But I was telling you about our workshops at Ascot house. I got distracted. Sorry.

One was called “self-esteem” and addressed our lack of it. We’d trail in and adopt the standard body-language of this state, sitting with legs twisted around each other, shoulders hunched winsomely, one slightly higher than the other, sleeves pulled down over hands blighted by eczema and purple with cold, cupped together loosely in the lap as if awaiting the communion wafer, waiting, hopelessly, for absolution, heads bowed but coyly cocked, eyes fixed humbly on the floor; expressive of feminine fragility, a twisted parody of the way models sit on sofas, dreamily nursing mugs of coffee in ads for new-build homes.

These sessions were usually run by Jane, the impressive therapist I’ve mentioned before, and a therapy assistant called Eve, who I absolutely loved, probably because she resembled my own friends (or the sort of person I used to be friends with, when I had friends.)

I thought, at first these workshops would be typical “because you’re worth it” exercises in being told to value yourself, so characteristic of the modern, millennial sense of entitlement. However, such straight talkers as Jane and Eve were never going to allow that. This was where we were first introduced to the very plausible model of negative thinking that I employ all the time to explain my silly behaviour. You’ll recognise it from other posts in this blog:
a. Past experiences are processed into
b. Negative assumptions about yourself which, in turn lead to
c. Unhelpful defeatist decisions and paranoid and destructive behaviours, designed to hasten the inevitable humiliations, which form
d. Negative experiences, which provide evidence to support
e. Negative assumptions about ourselves
Etc. etc. You’ll remember I talked about how the students I worked with conformed exactly to this pattern in their attitude to exams.

Jane and Eve used old-style flip charts and whiteboards and pens, talking with assurance, and rapidly sketching great curving arrows to describe the self-fuelling cycles. They asked us for experiences to fit into the model. We were happy to volunteer, with an odd combination of actual and feigned reluctance, eagerness to talk about ourselves, and a genuine desire to do our duty by each other, and to the process, by offering ourselves up to humiliating scrutiny.

I remained sceptical of all this, until it dawned on me that the model was applicable to many aspects of the way I function, for example, my tendency to argue petulantly with Jo, become childishly stubborn and difficult, and then give in and apologise, thus:
1. I make negative assumptions about myself based on past experiences – I’m a bit of a twat, immature, thoughtless, not particularly bright, self-indulgent.
2. If contradicted, I assume I’m going to turn out to be in the wrong, will deal with it badly, and will, eventually, have to surrender and apologise.
3. This thought makes me feel inferior and defeated. I become sullen, stubborn and nasty.
4. This confirms my suspicions about myself, and makes my opponent annoyed,
5. So I surrender completely, apologise abjectly, and make the relationship even more unequal.

This model could also explain why I’m so subordinate and un-empowered and why I make Jo make all the decisions: I’m an idiot, so the decisions I make will always be the wrong ones. This makes me deeply indecisive, proving I’m an idiot. Or why I give in to temptations: I assume I’m weak, so don’t bother resisting, proving that I’m weak…

So, anyway, Abi wrote me a meal plan, all full-fat yogurt and cheese. I was hull down, enduring the harangue, when she suddenly started insisting on seeing me only four days later, to make sure I’d started to put on weight. This was a bitch. Lip service wasn’t enough, anymore. Now she was actually demanding action! It felt like a sort of punishment for bad behaviour – a detention.

Then she said, “The NHS is spending a lot of money trying to make you better. Remember that. But we think it’s money worth spending, both on you as an individual and on principle, and we’re experienced professionals who know what we’re doing. Trust us. Believe that we’re right. Allow us to help you get better.”

I think that was the gist of it… I hope I haven’t just made that up, because it struck me as a comforting way of looking at things. You help people to live up to their principles by needing their help. You enact your value by justifying their belief in the value of all people, by allowing them to prove their value. Value comes from simply being a member of a community. As the relationship counsellor at Ascot House was always saying, you are worthwhile just by being present.

Before I was admitted to Ascot House, when I was very ill, Jo was my main source of comfort. She was the only person I could eat with or spend time with. In the evenings, when I finally let myself eat properly, I curled up in a cosy nest of Jo and Masterchef and my permitted food.

But on my first evening in Ascot house, on the phone, Jo revealed to me how angry and distressed my illness had made her. She’d held everything together (and in) until she’d got me into the care of professionals, then she could collapse and express what she really felt.

