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Companion Guide for A Season in Hell

QUESTION 2: HOW DID REGINA'S EATING DISORDER DEVELOP?

Regina was a chubby child and as such had to endure merciless teasing from other children. They called her "Regina Fatfield" and the "Reh-Gheena Monster." Although her mother gently pointed out that "there's a big people on both sides of the family," Regina's father criticized her for eating the wrong kinds of food. Regina incorporated all these disparaging comments into a very negative self-image and a hypersensitivity about her weight. When she was 14 years old, a boy whom she had a crush on for several years rejected her because she was fat. Feeling this was the "last straw," she decided to change her "package." This decision was reinforced by her observation of thin cheerleaders who seemed "so happy."

She began with what she claims was a sensible diet. The result was a loss of 15 pounds, leading to a good deal of social reinforcement. This motivated her to lose even more weight at a more rapid rate, using extreme methods (e.g., eating only one-half a sandwich every other day and sweating off fluid in an enclosed automobile). In the course of one summer she lost 60&emdash;70 pounds. The changes in her body shape were followed by other cosmetic changes, such as a new hairstyle, new clothes, and a retainer. She apparently did become more popular, as she began to date frequently.

As changes were taking place on the surface, pressure was building within. She had numerous, explosive arguments with her father. Hunger was mounting and willpower declining. On Thanksgiving of that year she gave in to hunger and ate "like I was on a frenzy." The lost of control and the shape of her swollen stomach frightened her, so she induced vomiting. Thinking she had thus found a way to indulge but not gain weight, she voluntarily entered the cycle of bulimia nervosa.

At first her family was pleased to see her eating again. However, they became at first suspicious and then downright concerned when it seemed as if she could not eat anything and not gain an ounce. Moreover, bingeing and purging did not help her manage hunger. In fact, these behaviors only distorted her natural hunger and satiety mechanisms to the point where it seemed as if she was eating and purging all day long. Her parents were grocery shopping every day, and her mother even went without her diabetes medication at times in order to afford more food for Gina. Similarly, bingeing and purging were only short-term solutions to the problem of managing emotions. As time went on, Gina became "possessed" by an animalistic drive to consume food and by an explosive anger in response to frustration.

By the Fall of 1984, when she was nearly 18 years old, the situation had become life-threatening. She was bingeing frequently and throwing up 10-20 times per day; in fact, she could no longer consume food or beverages without throwing up. She was also fainting periodically, and she lacked the strength to walk up stairs. In October of 1984, through the intercession of her sister and Mary Jo, she was hospitalized at the University of Kentucky Medical Center for two months. She did well and was released.

Her eating was again chaotic for a while. Then, with the help of monthly counseling sessions at the hospital, an eating disorders support group at her college, and her own determination, she stabilized her eating and her weight. Unfortunately, following a break-up with a boyfriend, she resumed bingeing and purging at a furious rate and quickly lost a large amount of weight. Her parents and Mary Jo persuaded her to be a re-evaluated at the hospital, and thus she was readmitted almost exactly a year later.

When filming concluded Regina was still very much in the grip of her eating disorders. She is still bingeing and purging, still obsessed with food and calories and weight, still subject to frightening episodes of feinting, and still trying to convince her parents and her finance and herself that things are under control. On occasion she will see a therapist and participate in a support group, but she is clearly not committed to changing. She appears to have struck a "devil's bargain" with many of the significant people in her life, a pact which says: "I will keep my weight up to a minimum level and not behave too often in a way that will cause you alarm; in return you will not press me by asking too many questions or by insisting that I really get help." She is wearied and pained by her disorder, but too frightened to confront it.