Anyway, Nicola was in charge of preparing us to re-enter the real world. It was like a boot camp. We were spies from an alien race being trained to fake rudimentary human behaviour, so we could go undetected in the field. We re-learned how to negotiate social situations. Later we would go out and practice them, supervised, at first, then independently, in walks to the shop, snacks out in cafés, even meals out (if we could afford them.)

In one of our assertiveness sessions, Nicola had drawn up a list of scenarios we might find difficult. I was surprised how accurately she’d pinpointed my behaviour. One, for example, was “starting and keeping a conversation going”. My way of dealing with socialising is to frantically hurl words at people, too panicked to listen to their responses, and then scarper, suddenly, but I thought that was just me. It turns out this is what we all do.

On another occasion, we had to role-play conversations that might lead to conflict. It was basically a conflict resolution workshop. We learned to state our case, listen to another person attentively, and hold our ground without rancour or distress, and we found it unexpectedly challenging.

For the first activity, we had to talk to a partner for two minutes and then they fed back on what they remembered of what we’d said. I was so keen to be an attentive, caring listener to my partner, Natasha, that I used every memory techniques I knew to recall what she said. I did quite well, better than she did, but it almost killed me. Mind you, Natasha’s talk on her cat was clear and concrete, whereas mine was a load of random waffle.

However, when it comes to putting these techniques into practice, we quailed. Jamie (the psycho-therapist) said this was because all anorexics are “risk averse.” It’s difficult sharing a house with strangers. Terrible tensions built up, especially between room-mates, and especially when people began to recover and thus not only had the strength for brooding and exasperation, but also to notice how maddeningly mad our comrades’ behaviours were. But we lack the nerve to confront the sources of the friction. Instead, we vented our frustrations in terrible bitching behind their backs. The atmosphere could become toxic.

Dylan and I managed to muddle along quite well, but we did it by a conscious commitment to loving each other, because there some things that really grated on me and I’m sure he felt the same. For example, I became so overwhelmed by having other people around me all the time. The brain power you need to expend to negotiate all those different relationships is exhausting, so I was desperate to read in quiet solitude when I went to bed, to recuperate. But this was the time Dylan wanted to chat about his day. At first this made me almost hysterical with frustration.

I decided to drive through the frustration by actively embracing these conversations. I told myself this was part of my commitment to Dylan and to supporting his recovery (Thus making myself useful, see?! Jesus, what a patronising bastard!), but, really, I was too timid to say anything. I’d much rather be self-sacrificing, or self-obviating than admit to Dylan what I found difficult about his behaviour. The conflict, the intimate humanity of it, would be excruciating.

Similarly, if Dylan suggested something to me, perhaps where I should go for my “snack out” (he’s a local), I felt I’d have to go there, because the stress of directly denying his suggestion would be too great. We were so reliant on each other’s good will, yet so overly sensitive.

Incidentally, it turned out Dylan was the exact opposite of me when it came to solitude. He was terrified of being alone because of the dark thoughts he was prey to with nobody to distract him, so much so that, when he started being allowed to go out on his own, he’d stay in if he had nobody to go with. Think about that: he CHOSE to stay within the walls of the overheated house where he’d been trapped for MONTHS, where you’re never alone, where you’re not even allowed to walk in the garden without permission, a house so claustrophobic that it felt like being imprisoned in a diving bell with 10 other people, as it fills up with their suffocating, exhaled carbon dioxide.

The Occupational Health specialist, Nicola, is small and slight, with luxuriant dark curls. She is unfailingly calm, tolerant and cheerful, so much so that I wonder if it is a studied and professional demeanour. I hope it’s authentic, though, because I think she’s lovely.

In our land of processed fast foods and ready meals, slimness is intentional. People who don’t think much about food and cooking, or about what they eat and drink, must become fat. The default body shape must be corpulent, if not obese, so I wonder how staff like Nicola, who no doubt value their slimness, manage to avoid being influenced by our concerns. Surely that obsessive scrutiny of our own body shape must rub off on them.

