An Apple a Day (16 page)

Powerful transitions, eh? Another day, another email out of the blue offering help. After all these years of keeping things locked up inside, I'm amazed how much support there is if you ask for it.

As I mentioned, my obstetrician friend says that slowing down could be the key to recovery. My mindfulness guru tells me I need to stop saying sorry and to stop feeling guilty. My mother says I need more cheese, healthy fats, and oils in my diet, and my boyfriend says I should move in with him. A woman from Paris emails that I should start eating meat and fish again, a professional cyclist from Scotland writes that “seven pots of cottage cheese per week” has been the key to his physical rehabilitation. My little sister tells me about EFT, the emotional freedom technique, my aunt about EMDR, an eye movement desensitization therapy. Some people swear by meditation, yoga, or Ayurveda, others
have recommended nutritional supplements. I attend a six-week insomnia course, I have weekly acupuncture sessions and visit a homeopathic doctor, I try to do my morning visualizations, I skim-read
The Power of Now
, I plough through a 600-page tome called
Miraculous Healings
, I look into Neuro-Linguistic Programming.

All these miracle cures and still I find the hardest thing is eating.

Over the years I've tried all these things and many more . . . and, as I've said, I don't think there is a silver bullet. If you've ever tried giving up smoking you may have experienced this kind of support overload and still found yourself reaching for a cigarette at the end of it. The truth is, all the hypnosis and Allen Carr books and nicotine gum won't help you quit if you still
want
to smoke. I smoked from the age of sixteen to twenty-nine, and I never thought I'd be able to kick it. The simple fact was, I loved it. I've heard it said we're born as smokers or as nonsmokers: my big sister, Katie, for example, is rabidly antismoking, and it's impossible to imagine her with a cigarette in her hands, whereas my other sisters and brothers are all either smokers or ex-smokers. And my parents too: Dad is a reformed ex-smoker but in his heyday he smoked cigarettes, cigars, pipes, cheroots, and took snuff. He gave up forty years ago but he admits he still sometimes misses an after-dinner smoke with a glass of brandy. My mum, on the other hand, just like Katie, has never even tried a cigarette.

For me, the turning point with smoking came when I began actively to dislike it. I was sick of stinking like an ashtray and being a social outcast and having to stand in the freezing cold outside the office puffing away with other losers and the rising price of cigarettes and developing a disgusting cough and wheezing in the mornings. It took thirteen years to get there, and I was still hooked on the nicotine (a substance more addictive than heroin), but I had to start really hating smoking and wanting to be an ex-smoker before I could attempt to give it up.

It's the same with an eating disorder—you have to get sick of it before you're ready to give it up. For all the support and advice in the world, I'm starting to believe that the single most important component to recovery is wanting it, really, really wanting to be free of anorexia.

It's the end of April and I've been writing the column in
The Times
for nearly six months now. During that time many girls have emailed me asking for advice—as if I'm in a position to help! I can see their logic, but it seems a bit like consulting a drug addict in rehab (especially when I've had a really bad day, and I've dodged my morning banana and halved my lunchtime apple, and then I get an email asking me how to put on weight). I'm not sure whether they actually want advice—when you're twenty-one and burning up your own body fat and muscle, when you're young and thin and beautiful, you feel untouchable—but I'd love to stop them from going through what I went through. Often, it's clear they just need to tell someone the worst things: the way they vomit after every meal, how their throats are bleeding, the massive laxative abuse (100 tablets a day), the self-harm and the razors.

And, once in a while, a death. Yesterday I received this email:

Dear Emma
,

Having followed your articles in
The Times
for the past few months, I would like to pass on my best wishes in your fight against anorexia. I have admired your gutsy spirit and determination, and hope you can manage to get on top of this dreadful illness. I'm sure there are many low, as well as high, points but your reporting so far sounds very positive
.

My daughter suffered from anorexia for ten years, like yourself, but found the constant battles just too difficult, and disappeared while on leave from hospital just a couple of months ago. She was
found, six weeks later, in the river close to our home, where she had originally driven the car on the night she went missing. Our grief is still overwhelming and we wish she could have got to the stage where she had the strength to fight this illness. But at least we know she is at last at peace
.

