by Alice Castle
As she was musing, York drew up in his car and parked blithely on the double yellow lines. While the traffic wardens, who once circled Dulwich as persistently as wasps at a picnic, were now nowhere to be seen, someone, somewhere was watching them all on a computer and firing off penalty notices into the ether. To everyone except policemen, of course. Beth opened the door and slid in. York smiled. ‘So, the Wellesley, then, eh?’
Beth briefed York as they drove, so by the time they glided into a parking space right in front of the long, neo-classically designed redbrick façade of the hospital, he knew as much as she did about Blue Whale and a shoal of other teenage troubles.
‘You don’t seem surprised at all this stuff. I was horrified when I heard about it.’
‘Surprised isn’t the word. We see a lot in this job,’ he said shortly. ‘But that’s not to say I’m not saddened and concerned by what you’ve told me,’ he said, glancing at her. She noticed that the tiny twinge of Irish in his voice was always stronger when emotions were in play. Then he cracked open the driver’s door decisively and the moment was gone. ‘Right. Come on, let’s get to it.’
As usual with hospitals, there seemed to be a game of hide-and-seek going on. Signs that were irrelevant to their quest were large and obvious, but anything pointing in the direction they needed was in a tiny font, and usually hidden by a member of staff who appeared to have been sworn to secrecy or was on their first day.
Eventually, they wound their way along a last pastel corridor to what seemed like the only door they hadn’t already tried. ‘Dr Maria Luyten’, said a small plaque. Eureka. A tap on the door elicited a faintly harassed ‘Come in’, and they peered into a small, square treatment room, with a bed covered in paper sheeting pushed against the wall, a folded screen, and a desk and three chairs crammed into the remainder of the space. A high window looked out onto bricks, and a 2015 calendar was turned to September, with an illustration of white horses thundering through a meadow. Beth envied them the freedom and space. There was a white clock on the wall, its bold numerals shouting the wrong time, though it was ticking loudly. Beth supposed it was still right twice a day.
Maria was deep in her computer, pushing this button and that in obvious frustration. ‘I’ll be with you in just a moment. Oh,’ she said, then threw up her hands. ‘No, I’m giving this up. I’m supposed to tick off my last patient, otherwise the central desk thinks I’m still with them. According to this, I have been with the same girl since 2pm yesterday. Even she doesn’t have that many problems. They will just have to work it out and send the next when she comes.’
She stood up to shake hands, her curtain of glossy hair swinging around her shoulders, her tall, slender frame reminding Beth once again of an elegant racing dog, vibrating with stylish energy. She smiled briskly at York and warmly at Beth, who to her surprise was drawn into a rapid kiss-on-both-cheeks.
‘Matteo has talked so much about his lovely time with you. This is not the moment, but we must arrange for Ben to come to us? We would like that very much. Now, do sit down, both of you, and tell me what it is I can help with.’
Beth had been expecting some sort of casual acknowledgement, but the enthusiasm of the woman’s welcome had disconcerted her. She sat down, allowing her fringe to flop forward over her face a little while she collected her thoughts. Just because Maria had greeted her like a long-lost friend didn’t mean she couldn’t ask the woman hard questions. They’d only met a couple of times. They weren’t bosom buddies.
But, as ever, the good mother within her rose. If there was a chance that Maria’s son was going to enter the charmed circle of Ben’s friends, then the two women would have to get on. She wouldn’t soft-pedal the interview, of course not. But she might just let York get on with it for the moment, see where he got to. She turned and looked expectantly at York, who blinked in surprise. From the way she’d been lecturing him in the car, she guessed he was expecting her to plunge in and drag as much as she could out of this expert on the foibles of teenage girls. But, on taking a breath, he seemed to accept the new balance of power. After all, thought Beth, he’d surely never complained about being given the lead before.
‘Ah, Dr Luyten. You probably know why we’re here.’
‘No,’ broke in Maria, looking from one to the other with a bright smile. ‘I have no idea what this is about.’
‘Really? No idea? When a teenage girl has just died of an overdose in a hospital down the road; when she was in the same class as your own daughter at school; when another is in the hospital as we speak and when you are an expert, or so I believe, on the mental issues of adolescent girls?’
York’s tone was even and non-accusatory, but it was still quite a litany he’d recited. Maria continued to look politely interested, but her hands started to toy with the NHS lanyard dangling round her neck.
‘Sorry, I’m not sure what the question was there,’ Maria responded. ‘But yes, you’re right, I do know about issues with teenage girls, absolutely. And I am very happy to help, if I can shed any light on the underlying problems which may have caused these girls to experiment with drugs.’
‘You think they took the overdoses themselves?’ said York.
Maria looked from York to Beth, obviously confused. ‘Well, yes. I thought that was the case. Very sad, of course, but still these things happen. Even in the best schools.’ She nodded and shrugged her shoulders slightly.
