Flora

Beginning to see the light

I was rather proud when I was told I was an “Atypical Anorexic”. At least if I am going to have the illness, I would rather be “atypical” than “run-of-the-mill”. However, it would seem that there is no such thing as typical anorexia and that must be the reason why it is so difficult to understand, both as a sufferer and as a carer.

It is certainly nothing to do with a desire to be thin; I have never aspired to be a super-model and have no illusions about the fact that I look too thin or looked terrible when thinner. I was already married when I developed the illness and pre-contracting it, never gave my weight or appearance a second’s thought.

On paper, I had everything and could not have been luckier. Perhaps my life been too happy? Would a few more knocks in early life have equipped me better to deal with life as a married woman in the real world?

I used to think it would but now I see that my personality and the expectations that I set for myself are what have caused these difficulties and that is one area in which I could be classed as a “typical” anorexic – these expectations are set very high and failure to reach them is considered a very worrying matter.

I would describe my descent into anorexia as a gradual loss of confidence that happened as a result of a series of small blows. They must have hit a particularly vulnerable area of my self-confidence and they also happened in quick succession over a short period of time and thus conspired to undermine the confidence I had in myself.

Not being happy at a time when one should be is not easy. Just married, lovely new flat, off to Cape Town for 6 months... why aren’t you happy? Are you ungrateful or just spoilt?

These negative feelings intensified during our time abroad. Visa restrictions forbade me from finding the meaningful job I craved and I had an overwhelming need to be busy, useful and achieving. It was then that I started living by rules rather than feelings. I set myself targets each day and took to constantly reviewing and rating my actions. Exercise became my principal measure of achievement. I began to gain satisfaction from being in control and from imposing a certain discipline on my lifestyle.

Self-control and discipline are very much tied-in with the need to suppress emotion. One of the things I have really missed over the past few years is the feelings of spontaneous emotion that make one feel human. I have become totally immune to feeling and have had to rely on remembering how I used to feel in order to express the correct emotion when appropriate.

The suppression of emotion happens as a self-defence mechanism against having to face failure, but it appears to include all emotion; positive and negative alike. As I could not justify my seemingly demanding and selfish needs, I learnt to put a lid on them by refusing to listen to my inner-voice. I began to obey another voice, one that would not allow me any treats or pleasure. If I disobeyed it, I felt terrible guilt and worry that I was living out of control. I enjoyed treating others as, in doing so, I was doing things that I ached to be able to do for myself but I did not need to feel any guilt. My selflessness was actually selfish as it was the only way I could respond to my needs without having to deal with any negative feelings.

The food issue is very much entwined in this web. Firstly, if food was previously a great source of pleasure, it makes sense that it would be one of the main things to be restricted and this restriction gradually led to weight-loss, which led to the physical effects of starvation. These effects were similar to the effects of denying oneself other pleasures in that, when and if I did allow myself something I loved, my body craved more and more and the potential loss of control that these cravings signified was terrifying. As I became more deeply hungry, my body sent constant signals to my mind to feed myself and consequently, my thoughts become totally obsessed with food. I learnt what I actually needed to get through the day and anything over and above was considered indulgent. As time went on, I tried to need less and less.

I was becoming more and more confused, unhappy and unable to understand what was happening to me. I sought help but my defence-barriers were so strong, nothing could get through them. I kept manically busy so as not to have time to think too deeply or allow myself to feel any unwanted emotions.

As the anorexia became more entrenched, my actions became more obsessive. Mealtimes had to be at set times, exercise had to be vigorous and daily and any attempt to make me eat food that did not feature on the ‘permitted’ list provoked angry and tearful outbursts.

I wasn’t coping very well but I really believed that I was and that I could not possibly live any other way as that would entail letting down the defences and facing failure. The risks of allowing myself to be vulnerable again were too great and I was not strong enough to take them. On one hand, I desperately wanted help but on the other, I resented anyone who tried to help as the prospect of having to challenge my ‘safe’ lifestyle sent me into a panic.

I had fixed objectives to achieve each day. These were utterly non-negotiable and if I had not had enough sleep or for some other reason could not fulfil them, then I felt the need to punish myself by means of food-intake. I needed constant reassurance that I was not being greedy and would latch-on to certain foods and could not imagine eating anything other than them.

The initial feelings of low self-esteem had multiplied and mutated and were now not only to do with my achievements but encompassed every aspect of me including friendships. To people I met, I think I still appeared to be confident and capable and I appeared to have endless energy that exhausted anyone who tried to keep up with me. I was convinced that I was leading an excellent lifestyle as I ate healthily and was never ill. I could do anything I wanted as one can if one does not listen to one’s mind begging one not to. I have also recently learnt that when seriously underweight, the body does not allow itself to get ill as it knows it would not have the energy to cope – my pride in my strong antibodies was misplaced!

In my more honest moments, I did know that this could not go on and I made a few attempts at increasing my weight. I have always said that I would go back to my original weight tomorrow if it was merely a matter of taking a pill – the weight is not the issue here, it is the physical process of allowing oneself the ‘luxury’ of eating, it is the fear of facing up to reality and of accepting oneself and one’s emotions. It is a case of breaking the vicious circle in which one is caught up.

