Category: Choosing Recovery


As something of an ED veteran, I feel somewhat obligated to add something to the enormous swell of posts and articles prompted by Eating Disorders Awareness Week 2018. It’s ironic that the very thing that stops me from writing about Anorexia is the Anorexia itself*… but I’m here now, tucked in a corner of Costa, so I may as well give my tuppence worth on the topic.

Eating disorders must be one of the most complex areas in mental health and it’s for this reason that they are also one of the most misunderstood. Incredibly difficult to treat, they confound and defy loved ones and doctors alike, resulting in horrible recovery stats and mortality rates. The fact that 20% of sufferers die of this illness weighs particularly heavy on me today, as this morning’s Facebook newsfeed informed me that March 1st is the birthday of a lovely young lady I was once in hospital with… Tragically, it’s a birthday that she isn’t here to celebrate.

I’m not sure that people really understand the gravity of this illness, possibly because it’s given quite a lot of coverage which seems to mark it as a teenage phase, and possibly because it has been so closely linked to models and media. Whatever the underlying message, I speak from bitter experience when I say that Anorexia can be fatal.

And not fatal in the casual way that people use the word. Y’know, like, “Ooooh! Don’t buy the Amazon Dot! Starting a conversation with Alexa is fatal..!” Not THAT kind of fatal. I mean the kind of fatal that leaves loved ones reeling, practitioners; gutted and blamed and helpless; figures on charts revealing that 20% of Anorexics will die prematurely because of their condition.

Image result for eating disorders get help

A couple of points for sufferers

1.  Getting help early is absolutely KEY. I know many people who have recovered because they got help quickly and did so when they were young. I get that you’ve probably heard it before, and I know it might feel terribly difficult but seriously, if you think you might be struggling with an Eating Disorder, get help NOW.

I also want you to know that although many people understand their condition, you may be one of those who don’t really believe you’re ill. It’s a tough one and it requires you to be very, very painfully honest with yourself (even if you can’t admit it to anyone else yet). Eating Disorders can be like child abductors. They can wheedle and whine, coax and cajole, smile sweetly… and then, when they’ve got you, they turn. It’s a horrible analogy, but its a horrible illness.

You might hear thoughts telling you that you’re just on a diet; you just need to lose some more; you just need to have some control; it’ll be okay if you get rid of everything you eat…

It may be an increasing set of rules. You can’t have anything unless you’ve been to the gym… Your friends and family are lying to you when they say you’re looking thin… You don’t deserve anything good… Your body is something you’re deeply ashamed of… You must get fitter and faster and achieve more and more and more and eating is the only way you can be successful…

Get help. If this sounds like you, it’s not. It’s the whispering abductor. Please get help.

I’m hoping that you hear the urgency that I’m writing with. Getting help today rather than next month could be the difference between a year battling Anorexia, or a decade. And yes,  it might go against everything you think you want but believe me, there will come a time where you will thank your self for refusing to listen to the manipulating voices in your mind.

2. Anorexia, Bulimia, Binge Eating Disorder, Other Non Specified EDs are not something to be ashamed of.  It’s not your FAULT and you’re not to blame. People who love you might not understand yet, they might be angry and frustrated, but that doesn’t make you wrong. It’s an illness and it needs medical attention. Don’t think that you CHOSE this. It targets its victims and then preys on their minds.

Take some comfort from the fact that what you CAN control are the decisions you can make to help yourself. You can get help, even though it’s a frightening thought. You can be brave enough. You can take tiny steps. You can be gentle with yourself and kind to yourself by allowing someone else to support you. Pick someone who might understand something about it… a kind teacher, pastor, wise friends…

Eating disorders aren’t choices. Recovery options are… or should be so long so long as provisions are there.  (That’s a whole other post!)

Let me know how it goes.

https___www.beateatingdisorders.org.uk_uploads_documents_2018_2_edaw-sticker-6

*If you don’t understand this, I need to explain that Anorexia impacts the mind in a multitude of ways, most of which, you’d never know unless you’ve suffered it. It’s not possible to go into more detail now, but I’ll do a post on it sometime!

https://www.beateatingdisorders.org.uk/support-services

https://www.nationaleatingdisorders.org/screening-tool

 

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I’m PAINFULLY aware of the gaping abyss that lies between this post and my last. I have been having huge problems concentrating my efforts on doing any ‘personal’ writing, and the little time that I HAVE been able to focus, has been spent doing the writing that is a necessary component of a course I’m doing.