Then there’s Jamie, the psycho-therapist. The other psycho-therapist, Jane, manages to be both a healthy weight and gorgeous, and claims not to think about what she eats, but Jamie is small and skinny. I guess everyone is afflicted by private torments that they can’t admit to at work, but their situation seems particularly dangerous. Do they require constant debriefing to ensure they haven’t, themselves, been infected? They could never admit it to us. It would give us the impression that our behaviours are normal and thus ok. It would also damage our confidence in them and shake our belief in recovery. And we’d exploit the knowledge unmercifully; we’d try to get them on side, we’d work on the weakness, persecute, even destroy them, just so they’d leave us alone to indulge in our secret practices. It’s an industrious little beast, anorexia.

(Incidentally, the phrase “a healthy weight” is an interesting one. To us anorexics it is definitely a euphemism for “fat” and thus to be taken, and offered, as an outrageous insult, yet it is an objective truth about Jane, which she owns in her forthright manner, so how does the normal world read those words?)

We are Feral. That’s the best word for it. (“Feral: of, relating to, or suggestive of a wild animal; not domesticated or cultivated: wild; having escaped from domestication and become wild” Merriam-Webster.com)

Don’t underestimate the attraction, hinted at by this dictionary definition, of the joyous escape from convention, the sense of liberation, and the power it conveys to the socially awkward: fuck the lot of you. Anorexia has its uses. Otherwise we wouldn’t do it.

We can’t be seen in polite society. We’re overwhelmed by the mass of data – the babble of voices, the stream of different social cues. We can’t listen: We can’t concentrate; we need the loo all the time. We’re so exhausted and starving that we can’t take any real interest in other people and only want to talk about food. We’re emotionally distant and lacking in empathy, yet so sensitive and emotionally volatile that we take alarm or offence at any opportunity. We may seem attentive, but it’s obvious that we’re not following the conversation. We’re far too self-absorbed. We’re horribly self-absorbed. A conversation is just a chance for self-hatred because we can’t engage with the conversation because we’re so self-absorbed. In other words, we’re deathly boring.

We can be gratuitously, pugnaciously self-effacing. We’re furiously signalling our low self-esteem and distress. we’re resentfully, passive-aggressively demonstrating our feebleness. “Look how crap we are!”, we’re shouting, “Do you think we like being like this? Is this fair?! Why doesn’t somebody DO something?!”

Or we ‘re simperingly un-assertive until cornered by a persistent mother or Eating-disorder specialist, when, in fear that we’ll lose control of the situation and, specifically, our food-intake, we can become blisteringly offensive. Realising we’ve ruined everything and everyone must be very angry with us, we see no reason not to burn our boats and bridges by being truly foul, embarrassingly nasty, just to clear a way out of the room, to get out.

And we over-think everything, but only in the very simple terms our brains can cope with. We’re not being clever or elaborate in our thinking, it’s just that we get confused by contradictory ideas, and, unable to judge which to follow and which to discard, we entertain all of them, simultaneously; one after the other.

Imagine us, then, at a party. You say, “what about this Prince Andrew interview, then?” I’m desperate not to say anything stupid, to be disliked or despised, so I say, “What? Why the hell would I know? I don’t know! I’m a useless gob-shite, why would you be in the least bit interested in what I say? I’ve got nothing to say! Oh, god, I’m being rude and self-absorbed again, aren’t I? I’m sorry. Please forgive me. No, actually, that’s just who I am! If you don’t like it, Fuck You! …What were we talking about, again?” (Thinks: “I wonder if I could manage one of those yummy looking mini blinis, if I don’t eat anything else all evening. Maybe if I only eat half… I know, I’ll lock myself in the loo, chew up half, to get the yumminess out of it, and then spit it out. Then I’ll put the other half in my pocket for later.”)

It’s kind of a conversation stopper. Everybody falls silent, staring embarrassedly at their glasses, while I wander off, feeling deeply ashamed, but hiding it beneath a carapace of impassivity.

Like the 1:1 therapy, the workshops encourage us to scrutinise ourselves and our responses to situations, rather than focussing on externals and assuming our reactions are natural and inevitable.

It seems counter-intuitive to be told to indulge in even more of the behaviour that we’re so ashamed of, but I guess everyone starts their trains of thought from assumptions, born of their experiences, that they are hardly aware of, and that dictate how they are going to react to things. One of mine might start “Given that I’m a useless, barely tolerated gob-shite …”, and might lead on to all sorts of unfortunate consequences, such as my tendency to be bloody rude, because what the hell do they care? It’s only little me: what impact could I possibly have?

