Jo thinks I’m relapsing. She’s probably right, although her evidence is just that I’m admitting stuff I’ve always done, like exercising and reducing the carbs (pulses) in my stews, etc. Is this complacence or a new openness that comes from seeing Phil? I don’t know.  Jo is also transferring anxiety and exhaustion that’s been cultivated in her by a criminally, cruelly demanding job, rather than having any obvious evidence from my behaviour. She thinks I’m being more snappish with the kids, for example, whereas I think she’s just less tolerant of my ever-present snappishness.

On the other hand, I am lighter than I was and more sensitive to the kids’ food foibles. I probably am relapsing, although I don’t think I’ve revealed much to Jo, and this could, I suppose, be, in part, because I’m picking up on her work stress. Families are a very complicated moiling soup of reflexive interactions.

Jo googled “anorexia relapse” and found an informative looking website (‘Informative looking’: that’s what amounts to credibility, in the internet age!) It said relapse was part of the recovery process, which was reassuring. (National Eating Disorders Collaboration, nedc.com.au) Jo claims I fit most of the criteria they lay out for someone who is likely to relapse: they are older when they develop the condition; haven’t been in-patients; exercise excessively; have low self-esteem; find it difficult to interact with others, have a low body-fat percentage; and have a diet which is low energy-density and of limited variety.

It’s amazing how lacking in autonomy I am and how predictable my behaviours, thoughts and motivations are with this condition. I find that reassuring, though. It reduces blame, for one thing: it suggests it’s an actual condition rather than a wilful, perverse and self -indulgent attempt to be as nasty and difficult as possible, for attention.

Anyway, the website said that relapse can be part of a process of learning how to control your anorexia, and, certainly, I feel more confident that I know what is going on and that I can stop myself from going totally off the rails. This could be just a self-satisfied lack of imagination, though. Now I’m off to do some more star-jumps.

Here’s an example of anorexic thinking:

I had a dreadful food day, yesterday. I made us Malaysian Curry, 279 calories a portion, if serving 6, but we’re only 4. I reduced the butternut squash, used 1 cal and reduced-fat coconut milk, but there was a huge amount of soupy sauce left over, probably more than a big bowlful. For some reason, I just ate it. I forgot there was coconut milk in it, and the problem with things like that is, just because they’re reduced fat doesn’t mean they aren’t still fatty or starchy or calorific, just less so than the original lump of lard it was derived from. I’ve felt dreadful ever since – very full and tormented by that feeling of gastric satisfaction. I worry (and simultaneously console myself with the idea) that I am feeling more active, more alert, and more sustained, physically and intellectually.  I’m writing this quickly and with unusual ease. I am less interested in food and have just flicked through my new cookery book, Meera Sodhal’s Made in India, without the avidity and relish I would normally bring to it. I’ve just thrown out two pints of milk, simply because they were weeks old and on the turn (Profligate Madness!) Even my farts are more aromatic, more richly expressive.

I’m squirming with it, desperate to take exercise, go for a run, yet unable to explain or justify it or spare the time, yet also feeling this resistance as weakness and failure. Going for a run would feel liberating and courageous and reassuring, all at once.

Written down, this is clearly, to a rational observer, illogical and twisted. It is further evidence that I’m getting back into my old habits. I’ve been maintaining my yummy breakfast (2 toasted crumpets and honey with 2% Greek Yogurt and some fruit) but restricting my daytime food and snacks and increasing my exercise, in order to really luxuriate in the big payoff – my tea, which is large but low fat and highly restricted.

Since I stopped seeing the Eating Disorders people, my weight has been gently creeping downwards. It’s not noticeable, day by day, but it has gone down, measurably, over the months. A little. I’ve started doing 200 star jumps a day, since I heard a woman on Louis Theroux’s documentary say she did 2000 a day. What is it about anorexics and star jumps? (And see how we take each other’s warnings as suggestions). They noticeably elevate my heart-rate, which seems encouraging, to me. I’ve also started running every time I need to go somewhere. It makes it much quicker, and I gives me a satisfying and reassuring sense of expending energy. Strangely, it makes me feel energised, but I’ve recently noticed that my legs feel faintly quivery when I’ve been exercising or rushing at work, and I’m concerned that my heart will start to feel slightly fluttery again, or at least delicate, as I sometimes imagined it did when I really pushed it in the past. I like and fear this (hopefully fictional) sensation in equal measure.

This could all be illusory or psycho-somatic.  The more you introspectively probe your physical sensations, the more they elude you. The point is, that instead of frightening me, feeling unwell seems comforting. I guess we’ve abused our systems so much that we’ve become alienated from our own physical senses. What feels like intolerable hunger to most people is simply a flicker of a familiar sensation to us. So these dangerous symptoms of failing health become the only way we can measure the success of our actions and be sure we have the control we so crave, and the excitement and relish of that most basic and important aspect of life: food.

The memory of other aspects of the condition are also returning to me. For example, I remember that my bladder muscles seemed to be weakened at my lowest point, so that I sometimes dribbled a little pee, in anticipation, just as I was fumbling with my flies. Perhaps this was some strange psychological, rather than muscular degeneration, because I really didn’t care about it, or the smell of pee that might accompany the removing of my boxers. I had more important things to occupy me. I think I wouldn’t have minded if I’d been staggering around constantly dripping down my legs like some mangy, incontinent ram.