Yes. You did hear that right. A course.

I’ve now been out of hospital since the 1st of August 2017. That’s almost a whole six months. A fact that, in itself, isn’t joyously impressive. What does make it count for a little more, is the fact that I actually managed the Christmas period without OVER compensating and reigning my calorific intake in so much that I end up with less nutrition on my plate than you’d find in one of those little, green caterpillars that I used to love when I was a small child. Moreover, my weight (a fortnight ago) is pretty much the same as it was when I left The Priory.

Before I crack open a bottle, I have to admit that I was still considerably underweight when I discharged myself from the hospital, AND, my diet has been less than ‘healthy’. I won’t go into that right now, suffice to say that I still have so far to go if I am to continue this uncertain path of something like recovery.

When I came out of hospital I began to give serious consideration to my situation. A situation that left rather a lot to be desired (and yep, that is in the literal sense).

I took stock.

I’m 40.

I’ve lost my teaching career. I live back at home. I don’t have a relationship. I have no children. I probably won’t ever have that as this illness destroys all kinds of natural processes, and the body is clever enough to redirect all its resources away from ‘unnecessary’ things like reproduction, the usual hormonal changes, skin and bone health, whatever… just in order to keep your heart beating.

Stradivarius eat your heart out, right?

Right.

Seriously. This is not a great situation. But then Anorexia will do that to you.

Anorexia will take all you’ve ever valued, all you’ve worked for, ached for, bled, sweated and cried for… Worse, it’ll take all that COULD BE, and it’ll rub away, like an eraser on the same piece of paper, until it finally destroys all your could haves and all your would be’s.

That’s why, I came up with PIE.

A simple recipe for something that might look like a life..

It’s hard going, and I’m writing now because it’s all about to get harder (I think). But that’s why I need to keep reminding myself (and any other ED sufferers) that whatever battle lies ahead, it just CAN’T be as bad as the constant torture of Anorexia. The torment of eating a little more CAN’T match the constant turmoil of bargaining with the illness, running though sum after sum, compromising with the darkness, allowing it to deny us TIME and TIME again. (I’m writing this praying it’s true). The opaque sense of flimsy truth is so hard to FEEL, and yet it’s all I have if the next six months is to look different again. That’s why I’m going to carry on reversing the pattern, adding to my plate, painfully bending the bars of the cage I’m in.

That’s enough on the matter for now. This is already so much longer than I intended it to be.

The pie will keep.

I’m in that awkward position again… The one where I find myself dodging my blog because I’m too much of a perfectionist to just sit down and type just any old thing. Instead, I wait for the perfect conditions; the perfect subject; the perfect words; inspiration; motivation; perfect moment in time… You name it… body temperature, mind space, bit of wisdom, poetic stance; I could go on…

Suffice to say then, if I only put a tenth of the energy I spend fretting into actually writing, this would easily be material for about four books!

And so I come at it head on.  Ignoring the pull of perfectionism. Here are my plain words. I’ll write something more substantial soon…

Watch this space.

animals-st-francis-2As a young girl, my conviction that I was able to communicate with animals, coupled with my parents’ point blank refusal to have anything other than a goldfish in the house, gave rise to my fantastical delusion that I was the living embodiment of a cross between Dr Doolittle and St Francis of Assisi.

Nowadays, despite still loving the idea of pets, the practicalities and the expense prevent it from becoming a reality.

So, I preface this post explaining that I’m not a real ‘animal person’. Not to be confused with someone who doesn’t care about animal cruelty. I do. Controversially though, I believe that human beings are of greater worth than animals (and find it endlessly sad that the NSPCC receives less donation money per year than the RSPCA) .

(I know. I know. There will be somebody somewhere wanting to spray paint the word ‘bullshit’ across my blog as I type this).

The reason I’m explaining my general attitude regarding animals is to provide some semblance of a context for what follows.

Yesterday  I was sitting on the sofa vaguely watching the early evening news while I threaded two tiny beads on a pair of metal findings. I rarely devote my complete concentration to the TV, and use that kind of ‘down time’  to make stuff; be it crochet, origami, knitting hats, scarves earrings, bracelets… whatever the current creative obsession affords.

