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Wasted
By Marya Hornbacher. New York: HarperCollins Publishers, Inc., 1998, 289 pp., $13.00.
Wasted is a graphic and gut wrenching autobiographical memoir of a female suffering from two eating disorders, anorexia and bulimia. Marya Hornbacher provides the reader a unique opportunity to vicariously experience the developing course of these disorders through her candid and compelling words. Hornbacher breaks down the pop-cultural and trendy façade currently associated with eating disorders and effectively communicates the severity and seriousness of these pernicious illnesses.
Reading this book may help psychotherapists gain insight into the personal cognitions and emotions experienced by an anorexic or bulimic. Reading about Hornbacher’s tragic and painful struggle may allow the psychotherapist to see their patients’ enigmatic and distressing world more clearly, promoting greater empathy and understanding for their cognitive and emotive experiences. It is hoped that reading this book will assist clinicians to have a deeper understanding of their clients, helping them to feel more comfortable disclosing personal thoughts and feelings.
This book may serve as a great resource for the parents and friends (specifically age twelve and above) of females suffering from eating disorders. After reading this book, it is likely that they will feel as if they have lived in the mind and the body of a woman with an eating disorder. They will have gained an intimate understanding of how food and hunger can infiltrate every inch of one’s skin and remain inescapable from one’s thoughts. In addition, the readers may develop a small sense of the struggle, fear, and pain that anorexics and bulimics endure as a result of their disease.
Readers are able to develop this understanding through Hornbacher’s explanation of eating disorders from a physiological, psychological, and emotional perspective. For example, she defines the medical diagnostic features of both eating disorders. Providing these definitions will educate the otherwise unaware or misinformed readers as to what characteristics define the disease. She also relates the personal meaning that anorexia and bulimia hold for her, and what may be representative of others with these disorders. She writes, “Bulimia is linked, in my life, to periods of intense passion, passion of all kinds, but most specifically emotional passion…it acknowledges the body explicitly, violently…my head was never quiet…in excess…Anorexia – not just a ‘diet,’ not just losing a little weight, but a full-blown, all-out big bang die-of-starvation,” (p. 93).
In addition to becoming more familiar with the medical and personal meanings associated with the disorders, the reader also gains a genuine and comprehensive perspective of the dysfunctional thoughts and emotions people experience when having this disease. Hornbacher writes that after she became bulimic at age nine, “It began to have a force and took on a life of its own. From this point on, there are no memories that are not related to food or my body or barfing…I did not put a bite of food in my mouth without considering, if, when, I would throw up. I did not ever look in the mirror without thinking, FAT,” (p.10).
This book may also answer readers’ questions as to “why on earth” a female would engage in these self-destructive and possibly fatal activities. Hornbacher shares the role that the media, her parents, friends, society, and her individual characteristics played in developing and maintaining her eating disorder. After living in her mind for 289 pages, the reader will have gained an understanding of the harsh reality of eating disorders and what it is like for someone who is suffering with these diseases. With this newfound perspective, they will be able to better comprehend the struggles and pain anorexics and bulimics endure. As a result, they may be more comfortable approaching the psychotherapist or patient in regard to what role they may play in assisting in a client’s treatment.
In addition, they may become more responsive and cooperative regarding a psychotherapist’s suggestion to become involved in psychotherapy sessions. With the help of the psychotherapist, they may learn to become an additional support system for the client. During treatment, family and friends can help foster and maintain the client’s work through recovery, especially in between sessions when the psychotherapist is not present to offer support and the client may be most vulnerable.
For the anorexic or bulimic client, assigning the reading of passages from this book during the course of treatment and processing them in subsequent treatment sessions may be a very powerful and effective aspect of one’s treatment. The brutally raw descriptions of how these eating disorders ravaged her life help to remove the glamorous image some clients may have of them. Experiencing Hornbacher’s thought processes and their consequences may help clients to see their own distorted thinking that results in ongoing harmful patterns of behavior.
By reading this memoir clients should experience a sense of universality. Rather than thinking that their illness is unique or an anomaly they may see it as painfully shared and endured by others. It is also hoped that the detailed descriptions of the author’s continuing recovery will instill hope in the reader that she too has the ability to recover. Assigning this book as a part of the psychotherapy process will provide the client with “real-world” proof that a patient may be successfully treated and recover from this disorder.
