Mealtimes and Milestones

by Barter, Constance

  We then went into a beautiful park. I just loved being in such a wide open space, because I often feel quite confined being in hospital the whole time.

  Next, we went to a museum. While we were there Dad and I built an arch out of foam bricks. It was really great to have a bit of a laugh with my dad, just playing and having some fun, because I think that he often feels a bit left out.

  The only hard thing was when we were walking back through the park there was a cross-country run on. It made me think about what I’m missing out on and how much this illness is holding me back, but yet, why don’t I want to let go of it?

  I’m like a balloon, I’m all the air inside trying to get out, I’m pushing against the walls of the balloon, the anorexia. I just want to pop out and be free, but I’m not able to find the energy to pop the balloon and beat anorexia once and for all.

  Sunday 16 September

  I was so excited that my friend was coming today, I just couldn’t wait. When she walked through the door I just felt such a relief. We hugged and hugged and my eyes started to well up. I realized just how much I had missed her and everyone at school, and how much was being taken away from me by anorexia. I want to be free like her.

  We just talked and talked and talked, and through one person I felt connected with everyone at school, and it reassured me that I wasn’t being forgotten about. The laughter that we shared seemed to penetrate my sorrow and release all of the pain inside me.

  Before she left we had a debrief with my key worker. We discussed how we thought the day had gone, and we all agreed that it had been really positive. My friend asked me how much I wanted her to say to people at school. I said that I don’t mind how much she says because I just think that it is a fact – it’s a reality – I am in an in-patient hospital with an NG tube. I would worry also that if people didn’t know the truth then it would be exaggerated at school.

  Saying goodbye was really hard, when we were hugging I just didn’t want to let go. I didn’t want to let go of this personification of hope, but I didn’t cry because I was worried that the staff would then think that it is a bad idea for friends to visit me.

  Despite this sadness within myself I managed lunch after my friend had gone, and I was able to stay up to date for the whole day. My friend represented hope and something clicked inside me. I didn’t feel that I could eat for myself yet, but today I did it for my friends at home. I guess the next step is eating for myself, but that’s only when I decide to believe that I deserve to nourish myself.

  Thursday 20 September

  It was agreed in my core team meeting today that I could have two friends to visit me this weekend. I really believe that this is the motivation that I need to come off the tube.

  TEXT MESSAGE:

  Hi. I just want to let you know how worried me and my mum are. Really hope you are getting better. Just keep strong. I miss you so much. Everyone I know is so worried about you; we can’t wait to see you when you are all ready and well. Love you so much. xxx

  Saturday 22 September

  In the afternoon with my parents we went into the local town and as a treat I was allowed to go to a beauty salon. I had my hair cut and my nails painted.

  I really do appreciate the treatments but I can’t help but feel guilty. I feel like I don’t deserve it. I know deep, deep, deep down that I do, but I need to work on trying to bring these thoughts to the surface.

  Sunday 23 September

  My anticipation waiting for my friends to arrive was almost unbearable!

  I was surprised, though, that I didn’t feel very apprehensive about them seeing me with my tube. I think it’s because last week it was all OK with my other friend. Even though I didn’t feel too self-conscious with them, it was still strange because it’s an anorexic status symbol, and I’m proud of this. My anorexia makes me feels good; it admires me and praises me for succeeding in being a good anorexic. It’s a companion to me and a friend. It understands me better than anyone can because it’s inside me. It always knows how I feel and how to resolve any of my imbalances. I’m so caught up within this powerful and overwhelming illness.

  My friends brought a teddy bear which we named Hope. Also a card signed by the whole of my year. I really appreciate both of these because I do worry that people will have moved on at school when I eventually go back, and that they will have forgotten about me, but this really put my worries aside and reassured me.

  When they left it was really, really hard because I wanted to try and stay positive because I had had such a good time. I had laughed and laughed and laughed, and I didn’t want to let go of that laughter and sense of fun, but it all just got too much and everything just seemed to escalate out of control and I went back to my coping mechanism of starvation. It wasn’t just that they had left, it was other things as well. I was really cross with myself for still being on the tube. I wanted to be liberated, but the illness just won’t let me go. As well as that, my periods returned at the start of this week. Although I am relieved, it symbolizes that I am putting on weight and getting healthier, which of course isn’t what the voice wants, and it seems to be punishing me mentally for this:

  ‘This is what they are doing to you. They have put the weight on you that has made your periods start. You are following the people who are making you fat . . . why are you doing this?’

  My key worker decided to have an impromptu key session to talk about why I was so distressed. We both lay down on the grass and practised relaxation techniques such as listening to the wind and the leaves. It was good to try and unwind, however I couldn’t stop crying for the rest of the day, and by the evening I was completely sobbing my eyes out. They are still bloodshot.

