Collapsing Into A Craving During Treatment For Bulimia

This is the seventh part of a nine-part series chronicling Iris' 46-year battle with bulimia. To read the other parts of the series, go here.


I hurriedly stuff caramels into my mouth. The same caramels I bought weeks ago. The same caramels that never before had posed a threat to my "no binge" resolve -- because, hey, they just weren't "my thing."

As always, the caramels rested in the cut-glass crystal bowl -- the one I regularly passed on my way to turn on the TV. The one I was now frantically digging my fingers into, pulling out handfuls of caramels, unwrapping them as fast as I could, and heedlessly popping them into my mouth.

Where was the pride I felt -- only this morning -- when I noticed the bowl was still filled to the brim with those butterscotch colored wonders?

That is why this sudden turn of events is so utterly terrifying. Only the night before, I was busy jotting down my random observations for the upcoming book I hope to publish on my successful battle with bulimia. And now I am once again enveloped in a whirling, jolting lack of self-control.


I hurriedly stuff more caramels down my throat in an effort to ward off such disturbing thoughts. I do not pause to savor the velvety sweetness as the caramels make contact with my salivating mouth. Then I heedlessly propel myself into the empty kitchen, and with even greater force of movement, pop handful after handful of bite size licorice bits into my mouth too.

I go back for more caramels. The bowl is empty. I'm numb, but not nearly numb enough to stop the fear from coursing through my veins. Is that what a relapse feels like? Like a bull charging a concrete wall -- courting disaster?

I groan.

"It's only a mini-binge at this point," I try to reassure myself. "I can stop before I inflict real harm."

I circle the kitchen island again and again, without reaching for more licorice. My breathing slows in response to the rhythmic, repetitive looping movements. I am beginning to shed the numbness. I blink and become more aware of the time, the bright lights, my sweating brow, and my racing heart. That familiar feeling of acute fullness is there -- more full than I am comfortable with -- but not bursting-full.

I clench my hands together. I draw deep, ragged breaths. The urge to grab anything sweet in sight is subsiding.

I wonder if things had gone differently had I been able to stay in the moment and slowly savor each caramel square and each mini stick of black licorice? Would I have been able to stop myself from stuffing the candy mindlessly into my mouth? How many pieces of candy would it have taken to satisfy my hunger, subdue the craving and vanquish ED-like behavior once more, if I had followed the therapy template to Slow Down and Savor?

I'm left pondering, but not purging. But I am also left anxious -- more anxious than I previous was -- over being without outpatient support for the next two weeks. I have two weeks looming ahead without intensive outpatient treatment and support. Can I make it on my own?

I am traveling to see three of my sons, two daughters-in-law and all my grandchildren. Spending jam-packed time with my adult children and their families is a scenario ripe with intensity and promise, reflecting the yearning in me for a sustained and highly pleasurable connection with those I love so passionately. Will I be able to maintain my serenity if my high expectations aren't met?

Being ED's love slave for 45 years makes me feel like a battered woman. And though it has been a full moon cycle since I have binged and purged -- and even though ED at times seems quiet and benign -- I am not completely reassured. His power force can erupt at any time -- often without prior warning. His command over me conjures up images of an uncontrollable epileptic seizure erupting from my body -- just like my evening encounter with the caramels.

I am no fool. I know what works for me: accountability -- knowing that three days a week I am an outpatient at an eating disorder treatment center.

It's the eating disorder treatment program in its entirety -- being present and watchful -- that keeps me in a constructive, energized and pro-active mode. Binge and purge free.

"What is your biggest concern?" Dr. B asks me at my last meeting of group before I depart. "Your biggest fear? The negative behavior you most want to avoid if things don't go perfectly?"

"Overeating to compensate for unfilled yearnings for more intimacy and closeness," I shoot back automatically.

"Well, what are the consequences for you of overeating?" she continues to probe.

I pause to consider. "Well, of course, the likelihood of purging increases. But also bloat, weight gain, disgust," I carefully list. "Oh yes, and disappointment, bad mood, discomfort and indigestion. And asking myself the same old question I always ask after a failed intervention: Why do I put myself through all this?"

"Hopefully, through treatment, you will move closer to an answer," Dr. B murmurs kindly. "For now, though, what can you do to prevent bingeing?"

I ponder this before replying. "I guess I can practice Mindful Eating, as opposed to Unconscious Eating. You know, what we are learning here - to be aware of what we put into our mouths. Slowing down and savoring the experience of tasting, chewing, swallowing."

Dr. B remains silent.

I hesitate. "Hmmmm, what else did I learn?" I ask myself out loud. "Oh yes," I exclaim excitedly. "Keep safe snacks ready on standby for when I start to feel ravenous," I blurt out triumphantly.

Dr. B knits her brows, her mouth in a firm grimace.

"Did I say something wrong?" I ask Dr. B, my body flooding with trepidation.

"No, Iris" she replies softly and patiently. "But you omitted an acronym that we here at the treatment center pay great homage to: HALT: Hunger. Anger. Loneliness. Tiredness. Those are the triggers."


She is right. As I am poised on the brink of a two-week journey, I need to hold that concept close. I need to internalize that the only thing HALT does in relation to binges is start one, not halt one.

As always, I welcome your comments, your feedback, your thoughts.

If you want more information about my forthcoming book Tales of a Bulimic Baby Boomer, or to sign up for my weekly newsletter, visit or follow me on Twitter @IrisRuthPastor.

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