Suddenly, a horrible bone splitting crash.

It had come from the large patio window at the end of the room.

Dusk falls darkly now that the October sun drops faster, and from a well lit room the opaque midnight blue outside seems blacker than it really is.  I went to the window, cupping my hands against it to erase reflection.

On her back, a female blackbird lay flapping, speckled breast skywards,  trying to right herself.  It was a heartbreaking sight, such a beautiful bird, so helpless and so shocked. It had happened so fast.

Instinctively, I scooped the bird into my hands and held her for a moment, felt her rapid heart, her tiny trembling. “Best left alone,” advised my companion. “They’ll very often pick themselves up and fly away when they’ve got past the shock”.

I set her down, right side up; draw away, the tip of my heels rolling forward to my toes.

female-red-winged-blackbirdThis evening, I am struck by my shocked response to her plight. My sudden immense pity for this little bird who, even if she could find flight, will never eat again. Her beak had clearly taken the impact of the smash, the glass sheet cruelly driving the top and bottom to twist in opposite directions. Never again will her meal be plucked from the ground with pincer precision. Never will the sharp beak meet to hold food for her young.

These twinges of sadness for my broken bird are suddenly shot through with irony. I realise that, for a decade, I have systematically denied my body the nourishment it requires in order to function in the way it is meant to.

Do I  pity for it?

Do I lament the months of deprivation? The semi starved state that results in hypoglycemia? amenorrhea? the inability to stay warm? a lower immunity? osteoporosis? reduced life expectancy? liver damage?  potential organ failure?

Why is it, that I am more upset about the broken bird than I am my breaking body?

I sound like my mother when she crosses into panic mode. And there aren’t any easy answers.

What I would say, is this.

An eating disorder pushes the sufferer to extremes that no sane minded person can conceive. It seems to contradict that which is instinctual: the drive to survive that ensures the continuation of the human species. Of course, the width of the gap between the urge to survive and the urge to starve depends on how deeply entrenched the eating disorder has become. I’d like to believe, that in its infancy, the illness may have been tempered, dare I say, hampered and arrested, by a glimpse into the future damage I would sustain. I’d like to believe that, because if that IS the case, then perhaps early warnings would make a difference to someone.

What I know is that part of the pathology of Eating Disorders, is that they can  somehow usurp the sufferer’s natural born instinct for self preservation. Anorexia hijacked mine to the point where my natural response to the idea of my body being ‘well’ is, at best, indifference and at worst, revulsion. In the topsy turvey world of Eating Disorders, many sufferers equate starvation with success.

Back in the natural world, nobody wants to fail. Failure is B A D.

This idea carries over into the world of ED. What doesn’t follow, is the notion that somehow failure is death. Anorexia screams that ‘wellness’ is weakness, health is self indulgent. Being healthy means being a ‘failed Anorexic’.

I know it sounds crazy, and it doesn’t apply to every person who has an Eating Disorder. If you have a loved one suffering, it’s worth a try to gently ask them about the contradictions between the ‘well’ part of them and the ‘ill’ part. Go easy though. They may not be aware of it or they may not experience it this way.

Personally, I’m trying hard to re-program my mashed up mind, so that I can go back to thinking about health and wellness in natural world terms, rather than the conditions set by Anorexia.

The little bird wasn’t there when I checked again. She has somehow flown away. I hope she will not starve.

20170619_150530If you think that being in hospital for five months would have afforded me ample time to write, you’d be right. Difficult then, to explain that although hours at my desk stretched like the Cornish coastline, my mind contracted and contorted like 17:30 on the M25.

Inpatient treatment for Anorexia generally leaves my insides steeped in a fluid sense of agony. Words curdle in my throat, congeal in my head. The process of weigh restoration at once answering the urgent cries of a desperately malnourished body, yet stealing every ounce of my self – styled safety. No half sane person can comprehend the half cocked comfort an Anorexic may take from being able to feel each rib; from seeing the deepened pit where the neck meets the sternum; feeling the valleys and protrusions of the clavicle and the hollow caves of the underarm.

It sounds like lust… Perhaps I am mourning the loss of my terrifyingly tiny body. Perhaps I am merely giving voice to the Anorexic fantasy, trying to confess the dark longings that lie like dogs with one eye open, just waiting for me to pass a full length mirror, or absently rub my recently re-fed arm.

