Tuesday, October 6, 2009

Erica Rivera Interviewed by Katie Drummond of True/Slant

INSATIABLE:  A Young Mother's Struggle With Anorexia by Erica Rivera

One mother’s war: Q&A with Insatiable author Erica Rivera

At only 24, Erica Rivera seemed to have it all: a white picket fence in the suburbs, a job as a teen counselor, a husband, and two young daughters. But dig a little deeper – or check her medical records – and it became clear that Rivera was falling apart. Her marriage was ending, credit card debt was mounting, and, oh yes – she was running 70 miles a week, subsisting on a meager diet and whittling her body down to the bone.

Four years after the vicious resurgence of a childhood eating disorder, Rivera has written INSATIABLE, the most candid, poignant memoir of war with one’s body that I’ve ever read. Rivera recounts, in unabashed detail, the battle that nearly killed her. What started as a post-baby weight loss plan soon turned into binging and purging, obsessive exercise and anorexia. Every element, from her nightly dinner (steamed vegetables, 1 cup shrimp) to her medley of unconventional attempts at treatment (a Reiki worker, astrologer, nutritionist, masseuse, tattoo artist and two aestheticians), is laid out starkly, without pause or respite, page after page.

And Rivera, who shares custody with her ex-husband, doesn’t shy away from detailing how her illness affected her children, whom she says “[were] as restricted by my diet as I [was].” Throughout Rivera’s health crisis, her two daughters, Julia and Lola, patiently endured the instability at home, the frequent trips to grandma’s and Rivera’s “Zombie Mommy” persona. And while many eating disorder patients find solace in counseling, in-patient treatment or other more conventional medical routes, Rivera consistently dismisses the options. Without her daughters, that dismissal could have killed her: a photo of Lola and Julia is what saves Rivera from a suicide attempt, when she glances at it and reneges on a plan to swallow a cocktail of prescription drugs.

Her daughters saved her, but writing gave Rivera another reason to work towards recovery. Still in the throes of illness, Rivera left her job as a residential teen counselor and started using words to explore her struggle. Soon, she was enrolled in the Creative Writing Program at the University of Minnesota and publishing guest columns in the local Star Tribune. And that’s where INSATIABLE comes in: though Rivera had read a number of memoirs, she’d yet to find one that addressed the precarious balance of a mother torn between her children and her eating disorder.

And so she wrote it. INSATIABLE is dark, yet richly funny; raw yet refreshingly candid. Somehow, Rivera weaves a story that is both terribly sad, and, at times, absolutely hilarious. I was lucky enough to ask Rivera, who now writes full-time, a few questions about the roots of her illness, the fragility of recovery and her decision to share every gritty detail with readers.

Your approach to treatment and recovery included medical intervention, but it didn’t follow any traditional “in-patient” program. Do you think recovery can be boiled down to a medical methodology, or are these illnesses simply too diverse and individualistic?

Traditional in-patient treatment felt too “one-size-fits-all” for me, though there certainly are cases where hospitalization is necessary for the survival of the patient. Women with eating disorders tend to be very headstrong. They are also extremely intelligent. It is my belief that unless the patient has an active role in planning her recovery, lasting change will not be possible. I had to do treatment “my way”, despite the mistakes and the set-backs, in order to feel empowered enough to overcome the eating disorder.

Eating disorder treatments often aren’t covered by insurance companies, because patients don’t fit the diagnostic criteria. Do you want to see disorders re-evaluated? And what about these “new” disorders, like orthorexia or diabulimia? What do you think distinguishes someone with a “focus” on health/fitness vs. an “illness” ?

Yes, I think the diagnostic criteria should be reevaluated, because a lot of women fall through the cracks of the insurance system. I still need treatment for eating disorder-related health issues despite no longer meeting the DSM-IV criteria for anorexia. The health “care” system has been a major source of frustration in my life this year. I’ve had to fight insurance companies several times.

As for these “new” disorders, I think there is a thin line between being passionate about healthy living and an eating disorder. I think many women with eating disorders hide behind the athlete/bodybuilder/yogini veneer (I know I did). A yoga teacher I know distinguishes between harmful and healthy like this: “Does your behavior shrink your world or expand it? Does it isolate you from others or increase your sense of connection?”

As with any addiction, when what you thought you controlled starts to control you, when it’s no longer a choice but a compulsive act, when you start breaking promises in order to maintain the behavior, or when you become so obsessed that you’re distracted from everyday life, that’s when you’ve crossed the line into illness.

Maybe my eye is trained to notice, because of the focus of my journalism, but I see more eating disorder memoirs on the market. Why do you think they’ve surged in popularity? And what made you decide to share your story, when much of it was so personal and probably difficult to put out there?

