When I was around ten or eleven, I fell off our garage roof, bruised my spine, and temporarily lost the use of my legs. I remember lying on the ground wailing, while, above me, everybody ran around wringing their hands and shouting at each other. It’s probably an invented memory, but that is my family’s traditional response to stress, a tradition I carry on with my own children.

We were a reserved family, shy of demonstrations of emotion, though not of irritation. As a teenager, I went through a period of lightly scoring my wrists with knives. It was the early 80s and self-harm was just becoming a thing, I think. I didn’t know anybody else who was doing this, but I’m fairly certain I didn’t come up with the idea by myself. I was probably doing it to get attention from girls, because I’d had a very safe, stable, and happy upbringing and was absolutely not traumatised or abused. Sure, I was slapped, occasionally, but this was the 70s and 80s: everybody got physically chastised. It didn’t work, but it did us no harm, unless taken too far.

Looking back, though, I guess it’s significant that, of all the ways of getting attention from girls, this was the one I chose.

When my parents discovered it, they went into stress-overdrive. They sat me down, stood over, and interrogated me: What the hell was wrong with me? Did I seriously want therapy? Hmm? Because, if I did, they could arrange it, although god only knew where they’d find the money…

Looking back, my poor parents were probably at a loss what to do. They hadn’t encountered this sort of behaviour from my older siblings and probably didn’t want to encourage it by being too supportive. No one in the 80s was very progressive in these matters, and there weren’t any support networks or online forums, as there might be today. They only had each other to rely on and, no doubt, they reinforced each other’s ideas.

The offer of therapy was clearly made to be rejected. To accept would be pathetic and demeaning. I wasn’t mad, just attention-seeking. Although we’d discuss politics and history ‘till the cows came home, our family simply didn’t discuss our psychological states.

I immediately shelved this memory and avoided examining it for years. Thinking about it now, I guess I was mortified and humiliated. My parents seemed so angry, as if I’d done something awful, as if I’d let everybody down, dreadfully. But, sure enough, I never had the nerve to self-harm again, at least not while I lived with them, which justified their strategy.

The message was clear: outbursts and expression make everybody unhappy. Shut up about it and it’ll go away. I imagine that lesson was reinforced throughout my childhood and I internalised it. That’s why I feel so daunted by therapy and ketchup. (I would never, ever, open up to my parents.)

Or maybe not: every thought process is locked away so tightly that I can only guess at its existence.

Therapy ought to be a golden opportunity to talk about yourself to somebody both trained and paid to take an interest in you, and presumably taking professional pride in listening attentively. It’s a fulfilling experience, but I always enter the room with a profound sense of inadequacy and emptiness. There doesn’t seem anything to say at all. There’s nothing to me. I’m a very ordinary dude who’s wasting everybody’s time, a fraud, an attention seeker, and therapists will feel deeply disappointed and bored with me, unless I can come up with the goods, which I can’t. Rosie, a very troubled patient, here, who’s been in and out of eating disorder clinics for years, screamed at our therapist, Jamie, and threw chairs about. That’s proper therapy behaviour! Jamie must have been delighted. Now, there’s something to work with!

If you’re messed up, if your identity’s evaporating, but you can do anorexia that well, where’s the incentive to recover?

To say anorexics are solitary and introspective is an understatement. I am continuing to find the constant noise, here, confusing and exhausting. My poor little brain can’t cope with all the sensory and cognitive information that overwhelms me when I’m with other people – the competing data streams of the television and radios, which are constantly on, even when nobody is watching or listening, and the various simultaneous conversations.

When I’m reading or writing, people interrupt and start talking to me, and my slight, weak concentration breaks down; I have to start all over again, working my way back into the text. And, of course, there is no haven from this, no place to get away from it and no time when it lets up, 24 hours a day. Even in sleep, someone else is in the room, breathing with you. It’s all so wearing and tiring and I’d just like a bit of time off, occasionally.

I was working on this blog, today, when a lovely nurse called Bridget came to have a ketchup with me. I assume I’m Bridget’s “priority”. We had a cosy talk, but I felt frustrated because I wasn’t getting on with my work. Being secluded here is a golden opportunity to write and I’m increasingly resentful of any distraction, even just people wandering into the art room, when I’m in there. I’m a nasty anti-social git and when, impulsively, I initiate conversation, it feels like failure, a lapse of self-control, a letting down of my guard. I’m wittering on to people, uninvited. What a twat.