In truth, I left the hospital against medical advice and nowhere near ‘healthy’. BUT, I have come a long way. I am not the death dodging spider that crawled up the hospital steps on March 15th. My heart beats without the frightening bradycardia… My white blood cells are better, I am no longer hypoglycemic (well… not AS much).

My insides are probably pinker…

I can string sentences together more easily. I can THINK enough to tackle some of the twists of a cryptic crossword (note: I say ‘some’!!)

I am grateful to The Priory hospital for their INCREDIBLE support. Their treatment was second to none, the best I’ve had by a long way. I was spoken to with such respect, kindness and, when I needed it most, logic. My views were listened to and the fact that the patient sometimes knows what’s best for them, was actually woven into my treatment plan.

I chose the groups I could manage and left the rest. I managed my own time.

I took comfort in creating.

I stuck it out until I reached the target I had set for myself, even went a little above. Three weeks later, I weigh exactly the same.

Sentimental bit…

My gratitude goes to all those who nursed me, and to Dr Iwona Kolsut, for her wisdom; Dr Lousie Bundock for her striking kindness and ‘normality’ ; Brian G for his immense compassion and the good guy Chris for his humour and humanity. They are all figures that my Anorexia resents but that I (the I that is ME) owe my life to.  Today I received my discharge notes. They make for positive reading. My hope is that I can sustain the light of hope that took such gentle hands and so many tender breaths to fan into a flame.

And as if that wasn’t enough… (More sentimentality…)

Huge thanks also go to those I know who prayed so much for me. My family (who won’t read this), my friends (some might), my beaut of a friend Chloe who so faithfully visited me every week to paint my torn up nails and encourage me with vision,  my incredible friend Valorie (who I’ve never met but who sent me an amazing box of gifts), my church friends, who never fail to love me as I am, those brave and suffering patients who I walked some of the way with, and all the people who I know hold me in thought and love.  I have everything to live for.

I just have to do it.

The following post is something I already published on a different blog. Call me lazy, but sometimes I’ve simply explained something as well as I can. No point reinventing the wheel, right?

Anorexia is a shapeshifter of an illness, deceptive in more ways than amyone could imagine. Don’t be fooled by the media perspective. Although anorexia makes its victims LOOK the same, the ways in which it infects each person, the periods of infliction and the ways it gets into someone are never the same. 

As some readers may know, I’m in a ten bed specialist unit and each person here carries their very own strain of Anorexia. 

Ive always been a fan of analogy. What follows is the story of how the illness got to me…

A small, blue clad child stands in the grey playground; back turned from her playmates; tiny hands pressed tight against her eyes as she chants numbers in a voice higher than it is loud.

Behind her, a group of dishevelled children move with silent, exaggerated care; the thrill of tension bursting from concentrated rosebud lips and then, delicious stifled screams as the blue child swings round, sudden and bellowing and the clenched stealth and stillness break, pouring a cool, white rush of pure delight over each small figure, even as they fight to keep the tension in their form.

Grandmother’s Footsteps.

The aim of the game was for the players to manage to creep up behind the person who is ‘it’ without being seen to be moving. ‘It’ could turn around at any point and the other players would have to instantly freeze. Those who were still moving when ‘it’ turned around were immediately sent back to the starting line.

Why am I writing about an old playground favourite?

You may well ask.
And quite simply, it is what came to mind when a despairing loved one asked me how on earth it got to this point.
Perhaps Anorexia’s approach is different for an adolescent or college student, perhaps it walks with a different gait, I can’t really speak for others. I can barely even trace its steps towards me. What I do know is that the illness wears many masks and easily poses as the smallest giggling schoolgirl until you turn away, reassured that it isn’t getting any closer.

For a 31 year old woman, Anorexia began as a wonderfully refreshing experience of exercising after giving up smoking. It’s steps were light, triumphant and exciting. Continuing to feel healthy, my body began to tone up and I lost a few pounds.
It doesn’t hurt to cut out a few foods in the name of being healthy, right?
Less bread, less cheese, less meat, less pasta.
Next time I checked behind me, Anorexia was a few steps closer and although a part of me knew it, another part didn’t really believe it would be interested in me. I was too old for that sort of thing. I was too ‘sensible’, too grounded, too self aware.
I turned my back.

