Change, choice, responsibility

When I first really sought treatment for my ED I was physically, mentally and emotionally very sick. I couldn’t choose recovery or take responsibility for my own care – that’s why I’d finally reached out in desperation, with the last of my energy, to people I hoped could save me.

They of course told me I needed to “choose recovery” and take responsibility for my health. I was bereft! Seeking help was about all the responsibility I was able to take at that point and I needed guidance and help. Instead I kept hearing that hateful phrase “What do you want to get out of this?” I had no answer of course. Not to feel shitty? Not to die?

I wish healthcare providers would stop trying to foist responsibility on ED patients who are not ready to shoulder it. Treat the illness, save the person. Don’t try and give them “coping tools” or encourage them to save themselves. They can’t. Nobody chooses to become anorexic, it’s a complex illness with neuro/bio (& psycho/social) causes. Likewise, you can’t just choose to get better. That’s just hurtful victim blaming. 

…However, I’m also quite keen on the Jungian ideal of treating the person as a whole, as opposed to focusing on just exorcising their pathological symptoms. Clearly, most people’s psychic malodies, their disorders and neuroses weren’t caught like someone might catch a cold. They’re part of the person and their maladjusted approach to life, an SOS from the subconscious. Just because they might have only shown up recently that doesn’t mean they weren’t bubbling under the conscious surface for a long while.

I’m convinced that by the time you show symptoms of an ED something has been Not Right With You for a long time. And ED is a last, desperate attempt to cope from someone who is struggling. I personally think my AN was a big “NO”. Overwhelmed by life for many years I eventually ran out of energy and had to put up boundaries. Nothing went in, no feeling, no food. It was a symbolic way of pushing all that messy, invasive, scary life away.

big no

Kinda like this.

But does that matter by the time you show up, dull-eyed, starving and suicidal at the Dr’s office? No. At that point they need to get you medicated, medically stable, furnished with emergency phone numbers and intensively helped with the basics like how to eat, how to leave the house despite your anxiety and get to the therapists.

I wasn’t unmotivated or reluctant to recover, I was incapable and terrified.

Like Carrie Arnold says in one of her excellent blog posts – the recaltriant non-compliant patient is a myth – it’s just that a lot of us can’t take the help offered. We can’t pick up those tools and make use of them. We need people to take that responsibility and do it for us.

So what am I blogging about here? I guess I’m saying that people with active EDs need nuts & bolts basic help, handholding and direction when they reach out for help. Sure, you’re just treating the immediate symptom of a deep psychic malaise but it’s important to provide help, not just the opportunity to pursue help. Because otherwise, many of us would actually be dead before we even made it to the top of the psychotherapy waiting list. 

And the deep psychic malaise can be explored later. I’m in therapy now and I’m able to make use of it because I’m not starving and I’m more mature. This is me taking a responsible step to cement my recovery. I wouldn’t have been here to do this if I hadn’t got the basic nutritional and medical support (eventually) when I reached out for help. 

So, to finish I’d just like to emphasise – developing an ED wasn’t your choice or your responsibility or your fault. Fuck anyone who tries to tell you you chose it and you just have to choose to get better. You’ll probably need to reach out for help, be that in the Dr’s office or from online support or from your friends. Do that, do it sooner rather than later and stand up for yourself and your needs. You deserve it. Yes, even you. 

Its been a while here’s where I’m at

My weight goes up and down, within acceptable limits.
My depression and anxiety is gradually lifting thanks to the prozac (and no thanks to the NHS who have had me on a waiting list for a therapist for over a year and a half). I’m feeling a lot stronger and more at ease with my weird self.
I’m settled on describing myself as genderqueer and have stopped worrying so much about whether I’m trans or just can’t deal with our cultures bogus gender roles or whatever. Neutral pronouns please.
I’ve been working a bit. Little baby steps into the adult world, being around people. My confidence has grown exponentially with every day I get through and don’t fuck up (or get attacked or summon cthulhu or whatever it is I’m actually afraid of).
I still live in an emotionally incestuous tense little knot with my parents but hey, right now were all getting on so things are OK.
I turned 30 and only freaked out a *little bit* about being so old and such a pathetic underachiever.