Jo’s already hectic and stressful life became much more so as she became a single parent and had to fit in her monstrous workload and responsibility with parenting, chores, cooking, running the children to clubs and visiting me, all on her own. On Saturdays, she’d drop the children at their drama club then drive an hour to see me. She could only spend 45 minutes with me before she had to drive home to pick up the kids.

Visits were rushed and impatient, and then infrequent. The phone connection was terrible, too. It cut out every couple of minutes. Calls became increasingly frustrating. We couldn’t explore our thoughts and feelings, letting the conversation go where it needed to. Instead we had to compose what we wanted to say in advance, then try to get it all across before the line went dead. We were trying to keep a relationship alive in brief, truncated telegrams of reproach. Luckily, we didn’t need to inform each other of much – our lives were both too monotonous and too internally dissimilar – but we needed to nourish our relationship by spending time just talking, and this was exactly what we couldn’t do.

I began to feel increasingly isolated and cut off from home. I’d realised from that first furious phone call that, after relying so heavily (and so unfairly) on Jo for so long, I’d have to do this recovery business on my own, something that the therapy at Ascot House kept emphasising. The problem is that the post-anorexia self you construct is kind of solitary. Your whole mind-set is different, the structure of your identity – how you view yourself, what you want and need, what you find threatening, stressful and undesirable.

When I was discharged, Jo came to pick me up. She was very apprehensive about my return. On the way back, she unburdened herself. She cried; she explained that one morning she had decided not to care what happened to me. That was the only way she could carry out all the obligation placed on her in an incredibly demanding life. She’d had to dedicate herself to it, and abandon me to my fate.

It may surprise you to know that I had (and have) no problem with Jo’s decision: it’s what I deserved and it’s what she needed to do. When you’re ill, you let all things pass you by with a shrug, but even now I realise something had to give if Jo was to survive and continue to function as the sole parent and provider for our children. I’m an adult and can look after myself.

What horrified me, though, was being shown the impact of my behaviour on other people and realising quite how selfish I was when I was ill. I’d been hoping for a ticker-tape parade, celebrations, congratulations on my strength in overcoming a vicious disease for the sake of my family. I now saw how inappropriate those expectations were: Jo was bloody angry. Justly so.

But it shook my confidence and I’ve felt vulnerable to her fury, ever since. Well, I always have, a little, but now I don’t have a leg to stand on. Forgiveness is a poisoned chalice, especially when the stakes are as high as the survival of a relationship. Every time we argue, I get this vertiginous anxiety in my stomach, as if the ground is dropping away beneath my feet, and I ask myself, “where is this going to end?” Afterwards there’s a sort of anxious, listless calm while I wait to see how Jo will feel later. It’s similar, I believe, to the atmosphere that descends on courtrooms when the jury retire to begin their deliberations.

So, when Jo is storming at me, I’m waiting for a resolution and I think that if she threw me out, I could find a calm and solitary harbour to comfort myself, and I wonder, then, if I will ever experience peace or psychological ease, except in the rare moments when I can be alone, asleep, or in the kitchen in the early morning. And I can’t ever talk to Jo about this because she would see it (understandably, though wrongly) as a rejection, and she’d be furious.

I think you can have two contradictory drives simultaneously. The fox in the hen-house may be horrified by what he’s compelled to do. It’s natural to be conflicted. If I was alone in a bedsit. I’d be unfulfilled and miserable. I’d miss Jo and Meggie and Daniel terribly. I’d feel worthless and hopelessly guilty.

But, sometimes, I still hanker for a calm, solitary simplicity.

In any case, there is always the certainty of life’s pointless finitude. Soon enough, all – all betrayals, all defeats, all insults given or received – will be forgiven by an endless silence.

Actually, there is one thing that disturbs me: Abi’s suggestion that I might be forcing Jo to eject me from the relationship. I know this isn’t true, but I know that I often feel most comfortable on my own. I can find other people overwhelming. Their noise and their needs can hammer on my brain. I can feel troubled, and beset by them, and thus isolated, because they don’t seem to feel the same. Just the possibility of their scrutiny can make me ashamed of myself. I’m not capable of offering them what they need and deserve to be given. At work, chatting to people can make me feel giddy and faintly hysterical, embarrassed by the way I’m pushing myself forwards, too eager to say my piece, talk over people, not listen carefully and appreciatively.

