Catharsis: CAPS and eating disorders

April 15, 2015, 9:01 p.m.

I have been struggling with bulimia for nine years. As of now, I have been purge-free for three months. And I attribute this exponential improvement from daily binge-purge cycles largely to my experience with CAPS, and Vaden’s eating disorders team. In response to Stuber’s Daily article arguing that CAPS provides inadequate care for eating disorders, I would like to correct a few misinformed statements and inform readers about the state of eating disorders on campus through personal experience.

The first time I sought help, I came into the session skeptical and arrogant — I was a veteran of this “bad habit,” having read extensively of the damage I was doing to myself, and was wary of bad reviews of CAPS. The therapist handed me a packet detailing things I already knew and gave me general advice that, as confirmed by other students in Stuber’s article, was easy to say, and nigh impossible to do without support. An appointment with a physician resulted in an EKG and a push to get bloodwork. Though I understood that she was concerned about the potential for cardiac arrest due to electrolyte imbalance, I thought that this was moving too fast too soon — I felt uncomfortable about her brusqueness, felt like she was using scare tactics to pressure me into treatment I didn’t want and wasn’t ready for. I left disappointed, resigned to the belief that because I had been purging for so long, my body had now been acclimatized to this way of life.

The second time I sought help was at the behest of my mentor, Steven Sust. My original intent was to talk about social anxiety and family issues, but, upon revealing that I was bulimic, the therapist saw that this was a more immediate concern. After two transfers, I found my current therapist, who has been instrumental in my recovery, and was placed in the care of an exceptional eating disorders team.

This team exceeded my expectations. At my worst, I was not pushed into treatment or medication; my care providers responded quickly to my messages, went out of the way to make themselves available (to correct Stuber’s article, the eating disorders team offers appointments at all business hours, not just Wednesday mornings; separate appointments are made with different providers). Most importantly: they didn’t make assumptions — about who I was, where I came from, why I did this. They listened to what I had to say and gave me control over my care.

But I know that this is not the case for many people; I just had the lucky side of inconsistency.

CAPS has been highly criticized as of late — for lack of accessibility and unacceptably ineffective care. Though these horror stories and sources of indignation are most certainly justified, dismissing CAPS as a lackluster resource for students broadly ignores the lifesaving role it has played for many students. It’s not perfect, nor might it work for everyone, but students should not be discouraged from at least attempting to seek help at CAPS.

Alternatives to Vaden include a limited number of support groups available on campus and residential staff. Programs like the Body Positive, the Queer Eating Disorder Support Group and the online Healthy Body Image Program have many attractions, but their niche target population and narrow methodology can exclude or turn off a wide range of students who are seeking help; finding the resolve to actually participate in these programs is already difficult enough. In the same vein, some might not want to impose a burden on their peers, RAs and RFs. CAPS provides a confidential and secure place for those who are not ready to “come out” with their eating disorder.

But CAPS should not have to be the sole bearer of responsibility of every student’s psychological well-being. At Stanford, we talk about the stigma of mental illness, and have largely broken the silence surrounding depression and disability; because of this, we are better able to support these individuals with unwavering compassion and support. But many people with eating disorders feel alone — it seems as if no one else has this same problem, and it’s simply too shameful to admit out loud. The stigma of eating disorders can be derived from stereotypical views of vain ultra-dieters or from self-shame, but the truth of the matter is that eating disorders are more than just a media-inspired need to be thinner, self-imposed by white, upper middle class young women. It’s as much of a self-destructive coping mechanism for life’s vicissitudes as other means of numbing pain.

It’s incredibly easy to hide an eating disorder — chalk it up as a quirk, strange dieting, long bathroom trips. But it’s also incredibly easy to be triggered by an offhand comment about body image and food waste, by being the lone person who can’t eat with everyone else, by feeling like a fraud when the truth is more terrible than covering up with a lie. From binging and purging after each meal to eating my first slice of pizza in 10 years, CAPS has helped me to regain focus and to be more confident in who I am and what I do — as Charlie from The Perks of Being a Wallflower would say, I’ve been able to “participate” in life with an exhilarating lightness.

With or without CAPS, overcoming an eating disorder requires more than silent, individual travail. We need an environment that feels safe enough to “come out,” to have the support of our peers, our communities.

It takes a long time to feel comfortable in your own skin. But it’s entirely possible to see the scars fade into faint discolorations, to feel a bit more grounded in who you are.

And you are not alone.

Vivian Lam ’17

Contact Vivian Lam at vivlam25 ‘at’ 

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