The central purpose of the programme, at Ascot House, is really to hold you in place so you can be fed up to a healthy weight. Abi, my local NHS Eating Disorders specialist, insists there’s a direct relationship between weight restoration and having a healthy mind-set. My own experience suggests that the more you starve the more existentially alarmed and threatened you feel. This is odd, since anorexia provides you with a bulwark against anxiety, in the first place. However, the more you dig yourself in behind the protective earthwork, the more ghastly everything becomes. It looms over you. When you try to locate the source of these fears you can’t unearth anything much. Abi claims that once you’ve returned to a normal weight, many of these feelings just evaporate and you can’t remember why you found life so daunting.

Ascot House offer a simultaneous programme of therapy and workshops. These all have a similar format because they’re all based on CBT (Cognitive Behavioural Therapy)-style attempts to consciously identify, and then address, the foundational assumptions and values of your thinking. There’s a lot of cyclical flow charts with arrows going from unhelpful assumptions to negative thoughts to destructive behaviours that reinforce the assumptions. The idea is that we identify points of intervention where we can disrupt these toxic cycles. It all makes reassuring sense, although internal coherence doesn’t necessarily mean a system is applicable, or that you’ll be able to recall it when ambushed by baseless alarm, or attacked by a bear.

One of the things Dylan and I share is our awkwardness with these sessions. I suspect we both feel ashamed of ourselves, so we hide our thoughts and feelings away, even from ourselves. At the beginning of each session, we are each asked to “check in”, to say how we’re feeling. Inevitably, Dylan, lounging back in his chair will say, in slow, easy, meditative tones, “Not too bad…yeah…not too bad.” This makes me laugh because he’s usually been climbing the fucking walls five minutes earlier. He’s not lying, he’s using language to push people away. It’s a way of saying ‘I DON’T EVEN WANT TO THINK ABOUT THIS!’

Although my performance, and my motivation for it, is different, I’m similarly secretive. My defensiveness comes across as a desperation to please. I pretend to be a lovely, willing and helpful person. To assuage my guilt, I have promised myself that I will embrace this process as whole-heartedly as I can. To hide how foul I’ve been to my family, I want to be thought of as a good person by everyone else. Anyway, nothing is to be gained from resisting and then collapsing after much grief. This is a voluntary unit, so if you want to take resistance to its logical conclusion, you can walk out whenever you like. I comfort myself with the thought that I can relapse, if I want to, once discharged. I’ve proved before that I can do it.

The aim is to stop wanting to relapse, and this is a difficult and threatening idea. A stable sense of identity is vital for mental well-being, and to stop wanting something so fundamental is a betrayal of self. Because it forms who they are, some other patients are willing to put a lot of effort into resisting the inevitable. While Dylan and I try to chomp through our meals and then run away, wringing our hands in distress, (although we’d never admit this is how we were feeling) other patients will sit stirring a bowl of soup, listlessly, for hours, making it as cold and unpalatable as possible. This is who they are and, unlike Dylan and I, they are effectively communicating their distressed personality. There is even a little rebellious pride in their stubborn resistance. They are sticking it to the man, maintaining their integrity as anorexics.

I think this is also why anorexics often get worse once diagnosed. Our behaviour has been increasingly erratic; our thinking increasingly disordered, but once we know what we are, everything falls into place. We know how we should be behaving; we take to it like a duck to water.

Sharing a room with Dylan has allowed me to feel helpful, something I’ve been seeking, because it partially assuages the shame of having to be here. I don’t feel superior to, or wiser than Dylan, despite being so much older, but, putting aside my book, with an inward sigh, to listen to his thoughts and concerns, sewing patches onto his jeans, supporting his opinions on the situation: all this satisfies my desire to be a useful person. I enjoy suppressing my own worries and concerns so I can focus on him. It challenges the natural garrulity that betrays me, so often, into embarrassing myself. Such self-abrogation feels right and morally healthy, although it probably goes against the principles of therapy. Anyway, I ought to be more guarded: I fear exposure.

I do need to confess what’s on my mind, occasionally, to cement our relationship, but my thoughts need to be edited. Dylan is deeply romantic, so any indication that my relationship with Jo might be under stress, for example, seems to threaten and upset him.