Being admitted to an in-patient facility isolates you from your family and friends. Far from making you lonely, this gives you relief from the difficult, complicated relationships that have inevitably developed as you became ill, freighted, as they are, with exasperation, injury and resentment on their part, and shame, inadequacy and bewildered hysteria on yours. Here, you may not be close to anyone, but you don’t have to confront the loss of intimacy from the people you loved, or feel the sense of guilt and regret that comes from that, so the alienation is less fraught and profound.

We live in a state of continuous, morose endurance, akin to loneliness, no matter what the situation, and because we’re too ill to feel the lack of company, the luxury of this isolation can be dangerously seductive. It’s tempting to get comfortable with it, to build a nest out of it.

So being forced into any sort of society is beneficial for me. I am being thrown into the deep end of a re-socialising process. I can feel it doing good for me and I am interacting with the others much more ably (I feel) than I would have even a few weeks ago. I used to creep feebly away from any encounter, cursing the fool I’d made of myself, not because I’d said anything particularly stupid, but because just opening my silly mouth was in some way mortifying, revealing my limited, grotesque, pathetic inner goblin to the burning scrutiny of others, their withering looks searing my cringing skin. Now I’m more forgiving of my flawed and limited self. No-one acquits themselves brilliantly, in life, but we tend to be forgiving of other people, if only because we don’t care as much.

As part of embracing the whole process, I’ve made a commitment to engage whole-heartedly with every conversation offered to me. Especially when Dylan comes in to the art room for a chat, or when he wants to talk at bedtime. I put down my book or my MacBook and try to give myself wholly over to the conversation. I’m helping him, and this gratifies my desire to be useful and of service. His friendship is so important to me that once I’ve accepted that I’m not going to get anything done, it’s relatively easy to immerse myself in talk. I can even reveal some things about myself, telling myself that to do so will help nurture a conversation that is of benefit to him.

Ketchup, however, is more difficult. It’s clear that care assistants do this out of a sense of professional duty, so when they come and seek me out, it feels like they’ve cornered me and that neither of us really wants to hear my shit. Still, I force myself to engage. I owe it to my family and to the NHS.

The regular Experience feature in The Guardian magazine always ends with the question, “Do you have an experience to share? Email Experience…” I sent them an email telling them that I was a middle-aged male anorexic, married with children, and were they interested. A few days later I got one of those standard (but sweetly tactful) little rejections, “Thank you for your email. I read it with interest but I’m afraid we won’t be able to use your story…” etc.

And I get that. It’s ok. Who’d want to listen to my piteous whining when they could be reading this week’s “I was hospitalised with a sex headache” (She got a headache while having sex and went to the doctor, but the doctor said she was fine.) or “I’m a full-time cat sitter” a couple of weeks ago. (He feeds people’s cats for them.) It’s exciting stuff.

The thing is, these articles are genuinely more entertaining and interesting than mine would be. There’s a lightness to them that mine would lack. People with problems are tedious.

We get one-to-one therapy, here, once a week, and are encouraged to seek support from staff. Each of the care assistants is given two or three patients to keep an eye on during their shift. They’re supposed to coax us into talking through our troubles, which should help us understand and come to terms with what’s going on in our heads.

Ascot House has its own jargon, and this process is called “catch up”. “Do you want a catch up?”, a kindly care-assistant will ask. The local accent makes this sound like “ketchup”, leaving me utterly bewildered, and Dylan paralysed with hysterical mirth (a sign of how much he’s recovered.)

My confusion seems appropriate, given how uncomfortable it makes me feel. In fact, ungratefully, I feel imposed upon. I’ve always squirreled away difficult and upsetting experiences, thinking that I needed to get on, and couldn’t afford to be paralysed with horror at my own past. Why would I want to? It’d only be upsetting. “Fancy a ketchup?”, I’m asked. “Christ, no!”, I reply, “You must be mad!”

This repression has become second nature to me, so that dwelling on things seems deeply unnatural, almost inconceivable, and there doesn’t seem to be anything to talk about. Talking is like trying to prize open a heavy iron blast door that’s rusted shut and is so covered with brambles and leaf litter that you never knew it even existed. It lifts great clods of unreflective feeling, laid down over years and years, as it comes.

