I’ve been in an Eating Disorders unit for the past month or so… part of the reason for my silence here.
I got out a week ago and so I’m dipping my toe back into the Blogsphere….
Watch this space!
I’ve been in an Eating Disorders unit for the past month or so… part of the reason for my silence here.
I got out a week ago and so I’m dipping my toe back into the Blogsphere….
Watch this space!
It was clear from an early age that I wasn’t ever going to make a scientist. Certainly, the most memorable things from my physics lessons involved throwing wet paper towels at each other, and the time when I fell off my stool because Leon Kavanagh pushed me too hard.
It’s really Mr Thomas that I blame for my ignorance on the topic of magnetic force. He had bad breath and liked to lean over your shoulder to illustrate his point. Awful as it is to conform to the stereotype of the bored teenager, surely it’s even more awful to conform to that of the fairly greasy, and very definitely sleazy, Physics teacher! All this to excuse myself for what follows; a very unscientific reference to a very scientific process.
It’s possible that if you belong to a certain generation, you’ll have had one of those arched magnets lying around the garage. You know the ones… a U – shaped piece of metal coated, in part, with bright red plastic.
I loved ours. My dad’s. As a kid, I’d be content to mess about with it, trying to get to that point where I could move the screws / nails without the magnet actually picking them up. You know THAT point? What was it that was SO satisfying about THAT point?!
Anyway. The magnet is something I often refer to when I’m attempting to explain something about the nature of Anorexia and, moreover, the PURPOSE that it serves. Because it does HAVE a purpose. And just because there may be no apparent reason why a person is dogged with this illness, doesn’t mean that it’s a completely random occurrence.
Although I am writing mainly about Anorexia Nervosa, sufferers with other eating disorders will identify with the fact that before they even had a hint of their illness, they were chronically anxious. In my own experience, I had suffered with almost crippling anxiety and panic attacks for many years before Anorexia hijacked my brain. I have heard so many other patients refer to their inability to manage everyday anxieties, stories of phobias, extreme panic, fear.
Whether it was recognised in childhood or not, I would hazard a guess that it is actually an anxiety disorder, generalised or specific, that underpins Anorexia.
And so, a sort of Anorexic blueprint, is born.
The child who is very frightened about being left alone to survive in the playground; the one who studies to be the best and so is the best and then lives in fear of not being able to keep being the best; the person at work who is held up as being exemplary, and is terrified of being ‘found out’ because he or she has no self belief and feels like a fraud. Anxiety. Anxiety. Anxiety.
You may be reading this and identifying the fact that this is something we ALL experience. Perhaps it is… but everybody manages their fears in different ways, and Anorexia, whilst still being a severe and enduring illness, often begins as a means for managing fear.
Imagine a tabletop covered in iron filings. Horrible little bits of grey, scattered all over Try to scoop them up and they go everywhere…
Now imagine that each of the filings is a different ‘free floating’ fear.
So many different things to cope with, too many. It’s all very out of control and you can’t rest because you’re in a constant state of hyper alertness; a state where heightened anxiety is natural because everything, EVERYTHING feels like a bit like a threat… a challenge… The filings don’t shift, if anything, they seem to multiply.
Anorexia is a magnet.
And it’s bigger than anything else.
And it’s really powerful.
Due to a force that I should at least have some understanding of (but don’t because I didn’t bother in my Physics lessons) the filings are immediately drawn to it as it hovers over the tabletop, sucking up every little shred of metal.
It’s what Anorexia does. All the individual anxieties stick to it…. fuse with it… until, one day, they don’t really exist any more and all that’s left is the illness. One giant entity. One focus. One fear.
That of never being able to be thin enough.
Yeah. About as simple as physics.
The hardest thing is the terrible realisation that you’re not holding the magnet any more and that it, in itself, is far, FAR stronger than you; As if somehow, cruelly, the incorporation of all those little grey shards, has strengthened the force that then turns on the sufferer him/herself and begins to diminish them.
“Just 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.
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.
I 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.
… And we’ll all sing along like before…
Goes the song.
Irritating when your internal MP3 is stuck on the same track and no matter how hard you shake it, it won’t stop. Trying to get away from it is just about as effective as trying to go on holiday without your head. And don’t we all wish we could do that at certain times in our life. Take enough hallucinogens and maybe it’s possible, but they’re not exactly cost effective and the insurance you’d need to take out is ridiculous.
