The Think Piece Interview: Marya Hornbacher

Marya Hornbacher is known for many things. Writing the definitive memoir on anorexia in Wasted, published when she was 22. Writing the definitive memoir on bipolar disorder in Madness, published when she was 32. Writing an acclaimed novel in The Center of Winter. And now writing two books for Hazelden, one on using the twelve-step process to address mental health, Sane, and the other on using the twelve-step process without a belief in a higher power, Waiting. We caught up with her in St. Paul to talk writing, mental illness, addiction, spirituality, David Foster Wallace, the danger of books, and the belief that one day what troubles you can be gone.

TP: When you’ve written your non-fiction books, did you have an intention of having them be used as resources, or did you primarily write them to tell your story?

MH: You write a book for two reasons. You write a book because you have an interest, and you write a book because you think it will be useful or helpful to people in some way, even if it’s as entertainment, which is a perfectly valid reason to write a book. One of the things I tried to do with Madness—less so with Wasted but certainly with Madness and the two Hazelden books—was think to myself, Why am I writing this book? Because there are a lot of memoirs out there. What I find useful is how I manage to get a handle on some difficult things. People really have a hard time managing mental health, managing addiction, things like that. So when I wrote Madness, it was important to get those details in about how do I live with this. And then as time went on it became a much bigger question that came up in Waiting. Waiting is a book essentially about ethics. It became a question not about how do I live with this but how do I live? That was a dramatic shift in my life. I had two memoirs that I needed to say, Here’s eating disorders, here’s mental illness, this is what it really looks like inside. Having done that, I sort of felt like, I did that, now I have to see what else there is, philosophically, ethically, spiritually. The books that will come next will have much more to do with that, then, than the other issues. I mean, you don’t need to have two memoirs when you’re 40. That about says it all. So that’s a long way of saying, That’s why I wrote those two books: to get help.

TP: How did your relationship with Hazelden come about?

MH: I contacted Hazelden and said, I have some book ideas; are you interested in them? And they said, Start writing. So I did. There’s a book used in the twelve-step community called Twelve Steps and Twelve Traditions, and Sane is essentially Twelve Steps and Twelve Traditions for people who trying to manage both addiction and mental illness, for people who are trying to understand dual diagnosis, because it’s a hell of a thing to have both going on at once.

TP: It seems like the dual-diagnosis assessment is relatively new in the recovery community.

MH: It is, but that’s the conundrum of it. They’ve known since the 1980s … people in treatment facilities have known since the 1980s … rather, research professionals have known since the 1980s, that the only way to effectively treat people with both mental illness and chemical dependency is to treat them simultaneously. But the strategy used by most treatment centers, and certainly by most physicians, has been to treat one or the other first, and the other one just pops up worse. The more I went after my mental illness, the worse my alcoholism got. The more I went after the alcoholism, the worse my mental illness got, because they were not being dealt with simultaneously. They’re genetically linked really tightly. For example, when I was in treatment for alcoholism and drug abuse, they had a group of people who were the mental illness group. We did nothing in regard to the mental illness. We were just our own group, because I think they thought we might be disruptive to other groups (laughs). There were people who had this issue, people who had this [other] issue, and then there were the people who had mental illness. The only thing we had in common was that. We were otherwise totally incompatible as a treatment group. But I didn’t go to Hazelden. Hazelden has developed a protocol and a curriculum dealing with dual diagnosis and now it’s being put into place in the other treatment centers.

TP: Is there enough funding and resources being dedicated to research?

MH: Not at all. You know the decade of the brain, in the 1990s, we learned a little about depression, and then we learned a little bit about how to manage Parkinson’s. That’s about it. There’s still so much undone and nothing’s being researched. There’s no research money in helping people with mental illness or addiction, because we sort of think of people who have them as a waste of social resources. Diabetes gets … I’m thinking of the National Institutes of Health, [which] gives a couple billion to diabetes research every year. The amount they give to bipolar research is so insignificant they don’t list it. The amount they give to depression is under a million. People make that much in a year. What’s so frustrating is [that] the loss of productivity and the cost to social services is so high that it’s really shortsighted to not research these things. And so you have people like me who are perfectly functional when medicated and doing what I need to do. When I’m not medicated and doing what I need to do, I am a waste of social services. I become absolutely nonfunctional, which has always been frustrating to me. The idea that you’re going to become nonfunctional when you know you’re fully capable is purely frustrating. It’s like you try to stand up and, a minute ago you could walk, and suddenly you can’t walk, and you’re like, What happened? What changed?