I don’t know how to explain the surge in eating disorder memoirs except to say that our culture must be more willing to explore them now. I decided to share my story because when I went looking for motivation and inspiration to begin my journey of recovery, I did not find anything written by a woman in my particular situation as a young, single mother. There were memoirs about teenagers or 20-something women without children recovering from anorexia, there were books for parents of anorexics, but there were no memoirs specifically about young mothers with anorexia.

Since writing INSATIABLE, I’ve been both shocked and saddened by how many women I’ve known for years have only now come forward and admitted that they, too, have battled eating disorders. These illnesses thrive on isolation, secrecy, and shame, so I think that the more people who tell their stories, the better for all of us.

I’ve had a number of people tell me that genetics loads the gun, but environment “pulls the trigger”. What’s your take on this? And do you worry about your own daughters with regards to hereditary traits, or environmental factors? How are you working to keep them from avoiding what you endured?

I agree with the theory that both nature and nurture play a part in the development of eating disorders. As for my daughters, the genetic component is out of my control, so I do my best to model healthy eating and exercise behaviors. I focus my praise on attributes other than their looks. They’re still so young, we haven’t had too many issues regarding food and body image yet, so I’m not qualified to offer up concrete suggestions for older children. Parenting is a learning process. I just take it one day at a time and do the best I can.

When I finished your book, I wanted a tidy ending and I didn’t get one. Do you think someone can ever fully “recover” from an eating disorder, or do you think it’s just something to manage throughout one’s life?

I’m glad you didn’t get the tidy ending! The conclusion of INSATIABLE was really important to me because I didn’t want to sugar coat the process of recovery. Many of the memoirs I read ended with the proverbial Prince Charming riding up on his white horse, proposing marriage to the author, and bam! “I’m all better.”

I didn’t have that moment. In fact, I don’t believe there is a single “light bulb” moment when you can claim victory over an eating disorder.

After my first bout with anorexia as a teenager, everyone sort of dusted off their hands and said, “We’re glad that’s taken care of!” I think that was a major mistake; there was no preparation or warnings about relapse.

My recovery as an adult was (and continues to be) much more mundane. It’s a decision, one I have to make over and over again every day. It’s not good material for a fairytale ending, but it’s my truth. As for the future…I don’t want to be fatalistic, but I feel as though the eating disorder just might be my cross to bear. It’s possible it will haunt me the rest of my life. Acknowledging that it may hover in the background forever feels more realistic to me and therefore, more manageable, than expecting a blemish-free recovery.

In your recovery, what were the biggest factors? What struck me was your passion for writing, and love for your kids. But I’m curious to know – when you were bottoming out and at your worst – what was the click that got you through (if there was one)?

I credit my recovery mostly to my daughters. If it weren’t for them, I can’t say where I’d be right now. For me, it took something outside myself to spark that change. That’s not to say that women without children can’t recover; they absolutely can. But I think that in order to dump your eating disorder, you have to fall in love with something bigger than yourself. Some people fall in love with God, or animals, or art. I fell in love with my children.

As a complement to that, having a talent, a mission, an interest, a passion—anything more captivating than the eating disorder—in which you can invest all that energy is essential to recovery. Writing was—and continues to be—that avenue for me.

And on a more superficial level, how is your physical health? Was your body able to rebound, or do you still deal with repercussions? Are you still running these days?

Unfortunately, I don’t think my body will ever fully rebound from the damage that I did while I was anorexic. It’s been almost four years since my initial diagnosis and many of the consequences of my extended starvation are just beginning to show up.

This year has been a hard one for me, physically speaking. I was recently diagnosed with osteoporosis and I am still amenorrheic. I’m not looking to have more children, but if I were, I don’t know if that would be possible now. There are also other health issues that I believe to be related to the eating disorder (allergies, high cholesterol, etc.) though my physicians have yet to pinpoint the exact cause.

As for my running, it is nowhere near the level it was while I was anorexic. At my sickest point, I was running 10 miles a day, seven days a week—in addition to lifting weights, swimming, cycling, and doing yoga! My entire life revolved around preparing for, participating in, and recovering from exercise. I’m still experimenting with the “right” level of activity for me, but suffice to say I don’t think I’ll run any more marathons. My body simply won’t put up with the abuse.

I had no idea how long-lasting and severe the damage to my body could be. I still don’t know. I’m scared to see how my body will hold up 10, 20, or even 50 years from now.

This is why I felt compelled to write the book. I hope the women who read the book will see it as a cautionary tale and re-examine their behaviors. When I was anorexic, I felt so omnipotent. Now I can’t stress enough that eating disorders cause serious harm and they can be fatal. Had I known then what I know now, I’m sure I would have made different choices.

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