Anyway, I don’t know why I stopped posting here but right now I’m inspired to start again. I think I might be having a teeny tiny micro mini relapse – I’ve been restricting for two weeks and feel the urge to dive back into reading about EDs…but even recognising this shows I’ve come a long way.

Privilege Denial

Is fat really the worst thing a human being can be?
I was going to blog about something else today but then I saw this article on Jezebel and its really bugging me.

In case you don’t have the time or inclination to click the link, the gist of the matter is: – This woman, Britton Delizia, has started a kickstarter campaign to raise money to create a book celebrating “thin and beautiful women”. Fine, fine, that could possibly be done well, as long as it celebrates the women as people first, rather than bodies and doesn’t objectify them. As long as it’s saying thin isn’t the only acceptable shape…
But of course, it’s not at all body-positive or female-positive. It’s a pile of delusional, thin privilege denying fuckery. Because, apparently she and other thin women are being persecuted for being thin. Apparently we live in a world where “fat culture is protected”.

Uh….no.

Thin Privilege exists. How can you not be aware of that? How can you deny that?! According to these figures on the ANAD website, 81% of 10 year olds are afraid of being fat. As a thin person, Britton Delizia can open a magazine or turn on the TV and see people who look like her represented in the vast majority. Obese Americans make less than their thinner co-workers. For whatever it’s worth, Anti-fat bias gets a wikipedia article.
If you are thin, you are privileged over someone who is fat. Fact. Our culture holds much, much more positive views about thin people and this will positively impact on the ease with which you progress through life. Of course, having privilege in this one respect doesn’t mean your life will be wonderful. And sure, thin people can be body-shamed, too. And it sucks for everyone. No one is denying that by saying fat people in general have it worse. And guess what, changing our culture to be more accepting (even respectful!) of fat people does not diminish the acceptance and respect you have as a thin person. It’s not about fat versus thin, it’s about accepting all bodies and also looking past the body and seeing the person. Pitting fat against thin in some ridiculous adverserial contest is not helpful, it’s a distraction from the real enemy – a culture that defines people (especially women) by their bodies and keeps us striving to conform to a shallow and narrow beauty standard just to feel worthy of existing.
It’s telling that when someone wants to insult a woman, most often the first insult of choice is one relating to weight. Usually that happens to be calling them fat, sometimes it’s calling them them thin. Either way I’d rather have my intellect, my moral character, my politics insulted if only to acknowledge I’m more than just a body to be looked at.

OK. Rant over. I just had to get that off my chest.

New books, old clothes, rambling

Your Weight in Perspective

I really need to stop letting my unchecked perfectionism prevent me from posting here. I have so much I could be blogging about but teasing the tangle of ideas out of my brain into neat single-issue coherent posts does not come easy. But, aside from drafting and discarding a bunch of posts, I’ve also been reading. I finally got my hands on a couple of ED books I’ve been meaning to read.

Fasting Girls: The History of Anorexia Nervosa (Vintage) by Joan Jacobs Brumburg – I’ve only just started this but it seems good. It’s a historian’s investigation into the history of anorexia, from fasting saints to the present day. Originally written in 1988, but it seems pretty comprehensive. While the author acknowledges the biological, psychological and cultural origins of EDs she says in the introduction that this book focuses more on the cultural. Which is fair enough.
I’ve also been enjoying Beyond Anorexia: Narrative, Spirituality and Recovery by Catherine Garrett. This is one of those books that had me pencilling excited annotations in the margins, agreeing with the authors insights. I may have found it heavy-going at times but I really think Catherine Garrett ‘gets it’. OK, it is perhaps a strange book, written by an academic and ex-anorexic, examining recovery and the need for narrative and spirituality (however loosely defined). Extrapolated from her own experience, interviews with 34 recovering ED sufferers, sociological and anthropoloical approaches. But it’s refreshing to read a book focusing on recovery and the meanings that come from getting well, not the meanings we can draw from sickness.

I think too often we get hung up on analysing the illness, it’s origins and perpetuation, the symbolism of the sick body. At the same time we percieve recovery – stepping up to meet the challenges of life and leaving behind the disorder as something which needs no explanation, something that ought to come naturally. Well…obviously for so many of us it doesn’t come naturally. We get stuck in that sick state because we lacked a roadmap to maturity, to independant adult life and personhood. We lacked the skills and knowledge to get there. It’s the path to recovery and living a ‘normal’ life that we need de-mystifying, not endless re-examination of our stalled, sick state. Oh, of course it’s important to gain insight into our sickness, but therapy shouldn’t stop there, like it so often does. As if knowing why/how we are sick will break the spell. For me, that was just the beginning, giving up restricting and gaining insight into my personality, my family’s dynamics and my past traumas did not magically teach me how to be a real adult person. I’m still unable to move forward into my own future, I feel totally lost and in the dark.

