Stab in the dark/ heart

I always forgot which workshop was which. That didn’t seem to matter because all of them were founded on the same concept of mind and thus similar models of behaviour. They each had similar benefits.

To quickly recap what I’ve said before, the way we respond to any situation or experience is rooted in our previous experiences and the conclusions we drew from them. Our habits and behaviours grow from these assumptions and invariably reinforce them. From them we develop tools and practices to overcome, or at least cope with, life’s difficulties. Even anorexia is a coping mechanism for some even larger, more deep-seated problem.

The best example of this cycle in action, isn’t actually an anorexic behaviour, it’s the attitude my students display towards exams. You’ll remember that I work as a learning support assistant in a secondary school. The students I work with don’t experience success. They are constantly assessed and found wanting but they are resilient and they develop strategies so they can survive.

Assessments, for them, involve having some sort of written or verbal question fired at them and feeling totally at a loss, but knowing this feeling will stop if they just volunteer an answer. Any answer. They don’t expect to get it right, so they don’t waste time trying to work out what the correct answer might be. They just blurt out the first thing that comes into their head. If it happens, by chance, to be right, they’re surprised and grateful to the teacher because they have no idea how they came to that result.

Usually, of course, it’s totally wrong, reinforcing their belief in their own inability. They assume successful students just have the right answer pop into their head, so they make no attempt to develop ideas in exams. They favour one or two sentence answers and skip any questions they can’t immediately respond to, allowing them to finish very early and then get the hell out to lick their wounds together, laughing and pretending they don’t care.

By getting it over and done with quickly, though, they can consign the humiliating experience to the past and forget it, concentrating on those things that comfort them and make the school day bearable: their friendships and feuds, their amusements, teasing their teachers…

I can remember working with a lovely, hard working but completely innumerate student and trying to get her to subtract 2 from 7 by holding up seven fingers, then curling down two of them. “So, how many fingers do I have left?” I asked.

“27”, she replied.

Similarly, last week, in a Geography lesson, another student was looking at a photograph of the huge buttress root of a rain-forest tree. They teacher asked him (unnecessarily), “so, is this at the top or the bottom of the tree?” He said, “The top.”

In both these cases the students knew, or were capable of knowing, the answer. The first student could count, and knew humans only have 10 fingers; the second doesn’t confuse the tops and bottoms of trees. However, they just followed the discourse formula they had learned to expect: an incomprehensible question followed by a random, incorrect response. They might as well have said “Haploid cells” or “Vermillion” or “The War of the Spanish Succession”.

But we all do this. In Ascot House we favoured selective memories that only brought bad things to mind; selective interpretations that only imagined the worst.

Back to the drawing board

To cure us, they feed us up. That’s the main thing. Anorexia generates the very anxiety it then, like some diabolical snake-oil salesman, offers to assuage. It just needs to get its foot in the door to start that destructive cycle. With me, it was exercise and a low fat, healthy diet, both of which became excessive. According to Abi, research on recovering anorexics suggests that if you can simply restore the sufferer to a healthy weight, their thinking becomes much more rational and constructive. That’s why she put me on those ghastly collagen shots the first time I got ill but couldn’t put on enough weight. Those vanilla flavoured pots of oily liquid with the vile after-taste were little shots of pure calorie, pure weight.

But our initial vulnerabilities still exist and we need to understand ourselves and fortify ourselves against relapse, so, to retrain our feral brains, at Ascot House, they used to herd us in to the “art room”, where we had workshops.

We’d trail listlessly in and scatter around the central island of tables, always sitting in the same place, growling and whimpering, gnawing on bones, crapping in corners because we don’t understand how the litter tray works. (Metaphorically, metaphorically!)

Actually, those of us who had gained a bit of weight fidgeted, gnawed our lips, looked stricken, jiggled our feet, wrapped our arms protectively around ourselves, stared morosely at the table to avoid each other’s gaze. Those of us who were new to Ascot House, and still critically underweight, slumped in our chairs, dozing, unable to find the energy to move a single, limp muscle.

We had quite a few different workshops, with different titles. There was (alphabetically)
• Assertiveness,
• Body Image,
• Dealing with Anxiety,
• Living with Emotions,
• There was something very frightening called “Motivational Chair”,
• Motivation for Change,
• Open CBT,
• Perfectionism,
• Radical Acceptance,
• Self-esteem,
• Values-Based Living

We got a right old going-over, psychologically.

I may seem thick to you, but I identify as clever!