No red meat. Only a few mouthfuls of pasta or rice. No bread. No cheese.
I swung round. Anorexia froze. I couldn’t tell if it had moved or not.
No meat. No carbs. No dairy.
Low calorie fish, salad leaves, fruit and water.
And where once I thought 6 stone would never be possible, now I dream of 5 and a half.

And Anorexia is playing. Oh definitely. It’s creeping now and it’s not bothering to freeze and I’m not bothering to turn my back.

Its steps, so quiet and so disguised at the start, are heavy and quite careless.

I can no longeer stop them in their tracks by turning around. I can’t make the fearless freeze.

Now my mind is full of the footprints and although I know tracks can be covered over, I’m not sure how and so the game has become a dance. My shapeshifting partner, both a close friend and a worst enemy, simultaneously giving and stealing life. One moment its steps bring elation, the next, bottomless despair. One day I dance with fluid grace, the next with lead-soled boots.
One thing I do know is that in reality, Anorexia Nervosa is about as much of a game as Russian Roulette. It has a higher incidence of death than any other mental illness and has clamied countless lives over the years.  Treatment is more effective the earlier the illness is caught but getting GPs to to take it seriously can be a problem (though why this is still the case, I don’t know).  You would think that in today’s social climate, any hint of onset of Anorexia, Bulimia or any other ED would be treated as serious enough to warrant immediate intervention. 

At thirty, I would have things mostly sorted. I mean, I would probably be settled down somewhere, I’d have a good circle of friends and a supportive and engaging church community.  I’d meet the man who could be my best friend for life and therefore be in a stable relationship and I’d have a challenging but fulfilling career.

At forty, I would be a fully grown woman.Although being middle-aged was a very hazy notion, I suppose I had something of an idea that by this point, I’d definitely at peace with myself. I would be content with my lot, and wise in to the ways of the world. I’d have worked abroad with my other half…. perhaps doing some sort of mission work. I’d be established in a teaching career of some kind. I’d certainly have written a couple of books, and maybe have kids or fostered for a while.

I shudder now at the assured faith of my younger self; my blind faith in the power of adulthood.

I think I must have believed that at key points in my life, there would be some sort of ‘latest update’ that would magically download and install overnight. It’d equip me with new software to enhance my resilience, bug fixes, small but significant improvements to my system. Just like the skin care products which companies like L’Oreal and Garnier so thoughtfully tailor to suit the relevant decade of a woman’s life, I thought I’d somehow just be able to apply certain elements to my life. Elements which would be suited to my age and stage… and again, like the miracle face creams, le28099oreal-paris-anti-imperfections-plus-whitening-cream-for-20-review4these would hopefully just get a bit richer as I got older.

I guess I might have believed that I’d still battle depression, but in my naivety, by late thirties, I would have gained victory over it, managing the dark hours with a quiet stoicism, helping others learn to do the same. Anxiety would probably always be present, but by forty, it really wouldn’t have any significant impact on my life. I’d have learned to combat it using my faith, my wisdom, a range of relaxation techniques and possibly my ole’ friend Pregabalin.

Whatever I imagined, one thing I wouldn’t have believed, is that at the ripened age of forty, I would be sitting in a hospital bedroom, typing a blog about Anorexia.

Nor would I have believed that by the time I got to this grand old age, a whole decade of my life would have been hungrily devoured by the same illness that would starve me to the point of death and leave me with the body of a malnourished child.

I’ve been an inpatient for almost nine weeks now..

You’d think by the time I’d endured four different inpatient admissions and three rounds of day treatment, I’d have got used to the agonies of refeeding. Think again. If anything it’s tougher this time than ever. Not that I’m in a different hospital than ever before, and not that my fellow patients aren’t amazing people who I feel privileged to meet. No… more perhaps that each period of recovery seems to ask for more energy than the one previous to it. It seems to demand more bravery, more patience, a higher pain threshold, more nerve.

At risk of sounding discouraging, I think that the longer a person suffers with an eating disorder, the older they get, the more entrenched it becomes and thus the harder it is to recover from. If there is anyone reading here who is suffering with an ED and is considering getting help, I urge you, please, GET HELP.  Do it before it gets worse. Do it before next week, or next month or your next birthday… Do it now and buy back some time because honestly, it might seem unimaginable, but this illness will sink into you until you are saturated. It sinks in a little deeper with each passing minute and before you can wring yourself out, it’ll rinse you of your strength.