These feelings can be particularly acute with my immediate family who mean the most to me and demand the most from me. What if I’m incapable of loving them as they deserve to be loved by a husband or a father or a brother or a son? I feel inadequate to the task, and this may be revealed at any minute. Then the shit will hit the fan. This can leave me guarded and overly cautious with my own wife and children, and brusque, rudely blunt and objectionable with my parents. And always anxious in any company. I want to tell them that I’m not really like that. These are just the transactional behaviours that I need to use at the moment. It’s such a headache. It’s a headache well worth enduring for my family, but it’s one I don’t experience if I’m sitting quietly on my own.

I usually get my tongue lashing from people I’m close to. Then I can abase myself, apologise with dignity, be difficult, beg for forgiveness, brood, condemn myself, cry, find excuses, impatiently dismiss it, laugh it off, look pathetic, maturely take responsibility, plan revenge, promise to change, storm off, sulk, tell them to fuck off, wallow in self-pity. I can, in other words, react appropriately.

But there’s supposed to be a professional distance between me and Abi so it’s much more embarrassing when she tells me a few home truths. She has invaded our de-militarized zone, and thus my personal space, and this makes everything far too intimate: raw and intense. She does this intentionally and it isn’t the first time. It’s a calculated intervention designed to give me a kick up the arse and set me back on the right track.

The silences are excruciating. Abi waits for me to respond, to reveal myself with honesty and openness, to confront myself, but I don’t know what I think and I don’t seem to own the thoughts I’m supposed to have. It’s as if I’m performing to please her. I’m divorced from the emotions I should be evincing, because inside me there is only an alert, uneasy quiet.

I need to demonstrate my commitment to recovery by articulating these false feelings with passion and conviction, but I can only just about manage an attitude of shamed humility. To have to speak out would be awful. I’m not sure why. I’d feel like an empty harlequin costume, shabby, masked, clowning across a derelict stage, and I worry I might somehow lose control of the dance. It might degenerate into some sort of frantic, antic hysteria.

This sounds like a typical fear of losing self-control and revealing my grubby secrets: if I rouse myself to action, I’ll blurt out something dreadful, either a terrible secret or just some vile, unwarranted obscenity, an upwelling of abhorrent thoughts and feelings and words.

But it seems to threaten something much worse than that, something indescribably awful, wholly destructive – an irreversible, fatal decision.

If I can carry on as normal everything seems to be fine, I seem to have emotional stability, even a relatively sunny disposition, but when faced by a falling weight and challenged to explain it, when asked, “why don’t you just keep to the meal plan?”, I need to be terribly guarded, to adopt a passive, defensive crouch. There seems to be something unsaid, unsayable, that needs to be said to clear the way to full recovery but I don’t know what it is, and if I did, and I said it, it would open a trapdoor to something catastrophic.

Perhaps I’d go into total mental shut-down. I’d fall to my knees and start dribbling. I’d piss myself as my wildly buffering brain tried to reboot. I’d be left naked and writhing, abject, supine, covered in my own faeces. I’d be revealed.

On the surface, I don’t feel that I feel disturbed by any of this, just very uncomfortable. I’m out of touch with any sense of being disturbed. Is this just numbness? Is this being habituated to people being unhappy with me? Do other people incur displeasure as frequently as I do? Is this usual? (Imagine my pathetic whine.) Because some of me is thinking, I don’t do anything majorly wrong – I eat; I don’t exercise excessively…

Rabbi Loew

When Rabbi Loew recognised the threat
he took some clay from Vlatava
and he made himself a thing, – a golem, a bodyguard.

But clay is barren stuff and hard to work and so,
to give it life, he built it up from pieces of himself –
his guts, his heart, his sinews and his thews

to give it musculature; to see, the lenses of his eyes,
and so that it could sense,
he looped it with his nerves, although

he knew he’d feel each blow and wound
as if it was his own. He fed it on his fat and marrow.
He clothed it in his skin

and it was fierce and strong and fearless
but he was blind and thin and weak
and bled easily.