In the workshops, we’re encouraged to ask “How exactly am I reacting? Why am I reacting like this? Is this the only way to view this situation?”, but it’s difficult to make this self-monitoring habitual and automatic, especially if we are in the middle of one of our all-absorbing-completely-trivial-to-everyone-else crises, when we resort to brain-freezing panics. We need practice and repetition. That’s where the similarity of outlook between workshops helps.

Take, example, the various attempts to re-socialise us because we’re basically feral. Anorexics are rubbish at people and this largely stems from our extremely low self-esteem (which is probably a causal factor in the development of our eating disorders, but is then massively exaggerated by it.)

So we have workshops on self-esteem, run by the psycho-therapists, that directly address our disdain for ourselves, then we have “Assertiveness” group, mainly run by the Occupational Therapist, Nicola (A.K.A. “The Re-socialiser”) that aim to teach us how to re-integrate into normal society and remember how to act normally. When we’re ready, this leads on to trips out, in groups, on our own with a care assistant and, finally, proudly independently, choosing and eating our own snacks unsupervised! What triumph!

And all this is underpinned by the engine of the re-feeding programme chugging away in the background: the rhythm of the kitchen producing meals and snacks, the call to the table, the bleak, quiet struggle to eat, sitting hunched at the bare, pine tables, gazing out over the damp, autumnal garden, strewn with sodden leaves, the stagger to the lounge to collapse on the sofas, where we’re monitored for an hour, the almost immediate repeat…

I always forgot which workshop was which. That didn’t seem to matter because all of them were founded on the same concept of mind and thus similar models of behaviour. They each had similar benefits.

To quickly recap what I’ve said before, the way we respond to any situation or experience is rooted in our previous experiences and the conclusions we drew from them. Our habits and behaviours grow from these assumptions and invariably reinforce them. From them we develop tools and practices to overcome, or at least cope with, life’s difficulties. Even anorexia is a coping mechanism for some even larger, more deep-seated problem.

The best example of this cycle in action, isn’t actually an anorexic behaviour, it’s the attitude my students display towards exams. You’ll remember that I work as a learning support assistant in a secondary school. The students I work with don’t experience success. They are constantly assessed and found wanting but they are resilient and they develop strategies so they can survive.

Assessments, for them, involve having some sort of written or verbal question fired at them and feeling totally at a loss, but knowing this feeling will stop if they just volunteer an answer. Any answer. They don’t expect to get it right, so they don’t waste time trying to work out what the correct answer might be. They just blurt out the first thing that comes into their head. If it happens, by chance, to be right, they’re surprised and grateful to the teacher because they have no idea how they came to that result.

Usually, of course, it’s totally wrong, reinforcing their belief in their own inability. They assume successful students just have the right answer pop into their head, so they make no attempt to develop ideas in exams. They favour one or two sentence answers and skip any questions they can’t immediately respond to, allowing them to finish very early and then get the hell out to lick their wounds together, laughing and pretending they don’t care.

By getting it over and done with quickly, though, they can consign the humiliating experience to the past and forget it, concentrating on those things that comfort them and make the school day bearable: their friendships and feuds, their amusements, teasing their teachers…

I can remember working with a lovely, hard working but completely innumerate student and trying to get her to subtract 2 from 7 by holding up seven fingers, then curling down two of them. “So, how many fingers do I have left?” I asked.

“27”, she replied.

Similarly, last week, in a Geography lesson, another student was looking at a photograph of the huge buttress root of a rain-forest tree. The teacher asked him (unnecessarily), “so, is this at the top or the bottom of the tree?” He said, “The top.”

In both these cases the students knew, or were capable of knowing, the answer. The first student could count, and knew humans only have 10 fingers; the second doesn’t confuse the tops and bottoms of trees. However, they just followed the discourse formula they had learned to expect: an incomprehensible question followed by a random, incorrect response. They might as well have said “Haploid cells” or “Vermillion” or “The War of the Spanish Succession”.

But we all do this. In Ascot House we favoured selective memories that only brought bad things to mind; selective interpretations that only imagined the worst.

