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Companion Guide for A Season in Hell

QUESTION 1: WHAT EXACTLY IS THE MATTER WITH REGINA HATFIELD?

Eating Disorder

Regina Hatfield has an "eating disorder." Technically, she is suffering from both anorexia nervosa and bulimia nervosa. However, before considering the specific signs, symptoms, and Latin psychiatric labels, it is important to remind ourselves what the phrase "eating disorder" means. An eating disorder is a collection of eating habits, weight management practices, and attitudes about food, weight, and body shape which result in:

• Inefficiency in the fulfillment of academic, familial, occupational, and other responsibilities.
  
• Misery in the form of food and weight obsession, recurrent anxiety about control, guilt, helplessness, hopelessness, and violent mood swings.
  
• Alienation in the form of social anxiety, social withdrawal, secrecy, mistrust of others, and self-absorption.
  
• Disturbance of self and others through loss of control over dieting, body image, eating, emotions, and decisions.
  

A Season in Hell does not preach about the dangers of dieting and disordered eating. However, the film makes it very clear that the IMAD characteristics apply to Regina's life. These characteristics help to remind us that both anorexia nervosa and bulimia nervosa are very serious problems for the person and others.

Anorexia Nervosa

• An intense and irrational fear of body fat and associated experiences (e.g., feeling full, seeing the scale register a gain of one pound, being given even a modest amount of food to eat).
  
• An iron determination to become thinner and thinner, regardless of other people's alarm at self-starvation, significant weight loss, or drastic weight management practices.
  
• A distorted perception of body weight or body shape, such that the person feels fat even when emaciated or literally sees fat on the body where others see none. This often contributes to a denial of being ill.
  
• An unshakable refusal to maintain a healthy weight for one's age, height, and genetic constitution. This leads to a drastic weight loss and to maintenance of weight at 15% or below the weight expected.
  
• Abnormal reproductive functioning. In females this would mean the absence of three or more consecutive menstrual cycles when they would otherwise be expected to occur.

In essence people who suffer from anorexia nervosa are driven to starve and otherwise purge themselves in order to lose body fat, to weigh less, and to keep themselves under control. Ironically, and tragically, as starvation proceeds, the person loses control over hunger, thoughts, emotions, and choice. Food, calories, eating, weight, and weight management come to dominate the person's life, and woe to anyone who tries to disrupt this private, obsessive&emdash;compulsive system.

Many people associate anorexia nervosa with shocking emaciation. Regina Hafield looks gaunt and haggard at times, but she certainly does not look emaciated. Indeed, many viewers will probably envy her slender appearance and her "victory" over chubbiness. Yet it is clear that Gina meets the criteria for anorexia nervosa. Signs and symptoms to look for in this regard are:

(1) Gina's weight loss of 60 pounds in one summer, resulting in a gaunt and tired appearance. Her sister claims that Gina ate only "rabbit food" for that period.

(2) During that summer Gina became increasingly "scared to eat" and increasingly frightened by her dwindling willpower.

(3) During that summer Gina tried to sweat weight off by wrapping herself in Saran Wrap and sitting in a car with black interior and the windows rolled up.

(4) Her father reports that, as Gina lost a large amount of weight, she "couldn't seem to slow down." Although not a criterion for anorexia nervosa, such hyperactivity is a commonly associated feature.

(5) Gina's hatred and loathing of herself as a chubby girl. This fueled her fear of fat and her determination to become thin and popular.

(6) Tumultuous mood swings, as seen in Gina's screaming bouts with her father and her putting a fist through the wall.

(7) Gina's preoccupation with food and calories, as noted in Mary Jo's recollection of her first meeting with Gina, and as seen in Gina's tour of her kitchen.

(8) Gina's palpable anxiety about what happen if she stopped watching her calories and her weight.

(9) A very thin Gina says, "I still feel fat."

Bulimia Nervosa

• Recurrent and secretive episodes of binge&emdash;eating in which the person consumes a large amount of food in a rapid, automatic, and helpless fashion. The food consumed during a binge is usually thought of by the person as "bad" or "forbidden" because it is rich, sweet, or otherwise fattening.
  
• Recurrent attempts to undo the immediate effects of binge&emdash;eating and the anticipated weight gain by purging oneself through self-induced vomiting, reinstating a restrictive diet, vigorous exercising, or using drugs (diet pills, laxatives, diuretics).

People with bulimia nervosa suffer from self-perpetuating and self-defeating cycles of binge-eating, etc. Restrictive dieting sets the state for mounting hunger and negative emotional experiences, which trigger the desire or even the need to binge-eat. Binge-eating may produce short-term relief from tension, but, as more food is consumed in a helpless fashion, there is increasing anxiety and guilt about weight gain and "being bad." Purging eliminates these negative feelings, but also serves as a sharp reminder of the increasingly prominent role of the loss of control in the person's life. This motivates further restrictive dieting and other forms of perfectionism, thus resetting the cycle. Over time the process may become a habitual associative chain, such that bingeing and purging legitimize each other.

Regina clearly meets the criteria for bulimia nervosa. Signs and symptoms to look for in this regard are:

(1) The Thanksgiving dinner where Gina's was feeling so starved that she gave in and went "on a frenzy," devouring food until her stomach was painfully distended. Viewing her temporary disfigurement, she became convinced "all control was lost" and that she would instantly become fat and stay that way forever. This motivated her to induce vomiting. The connection between dieting, bingeing, and purging is reiterated later as Gina in her apartment describes consuming and purging 6 creme&emdash;filled donuts and an entire tray of bacon.

(2) Gina's misguided belief that she could, to paraphrase her, "have her cake and not have it, too." She thought she could control bingeing and purging for the purposes of indulging (the "full feeling"), anesthetizing her emotions, and weight management. However, as is almost always the case, the cycle became uncontrollably habitual. By the time she met Mary Jo, eating and drinking had become such threatening experiences for Gina that was throwing up even small amounts of food and non&emdash;caloric beverages.

(3) The loss of control that becomes an increasingly sad refrain through the second half of the film: The "Apple Stack Cake" incident; the "christening" of her apartment; her almost off&emdash;hand admission apartment that she has been that she had been throwing up every day; a desperate Gina driving along, describing a week of hell, bingeing and purging every day, going through 50 dollars just on junk food. This culminates in Gina's final soliloquy about the anguish of clinging to an eating disordered life and more powerful dread of regaining weight and normal feelings.

(4) Her parents' description of an "animalistic" Gina eating so much food that they literally could not keep enough groceries in the house to feed her. Her father describes Gina as a "ghost," "slipping" from the kitchen (to obtain food) to the bedroom (to binge) to the bathroom (to purge).

(5) Gina's description of using repetitive binge&emdash;eating and purging to manage feelings of anger and disappointment isolate herself from others.

(6) Gina's startling characterization of binge&emdash;eating as being like "sticking your finger in a light socket. . . . . . it goes on and goes on and goes on." She then describes herself-induced vomiting as "kind of like somebody unplugging it . . . . and after that I don't feel nothin'."

(7) As noted previously, Gina's preoccupation with weight, fat, food, calories, eating, and control/loss of control. Her conviction that slenderness is her anchor (and not her cement shoe) is revealed when her facial expressions resentfully challenge Mike's contention that he would have gone out with her even if she were the chubby girl revealed in her high school picture.