“You didn’t eat all your cheese,” the nurse said as she pointed to the strip of orange on my plate.  “Don’t even try to get away with that here.”  

When the shuttle bus dropped me in the parking lot, my first thought was that I’d arrived at a posh resort, tucked in the lap of juniper-flecked foothills. Ocotillo and yucca shot up through the pebbly ground; sprinklers hammered away at lawns that stretched, languid and cool, between soft brown casitas. 

Clearly, I had no idea what I was in for. All I knew is that I was grateful to be under the abundant Arizona sun, rather than shivering in Boston, curled up under an electric blanket in my college dorm room, as I’d been for the past month. Though it was only October, my frail body was no match for the chilly fall air. After finally agreeing to visit my college’s infirmary, Just for a check-up, my dorm mother emphasized, I wound up here, in the desert. The idea that I’d have to gain weight hadn’t really dawned on me yet; I was merely relieved to be warm.

Then came that thing with the cheese, and all those sessions of therapy. Not therapy in a well-appointed womb-like office, but on ropes courses, yoga mats, and climbing walls; while walking among the cactus, grooming horses, and sitting around a campfire. Every situation was considered potentially “therapeutic.”  

We used art supplies to depict our eating disorders; I drew prison bars. We made lists of what our eating disorders had stolen from us; I wrote about the fact that, over the course of my freshman year, I’d become increasingly fearful of social situations and the food they entailed. I wrote about the time I told friends I couldn’t go out because I had to stay home and make curtains for my dorm room. No longer did I spend my weekends at fraternity parties, drinking beer and eating pizza, pretending to fit in to a world which bore little resemblance to the public high school I’d attended in far-flung New Mexico. Instead, I spent my weekends running, counting calories, and studying. And making curtains.

Once I was at the treatment center, however, all of that came to an abrupt halt. My days became a blur of therapy and meals, a process which was exhausting, physically and emotionally. But because I was sufficiently scared of how sick I’d become—at one point my heart rate dropped to a paltry 35 beats per minute, while awake—I threw myself into treatment. It helped that I was, like many anorexics, compliant and eager to please. I was being told to eat, so I did it. In addition, I was just 19, one of the youngest patients at the facility. I felt I had something to prove—to the other patients, who were older and more seasoned, as well as to my therapists, whom I saw as prescient and composed, self-possessed and at-ease. Everything I was not.     

Soon enough, my motivation flagged as the hard reality of treatment set in. The low point of my six-week stay came during my first “Quiet Meal,” which was, as expected, extremely quiet. Without words, there was no distraction, just food and all those impossibly big feelings of loneliness and anxiety I had tried so hard to deny. As I sat at that round wooden table, tears streaming down my cheeks, I realized that as long as I kept talking, flitting from one topic to the next, I could pretend that I was fine, that I didn’t need anything, not least of all food or other people. I was self-sufficient, independent, invincible.  

But in that silence, with only the sound of silverware clinking and jaws at work, there was nowhere to hide. I was raw and utterly vulnerable. It was how I usually felt, though I never let anyone know it. Here, I was surrounded. The women at the table gazed at me with profound empathy, nodding and smiling, encouraging me to press on and eat more. I wanted to look back at them, to lock eyes with the other patients and bask in their support. But mostly, I looked away—humiliated, furious, ashamed.      

Bite after bite, I forced myself to eat, until my fear cracked open and something soft, yoke-like, emerged. It wasn’t exactly hope; I was still too beleaguered by the Anorexia for that. But it was the recognition, at once empowering and bewildering, that hiding was no longer an option. I couldn’t stay home and make excuses about curtains. I would have to step into the light and let others see me, starving or fed, broken or whole.    

When I look back, it’s clear that my stay in residential treatment brought me back from the brink. At intake, I was an emaciated girl hiding behind a pillow, trying to fold herself into the couch. Six weeks later, I’d gained close to 15 pounds—a good start—and with it, a burgeoning self-respect. I had begun to remember that I could be funny, that I was good at relating to others and that I knew how to relax. And for these things, I was extremely grateful. 

That was nearly 30 years ago. In many ways, my positive experience in treatment propelled me to become a Psychologist who specializes in eating disorders, as I ultimately did. Over the course of my career, I’ve worked with thousands of people from all walks of life. Many have had eating disorders, though more often they’ve struggled with anxiety, depression, or the day-to-day challenges that plague us all. And though each story is unique, I find myself going back to the same phrases again and again: find your voice, take up space, ask for what you want. Things that once felt impossible for me.  

And though I share this advice freely–with my clients, my supervisees, and even my two young daughters–I’ve learned the hard truth that asking for what I want isn’t always well received. At one point, I told a supervisor that I couldn’t take any more clients; I wasn’t sleeping well or being effective. Instead of the warm reception I was hoping for, I was told it’s better to not be so vocal. Another time I built up the courage to tell a manager that I once struggled with an eating disorder, and sometimes worried about backsliding. She told me I should think carefully about saying such things at work.

Stigma is real. But being less vocal isn’t always an option, since it means going back to a place of isolation and pain. Healing, for me, meant having to take risks and share more of my thoughts, fears, and ideas, in order to suss out whether people are trustworthy. And I applied the same strategy to work: I needed to test the environment to determine if I felt challenged, but in a respectful, tolerable way. This didn’t mean that everyone agreed with me — in fact I often got significant push back about ideas. But it meant finding a work culture in which I felt heard and valued, key ingredients that have allowed me to grow as a leader and, perhaps most importantly, become comfortable in my own skin. 

For now, my two young daughters know that I’m mom, and that I have a job I love– even though I sometimes need to sit in silence at the end of a long day. They don’t yet know my history, or that the ghosts of my anorexia sometimes slip back in, telling me I shouldn’t speak up in that meeting, disagree with a colleague, or show the slightest sign of vulnerability. 

When my daughters are older, I will tell them about that period, and how learning not just to eat, but to control less and trust more, saved my life. I will tell them how I outgrew the paradigm of perfectionism, and that my career, health, and family all rise and fall on my ability to be tethered to the present, in full command of the skills I’ve learned along the way. And I will tell them how much I love my messy, imperfect life: because it is mine, and because I am no longer hiding. I can think of no better gift.