To cure us, they feed us up. That’s the main thing. Anorexia generates the very anxiety it then, like some diabolical snake-oil salesman, offers to assuage. It just needs to get its foot in the door to start that destructive cycle. With me, it was exercise and a low fat, healthy diet, both of which became excessive. According to Abi, research on recovering anorexics suggests that if you can simply restore the sufferer to a healthy weight, their thinking becomes much more rational and constructive. That’s why she put me on those ghastly collagen shots the first time I got ill but couldn’t put on enough weight. Those vanilla flavoured pots of oily liquid with the vile after-taste were little shots of pure calorie, pure weight.

But our initial vulnerabilities still exist and we need to understand ourselves and fortify ourselves against relapse, so, to retrain our feral brains, at Ascot House, they used to herd us in to the “art room”, where we had workshops.

We’d trail listlessly in and scatter around the central island of tables, always sitting in the same place, growling and whimpering, gnawing on bones, crapping in corners because we don’t understand how the litter tray works. (Metaphorically, metaphorically!)

Actually, those of us who had gained a bit of weight fidgeted, gnawed our lips, looked stricken, jiggled our feet, wrapped our arms protectively around ourselves, stared morosely at the table to avoid each other’s gaze. Those of us who were new to Ascot House, and still critically underweight, slumped in our chairs, dozing, unable to find the energy to move a single, limp muscle.

We had quite a few different workshops, with different titles. There was (alphabetically)
• Assertiveness,
• Body Image,
• Dealing with Anxiety,
• Living with Emotions,
• There was something very frightening called “Motivational Chair”,
• Motivation for Change,
• Open CBT,
• Perfectionism,
• Radical Acceptance,
• Self-esteem,
• Values-Based Living

We got a right old going-over, psychologically.

Feeling, an ability to grasp and acknowledge the spiritual importance of others, and of the external world, the sense that they occupy metaphysical space, is a neurological capacity, a form of intelligence, not simply a characteristic of that external reality.

Our anorexic brains are inadequate to that task. Sure, they patch something together that appears to cover all the ground, but if someone politely challenges us, we freeze, rigidly refusing to budge from our position. It’s not that we need to be right all the time, it’s more that we crave certainty because we are permanently on shaky ground. (Literally – think of the number of times I’ve stumbled and fallen when jogging, or think about my friend Cath, at Ascot House, coming down the stairs on her bum, every morning, to avoid tumbling down the whole flight). The idea that there might be two opposing interpretations of something suggests a world of profound uncertainty and is thus highly threatening.

We absolutely refuse to change our opinions, because we lack the mental flexibility to change direction, and our anxiety makes us fear it, yet we recognise how unreasonable we’re being, so we’re not entirely sure that we aren’t joking. We can’t even read ourselves, anymore. And we feel overwhelmed by the emotional complexity of negotiating disagreement, with its potential for conflict, when we’re desperate to be liked but feel we are hateful.Our solution is to push our interlocutor away and run for the hills. In other words, to pre-empt the inevitable rejection, we’re foul to everyone.

Our panic leads us to a sort of hoarse and hysterical, accusatory whining, which would be shouting if we had the energy. We’d cry if we weren’t desiccated husks, incapable of generating tears. (We are the hollow men/ we are the stuffed men/leaning together/ headpiece filled with straw. Alas!)

Conversations often go something like this (my lines all delivered in a mumbled, listless monotone):

Me: Pineapple on pizza is disgusting.
You: Actually, this may sound weird, but I quite like it. it reminds me of my childhood.
Me: No. No. Why are you saying that? You can’t honestly think that.
You: Well, that’s just me. That’s what I think.
Me: Oh, God. You’re right. I’m sorry. I’m being totally intolerant, aren’t I? Christ, I’m such a shit…
You: Calm down! This conversation isn’t about you. why do you have to turn a perfectly pleasant chat into a self-hating monologue?
Me: Christ, you’re right. Oh, god, I’m such a self-centred arse-hole…
You: Oh for goodness sake! I’m leaving.
Me: (calling after you) I don’t blame you. I’m surprised you put up with me this long.
Me: Ah, blessed loneliness. Christ, other people are stressful.