Our very best wishes go out to you, I dearly hope this illness can be beaten and that you realize your wonderful ambition of becoming a mother
.

Regards
,

Mrs. V

It was a sunny Tuesday morning, unseasonably hot for late April; I had the balcony doors open and was sitting at my breakfast bar, typing away at my laptop, barefoot, in denim shorts and a bright blue Inca Cola T-shirt Tom had brought back from Mexico, when the red light on my Blackberry started flashing. I picked it up, read the quoted message above, put it down and carried on working. A few minutes later I stopped, and reread the message, and called home. I needed to speak to my mum.

I try to reply to every email, especially those asking for advice, but I don't know if it makes any difference. And when I look back, I wonder if anything would have made me give up anorexia in my twenties: I was high on hunger; I felt untouchable too. For all my attempts to get better, did I really want it enough? What I always want to say to these girls with anorexia, bulimia, and worse, but in a more eloquent form, is:
Stop now . . . give it up right now and don't waste the years ahead, and don't kid yourself that there's some point to being hungry or that it gives you any control over things because it doesn't and life is uncontrollable and anorexia is just another way of hiding
. . .

A wise man once said: never take the advice of someone who has not had your kind of trouble.

Which is why, even though I have anorexia, I strangely
do
feel qualified to offer advice. In a funny way I'm more expert than a doctor or specialist, because I've been through recovery and I'm still going through it. I got myself from 77 to 105 pounds, bite by agonizing bite, and there's still more work to do. I don't have the secret to an instant, perfect recovery—and it's impossible to generalize when everyone is different—but I am intimately familiar with the dangers and triggers. If nothing else, I understand what helps and what harms . . .

My number one tip for recovery is this: get rid of your thin clothes. Go through your wardrobe and chuck out the size zeros. Be ruthless; do it now. Sounds trivial but it's crucial: so much of how you feel about eating and food and yourself, walking around in daily life, is inside your head. Anyone would be uncomfortable in tight clothing, and anorexics are particularly susceptible to this kind of body panic. I know it's tough: taking my J Brand skinny jeans to the thrift shop was hell. But really, why are you wearing age-fourteen clothes? You're not fourteen, you're an adult. Don't weigh yourself too much and don't wear tiny clothes, and that's half the battle won.

Other advice? Get help quickly. Be honest with yourself—you know if you have a problem; don't wait until you've lost nearly half your body weight like I did. Like drug addiction, like any bad habit, anorexia becomes ingrained; the longer you're underweight the harder it is to recover.

And when you're trying to gain weight, eat whatever you can. In an ideal world everyone's diet would be the perfect balance of carbohydrates, proteins, and fats, but don't worry about it. I have a fat phobia but I crave healthy stuff—I'd never be able to eat fried food but I can cope with carbs. If you like chocolate, eat it; if you love baked beans from the can, or toast and jam, that's fine too. If you're better with those high-calorie drinks or milkshakes,
fill your boots. Don't worry about balance at the moment, just get the calories in. In terms of nutrition, a few months of Jell-O and ice cream will not do any long-term damage.

Be kind to yourself. A cliché, yes, but important. Drink wine if you like it, have hot bubble baths, go to the cinema, find activities that absorb you. For me it's writing; for you it could be singing or learning a new language. The more interests you have that are unrelated to food or exercise, the more of your identity you preserve from anorexia. For years I devoted my life to self-punishment: sub-zero runs at dawn, starvation, isolation, hurting myself with men who didn't love me, abandoning men who did. Stop the internal warfare; it doesn't get you anywhere.

As well as eating
whatever
you can, eat
however
you can. Don't worry if your methods are abnormal. If you need people around to distract you, eat with others. If you prefer to eat alone, that's OK too. A few years ago I found eating in public so difficult I'd eat on a bench in Regent's Park, even in winter. I simply couldn't cope with lunch at the office.