It is strange to feel you have transgressed, to feel you have disappointed and upset people – betrayed them, even, without having done so with any malice. I haven’t given in to a sinfully pleasurable temptation. I don’t feel that oily, staining shame you get from viewing an individual l transgression. I don’t feel the regret that bites like an axe, deeply and sharply into the roots of your self as you realise you’ve betrayed your core principles and are not who you thought you were.

Instead I feel like I’ve just been toddling along, harmlessly being myself, but this has triggered disdain and rejection from other people. I am toxic to them. I have a sense of shame, but it’s more general, holistic. I guess this is more damaging. If you’ve made a single error you can isolate that fierce remorse, apply it only to that action, and try to make up for it, atone for it.

In this situation, however, while no less upsetting or shaming, it’s easier to shrug off the obligation to do anything about it. You can endure, mumble, mournfully, “Well, I guess that’s just me. I’m not fit for human society. I should go and live alone in a hole in the ground.” Then you don’t have to change your behaviours at all.

I tend to curl up, all weak and powerless, and endure. I pull in my limbs and head like a tortoise, protecting myself inside a carapace of placatory but non-comital murmurs, and I wait for it to end.

I say to Abi that it’s not as bad as she paints it, that I’ll sort it out, increase my calorie uptake. She doesn’t believe a word of it. She has too much experience of the mendacity of anorexics. We’re just trying to reassure, but the urge to get off the hook, to make it stop, makes us lie through our teeth.

The thing is, I don’t know how much you or I can trust even what I write in this blog, or say in mitigation or excuse because I’m not sure how much of this is the plausible voice of the anorexia itself, just as I’m not sure when I’m talking to Abi. It’s very very difficult to disentangle the demon from the “true you” anorexia is formed from you; it’s normal, justifiable behaviours taken to grotesque and damaging extremes; it grows from your root stock. It is you. or an aspect of you.

Yet it occupies more than its allotted space in your head. It possesses you, but this doesn’t absolve you of responsibility or blame. You are entirely complicit: Anorexia was your idea. You let it in. You entertain it. It serves your needs.

So, in one way, Abi is like an exorcist. She is directly addressing the demon in her quiet, excoriating diatribes: “I abjure you; I renounce you in the name of all that is sacred: of family, of love, of health, of the NHS, of the Mental Health Act 2007, section 4a…” The problem is I’m the human shield, tied to the front of the tank; mine is the vulnerable flesh that feels each blow, that bleeds.

And, in another way, Abi’s not an exorcist. She’s talking directly to me and telling me to get a grip before I do more permanent physical damage to myself and psychological damage to those around me, as well as to my relationships.

Ah! Yes: duality: ambiguity, uncertainty, ambivalence, “being in two minds”: the defining characteristic of the condition.

At least she’s taking me seriously.

I discussed this with Phillip, later. Being taken seriously creates its own problems. It gives you an identity; it embodies and consolidates you.

I saw Abi recently. When she weighed me, the scales kept registering 59.9, then 60, then 59.9. I was thinking “come on, come on…” but no, 59.9 it was: I’d lost weight.

Abi tore into me. In level, unadorned tones, punctuated by long silences, she told me that:
• I’d have to be recommitted, but not to somewhere as nurturing as Ascot House; I’d end up strapped to a bed with a cannula up my nose (ok, that’s my embellishment.)
• I’d lose Jo and the kids, because Jo had said, explicitly, that she couldn’t deal with it again.
• But maybe, Abi suggested, that was what I really wanted, that I wanted to be alone and if I could encourage Jo to throw me out, I could achieve that without responsibility or blame.
• She, Abi, suspected I’d starve myself to death if that happened, but it might be the curing of me, if what I was signalling was my unhappiness in the relationship,
• in which case I should have the courage to directly address it with Jo, not kill myself.
• But whatever the outcome of that, Abi felt if I was to continue to lose weight, with my children entering those vulnerable, impressionable teenage years, she’d consider it an act of neglect, and she’d be forced to involve social services.

I was mortified. I’m 48 and here I was, being told off like a schoolboy! I guess I could’ve walked out, saying, “I’m not putting up with this! I’m an adult!” because I’m sort of here by choice. (Abi can’t do anything with me if I won’t co-operate.) But is it really a choice if the options are to work with Abi and recover, or destroy my family and face destitution and an imminent, lonely death?