Alternatively:

Me: What sort of ignorant, bigoted monsters voted Leave?
You: I think you’ve got to understand why Brexit appealed to some people.
Me: What? I never took you for a fucking Nazi.
You: Now you’re being unreasonable…
Me: Well, fuck you, you fucking Nazi. At least I’m not a fucking Nazi.
(You storm off)
Me: Ah, blessed loneliness. Christ, other people are stressful.

When I was at my illest, I was bloody, openly rude, usually because it felt like people were filling my head with their words and actions and opinions. In a fluster, I told them exactly what I felt to set them straight, to get things straight, in my own head. If people hated me – well, that was the lesser of two evils. I’d survive it. I hated myself. I’d feel mortified and guilty but I was used to that as well. That was just me: I’d expect nothing more from myself. At least I could dispense with years of fawning pretence that I was a nice person. I could let my guard down and reveal the true, nasty me underneath.

Looking back, it’s all so embarrassingly solipsistic, but it felt like trying to stand up in one of those ancient cockleshell boats: when you’re flailing around trying not to upend yourself and drown, you haven’t got much time to look about you.

I used to fantasise about cutting out my own tongue.

Not everyone is equally able, psychologically. The more intelligent you are, the better you can engage with and comprehend the world. Those of us who are intellectually compromised, through birth defect, illness, inherited incapacity, must live a more dream-like and bewildered existence, preyed on by inexplicable monsters that appear out of nowhere.

We anorexics lack the mental energy to picture the future with any clarity. We are left with the vaguest, theoretical glimpses. We’ve abandoned any personal goals or plans to struggle with present problems. They loom up, hugely, right in the foreground of our consciousness, and demand to be dealt with immediately.

We are reactive. We are driven by compulsive habitudes that we’ve developed to assuage these anxieties. Any negative consequences of our comforting rituals will just have to be dealt with later. That’s why we can starve ourselves to death by accident. And Anorexia is a self-fuelling engine. The thinner you get, the more anxious and uncertain you become, the more you need an urgent, controlling obsession to occupy and comfort you.

When it comes to our relationships, we lack imaginative empathy. Through insomnia and malnutrition, we are operating a skeleton neural service. We understand, in a technical, theoretical, almost mathematical way, how other people might be feeling, or how their thoughts work. We can deduce what they’re likely to say or do (or say they think), but we don’t get it on an emotional level. Is this similar to autism? Is it similar to sociopathy?

We don’t feel the impact or the importance of words, relationships, events, something most people do so easily and automatically that they don’t even realise they’re doing it. Our cognition has flattened out. It’s all surface, whereas theirs has depth and intensity. There’s a spiritual dimension, a profundity, to other people’s reflections that we simply don’t share. It’s all one to us – life, death, other people…

Going from our perspective to theirs would be like seeing a 3rd dimension suddenly spring out from a flat picture surface, endowing it with substance, bringing some things to prominence over others, making sense of a crowded jumble of shapes.

The human brain is a utilitarian organ. It developed its skills to counter life’s challenges long enough for us to reproduce. It wasn’t designed to apprehend the universe in all its vastness and complexity. It doesn’t need to. Think of the number of times in a single day that you are forced to think, “Well, I don’t get that, but I’ll just have to accept the incomprehension and move on.” Especially in the age of the algorithm. (And this experience is multiplied a thousand times for us anorexics.) The brain responds to, and mediates, the sense data from the tiny proximal patch of existence that we are heir to. I suspect most of our more thoughtful functions are freeloading co-incidences or side effects.

Even Albert Einstein couldn’t remember where his glasses were or why he’d come into the kitchen or why he’d put his keys in the fridge, but it’s not just that we are all capable of intellectual glitches – vast tracts of the universe are denied to even the most intelligent human, although we can assign some areas symbols or metaphorical images to stand in for meaning, the “Here Be Dragons” labels on the blank bits of the map, that allow us to write codes and equations to navigate them.

For example, I’m told the human brain has a limited capacity to understand the concept of plurality. Apparently, our brain goes “1, 2, 3, 4…Lots”, So a million is “Lots and Lots” and doesn’t appear much different to a billion, which is “really lots and lots”. Because we can do the calculations, following each step mechanically, we think we understand it, but the truth of such orders of magnitude is lost on us. This wreaks havoc on our ability to work out how likely we are to win the lottery, or understand the odds if we have a “1 in 10 chance of survival”.