These talks are beneficial for me, too. I’m aware of that. Being forced into company re-socialises us, as I’ve mentioned before. You become terribly anti-social, misanthropic and solitary as you descend into the pit of your eating disorder. I think as your mental functions become more primitive and limited, it becomes increasingly difficult to process the mass of data that other people, those most complex of organisms, represent.

As various writers on Eating Disorders have pointed out, therapy is an opportunity for sufferers to keep food and weight gain at arms’ length. You tell yourself you can postpone the challenge of eating while you sort out your head (see, for example, Carrie Arnold’s Decoding Anorexia, 2013, London: Routledge, p14.) As part of a therapy that prioritises gaining weight, it makes sense to be encouraged (gently) to engage in the normal behaviours that you will need once you’ve returned to society, and to do this while you’re recovering. I suppose each part of the process should reinforce the others. Still, it’s exhausting; it strains our poor, labouring, overtaxed little brains.

There are some differences in our eating disorders. I felt a frantic need to exercise. This was partly to mitigate the effect of the food I couldn’t resist indulging in. I felt it puddling around my midriff and saw that as evidence of my weakness. More importantly, yet less clearly, I felt driven to always be, somehow, productive. I think I wanted to justify my consumption, my carbon footprint, my drain on the planet’s resources, on other people. I’d always wanted to be a writer, but I never seemed able to sit down and write. In the absence of any other big project with a clear, socially beneficial impact, I needed, existentially, to be busy, to use all my time effectively. I needed to be active, to be constantly expending energy, to be cooking or cleaning, or going shopping, or taking the kids to school, or putting a wash on. But even this wasn’t enough to compensate for an indefinable, almost spiritual sense of falling short, so I filled up the gaps with running because it was effortful, literally driving my stumbling legs forward until exhaustion became an overwhelming excuse, and being able to function at all became a source of pride.

Dylan, on the other hand specialised in complete denial. I lack the strength for this. I always ate; I just made sure my calorie expenditure far outstripped my intake. Dylan would go for days without eating at all. He developed techniques to block or postpone his needs. He used to go to bed as early as possible and get up as late as he could manage. Indolence became his secret weapon. This seems odd for a boy who’d had a work ethic drummed into him. Starving yourself is hard work, so perhaps he felt no need to demonstrate any further effort, but I suspect that there was an element of surrender in his behaviour. Perhaps he’d despaired of ever living a productive life, and so he’d just given up. Anorexia allows him not even to try (and fail.)

Despite our differences, it’s tempting, in both our cases, to see anorexia as the product of a modern experience of thwarted masculinity. In our (slightly) more egalitarian society, with its relative loss of male importance, perhaps we feel a sense of disempowerment or disenfranchisement. We can no longer sit on the porch with a beer, comfortably embodying our valuable maleness. We need to enact our value. We need to have a purpose. Jo and I have been going to a family therapist, who says I need to spend more time around the children just benevolently existing, but I still feel that fatherhood needs to be demonstrated. I need to pursue the activities of the role.

(All these explanations don’t feel quite right. I guess imposing a verbal construction on mental states alters them. Then the question becomes not “is it true?” but “is it coherent?”, which isn’t the same thing.)

Dylan is from Port Talbot where his mother owns an independent garden centre. Theirs is a hard-working family and the expectation for Dylan and his 3 siblings was that, after school, they would get jobs, settle down and start saving towards a mortgage. Dylan hasn’t done this, which he and I suspect is a contributing factor in the development of his condition. He went to college after his GCSEs and studied drama. Since then he’s worked as a barman.

We are VERY different. Dylan is 20; I was already 27 on the day he was born, and so am easily old enough to be his father! He’s not interested in politics or the news or travel. He’s never been abroad, or even to London. Most importantly, he doesn’t read any printed material, although I suspect he has a greater facility for it than I do. I recently said to him, “you should read a book. It’s good for the brain” He said – “No it isn’t. It makes you infertile”.

