by Grace Bowman
FRIEND 1: It’s just as if you’ve broken your leg. Like your mum told you. There is nothing to be ashamed of.
[There are glances and nervous looks from the pub crowd. Grace looks up at the TV screen. The Spice Girls are on MTV talking about Girl Power. Grace looks at their thin figures. Some people are drunkenly singing along to the music. Grace imagines their real and loud inside voices. We hear them played over the tableau on stage.]
GIRL 1 (INSIDE VOICE): She could change if she really wanted to, the cure is surely right there before her on a plate.
GIRL 2 (INSIDE VOICE): Let’s be honest here, this is a disease of vanity – all you have to do is eat; it isn’t hard.
BOY 1 (INSIDE VOICE): Three times a day, taking the food from the plate into the mouth. A forkful in the mouth – a simple process.
GIRL 1 (INSIDE VOICE): Sympathy can only extend so far. It’s hard to keep being so understanding.
[And then we see the inside voices getting out into the room. They leak out because they have been building up. Grace’s inside voice never comes out. She swallows. There is a conversation about diets and losing weight.]
GIRL 2: I haven’t eaten anything all day – I just forgot!
[Grace gasps.]
GRACE (INSIDE VOICE): How can they forget? Don’t they feel the thrust of anguish, the deep stretching pain in their stomachs too? What do they do with their hunger?
[Then crisps appear on the table and the crowd fearlessly demolish three bags. Grace watches them intensely, counting the grams of fat that they put inside them. One by one, counting, adding and totalling.]
[Curtain closes.]
Explanations
I need to stop my story here. My secret has started to unravel: one moment a child, then a teenager and then an anorexic. The expanse of time beneath these indentations of memory is so huge, and even those individual imprints upon it are murky and sporadic. There is not the control of the story that you may have anticipated. But perhaps you will also see how easy it is to be cast from one definition to another in a matter of words. One minute everything is fine, and the next, you are wondering how you managed to tear everything apart. Actions force things forward, and the grip you have on things is lost, and all at once. What you think you own, and order, and manipulate, is suddenly out of your hands.
I could leave my story this way, hurtling along from one action to the next as it was experienced, as it was breathed, memory layered upon memory, but I cannot. Because my story is a true one, it is not only inwardly folding. There are things in this story which happen in the real world, in real time, every day. There are parts of what I am telling you which need to be broken down, and there are questions which I want to answer. How did I get here? Let me take a step back.
Any parent or friend of a newly labelled anorexic must think about the possible factors that are to blame for this illness. First thoughts might be, ‘Why did we not see this earlier? Why did we not know this? What could we have done to prevent this?’
I know that my parents went over and over in their heads every possible moment or chance they thought they could have conceivably raised it with me, or tried to open me up. At the time, I would not let them get near me. I would, instead, deflect them, ‘No, no thank you. Everything is fine.’
Because of my detachment from what I was doing to my body in starving myself, I couldn’t have explained the reasons behind it at the time. I didn’t have the capacity, I wasn’t able to answer my parents’ questions; I wasn’t engaged with a wide enough perspective to give a proper theory on myself, a perspective which I now have.
There are so many fingers pointed when it comes to eating disorders. It seems too painful not to allot a proper explanation. Surely there is no possibility of understanding anorexia, if there is nothing to target all the pain and exasperation towards? And so it is easier to take a view. Many do. They say that it is about low self-esteem; others root for the cultural target, some to a chemical imbalance in the brain, a personality disorder, born under the wrong star sign, born too late, born in difficulty, a result of the image of thin beauty in magazines, the female brain, the media, the government, a genetic predisposition or even something more fundamental, something elemental about a renunciation of feeding. The list goes on and on and the issue becomes more and more confusing.
The most disturbing of these conclusions is seemingly one of the most prevalent among the medical profession and public – the belief that the anorexic is to blame, purposely seeking out attention through self-starving.2
‘Silly girl.’
‘Ridiculous diet.’
‘One of those little phases.’
Anorexia nervosa is not about stupidity or playing up; it is an expression of something else. The body becomes a symbol to try and put across that expression, whatever it may be. The body finds a language to discuss things which cannot be articulated, or which haven’t yet been acknowledged or explored.
My experience of this illness is only that – my own – but my understanding of what I went through is not confined to the edges of me. It relates to the stories of others; its sounds often resonate with theirs even if their beginnings or endings are not like mine.
So before I come to tell you more of my secret story, perhaps it will make more sense, feel less out of time, if I try and provide some reasons, some explanations, some retrospect; something to alleviate the confusion and break down the myths that surround this illness.