And so…I have a suspended life between recovery and relapse. I cleaned out the attic recently and found a load of bags of clothes from my most emaciated days. Why do I do this to myself? I could have just thrown them out, but I had to keep them to trigger my future self. I was genuinely amazed looking at some of my old jeans that they even make adult clothes in those sizes. I never percieved myself as being that thin, but clearly I must have been. I always remember that quote from Hilda Bruch’s book, The Golden Cage: The Enigma of Anorexia Nervosa “An anorexic patient cannot be considered outside the danger of relapse unless she has honestly reported on the terror of starvation and her inability to repeat it.” By keeping those clothes I was in some part of my mind planning for relapse. I have no idea why, but if I’m really honest part of me does still feel the need to repeat that experience, the anorexia is like a weed that’s been cut back but the roots are still there in me. I threw out some of the clothes this time, but I still hung on to some, like I still hang on to the posibility of starvation.

OK, OK. Enough.
I’ll come up with a ‘proper’ post next time, rather than all this negative autobiograpical rambling.

So which is it?

I keep coming across these conflicting messages about the significance of the physical body in eating disorders.
Either we’re trying to deny it, obliterate it and become free-floating intellects. Pure, transcendent above the messy, sinful, unruly meat-puppet.

Or…We’re over-valuing our bodies, thinking that if we starve and exercise them to perfection we’ll be perfect people, finally free from worry and able to present ourselves to the world with confidence. We’ve taken on the cultural message that thin = happy or even worse, that thin = the only acceptable shape.

And if we’re not brainwashed by the media and skewed cultural attitudes to bodies, we’re using our bodies as billboards for our inner torment. The emaciation is a big flashing neon sign that Something Is Not Right With Me.

And Yet…We apparently go to such devious lengths to disguise our weightloss, baggy clothes and weights in our underwear when we go to the doctor.

We’re neglecting our bodies and our self-care or we are obsessed with our bodies and their appearance, spending hours at the mirror.

No wonder we have confused feelings about our physicality. The body can be an ascetic temple of perfection or a scary uncontrollable beast, it’s at the centre of our disorder or it’s just a side effect. Doctors tell us we are silly for trying to conform to unattainable standards of beauty we see in magazines, then tell us to gain weight and conform to their standards as seen in BMI charts. As women especially, we really have to fight to take ownership of our bodies. They are sexualised, medicalised and moralised by other people.

My Self and my Boundaries

a spiky bodice

I’ve been reading a lot of psychoanalytical interpretations of anorexia. I’m not always convinced by some of the wackier explanations of our unconscious motivations and I think there’s a dangerous suggestion of victim-blaming in a lot of psychoanalysis. And a lot of dicks, of course. Nevertheless, I think they have some interesting general ideas for an anorectic to try on for size, even if they ultimately don’t fit for that individual.
Personally, after faking my way through lots of superficial, unsatisfying and ineffective Cognitive Behavioural Therapy I feel I need to go deeper.
….God, everything I type  now sounds like some kind of innuendo, thanks a bunch, Freud.

The psychoanalytical Object-Relations theory attributes our current problems largely to failures to negotiate developmental stages in early childhood. These failures to form a coherent sense of ourselves and the world around us manifest in our unconscious mind, a source of dissonance between how we perceive the world consciously and our maladjusted unconscious motivations and fears. Well, that’s my generalised understanding; I’m sure google will direct you to a lot more expert info.

I’d already come to see my ED as anchored in two issues: Boundaries and my lacking Sense of Self. Psychoanalysis explains these quite well with the suggestion that as a baby (and perhaps throughout life) I struggled with the process of Self-Individuation.