I think there’s an element of rebellion in the anorexic mind-set. The duality of mind I’m always going on about means we’re perfectly aware that we look and act weird, that we’ve gone to Tesco’s in crotch-stained pyjama bottoms, hiking boots, 4 old jumpers and a tea cosy. In summer. (My mother made us an outsized tea-cozy, and I genuinely did wear it on my head for a while. It was wonderfully warm.) We know what you’ll think, but we just don’t care, presumably because, through malnourished mental exhaustion, we’ve lost the ability to feel things from your point of view.  However, a little voice in our heads suggests that this dismissive, narrow-minded attitude is mischievously challenging social norms.

I suspect we extend this attitude to our constant talk about food. We are being intentionally boring. We tell ourselves that we are rebelling against the idea that more pompous concerns are more profound than our most elemental needs. We tell ourselves that we are suggesting re-evaluation.

A woman on Louis Theroux’s documentary about anorexia was talking about the “guilt” she’d feel if she ate too much. I think that isn’t the right word. I have started, again, to experience fleeting sensations of a sort of rootless distress, which I think is related to this “guilt” and is presumably just a side-effect of hunger and exhaustion. It seems to alienate me slightly from the normal world, as there was a thin, transparent film between me and it, like I’m a ball of anguish wrapped in cling film. Maybe this is because I know I can’t properly attribute the feeling to anything in that world.

And it’s a self-fuelling cycle. The same woman tells Louis Theroux, “when you’re starving it gets so bad you feel pain; it numbs everything.” Malnourishment causes or sustains anguish and a terrible sense of alarm, but the immediate, urgent, sensation of hunger numbs it.

I also seem to have gained an almost febrile creative energy on the way down between the increasing moments of exhaustion (I think this happened last time.). As long as I see any sort of relationship between the creativity and the other, more manic aspects of my behaviour, it’s difficult to give them up.

The pernicious thing about this condition is that it’s the individual action that’s difficult to give up. We’re all totally committed to the principle and the project of recovery, but when faced with a specific choice between, say, running or not running, we struggle, then, often, make the wrong choice. The torment of not burning calories, of allowing them to moulder away inside us, turning into staining, corrupting, fat is uncomfortable enough to mean that we often give in to the urge to exercise. Then that wrong choice becomes habitual, the new norm. This is, of course, compulsive behaviour, and may build up to a return to anorexia, but we reassure ourselves that it’s just one extra run, and so we aren’t abandoning the campaign, which would be an open betrayal of the trust everyone has invested in us.

On Louise Theroux’s documentary, a team of health-care professionals was looking at a patient’s weight-gain chart. Her weight was constantly flirting along the line of minimum acceptable increase, even though she was unaware of the existence of this chart. It was nowhere near the ideal line. So, you see, we are constantly “dancing on a volcano”. Dancing is fun, though, and I haven’t gone over yet. At least I know the volcano’s there, now…

I’m a learning support assistant in a large, English comprehensive school. This year I’ve been supporting a student, who I’ll call Philip Pirrip, in his English classes. This kid is on the autistic spectrum and has a number of anxiety-induced tics. When I first started working with him, he kept saying something that sounded like “wilefingbahapemy”. He repeated this with increasing insistence:  “wil-efing-ba-happe-me”, until I realised he was saying “Will anything bad happen to me?”. He says this to me in every class, usually three times, with varying degrees of urgency, depending on how anxious he’s feeling. He also, occasionally, asks, “Will I become a paedophile?” I reply “No, Philip, I think you’ll probably be alright. Now, let’s get on.”

I told this to Abi, before I stopped seeing her and she said “You can’t say that. It’s not your role to say he’ll be alright. How do you know?” I said, “Well, I can’t do a deep psychological intervention at the back of his English lesson, while the teacher’s at the front trying to discuss images of sleeplessness in Macbeth or something.” Anyway, I’m not qualified to run therapy sessions.

Actually, at first, I did say “Well, I don’t know, Philip, what do you think?” Because I don’t know, do I? Philip looked at me with irritation and said “No, no, you have to say ‘No’”. So I did, and do, but I feel uneasy about it.

The first time this happened I felt a little weepy, confronted with such familiar existential anxiety, exactly the condition that I don’t deal well with, in myself.  I think, also, Philip’s anxiety resonated so much with my own that I felt a poignant burst of empathy for him. And empathy is exactly the sense I’ve lacked while anorexic, so I felt not only deep sympathy, but also gratitude towards this odd, self-absorbed little bunny. It was a little overwhelming.

I wouldn’t say I “suffer” from anxiety, though. It’s simply the background hiss to my life, the white noise; the dark wash on the watercolour; the filter on the camera that brings out dramatic contrasts; the drone to my bagpipes… Anyway, like experiences of pain, you can only infer other people’s perceptions, an inexact science. Perhaps everybody has an identical experience of alertness, or wariness, or foreboding, but they don’t label it as anxiety.

If you operate with what appears to be a higher level of background anxiety, though, you tend to battle your way through your days with a general sense that everything is fraught and alarming. Everything has to be struggled with. When you can stop and challenge this feeling, you can’t find its source. This tends to make me feel temporarily better, but, still, I make heavy weather of living. The doomy feeling is intensified, almost into a fever, by extreme hunger.

I guess I’ve always been a nervous wee pudding, but something was clearly triggered by having children. The experience of parenthood is of terror and guilt, I realised as my daughter Margret wobbled along the pavement on her tricycle, right next to the enormous, death-dealing wheels of gear-grinding, roaring juggernauts. This was particularly emphasised by the one and only time we ever flew with Margaret.

I used to cross myself, as the plane picked up speed on the runway, grip the headrest in front of me, and try to reconcile myself the possibility of an imminent and fiery, though mercifully brief, death. Then I just had to get on with life, because there was nothing I could do about it.