He’s quick-witted, and his madcap humour, when he’s in the mood, is one of the things that endears him to me. I recently showed him how to sew badges onto his skin-tight jeans. Marie, one of the care-assistants caught sight of this and asked, incredulously, “where did you learn to sew?!” Dylan said, “Xan taught me”. “But where did he learn to sew?”, she asked. “I taught him”, Dylan replied. Funny Boy.

Because he never reads, Dylan is ready for more serious conversations when we’re lying in bed. I resented this at first, because I’d hoped this would be a quiet, recuperative reading time after another day of communal living, with all its head-ache-inducing chatter. I now recognise that this period keeps our friendship healthy, and it is vital that we continue to get on. This is when we have our most successful conversations about our condition. We compare our experiences and support each other. It feels very healing and sustaining and must aid our recovery immeasurably.

Despite our differences, our experiences of anorexia are very similar. We both began by eating healthily and ended by taking it too far. Like me, his eating disorder is partly a distorted extension of the work ethic we inherited from our families. Both of us felt our mortal thinness was won through the hardest of hard work at a time when we didn’t feel we were very effective or useful members of society. Losing weight was a tangible, measurable success, and we didn’t feel we were experiencing much of that. What we’d achieved was harder to discern. Perhaps, in some way, it was a successful expression of our inner state of mind.

Dylan was hospitalised before being transferred directly to Ascot House. He’d eaten pasta bolognese with his mum on Friday, and then, because he felt he’d eaten too much, he hadn’t eaten anything until he was admitted to hospital on Sunday. This felt, in our confused terms, like an achievement, and, secretly, I envied and admired his commitment. He recently showed me a selfie he’d taken days before arriving here. He’d delayed showing me because he was worried about how I’d take it. This was patronising but wise, because I felt humbled by how magnificently shit he looked: grey skinned and impossibly emaciated. It made me feel disappointed in myself, and inadequate. I was never that bad: his distress signalling is way better than mine.

Then, of course, I questioned my commitment and my right to be here. Was I just a fraud, an attention-seeker, taking up a valuable bed? Was I just pretending?

In fact, I’ve been incredibly lucky in my room-mate. He’s been unfailingly kind and accommodating, since my first day, when he made a point of welcoming me and showing me around. He seemed such a sweet boy, so gentle and so at odds with traditional masculine tropes that I wondered, at first, if he might be gay. This turned out to be far, far from the truth, as we will see.

He has also been astonishingly tolerant of my snoring. This morning he told me, in forgiving tones, that he’d got to sleep around 1.30am because of it. On occasion, he’s had to sleep in the lounge. I’m still waiting, apprehensively, for him to reach the end of his tether, but so far there has been no sign of it. He has an older brother, and they shared a room as children. Bunkbeds foster tolerance in the worst of us. It also helps me that Dylan fears the dark moods that descend on him when he’s alone and so tends to be grateful for company despite its distastefulness. We are fucked up kids.

I’m still troubled by the snoring. It makes me sad because I’m causing trouble to someone, and testing their patience, without being able to do anything about it. I seem biologically designed to be irritating and dislikeable, and it makes me beholden to someone and reliant on their good nature. I’m forced to be grateful simply because they’re willing to tolerate what I am. And I truly am grateful, but how galling it is to be tolerated, for people to congratulate themselves on their virtue, just for putting up with me. I know, I know, I’m repeating myself…

Surely I wasn’t like this when I was ill? I barely slept, after all! Is my increased corpulence, my greater heft, leading to this nasal flatulence, this adenoidal eructation? Gone is the waif-like anorexic’s lightness of touch. Is this the ignominy of the corporeal, the indignity of corruptible flesh weighing heavily on my sleeping frame?

Jo tells me, though, that I’ve always been this bad. She’s just used to it and Dylan isn’t. I don’t find this very reassuring.

This might be a good time to introduce my room-mate, Dylan. (I’m getting mightily bored of talking about myself.) As the only male patient before I arrived, Dylan had 6 luxurious weeks with a room to himself, but this is a repurposed Edwardian town house and its largish, high-ceilinged rooms comfortably accommodate two beds. Given the sheer number of people waiting for places in eating disorders units, sharing was inevitable.