However, Ascot House wants patients to challenge themselves as much as possible, and, as I’ve decided to give this programme a go, I’ve promised myself never to refuse a ketchup. We need to be re-socialised, and if it does nothing else, ketchup forces us to engage with other people, although I wouldn’t go so far as to reveal any of my secret feelings or thoughts. That would be a step too far. They must remain closely guarded.

Jamie, one of the therapists, has noticed my twitchiness in workshops. He suggested, gently and tactfully, that I was massively overthinking and over-complicating things. I should probably stop with the self-obsessed self-scrutiny and focus on the topic under discussion. Everyone has flawed, human motivations, he claims. You should just accept them without condemning yourself if they’re not entirely spiritually exalted. Is this my (mildly) Christian upbringing? The idea that there is a moral dimension to all human actions, inviting profound, cosmic condemnation?

You’re constantly questioning yourself about this: Am I being overly harsh on myself? Is it healthy to repress my own self-expression? Will this perpetuate the twisted and unnatural growth of the thoughts, values and personality that lead to all this lacerating nonsense in the first place? On the other hand, why is it so difficult and wrong to subordinate yourself wholly to the needs of others, if to do so means you have a happy and comfortable life where, largely, you are valued and have your needs met?

By the end of a day, the pure, keen spirit-blade of consciousness has become so corroded and blunted by anxiety, that you’re exhausted. There’s nothing to be done but go to bed and start again tomorrow.

I guess sensible thinkers would ask why it matters so much. These are trivial issues, but they seem of overwhelming importance to us, and getting them wrong threatens, in some unexplained way, to be disastrous. Oversharing makes you vulnerable. You’ll say something stupid and reveal what a moron you are. You’ll make yourself disliked, disdained. You’ll be a burden. That would be terrible.

To save energy, starving brains shut down their emotional depth perception. Bald facts remain bald facts. Normal, healthy people understand a situation with a sudden imaginative pang, an empathy. It’s as if we see things in two dimensions, while, for them, a third dimension, a depth, springs outwards like a camera lens clicking into focus.

For us, all ideas, feelings, all assertions, are therefore subject to a doubtful and suspicious scrutiny. Especially our own. There’s something undefinable that we know we’re missing, that we don’t quite get, and we have profoundly shaken our confidence in ourselves. Our thoughts flicker backwards and forwards over the surface of things. We return and return to the same troubling points, thinking, “Why did I say that?”, “What did she mean by that?” The most innocent of passing comments are instantly converted into threats. “You’re looking well” inevitably provokes gasps of shock and outrage: “What does THAT mean? Am I looking fat?” Do you remember, a poor care assistant once said to Dylan, to his horror, “You’re looking well. Your face has really filled out”?

During my weekly review meeting, Mark, the consultant psychologist, said he thought I was an asset to the hospital, and, in a workshop, Eve, one of the therapists, said I put things very well! These are compliments, even to an anorexic, but praise makes me uneasy and unhappy. It threatens to dismantle my negative self-image and leave me with no identity at all. But it did make me feel useful, so soon I was thinking, “I must be an asset! I must put things well! Only then can I be worth anything.”

In workshops, we are all overly self-aware and self-doubting. People are always apologising for joining in, comparing themselves unfavourably to each, sitting in miserable silence. That’s when they’re not dozing off from sheer exhaustion.

We’re kind of feral: hyper-alert, yet dismissively insensitive, skitteringly nervous, bloody rude. Nicola, the occupational therapist, in an attempt to re-socialise us, started a debating group. The idea is that by reintroducing us, in a structured way, to the concept of sociable discussion and the courteous presentation of opposing views, we would learn to talk to each other again (sensibly).