  Monday 24 September

  After weighing this morning I was a bit worried because I knew that my out-patient team had set a weight for me to get to while I was seeing them before I was admitted to the unit, and I have now reached that, but I am still continuing to put on weight. I spoke to my key worker who reassured me that the weight gain wouldn’t go on for ever, and I still wasn’t at 100 per cent weight for height. The reassurance helped.

  As well as getting reassurance from my key worker today, I also got support from my key teacher, because at the weekend a huge box of books from school arrived for me, and it was quite daunting because I am never going to be able to catch up on all of the work. She reminded me that my priority at the moment is my health, and the work will still be there when I’m better, whereas if I hadn’t got help to deal with the anorexia then I probably wouldn’t be here. It was helpful that someone else could put things into perspective for me.

  Tuesday 25 September

  In my key session we went outside and practised ‘how to get angry’. We started by whispering nursery rhymes, and then saying them, and then shouting. I found this exercise really hard, because somehow, in my exploration of emotions, shouting is classed as bad and negative feelings as things that shouldn’t be expressed. Instead, I bury them further and further inside me – but now they’ve emerged as an eating disorder. Although I felt really uncomfortable, it helped me to start by realizing that it is OK to get irritated or upset. My key worker had to keep telling me not to smile, but it’s just a natural reaction for me. When I feel out of my comfort zone or I’m scared I just push everything inside and conceal it by smiling, and I think that it’s going to take a lot of practice to break this habit.

  The most helpful part was when we pretended to play the two voices inside my head. My key worker was the healthy one and I was the anorexic one. We went through basically the battle that is continuously going on inside my mind every single day like a simultaneous role-play. It went something like this:

  HEALTHY:

  Why can’t I show my emotions?

  ANOREXIA:

  Because then you ’ll get better, you have to cover everything up, people don’t want to know grumpy people.

  HEALTHY:

  People aren’t always happy though, it’s just not normal.


  ANOREXIA:

  Well, you ’re hardly normal, you ’re a complete loser.

  HEALTHY:

  I’m not; I know that I am not. You are just the deceitful voice inside me.

  ANOREXIA:

  No . I offered you so much, Constance. When you were standing on the edge of a cliff and no one was noticing you, I did, I saw your pain and loneliness. I gave you the opportunity to be thin, a great runner, goals to aim for, and I know that you love aims and challenges. I know you so well, I’m such a big part of you, and you would go back to being nothing without me. You’ll be nothing if you let go. Nothing.

  HEALTHY:

  No, I would be healthy and have a life, and not have to be kept alive by a piece of plastic going into my stomach.

  I found this exercise so helpful because I didn’t think about how to phrase it, it all just came out, and it is my true battle. I’m sitting here crying now as I am writing this down because every day is such a continuous battle and struggle with such a split mind, and the anorexic voice seems to have an answer for everything. What was good to know was that my key worker was saying the same things that I say to myself. It was reassuring to know that if someone was in my shoes then they would be saying the same opposing things.

  I don’t know whether it was the key session or the fact that I didn’t want to be fed, but I managed all my fluids today, and I seemed to handle the consequential thoughts much better, which I suppose is a big achievement.

  Wednesday 26 September

  In therapy we talked about how I would feel if I had to give up a GCSE, and I almost can’t bear to think about it. The embarrassment would be intolerable. I have an expectation of myself. My parents, the staff and my friends say that they don’t have one, but I don’t believe them. I would feel so ashamed that I couldn’t cope. I personally think that it would have the opposite effect if I was made to drop a GCSE because I would feel that I would need to compensate and work even harder on the other nine, and therefore just get into the cycle again of work becoming an obsession. I cried about this. I don’t want to be more of a failure than I already am. Failure is a catastrophic event for me – and I just seem to fail at everything I attempt – that’s why sometimes I don’t know why I attempt to do things because I know what the outcome will be. When I fail it feels like I am falling into a bottomless black pit within myself, and all my attempts seem to wither up inside me. People say that I haven’t failed – but I don’t believe them. They all say I am a ‘high achiever’, but that just puts more pressure on me. I guess that I have learnt to cry though since I have been here, and realize that it is OK. I just haven’t reached that stage yet with anger.

  Thursday 27 September

  I had family therapy today with my grandparents as well. It was great to see them, but the first thing that my grandma said was,

  ‘How lovely it is to see you. You look so beautiful and so well.’

  I found this hard to hear because I know that I am really not beautiful, and I also found it interesting that she thought that I looked well when I had an NG tube up my nose! – I guess a different take on it!

  We talked about the past and how my grandparents looked after me for quite a long time while my parents were both working full-time. We discussed how our family is like an upside-down pyramid. I’m the only person of my generation, so it’s like I am supporting the rest of the family, which could put me in a hard situation, because I feel that if I do something wrong, then the rest of the family will crumble.

  My ‘upside-down family pyramid’

  Grandma also used the expression that I am the ‘jewel in the crown’. I think that this just shows what the family thinks of me, and that increases the expectations that I have. A jewel in the crown is never bad, and also is always polished. I have to live up to that expectation.