On that flight with the baby, though, I thought I was going to have hysterics. It felt almost unbearably claustrophobic, like we’d been sealed into a tubular coffin. It wasn’t the possibility of my own death that freaked me out, it was the sense of how little control I had over an environment that could kill my daughter. “If the wings did fall off”, I thought, “how could I protect her as we plummeted towards the sea? What could I say to reassure and comfort her?” I thought I was going to run screaming up and down the aisle, battering at the doors, because there was nothing I could do about it.

Then, when we first moved to the East of England, we laid down some lawn in the scrubby garden we’d acquired. It didn’t rain for the next 12 weeks.

I was born and raised in Ireland. For me, a dry spell means it only rains for a couple of days a week. So I was surprised, at first, walking up and down with the pink plastic watering can my daughter had chosen, squinting up at the sky. Soon, however, I started to feel alarmed. Jo bought us a garden hose. I continually scrutinised an impassive sky. Every morning I’d wake up and pull back the curtains, hoping for the shine of water on the tarmac. Nothing. Dry as bone. Then I started waking up in the middle of the night, listening hard for the sound of rain. Sometimes I’d hear the lovely, loose drapes of rain hushing the roof tiles. I’d leap up, but it would only be the blurring sound of a light breeze. Could it be a breeze that promises a change in the weather, the coming of rain? No.

And then, as I lay awake at night, sinister “what if”s began to creep into my mind. What if it never rained again? This was the longest drought anyone could remember: was this caused by climate change? If so, then no weather patterns could be guaranteed again. All those interlocking climate systems, the Gulf Stream, North Atlantic Drift, that guarantee our reliable, damp British weather, could cease. If the whole global climate was changing, just because it had never happened before didn’t mean that it wouldn’t happen now. This was new territory and we were reluctant climate pioneers, forging forwards into a vast, black storm. There is now more carbon dioxide in the atmosphere than has ever been breathed by human beings before, after all.

I was having night terrors, real spasms of overwhelming, gasping panic confronted with a pitiless universe that could snuff us out at any moment. What could I do? What could I do? I gleaned tiny grains of comfort from picking up rubbish when I went for a run or from furiously composting everything, (although, horrors, the breakdown of organic matter increases CO2 emissions). I wasn’t suicidal, but I began to feel that it might be better to be dead. I would no longer be producing CO2, which would benefit my children, and I wouldn’t have to cope with the almost unbearable panic. It would be such a relief.

Of course, eventually it rained again and I slowly relaxed, but I had been rattled by these two events. What seemed to link them was the issue of control, especially when it came to my children. I felt powerless confronting the vast forces of global climate catastrophe or gravity itself. How could I keep them safe? How on earth would I provide for them, if we became climate change refugees? (Don’t laugh – it happens.) I felt I just didn’t know what to do. I also wouldn’t know how to marshal and direct the children in these situations. And this, I think, comes from the circumstances in which I became a father, and my attitude to fatherhood itself. I’ll go into this in my next post.

Sorry I haven’t uploaded anything for so long. I’ve been working on a couple of posts but they haven’t been coming out right. In the meantime, here’s another response to another documentary about the oddities of modern eating.

The Food Programme on Radio 4: How we eat: eating by the rules, dealt with clean eating, the difficulty of eating healthily in a junk food society, the ensuing desire to control your food intake, and, inevitability, anorexia. Again, it’s remarkable how many of these things are similar to my own experiences with food.

Surprisingly, though, the programme didn’t chart the weary road to anorexia as I’ve just given it to you. Instead, while it did touch on the deeply dysfunctional relationship we have with food in our oversupplied societies, Sheila Dillon concluded, “In a world hooked on maximum choice…the unlikely conclusion seems to be that the holy road to freedom and happiness, might lie in learning to eat by the rules.”

This seems to me to be an overly optimistic rendition of the situation. Anorexia is pernicious precisely because it is rooted in reasonable and genuine concerns about healthy eating. We need to be alert to which of these perfectly justified ideas and attitudes could be twisted and cannibalised by the condition. There are a number in this programme.

Firstly there’s the tendency to see food as a threat. The nutritionist Dr George Wilson is recorded pointing out that in a garage shop “most of the food would be processed and sugar-based and addictive in the sense that it’s just that fast fix”. Talking to someone on a weightwatchers programme, Sheila Dillon suggests “the environment is almost scary. You could go out of control. You could go out to buy your morning paper and end up with 10 chocolate bars”. If most food is nasty and soiling, then abstinence from food is pure and clean.

Secondly, to resist the impulse to gorge yourself on vile, poisoning snacks, the programme makers suggest you need to adhere to a controlling system, a healthy eating regime. Dr Wilson, says “It’s about discipline, not sacrifice…When you’re surrounded by a society that’s basically junk food”. Here, we have the idea that abstaining from eating is admirable and praiseworthy.

Thirdly, the benefits of healthy eating are emphasised through the example of the boxer Derry Matthews. As a featherweight and lightweight boxer, he used to starve himself in the days before a fight. He began manifesting many of the typical symptoms of anorexia: exhaustion, reclusiveness. He even found that he was getting cut extremely easily. These ailments ceased when he began to eat using a diet plan devised by a sports nutritionist. Sheila Dillon said “it does sound, Derry, as if the rules have set you free and made you happier”. Jackie, from Weight-Watchers said “It does help to have the structure. You enjoy the taste more” (presumably because you’re hungrier). They agree that “it’s really good to feel in control”. So, here, we have the idea of plans and controlling your eating in order to be successful. Derry is successful because his diet is planned for him and his choices are much more sensible, now. For other people, the problem is, when does the planning become obsessive and who decides what’s on the meal plans? What is their true agenda? What if controlling your food intake, and losing weight, becomes a substitute for control and success in your wider life?

