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Anorexia
 

 

I suffered from anorexia nervosa between the ages of about 15 and 26; by the end of this period I had lost nearly half my bodyweight and was pretty much debilitated by starvation-induced depression, obsessive-compulsive disorder, physical weakness, cold, hunger, and mental rigidity. In the autumn of 2008 I embarked on a nine-month course of cognitive behavioural therapy with Dr Shawnee Basden at the Centre for Research on Eating Disorders at the Warneford Hospital, as part of a clinical trial being carried out by the University of Oxford Psychiatry department. During this period I regained weight and strength, and came gradually back to life, and over the years that followed I relearnt, slowly, how to lead a life that no longer revolves around eating and not-eating. I now consider myself fully recovered.

During my illness I wrote a long autobiographical account of my anorexia's origins and effects (2004) and a novella (2007) which told the story of a fictionalised me who tried to get better, a year before I managed to. You can find excerpts of both below. Since August 2009 I've written a blog on eating disorders for the US website Psychology Today, called A Hunger Artist; all my posts are listed below.

Last year I contributed a post to the Imperfect Cognitions blog ('on delusional beliefs, distorted memories, confabulatory explanations, and implicit biases') entitled 'All that glitters...' (2015) - it was my response to the blog founder's invitation to think about whether anorexia might have any pragmatic or epistemic advantages, any 'silver linings'. Longer ago, I published an article on anorexia in the Psychology Today magazine (March/April 2010: 43(2), pp. 88-95), and contributed a chapter entitled 'Dying by Inches' to First-Person Accounts of Mental Illness and Recovery (2012), edited by Craig W. LeCroy and Jane Holschuh. I gave an interview together with my mother for the BBC Radio Scotland series A Life in Limbo (transcribed in the blog post My mother and I: A radio interview on anorexia', below), and one for the Daily Mail (1 October 2010). My mother has written a post on how she coped with my anorexia on her CommentIsFree blog (as well as a guest post on my blog, 'You can't save your child from their anorexia'), and I've contributed to a Priory Group article about the growing problem of online 'thinspiration', as well as a health.com piece on 'What to say to that one friend who's always criticizing her body'.

All these are my attempts to use honest testimony and careful reflection to counter the many misconceptions about anorexia and other eating disorders, and the widespread tendencies to glamorise them. The ultimate aim is to help those still caught up in disordered eating to let it go, and everyone else to understand it for what it is.


Psychology Today blog posts:

Is thin beautiful? Looking and seeing (Part II) 3 August 2017

Is thin beautiful? (Part I) 3 August 2017 (chosen as an Essential Topic)

An app for recovery from anorexia 27 June 2017

Hunger 15 June 2017

How much does a blog title matter? 29 April 2017

A mathematician's education in mental health 31 March 2017

Why your mistakes matter less than you think 29 March 2017

Making space for the exceptional 8 March 2017

Early intervention as panacea: Reality or myth? 31 December 2016

Christmas in recovery 25 December 2016


Lose your phone, find your body 27 November 2016

Biscuits before breakfast: Recovery in microcosm 30 September 2016

Questioning medical authority by accident 25 September 2016

Dissecting the clean-eating meme 29 August 2016

To failure 30 June 2016

Am I really this selfish, or is it just the anorexia? 30 June 2016

The forking paths of children and no children 13 June 2016 (chosen as an Essential Topic)

How does metabolic rate really change after anorexia? Part 2 31 March 2016

How does metabolic rate really change after anorexia? Part 1 30 March 2016

Twelve hours a world champion, another lesson learnt 1 March 2016

Sleep and dreaming in anorexia 31 December 2015

The road long past recovery... called life? 17 December 2015

How to help someone with an eating disorder 9 November 2015

Why control won't bring you happiness 28 September 2015

Taking, losing, and letting go of control in anorexia 18 August 2015 (chosen as an Essential Read for the Eating Disorders Topic page)

