Tying ourselves in knots

Elizabeth, the oldest and most emaciated patient here, was having exactly the worry I talked about in my last post: that she didn’t deserve to be here because she wasn’t really ill, just being childishly difficult about nothing. Surprised, I asked her which of us she thought was most in need of care. She thought for a moment and then said, “I think probably Cath.”

Cath is undoubtedly very unwell, but is less cadaverous than Elizabeth herself, so this response is intriguing. I don’t think anorexia inclines us towards imagining things that aren’t there at all. Instead, we exaggerate (consequences of over-eating) or diminish (portion sizes) to the point of delusion.

I think, though, Anorexia is better represented by our conscious acts of nonsensical self-sabotage. We tend to know the truth, but, driven by contrary emotions, deliberately act against that knowledge. It’s not just counter-intuitive, it’s counter-sensical and counter-logical.

I’m not saying Elizabeth was being disingenuous, but she must know, somewhere inside her head, that she’s more ill than Cath. The purpose of language is not the statement of factual truth, it is expression of thoughts, and manipulation of the world around you. For example, Body dysmorphia is a famous characteristic of anorexia. It would be reassuring to demonstrate this symptom. You can justify your placement here by convincing yourself that you don’t need to be. Ironic and confusing, but effective.

In addition, we all feel terribly guilty. Having floundered around our own lives like bulls in china shops, destroying everybody’s happiness and peace of mind, we’re desperate to compensate by being lovely to other people. (I am absolutely charming to old ladies in supermarkets.) Cath is deeply troubled, with a difficult home life. Identifying her as in need of support and nurturing reassures us that we’re kind people. Elizabeth is also formidably intelligent, so this sort of overthinking will be easy for her.

Perhaps I’m just horribly cynical and nasty because I’m attributing my own self-doubt to everybody else. God! I’m giving myself a headache! Overthinking is hard work if you’re dumb.

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