Feeling, an ability to grasp and acknowledge the spiritual importance of others, and of the external world, the sense that they occupy metaphysical space, is a neurological capacity, a form of intelligence, not simply a characteristic of that external reality.

Our anorexic brains are inadequate to that task. Sure, they patch something together that appears to cover all the ground, but if someone politely challenges us, we freeze, rigidly refusing to budge from our position. It’s not that we need to be right all the time, it’s more that we crave certainty because we are permanently on shaky ground. (Literally – think of the number of times I’ve stumbled and fallen when jogging, or think about my friend Cath, at Ascot House, coming down the stairs on her bum, every morning, to avoid tumbling down the whole flight). The idea that there might be two opposing interpretations of something suggests a world of profound uncertainty and is thus highly threatening.

We absolutely refuse to change our opinions, because we lack the mental flexibility to change direction, and our anxiety makes us fear it, yet we recognise how unreasonable we’re being, so we’re not entirely sure that we aren’t joking. We can’t even read ourselves, anymore. And we feel overwhelmed by the emotional complexity of negotiating disagreement, with its potential for conflict, when we’re desperate to be liked but feel we are hateful.Our solution is to push our interlocutor away and run for the hills. In other words, to pre-empt the inevitable rejection, we’re foul to everyone.

Our panic leads us to a sort of hoarse and hysterical, accusatory whining, which would be shouting if we had the energy. We’d cry if we weren’t desiccated husks, incapable of generating tears. (We are the hollow men/ we are the stuffed men/leaning together/ headpiece filled with straw. Alas!)

Conversations often go something like this (my lines all delivered in a mumbled, listless monotone):

Me: Pineapple on pizza is disgusting.
You: Actually, this may sound weird, but I quite like it. it reminds me of my childhood.
Me: No. No. Why are you saying that? You can’t honestly think that.
You: Well, that’s just me. That’s what I think.
Me: Oh, God. You’re right. I’m sorry. I’m being totally intolerant, aren’t I? Christ, I’m such a shit…
You: Calm down! This conversation isn’t about you. why do you have to turn a perfectly pleasant chat into a self-hating monologue?
Me: Christ, you’re right. Oh, god, I’m such a self-centred arse-hole…
You: Oh for goodness sake! I’m leaving.
Me: (calling after you) I don’t blame you. I’m surprised you put up with me this long.
Me: Ah, blessed loneliness. Christ, other people are stressful.

Alternatively:

Me: What sort of ignorant, bigoted monsters voted Leave?
You: I think you’ve got to understand why Brexit appealed to some people.
Me: What? I never took you for a fucking Nazi.
You: Now you’re being unreasonable…
Me: Well, fuck you, you fucking Nazi. At least I’m not a fucking Nazi.
(You storm off)
Me: Ah, blessed loneliness. Christ, other people are stressful.

When I was at my illest, I was bloody, openly rude, usually because it felt like people were filling my head with their words and actions and opinions. In a fluster, I told them exactly what I felt to set them straight, to get things straight, in my own head. If people hated me – well, that was the lesser of two evils. I’d survive it. I hated myself. I’d feel mortified and guilty but I was used to that as well. That was just me: I’d expect nothing more from myself. At least I could dispense with years of fawning pretence that I was a nice person. I could let my guard down and reveal the true, nasty me underneath.

Looking back, it’s all so embarrassingly solipsistic, but it felt like trying to stand up in one of those ancient cockleshell boats: when you’re flailing around trying not to upend yourself and drown, you haven’t got much time to look about you.

I used to fantasise about cutting out my own tongue.

The Trials of the Dumb

Not everyone is equally able, psychologically. The more intelligent you are, the better you can engage with and comprehend the world. Those of us who are intellectually compromised, through birth defect, illness, inherited incapacity, must live a more dream-like and bewildered existence, preyed on by inexplicable monsters that appear out of nowhere.

We anorexics lack the mental energy to picture the future with any clarity. We are left with the vaguest, theoretical glimpses. We’ve abandoned any personal goals or plans to struggle with present problems. They loom up, hugely, right in the foreground of our consciousness, and demand to be dealt with immediately.

We are reactive. We are driven by compulsive habitudes that we’ve developed to assuage these anxieties. Any negative consequences of our comforting rituals will just have to be dealt with later. That’s why we can starve ourselves to death by accident. And Anorexia is a self-fuelling engine. The thinner you get, the more anxious and uncertain you become, the more you need an urgent, controlling obsession to occupy and comfort you.