I perceive my boundaries or lack thereof very acutely. Not only have they been violated quite traumatically in the past, they feel very flimsy and always in danger of being washed away by forces outside of myself – other people, their wishes, life events. I don’t like to be touched, at least not unexpectedly. I’m very protective of my personal space, very private, secretive. I also have trouble adjusting my boundaries appropriately; I’m either sealed up within myself, admitting no one or I’m wide open and feel I’m being steamrollered by other people. My walls are either impenetrable or non-existent.

Stemming form my uncertain psychic, emotional, physical boundaries is my equally weak sense of self. Where do other people end and I begin? Is my body part of myself? Am I in danger of being subsumed and annihilated by my environment? These sound like ridiculous questions to my conscious, thinking mind but they feel like legitimate concerns. Underlying my constant nameless dread it feels like there’s a subconscious, id-level belief that I really might be annihilated. Why do I panic for apparently no reason? Why do some minor problems suddenly start to feel like a full on fight-or flight survival crisis? I’m willing to believe it’s because a primitive, confused part of me is actually afraid of psychic death if I let down my walls, my impermeable boundaries and allow my self to meet with my environment.

And it’s easy to see that restricting my food intake might follow on from this subconscious belief. My physical self is somewhere I can appease my fear of violation, my lack of strong boundaries. Food is a foreign substance, part of my hostile environment, not part of myself. It could even come to represent everything outside of myself – all physical or abstract threats. If I control it, allow in only small, comfortable amounts I can remain intact. The whole external world might be a tsunami poised to wash me away but I can find some relief from that fear in this one act of control.

Some have theorised that the emaciated anorexic body is an attempt to communicate inner distress, that it’s a message to the world. I’ve never bought into that, instead I think the emaciation is mostly just a side-effect. The real act being played out with my body is for an audience of one: myself. It’s where I get to claw back some control so I can feel safe. That’s why demands made of me to eat, or eat more than my self-imposed level of restriction feel so impossible to acquiesce to. Firstly, they are demands from other people, objects outside my self which in my binary state of boundaries-up/boundaries-down I can’t risk acknowledging. The fate I’m trying to avoid by not eating is psychic doom, annihilation so by asking me to eat, I feel they might as well be asking me to jump off a cliff. My rational conscious mind has always been baffled by my incredibly strong feelings in this situation, why am I so adverse to eating? I now think it’s because to eat symbolises the destruction of my boundaries, the loss of myself. In essence, at a dumb subconscious level I think food will kill me.

Does all this dramatic introspection make sense? I’m never sure when I write if I am actually organising the information coherently. And it doesn’t help that when it comes to ED etiology and the subconscious I’m feeling around in the dark.

Plus, knowing these things doesn’t instantly cure me of my need to restrict. I’m not sure if it’s supposed to or if I should instead just learn to work around my issues without trying to cure them completely. I certainly find I’m able to pay closer attention to my feelings and motivations as opposed to what I think I should be feeling. Sometimes I feel bad for weird or inappropriate or unclear reasons and that’s okay. I don’t have to deny feeling bad just because I can’t find a worthy or simple reason for my feelings.

Reading List

Just a collection of non-fiction eating disorder books I want to read/re-read.*
I’ll no doubt be updating this list as I keep discovering more. Always open to recommendations too!
All the links are to google books.

Anorexic Bodies by Morag McSween
The Thin Woman by Helen Malson
The Social Construction of Anorexia by Julie Hepworth
Hunger Strike: The Anorectic’s struggle as a metaphor for our age by Susie Orbach
Unbearable Weight: Femism, western Culture and the Body by Susan Bordo
The Hungry Self: Women, Eating and Identity by Kim Chernin
The Obsession: Reflections on the Tyranny of Slenderness by Kim Chernin
Trends in Eating Disorder Research by Pamela I Swain
Feminist Perspectives on Eating Disorders by Particia Fallon et al.
The Golden Cage by Hilde Bruch
Hungry Hell by Kate Chisholm
Fasting Girls by Joan Jacobs Brumberg
Beyond Anorexia: Narrative, Spirituality and Recovery by Catherine Garrett
The Body Betrayed by Kathryn J Zerbe

And just for fun…
Feminist Interpretations of Rene Descartes
Gender/Body/Knowledge: Feminist reconstructions of being and knowing

*If I can actually get hold of them/afford them. I think it’s ridiculous how some of these academic texts retain their prices as e-books. £60 for some endlessly replicatable data? Really? Where is all the book-piracy at?

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