Back in “Self-Esteem Class”, Jane was interrogating one of the other patients. Elizabeth has the lined and wizened face of a veteran, with twenty years’ experience of anorexia. She kept mentioning other people’s needs: her sister’s, the dog’s, rather than her own. Jane suggested that, as she recovers, Elizabeth may find her motivations change and she begins to do things more for herself and this was ok. Elizabeth gave a moue of distaste, and said, “It seems really selfish to do it for yourself”.

There’s probably an element of virtue-signalling in this. We’re terrible virtue-signallers. We need people to notice what we’re doing right to alleviate our shame, to plead for mitigation against our disgrace. But there’ll be truth in it too: we need to serve. Industry and effort cleanse us.

We need to make amends, of course, but also, if we lack intrinsic value, we need to be valuable for what we do. Without work we are simply a drain on resources; a moral deficit. Our continued existence degrades the experience of others. It takes from them, jostles them out of their rights and enjoyments but adds nothing, benefits no-one.

So my own defence against what I saw as my powerless, pointless, morally redundant life was to try to work for my place in the home, to intentionally subordinate myself to the wishes and needs of the rest of my family. I must always be active, doing useful work, adding value, a desire that became increasingly urgent as I grew more feeble and less able to be effective.

To this end, I took over as many household tasks as I could manage. As Jo was working so hard and paying for everything, I cooked, made tea, washed up, went shopping, ran errands, picked the children up. This was my job. Exclusively. No one could say I wasn’t pulling my weight, even as I became less and less able to engage with people. Parenting, husbandry, became an activity, not a state of being. Because, increasingly, I had no stable state of being. I was losing myself in a white-out of malfunctioning neurones.

Which was what I wanted.

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