Then Dylan started self-harming. One night he took off his shirt to reveal a whole series of small, precise parallel cuts on the side of his torso, under his right pectoral muscle.
At Ascot House, we’d have periodic room searches. We’d be herded in to the lounge while the nurses strode upstairs with pugnacious aplomb, trailed by the more apologetic care assistants. They were looking for “contraband” – forbidden items that we might have stashed away: appetite-suppressing chewing gum, laxatives, food that we’d smuggled out of the dining room to avoid eating (meals were supervised.) Most importantly, they were searching for “sharps” any edged or bladed objects we could use to self-harm.
I’d managed to keep hold of a set of needles, which I used for making model aircraft. I reluctantly gave them up to a locked cupboard in the art room, but became more and more lax about handing them back in when I’d used them.
Dylan wanted to sew badges onto his jeans. I showed him how to do basic stitching and lent him my needles and thread, and he’d sit in the lounge quietly sewing. He’d stolen one of these needles to cut himself.
Self-harm is very common among people with eating disorders. It’s another way of writing our inarticulate distress on our own bodies. Dylan made no attempt to hide his wounds from me, an indication that he was anguish-signalling.
We sat in bed and discussed it. I told him I did a bit of this as a teenager: very slight scratches on my wrists with a knife. It’s not very mature behaviour, if maturity suggests the wisdom and experience to negotiate life’s problems sensibly and effectively. Maybe our differently configured brains make it more difficult to absorb life lessons, because we are still pre-occupied with sorting out more basic thought processes that others have already mastered.
Jane, Dylan’s therapist, has suggested he may be manic-depressive, and there’s a flavour of this in his self-harm. You know, an excess of frantic energy and brain activity that, finding no other outlet, turns on its own body, lacerating it.
We agreed that anorexia seems to be an inextricable part of our identities. As he became better nourished, he feared losing himself. As with his resumption of smoking, he was looking for other crutches to prop up his sense of self, ones which would communicate how troubled he was. He was saying, “although I’m now better nourished, I am still not alright”. These crutches were compulsive and addictive, like anorexia, because they brought immediate relief. Dylan was doing this when he felt particularly challenged. He’d been out for lunch with one of the care assistants, (another of our goals) and had found it difficult, choosing what to eat from a menu. He was also very concerned that he was getting a fat tummy. This was a subject that caused him so much distress that, in all the time I was at Ascot House, Dylan never once said the word “fat”. Whenever that difficult subject arose, he always spelt it out: “F.A.T.”
I was very unsure what to do about his self-harming. I decided to do nothing: always the easiest solution. I told myself it wasn’t my concern. I didn’t want to betray him – that would destroy a vital trust and relationship between us. As we shared a room and all our time, this could even have jeopardised our recovery (god, this is so self–justifying!) I didn’t want Dylan to lose his stair-access, one of the privileges he’d gained, but was allowing him sneak off and hurt himself in secret, and I didn’t want him to resent me over it. I also didn’t want to get into trouble over having unregistered needles lying about or for hiding Dylan’s behaviour from the staff. I made him promise not to do it again, and he said “it was a one off”, but we both knew he would. And we both knew the situation would soon come to a head.
 Apparently, horrible festering mounds have sometimes been found at the back of wardrobes.
 WHAT?! Don’t sneer at me! It’s calming!
 You’ll remember, one of the care-assistants asked, in astonishment, “Where did you learn to sew!?”
Dylan said, “Xan taught me.”
“But where did he learn to sew?”
“I taught him.”
 Especially bulimics, apparently, see Carrie Arnold, 2013, Decoding Anorexia, Hove: Routledge