The programme does acknowledge the dangers of this approach. Right at the beginning, Sheila Dillon talks the food blogger Madeleine Shaw. She admits to having had an eating disorder in the past, saying “we’re all control freaks in some ways, and I think food can be quite overwhelming of making choices…people quite like it because it almost gives them an identity…For me it was a control thing…it wasn’t necessarily about being skinny it was like ‘if I control what I eat I’ll control my life in some way. And I think that food is something that we can control as well…food is the one thing that you’re actually in control of, especially once you’ve left home…suddenly you’re given this responsibility of feeding yourself and I think that is amazing and empowering and exciting , when you first left home and you went shopping it was the most exciting thing but I think that obviously leads to complex relationships with it because you can kind of use that element of control in a negative way”.

However, they do not question Jackie when she says “I want to feel better than I do now, which is much better than I did four months ago”, yet this is classic anorexic thinking: she is so encouraged by her success that she isn’t content to simply enjoy the benefits of achieving a healthy weight. She wants, now, to keep going, to push it beyond her original goals, beyond what is advisable.

The similarities between these people’s experiences and my own is striking. Like Dr Wilson, I felt assailed on all sides by nasty, fattening foods. Like Madeleine, my anorexia was an attempt to control my life at a time when much of it seemed beyond my control and it looked like Jo, our family’s main bread-winner, might lose her job, and there was nothing I could do about it.

Like Madeleine, this sense of control grew out of the exciting and empowering responsibility I felt in continuing to shop for and feed myself and my family so well, despite this impending catastrophe. Like Jackie, I was elated by my success at making my diet as low fat as possible and with how well it had made me feel, creative and energised, and like Derry, freed. And I was determined to continue that feeling by continuing the behaviours that led to it, until I had taken it all too far. And then, like Derry, I found myself, exhausted and reclusive, cutting far too easily…

I guess the lesson is that this dangerous madness erupts out of, and subsides back into, perfectly sensible thinking on perfectly ordinary topics, the subjects of thoughtful, harmless documentaries on radio 4. And there it lurks, waiting…

Phoebe, The One Who Knows Things, told me that she no longer knew what love meant. Do we ever? Phoebe is worried by how, when you’re ill, you can look at somebody you know so intimately with such apparent lack of feeling. Personal relationships, and the emotions that fuel them, are aqueous and difficult to pin down at the best of times, and, as we know, the brain’s capacity to entertain these subtler aspects of the human experience are switched off as you become more undernourished and your body has to prioritise more vital mental functions. (You can tell I’m a firm believer in the “Mind is Brain” doctrine, can’t you?)

I started thinking about romantic relationships, although that wasn’t what Phoebe meant (probably because she lives with her mother but I live with my wife). Starvation teases out the whole complex of synapses, neural pathways, that make up that complicated tangle of attitudes, relationships, feelings, thoughts and urges, like a fishmonger lifts out the whole skeleton of a fish, then picks out the last pin bones with a pair of tweezers: there’s nothing left. You no longer feel sexual urges, but you also don’t even comprehend attraction in romantic relationships. You really do look at the most beautiful, sensual people with a blank incomprehension. What on earth could induce them to act in this way?

When I was a teenager, enduring puberty, my whole year group had to stand up in our morning assembly because there weren’t enough chairs, the school having recently expanded, and I used to get these involuntary erections. I guess my changing body was running some tests. I grew to dread these assemblies, fearing the random visitations, which couldn’t be hidden as they might if I was sitting down. What if somebody saw? Oh, the shame! Singled out forever as The Boy with the Erections, The Boy with the Massive Schlong. How terrible…

Well, they do say education is wasted on the young. How I would love to have that ability (or that reputation) now. But I’ve put on some weight, as you know, and I’m beginning to experience stirrings of sexual desire. The odd half-erection, on waking, lifts the mood. I relish it.

There is a whole beach on Achill Island that disappeared, due to the vagaries of the currents, in 1984, and returned a couple of years ago, virtually overnight. There was an article in the paper about it one Saturday and it’s an appropriate analogy. There was also a picture of a couple going skinny dipping. You only saw them from the back, but I was suddenly struck by how attractive the girl looked. She seemed tallish and slim but healthily solid, a look I particularly like (odd, given that I’m anorexic) There it was: undeniable, pointless, inexplicable sexual attraction.

But there’s the very problem: this young woman isn’t my wife and I guess one of my issues has always been that I have a low opinion of myself and my self-control. I don’t condemn the impulse. As I said, it exists because it exists, but I probably shouldn’t entertain it and, deep down in the liminal subsoils where the conscious brain blends with the unconscious, I guess I don’t trust myself.  Get me drunk enough and I’m not sure I wouldn’t sleep with her if she came onto me. I hope I wouldn’t. The idea currently fills me with horror; I’m terrified of the idea of Jo reading this entry, but I have experience of my former self. There have been many moments in my past, before I met Jo, when the spinning plates have suddenly flipped off and smashed, when the person I was suddenly said “Fuck it! Why not?!” I hope I’m not like that now. I understand, but still sympathetically condemn, such behaviour;  I don’t want to be like that again.

Anorexia resists base, physical impulses and appetites. It rejects with the Cartesian dualist’s disgust the body and all its farting, burping, spermy, pooing, spewing, snotty treacherous physicality. With some success, actually: you don’t fart; you rarely poo and when you do it’s a dense, black, odourless product, like sheep dung.

And you don’t feel sexual desire. You chemically castrate yourself. See, my love, I did this for you: Self-control taken just a little too far.

