Making Heavy Weather of It All

So, it’s finally dawned on me that, for mental health, you need to be aware not only of the phenomenological world itself, but also the process of your brain goes through in addressing those phenomena; not only your thoughts, but how your mind goes about thinks those thoughts.

All my post-pubescent life, I’ve been psychologically malnourished. It wasn’t just the drinking and the smoking and the late nights and the petty arguments and the lack of care for others, it was the silly way I thought about myself, about the world. Well, I didn’t think, not clearly, not to reach any helpful conclusions.

I believed that only the most explicit and verbal constructions could be defined as mental activity. Vague and visceral tensions; apparently unfounded apprehensions or aversions: they didn’t count. It didn’t matter how obviously mind-forged they were, or how much they messed up your life, if they couldn’t be immediately and consciously accessed and explained, they didn’t really exist.

My mind seemed completely empty, most of the time, until I found myself doing or saying something awful and wondered what had possessed me. I didn’t acknowledge or articulate many of the thoughts that floated through. They were half-thought or even un-thought thoughts. Alarming things erupted out of a fog of thoughtless emotion and I fought them off in a reactive fury of self-justification. I lacked any perspective, any wisdom. It was all hand-to-hand combat: close-quarters stuff.

Even now, it’s easy for my subconscious to resist investigation. It does so with such practiced skill that only recently have I admitted to myself that there was anything else going on. It’s kind of a relief, because it suggests that I’m less of an empty-headed fuck-wit than I thought I was. All those years when the only thing inside my skull was the Muppets’ “Manna Manna” song on endless repetition? Actually, my brain was industriously fucking me up behind the scenes. What a clever, hard-working brain!

I think my relationship with Jo finally gave me enough stability for my issues to catch up and confront me (not the other way around. I don’t have that sort of courage.) I could no longer ignore all the tics and all the ominous rattling and clunking noises, or attribute them to the usual facile and superficial causes of being badly treated by girlfriends, the editors of poetry magazines, life itself, existential angst. It wasn’t where I was going; it wasn’t the rockiness of the road (going nowhere means not going anywhere unpleasant). I’d been hurtling down precipitous hillsides, through terrible storms, for years, and it was only when the ground levelled out that I realised what a graceless hash I’d made of the simple task of living. Not only were the hillsides and storms completely self-generated (making heavy weather of it), I’d also totally fucked up the whole engine.

As the tempests blew themselves out, I didn’t exactly question who I was, or the meaning of life, but I realised I lacked the certainty of purpose, identity and community that normally pegs a person in place. By not showing enough care or concern for the communities that had attempted to sustain me, by not attending enough to the interiority or the emotional needs of those who had offered me friendship, I had betrayed and lost both. I was far from home and flapping about like an unmoored tent in those last strong gusts.

Anorexia is more a way of managing a nervous breakdown than the breakdown itself. It offers structure and control and a way to occupy the mind. It was a relief to occupy myself with scavenging little scraps of food. How satisfying, and thus absorbing, it can be, seeking out the deliciousness in the scrapings of porridge from somebody’s porridge pot. Your focus is on manageable close-ups. When you are well, tastes become bland – overly smooth and unsatisfying, monochrome. Eating becomes virtually pointless. You are forced to look up, shift your focus to the universe, admit its utter vastness and thus your true insignificance; the briefness and swiftness of your life; the insignificance of human endeavour: no triumph or failure, no betrayal or suffering, has any meaning, when you’re living so close to oblivion. Ceasing to exist would be of no consequence at all

As you can imagine, neither the anorexia or the pre- and post-anorexia blues nourished my relationships very well. I was taking my family for granted while I attended to the absorbing drama of my own fucked-upness. In fact, I was press-ganging them into those dramas.

Suspicious Minds

Dr Allan Ropper, in his Reaching Down the Rabbit Hole, remembers how dismissive medical students used to be about neurology. “They called it a masturbatory speciality. You couldn’t do much of anything in the way of cure or even prevention, so you just sent patients back out on the street (“treat-‘em-and-street-‘em,” is how they put it)” (Atlantic books, 2015, p.136) Just imagine what they thought of Eating Disorders hospitals and their therapy programmes! These must appear as classic treat-‘em-and-street-‘em institutions because I suspect the relapse rates are high. No matter how much you scour your brain out, some little scraps of odd behaviour, some tics, cling on, somewhere, like cancer cells, ready to flourish as soon as you become less vigilant.

Hopefully, though, your time inside is part of a longer process that ends in recovery. Therapy’s relentless focus on the self does seem to bear fruit. You at least become more aware of how your head functions, and the exercise of thinking about your thinking isn’t at odds with rationalist, scientific principles, is it? You are simply approaching your actions, your thought processes, and your emotions more objectively and thoughtfully. You’re dealing with some very muddy, unclear areas of cognition, after all.