We were both apprehensive about it, especially after I realised that the old lags, who were about to be discharged, had been here for 6 months! If we were to share a room for this length of time, it was imperative that we got on. Each of us feared that the other might be an intolerable moron, or a dreadful bigot. Worse, what if our room-mate discovered just how dislikeable and exasperating we each were?

You see, I snore. That’s why I don’t like sharing a room. It only takes me one night to squander any goodwill I’ve managed to build up during the day. According to the many exasperated and hollow-eyed veterans who’ve shared rooms with me, it’s my inconsistency that disrupts them so. Apparently, I will be quiet for long periods, so long that they often think I’ve stopped breathing altogether, before letting out an enormous, window-rattling honk. (Jo reckons I suffer from “sleep apnoea”.)

Anorexia is an attempt to suppress or control your base instincts, yet in sleep your true self is revealed: the grotesque, malodorous animal that you’ve spent all day trying to deny. Snoring is the perfect example of this. In your most unguarded moments, when you are most essentially yourself, you piss people off. You are a burden on them, requiring, at best, a demonstration of virtuous tolerance. It is a frank admission of your fundamental dis-likeability and it’s completely beyond your control.

This isn’t helped by intense, nasty night-sweats. The dietician reassures us that this is an inevitable part of returning to a healthy weight. In sleep your body is restoring tissues. Converting food to glycogen and internal fat reserves requires energy, ironically, and respiration, the process by which food is converted to energy, is an exothermic process: it produces heat. That’s no consolation to you when you wake with wet sheets clinging to your skin while sweat drips off the back of your knees. It is rank and squalid.

And, as you are unguarded in sleep, so you are vulnerable. What’s to stop my room-mate, worked to an ungovernable fury by lack of sleep, from rising in the night and smiting me as I lie, supine and defenceless, sprawled in my swinish, slovenly, sty?

Sure enough, on my second night, I was woken by Dylan, roaring “Oh for FUCK’S SAKE!! “Snrk? Gschwink?” I replied, wittily, opening one bleary eye to see Dylan punching his pillow.

For the rest of the night, I kept starting awake in alarm.

So we dither and we brood. We prevaricate and we dig in our heels. And, meanwhile, meals and snacks appear with alarming regularity and the staff stand over you, in the nicest possible way, to ensure you eat them. Anorexics always think, “I just need to sort my head out and then I can start eating properly”, but the reality is that you need to be better nourished to start thinking straight.

After a while, a span of days filled with sullenly champing jaws, I thought, “I can’t stay here forever. I’m in limbo. I need to get out.”

I discussed this with my room-mate, Dylan. We think that the most effective way of escaping is to embrace the programme, throw ourselves into the therapy, meet each challenge head on. The exit, out into the sunlit streets of freedom, is past all this stuff so it’s best to put your head down and charge through it, trying not to think too much. Ascot House promises a cure for an illness. There’s undeniably something wrong with us, but if you resist the therapy, if you won’t even try, you are admitting that you don’t want to be cured. Why not just try it out? If you really can’t cope with recovery and weight gain, you’ll have plenty of chances, when you’re discharged, to take it all off again. We, of all people, know we can do that. (although, if I do, I’ll be single, childless and jobless, and probably confined to a hospital bed with a drip up my nose). No individual meal is, on its own, a pivotal moment, an unsalvageable catastrophe, a mortal sin. You survive each eating experience; nothing very terrible results. Changing habits are what makes the difference. Or so we tell each other, pleading for reassurance.

Accepting challenges and surviving them feels like progress. Unfortunately, that means refusing any challenge at all feels like a loss of momentum. The therapy team soon worked this out and exploit it. They come to us and say, “Dylan, Xan, we’d like you to try eating a bucket of chips this lunchtime. Come on! It’ll be Great!” and we say, “What?! No! wait! I can’t…*sigh* alright…, where’s the damn bucket…”

Then they say, “and we were thinking, on Thursday, you might like to press your faces into a bowl of lard…”

I’m sure this emotional and cognitive illiteracy, this deep suspicion of opening up, is common to people of my age, gender and socio-cultural background. I was brought up at a time when psychological anguish was seen as self-indulgent, self-absorbed and weak, especially if you were male. Why didn’t you just man up and get on with life, for Christ’s sake? It’s not all about you!