I think we see intelligent thought as a form of perception, allowing us to perceive the reality of the world with clarity. But the very concept of a perceivable reality suggests that the whole universe can be encompassed, at least in its principles, by a single human mind. To know something for certain, so much else must first be known. This is astonishingly arrogant.
(I’m not a post-modernist. I still think truth exists, it’s just very difficult to come by and even more difficult to be sure of. That’s what makes it so precious and worth striving for.)

So, in fact, your understanding of the world is as limited and reactive as that of your cat. And I’m not praising the cat. We once fostered a young, snow-white cat who was so fascinated by the flush that he fell in the toilet bowl, took fright and shot up the chimney to hide…

Alongside the 1:1 therapy, workshops are safe, controlled environments where a simplified version of social interaction can be played out. We’re feral – pariahs who eat out of bins. We need to be re-socialised.

At Ascot House, Nicola, the occupational therapist, organised debates and discussions on current affairs so we could practice our skills. In the first one of these that I attended, we discussed what we thought the government’s priority ought to be for spending its tax revenue. We all dutifully and laboriously contributed, hating the sound of our own reedy voices, apart from Dylan who sat in grim silence, with his arms folded, looking miserable. I think we could all tell he was feeling dumbstruck by his own sense of inadequacy, and, sure enough, his only contribution, at the end, was to say, “I’m not interested in that shit”, which is basically an anorexic’s way of saying “I’m so rubbish!” (it’s funny how we can turn a discussion on politics into a way of hating ourselves.)

Out in the normal world, we’ll have to constantly negotiate relationships, remaining vigilant to the feelings and needs of others, monitoring ourselves to ensure we don’t dominate or irritate or offend. The additional cognitive processing demanded by all these extra data streams and considerations is exhausting. Being left alone is much less taxing. For our degenerating, malnourished brains, even concentrating on the music and art classes leaves us completely drained. We’re like grumpy old men and need naps. (Remember the osteopath said I had “The body of an 80 year old”? Well, I guess we have the minds, too.)

I find talking to strangers difficult at the best of times. I want to fill the awkward silence, but often act impulsively and inappropriately, either wittering on endlessly and inanely about myself, or asking, “So, have you ever had an abortion? Yes? That must have been a bitch!” I don’t trust myself to act or speak appropriately, or to react with appropriate emotions, at an appropriate level. It’s best to just dump out all my words in one go, without listening to anyone else, and then speed off. It’s a sort of drive-by monologue. I’m like an alarmed squid, ejecting a cloud of word-ink to cover my escape.

Conversations are even more disastrous, now. We anorexics tend to state things over-emphatically, because we lack the capacity to express nuance. It takes all our energy just to compose, and then wrestle the simplest slurred utterances past our slack and enervated lips.

Like all addicts, the niceties of social discourse seem unimportant compared to our overwhelming need. If people are upset and dislike us: fuck’em! We haven’t got the energy to deal with or care about it.

For example, when I was first allowed to go home for the weekend, from Ascot House, I had to find my way to the station. One of the care assistants, Sarah, kindly gave me directions, but they were horribly overly detailed. After the first couple, I was just nodding and smiling, hopelessly bewildered. Unfortunately, as she finished she said, “so, when you reach Debenhams, where should you go?” I said “I have no fucking idea.” She looked cross. I was embarrassed. But only mildly.

But it’s not just a lack of concern. We think so little of ourselves that we don’t understand why we’d have any impact on other people. If I said to someone, something like, “For fuck’s sake, that’s a really stupid thing to say!”, I’d be perplexed as to why they were upset. Why do they care? Surely they don’t put any value on what I say, do they? I don’t. Anyway, if they said it to me, I’d just accept the truth of it and add it to my little treasure trove of sad but true things that I use to torment myself.

It must be so exasperating dealing with anorexics. You can see your furious truths hitting home in their flinching, miserable faces, but you know it won’t change them. They’ll eagerly absorb it to fuel their self-hatred. They’re just thinking, “I know. I know. It’s true. I’m such a shit.” They think the purpose of the conversation is to confirm their low opinion of themselves, so they make no effort to solve the problem. We don’t think we’re capable of change, because change occurs in the future and we lack the brain power to properly imagine any future.