Beth didn’t quite understand why, but she felt anger rising. Maria seemed to be making a very neat assumption that Simone, and now Lulu too, had taken a decision to end it all. The overload of emotions Beth had seen in the park, when she and Katie had had coffee with Maria, seemed now to be tucked deeply away. It looked as though the woman had thought better of her outpourings that day, when she had all but accused one of the College girls of targeting her own daughter and driving others, including Simone and possibly Lulu, to experiment with things that were way beyond their comfort zones.
‘Are you really saying both girls were just suicidal? That this is all deliberate?’
Maria turned to her politely. ‘I am not sure how you infer that from the little that I have said, but if it were the case, then Simone would not be the first troubled teenage girl to have taken her own life in this way, surely? And the other girl, this Lulu, as well, I suppose.’ Her hands were spread wide now, the fidgeting forgotten. She was on surer ground. Immediately, Beth wanted to backpedal, to see what would make Maria nervous again. All her radar was beeping frantically. There were secrets in this room.
‘Of course, you understand that I can never break my patients’ confidentiality.’ Maria had turned to York with her large beseeching eyes – eyes that reminded Beth of her unsettling son, Matteo.
‘Was Simone actually a patient here?’ Beth asked abruptly.
‘Well, no, she wasn’t…’
‘Or Lulu Cox?’
‘No.’
‘We can hardly breach their right to privacy, then,’ said Beth, then realised she’d sounded harsh. She started again, in more conciliatory mode. ‘You seem to be misunderstanding the reason we’re here, Maria. We want to get some background on teenage behaviour, the kind of dynamics that go on in these friendship groups that girls have at this age.’
‘You sound as though you know a lot already.’ Maria favoured Beth now with one of her lovely smiles, again tinged with relief, and Beth wondered what that meant they were missing.
‘Of course, when we were at the park, we did discuss this a little and I talked in general terms about teenage girls,’ Maria continued. Beth noted the way that Maria was emphasising the general. Surely their chat had been quite specific? But Maria was carrying on.
‘As we have said, things can become exceptionally intense. When girls of this age form a tight bond, it can become almost like prisoners of war or survivors of a particular trauma.’ Maria gestured with her hands, interlocking the fingers. ‘They consider themselves to be surrounded by hostile forces, they turn inwards, and their own
value systems become reinforced. They may develop codes, systems of behaviour, that we outsiders would consider abnormal.’ Beth could see that Maria’s knuckles were turning white now, so tightly were her hands pressing together.
‘You mentioned hostile forces,’ said Beth. ‘What would those be exactly?’
‘I’m afraid that’s us.’ Maria smiled deprecatingly. ‘Their parents, their teachers, definitely any doctor trying to look into their state of mind. Any authority figure, really. Teenagers are caught between the powerless state of children and the powerful – or possibly I should say potentially powerful – state of adulthood. It is never easy to be in transition. For a brief period, there are no clear rules, and that is difficult for everyone.
‘On the one hand, you cannot put them to bed when it gets dark any more. But what time should they go to bed? In any class, you will find a wide variation, which they will discuss amongst themselves and start to resent. That is just one example of the huge variety of adjustments and discrepancies any teenager will be measuring themselves against. And puberty itself is a lottery. There will be girls in Year 9 who are at the same height and stage of development as a Year 7 child, but the girl sitting next to them may already have the body of the Venus de Milo. These differences are hard on everyone. Girls are not always kind, as I’m sure you will remember yourself,’ said Maria, with a searching look at Beth.
Beth tried not to react, but her eyes widened and inwardly she squirmed, as excruciating memories flooded back. Yes, she’d had a hard time of it as a teenager. She remembered the rest of the class becoming curvier by the day, while her own two sturdy stumps and solid body seemed as determined to remain unchanged throughout the years as Stonehenge.
Soon, her former best friends had started collecting in small gaggles to giggle over boys while she, as uninterested as she was undeveloped, was baffled and bored. She had an older brother, so males were very far from being intriguing creatures. Josh, at that age an angular amalgam of smelly socks and stupid jokes, had no mystique and his friends were equally uninspiring. So, her flock of classmates had morphed into birds of paradise overnight, flying away to parties and snogging while she remained earthbound and bereft. The only plumage she’d developed was her enormous fringe, which she still hid behind to this day. Bloody psychiatrists, she thought, trying hard to maintain a neutral expression, and even a faint smile, while she wanted to glare hard at Maria.
She told herself that Maria couldn’t know how accurately her dart would hit home, scoring a full 180 humiliating points – though the woman was trained to infiltrate people’s psyches, and she did have the evidence of her own eyes. Beth was still tiny, and in many ways had carried on representing the ‘before’ picture in the puberty manual. And had Maria ever met any short people who weren’t sensitive about their height? But still, she didn’t want her anger to derail the interview. That would make things altogether too easy for the doctor, and there were things they needed to find out.
‘Sometimes women aren’t that great either,’ she couldn’t resist saying, with an ironic twist. ‘But if we could come to Simone’s case in particular?’
‘But I know nothing of Simone,’ said Maria, spreading her hands wide. ‘I thought we had established that.’