In all these anorexia documentaries, it seems to be the fathers who don’t deal with it very well, and whose relationships with their daughters seem to deteriorate. They’re the ones who seem to be saying “Look, why don’t you just eat some bloody Weetabix, for Christ’s sake, and stop spoiling everybody’s morning.” When I was at my twitchiest and maddest, my parents were visiting and I was eyeing a slice of pizza (or something) longingly, so I said “Dad, why don’t you finish the pizza?” He replied “No, no, you have it”, obviously completely forgetting the elephant in the room. Mind you, I don’t have to live with him looming over me, fuming. As I’ve said before, it’s much easier to be quietly anorexic if you don’t live with your parents. Poor teenagers!

My daughter is now 12. Puberty and anorexia have played havoc with our relationship, too. More unusually, though, while the puberty is hers, the anorexia is mine. We’re both totally unreasonable and volatile. We snarl at each other and take offence. I’m totally unreasonable about food and people not ‘jumping to it’; she’s totally unreasonable about EVERYTHING ELSE. Unsurprisingly, when the other one is ‘being difficult’, we both take a self-righteous pride in being reasonable and calm.

The unnatural or unwholesome part of this scenario, as I’m sure you’ve noticed, is that a 12-year-old shouldn’t have to be the reasonable one. It’s her privilege to kick off – she’s the child – she didn’t ask to be born the way she is! I’m the adult; it is my duty simply to love and support her no matter how often she tells me she hates me and I’m horrible because I asked her to pick up her onesy.

I’m not that bad. It’s just that, as Jo says, food is too important to me. It matters to me if the lasagne I’ve made gets inadvertently tipped onto somebody’s lap. It matters if there are peas all over the floor; it upsets me if my food is rejected because it’s got vegetables in it. I feed my family immensely well, but I’m incredibly controlling: I create weekly menus on scraps of paper and become flustered and agitated if anyone proposes changing the plan or I lose the scrap of paper. Food is pretty bloody tiresome for everybody else, so much so that Jo now can’t face any conversation to do with it.

My answer to that is – well, if I have to make all the decisions around food on my own, it’s unfair to complain because “the tomatoes are too floury”, as Jo does. What sort of example does that give the kids? You should just eat what’s put in front of you.

But, giving an example to the kids – there’s the rub. Ironically, what makes mealtimes particularly fraught is my fear that Margaret is quietly absorbing dangerous lessons from me. At the moment, she eats well. She is growing and active and constantly hungry, but I worry that she will learn to use not eating to express her angst. This makes me scrutinise her eating too closely. How she eats is manifestly too important to me. It is probably only a matter of time before she decides to weaponise eating and use it against me.

I’ve been mulling over Mark Austin’s documentary about anorexia, and his conclusion that, when he argued with his anorexic daughter that he wasn’t addressing his daughter he was “talking to this thing called anorexia”. I understand the attraction of this conception of anorexia: it absolves both your beloved, apparently psychotic daughter, and your intemperate self, of blame. The anorexic brain’s aims and intentions are so much at odds with the sufferer’s best interests, and are so blatant, that the condition seems to have an independent volition.  It makes sense both to the sufferer and their families, to see people with anorexia as possessed, hollowed out and replaced by a malignant entity, like the demon in The Exorcist. (“Do you know what she tried to do, your cunting daughter?”) In the Radio 4 documentary I mentioned before, Maya’s father talks about “seeing her turn into this monster”.

This way of seeing the illness seems to occur to us all independently, but I’m beginning to be uncomfortable with it. For a start, it implies that the real person, who is undeniably present and involved in the conversation, is being ignored. Presumably all conscious lives are lived equally vividly and, as such, deserve to be acknowledged. The self is not constructed in isolation, but in communication with others. Part of who you are is socially and communally constructed – how you are perceived and reacted to by others, how you respond to these reactions, and so on. Robin told me that he believes the mind makes the best decisions available to it at the time. Robin’s point is, I think, that if you develop anorexia, there will be reasons for this, rooted in the soils of yourself and the alternative might have been worse – suicide? Complete loss of sanity? Which is not to deny that anorexia is horribly undesirable and that the starved brain cannot be reasoned with, as Abi would point out.

The transformation itself is interesting. I think we tend to make the error of seeing our identities as having an irreducible, unchangeable core, so that if someone’s character changes so fundamentally we think they can’t truly still be themselves.

I think the self is probably much more complex and troubling than this. I think the brain is a systemising organ. It is designed to draw all the different functions into a coherent and co-operative whole. Our different nervous systems interact and, as part of this web of neural activity is consciously governed, a single human identity, a person, is conceived of, as a sort of organising principle. After all, it is contained in, composed of, and sustained by, a single body.

As anorexia begins to starve your brain, various pathways cease to function. You may lose the ability to react to pain, or to feel immediate empathy with others; you may become inarticulate, and frustrated by that fact. Your systemising brain still draws the remaining threadbare strands together, however. It attempts to maintain a self out of what is left to it. So rather than being a completely alien parasite that inhabits your body, a demon, a cuckoo, a boggart, anorexia constructs itself out of you. It thinks with your thoughts. In a horrible way, it is you, grotesquely transformed. Everyone can recognise the parts; they are horribly familiar: a Frankenstein’s monster horrifyingly constructed out of pieces of the person you know so well. The insults parents hurl at the monster damage their vulnerable child.