As a teenager, I flirted with self-harm, lightly scoring my wrists and the inside of my lower arms with scratches from kitchen knives. I think I did this to get attention from girls, although I guess it’s significant that, of all the ways to get attention from girls, I chose this one. The easiest to achieve, I suppose.

I don’t know why it occurred to me. Self-harm must have been in its infancy as a culturally defined form of expression, and there was no internet to infect me with its memes. I don’t think the idea came to me spontaneously, though.

Eventually my parents found out and confronted me. I sat, frozen to my core with shame, while they stood over me, upset and threatening. “Do you want to see a psycho-therapist?! Is that what you want?! Hmm?! Because we can arrange it, if you do!” It was obvious that the correct answer was, “No, of course not! I’m not mad!”, an answer which I duly gave and seemed to satisfy them.

I suspect they had no idea where to look for support for either themselves or me, so they wanted me to tell them that they didn’t need to. I also had the impression that they couldn’t afford it. Therapy was for pathetic, self-pitying whiners or madmen. Going to a therapist was either an unjustifiable luxury, a pretence at madness, or it was an admission of complete psychological inadequacy. Honest, decent, hard-working people had the strength and resolve to over-ride these momentary fancies!

I never had the nerve to repeat the scratching. I wasn’t scared of my parents; I was terrified of the mortifying experience of opening my inarticulate inner-self to such alarm and distress. No further attempt was made to address the issue or talk about why I had done it, and we all seemed perfectly content with that. The suggestion seemed to be that if the behaviour could be suppressed, the problem would cease to exist. To them, there was no inner state that had led to this, and thus there was nothing to discuss. These were just whimsical and impulsive actions. Therapy would indulge the whim.

I guess they hoped they could beat it out of me, whatever “it” was. We were both a reserved and a shouty family. When I was around 11, I fell off the garage roof, bruised my spine and temporarily lost the use of my legs. Everyone thought I’d broken my back, and because they loved me (it embarrasses me just to write that), everyone spent the next hour yelling at everyone else.

Poor mum and dad! See how we punish them, for the rest of their lives, for their well-intentioned errors? Who’d be a parent?

It wasn’t just my parents, though, it’s that whole generation. When my Father-in-law was told I had anorexia, he said, “Anorexia? I thought that was something teenage girls got”. I don’t think, for him, acting like a teenage girl is something to be admired.

My resistance to treatment is reinforced by an automatic scepticism of it. I squirm at the very idea of therapy and feelings and all that girly nonsense. It smacks of self-obsession and I assume nothing will come of it.

When forced to own up to my condition, I want to say, sheepishly, “Apparently, I’ve got ‘Anorexia’”, making quotation marks with two fingers. Then I want to snigger with a toxic mixture of derision and embarrassment, dismissing the condition, those who diagnose and treat it, other sufferers, and myself, all in one craven act of betrayal.

For some reason, I can’t see a tangible link between my underlying experiences and attitudes and my thoughts and behaviour. Considering my own thoughts feels like following a road into a valley: I can see a road climbing up the far slope, so it’s reasonable to assume it’s the same one, but god knows what’s going on down on the valley floor.

This makes me doubtful of all explanations: I just don’t see the connections. When we’re talking about other people, the various theoretical models of brain function and process seem relevant and plausible. The feelings of another person, and the reasons for that feeling, are equally speculative, so there’s no reason why they shouldn’t go together. However, when applied to myself, the explanations seem self-evidently false, and therefore pretentious and self-pitying. To me, to define something as rooted psychologically, is to deny it substance, to make it non-existent. Character, thought and behaviours have the fixed solidity of concrete and do not need to be reflected on. Any deviation from expected norms has a profound, metaphysical falsity. It is “attention-seeking” “silliness”, and is as motiveless as the villain’s commitment to evil in a badly thought-out movie. Destructive thoughts and behaviours are somehow untrue to the point of being unreal, not cut from the fabric of reality, but rather that of fabrication and unreality. They are “wrong”, both in terms of being “bad” and “in error”.