No way around it but to play enough music to flush this one out of the system.
This particular musical ghosting is a song by Del Amitri (who for some unknown reason, I always confuse with Dire Straits). An especially depressing number, aptly named, ‘Nothing Ever Happens’.
I guess it’s the theme of repetition that lends the song to my worn out inner ears; and for good reason.
On Wednesday, I retrace my tracks to the very same unit I was in over Christmas.
Wednesday will see me standing outside what is going to feel like Hell’s doors.
And to be clear, it’s not that nothing will have changed, because I have. My illness has. My thinking has. I’m not on exactly the same rung of the ladder as I was in December.
What is hard, is that it’s the same old hole. The same darkness. And, pretty much the same distance to the light. (So maybe I AM on the same rung…)
Hence, ‘we all sing along like before’.
Last time I
came out ran away because I couldn’t stand the increases in my diet. I left with a BMI of 15. Clearly not recovered in any sense really… Although it felt like it.
I want this to work… which means that I will have to work. Very hard.
It will be bearable, though it won’t feel it.
It won’t kill me, Ironically, it could save my life. But it won’t feel that way because the process of weight restoration will involve the slow death of a part of this illness, so it will feel like it.
In all the darkness, I must somehow manage to fix my eyes on a light I will not always see.
In order for recovery to take place, you have to believe that, just as there is always a sun and a moon, there is a new life beyond, and there is a different person behind, the illness / addiction.
The courage it takes to make this leap of faith is immense and for me personally, I don’t know if I can sustain it.
It’s very, very difficult to describe the mental torment that can suddenly twist itself in and around the brain of someone suffering with an eating disorder. I’ve struggled to find the words.
You can perhaps imagine the immensity of my relief when I stumbled across a talk given by an American doctor called Laura Hill. I was searching through TED, looking for interesting talks. when I first heard her. I was amazed when she began to describe ‘the noise’ in MY head, when I am faced with choices about food. I had that overwhelming sense of awe and relief and terror that you get when somebody describes your innermost, thus far unarticulated, maybe even unformed, thought traces… You know the one, right? That whole ‘strumming my pain with his fingers, singing my life with his words’ thing?
What she proceeded to do blew a hole right through me.
She had a tape recording of what she called ‘the noise’. The noise experienced / heard by an Anorexic whenever they have to think about selecting food from a menu, a supermarket shelf, a fridge, freezer, list or lunch bar. She played this raw cacophony of voices, a medley of ordinary conversation, accusatory interjections and deeper inner ‘voices’ commanding, bargaining, questioning. Listening to it, I feel as though she has somehow wired up my brain and translated every thought, every voice, every snippet of inaudible agony, into words and sentences. It’s the chaos of the calories, the constant mathematical equations, ratios, percentages that need to be calculated in order to work out how much energy is allowed, or NOT allowed. The numbers that fly in and out, unable to find a carpet of reason on which to rest, the foods that fall into the red, the orange and the green zones of safe and unsafe foods; the protein, the fat, the carbs, the fruits; whether I’ve been more active or more sedentary; the form the food takes…. All these factors dart like pinballs across the Anorexic’s mind, making a noise that you could drown in.
It’s noise of the kind that you might expect in the psychotic mind. Noise that, for me, doesn’t stop unless I make the decision to abstain.
I tried to put together a video using Dr Hill’s sound clip. It’s not brilliant. I’ve never done it before… But it might make someone else feel understood… or give a little insight into what is happening in the mind of a loved one as they try to pick a snack, or a meal.
It might help somebody understand why it is so very difficult to recover. It’s not just as simple as ‘eat’, because just thinking about eating invokes the noise.
What I have tried to do is to argue with this noise, shout back at it, reason with it… But this is rarely helpful and I have often resolved to skip the food in the desperate rush to close down the clamour.
What I am now trying to do, is to allow the noise to exist without giving in to it. Allowing it to happen but still allowing nourishment of some kind. I hope that the practise of this will eventually afford me a ‘quieter noise’, a lower volume if not complete peace. One day, perhaps they’ll research this illness more and find a drug which will block out the noise and the panic, but for now, I will continue to work towards recovery despite the noise.
Does anybody else identify with this? If so, what helps you and how do you deal with it?