The less time you tolerate this illness, the less time it will need you to fight it and the more of your soul you can save.

Get help.

 

You know “the grass is always greener…”?  It’s a common enough expression.

But when you think about it, it doesn’t make sense.

WHY green when it’s actually red?

The grass outside my window is no more green than Bob’s my uncle.

I can hear your confusion and I know what you’re thinking. You’re wondering where the hell this is going…  A puzzle. You’re frowning. Figuring out the point.

My point is this: that every time you look at that park, or that garden… you’re thinking that the grass is green. You’re SEEING it with your own eyes. ACTUALLY SEEING it.

So you believe it, right? You can see the grass is green so you believe it. Perhaps you’d even swear to it.

But you are, quite simply, wrong.

It’s not green.

You’re still frowning… or your lip has turned up slightly at the very edge…

What will it take to convince you that grass, as a natural product of this beautiful earth, is bright red ?

Stop and think. Just for a few seconds. What would it take?

Because that’s what everyone else sees.

Everyone else knows it’s red.

 

Have they just been agreeing with you?!

Going along with you… Not daring to challenge your view.

Nice one.

That’d be why you still believe it’s green.

 

I know and understand that you THINK this is madness. I know you SEE green… But it’s red.

FACT: Everyone else knows and sees red. You alone see it as that bright green colour.

red-grass-

Stay with me. I’m trying to make sense (despite all evidence to the contrary).

It can be argued that a certain degree of body dysmorphia is part of the human condition.

However, whilst for many of us the distortions in our perceptions are not significant enough to cause distress, it’s very difficult to gauge just how accurate our perceptions are, particularly when they involve our appearance. Hence, a person may grow up with a mole on their cheek and barely see it, whilst another with the same mark, may grow up feeling ACUTELY aware, paranoid even, that it’s all anybody notices. Certainly it may be all THEY themselves notice.

Although each case is different, Anorexia and Bulimia often incur constantly shifting distortions in the sufferers perceptions of their body. the extent of this may depend on the individual’s mood, the amount that they’ve had to drink, the whispering voice of their illness, or how full / empty they feel at any given moment. It doesn’t appear to matter whether the ill person is a  tortured artist or a brilliant scientist, the degree to which they are susceptible to absolutely absurd thoughts about food and the body’s relationship to it, remains the same.

For example, as a level headed and rational being, I know that I CAN’T be big in any way because the measurements, weights, body mass I am faced with are completely accurate. The ratio is too low for my body to be fat; too low for my body to be healthy.  The figures are scattered on the green grassy earth.

As a sufferer though, I look in the mirror and that grass is DEFINITELY RED. I can SEE it. DAMN IT! IT’S THERE IN FRONT OF MY EYES

AND YOU’RE STILLSTILL trying to tell me it’s green!

I’m fine! There’s nothing wrong with me! I look normal… healthy.

Some days, my arms look chubby… and my thighs often look massive towards the end of each day… but generally, I look perfectly normal.


Arguing with an Anorexic can be hugely upsetting, incredibly perplexing and downright frustrating. You see one thing, they see another.

Families in particular will suffer the agony of watching their loved one deny the truth; a blank refusal to hear the other side of the story. It’s painful to be stonewalled or to have your words hurled back at you. Few can identify with the desperation and helplessness experienced by screaming at a skeleton whose rock solid belief is that they are ‘fat’ or ‘fine’. Not everyone can trace the ridges of the bone along the clavicle of a loved one who refuses to eat because they think they’ve got plenty of fat still to lose.

My message is convoluted. It’s a poor attempt to somehow explain the complex illusion / delusion experienced by the victim of an Eating Disorder like Anorexia.

I know many, many women who dislike parts of their body, or at least, are dissatisfied with particular aspects of their appearance. When someone develops an ED, that dissatisfaction, becomes a rigidly held belief which apparently robs them of a realistic view of themselves. Much like joining an extremist party or cult, Anorexia transforms the mind in such a way that makes reasoning with them, impossible and unrealistic.

Hopeless as this sounds, my final message is to anyone who is having to watch a loved one starve .

Don’t give up.

It can be heartbreaking and it’s often a long, tiring path, but if there’s one thing that will help to save them, it’s a quiet, pervasive message that it’s the ILLNESS that’s lying to them and not the rest of you. If you’re met with a brick wall, don’t employ a bulldozer. You’ll flatten the person rather than the illness.