Of course, all these attitudes are nonsense. All behaviours are bio-chemical facts. Even if someone is acting up to a condition, that’s still the manifestation of a psychological state, so it’s worth asking why they’re doing it. Anyway, we anorexics trump scepticism with the sheer ferocity of our commitment. No matter how unknowable and nonsensical our aims, we’re willing to risk death in pursuit of them. That’s got to make the nay-sayers back down, especially as we’re too hungry to care what they think!

My problem is that I don’t believe my own excuses. Something must cause me to starve myself, but I disbelieve any explanation I could come up with. I treat it almost with levity, thinking, “oh come on! I’m not actually ill! I’m just, sort of, pretending.” This may partially explain why I continued to abuse my common sense and the resilience of my body, day after day, with incredulous glee when it continued to function at all, despite the clear discrepancy between my exercise-driven 4000-calorie expenditure and the small amount of food I allowed myself to eat.

And I suspect my profound disbelief in my own psychological states has deep implications. I seem to view my inner self, my deepest thoughts, as somehow unreal, illegitimate. I am, in my own eyes, a ghostly, insubstantial presence, with little weight or importance. This allows me to dismiss the harm I can do, not only to myself but also to my family. What impact could my behaviour have, for goodness’ sake? They’ll be fine.

Is the anorexia a demonstration, of this sense of insubstantiality? An illustration of it?

My sense of self is critically damaged by the sense that I’m not valuable, which, in turn, drives my desire to be active and useful, which became twisted into the desire to control my eating, because, in the absence of any other laudatory characteristics, at least I don’t have to look like an unwashed, sweaty, hairy-bellied slob. In an attempt to balance the metaphysical books, I also wanted not to have too great an impact on the earth, reduce my consumption and my footprint, almost literally. Become light. Evaporate.

Legolas walks on the surface of the snow as the rest of the nine wade and wallow through the drifts. He is ethereal.

At my final meeting with the NHS Eating Disorders team, Abi and Jo said I needed to be admitted to an in-patient facility, and Abi said Ascot House had a good programme. I shrugged. I was too tired to have an opinion.
I was in no position to object.
I was in two minds, the perennial anorexic’s condition.
I took everything on trust.

After a few days, though, I became more alert. Alarm replaced listless, befuddled acceptance. Each meal was a cliff-edge. I wanted to shout, “No! Wait!”, as a plate, heavy with food, was thrust at me.

And it did feel like I’d been hurled off a cliff: an uncontrolled, flailing fall, through precipitate air, with disaster rushing up to meet you. Like most anorexics, I was just trying to keep a handle and a lid on things, because otherwise it felt like everything would go to hell in a handcart. (Anorexia generates the very anxiety it comes into being to resist.) And here they were, expecting us to eat as if there was no tomorrow, as if there were no consequences, as if it didn’t matter.

I had no idea of the medical theory or ethos that the programme was based on, if any. How did I know they knew what they were doing? What WERE they doing? What had we let ourselves in for? I had given over all decisions about every aspect of my life to an organisation I knew nothing about. Didn’t this just encourage emotional and intellectual dependency? It was like joining a cult.

I needed, very much, to trust these people not to lose control of me or my weight or my state of mind, but now I was having doubts. I was resisting.

I’m wary of reducing anorexia to an autonomous parasite that’s wormed its way into my head; that’s too simplistic and too forgiving an explanation: I’d just be blaming it all on somebody else. However, in retrospect, these doubts did resemble a creature, one that cannibalises my thoughts to form its own, that was beginning to feel vulnerable, to squirm and lash out in distress. That’s what parasites do when they’re put under pressure.

The therapy team have a perfect reply to these doubts: this is a voluntary unit. You haven’t been sectioned (yet), so if you resist treatment, why are you here at all? Are you ready to admit that you don’t want recovery, that you’d sacrifice everything and everyone for your right to starve yourself to death?

Very far away, across oceans, a voice was whispering, “No, but, seriously, what IS the problem with eating? What do you think is going to happen?”

And that is blasphemy.