Purge: Rehab Diaries

Purge: Rehab Diaries
by Nicole Johns
2009
274 pages
ISBN: 978-1-58005-274-0
Cincinnati Public Library

I got this book out of the Cincinnati Public Library when I saw it on the "New Books" shelf. That particular library visit was during Brain and Behavior II (which included pretty much all of the psychiatry that we're going to see). I thought that this might be a useful read because while I think that I know a decent amount about most types of psychiatric treatment, I didn't feel like I really knew much of anything about the treatment of eating disorders.

For the purpose of learning more about inpatient eating disorder treatment, this book was certainly useful for me. I think that it was also useful for me in that it is forcing me to face the reality that I actually have somewhat limited sympathy for eating disordered patients. I find them frustrating. I feel this way even though I believe that their disease is a real one. There were points in this book, when Johns sneaks off to purge after a meal, and I literally wanted to reach into the book and slap her upside the head. This is a woman who has serious heart arrhythmia at the age of 22 due to her eating disorder. She really needs to stop vomiting. Really. Now.

Now as someone that is very seriously considering a career in child and adolescent psychiatry, this is obviously an issue that I am going to have to work on, so I have to admit that it is useful to be able to acknowledge it at this point in my life. I'm not sure really what I'm going to do about it, but I guess admitting that you have a problem is the first step, and I admit that I really have a problem here, and that deep down inside, I not-so-secretly want to feed those girls a cheeseburger. I think they'll feel better.

To be fair, I think that part of my struggle is that Johns expresses some of the stereotypes that so often go with eating disorders that I personally think undermine my ability to take them seriously as medical disease. She describes herself as a perfectionist and an overachiever that is looking for control in her life, over and over again. I know that perfectionism is linked to eating disorders and on and on, but I am an upper middle class, over-achieving, perfectionist, white woman from the east coast, notorious for putting unreal expectations on herself. And seriously, I love a good cookie. Too much really. I need to stop with the cookies.

There is a part of me that realizes that because I fit the demographic of this disease but find it so foreign, so unimaginable, that should make the idea that it is genetic/medical/biochemical all the more legit. Because it's not just being a perfectionist. Really. And it's not just always wanting more from yourself. There is something else going on there. But the patients and doctors and general public so often attribute this disease to women taking control of the an area of their life that they can control when they feel that other parts of their life have gotten out of hand. I think that's a VERY bad way to think about it. Because, really, that description includes the words "something they CAN control" with regards to the eating/exercising/purging habits of these women. And I have to believe, if I want to have sympathy for them, if I want to ever be able to develop into someone that hopes to be able to deal these patients in any sort of therapeutic way, that it is not something that they can truly control. I have to believe that they have lost control and that the goal of treatment is to help them find it. Because if starving themselves or throwing up after all their meals IS a choice, then I want to feed them a cheeseburger. With Bacon.

Johns does a good job of capturing that out of control feeling, and she does a decent job painting a picture of eating disorder treatment in a way that I think was useful for me to encounter. This is an adequate memoir for what she says in the prologue she is trying to accomplish, but as one of the recent crop of memoirs from people too young to be seriously writing memoirs, it's really middling.

That's not to say that reading this is not going to affect my thinking, because it has. It challenged me, but that is more because it made me realize something a little bit ugly in myself than because it is an outstanding piece of writing. Still, for what I got, I am grateful. The thought process that pops into my head listening to people describe their eating disordered behavior is different and downright mean when compared to that which is in my head during accounts of other psychiatric disorders. That's something that I am going to have to deal with, something that I am glad I can admit to myself now, while I have a long time to wrestle with it. Because if nothing else was clear in this book, these women need some help.