Remember the quiet echo of the drip that splashes against a stone surface. Gentle but unswerving,  the message will sink in, and though they may always see a tinge of red, at least they will accept that, mostly, grass is green

water on stone

spaghettiJust eat! It’s really that simple”

The well meaning eyes of family and friends cast along the frame of an ED sufferer; pupils travelling the ridges of the clavicle, the skeletal hands and down the birdlike legs.

Just say, I CAN do this

Just make up your mind that you’re GOING TO do it and then DO IT

Lots of ‘justs’. Lots of good suggestions. Lots of spilled frustrations.

So why isn’t it ‘that simple’?

Surely it’s not rocket science…

Well…. in actual fact, although it’s NOT about rockets, there is quite a lot of science involved; physiology to be precise.

When someone is well below a healthy weight, the list of psychological blocks to recovery may be a mile long. However, unbeknown to many, there are also many physiological reasons. Chemical and hormonal shifts in the brain that induce behaviours which can make it incredibly difficult to behave in a ‘normal’ way around food. Experts in the ED field will tell you that a full recovery isn’t possible until weight has been restored to the point where a patient’s BMI is between 20 and 25. In fact, many argue that it is ONLY when a patient reaches a safe, healthy weight (and so, BMI) that recovery can begin.

I agree.

One of the strongest pieces of supporting evidence we have for this idea comes from a ground breaking, wartime,  experiment into the effects of starvation, performed by Dr Ancel Keys.

In 1944, as war raged throughout the world, Keys recruited 36 young men (mostly conscientious objectors) all deemed to be at a peak of physical fitness and mentally / psychologically healthy.  Over a period of a year, he studied the behaviours and mind set of the men as he systematically cut their calorie intake and increased their levels of exercise . By the end of the ‘starvation phase’, the men had lost around a quarter of their body weight and their physical appearance was skeletal.

Photographs of the subjects reveal bodies not dissimilar to those who had suffered in concentration camps. Certainly, the men appeared to have been subject to a lifestyle which denied them of their most primal need; much like the self inflicted discipline exercised by those with Bulimia or Anorexia Nervosa.

For someone attempting to recover from an eating disorder, the most pertinent revelations of ‘The Minnesota Experiment’ lie in the fascinating changes in behaviour displayed by Keys’ subjects. Behaviours and attitudes practised in secret, cloaked in a horrible sense of shame, perhaps feared by the sufferer to be so ‘odd’, so far from ‘normal’ that nobody should ever find out… Behaviour that actually, The Minnesota Experiment, proved to be a direct result of the human body being starved and therefore, some way beyond the sufferer’s control.

Keys documents that the more the men starved, the more overwhelming was their obsession with food. Food became an absolute priority while the rest of the world, family, politics, opinions, religion etc, all faded into obscurity.  The men were restless, their minds unconsciously forcing their bodies to forage for food, allowing little sleep as the need for nutrition overrode all other basic needs.

Interestingly, all the men developed ‘abnormal’ eating patterns, becoming ritualistic, taking up to two hours to eat a meal, cutting food into tiny pieces,  mixing food with liquid to make more of it and hoarding food so they could take it back to their bunks and graze on it. Moreover, the thinner the men became, the less able they were to judge their size as being thin or underweight. A few of them even went so far as to express thoughts that others were too fat. Spot the quandary of an Anorexic.

There were many, many physical effects, most of which an Anorexic will experience as par for the course, but in order to explain why it’s so damn hard to ‘just eat’, I wanted to draw from the physiological findings of Keys’ experiment. The state of semi starvation, of extreme self denial, is in itself, a trap. Being below a healthy BMI produces its own set of barriers to eating, making the initial ‘pre recovery / weight restoration’ phase about as difficult as it could be.

It’s really not as simple as it might seem.

Certainly, during the period of re-feeding, the men ate happily (obviously not suffering from an ED) but my point is that whilst starving, the men underwent such changes to the chemical balances in the brain, that food became an absolute obsession and habits previously unheard of, became commonplace.

When an Anorexic tries to recover, they not only battle the mental blocks that the illness creates, they also have strange, unseen physiological blocks.