Perhaps, also, the conscious governing systems are, themselves, weakened and thus fail to reconcile our totally contradictory thoughts and impulses.  Whereas, previously, nonsensical and self-destructive ideas would be suppressed or abandoned or drowned out by the healthier or more vigorous or more urgent thoughts, now, in your weakened brain, all idiotic, damaging mental patterns, rooted in your dark, emotional subconscious, can grow up and explicitly compete with your more sensible thoughts and aims. So you can sincerely wish to get better and still be secretly, intentionally, throwing away your food to satisfy another, darker, baser urge. It’s as if the weeds of your subconscious, formerly shade-loving, have started appearing in the bright sunlight of the well-tended garden of your conscious mind, unashamedly and with aplomb, demanding to be treated equally, because you are no longer capable of weeding them out.

(What did you dream? It’s alright, we told you what to dream.)

I couldn’t tell you the exact train of events that led to me being diagnosed as anorexic. My memory has always been rubbish, something to do with my mild dyslexia, Jo says. By that point, however, everything had become vague and confusing, anyway. In my memory, I seem to wander listlessly through a series of familiar rooms, full of people; bemused by yammering, wittering voices, some of which were my own; challenged by awful, indeterminate crises, my exhausted dozing disturbed by fretful anxieties. I was a weakened swimmer being rolled under sandy breakers by turbid undercurrents and treacherous backwashes. (So to speak.) I kept tripping over and cracking my ribs or dropping things. Walking slowly down corridors, I would dribble to an exhausted halt and lean against the wall.

I think Jo insisted I went to see the doctor about my weight loss, “just to check”. I was weighed and admonished and sent for assessment by a series of quietly sympathetic women and men with ID badges saying things like CAMHS and MIND, who all asked me the same questions. Was I suicidal? – “Christ, no”, I’d quip, “Who has the energy for that sort of behaviour?”. And anyway, I was far too bewildered to feel sad.  A GP told me, severely, that she was recommending me for treatment because I had children and she was concerned with the effect my behaviour was having on them. (Presumably if I was a bachelor I could starve, as far as she was concerned.) A beautiful young woman told me I was too thin for Cognitive Behavioural Therapy. Somebody said, sympathetically, “It’s a terrible thing…” then added, quickly, “…that you’ve done to yourself”

Then, at last, I met Abi, the Eating Disorders Expert-Lady, who zips madly around the whole county in a little red car, taking no nonsense from mumbling bull-shitters like me. She took one look and that was it: and she’d got the measure of me.

So now I’m a recovering anorexic, clutching the diagnosis like a talisman. Looking back, I’m pretty happy with my treatment by the NHS. They took their time working out what was wrong with me, but, then, so did I. Once they took me in hand, I never felt I was going to drop out of the system. Or maybe I did, but in the end, I did get looked after and I was never told that I wasn’t thin enough for treatment and should try harder, which seems to be the most common complaint from fellow sufferers. My experience doesn’t seem to be universal, though.

Maddy Austin, the daughter of the presenter Mark Austin, is an ex (or recovering?) anorexic. The pair of them have just made a documentary.  (Channel 4: Wasting Away: The Truth about Anorexia,25^th August 2017, I think). Like “Maya”, in the Radio 4 documentary, Maddy’s experience was oddly similar to mine. Her mother described the signs of her physical deterioration (“Cold, heart-rate very very slow, blue lips…Her skin broke down”), all of which I experienced. Mark Austin talks about the same sort of damage done to the family: “home became a battle zone…She became secretive, cunning and manipulative. Our relationship collapsed.” Mark also began to think of the condition as a baleful, autonomous creature who had possessed their daughter: “I wasn’t talking to Maddy; I was talking to this thing called anorexia”.

They are mostly concerned, however, with the inadequate and inconsistent response many sufferers experience, once they have been diagnosed as anorexic. The Austins seem to have done their research well and the documentary is full of useful stats, so we learn that “1.2 million people suffer from eating disorders in Britain… there’s a 16 month waiting list for treatment in many parts of the country…There are just 202 beds in the whole of the UK for children and young people with eating disorders…213 eating disorder patients have been sent out of area for treatment this year” (That’s private treatment, which the NHS pays for, presumably at a greater cost than its own services, because, confusingly, it can’t afford to provide the service itself.)

They paint a sorry picture of the help available from a chronically underfunded health service. As these figures show, there are far fewer beds than there are sufferers, and out-patient support is far too thin on the ground. All too often, anorexic outpatients seem to be abandoned once they hit an acceptable BMI, presumably as their overworked Eating Disorders team rushes off to the next crisis. Maddy and Mark talked to a woman whose daughter, Lydia, was discharged from Norfolk’s Eating disorders clinic once her BMI was normal. Actually, this is not quite so neglectful as you might think, because it’s starvation that makes your brain go truly mad, and, of course, actually kills you, so once you reach green band on the BMI scale, you begin to think more sensibly about eating. This gives the poor old over-stretched NHS the chance to put you down as a success, discharge you, rush on to the next acutely underweight teenager, and hope for the best. Unfortunately, without support, Lydia went on to commit suicide.

I think the problem is that anorexia is a psychological disorder. It presumably has underlying psychological causes that need to be addressed at length. Nowadays tax-payer funded services are expected to have explicit, measurable targets, but, with mental health problems, it’s difficult to precisely define when, if ever, the patient is completely better and you can leave them to their own devices. Most people would probably like to have occasional therapy for the rest of their lives. Moreover, Mental health treatment seems very vague and uncertain. It’s not clear exactly how or why the brain goes doolally or how to set it right again. Talking therapies feel beneficial, but it’s difficult to measure the impact of a conversation. So it’s difficult to be sure what is the most cost effective way of treating us, and the NHS is expected to make constant savings. It can also be difficult to diagnose us. The suicide stories you hear always seem to include somebody saying “They seemed fine. They seemed to be getting better”. Maybe the suicides are our way of justifying all the trouble we’ve caused once we start to get better: “Look, we were genuinely ill. It wasn’t just attention seeking.”