Over time, you begin to accept that you can be the subject under discussion, and that’s ok. You need to be prepared to dissect yourself in a workmanlike fashion without squirming.

The embarrassment itself is interesting. I think, when I was young, most people assumed that self-awareness was self-obsession, that therapy was quackery and that to take an interest in your own mental health was weak and selfish. Self-control was much admired, at least in my family, and its breakdown was to be feared. You were supposed to pick your way through life, arms at the ready, expecting to be ambushed at any moment.

Perhaps our scepticism is the condition defending itself, but I’m not sure how I feel about endowing it with voluntary power instinct. To see us as struggling with demons that possess us helps to explain our illogical, self-contradictory, and self-defeating behaviour. Our chronic indecisiveness and duality of mind, the way I can be afflicted by the blackest despair when my blood-sugar is low, yet terrified if I’m not visited by that Black Dog because it implies I’ve eaten “too much”, all this makes much more sense if each strand is attributable to one of two separate people, the demon and “the real me”.

But we are trying to dodge responsibility for our own sins: all the bad stuff comes from the horrible creature; only the good stuff is genuine. Is this part of a larger abdication that characterises eating disorders. Isn’t all anorexia a refusal to engage? Because, in fact, we chose this. And there are reasons why.

And I’m probably reluctant to admit that I’ve mishandled my whole cognitive realm, for the half a century of my existence, up to this point. Which is disappointing. I could have got so much more done! And now there are so many elements that have gone into the soup of my interior life that it’ll take ages to trace each ingredient. It’s a complicated recipe.

But Illuminating moments occur. They are usually ideas that are bloody obvious to everyone else, and that you used to be aware of yourself. What’s new, or what’s been rediscovered, isn’t the thought itself, it’s the sense of conviction – a sort of profundity of feeling that you’d lost, as if the solidity and significance of things doesn’t reside in the things themselves, but is generated by the brain. Perhaps we have “importance neurons” that cease to function when the brain begins to starve.

At first it’s exciting to rediscover something about yourself, but very soon the revelation comes to seem so blindingly obvious that you’re astonished you were ever ignorant of it. Or had made yourself ignorant of it.

Diving into the Therapy Thing

I think I’ve reached that part of my recovery where, having dealt with more the more superficial or immediate dangers and difficulties, I am ready to turn to the underlying, foundational problems. It’s as if I’ve been spring cleaning the house to expunge a lingering smell, and I’ve been putting off tackling the cellar, which I know is the true source of the problem: the enormous space that takes up most of the foundations, where the bodies of the murdered are mouldering still. Now that the house is more ordered and cleaner, it’s time to throw back the shabby old trapdoor in the kitchen floor and peer down the rickety steps, leading into the darkness. The stench exhales from that black mouth.

Here goes…

Overthinking is What We Do, Here!

Despite all this performance anxiety, therapy sessions were always edifying. Jamie used a whiteboard, propped on one knee and angled towards me, like a ventriloquist with his dummy. On this, he drew the same schema and models of self-reinforcing mental systems that we saw in the workshops (some of which he ran.) We slotted in the behaviours, drives and assumptions I may operate by. The aim was to find ways to disrupt the unhelpful cycles and replace them with more beneficial ones. These discussions were directly applied to eating disorders, unlike those I have with Phillip, my therapist at home, which deal more with the roots of my states of mind.

After a while, patterns or motifs started to emerge. We began to form plausible, or at least coherent, narratives and explanations of my behaviour. I was cautious of accepting them wholly, though. Their very coherence, their internal narrative consistency, made me slightly suspicious. Surely the mind isn’t so neat and thoughtful in its subconscious workings. Isn’t it just a mess of reactive emotion, rather than a creator of careful theories and concepts of self?

I guess I’m suspicious of explanations that excuse my behaviour. They seem too convenient, self-serving. On the other hand, these suspicions are themselves manifestations of the old tropes of doubt about the self, psychological blindness, unwillingness to admit any explanations other than unreflective self-condemnation. Am I wallowing in a sense of my own irredeemability? (Then again, am I condemning myself for condemning myself?) (Should I be condemning myself for condemning myself for condemning myself?)