Delete the word “greed” from your vocabulary. Don't allow eating to become an emotional battleground of want and worth; stop feeling guilty about it. Remember, your brain and internal organs need food to function properly. Try to be strict with yourself and just fuel your body the way you put gas in the car. Anorexics have phenomenal willpower; now you need to turn that willpower to your advantage. You've proved you can starve yourself, now it's time to make up some new rules.

As well as good nutrition and professional help, you need emotional support. Keep reaching out and asking for help (I'm bad at this). Don't isolate yourself, don't hide away. Join things, visit places, maintain physical contact with the world, go for a massage or give yourself one. At my sickest I avoided human touch (it made me want to cry), but trust me, you need
lots of hugs. And by the way, when the ability to cry returns, it feels amazing.

Don't get too deeply involved in online forums. The more time you spend discussing the illness on message boards, the less time you're out in the real world, meeting real people, getting on with life, and the more the anorexia will come to define you. Similarly, I avoid group therapy, although individual therapy has been invaluable. For me, online anorexia groups and websites quickly become a world in themselves—they can encourage comparison with other, sicker sufferers and can even trigger worse habits—but this is just my personal opinion; you may find them helpful.

Invent your reason to get better. Dream up a goal or reward: a country you want to visit, a baby you want to have, anything that galvanizes you. You need something greater than the illness to beat it.

Finally (and this is slightly paradoxical) remember that nothing is irrevocable. Treat your recovery like an experiment. Just try gaining weight for once, see what a difference it makes to your mental and physical well-being. Every pound you are able to put on will help the healing process. If you really hate it, you can lose all the weight again, but for now just try eating, try being well.

* * *

Not exactly rocket science, but after everything I've tried in the ongoing fight against anorexia, this is the essence of what helped me.

When it comes to professional treatment, I can't pretend that anything “worked” for me. As I've said, I believe the most important step in recovery is actually wanting to get out into the world again, really longing to be well—not just saying it to your doctors and parents but meaning it, in your heart. Anorexia may
have the highest mortality rate of any mental illness, but this isn't cancer or AIDS we're talking about here: in the vast majority of cases, if you decide it and fight for it and start to eat and keep at it, you can recover. The personal decision is half the battle. Having said that, I wouldn't disregard professional intervention. I've had my fair share of it.

At Oxford, where the weight loss kicked off, I had what was called “counseling.” These were weekly sessions with a kindly college nurse who weighed me each week and looked worried when the scale dipped below 84 pounds and kept falling. I remember the excruciation of sitting in the waiting room with the other girls from college; they were waiting for the morning-after pill or a flu shot, and they all knew why I was there. Nurse Brenda, a pudgy lady in her sixties, would ask, “How's your appetite this week, duck?” and I just sat there and felt numb. I'm not sure she had any experience with eating disorders.

Three years later, back in London, I had six months of psychoanalysis at the Tavistock Clinic. This was probably the most traumatic experience of my life, psychologically speaking. I'd been referred to the Tavistock a few weeks after Greg's suicide (because my GP was concerned about my sudden bereavement and concurrent weight loss). The evil psychoanalyst, a cold bitch from some kind of Jungian nightmare, dressed in brown silk with frightening black kohl eyeliner, sat in the corner and stared at me for what felt like hours on end. For the first three weeks—each session lasting ninety minutes—she said nothing, not a single word. It's surprising how this gets to you. Finally, halfway through week three, I began to cry (from the strain of it all, I suppose) and she continued to stare at me silently. It was as if she had to break me down before she would start to do her job, whatever that was. The interaction (I won't call it a conversation) began once I was “broken,” but we never approached anything like a
trusting or helpful relationship. The woman questioned and then overturned everything I believed in: my happy childhood, my grief at Greg's death, my desire to recover from anorexia. I have never felt so wretched or alone as I did on that couch at the Tavistock. I find I haven't been able to think about it directly for years, but I've remained somewhat distrustful of the manipulative, bullying nature of traditional psychoanalysis. Of course I was in a bad way—vulnerable and bereaved—but surely therapy should not destroy you without rebuilding you? I'm still not sure what she hoped to achieve.