A book from this blog 14 July 2015

Watching a play about anorexia 27 May 2015

To weigh or not to weigh? 14 May 2015

Anorexia and the dangers of blog post titles 26 March 2015

You can't save your child from their anorexia 18 February 2015 (chosen as an Essential Read)

Recovering from anorexia: how and why to start 19 January 2015

How to do Christmas better 12 December 2014 (chosen as an Essential Read)

The Fast Diet: a fast route to disordered eating? 5 November 2014

Recovery from anorexia: why the rules *do* apply to you 12 August 2014

What anorexics really feel about food 15 May 2014 (chosen as an Essential Read)

Eating disorders in the online world 25 March 2014 (chosen as an Essential Read)

Recovering from anorexia: how and why not to stop halfway 22 February 2014

Anorexia on Prozac 11 October 2013

Not being the thinnest anymore - how to adjust 27 June 2013

Seeing and (not) believing in anorexia 16 December 2012

Anorexia and the right to die 22 July 2012

Anorexia and The Diet Delusion: healthy eating after recovery 7 June 2012

A partner's perspective on anorexia 6 March 2012

Is anorexia a disease, a series of bad decisions, or both? 31 January 2012

Hospitalisation and recovery from anorexia 31 December 2011

Not leaving recovery 'til it's too late 30 November 2011

The physical effects of weight gain after starvation 31 October 2011

Is 100% recovery from an eating disorder possible? 30 September 2011

Wasting time: symptom and enemy of anorexia 31 August 2011

Making an exercise obsession healthier by eating more 31 July 2011

Where next after anorexia: death, recovery, or another eating disorder? 30 June 2011

Fully recovered, but not quite: the long post-anorexic road 31 May 2011

Seeing through anorexia’s academic charade 30 April 2011

Escaping from anorexia II 31 March 2011

How to reunite work and life after anorexia 1 March 2011

What weight-lifting can do for a former anorexic 24 Jan 2011

Christmas and New Year make the perfect time to challenge anorexic behaviours 24 Dec 2010 (chosen as an Essential Read)

Starvation study shows that recovery from anorexia is possible only by regaining weight 23 Nov 2010

What's the difference between being fussy and having an eating disorder? 25 Oct 2010 (chosen as an Essential Read)

Learning how to relax after anorexia 24 Sep 2010

Constructing a character after anorexia 25 Aug 2010

Anorexia and today's world 1 Aug 2010 (chosen as an Essential Read)

My mother and I: a radio interview on anorexia 3 Jul 2010

Not only stopping starving, but starting living again 6 Jun 2010

My mission statement for keeping on recovering 8 May 2010

Anorexia and the invisible changes to its immovable rules 24 Apr 2010

A history of anorexia while skiing: part three 3 Apr 2010

A history of anorexia while skiing: part two 2 Apr 2010 (chosen as an Essential Read)

An article on my anorexia in today’s Daily Mail 1 Apr 2010

A history of anorexia while skiing: part one 1 Apr 2010

The end of feeling my hunger becoming nausea? 2 Feb 2010

A night with friends, overshadowed by food 3 Jan 2010

My second grown-up Christmas, eating 30 Dec 2009

This autumn and last: from student to tutor 16 Nov 2009

Bumps in the road to recovery 3 Nov 2009

Having the strength to cope with what life throws at you 19 Oct 2009

In my father's house: a weekend of food and memories 5 Oct 2009

Eating, continued 28 Sep 2009

How it feels to eat again 21 Sep 2009

Defying my own conventions: the day I started eating again 13 Sep 2009

Escaping from anorexia 6 Sep 2009

Facts and fictions: stories of a hunger artist, and lettuce 30 Aug 2009

Five anorexia myths exploded 23 Aug 2009 

After a decade of starvation… 15 Aug 2009

 

A Hunger Artist: excerpt

The ‘autobiography’ of my anorexia, written in the exhausted summer after my Final examinations at Oxford, separated ‘she’, my past self, from ‘I’, the very ill self writing.  This chapter describes the emergent preoccupations with body shape and weight of my 15-year-old self.