Growing
The doctor was able to label me anorexic because I fitted into a certain set of criteria. I was an anorexic because I:
refused ‘to maintain weight at a minimal normal level for height and age, such that the body weight is 15 per cent below that expected for the individual’s height and age’
had ‘an intense fear of gaining weight and becoming fat’
had ‘a distorted notion of body shape and image’, such that I ‘continued to complain of feeling fat even at a very low weight’
had ‘amenorrhoea’3
I was no longer just a teenage girl playing with her food; I was now in a completely different territory. The above criteria tell one story of how extreme the illness is compared to someone trying to lose a few pounds, but another starting point in understanding the aetiology of the illness is that an anorexic (often unconsciously) uses food control and self-starvation to mask deep-rooted fears and feelings. These issues take refuge in the control and order of a diet and when they appear to dissipate as a result, an anorexic feels that it is definitely the self-starving that has solved them.
One of the common anxieties which anorexia works particularly hard at attacking is growth (in all senses). An anorexic circumnavigates growth or change by evading it, by stepping out and stepping back from the fear of it. This can happen at any life-stage and in either sex (10 per cent of eating disorder cases are male4), although the average age for the onset of anorexia is between sixteen and eighteen years. This is a time of huge physical and emotional change.5 This transitional period involves: leaving home, moving away from what childhood represents, and developing sexual and adult relationships – changes which many teenagers feel they don’t know how to handle.
In post-pubescent anorexics, weight loss is often a physical manifestation of the rejection and fear of growing up. During puberty, the body changes. In girls, body fat increases to provide the tissue for fertility and menstruation.6 Anorexia forcibly stops this growth and reverses it; amenorrhoea (absence of menstruation) occurs and the body slides back to a pre-pubescent state. Physically, the anorexic is stating that she doesn’t want to be, or look like, an adult.
In my case, at eighteen years old all of a sudden, I didn’t feel right about impending adult changes in my life. I felt uncertain about things, I felt there would be no going back to my own bed, in my own home, where I had lived all my life with my brother and sisters and my mum and dad. I felt like things were shifting and moving and growing, and I wasn’t sure I was ready to grow with them. Where
as some people, when they are dealing with adolescence and growth, go out and rebel, or become moody, smoke, drink or take drugs, I did not know what to do, I did not know how to react. I did not feel that I should react, being the gold-starred girl that I was. There was a vulnerability within me, which was exposed and which meant that I was less able to deal with taking ownership of the changes within me than other people going through the same experience. Paradoxically (and anorexia is full of such paradoxes), I was desperate for my independence, but the freedom I so craved was a theoretical one. I believed myself to be mature but it was an intellectualized independence, not a practical, lived-through one. (I passed my driving test but was scared of driving, I achieved my A levels but wasn’t ready to go to university.)
A flicker of my fear turned to action and into a controlled, rigorous diet. The initial diet, I thought, was a means to lose a bit of weight but, in fact, it became more about evading the pressure and anxiety in my life. Focusing on my gradual path to self-starvation made me feel better temporarily and therefore, I thought, better able to deal with my life changes, but in fact it was the inverse.
The question is then why did I, and many others, use self-starving as the supposed answer to that uncertainty? A part of this answer tends to come straight to the issue that in our society being thin means being popular (very important things to a young person). The answer to all the growing-up issues is simply and neatly packaged in a smaller, more slender body. It is an answer that is also dangerously internalized. A diet might be discussed, but anorexia is rarely something shared with friends. It is a secret, personal and private territory. In fact, many teenagers seem to identify with the sense of cerebral and bodily enclosure that anorexia effects. Some anorexics have written about how special they think they are and how anorexia has answered their feelings of being detached and disengaged from the world. I think this has led to a horrible glamorization of eating disorders and of being young, thin and aloof. I have heard and read on more than one occasion about young teenagers who have admitted to being inspired to actually start an eating disorder. They have recognized a set of feelings about the world in other anorexics’ descriptions, and have made some sort of confused decision from there, without understanding what the dreadful implications are. Anorexics come to the (wrong and misplaced) conclusion that their shape is their identity, and that it is their shape that controls their future. Of course, it does end up controlling their future, but in the most destructive and irreparable way.
For me, it was not such an informed decision as deciding to imitate someone else. I feel that the best explanation is that one day my view of the world changed. I suddenly had a concept of the presence of myself, and with this a raft of emotions, and I didn’t know how to handle it. What I knew, what I believed in and what I trusted was the home that I grew up in, the family I was nurtured in and the small town that cushioned me. Then, all of a sudden, I felt transplanted. It was all too much: the decisions (no longer imaginary, but real, adult ones) and the size of everything facing me. And so I disengaged from feeling. It was not conscious. It was not as if I made a choice to starve myself based on a considered self-awareness. I was just struggling to find my place, like anyone experiencing change and growth, and nothing seemed certain any more, except what I did or didn’t eat.
Addiction
My anorexia did, on one level, start with a diet, but it quickly turned into an addiction. One minute I was counting Easter eggs and the next I was on a path to self-destruction. Something happened, something clicked when my relationship with food changed from one of routine and normality to one of denial and control, and it spiralled from there. Food, and my focus on avoiding it, was suddenly an all-consuming obsession. My immense, and often overwhelming, hunger for success, perfection and achievement was forcibly quashed by this new focus on the suppression of my appetite. The more I fought my hunger for food, the more my desire for everything else disappeared. Suddenly I was totally trapped and addicted to this new relationship with food and could not begin to understand how that was the case.