To work hard at work worth doing -Theodore Roosevelt

It seems ironic (although, in fact, it’s perfectly logical) that an obsession with accounting for ourselves and our place in the world through effortful work, should land us in an institution where we weren’t allowed to do anything at all. It was an enormous relief to be forced to down tools at last. It was also alarming. we felt undefended, as if someone had tied our hands so we couldn’t ward off blows we knew were coming. At the same time, it felt horribly stifling because our reassuring food-denial and exercise compulsions were being constantly thwarted. (Added to this, the house was literally stifling, due to the windows all being tight shut, and a phantom thermostat-resetter who kept turning the heating up when no-one was looking)

It’s very difficult to convince yourself that doing nothing is now your job, that the hard work is psychological and internal. Perversely, this encouraged us to ham up our symptoms to persuade ourselves that we deserved to be there, or to comfort ourselves that our enforced idleness was necessary. You will remember me telling you how, when I entered Ascot House, I had little problem with eating once I was committed to it. In fact, being so hungry, I always relished it. My problem, at home, was that I didn’t allow myself to eat quite enough, or often enough, for all the exercise I did.

After the first meal, at Ascot House, looking around at all my miserable comrades, sitting there listlessly stirring their soup until it was cold and unappetising, obsessively deconstructing their sandwiches, then reluctantly, picking at each article with fastidious, beautifully painted nails, so as not to soil their fingertips with food, I felt like a complete fraud. From then on, I made sure to appear just as unhappy as everyone else and played with my food with the best of them. No doubt this alarmed them just as much as they did me, and made them feel just as fraudulent.

The proper study of mankind is man

We had 1:1 therapy once a week. I had my session with Jamie on a Tuesday. These tended to deal with similar issues to the workshops. I guess this is unsurprising: the therapists usually ran with whatever was on our minds, which was often something thrown up by the workshops.

Tuesdays felt like hard work, and it was a relief not to be languishing around doing nothing, for once. After a couple of workshops and a therapy session I’d be exhausted, my mind a whirl of confused thoughtlessness. I’d spend the rest of the day staring dully at this laptop. Ok, that’s what I normal did, but at least, on Tuesdays, I could justify it. I’d often wake at 3am and be unable to get back to sleep. That’s kind of like work stress, right?

I (sort of) looked forward to therapy. I knew I’d be listened to for an hour by somebody who was professionally obliged to take an interest. It must be a uniquely satisfying privilege to know that your abject whining is earning someone their salary or their sense of professional pride. It did nothing to assuage your sense of guilt at your cost to the NHS or your occupation of a bed that could be put to better use, but this was a constant, whether you were in therapy or not.

On the other hand, as the time approached for these 1:1 sessions, I’d scan my mind for any evidence of anxiety or anguish, or odd behaviours or beliefs, that I could use to prove my madness and demonstrate that I wasn’t a time-wasting fraud. I guess we probably all crept sheepishly in to our sessions, thinking, “I’ve no idea what to talk about. I’m fine, apart from my attention-seeking. I’ll be unmasked. I’ll be denounced.”

I felt I needed to produce the goods for Jamie, or he’d hurl me bodily from the door, followed by my bags, roaring, “As I always suspected! Get thee gone, thou Fraud! To think of all the time I wasted on this pretence! Hast thou not seen the waiting list for beds?” (A condemnation of King James biblical proportions.) I’d crawl off wringing my hands and whispering, “I know. I know. I’m sorry.”

I still have this worry when seeing my therapist, Phillip, now. I’ve even tried writing things down in a notebook that I could brandish in my defence, so I have something to say. I tell myself that it’s just a record to aid my memory, but what I really mean is, a prompt to aid my performance. This goes against the spirit of analysis. Phillip says I need to just turn up with a willingness to explore, and implies this very anxiety is symptomatic of a lack of a sense of self. What and how people think and feel, and how they enact this, is of interest, not what they remember to profess or how they’ve decided to act or to view themselves. You are who you are, here and now. It takes a long time, and a lot of therapy, just to realise that the mind is never idle. Even the deepest sleep is just another mode of processing. The very fact that you think your mind is empty, and there’s nothing to say, and that you are a charlatan, is worth discussing.

This all makes sense, consciously, but my hind-brain remains unconvinced

Yar Boo Sucks!

I’m fully aware, by the way, that an uncharitable reader could sneer at what they saw as my “bourgeois” concerns, my talk of dishwashers and in-laws, of Christmas dinners and council tax, the petty anxieties that beset people living an easy life. I bow to these criticisms; I remain defiant. I can do no more than describe the life I lead with honesty. What advantages do you have, gentle reader? Because I’m sure you have some, and you may squander them with just as much thoughtless ingratitude as I do. I didn’t ask for, nor pursue, such a life, just as I didn’t ask to become middle aged. This is where I’ve found myself, and at least I have the grace to handle it badly. Perhaps that’s one of the attractions of anorexia – it adds drama to a soft existence; it gives it an edge.