We discuss how governments should use tax revenue, or something. I get my usual contribution anxiety. I feel an urgent need to help make it work. If I want to get better (I think I do. Sort of), I need to throw myself into all curative or palliative activities. I also want attention, to bellow my opinions, to be heard and recognised. I talk a lot. I am over-contributing, and being domineering, forcing my boring voice and opinions on others. I feel breathless with anxiety and excitement. I try to ration my contributions, but seem to lack the self-control. I monitor myself, trying to exercise a judicious restraint, supervising and assessing my involvement, limiting myself to a few brief comments and to prompting questions, when the conversation flags. I congratulate myself. I feel successful and relieved. Then, suddenly, I’m gabbling about nothing, again, running away with myself, trying to swerve my (now unwieldy) anecdote back on track, feeling I have imposed and exposed myself, feeling self-conscious, that I’ve failed, blushing with an oily and unpleasant shame. It is all so complicated and exhausting.

Dylan, meanwhile, stays resentfully silent, staring fixedly at the table, stonily unmoveable apart from one frantically jiggling leg, and I know he’s wallowing in a self-pitying sense of inadequacy. Sure enough, afterwards, he says “I’m not interested in that sort of shit”. His defiance masks a baleful self-blame.

This is what we all always do. We’re far too focussed on ourselves.

If anyone is reading these posts, I apologise for their tedious self-involvement. An eating disorder is a coping strategy. Once the crude and bloodied blade of self-harm is prised from your rigid grip, you lose the tools that allowed you to continue with some semblance of an existence. The rituals help you to get through your day, to perform at least the most rudimentary functions and thus engage, in some way, with your life, its people, its basic demands.

Now, though, we are left with nothing. Between meals and workshops there is nothing to do except sit in the lounge, until our bums ache, idly half-watching the TV, flicking listlessly through our phone apps, dozing.

It is inevitable, then, that our thoughts are going to turn inwards. If we’re to defeat this thing, we need a deep scouring, right down to the foundations of our minds, to rid ourselves of the last, infecting shreds of this disease, and embed cognitive techniques and strategies. If we leave behind even the tiniest culture of irrational eating habits, it will multiply, recolonise our brains.

Our heads are old, dirty pots, blackened by years of misuse.

Or maybe an even more hackneyed analogy works better: These compulsions have grown out of, and feed on, the dark soils of our minds and we need to dig down to make sure we leave not a single root behind or they will regrow. The tiniest foible or innocuous eccentricity can blossom into the full-blown madness again, partly because, at each stage, it doesn’t seem like madness, it feels like expediency – an expedient response to the alarm the condition itself generates.

Another advantage of anorexia was that it didn’t matter what people thought of me. If they thought I was self-absorbed or disliked my shtick, they could go and fuck themselves. Unfortunately, an anxious sensitivity to other people’s opinions has come creeping back. Dylan’s recovery has made him a lot more active and noisy and he sometimes gets on the nerves of another patient, Kim. If she makes any critical comments, his response is, “Well I don’t fucking care!”, which I think suggests that he does care. Very much. He wouldn’t have, a few weeks ago.

Starvation also stopped me, at last, from being so fidgety. Before I was ill, I used to spend every minute of any activity clockwatching, desperately yearning for it to end. For no reason. Even if it was an activity I enjoyed, I needed to finish it and be on to the next thing. I lived in a state of permanent unprovoked impatience. I only sat down during rigidly scheduled rest periods. When I became ill, if I allowed myself to rest, I could sink gratefully into a warm, cushioned lassitude and allow my mind to scud over the surface of what people were saying. Rather than being desperate to bounce out of my seat, any enforced stillness – meetings, bus queues, concerts, trips to the cinema, became opportunities to snatch a quick, restorative snooze. That passed the time.

Jitteriness is pretty universal in Ascot House, so much so that one of the many rules is that we’re not allowed to jiggle our legs during workshops. It’s distracting, but we’re also such an untrustworthy bunch, that the care assistants can’t be sure that we’re not trying to burn off extra calories and that it won’t flare up into excessive stair climbing or walking around the garden (Horrors!)

Kim claimed, yesterday, to have “Restless leg syndrome”. We’re very keen on syndromes, here. I think we can’t quite believe our own problems. We think we’re putting them on, causing a fuss. Named conditions help us to explain ourselves. Our families reassure us that we’ve gone a bit mad, and the desire to acquire syndromes is, itself, not a sign of wellness. Still, it feels like we’re putting on airs.

I guess I lack a sense of intrinsic value. I need to calculate my worth by how much I benefit other people, by being of service. On the day of judgement, in the great cosmic hall of justice (or even just the petty-session blame-courts of the wronged and indignant), I’ll call upon this body of evidence: “Have mercy on me! I was the one who always put the bins out!”