From a physical perspective it is possible to explain how, under the effect of self-starvation, the brain becomes obsessed with food. When the body is satiated it can relax, it can sleep, whereas when the body is hungry, its response is to be awake, on the alert for potential food sources. This leads to fantasizing about food, thinking about it constantly, even dreaming about it because the body is craving.7 I would dream of roast dinners, my mouth crammed with food, bursting with it. I would wake up, petrified that this might have been a reality, and take a huge breath of relief when I realized it was only a dream. It could be argued to some extent that this can happen even on a diet, so how did a diet, which supposedly has the focus of looking and feeling better, collapse into anorexia which has such self-destructive objectives?
Being anorexic means being constantly fixated with food; it takes over and, crucially, it doesn’t stop. This is very different from a diet, which has an ending, which is set in a finite term: ‘Drop a dress size in two weeks.’ ‘Get a bikini body in seven days.’
A diet comes to a close, until the next one begins, whereas anorexia is never satisfied by such a completed goal. It presents the sufferer with the feeling that ‘if only’ more weight were lost, then everything would be OK. The problem is that this resolution is rarely reached. This is why the definition of anorexia nervosa – that absence of appetite – is so misleading, because it is in fact a continual, endless and ever-present obsession and interest in food, body and weight. The appetite is there, most definitely – it is just too dangerous to let loose and so every energy is focused on stopping it.
Most importantly, what happens at the start of an addiction to not-eating, and in my case to a restrictive eating disorder, is that it seems to act like a panacea. I felt better when I ate less. My addiction to not-eating was actually an addiction to feeling better, to feeling fixed. I also had very low self-esteem, in common with many people who develop anorexia. Beneath the layers of the achieving, accelerating Grace, there was an inner lack of self-confidence. It so happened that food restriction was the mechanism for me that initially helped me feel less fragile, and triggered this change of mood inside.
The initial buzz that not-eating provides is something that I often hear repeated. Take two girls talking about fasting, about restriction, as a means of finding themselves and feeling better:
‘It’s amazing. It’s like I’m a different me. I’m superwoman when I’m fasting! It helps, with everything.’ The faster casts a wry smile.
‘But don’t you get hungry and need energy to live a normal life?’ The listening girl is intrigued.
‘I feel a bit spaced out when I do it. I can’t concentrate on problem-solving, that type of thing, but I totally escape myself. It’s a freeing feeling.’
I can recall the beginning of my addiction to not-eating. The feeling of lightness – of happiness – and a fuzzy, airy kind of an energy, which seemed to be irreplaceable. This is the high – every addiction has one – something that makes you feel good, something that is worth the low, or so it seems. Initially, my addiction brought me power and pleasure. With each new shape I made for myself, I was more optimistic, more alert, more euphoric and more in charge. I ended up feeding only from my addiction. I was surging off the highs that my super-control gave to me.
Power and Control
Those suffering from eating disorders often feel that they have walked into a relationship with food they did not choose. They feel that it took them over and that they are suddenly powerless to its effects. They didn’t mean to get addicted, they didn’t mean to lose so much weight; they didn’t mean to interrupt everyone’s lives, not on purpose, anyway. At the same time, however, they also feel a sense of immense control over their relationship with food. Whereas other issues and decisions might seem overwhelming and unconquerable, food is manageable and can be manipulated by the sufferer. Anorexia moves life into a restricted pattern of behaviour based sol
ely around food and exercise. It means a regression into a simple, straight, black or white way of living.
In my experience, my food patterns gave me comfort – there were answers to problems. There were merely shapes – shapes of me – that told me how good or bad I was feeling and this reassured me. Not-eating seemed to work like a magic trick – the more I restricted myself, the more I sensed my own power. I also developed a feeling of righteousness about what I was doing. Controlling and restricting my body empowered me with a code, a way of fixing and structuring anything that was thrown at me.
In fact, many anorexics, when forcibly taken to the doctor for a diagnosis (as often happens), can only see the positive in what they are doing. They feel that other people simply misunderstand them, because there really is ‘nothing wrong’. They are acting to expectation, they are being ‘healthy’ and ‘fit’ and ‘thin’. They are not shovelling fast food into their bodies and eating all the ‘wrong things’. They are in control, right?
However, whereas their friends who count their WeightWatchers’ points or watch their GI levels are conforming to other people’s patterns, and obeying the most current world order, an anorexic is actually defying it, and making up a set of her own rules. A diet is acting to a set of prescribed rules laid down by a book, a magazine or a slimming club. It is about participation and regulation. An anorexic does not want this direction from the outside. She wants control of her own game, thank you very much.
I certainly did not want any help with my anorexia. I knew that what was happening to me wasn’t right but I couldn’t get past the feeling that I had everything in place just as I wanted it. Any discussion of interference into my way of handling it was terrifying and inconceivable. I was petrified that if I didn’t keep my hunger under control everything would collapse.