(Another terrible hidden suspicion of The Anorexic, that their appetites will become insatiable once they begin to refeed, is also borne out in Keys’ evidence, producing yet another barrier).

I could go on and on about this great study in starvation, but it’s all for another post. What I want to convey is that, despite all appearances, recovery is never as straightforward as ‘just eating’. Refeeding, within itself, is fraught with unconscious physiological blocks and hurdles.

For me, personally, despite this knowledge, and armed as I am, I still stand on the wire, looking at that vast expanse that is ‘no man’s land’, weighing up the risk, trying to see where the mines are set, where the searchlight falls.

It’s been ten years raging, this war.

gripping barbed wireI still want to fight…

…but the real enemy

lies in the woodland

on the horizon

I still need to make it to.

THAT’s the pathology of an eating disorder.

THAT’S the physiology of starvation.

… I’ve given up blogging… Anyone stumbling upon this site could be forgiven for thinking that this is just yet another open ended account of a person whose fingers stopped typing, whose mind stopped composing.  I come across them so often. Those who suddenly stop. Dead? Fulfilled? Too busy?

Anyway, as I say, to all intents and purposes, it looks as though I too have joined the unblogged.  The reasons are many but, irritated at the fact I feel something akin to guilt, I am deliberately choosing to keep them to myself. (As though THAT’S going to make a difference).

For anyone interested, what follows is an update.

After thirteen long, gruelling (yes, that is a pun on hospital food) weeks, I finally left the unit where I was an inpatient. In truth, my reasons for choosing discharge over a longer stay were driven by the Anorexia. A fact which I was very open about but also very upset and frustrated at.

The expected rate of weight gain was a minimum of 1 kilogram  per week. If this wasn’t achieved, the weekly ward round discussion invariably resulted in an ‘increment’ being added. In the language of the real world, it means that another 300ish calories were popped into your meal plan, so in addition to your 70g serving of breakfast cereal, you’d have 2 pieces of buttered toast in the mornings, or a pudding after your lunch, then another at dinner… All these options discussed, argued, wept over, refused over a patient’s admission.

My second time in this unit, I got as far as a second ‘increment’ and was defeated by the addition of puddings.

Many readers will scoff and shrug at this point, unable to comprehend the absurdity of the Anorexic dilemma. I get that. I too find it ridiculous that, in an underweight, malnourished state, I refuse to eat a small bowl of apple sponge and custard (though honestly, you could fill walls with the stuff) because I am terrified of what it will ‘DO’ to my weight… I’m scared that that bowl will be the thing that layers itself onto my thighs, adding inches, smears itself around my insides, pushing me outwards, thickening my stomach, disguising my waist.

It’s craziness.

“Not very PC!” cries the world of mental health.

“Not very empathic!” cry the sufferers

But it is. I insist. It is crazy. Which is why, like it or hate it, Anorexia Nervosa is a mental illness, not just a fad or a phase, not an addiction, not a lifestyle choice, not a decision taken by the vain. It’s completely mental. It’s a trick played in the mind of an otherwise very rational being. It almost borders on psychosis; the infliction of unreality, the blindness, the invasive thoughts and sensations.

Recovery though, that IS a decision. It’s one I made when I chose to go into hospital, despite my knowledge that I would have to face my worst nightmares. Despite the fact I would end up crawling on my floor, doubled up in an unspeakable and inexplicable agony.

I’m not saying I want a medal. I’m not boasting. On the contrary, when the going got too tough, I ran. But I’m home in a better state than when I left. What I forget every time though, is that the freedom that looks so appetising (pun-tastic here) from the confines of a prison, isn’t freedom at all. I remember now that the prison isn’t a locked hospital ward. It’s not twelve bedrooms down a squeaky corridor, or a cramped obs room where you sit in stillness til your time of rest is over. The prison is inside. It’s there when you’re ‘out’ as much as when you’re in. The difference is that the freedom you smelled on the inside, comes from not pla
ying by the rules you have to abide by when you’re in.

Fprison-bars-handsreedom for me, right now, is what I get when I skip a snack or skimp on a meal. Freedom is exhilarating, dizzying, confusing. It’s less calories than I had in hospital, less carbohydrate, less fat. And I feel great… in the moment…

But in an cruel, ironic twist, I’m still a prisoner. And it’s at the times when I most celebrate my freedom, that the walls move closer and the chains get tighter.