The Industrious Doctor

Cass knows the importance of being adaptable. She’s changed careers a few times, her latest achievement being a PhD in Health Psychology. Her analytical brain likes to dissect and study behaviour patterns; that’s what she does for a living. She’s also an expert at dissecting her own behaviour. She’s one of those souls that feel considered, measured, with a whole dollop of fun on the side.

We first met through a mutual friend 11 years ago. We knew about each other’s bulimia via our friend. Not that we ever spoke of it – it was too uncool to bring it up around the chip and dip table.

I hadn’t spoken to Cass for six years when I emailed to ask about an interview. To my relief, she swiftly agreed as she’s all about busting open shame too. When I saw her I discovered she was in full bloom – seven months pregnant. Here is our chat.


BB: How do you think bulimia has affected you?

Cass. Everything that happens to us leaves an imprint. And yes, that definitely has. I think some of the compulsions and emotional underpinnings of bulimia are still there so it’s an issue of management.

BB. Do you mean food compulsions?

Cass. When I was younger I used to just want to eat and keep eating – binging started when I was quite young – but I actually don’t have that drive anymore; it will be channeled into something completely different. My experience is that there is an energy, and it needs an outlet, and somehow over the years I have managed to disengage from food as my outlet or source of fulfillment, but along the way it’s transitioned to other things, like wine, smoking, other irresponsible and not self-caring behaviours. When I was really having a hard time with bulimia I would think, I’m not going to eat dinner and I’ll have a glass of wine as at least I won’t binge and purge.

BB. I know that one – eating’s cheating. You said it started really young for you. What happened?

Cass: From about nine or ten years old, I was at home alone a lot. My brother was five years older than me so he would be off with his friends and I would come home and eat. I would make, like, eight pieces of toast and eat them watching Guiding Light soap opera, and then have a bowl of cereal and then take a nap, and then my Mom would come home and we would have dinner.

BB. Did she know?

Cass: I don’t know. There was some talk about my weight. We had a sabbatical year in California and when we came back, I was about six or seven, and at a small rural school, slightly chubby, and the kids were like, ‘Quarter pounder and fatty fatty two by four’ and there was a lot of feeling like I didn’t fit in. I used to go home and say to my Mom, ‘None of the kids like me because I’m fat.’ You know, being one of the last ones being picked by the sports team.

There were issues of self-esteem and then there’s parental involvement. My Mom would say, ‘Don’t worry, nobody liked me when I was kid either and sing that song nobody likes me everybody hates me…’ It probably wasn’t a good thing to say but people do what they can. Then my parents divorced and I started getting more concerned about my weight. My Dad was trying to help me but he had some strategies that probably weren’t the most effective; he took some cool behaviourist approaches, like rewarding weight loss with money and punishing thoughts about eating with elastic bands around the wrist. They were interesting things to try and get my behaviour more streamlined and help me lose weight. He was doing the best he could.

In retrospect, my parents never said, ‘You’re OK the way you are’ or ‘let’s get out and exercise together.’ This is what kids need. You don’t need to be told what to do but you need your parents to demonstrate and be good examples, but you don’t know until you know and they didn’t know. I guess my Dad had his own challenges with being a chubby kid and he was quite worried about me being chubby, he was trying to protect me from being hurt.

I was gaining more weight and I remember trying on some chaps for horseback riding and my Mom saying, ‘Jesus Christ you can’t even fit into a man’s pair of chaps.’ So I would get upset, and then come home and eat food and they did know I was gaining weight but they didn’t know why and never asked how much I was eating afterschool. Too much time on my own.

BB. Where did the idea for bulimia come from?

Cass: It didn’t really at first. I was about 12 and I really wanted a boyfriend and I remember flipping through a magazine and looking at all the pretty girls and thinking if I looked like that, then I’d have one.

It seems silly but they do seem to have an influence and at school, all the popular kids were pretty and slim. So I decided to go on a diet. My Dad and Stepmother were about to be married and it was around that time that I decided to stop eating desserts.

BB: Quite a sensible diet.

Cass: Yes I was quite onto it! So the last dessert I had was at their wedding. It gave me a real thrill to make a decision and start to see a result. And then you know where that goes. I went form ‘I’m not going to eat desserts to I’m not going to eat more than x many calories a day.’ A slow change into anorexia. And I lost all kinds of weight and stopped menstruating and got all my downy hair and had no energy. I became really thin, anorexic as you’d be clinically defined. Mom was like ‘oh my god, you’re dying,’ and Dad was going ‘Here, eat ice-cream’. A total switch.

And my Stepmother would say ‘she’s not going to eat it’ and there were all sorts of weird dynamics around that as she stopped eating too as there was an interesting interplay for Dad’s attention. As my eating or not eating became more of a focus then she would start picking at her plate and not wanting to eat at dinner time and things like that. At first my Dad was really happy that I was losing weight and there was a lot of ‘oh my, you look so great’ and all this adulation, but then there was a point where I remember people saying ‘OK that’s enough now’ but I had a fuck you kind of attitude.