  Altogether it was a good session and I think that we all learnt a lot.

  Friday 28 September

  I had a review today. It was decided that the treatment programme will continue whether I have the tube or not. I am quite pleased about this because the tube is acting as a complete block against making progress – so long as I have it in, I can’t have meals with my parents, let alone go home at weekends.

  After my review, my parents and I had a meeting with my key teacher to talk about my GCSEs and future education. My teacher was concerned that trying to do ten GCSEs while still having anorexia would be too much, and, knowing that I would accept nothing less than A* grades, she was worried that it would put my recovery back. She suggested that we just bounced ideas around the room. Mum went first. She said that she would be quite happy and delighted if I turned round and said that I would only do five. Dad then said that he wouldn’t be bothered if I said I wanted to drop everything and go surfing for a year, and then do some GCSEs when I felt ready. I obviously wasn’t too happy and got quite emotional about it. I just can’t understand what they are talking about. Here’s why:

  1.

  Only three years ago I had a tutor to help me prepare for my 11+ exam and scholarships.

  2.

  I don’t think asking me to drop something will help, because I’m just going to have to compensate for it and so I will work even harder on the others.

  3.

  I would be too ashamed to go back to my friends at school and say that I have had to drop some GCSEs. It would be just too unbearable. I will have let myself down, and also all my friends.

  4.

  I gain my self-confidence from three things: sport, thinness and academia. I’m not allowed to do sport for the time being, and I am never going to be allowed to become thin, so therefore academia is my only thing that I have to define myself; if that is taken away then I would just feel like my life was even more out of control, and then there would actually be nothing to live for.

  My teacher then suggested moving schools. This also was not going to happen in my mind. Even if I was too ashamed to face my friends, and parts of the school such as the toilets would bring back memories, I know that it is the best school for me, and it has offered me so much support.

  At the end of the meeting I could hardly bear to even look at my parents, I was so cross with them. I just stood there like a statue while they put their arms around me and hugged me goodbye. I wonder how the visit will go when they come again tomorrow, and whether I am still going to be angry.

  Saturday 29 September

  When Mum and Dad arrived I seemed to forget about the day before and just got on with my visit as normal. In the afternoon we went to an RAF museum. While we were there, one of the guides asked me what the tube was for. I felt really awkward because I didn’t really know how to answer or even if I wanted to answer at all. Mum stepped in, though, and just said:

  ‘She hasn’t been very well lately, and has just come out of hospital for the afternoon.’

  It was left at that, but it was still quite a peculiar situation because I have never been confronted by a stranger about the tube before. Although I was embarrassed, part of me craved the attention and was delighted that someone had noticed me and that I was ill. I just want it to end, my anorexia or my life, either one will do, but right now I would rather have the latter. The misery that is caused by this unspoken voice is what I deserve.

  After the museum we went into town and I was bought a ring which is hopefully going to help me get off the tube. I will wear it, and it is to symbolize that I am struggling, rather than having to have a tube to show it.

  In the evening I read an article in the newspaper about how you can inherit anorexia. There was the mother’s story and then the daughter’s story. The final line of the mother’s was ‘. . . and I’ve just learnt to cope with my anorexia.’ This hit home really hard for me and I am quite daunted by the thought that anorexia will never leave. Does that mean that I will just have to ‘cope’ with it? Just for example, at my wedding will I not be able to have a slice of wedding cake because I will be too worried about the calories? Will I n
ever wear a bikini because I wouldn’t want people to see my figure? The word ‘cope’ denotes struggle for me.

  Monday 1 October

  Today was quite good because I was told that my level of observation had been reduced, and I wasn’t on observation after meals anymore. I was pleased because I’m not going to act on any of my really powerful thoughts any more. Although I’m still struggling to see the benefits of getting better, at least now I don’t want to take my own life.

  TEXT MESSAGE:

  We all love you so much and please remember that – please. All I want is for you to get better. School is OK – would be tons better if you were here though! I miss you more than a kid misses its toy. All my love. xxx

  Tuesday 2 October

  I had a really good phone call with my parents tonight. It feels like real progress to have a positive phone call. We talked about how I find it more comfortable to know that my friends know the truth, which came up when my friend visited me, because I think that her knowing has stopped any rumours. Perhaps being honest doesn’t work for everyone, but for me it is the best thing because I have found out who my friends are, and instead of living a double life, I’ve found out how much support people radiate out of themselves for other people in times of need, and these rays of support have really helped me.

  Mum also said that some people were upset that I hadn’t invited them to see me, and we discussed why. I realized that these particular people were really close friends who I had known for a really long time, and I would feel too embarrassed for them to see me so ill. But right now I just needed their continual support, which I wouldn’t have received if I hadn’t been honest about my anorexia, so I wanted them to know about it even if I wasn’t ready to see them.