If your default state of mind involves a relentless drive towards perfection.
If the eye flinching, wincing, mincing voice of piercing criticism carries through veins and synapses
If your head is bent and darkened by the brightness of those around you
If you cannot bear the bird that longs to nestle in your palm, for fear that it will turn and peck your sockets hollow
If your thoughts are spurs and feelings, whips that lash your saddened soul
and your mind set is a thirst that’s only quenched by a glass half full
then hear the call and heed it
Rebel against your own state of mind.
“Rebel against your own state of mind…”
The background noise penetrates my concentrated, musical rhythm of ‘knit one, knit one below, knit one, knit one below’…
A glance at the TV brings an advert into sharp focus; a sleek grey car wheeling across a dramatic rural landscape. It seems obvious that it was a car ad but really, it might just as well be the Scottish tourist board (or another bloody Party Political broadcast – Please no more!)
It’s not important. What matters is the fact that I’m having to count my stitches again because one sentence has lodged itself in my mind. It’s vying for my attention, playing on a continuous loop which forces me to stop counting and think properly about how this one sentence resonates deep within me, and how relevant it is in the context of my recovery and, perhaps, recovery in general.
My state of mind is founded on a determination to recover.
But it’s complicated.
‘Complicated’ because I swing between an absolute conviction that I WILL beat Anorexia and that I CAN and AM; and the absolute desperation that highlights the impossibility of it all, the futility of trying and the agony of succeeding at weight gain. (Yes, the presence of absolutes is noted).
The twisted paradoxes that lie like fatal, open jaws, are manifold and make the journey towards recovery all the more perilous for those who crawl along the path.
I want to eat, but I don’t want to gain weight.
I want to gain weight, but I can’t let myself eat.
I pick up my food, but I can’t put it in my mouth.
I drool over supper that I scrape off my plate
I eat all my meals, but I can’t keep them in
I cut off my nose…
Irony after irony. Stacked up, an impossible pylon to climb up or climb down.
I’m losing my thread (which won’t come as as surprise). The point is, in order to recover, I have to rebel against my state of mind.
Anorexia has become a default setting, a default state of mind. It is no longer possible for me to remember when I didn’t much care what I ate, when life wasn’t just about food, or no food. Even when I am absolutely convinced that I am going to crack it, determined that I can do it, the resolve can evaporate before I can pull the top off the yoghurt.
Rebel against your state of mind.
This six word commands a practise that might help in the battle towards restoring some of the balance that the eating disorder has stolen. Rebelling against your state of mind means a battle, a defiance, a disobedience.
Making peace with my state of mind will be about as successful as Chamberlain’s approach to Hitler. Appeasement is not an option.
I realise this post is a slightly bizarre conglomerate of thoughts and metaphor. Out of the habit of writing, I am at once struck by how much Iies unexpressed, and how tangled and tangential, my thoughts.
A peacemaker would beg forgiveness but in a spirit of rebellion, I post this anyway and pretend I don’t care.
… sometimes takes more courage than to continue a fight.
Sometimes it makes more sense to submit than to lose everything by fighting a battle you’re not equipped enough to survive.
That won’t please the shiny miracle brigade. Those who remarkably manage to cling to a hope that pays off once in a very blue moon. I’m not saying anything is impossible, just that suggesting that holding out hope can sometimes be a little like burying your head in the sand.
Believe me, this isn’t an easy thing to write on a blog referencing hope in the title; a blog whose very essence was supposed to be hope. A place which might offer encouragement to others, and help deepen understanding about the struggle of recovery, insight into the world of mental health and eating disorders.
However, it would be dishonest to spout rubbish about a recovery that I haven’t yet made. This is where I find myself; admitting defeat. I’ve had to have an honest look at No Man’s Land and an inventory of my fire power tells me that I need to regroup in order to stay alive.
I am being admitted to an ED inpatient unit on Monday. The admission is for a month, at least, so that they can prevent organ failure and minimise the risk of death that is posed by my current BMI. (Body Mass Index, for those who may not know, is a calculation of relative body mass and height, which gives an indication of where an individual is in terms of the healthy weight range of 20 – 25).
I’m lying in the trench, a little wounded and very weary. It has taken guts to submit. I’m losing the battle in the hope that I might still win the war. If I carry on fighting, there’s absolutely no chance.