Chapter Three – Backtracking

The flat stomach I’ve always wanted.  But since when is always?  I’ve been reading, searching for the moment at which always began.  I read backwards, find a hundred beginnings, each one spoiling the one before – or rather, after.

I seem to have found a time before always.  A time when cooking could be a randomly creative pleasure: I made a cake for dinner, a sort of banana and raisin loaf – not from a recipe, for a change.  It’s the first thing I’ve just invented – and it was simple but good, and so much more enjoyable.  It takes about half the time, because you don’t have to bother weighing everything, and it’s really good fun and creative, almost, just throwing things in and seeing what happens.  That’s what real cooking is – throwing in a bit of this and a bit of that, and knowing it will turn out all right.  I suppose you could say that of life, too… (18.06.97).  The fifteen-year-old philosopher knew more despite her posturing than I do about the necessity of spontaneity; I eat up time doing what she learnt to sidestep, weighing and measuring; I eat little that comes unpackaged, unlabelled with nutritional reassurance. 

She berated herself for lack of that which is destroying me – I really am not very good at self-discipline; if I don’t absolutely have to do something, I don’t do it (29.06.97).  I feel quite sick – I’ve eaten far too much today and it serves me right.  I won’t do it again tomorrow (at least, I probably will – I never learn – but tonight I’m full of good resolutions) (14.10.97).  But she still enjoyed the exquisite privilege, impossible to value until it’s gone, of having an appetite and eating by it: I woke up at seven this morning feeling really empty so I went downstairs and made some bread and jam and then went back to bed.  I woke again at ten and had a second breakfast of scrambled eggs and mushrooms and toast (12.10.97).  This, admittedly, after a Saturday night of drinking beer and throwing it up again – but the italics were hers, that emptiness was notable, and as something to be filled, not to be hated and treasured, loved and feared, as now.

Then, in the failing light of an early summer evening, I stumble across what really seems to be the first time, in writing if not in thought, that that phrase emerges: I feel better now having had something to eat – on the train coming here I felt quite sick – still recovering from last night’s excesses.  I’m so fat, it’s really depressing me.  I have to worry about which clothes will show it and which won’t.  I’d love just to have a flat stomach.  I suppose most women would (26.10.97).  That glorious ignorant misery, thinking it would end with the flat stomach rather than grow as the stomach shrank, thinking there was such a thing as a flat stomach, thinking that worrying about food would be better than worrying about clothes – not that the former would just make the latter a worry in a different way.  And all this after just having been made to feel better by food – though better after feeling bad for having eaten too much and drunk too much…  Food already and forever friend and foe.

Funny and sad to think how my ideals of beauty have made me so much uglier in the eyes of the world – because even when the world called out its admiration in compliments and cat-calls she couldn’t believe it, the mirror gave a different testimony from the rest: walking anywhere in the daytime, all the men whistling, hooting their horns, saying hello, it gets me down, I’m not flattered, it intimidates me (16.08.97); I’m always astonished when people say to me ‘Oh, you’re gorgeous’, or ‘You’re elegant’ or glamorous, or even pretty.  I have no confidence in my own appearance; no matter how many times people say this to me, I don’t believe them.  I look in the mirror and see an ordinary, sometimes unpleasant face, and a rather badly-formed body.  I don’t think people – certainly not Adam [my mother’s partner] or Kylie [my best friend] – are coldly, intentionally flattering, just misguided (29.07.97).  Teenage angst, much of it, perhaps; and certainly not yet centred on size, more comprehensively critical; but unwavering rejection of what clashed with her own vision.  She was passing herself off as twenty-one to nightclub bouncers, her well-learned date of birth ’76; she got asked for ID more and more often the older and thinner she became.

It was a time, too, when food, if not a source of carefree pleasure in creation or consumption, could be a simple nonentity, even in excess: Little to report today.  Food, food, and more food.  Very good food, but not terribly interesting to write about.  There are two things I’ve been thinking about… (07.09.97) – boys and travelling were the mental foreground of a day only physically defined by food.