‘You treated some of her group, though, didn’t you?’ said York, who seemed eager to get back in the conversation. Well, he was welcome to it. She’d had just about as much of Maria’s focus as she wanted.
‘I did, yes, and indeed some are still coming to sessions. I treat them individually. We occasionally offer group sessions, but I find with the teenage girls that they unfortunately swap ideas. There is a lot to be said for openness, but they are extremely suggestible at this age. We don’t want those who are anorexic to make it seem appealing to those who are already vulnerable.’
‘Really? That happens?’ York leant forward, hands on his knees.
‘Oh, absolutely. Peer pressure is very strong at this age and with girls who are already at risk, one word out of place can trigger the most unfortunate trains of thought.’
And you’d know all about that, thought Beth sourly.
‘There are many websites, for example, that feed on this interest of teenage girls. And of course, now Instagram, Snapchat, and so on. They call it “pro-ana” or “thinspiration”. And there is “pro-mia” too, supporting bulimia. These sites are very popular. There was a study recently… I was sent it.’ Maria started searching her in-tray but soon gave up the fight. ‘It said that something like twelve per cent of girls between thirteen and seventeen have visited pro-ana sites. Meanwhile, one in three girls from six to seventeen have Googled diet tips.’
‘Why aren’t these websites stopped?’ Beth couldn’t resist butting in.
Maria spread her hands. ‘They position themselves carefully. They suggest they are offering a forum for sufferers, allowing them to find support on their journey back to health. Then they post galleries full of pictures of girls who are little more than skeletons. The girls take the pictures themselves and upload them, supposedly to show their progress, but in fact to gain praise for their emaciation. And there are many on these sites that deny anorexia is a medical condition and seek to redefine it as a lifestyle choice.’
‘Surely that should be illegal?’ Beth turned to York, who shrugged. He didn’t need to tell her that the Met Police had enough trouble dealing with grannies being mugged on the streets without venturing into teenage girls’ headspace.
‘It is so hard in this age, when models are venerated and celebrated. Kate Moss, for instance, once said that “nothing tastes as good as skinny feels”, and there are a lot of websites that take that as a mantra,’ Maria continued. ‘There are a lot of conflicting messages in the culture. To an extent, we promote the view that self-denial and exercise are good, but then we swing to the other extreme and demonize those who, in our view, go too far with this. It is not surprising, perhaps, that the young – and boys can be sufferers too, we should not forget – become very confused,’ said Maria.
‘And at the same time, we attack those who are obese, we “fat-shame” them, and the papers are full of stories about the perils of overeating; diabetes, heart disease, and so on,’ Maria continued. ‘Girls can see this and feel, to some extent logically, that they are doing the right thing.’
‘We’ve got on to anorexia – do I take it that some in the group from the College are suffering from it?’ As ever, York went to the heart of the matter.
Maria, who had been leaning forward expansively, abruptly sat back in her chair.
‘You know our confidentiality issues. What I can say is that we deal always with a mixture of issues here. But perhaps you have heard of Wellesley family therapy?’
Both Beth and York looked blank. Maria seemed much more comfortable talking in generalities than skirting around their specific case. Her duty to her patients’ privacy loomed large, but Beth wondered if there was more to her reticence than the usual concern for confidentiality.
It was something she kept in mind as Maria spoke. On sure ground now, and with her shiny helmet of hair gleaming under a neon strip light that Beth was certain was doing nothing for her own English pallor, Maria explained the system. ‘It was developed here, in fact, and it has been found more effective than individual therapy, for patients who are under eighteen and who are within three years of developing the condition.’
‘The condition? Just to be clear, we’re talking about anorexia here?’ York interjected.
‘Yes, anorexia, that’s right,’ said Maria, hurrying onwards, and again Beth wondered what it was she was so keen to leave far behind. ‘There are three stages, which hopefully help towards a positive outcome, that is, to lead to the patient “growing out” or certainly growing away from, the disease, if you will.’ Maria ticked them off on her fingers: ‘Weight restoration; returning control to the adolescent; and establishing a healthy adolescent identity. One of the keys is that the parents do not blame or chide the child. The
y take over responsibility for feeding the child initially, and the condition is seen as an external disease. We treat it like any other illness that can befall someone, and there is no blame of any sort attached to it.’
‘Even though these girls are flirting with “catching” anorexia, by visiting these websites and developing the obsession?’ said Beth.
‘Yes, despite all that. For, if someone becomes obsessed, is it really their fault? And, more importantly, does it matter whether it is their fault or not? Could we not say that the obsession with bodies is society’s fault, after all, and the girls’ only misfortune is to be part of such a society and perhaps too susceptible to its pressures? Dr Susie Orbach, for one, published research showing that girls’ self-esteem plummets after three minutes of looking at retouched photos of other women in magazines. We are all exposed to these images all the time, in adverts, on television. It is no mystery why teenagers, whose own sense of self is not yet robust, are so badly affected.’
Everything Maria was saying made perfect sense to Beth, but she still wondered what was not being said.
‘Do you think the Wellesley system, with these three targets, actually works?’ she asked.