TP: In Madness you wrote about hospitalizations being a regular part of your life, almost something that happened on a seasonal basis. Have you been hospitalized recently?

MH: Nope. I haven’t been hospitalized since 2007.

TP: Wow. Why?

MH: That’s one of the things I find most fascinating about mental illness recovery, which is not a phrase you hear very often, except in mental illness recovery circles, because the idea for most people is, if you have a mental illness, there is no recovery. I’m not going to have a situation where I had bipolar and I no longer have bipolar. But the process of recovery is concurrent with the process of learning to manage. You know, you manage the mental illness, but its effects on you lessen and lessen and lessen until they basically fall away. I can’t imagine now being in the hospital. I’m sure that it’s possible but it’s so far from the experience of my life right now. My life right now is extremely dull (laughs). I basically write, clean house and make dinner and see friends and whatnot, but it’s not that constant crisis, constant chaos. When I give talks to families of people who have mental illness, they’re all so shocked by the crisis that has suddenly erupted in their life. I have to say to them, It might take 10 years, but things will not always be in chaos, things will not always be in crisis.

TP: How present do you find the stigma of mental illness to being a barrier to people accepting treatment?

MH: It’s very powerful. Some people just don’t want to take meds. I have never fully understood why. It’s very odd to me. I mean, nobody knows I take meds. When I’m sitting in a coffee shop, I don’t wear a sign that says I take seven or eight meds every morning. And even if I were wearing a sign, it wouldn’t bother me much because those seven or eight meds work really well.

TP: Can you tell us about your early days in AA and your struggle to get with the program since you didn’t, and don’t, believe in a higher power?

MH: I really struggled with the concept of a higher power, and needing a higher power, when I was going through my alcoholism treatment. The twelve-step groups can become not just spiritual but religious. I had a hilarious thing happen the other day in a group where I was saying that I felt certain things in my life had been allowed by grace. And this little old man looks at me and goes, His name is God, and I’m like, Wow, that’s certainly definitive. For a while, [I thought] if I don’t get this God thing I don’t have a chance of getting sober. And I do think a spiritual life is necessary, whether or not you believe in God, and that’s why I wrote Waiting. Atheists are missing out on something important. To take away all spirituality from existence leaves us very lonely. Not that there’s a God-sized hole in each of us, because I don’t buy that, but we are human and social creatures, and so getting to the point where we can be alone with ourselves and not spiral takes work, ongoing work. This just popped into my head. The most peaceful I’ve ever been was when I took a hike around Lake Superior, by myself. It took forever. It took weeks. I don’t think I wrote about that in Waiting, but it was the most peaceful I’ve ever been, and I came back and got a divorce! It wasn’t that I was so peaceful I didn’t want to be married. It was just I had to get some thinking done, and I went out and I came back and went, OK, this is not a joyful combination anymore. I’m not serving this relationship in any kind of way. I need to be serving the world in a different way. This marriage is not helping anybody (laughs). It was really difficult because a relationship is a nice pod in which to exist. There’s this idea that there’s two peas in the pod and everything fits and everything’s right and you provide all needs for one another. I have not found that to bear out very well.

TP: You’ve never liked the notion that writing memoirs is therapeutic. Do you still feel that way?

MH: Maybe they are therapeutic to some people, but I think that’s a notion we apply to writers, that we all write for catharsis or for self-expression, which is a phrase I hate—to express myself is moot. I have things I want to say, things I want to examine, but I use the book to examine those things, not to paint myself all over the page, which is why I’m sure it’s very confusing, because two of my books are memoirs. But actually my psychiatrist has never been so relieved than when I finished Madness. He goes, Thank God that book is over (laughs). Writing Wasted and writing Madness were both very, very painful experiences. You don’t go [joyfully] into writing about something that’s wildly stigmatized; you don’t go galloping in and think, This will be really fun.

TP: I’ve often wondered what the impact is on the writer who writes about a difficult period. Is it healthy to relive the past that way? It almost seems dangerous to me.

MH: I think books are dangerous. Not for the reader, necessarily—sometimes for the reader. But for the author. I look at David Foster Wallace. I haven’t read his biography, the new biography. I adore Wallace. I was in a hotel room in Boston on a tour when I opened up the New York Times that day and read of Wallace’s passing and thought, Oh my God, I just sobbed because I always had the sense that he was not OK. He was so tormented in some ways, and it comes through in some of his writing, and it comes through in his interviews, and it comes through in some of his exes’ commentaries about him. But when I realized he was stuck on a novel, just stuck on The Pale King, he was just at a horrible stuck point, I’m like, the book killed him. That’s a horrible minimization of all the factors that went into a decision like that, but when I looked into it, not only was he struggling with the book, he had just been taken off all of his medication. He was on some medication for depression. What a loss. What an incredible loss.