The always seems to insinuate itself as the ever-headier potency of a mixture of the emotional and the physical effects of eating, the intimate and the comparison with others: I’m really knackered and I feel I’ve eaten too much, and I’m jealous of Kylie – her figure (03.10.97)

The next discovery I make in search of this ascendancy is perhaps the active beginning worked up to by those wallowings in self-critique; this is the moment when for the first time her body becomes the sum of its dimensions, existence and desire become quantified, made abstract and compared with others.  She was writing a few days late: I really can’t remember much about Thursday at all.  Apart from watching too much TV in the evening – oh yes, at games there were two students doing research; we had to do the bleep test.  I did all right.  And then have our height and weight measured.  I was 5’6” I think, and 61kg – the same as Kate!  It made me determined to get fit and get rid of my stomach, if you see what I mean.  I’m sick of being fat, of having to worry about what clothes to wear and all that.  I’m going to find out about the swimming times at the pool down the road – I think there’s a piece of paper somewhere on our chaotic notice board, struggling for space with taxi numbers and old postcards.  I can’t eat much less, I have to do more exercise.  Clubbing’s good, as long as I don’t drink too much – that’s another point, I can drink less beer (06.11.97).  In her précis of that Friday night’s clubbing there was no mention, between descriptions of the topless men and the techno and the adrenalin, of how much beer was or wasn’t drunk.  It’s a second shock for me, though, that 61; like the 50 only six months later.  Twenty kilos, to within a few hundred grams.  Twenty kilos less of me.  You wouldn’t have thought I had that much to spare.  I suppose I didn’t.

Fascinating, too, that this writing and thinking towards thinness was resolutely anti-anorexic, the sensible route of exercise not starvation – though alcohol was the first casualty, it seems, the first place denial could be practised, the first place social effects started to take second place to personal ones.  I can’t eat much less – did she really think that?  How long for?  By Monday she seemed to be contradicting herself, gorging herself on the flavours of asceticism, even while disapproving of them in general, for others: of a friend who never served much purpose beyond ungainly, unfortunate foil to her own qualities, she wrote with moralistic ridicule (verging on the ridiculous): she’s always complaining that she never has any money, and that she’s always starving, but today – you should have seen the inside of her desk.  It was bursting with packets of crisps, sweets, chocolate, fizzy drinks – as well as her lunch sandwiches.  She spent almost three quid today just on food!  And then she moans that she’s really fat and her mum’s trying to make her go on a diet.  I don’t approve of diets in general, and especially not when they’re instigated by someone as fat as her mum, but really – does she expect to be thin as a rake if she stuffs herself like that?  She says she won’t eat any more sweets till her birthday, which is – guess when? – Thursday!  It makes me feel quite virtuous, watching her stuffing her face.  I always say no when she offers me things.  It gives me a sense of power.  A false sense, but there you go (10.11.97).  She knew about that falsity – as I know about it; she was clear-sighted enough to see through it, but not strong enough to see a way past it, or, later, out of it.

 

The Cat and I: excerpt

Chapter One

The cat sat poised on the gunwale in the evening sun, her spare frame outlined black against the glinting gold water.  She moved and miaowed at her owner’s approach.  The girl tied up her sleek black bicycle, lifted off a pannier full of books and another of food, passed between sentinel blueberry bushes on to the landing stage and down on to the boat, which moved gently, fenders squeaking, under her weight, her hands too full for a cursory stroke, cursing the clumsiness of digging out keys, finding the right one, unlocking the padlock, unbolting the bolts, sharing the narrow entrance with the cat, putting panniers on the sofa – the mess of it all.  Her gaze glanced off the clock, her hand to the radio, eternal haste.  A cleverly scripted conversation was already in full flow: she’d missed the first minute or two; always this daily pleasure she tried to make more special and ended up spoiling, through the haste of returning just in time, not quite in time.

