Review of Purge: Rehab Diaries by Nicole Johns

Despite the public understanding that the medical community has brought about regarding behavioral disorders, the stereotype of an eating-disordered young woman is still much like Angelina Jolie's character in Girl, Interrupted: attention-seeking, histrionic, and self-destructive. Author Nicole Johns offers a different and more realistic version in her memoir Purge: Rehab Diaries. She tells of her summer at an eating disorder rehabilitation center in Wisconsin: the friends she made, the daily routine of the center, and her struggles to control her urges. In so doing, Johns accomplishes what she describes as her goal with the memoir: "I chose to write about the three months I spent in residential treatment for Eating Disorder Not Otherwise Specified because there is a dearth of well-written, timely, and accurate literature about eating disorder treatment."

The most important detail of the book could be that patient Johns was not over- or underweight when entering the center, at 5'4'' and 133 pounds. As she points out, eating disorder is about controlling food and the body. The memoir develops interesting themes around self-control, social expectations, sexuality, and mental health. Purge is an excellent read for women who have an interest in any of those themes. However, because I am a male reader, I found other aspects of Purge intriguing: namely, the memoir is an excellent insect-on-the-wall view into the real-life experiences of young women in American culture. When Johns describes her feelings of not being good enough, such as how she wasn't the "pretty girl," I really came to understand the pressures that girls must deal with as they grow up in our culture. As with any behavioral disorder, the extreme outward behaviors come from a desperation at not controlling inward emotions.

Johns' book is not a confession, though. Reading the text, I noticed an emotional distance from her subject that makes somewhat shocking behaviors -- obsessive weighing, excessive exercise, and caloric restriction (i.e. starving) -- seem to be happening to someone else. This is the odd reality of mental health illnesses: the patient knows what is right and wrong, but is compelled to do the unhealthy behaviors anyway.

The book is a definite page-turner, and Johns' writing style combines an expository style with just enough literary flair to make each sentence worth reading. Her short chapters build a plot-driven narrative instead of a navel-gazing one. Johns writes with a thoughtful introspection one does not often encounter from twentysomething writers. The creative chapter headings kept me wanting to read the next short chapter.

Purge is not perfect, though. Ever since James Frey got reamed by Oprah for publishing his memoir with elements of fiction, the memoirist toes a thin line between manipulating her content for effect instead of presenting what actually happened. Sometimes staying true to what happened works brilliantly for Johns, for example when she writes of the rural Wisconsin staff's backward attitude toward same-sex desire (in contrast to the patients' progressive attitudes). But I would have liked Johns to recreate dialogue from the other patients at the facility; largely leaving out dialogue makes the memoir more accurate because it's solely from the author's point of view, but the other characters do not get developed. This shows most strongly at the end of the book, when a well-crafted ending is ultimately disappointing because while the reader knows the author, we are left striving to understand her other characters -- and thereby feel like we could still understand eating disorder more fully.

However, these are minor complaints. As a memoir of the experience of an eating disorder rehabilitation facility, Purge is the most interesting read I could imagine. The book is full of insights into young women's minds. The reading comes alive when we see patients acting out; I understand much better our culture's thoughtless ideal of "thinness." The raw honesty of a passage about what it's like to have an all-consuming urge to puke up one's meal -- and thereby purge the troubled self -- makes Purge a courageous book.