TP: It seems like he was haunted by being defined by Infinite Jest.

MH: Yes, once you publish a book you are defined by it. You either fight that or you accept that and continue writing what you want to write and what you think will be useful and hope those new books find their audiences. I’m always going to have written Wasted. There’s nothing I can do about it now. But I wrote the book when I was twenty-two, and should one ever be defined by what one said or did when one was twenty-two? Probably not.

TP: What was the effect on your having written Wasted?

MH: The primary side effect of my writing Wasted was the worsening of my alcoholism (laughs). I couldn’t really relapse into eating disorders because that would have been bad form. But I also had effectively just turned twenty-one, so I could drink anywhere at any time with anyone. Also, the assumption of the crazy alcoholic writer is still very alive and well, and so I got a pass for a long time on how much I drank and how crazy I got when I drank because people would say she’s just a crazy writer. Fact: I indeed was a crazy writer (laughs). The effect of Wasted, still exists. There are people out there who only know about that book of mine, who find out I’ve written other books and go, Oh my gosh. The assumption is sort of, Why? And I’m like, Well, I don’t know, I had some other things to say (laughs). And so I have a bit of a battle with Wasted because it came out when I was so young. Written in the voice of such a young person. It serves its purpose, it has its place. But I can’t imagine writing it now. I can’t imagine having the experience either. I think that’s because I wrote it and now it’s encapsulated in a book. And I so I look at the book and go, Ugh. I mean, I think the book is fine, but I haven’t read it in many, many, many years. I give lectures on eating disorders, but I’ve now been in recovery for twenty years. Twenty years of recovery from an eating disorder is unheard of. That’s what I want to bring to people when they ask can I give a lecture on eating disorders: I say, absolutely, I’m going to give you a recovery lecture.

TP: Do you believe it’s possible to not only recover from a disorder and learn to manage it, but actually one day shed it?

MH: I do. The thing they say about eating disorders is that you’re always going to be dealing with this. Being told something is always going to be with you does two things to you: makes you feel like you’re being haunted—this thing is tied to your left leg and you can’t shake it—and it gives you an out from recovery. You think, Hell, I’m always going to deal with this, why recover? If it’s always going to be there, why not be deep in it? It’s a strange, strange logic, but it works that way. I started questioning, Is this something that has to be with me? Or can I walk away from it? And eventually you realize, I’ve got what I need in my life, I can walk away from this. So the eating disorder is not only [something that] doesn’t trouble me anymore; it isn’t mine. I’ve kind of disowned it and it’s disowned me.

Whereas with alcohol and drugs … I do very much see eating disorders as an addiction, because they have such an addictive property—you lie, you manipulate, you do anything for it—it becomes a part of your life, it becomes another person to you, you let the rest of your life go. It’s got all these addiction qualities, but I’m genetically predisposed to want to drink. You put a drink into my body, I will not have one drink, I will have ten. One is never enough. One is too many and 100 is never enough, that whole phrase. So if you put a drink in front of me, I can ignore it, yes, but if you put the drink in me, I’m toast (laughs).

But with an eating disorder, I think a similar factor would be if I went on a diet, or something like that, it would trigger all those old habits of like, Why would I bother dieting? I know how to do this. I have a way of doing this that is more effective, more efficient, more devastating, more deadly. They’re similar in that way, but I think it is easier … there’s a structure to where to go to get help to recover from addiction; there’s no structure to get help to recover from an eating disorder.

TP: Do you believe you get better as a writer as you get older?

MH: Absolutely. Your writing gets better and better as you get older, for two reasons. You have more practice. You’re practicing hopefully every day. You’re practicing, practicing, practicing. And you’re also gaining experience, not so you can write about it, so you can have it. Have it as your back story. Have it as your framework in which to look at the subject you happen to have in front of you. Until you have that framework, you’re really just shooting from the hip.

TP: What are you working on now?