And, of course, if asked, anorexic people tend to say they’re fine. We feel ashamed. Unlike famous mental ailments like schizophrenia or manic depression, anorexia is clearly something we’ve done to ourselves. It’s obviously a form of self-indulgence. You’re being silly and attention-seeking and perverse and making everyone miserable. You’re causing everyone a lot of trouble, and costing the NHS a lot of money that would be better spent on more deserving cases, so if somebody asks you how you’re coping you’re likely to say that you’re ok.

In fact, I even felt uncomfortable with how forth-right Mark and Maddy Austin were being about the underfunding and the lack of care. I wanted to say “No,no, don’t worry about us! We’ll be fine…”

I have finally been signed off by the eating disorders clinic. Abi, the specialist nurse, is satisfied that I’ve shown myself capable of gaining weight, although I’m below my high point of around 60+ kilos. (I’m currently 57, or so. My BMI is 17.-something). She thinks I’m more in control of what’s going on, and more aware than the bewildered, jittery, snarling little animal she first met. She says it’s up to me now.

I think we’d both felt the relationship was petering out, and this sort of medical intervention consists almost entirely of forming and maintaining a relationship – a difficult thing to do with people who keep themselves hidden behind habitual dishonesty. I was bouncing along around, or just under, 60 kilos, whatever advice or incentives Abi was giving me. Besides, Abi is retiring soon and works for a chronically overstretched and underfunded organisation. I’m sure they are very happy to get me off their books and marked down as a success.

And I’m happy to go. My initial response is a sense of liberation. Being supervised, regularly weighed and judged feels oppressive. The demand, or the obligation, to confront your problem, to force yourself to eat, to put on weight according to someone else’s, admittedly sane, judgement of what is reasonable and healthy, is stressful and odious. And you feel so guilty for wasting the NHS’s dwindling resources with your self-indulgent crap when there are so many much more deserving sufferers. So not having all that anymore feels like a weight off my shoulders.

The pun is appropriate. This does feel like a climactic moment. Up until now my motivation for gaining weight has been tied up with my relationship with Abi and with Jo and with Helen, the dietician I used to see. I felt the pressure of being exposed as a cheating exerciser and food-ignorer. I made extravagant promises I both intended to keep and knew I wouldn’t, or knew I would mitigate with exercise. Now, most of that is gone. I need to make my own decisions, to do this for myself and my family, if I’m going to do this at all. Abi has taken the stabilisers off and I’m wobbling down the road on my own.

And it is “Wobbling”: my weight has been dropping slightly since the summer, before Abi signed me off (although the summer was when I stopped seeing her so regularly, now that I think about it.) There are various warning signs that go with this dip. I’ve become a little exercise-y, doing a short 25-30-minute run after work every day, as well as my weekend runs, which have gone up to an hour each. I take my mobile everywhere because it’s got a fit-bit app that measures my steps and distance travelled. I weigh myself nearly every day and I suppose I may have a sneaking sense of satisfaction when I see a clear gap between the needle and the 9-stone mark on the dial. I’ve cut down on my daytime snacks; I’ve reduced the amount of milk I have in my coffee. I go to bed happily anticipating my breakfast and wake easily and very early from dreams so feverish they border on nightmares, but are not, quite. Today, I considered throwing away a quarter of my roll because, at 284 calories, it was around 50 calories more than the sushi I usually have.

Even more ominously, I feel good – dynamic, in control, like I’ve got my life back on the right lines and am forging ahead. Recognise this? I suppose, soon, if I don’t get a grip on this, I’ll use up the meagre fat reserves I’ve painfully built up and will, suddenly, collapse again.

Which is why I now need to show my mettle by turning myself around this time, without help, to show Abi and Jo and myself that I can do it. Wish me luck.

I’m always saying that anorexics are too ill to have much of sense of solidarity. We don’t have the energy to form self-help groups. BEAT doesn’t seem to be staffed by acute sufferers. So I was doubly affected by a recent edition of The Untold on Radio 4, called Getting to Grips with Anorexia. It was a poignant story as “Maya” and her family battled against the disease while also preparing for her A levels. The thing is, I felt deep sympathy for Maya’s family, and empathy for Maya herself! That must mean I’m getting better!

When I first realised I was ill I’d have been surprised to find myself identifying so closely with 17 and 18-year-old girls. But one of the strangest aspects of anorexia is the way it manifests itself in such predictable, almost scripted, ways. Abi once gave me a standard printed NHS questionnaire about my thoughts and feelings. The answer to the first question had already been filled in as an example and it described exactly how I experienced and thought of my condition. That was a humbling moment.

Maya’s experience seemed to have quite a lot in common with mine. For a start, she spoke in the typically hoarse, flat voice of the anorexic running on empty. My own voice very suddenly set into a strange, forced shouty whisper, as if my vocal chords had gone into spasm. When I put on some weight my voice went back to normal. I still have no idea why that happened.

Then there’s the way the illness developed. She says “It started off being about nutrition; what’s healthy. Then it started being about food groups, so I want to cut down on complex carbohydrates or saturated fats, and then it started being about calories”. My own experience mirrors Maya’s, here, step for step. When her mother says “I just noticed she was getting more and more edgy around mealtimes; more and more controlling over what she wanted to eat”, it could have been my wife, Jo.

Even more interesting, I think, is how similar my anorexic thoughts were to Maya’s. We both saw our unhealthy state as temporary, partly because we had arranged things so that we could only think as far as the next meal. Maya said that she saw her low weight as less dangerous than everybody else did because “my recovery is inevitable”. That’s exactly it. – it’s just how you are at the moment – so, therefore, it’s nothing to worry about. If you dip down to a dangerous weight, you’ll soon come up again.