She swapped black ankle boots for pink slippers, and wrapped a kimono-like dressing gown round herself.  She got out her two favourite knives – the bread knife with the soft worn wooden handle, the steel knife with the most elegant lines.  The chopping board in line with the edge of the hob.  All the while her mind fixed half on the radio, the unfolding of the evening’s fifteen-minute serialised farming dramas; half on all this, here.  She fetched margarine and vegetables from the fridge, bread from the chaotically ordered cupboard, tightly wrapped in its own wrapper and an extra plastic bag that protected it from air and somehow negated its existence, neutralising it for the 23½ hours of the day it sat in the cupboard not being eaten.

She began to make her food.  She began always by weighing out the bread: 150g.  How long had it taken for the amount to settle upon that figure – how many years since she had made that first crucial shift from just judging by eye – or by stomach, even: by appetite? – to curiously checking sometimes with the scales to see how much she tended to have?  She remembered how she had looked up, once, in a little book of calorie-contents, how many bread was meant to contain; she had idly calculated how many she was getting.  She no longer had slices of bread, either, but a varied array of slivers and fragments and one huge chunk, in a pattern on the blue-spiralled plate congealed now into necessity.  Much the same thing had happened with the margarine: moving from spreading butter as one does, coating the bread in an unctuous, nonspecific layer, to finding lower-fat spreads instead, and measuring the amount, to needing this very-lowest-fat variety, and not spreading it any more, but scraping it with minimal effect over all but one corner of the thick piece of bread, where she’d heap a huge lump of it, so as to make her last mouthful a dense fleetingly totally satisfying mouth-quite-full of starch and fat.  And perfected with salt.  Now she ground salt and pepper over the ‘buttered’ bread, never able to try very hard to restrict the time she turned and turned the glass handle of the salt mill, covering the plate in whitish crystals; the pepper more a vestige of convention.  She rushed outside, straining not to miss too much of the radio, to the herb pots on the landing stage, to pick half a dozen tall strands of chive to place on top as a final adornment.  Then she boiled water in a pan for celery and cabbage, opening the door to let the scented steam out; hoping her neighbour wouldn’t be there, either to disturb or to be disturbed.  And as they cooked, the lettuce.  Precise here-and-now lettuce-weighing; with mental images of farmyards permeating it, completing not intruding.  She paid concerted but ever more automatic attention to the leaves she cut from the dense half iceberg-globe, part of the whole orchestration of other smooth movements: turning, turning the tap, filling a saucepan, cutting cabbage, lighting gas, spreading margarine, sprinkling dried herbs, rinsing hands, draining out water, positioning on plate, grinding pepper and salt, wiping the surface, standing back a minute, judging, checking, looking up: a gradually choreographed –

– Oh, Ebony, Ebony, for God’s sake, what is it with you today?  Will you please shut up, get out the way – you really can’t be so desperately hungry you can’t wait another few fucking minutes till I’m finished with this, can you?  You know you’ll only be hungry too early in the morning if I feed you now – just ’cos I’m making my food now doesn’t mean you need magically to start needing yours, does it?  I don’t start bawling as soon as I start getting hungry, do I?  Haven’t you ever heard of self-restraint?

There would be no peace now till the cat was fed.  Sometimes the miaowing was soft and pitifully plaintive; sometimes – this evening – it was tinged with shrill mania.  It came again and again until she too wanted to scream; did scream, swear:

– Oh, just shut the fuck up, Ebony.  Can’t you see I’m feeding you now – can’t you just wait?  Can’t you just see you’ll get it quicker if you just let me… 

She suspended just above cat-head-height the remaining 1/6 of a tin of fishy jelly-encased meat, chopped up in the little white ceramic dish, sprinkled with brown fish-shaped biscuits, just for a moment till the cat stood up and begged for it, though ever more feebly these days; then she set the dish down on its plastic mat on the floor at the end of the work surface, by the matching white dish of water.  The cat lowered her head and ate, ate, chewed too quickly, didn’t look up.  The girl hovered a minute watching her, marvelling at her.  She wondered: wasn’t Ebony really much much thinner these days, quite suddenly; angular where she had been lissome?  But she was eating so much more – clamouring so much that she gave her often almost half a tin every day now instead of a third; why was she always hungry, why then ever thinner?  She did throw up sometimes, but not often. 