MH: I’m working on two books now. One of them will be another Hazelden book, about service. My editor there, Sid Farrar, is phenomenal. He used to be the editor in chief at Milkweed Editions. The current book is a book of short stories, and I’m having so much fun! I’m enjoying it the way I enjoyed writing Waiting. I loved writing Waiting. Oh, God, what a joy that was. It was such fun to write. It was such a difficult, challenging, intellectual process of articulating how to have a spiritual life without a god. It was such a quandary to get that into words, because people have been saying to me forever, How do you have a spiritual life without a god? I’m like, I just do.

TP: You must get so much feedback from readers.

MH: I do. I get tons of letters, on Sane and Waiting. I get letters on everything, except [I get only] the rare letter on The Center of Winter. Most letters I get are people’s stories. The greatest gift you can give an author is to say, You told my story.

TP: How does it feel when someone says you saved their life?

MH: People say that and I can’t hear it. You just don’t listen. That’s like too big a statement. That’s like, You’re the best person in the world. It’s hyperbole. You’re like, OK, I’m glad the book was useful because that’s all it ever is.

TP: How has your writing process changed through the years?

MH: The thing I’ve learned is I’m much more prone to trust my instincts now than twenty years ago. Sid didn’t make a lot of changes on Waiting or Sane; they were pretty much just written and he’d have a tweak here or a tweak there.

TP: Does it ever frustrate you to not get to all your ideas?

MH: Not really. I can put work away for another time. I was working on a novel that I will finish, but I realized I wasn’t old enough to write it. I didn’t have the research capacity for it. It’s a novel about the second Russian Revolution. I got maybe 200 pages in and I thought, OK, I’m putting it in a drawer until I know how to write it. And then I went on and wrote Sane and Waiting, and now I’m writing short stories and another spirituality book and then I’m going to go back and write this novel on the Russian Revolution.

The one great thing I had about getting a very early start on my writing career was I had a huge amount of time to experiment, to write in different genres. The thing of it is, I have a book of poetry, I have a book of short stories. There’s all manner of projects. I’m never bored. At the same time, one needs to have, if not a day job, some other major project, that  gives you that framework for how you see writing, because writing in isolation gets very isolating. It’s like writing without reading. How can you do that? What do you write? You’re not learning. If you’re not learning, you’re writing the same thing over and over, and that’s just a waste of everyone’s time.

TP: How productive is your writing life now?

MH: Right now I’m in more of a slow writing period; I’m doing maybe a story a month. I write for at least an hour on the days that I’m not writing and for many hours on the days that I’m writing. I’ll write anywhere from one hour on a non-writing day, to twelve hours on a writing day, to fourteen hours if I want to make myself crazy.

TP: Do you ever get blocked?

MH: I used to struggle with the blank page. How do you start? Then somewhere along the way I realized that the first line will arrive. Sometimes you have to start with the second line and realize, this is not how it starts, and just start anyway. I’m always getting the first line at inconvenient moments. Sometimes I’m in the shower, sometimes I’m in the middle of a conversation … sometimes I’m in the middle of a conversation, and I’m like, Hold that thought, and I’ll have to write down that first line. But the thing that has always made me struggle is the beginnings, just because they’re not there yet. So sometimes I start with the ending.

TP: What else fills your time?

MH: I teach in the graduate creative writing program at Northwestern University and I’m in a master’s program for counseling at Hazelden. When I graduate, I will be a licensed professional counselor and a licensed alcohol and drug counselor.

TP: When will you be done?

MH: It’s two years packed into one year, so it’s like twenty credits a semester. It’s an astounding amount of work! I’m going to be in school solidly three days a week, writing two days a week, then I’ll clean the house. It’ll be a year and a semester once I find appropriate funding for my mental health semester. I’m so excited about it, it’s just ridiculous.

TP: It sounds like becoming licensed as a counselor is a natural extension for you. Do you sponsor people going through mental health recovery or addiction recovery?

MH: All the time. Actually an interesting thing that’s come out of Sane and Waiting, people contact me by e-mail and ask me to be their sponsor, so I have sponsees in British Columbia and Toronto, one in L.A. and one in Chicago. It’s all by e-mail. When they write and ask, What do I do about step 4? I write back and say, Have you tried this, this, this, and this? It’s different than taking an hour out of your week. I get a lot more communication with them if we’re e-mailing each other back and forth as often as they need. It’s people with various interests, needs, backgrounds. That’s the blessing of sponsoring. You’re with people who are totally different than you, but you have this thing in common. It’s amazing. The witnessing of that. It’s the greatest privilege in the world.

This interview has been edited and condensed for publication.

For more on Marya, go to www.maryhornbacher.com.

Adam Wahlberg

Adam Wahlberg


Founder of Think Piece Publishing

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