Psychopathologies are difficult to isolate and pin down. They are like dissolving shreds of mist. They aren’t experienced in solid blocks; they’re tangled up in knots with other mental activities which are also insubstantial, shifting and dissolving.
Mental disorders start as normal behaviours. Anorexia often begins as an attempt to be healthy, eat well and take exercise. It is empowering and aspirational and shows your determination to live a better and more successful life. It is also an effective coping strategy, so it doesn’t start as a minor problem that becomes worse. It starts as a beneficial and admired set of behaviours.
Yet everything is so approximate and conditional. You are habituated to living like this and there is a legacy of normality in these activities: you’ve been living like this for ages and it’s been no problem. In fact, it’s been a good thing. So, claiming to be anorexic doesn’t feel like a courageous admission, it feels like a lie. You feel like an attention-seeking fraud. That’s part of the reason why anorexics are always checking themselves back out of anorexia clinics, once they’ve met the other patients, claiming not to be ill enough.
For months, I couldn’t admit to myself that I had an eating disorder, although I knew I was getting unhealthily thin and couldn’t stop it. I spent that time being shuttled backwards and forwards between overworked healthcare professionals, collecting inconclusive and speculative half-diagnoses of OCD and anxiety, and so on. At each consultation, I’d tell the bemused clinician, “I’m pretty certain I’m not anorexic; I don’t fit the profile…”
It took a clear-sighted Eating Disorders specialist, Abi, who sat in on a session I was having with a psycho-analyst, to finally say, “Yeah, yeah. Cut the self-effacing bullshit, kid. This is text-book anorexia.”
Ironically, once you’ve been diagnosed, your symptoms intensify. You think, “Oh! Ok. Anorexic: that’s what I am. Now, how should anorexics behave…?”