Maya also responds to her treatment in a similar way to me. She says “I feel quite pressured to make progress”. Her NHS eating plan says she has to put on at least 500 grams a week, which causes her to pause and almost audibly gulp. The weight gain they force on you seems horribly suffocating and panic-inducing. When you begin treatment, the urgency and speed with which the eating disorders team want you to start eating is startling. You want to cry out “Wait! I’m not ready!”; you’re terrified of losing control. In the documentary, you hear Maya arguing in a shrill, panicky tone with her mother about what she’s going to eat for dinner, trying to wrest back control.

Maya’s response to this, like mine, seems to be to find ways of compensating for any increased calorie intake by finding ways of burning off those calories through exercise. She tells us in her audio diary that she’s going to the park to meet her friends and possibly have an ice-cream (though she says this with the shy tones of someone who is being dishonest, to my ears) and that she’s going to run to make sure she doesn’t add any calories. Later on she tells us “I had three pieces of toast and Nutella and in the 20 minutes that I should have been getting ready for school I was just panicking and thinking of all the ways I could use as much energy as possible” and “I’ve had to wake up early to exercise in my room”. This is exactly like me. You sift through every part of your day, looking for the minutest possible scrap of exercise to make up for any increased calorie intake, like you’re panning for gold. I remember going to London for somebody’s birthday treat, and while the rest of the family stood on the escalators on the underground, happily savouring their London experience, I trudged down them and waited at the bottom, purely for the couple of calories I hoped to burn off. Anorexia gets soaked up into all your experiences. As Maya’s mother says, “anorexia… creeps in. It finds little cracks”.

On the other hand, we want to please people. We want to get better to show our families that we love them and that we know we are upsetting them, and this means we try to say, and we try to mean, what you want to hear. While acting in this way, Maya still says she feels really confident about her recovery. A few months later she is telling her mother her “mind-set is totally different” but the mother thinks she’s throwing her sandwiches away. Maya admits “I’ve been telling my parents that I’ve been gaining more weight than I have”.

Then there’s the confused response to a treatment that seems to be an indulgence, a form of surrender. When you eat your yummy food, it tastes lovely, something medicine should not, and you feel that you’ve weakly given in to your hunger, the intense desire to eat, so every success feels like failure. Maya complains “I don’t feel any achievement for eating a bowl of pasta. I feel shit for eating a bowl of pasta”.

She also, like me, needs to eat separately from people who have too much invested in her recovery and who may scrutinise her too intently as she addresses the difficult problem of eating. In Maya’s case she can’t eat with her father; in my case it’s my children, who I fear may end up modelling my behaviour and attitudes to food. Actually, I’d always prefer to eat either alone or just with Jo. At work, I never eat in the staff room. I sometimes end up locking myself in a cubicle in the loo – not a very appetising atmosphere!

Of course, there’s the damage you do to your family relationships: the guilt, and the way you can’t express that guilt. Maya says, apparently without emotion, “I’m obviously so distressed by the symptoms of the illness that I don’t actually think about my family”. Understandably this admission isn’t enough for them. Her suffering family want clearly expressed guilt: Her 14-year-old brother says, wearily, “all we talk about is food” and “I think she knows a little bit but she doesn’t really know to the full extent [what she’s doing to him]; she doesn’t really care”. Her father says “she was friendly; she was loving; we used to enjoy each other’s company; we used to go out and eat; she had a very good friendship group at the school; she had every opportunity”. He also mentions watching her “change into this monster” Her mother says “No one wants to see us – she’s ruined…”

Poor Maya! I think her family don’t fully appreciate the duality of mind I’ve talked about before. You can really, honestly, understand what you’re doing and why it is wrong and unfair, and still actively pursue the behaviour. In the documentary she made with her father, Maddy Austin said they’d had screaming rows about how she was tearing the family apart and “that absolutely broke my heart”. Mark Austin replied “Well, it didn’t break your heart enough to stop and that is the problem” (Does this reveal a masculine, punitive conception of parenting?) People tend to say “Well, if you know it’s wrong and you really want to stop, why don’t you just stop?”, not realising how you can have two totally different, conflicting agendas existing in your brain simultaneously. These two creatures are locked in a mortal struggle that completely fills your head through every waking hour. But one of them is struggling unceasingly for you, dearest family, to get back to you and make it alright. The lying and cheating is caused by a genuine desire to commit to, and do, the right thing while the anorexia just ploughs on regardless. The misery, guilt and embarrassment this causes is further compounded by people you love being unable to understand it.  They think you’ve reconciled yourself to being a nasty person, whereas, your whole mind is an unreconciled battlefield:  Maya’s brother talks about her “arguing and shouting” when I think she’s probably just manifesting distress.

In this respect, I think teenagers have it worse than me. Because they are still in their parents’ charge, they have more to resist and can focus their resistance on their parents, who feel obliged to administer the recovery plan. This may speed up recovery, but must massively increase the pressure on the kid. Unfortunately, it probably feeds into existing teenage conflicts and desires for independence, so that anorexic panic is misdiagnosed as argumentative, teenage rebellion.

There’s also the hormonal issues. When you starve your brain, it starts to malfunction. That’s why you go so weird. As an adult, once I started to get better, the madness of anorexic thinking became starkly apparent. But teenagers are half mad with hormonal imbalances anyway, so it must be difficult to work out what is anorexic thinking and what is teenage angst. Maddy Austin talks about becoming withdrawn and isolated because that was the best way to deal with “all these really horrible emotions that were going on inside” but I suspect those emotions were actually generated by the anorexia itself.