I dropped down to wearing kids sizes again. Then, at 14, I went to a nutritionist who told me I had to start eating, to survive. So I started to make diet muffins and eat diet yoghurt, only eating weight watchers dinners because I knew exactly what was in them. Meanwhile cooking full fat foods for everyone else saying ‘Eat, eat!’ like an Italian grandmother.

And then I don’t know what happened but I guess there was some release. Thinking maybe I could allow myself to have one cookie but then I had 15. There had been so many brakes and restraints, and then it just came off. I don’t remember whether it was part of being self-destructive or actually a healing thing, allowing myself to eat, but it was torturous because the guilt and feelings of disgust and concern about the weight gain hit me. But then that was it. I was bingeing. And the body wants to do that after it’s been deprived. I had an animalistic drive to eat. And eat a lot. And that’s what started the bulimia. But then it was like wow, how can I deal with this? I had to get rid of the food. I don’t remember having educated myself about bulimia beforehand, I just did it.

But it didn’t work. I ended up gaining a lot of weight within six months. My Brother said, ‘You’re turning into a fat cow again’ and people at school were saying ‘What’s going on with you?’

Nobody intervened then. No counsellors. On the one hand they were saying, ‘Great she’s eating and gaining weight’ and then it was like, ‘Holy shit, you’re really fat now.’ But after that I had a calming period. The tumultuous time faded away and I got into music and singing at school and the weight fell away naturally. My body started to balance out.

BB. And the bulimia stopped?

Cass. Yes. I don’t think I ate the healthiest and I was still worried about being fat but at 16 I was introduced to other things…. It tapered off. It came back at other times but always with some sort of emotional trigger. The next time it happened I was about 18 or 19. I had started to gain weight again and that thing, that worry, ‘oh my god, this is horrid’ the intensity of the feeling, it’s visceral: feeling the way the body’s getting bigger, feeling a little extra roll, noticing pants a bit tighter which set off alarms, which led to restriction, which again, I couldn’t maintain and then the cycle began. And that happened a few times up until the age of 30. And I think the last time was for a year and a half, pretty steadily and was so bad I was leaving university lectures because I had to go home and eat.

There was a real emotion regulation component, a spur of something going wrong: a relationship break, something where self-esteem was tied up.

BB. That’s the addictive part of bulimia; it becomes a crappy tool to drown bad feelings and experiences.

Cass. I think it is an emotional tool when you’re younger too but there isn’t a template for understanding it. Kids who regulate well, emotionally, and are listening to internal signals then they don’t hoe into twenty pieces of toast after school either. Emotions just intensify as you get older and the kind of experiences you have.

BB. I agree with you about how to show children and teens rather than tell them about food regulation and body acceptance – enjoying exercise, getting them outside, loving meals together. No restrictions, no bingeing. I learned about diets from my mother but she was only doing her best at the time.

Cass. Diets don’t work.

BB. No they don’t. But they’re great for a multi-million dollar industry. I was 19 to 30 too. So how did you stop?

Cass: I didn’t want to do it anymore. Turning 30, I wanted to stop. And I did. I had one slip up, relationship related, depressed. But I’ve done pretty well. Although the drinking did increase pretty significantly. That’s been something else. You know there’s been a couple of points where I have felt that urge but now I can eat some chips and say, ‘I’m eating more than I should and that’s OK, but that’s enough, put it away.’ And with chocolate. I recognize what that signal is. It’s the same feeling that comes up for a drink or a cigarette, there’s a kind of need or a want. More!

That’s a learning process and there‘s still a lot of work that I need to do because I’m not good at moderation. But I have learned to do it with food. And I managed to quit smoking on my 35th birthday.

BB. How have you been with your body since?

Cass: I still get pretty grossed out with myself when I put on weight and the way I have managed my experience around that is exercise, so as long as I get a certain amount that I deem to be appropriate then it dampens my neuroticism. But if I don’t get it then I start to complain about getting fat all of a sudden and it’s irritating to everyone around me. And me. I told my boyfriend, ‘I’m like a dog; I need to be exercised every day.’ Otherwise my energy is all over the place. It’s compulsive behavior but at least it’s channeled in a proactive way. My boyfriend was like, ‘Couldn’t you have picked sex?’

So back to your first question about bulimia and how it manifests in different ways: in obsessive behaviour fuelled by an addictive drive, looking for ways to manage emotions and allowing energy to be there without reacting to it, but there’s a layer of judgment and all that lingers, which makes it hard to be a chilled out person.

BB. Unless smoking cigarettes and drinking wine…

Cass. And then totally fun.

BB. So how does it feel getting bigger, being pregnant?

Cass. It feels like I’m doing something wrong because getting bigger was always bad and that’s never gone away. I’m trying not to eat too much more and going to yoga but it is hard.

BB. I battled those feelings when I was pregnant too. I even went to a therapist who told me to think of myself as ripe, not fat.