This is probably why I’ve always been socially awkward, although I used to be drawn to company and liked being noticed. My solution was to clown around. When I was young I’d say the most outrageous things just for a bit of attention. I’d embarrass myself and earn the disdain of the people I most wanted to impress. I’d still stay doggedly to the bitter end of even the most tedious parties, convinced that the minute I left they’d bring on the dancing girls, the painted elephants, swinging their trunks, their tusks covered in gold leaf, the fire-eaters…

More recently, but still before I got ill, I’d swoop in to any gathering of people, deluge everyone with a defensive ink-cloud of jokes, opinions and anecdotes, then scoot off like an alarmed squid, realising as I did so that I hadn’t learned anything at all about anyone else. In both cases, I managed to isolate myself by talking. I used to wonder if I was sociopathic. Now I think I’m just clumsy in company.

In workshops, all this translates to a compulsion to fill the silence. I want to help, to be the one who makes it work. At first I enjoyed supporting the group through judicious contribution and well-timed, attentive listening. I was committed to letting others talk, unless there was an awkward silence. I’d end each session thinking, “well, I did my bit, there. Hopefully that was useful and productive for everyone else.” I know, I know – how patronising and ego-centric: “Me, Me, Me! Oh, Please, let me be the one who saves the discussion!” – a patient pretending to be one of the doctors. It was a way to avoid confronting myself.

Worse, as I gained energy I became overwhelmed, again, by the desire for attention. I now had to include myself in every conversation. I became agitated and couldn’t concentrate on the heartfelt, soul-baring revelations of the others. I was so desperate to contribute that I could barely contain myself. I’d say things impulsively, for no reason.

Even if a topic had been fully worked through by other patients, I had to have my self-important tuppence-worth at the end, adding my boring experience and opinions, as if anyone cared; as if they’d be grateful for my support. God, it’s embarrassing! It’s self-indulgent. It’s also selfish and unhelpful because it blocks other people from talking. I’m monopolising the conversations, and oversharing. I keep thinking what everybody else must be thinking: “shut up you boring twat”.

This began to bleed into my interactions outside the workshops. Whereas, previously, we’d pass each other in corridors in silent, miserable solidarity, now I am chatty, over-confident and excitable, passing pointless comment on any number of trivialities. It makes me feel flustered, sick and agitated. I want to restrain myself, be less impulsive and more measured, pause and think before I speak. I want to know what you think, dear reader, but I can’t reach you.

I fantasise, sometimes, about cutting out my tongue.

That was one of the advantages of being ill. After nearly half a century of hearing my own hateful voice droning on and on, I finally managed to starve myself into a blessed silence. I could listen. (Well, sort of, half-listen; listen with partial understanding, scud across the surface of your meanings)

(Half of what I [heard was] meaningless but I [listened] just to reach you…)

I always find these workshops constructive, possibly because my brain works best in dialogue with others, rather than on its own. Is this something common to all human beings? We’re pack animals, after all.

Perhaps the practice of talking to other people about your inner states gives you the mental tools and language for self-analysis. This sort of behaviour was discouraged, when I was growing up, especially among men and I find internal dialogue difficult. My thoughts are always fragmentary and insubstantial, and seem to instantaneously evaporate. To make them durable I have to compose a persuasive speech addressed to some other person. Even then, if I formulate a pleasing phrase it just goes around and around in my head. (is this just me?)

This means that my own state of mind is totally unknown to me. it is a closed book. I shout questions into the empty vault of my skull, but all I get back is confused echoes. The only way I can get anywhere near understanding myself is to deduce my inner state from my behaviours, as if I was gossiping about a friend, and my inferences seem to have no more validity than gossip. I’m very doubtful about any conclusions I come to about myself. It always seems like empty, self-justifying waffle. I doubt my sincerity.

But I contribute a lot to the workshops, especially if the others are remaining silent. I want the sessions to go well, to make the staff’s job easier, and to rescue those who don’t want to contribute. I want the therapy team feel it was a successful and productive session and recognise, with affection and gratitude, my part in that. I want to be a supportive fellow patient. In other words, I want to be loved.