When it comes to our relationships, we lack imaginative empathy. Through insomnia and malnutrition, we are operating a skeleton neural service. We understand, in a technical, theoretical, almost mathematical way, how other people might be feeling, or how their thoughts work. We can deduce what they’re likely to say or do (or say they think), but we don’t get it on an emotional level. Is this similar to autism? Is it similar to sociopathy?

We don’t feel the impact or the importance of words, relationships, events, something most people do so easily and automatically that they don’t even realise they’re doing it. Our cognition has flattened out. It’s all surface, whereas theirs has depth and intensity. There’s a spiritual dimension, a profundity, to other people’s reflections that we simply don’t share. It’s all one to us – life, death, other people…

Going from our perspective to theirs would be like seeing a 3rd dimension suddenly spring out from a flat picture surface, endowing it with substance, bringing some things to prominence over others, making sense of a crowded jumble of shapes.

Cogito, ergo…sufflimandus sum! (Sorry!)

The human brain is a utilitarian organ. It developed its skills to counter life’s challenges long enough for us to reproduce. It wasn’t designed to apprehend the universe in all its vastness and complexity. It doesn’t need to. Think of the number of times in a single day that you are forced to think, “Well, I don’t get that, but I’ll just have to accept the incomprehension and move on.” Especially in the age of the algorithm. (And this experience is multiplied a thousand times for us anorexics.) The brain responds to, and mediates, the sense data from the tiny proximal patch of existence that we are heir to. I suspect most of our more thoughtful functions are freeloading co-incidences or side effects.

Even Albert Einstein couldn’t remember where his glasses were or why he’d come into the kitchen or why he’d put his keys in the fridge, but it’s not just that we are all capable of intellectual glitches – vast tracts of the universe are denied to even the most intelligent human, although we can assign some areas symbols or metaphorical images to stand in for meaning, the “Here Be Dragons” labels on the blank bits of the map, that allow us to write codes and equations to navigate them.

For example, I’m told the human brain has a limited capacity to understand the concept of plurality. Apparently, our brain goes “1, 2, 3, 4…Lots”, So a million is “Lots and Lots” and doesn’t appear much different to a billion, which is “really lots and lots”. Because we can do the calculations, following each step mechanically, we think we understand it, but the truth of such orders of magnitude is lost on us. This wreaks havoc on our ability to work out how likely we are to win the lottery, or understand the odds if we have a “1 in 10 chance of survival”.

I think we see intelligent thought as a form of perception, allowing us to perceive the reality of the world with clarity. But the very concept of a perceivable reality suggests that the whole universe can be encompassed, at least in its principles, by a single human mind. To know something for certain, so much else must first be known. This is astonishingly arrogant.
(I’m not a post-modernist. I still think truth exists, it’s just very difficult to come by and even more difficult to be sure of. That’s what makes it so precious and worth striving for.)

So, in fact, your understanding of the world is as limited and reactive as that of your cat. And I’m not praising the cat. We once fostered a young, snow-white cat who was so fascinated by the flush that he fell in the toilet bowl, took fright and shot up the chimney to hide…

Iterum Sufflimandus Sum

Alongside the 1:1 therapy, workshops are safe, controlled environments where a simplified version of social interaction can be played out. We’re feral – pariahs who eat out of bins. We need to be re-socialised.

At Ascot House, Nicola, the occupational therapist, organised debates and discussions on current affairs so we could practice our skills. In the first one of these that I attended, we discussed what we thought the government’s priority ought to be for spending its tax revenue. We all dutifully and laboriously contributed, hating the sound of our own reedy voices, apart from Dylan who sat in grim silence, with his arms folded, looking miserable. I think we could all tell he was feeling dumbstruck by his own sense of inadequacy, and, sure enough, his only contribution, at the end, was to say, “I’m not interested in that shit”, which is basically an anorexic’s way of saying “I’m so rubbish!” (it’s funny how we can turn a discussion on politics into a way of hating ourselves.)

Out in the normal world, we’ll have to constantly negotiate relationships, remaining vigilant to the feelings and needs of others, monitoring ourselves to ensure we don’t dominate or irritate or offend. The additional cognitive processing demanded by all these extra data streams and considerations is exhausting. Being left alone is much less taxing. For our degenerating, malnourished brains, even concentrating on the music and art classes leaves us completely drained. We’re like grumpy old men and need naps. (Remember the osteopath said I had “The body of an 80 year old”? Well, I guess we have the minds, too.)