Cass: I have different feelings about the whole experience. Sometimes I lean into it and feel how intense it is in terms of creation and participation in life – not something I have always done, avoidance tendencies exemplified in eating disorders made me come out of life, hide – so in some ways, this, and the commitment is hard for my natural way of engaging. If I tap into the magic of it then it makes me want to cry. And then there’s a lot of time when I’m thinking wtf? What is inside me? It’s a slow coming to, warming up. But keeping up with exercise has been important for managing it. And I feel myself loosening around the weight gain as I can’t do anything about it.

Last year I started using more affirmations around weight as I used to say to myself ‘you’re fat’ all the time and I do believe you are what you think so I was becoming more mindful of that and rather than say the fat word I would say ‘you’re losing weight’ and interestingly enough I did start to lose weight. I’m conscious of what I say now.

BB. Have you heard of Patricia Moreno? She’s made a career out of teaching women that you are what you think. She does affirmation exercise classes called intensati.

Cass. No, but I do believe in the power of the mind. Richard Simmons was an early proponent of that.

BB. And he was bulimic! So let’s go back to the magazine thing, how you think it affected you.

Cass. It’s a human condition to think, ‘if this, then that.’ A sense that something better or something more will make us feel better. The wave of mindfulness that’s starting to take hold now is that we learn, at a certain age, that that’s not necessarily true. If we get the thing then we are left feeling like we want the next thing, it’s not enough. So, many people are learning to be in the moment, acceptance. But magazines do have an effect. I think it’s important to teach women critical thinking. On Facebook we’ll see videos forwarded around, like the Dove campaign, but at the same time there are ads coming at us all the time to lose weight and lose wrinkles, and everybody wants to fit in, so teaching kids critical thinking skills to discern and know the tricks of manipulation and role of industry and what’s driving it are important.

How are you with food around your children?

BB. I’m not as carefree as I would like to be, but maybe one day… I’ve tried to stop having fearful thoughts around food though. If I want the brownie then enjoy the goddam brownie.

Cass. It’s interesting, it’s not about the food is it? It’s the anxiety. The emotions going on underneath. So it’s about not channeling those feelings into food but just letting them be. That’s the biggest gift we can give to ourselves and our kids. Letting feelings be ok.

You said before, ‘maybe one day,’ and I don’t actually think that the one day philosophy is helpful, as it frames the present as wrong. Part of the healing process is letting some of the significance go, letting uncomfortable feelings rise and fall without having to engage with them or think ‘oh I’m not healed yet’ – you know alcoholics say they feel urges to drink after thirty years of sobriety but the trigger for whatever made them want to drink is just a feeling, it passes – know what I mean?

BB: I do. Because bad feelings or experiences don’t go away just because we’ve stopped vomiting. Life goes up and down. Stuff happens. We have to learn how to deal, not look for ways to numb hard times.

Cass: Yes, there is always going to be negative and positive thoughts, and feelings of wanting to self-destruct. Every major psychology theory recognizes destructive instincts. Most gods and goddesses, like the Hindi goddess, Kali is both destructive and a creative force, yin and yang, all these opposites exist. We could never expect to have a purely happy, accepting mind.

Recognizing what the triggers are, what the internal response is and how one reacts to the cascade of experiences, that’s it. I bet I will always have a neurotic tendency with slightly obsessive compulsive behaviours. Moving forward, I hope I will recognize myself more and know ‘oh that’s this thing I do when I am feeling this way’ and I won’t have to take it any further, it’s just me reacting because that’s the way I used to do it when I was feeling unsafe, when anxiety was creeping up and feeling at a loss. Knowing what my core trigger points are and major emotional buttons that get pushed – that make me feel like nobody loves me, I’m not good enough – understanding those core negative beliefs that caused me to engage in behaviours that were not healthy. If I can catch those feelings and be aware of them then I can choose my response.

I think bulimia is a highly emotional experience as well as a short term (terrible) strategy for weight loss.

A few years ago I went to the doctor and he recognized an irregular heartbeat and it was a crazy thing to get a test done and have a cardiologist say, ‘well you actually have relevant history with your bulimic past. It’s a hard thing on your heart.’

BB. Our poor hearts!? I never thought of that.

Cass. The good thing however is that if you stop it early enough, then the heart is a muscle and there is time for recovery. Plus we’re growing our hearts in other ways with self-acceptance.

BB. What’s your sense of eating disorders: increasing or decreasing?

Cass. It wouldn’t surprise me if they are increasing, there is this drive for perfection that is rampant in our society and it’s not just looks, but having the right career you feel totally happy with and having enough money to do this, and the house, and vacations, and we are constantly presented with the ideal life all around us, and we are all striving for it in some way or another and it’s hard to let that go. Inevitably we are going to be unsuccessful so the way we choose to deal with that gap between expectation and reality, for some women (and men) is going to be eating disorders, for some men (and women) it will be alcohol or violence because we don’t necessarily value or propagate self-management. It takes work to be accepting, it’s not easy, I have learned a lot about it but you have to practice it. Every day.

BB. Wow. Thank you so much for that chat. Amazing, I feel wiser and calmer.

# That’s not Cass in the picture, but she loves water and it looks like her from behind. (Image source)

Fancy more reading?
Brave men coming out with bulimia: Brian Cuban… and Sam Thomas