some sessions, all right. "No. I won't tell you how much to eat, or how often. I won't try to order you to do anything.

"I know a lot about healthy living. The first rule: you need a healthy attitude. You need to want your body to function well; that's what's most important.

"And I've taken enough of your time! You probably want to unpack and set up your room and all that. Unless you've got questions or want some help, I'll leave you to it."

He said, "Does the room have cable and internet hook-ups?"

"Sure does," I told him. "They're over here; let me show you."

*X*X*

My mornings are always early. At 5:45, my alarm rang. It was Wednesday; that was a jogging day. I got suited up, did my stretches, and quietly left the condo, locking the door behind me.

My walks and jogs are usually when I do my calmest thinking. This morning, I thought about the quiet, intelligent, vulnerable young man who had just spent his first night under my roof. I was confident that he hadn't purged last night. It was a good sign, but only a sign. When a person's routine is interrupted, she or he often takes two or three days to adjust before returning to that routine. Besides, a change of address is usually stressful. That kind of stress makes one tired; he might have been so tired that he had skipped throwing up for that one day.

Well, I don't just teach positive thinking, I practice it. I told myself that we were building momentum. I would do a great job of intervening. Terrison would substitute healthy behaviors for unhealthy ones. Providing alternatives was part of it, just the way enlightening him was.

I luxuriated in the gentle morning light. It was late spring; it was southwestern Georgia; it was a wonderful place and time. Terrison had been an athlete several years ago. Now he wasn't. He hadn't yet admitted it to himself, but he'd quit because he was weaker and more easily injured than his peers now. Could I get him back into the sunshine and remind him how fun it was to simply run?

*X*X*

It was 6:20 when I got back home. There was no sign that Terrison was awake yet. I didn't know when school started for him. Oh well, I'd find out soon.

I took a quicker shower than usual, on the off-chance that my young house guest would need it right away. I got dressed for the day and went to the kitchen. I wasn't sure whether I ought to make breakfast for both of us. I put on an apron and made some white rice with a little ham and a fried egg. It would be easy to save the extra rice and ham and frying another egg or two would be simple.

No sign of Terrison when I finished preparing breakfast. I started eating.

The sound of a door and then the shower running told me that something had wakened him. I took my time with my juice and my food, because I still had to give Terrison a key to the condo before I went to work.

I gathered my purse and briefcase. I turned to the Weather Channel and looked at our forecast. I started checking my texts.

Terrison appeared from the hallway.

"Good morning," I said. "There's rice and ham, if you want. Here's your key to the front door, too."

He looked less tired than he had the day before. I smiled and put the key in his hand. "I might be back a little early this afternoon, but I might not," I said. "Have a good day! We can talk when we both get home."

Sure, it might have sounded like I was making him a really low priority. He was a senior in high school, so I thought that was a risk I could take. What I had to do at this point was build some trust and show him that I wasn't going to smother him or make demands.

*X*X*

My workday went by quickly. I had six patients to counsel. One of them was new to me; the others I'd seen before. One of the girls was still having more difficulty than I had hoped; I referred her to a physician who could (and hopefully would) give her a prescription that would help with her anxiety.

A few minutes before 4:00, I got back home. I figured Terrison would be there already and he was. He was in the kitchen, drinking a vitamin-rich smoothie. He turned when he heard me coming in.

The young man was in a talkative mood. "Were you really in my grandma's class?" he asked.

"Sure was. I knew her all through grade school and high school."

"You just...don't look like her. You don't talk like her. You look like you're Mom's age."

Compliments like those don't miss the mark. "Thank you, sugar!" I said. "I'm careful about how I treat this body; it's the only one I'll get, after all."

Terrison didn't flinch from my gaze. "I'll only get one, too. I know that. And I know you want me to gain weight-"

"-Not really," I said.

He leaned back against the counter behind him, looking at me skeptically. "You don't...really?"

I went to the kitchen and stood in front of him. "I want you to be healthy. Up here." I touched his temple. "I think that if you get more self-respect, you will gain weight, but that's just an effect. I want you to feel good, in your own skin."

"How?" he asked.

"There's too much to tell it all at once," I said. "That's why it's not easy to beat a disorder. But for starters, I want you to know that you can feel better than you do. Remember how good you felt when you were playing ball and running track? If you stop throwing up, your body will start functioning better right away."

"Everyone's going to be so much better than me now," Terrison muttered. "I won't ever catch up."

I put my hand on the side of his face. He was startled. "Actually, that's exactly what you'll do. You'll get good again. You need a new challenge.

"Here's what we've got: old challenge was to stay thin. You did. It's no challenge anymore.

"New challenge is to become healthy and strong.

"You know who thinks you won't be good in sports anymore? You do. Your peers do. But do you know who's seen kids in your position go on to run in state track meets and win tennis and basketball championships? I have.

"Step one of the new challenge is that you stick with me through the 5k race coming up six weeks from now."

He smirked. He didn't laugh, but he smirked.

"You're thinking, 'That's no challenge.' Okay, young pup, prove me wrong."

His smirk faltered. "I think I can do it. But I've never run five kilometers before," he said.

"If it was easy, everyone who tried would succeed. Fact is, most don't," I told him. "But you have youth on your side. Fitness is two components: diet and exercise. I never got certified as a trainer, but if you want me to show you what runners need to fuel their bodies, or some stretches, or some workouts, I'd be happy to."

"...Okay," he said.

"Here's what you need to be ready for, young man," I said. "Your body is going to change. It's going to look different. You will feel that it is a good thing. You will love the new you."

*X*X*

It went slowly during the first week or so. (Dionna called me once during this week. I lied to her and said he was eating more. I was a little sorry to do it, but I preferred it to letting worry continue to gnaw at her. She would see whether Terrison was making progress or remaining stuck in his rut quite soon.) In the earliest days, Terrison cut back on how much he'd been eating. That did not worry me; since he wasn't going to 'purge' it, he would need less food in the beginning of his healing process. Soon enough, he would eat more and drink more and he would begin to gain mass and strength.

The best signs were that he began to sound better and look more rested. He was only throwing up at school, or he had managed to quit doing it altogether.

I did my part by complimenting him and encouraging him often. As he began to start looking and sounding healthier, I engaged him in talk more often.

pacifist91w
pacifist91w
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