There are other complications, such as having become used to receiving special treatment and attention from others. Being too thin was an outward manifestation of inner vulnerability and a signal that I was not coping too well although I hated to admit it. When I return to looking ‘normal’, I will have no excuse not to be treated normally again and what if I can’t cope all over again?

Whilst I was willing to seek help, I was relieved when the help I took showed no signs of correctly diagnosing my problem or of challenging my behaviour. I dutifully went for a while to satisfy everyone that I was trying but felt frustrated at being told what I was and wasn’t and at being told I was concerned with body image when I clearly wasn’t.

Eventually I started treatment for Obsessive Compulsive Disorder. On the one hand, I felt some relief that finally someone could relate to what I was going through but on the other I was terrified by the fact that the lady I was talking to could read my inner secrets and knew exactly what was going on in my mind – she, too, had suffered from an eating disorder. These contradictory feelings have been a constant in my quest to get better; I want help, I don’t want help, I want special treatment, I want to be the same as everyone else, I want someone else to take control, I am terrified of losing control. She believed that to cure anxiety disorders, you had to jump in at the deep end and confront your worst fears and so ideally, I would gobble a Krispy Kreme Donut at 11am and realise that I could live to tell the tale.

I stopped this line of treatment but was finding life harder and harder as hunger, cold and worry were dominating every waking hour. I wanted someone else to take over the shopping and cooking and so asked my mother and husband to do so. What a nightmare job for them! We all still knew very little about anorexia then as, amazingly, despite having been to see a variety of ‘experts’ no-one believed that that was what I had. I think that my lack of concern over body image threw them off track. They took advice from the only person who, at that stage, had shown much understanding of my problem, the OCD treatment lady. She advised them to challenge me daily with my most scary foods and to keep everything a secret until the moment I had to actually eat it. Poor them! I can only explain my reactions to their (actually very good) cooking as provoked by total fear and panic. My whole being was rebelling against what was happening and my responses were beyond my control. Whilst this severe treatment may work for some types of phobias I think that it is too extreme for most anorexics as the anxiety it entails causes them to shore up the defences even more and for the first time in my anorexic-history, I began to tell lies as I really couldn’t cope with the fear it involved. After a sorry few weeks, we all realised that this wasn’t working and I was becoming more and more rebellious – being forced to eat may have been making me put on weight but it was alienating me from my family and, as it was not tackling the root of the problem it would not have any long-lasting effects. Should I go into a clinic?

Although my BMI was not quite in the danger-zone, it was low enough to be admitted to a clinic but, being a teacher, I could not just abandon my classes at a fairly crucial time in the school-year. I was torn between the ideal of wanting to be whisked away and then being returned home fully cured a few weeks later and a sense that, at all costs, I wanted to remain in control. A relation, who had been treated in a clinic for alcoholism, sweetly travelled miles to talk to me and to urge me to tackle this problem from the roots. He made me aware of the different areas that needed to be addressed: mental, physical and spiritual. I did not fully understand what he meant at the time but I can now totally see the three strands: I needed to put on weight, turn around my mind-set and recognise my inner-being after so many years of repression.

We found a counsellor locally and although I found her method rather disconcerting as she didn’t speak much, offer advice or tell me what to do, she allowed me to explore my feelings just by talking aloud. She also made me realise that it is acceptable to feel what one feels and that I had no need to punish myself. From these sessions with her, I suppose I set off on a much clichéd ‘path of self-discovery’ and I am learning to define myself in terms of who I am rather than what I can do.

On the physical side, I aim to eat as much as I can although it is still extremely rigid and controlled. I have been having bi-weekly sessions with a dietician and this is invaluable to me as it has enabled me to understand how the body works, why it reacts as it does when deprived of food, and when given food once again. I feel more obliged to eat if I have a mental image of food as a medicine, flowing to heal and nourish different parts of the body. Even if sometimes I don’t feel as if I deserve food, at least my body does.

The difficulty of getting better in the ‘real world’, rather than in a clinic is that progress is very slow. When I started, I had visions of a couple of months but now realise it will take at least a year and that I may never return to person I was before. Just as someone who has had a physical accident may always walk with a limp, a mental accident may leave the equivalent minor disabilities but the important thing is that these disabilities will be minor rather than life-ruling. The other problem with working from home, as it were, is that inevitably things come up, such as social engagements, that throw one off track. It is a balance between not totally withdrawing from life and losing friends in the process and not doing too much that causes panic and leads to backward steps.

For the first few months I was unbelievably fragile. I felt as if I wanted to hibernate at home and get on with what I had to do. I had stripped away all the defences and completely laid myself bare. Other people scared me as they seemed so confident and whole compared to how I was and I needed desperately to feel safe. I was a completely deflated balloon as all the mis-beliefs I had had about myself had been let out. My sessions with the councillor had enabled them to float to the surface and evaporate. Since that time, I have been gradually re-inflating myself and have been enjoying getting to know myself again and allowing myself to feel emotion. I would be lying if I claimed that it was easy but with an enormous amount of help from Robin and my family I hope that I will be able to continue taking small steps in the right direction. My relative promised that not only would life eventually return to how it was before all this set-in, but that it would be infinitely better and slowly, seven months into the process, I am beginning to see that he was right.

Flora

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