I find talking to strangers difficult at the best of times. I want to fill the awkward silence, but often act impulsively and inappropriately, either wittering on endlessly and inanely about myself, or asking, “So, have you ever had an abortion? Yes? That must have been a bitch!” I don’t trust myself to act or speak appropriately, or to react with appropriate emotions, at an appropriate level. It’s best to just dump out all my words in one go, without listening to anyone else, and then speed off. It’s a sort of drive-by monologue. I’m like an alarmed squid, ejecting a cloud of word-ink to cover my escape.

Conversations are even more disastrous, now. We anorexics tend to state things over-emphatically, because we lack the capacity to express nuance. It takes all our energy just to compose, and then wrestle the simplest slurred utterances past our slack and enervated lips.

Like all addicts, the niceties of social discourse seem unimportant compared to our overwhelming need. If people are upset and dislike us: fuck’em! We haven’t got the energy to deal with or care about it.

For example, when I was first allowed to go home for the weekend, from Ascot House, I had to find my way to the station. One of the care assistants, Sarah, kindly gave me directions, but they were horribly overly detailed. After the first couple, I was just nodding and smiling, hopelessly bewildered. Unfortunately, as she finished she said, “so, when you reach Debenhams, where should you go?” I said “I have no fucking idea.” She looked cross. I was embarrassed. But only mildly.

But it’s not just a lack of concern. We think so little of ourselves that we don’t understand why we’d have any impact on other people. If I said to someone, something like, “For fuck’s sake, that’s a really stupid thing to say!”, I’d be perplexed as to why they were upset. Why do they care? Surely they don’t put any value on what I say, do they? I don’t. Anyway, if they said it to me, I’d just accept the truth of it and add it to my little treasure trove of sad but true things that I use to torment myself.

It must be so exasperating dealing with anorexics. You can see your furious truths hitting home in their flinching, miserable faces, but you know it won’t change them. They’ll eagerly absorb it to fuel their self-hatred. They’re just thinking, “I know. I know. It’s true. I’m such a shit.” They think the purpose of the conversation is to confirm their low opinion of themselves, so they make no effort to solve the problem. We don’t think we’re capable of change, because change occurs in the future and we lack the brain power to properly imagine any future.

Sufflimandus Est

Jane, the other therapist at Ascot House along with Jamie, points out that anorexic behaviours are exaggerated forms of normal behaviours. Everybody worries about how they appear to others. Everyone prepares a face to meet the faces that they meet.

Jo attended a couple of workshops for the carers of anorexics. She felt the other two attendees, a mother and a husband of two patients there, were very keen to say how successful their family and home life was, how stable, happy and supportive, how open and honest everybody was about their feelings. Jo didn’t believe a word of it. She was blisteringly honest about the strain my illness puts on the family, how betrayed and alienated she feels, and how guilty for not supporting me better, but also for not adequately protecting the children from me, or at least from the anorexia, how she worries that she ought to leave me for the sake of the children, as some of her friends have advised her. (The treacherous rats!)

Then, of course, she felt terrible. She worries that the other two really did have perfect lives and she’d exposed herself as a ruthless shit and her family as dysfunctional, and that everyone was looking at her with horror. So the same issues of guilt and inadequacy and self-consciousness and anxiety were played out, although perhaps in more rational and muted tones.

I think the carers’ workshops are more set up for mothers than for partners. Mothers seem capable of the most resilient endurance and unfailing support. (Don’t hate on me: the gendering is society’s not mine.) Every documentary on anorexia I’ve watched has the loveliest teenagers being absolutely foul to their long-suffering mothers. The intimacy of the relationship allows them to offload, confident that the mother will take it without abandoning them. Parents are probably biologically driven to be self-sacrificing in the defence of their children, even if the threat comes from the child themselves. Parents are also in a position of responsibility and authority (nominally, at least) over their children and can insist on certain rules being followed in their house.

That’s not the case with partners. You can’t really order them to eat. There is an unwritten contract between spouses, an understanding that each will act in a certain dependable way: be supportive and caring, perhaps. Either partner can breach this contract. It can be dissolved, in a way that is simply not open to mothers and their children. Your daughter or son remains your son or daughter even if they never speak to you again. You remain their parent. Jo left these workshops feeling guilty that she didn’t provide me with a level of support that would be wholly inappropriate and self-negating, and which she isn’t in a position to provide, given that her primary obligation is to the children.