I go to Abi because I’m supposed to be committed to recovery. I’m supposed to trust her to do what’s necessary to encourage me; and, in return, I promise to do what she asks. (No Eating Disorder Specialist would be so naïve as to trust an anorexic!) To walk out, even once, would be to dissolve the agreement between us. By deciding what I was willing to listen to and what I wasn’t, I’d be rejecting her help, and thus the NHS’s. I’d choose not to listen to the all the cringe-worthy things that need to be said and so I’d be abandoning the struggle. I might never get another such opportunity, and, even if I did, I’d always know walking out would be a possibility. And that would ruin my resolve.

So my job is to sit there and endure. And I can do that. I’m used to disappointing people and making them angry, letting people down through my own inadequacy or weakness. And I’m used to being harangued about it. I’m cool.

Jo sometimes accuses me of “Gas-lighting” her over my anorexia and whether I’m eating enough. She says, “You make it seem like I’m the one who’s mad!” I say, “I’m not gas-lighting! I’m reassuring!” (and, anyway, why does anyone have to be mad?)

I feel indignant. She’s accusing me of being calculating and malicious, and, most importantly, domineering. As this blog repeatedly demonstrates, I like to view myself as the poor afflicted martyr to a terrible disease, triggered by HOW BADLY life has treated ME. not the other way around! I’m not the Brooding Tyrant!

Jo maintains, though, that the disease is. When she berates me, she claims it’s the disease inside me that she’s attacking. The problem is that, to get at it, she has to go through me. And that’s pretty bruising.

Anorexia is a mendacious little bastard and it lies to me, as well. Or, rather, I allow myself to be convinced by its equivocating logic, because, one level down, it’s being completely honest. I know exactly what’s going on. At least I do now, after years of meeting with Abi and Phillip and Jamie and writing this blog and talking and talking about it.

I am thus entirely complicit. This shouldn’t surprise us. We’ve discussed before how the whole ghastly monster is not only rooted in our psyche and experiences, but has cannibalised our brain to create itself. It is made up of grotesquely distorted and distended pieces of us, of our normal behaviours.

The rituals of restriction are mantras that helps us deal with other difficult aspects of our lives, largely the anxiety caused by starvation! (Hurray, we’ve created a perpetual motion machine! We’ll make our fortunes!)

What I do is, when driven to confront my illness head on, to make that dreadful choice, I just put it off until I’m ready. Perhaps I’ll never be ready, but I don’t have to deal with that right now. In fact, the thought is very stressful, so, in the meantime, I’ll carry on with the comforting rituals I’ve put in place to deal with stress, arranging the cosy, fortified nest of my life.

When reassuring Jo, I’m responding to, and dealing with, the immediate challenge from her anxiety and anger, and promising myself I’ll get around to dealing with the restrictive eating later. That’s what I do when I don’t implement my meal plans fully – I’m delaying taking the plunge, although I fully intend to do it later – manana.

Jamie, at Ascot house, suggests you can look at this in evolutionary psychology terms. We’ve evolved to deal first with immediate threats, that confront us right now. However, as our brains have developed we’ve become able to create monsters in our own minds which we perceive to be just as real as a sabre-toothed tiger lurking in the bushes, and which we respond to with equal intensity.

The important goals of recovery are so remote they’re almost theoretical and can only be achieved by overcoming a whole lot of hardships and trials along the way. Because of this, the more immediate threats have much more urgency, and dealing with them leads to much more immediate bio-chemical rewards: relief, well-being.

This is a wonderfully forgiving idea and thus a relief to us guilt-ridden wrecks: it’s all to do with our limbic systems, or our sympathetic nervous systems, or something. The human animal just isn’t that well designed.

It’s probably wrong to regard anorexia as simply wrong. It is a response to something. It serves a purpose and it constructs itself out of good things, a healthy diet, a philosophical attitude, for example.

Taken too far, my (Buddhist) monkishness counts against me. I believe that these great, apparently edifying experiences are just the icing on the cake. They’re only details: perhaps the architecture and the flora are different, but the fundamental joy of being alive and conscious of it is the same. Why, then, fly on holiday? I ask, rhetorically. Why take even the 1:10 million risk, if the benefits are so negligible?

For the children, Jo snaps back at me, for the bond the enduring memories will provide.

Perhaps this whole train of thought is just anorexia’s numbing psychological alienation, the way beauty abandons you, leaves you unmoved, the way the moon, the constellations, just become points of light.