However, the candor with which Hornbacher writes about her recovery, including traumatic relapses and painful rehabilitation steps, may intimidate some readers and cause them to think that they do not have the strength or will to endure the struggle of recovery. Thereafter, they may feel treatment would be pointless and recovery unattainable. In this respect, the psychotherapist may need to carefully consider the fragile nature and type of personality of each client before assigning this book. Monitoring each client’s reactions to the passages read and addressing them in treatment will be a very important aspect of the treatment process.
This book may be assigned to clients as a part of their ongoing psychotherapy because it can help clients become more aware of how tragic and severe the illness can become if left untreated. Hornbacher includes a portion of a letter her friend wrote to her after seeing her several years after she had developed an eating disorder. She writes, “I was surprised to see how little you had grown. I guess people who eat grow. And your head really looked too heavy for you to be carrying it around on your bones…I remember my friend Ryan thinking you were terminally ill and me saying I hope the hell not…” (p. 259). The author also includes numerous excerpts from personal letters, conversations, journal entries, and medical reports in her book. This feature of the book solidifies the believability and legitimacy of her story. The psychotherapist may wish to thoroughly discuss this aspect of the book with clients in order to make them aware of the realistic consequences that result from the maintenance of this disorder. In reaction, a reader may come to view this disorder as an illness that deserves immediate attention and intervention and can help increase their commitment to treatment.
Another special feature of this autobiography is the inclusion excerpts from various poems and portions from Alice in Wonderland before she begins each chapter. She begins her story by quoting Neitzsche, “The awakened and knowing say: body I am entirely, and nothing else; and souls is only a word for something about the body,” (p.1). It seems that Hornbacher entices and captures the reader’s attention with the mysterious nature of a poem. Thereafter, she explains the abstract meaning of the excerpt by defining it concretely in terms of her eating disorder. Including a medical, psychological, poetic definition of anorexia and bulimia may provide the reader with a deeper understanding and appreciation for her experiences and her illness. They may come to understand how the disorder can contaminate and destroy one’s mind, body, and soul. It is hoped that once readers have developed a more complete understanding of the true nature of eating disorders they will be more prepared and apt to endure the arduous process of treating them.
The psychotherapist may specifically chose to discuss the poetic verses included in this book when dealing with clients who seem uneasy and hesitant toward beginning therapeutic dialogue. Some patients may be intimidated by the medical terminology and psychology jargon associated with their illness. To foster communication, clinicians may redirect the clients’ discomfort with the disorder by requesting that clients convey their personal interpretations and feelings in reaction to the poetic verse in the book. Initially discussing the poems may offer a more approachable and engaging topic for clients to share with the psychotherapist, which may foster an open and effective communicative relationship that would have otherwise been stifled by the patients’ fear of discussing the diagnostic features of her disease. Once the clients have discovered a personal meaning and understanding of their disorder, they may be more comfortable and verbally responsive to treatment and when asked to consider the medical and psychological elements of their disorder.
While this book provides the intended audience with a vivid perspective into the world of a female with an eating disorder, it is missing several essential elements. Hornbacher provides an articulate description of short-term health consequences someone with anorexia or bulimia may endure. However, she relates a vague description of the long-term physiological consequences of these dietary behaviors. The reader may not comprehend the fact that engaging in eating disorders may cause irreversible and permanent damage to one’s body. By not including this aspect of the disease, the reader may not truly comprehend the serious and potentially fatal outcome of anorexia and bulimia. To compensate for this missing feature, the clinician may be advised to supplement this book with additional information regarding the health problems associated with anorexia and bulimia.
Additionally, Hornbacher relates a vague description regarding the impact that her eating disorder had on her family, friends, and lovers. Because this book only includes a superficial discussion on this topic, the psychotherapist may wish to devote time in treatment focusing on the effects that the client’s disorder may be having on significant others in her life. It is important that the client be made aware of the fact that by engaging in maladaptive dietary patterns, she is also hurting those who love and care for her.
Despite these limitations Wasted may be utilized as an effective tool to supplement psychotherapy with clients suffering from eating disorders. This book provides psychotherapists, clients suffering from eating disorders, and clients’ friends and family members a profound insight into the idiosyncratic thoughts, emotions, and baffling experiences associated with anorexia and bulimia. With the newfound insights and understanding that result from reading Wasted, clients may be better able to more fully participate in, and benefit from, the psychotherapy process and loved ones may be better able to support them through this work.