If only we had direct access to the consciousness of others! Then you could compare your interior state to that of someone who is clearly manifesting one of these conditions.
When I was admitted to Ascot House, I looked around at all these wasted cadavers and immediately felt like an attention-seeking fraud. They really knew how to starve themselves! I had to hurriedly adopt some strange eating rituals to justify taking up a place.
While I was being treated, a succession of miserable little figures checked in: emaciated, yellow-skinned and creased, like baby monkeys. They were so hungry they were barely conscious. Yet, after a couple of days of nourishment, they were all confessing to feeling fraudulent, telling me they should give up their bed to somebody who truly needed it. You’d reassure them that they looked dreadful and they’d say, “oh, thank you! But I know you’re only saying that to be nice.”
I’m sure I never looked anywhere near as bad as they did, but could that be body dysmorphia? I don’t think I ever had that, but it’s impossible to be certain. How can you know how your interior experience compares to that of others? That’s the curse of singular consciousness: We are all hermetically sealed into our own heads.
What’s worse, starvation forces you to power down the parts of the brain that aren’t essential for survival, to save energy. This includes the capacity for imaginative empathy. I wasn’t aware that we could automatically perceive the depth, the self-hood, in others until I lost and then (partially) recovered it. It was like recovering a dimension, a depth perception, or a colour, a richness in your sight. I found this the single most rewarding part of getting better and the most powerful motive to pursue recovery once I got a hint of what I was missing. It’s almost worth getting ill again just so you can experience recovering this ability. (I’m joking! I’m Joking! Jeez – lighten up!)
When you are ill you withdraw into yourself and other people also seem to recede. Thick coverings of skin deny you access to them. You can batter at them with your words but you are numb to theirs. You are forced to deduce their experiences from their behaviours and their rationales, but it is all theoretical, not felt: you understand that their thoughts and their points of view are humanly plausible, but you don’t share them.
This creeping numbness burrows down into your soul, like the growth of mould. Food is your overwhelming concern and this is a relief. It simplifies things. It protects you from the wounding, complicated agony of interacting with other people. Anorexia makes you incredibly thin-skinned, both metaphorically and literally: it eats your subcutaneous fat and makes you neurotic. We are so sensitive that the slightest interaction can be mortifying. But it also protects you from humiliation. You muffle it with hunger.
But the hunger muffles all emotions. Eventually, if the most important people in your life dropped dead at your feet, you’d just feel a little nonplussed.
And we extend this heartlessness to ourselves.
 Discussing the famous Minnesota Starvation Project, Carrie Arnold defines Neuroticism as “the persistent experience of negative emotional states like depression and anxiety.” She also notes that “Violent mood swings became common among the starving men, as did anxiety, hostility and isolation.” (Decoding Anorexia, 2013, Hove: Routledge, p86) I used to have persistent intrusive memories of humiliating events from my past. As I became thinner, this sense of humiliation extended to all memories, whether negative or positive. I couldn’t bear to remember anything. Any memory, especially a happy one provoking a sense of nostalgia, tormented me unbearably. And memories of the past are largely emotional…