She shivered.  She had closed the door again now; but she was always cold these days.  And especially now that the nights were getting so swiftly so much shorter she dreaded the winter: the engulfing blackness that was the prospect of never being really warm again till spring.  She pulled her dressing gown tighter over her jumper, retied the belt; she knew she herself had been getting thinner too; though not by eating more…  She wondered: Ebony wasn’t somehow – copying her, was she?  Or somehow affected by her own actions so that she might – waste away in sympathy?  No, that was stupid; that simple hungry unheeding eating – what did that have to do with any weird human habits.  She might be warmer in her night things.  Cosier, anyway, less constricted.  White silk nightie and purple fur-collared cardigan replaced skinny jeans and jacket, and with thick socks and dressing gown back on she felt the deep relief of the soft looseness of these wrappings: the feel of them meant another part of the day truly over.

The food sat at the end of the kitchen counter, neat on the clean surface, put aside for later.  In the kitchen, her eye was caught by a pinkish gleam from the two vertical windows in the front door; she opened it again, and stood looking out over the very last of the sunset.  She felt a deep calm sense of reverence; an immense gratitude for being allowed to be here, in this city, on this boat, in the midst of all this beauty and privacy and freedom to think.

Then the beam of pink was gone; and there was only guilt at feeling all that so rarely, so fleetingly.  It was time to make her first drink.  Mug, teabag, kettle, milk; another act of orchestrated nonchalance, nonchalance in elegance.  Filling the water to just the right level; the well-known pressure of teaspoon squeezing teabag against the mug’s thin creamy bone china wall; the fluid fling of used teabag into green metal dish for later; milk then, to turn the liquid just the right amount paler and creamier; a few drops more water, to top it up to the very brim; all to be carried to her chair always with the straight back and pretence of ease that let her cling to the self-respect of perspective.  And in this flowered kimono thing her steps were shortened by the tight-wrapped fabric; she liked the hobbled grace of it.  She admired in full flow the fluidity of self-observed self-observing movement – cut short by that cat, under her feet again, finished eating already, hungry again already?  Or seeing through the act, maybe; wanting to mess it up?

The cat had a mat on the bed, close to where the mouse-mat lay on the silken quilt, next to where she sat at the end of the bed in rocking chair with rug wrapped around knees, laptop balanced on lap, tea at hand, books at hand, notes at hand, the light fading.  The cat washed itself, starting with the legs.  Sentences beckoned and came and went and were captured, the essay grew.  ‘The world Rousseau creates for himself in the writing of the Confessions is populated not only by a fictional self but also by fictional others; his solitary reality gives birth to an imaginative society.’  They came easier when there was still tea in the mug; when it was finished – all but the last millimetres that would be the basis for the next mug with reused teabag – it was more laborious, without the urgency and promise of imminent reward that the mug there, waiting to be sipped from, gave her.  With it empty there, she thought still about the sentences, but she thought more and more about the clock in between and within them, calculating the time she ought to have, or would have earned, the next cup; liking it all to be as late as possible, even while knowing that would only mean she would wake later in the morning – liking when things somehow conspired to mean things had to be later; such a very powerful feeling, the feeling of power in keeping working later – even if it was at its guiltless best when the lateness could be labelled unavoidable…

The hours passed.  She drank all her five drinks, wrote as much as she could.  ‘…Similarly, in the Rêveries, the danger of the social exchange which is so emphatically denied is replaced by the pleasurable security of internal reciprocity, of conversation through the text with himself, as with “un moins vieux ami”.’  The cat was there, sometimes, hovering round her mind and mouse-mat.

Eventually, a little later than the night before, it was time to have her food.

 

 

 
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