Now I am a psychotherapist, specialising in clients with underweight or overweight issues (and I’ve written two books on my original thinking, more about which will follow after some personal details). Then I was as a child growing up first ‘fat’, with the typical bullying and negative attention from others that they apparently feel they have the right to perpetrate. When you are a fat child, you are treated with a combination of toleration and derision. But when I was 16 something happened. I left school early, and that allowed me to grow my hair. Suddenly I was no longer a shapeless blob, I was a strikingly good-looking – ‘pretty’ – young man.
The positive attention led me to wanting to do something about the weight that, although not as pronounced as earlier in my life, still made me self-conscious. I started to diet and exercise, to over-exercise and restrict. I became anorexic, and over a two-year period my weight dropped from 11.5 stone to 6 stone 9 lbs. At this point I had a breakdown and was sent home from work. I was living in rural Durban, South Africa: there was no outside medical or therapeutic support. This turned out to be fortunate – at the time the only ‘treatment’ offered people with anorexia was electro-shock therapy (EST).
I was left on my own to cope with my illness. And so I turned inward again, but this time, rather than listening to the voice telling me not to eat, rather than the inward turning becoming an obsession with exercise, I turned inward to understand my illness. My MA Dissertation is entitled ‘The Nature of Anorexia and Recovery: a Heuristic Self-Search Inquiry’ and I’m drawing from my research to inform this blog.
What I discovered, in fragments, in the void of self-knowledge, was that there were essentially two parts to me. The one which was under the influence of the illness I call the anorexic self; the fragile, frightened, small part of me that wanted to get better I call the ‘healthy self’. At the time I thought of the situation as being a ‘David and Goliath’ battle: I was David, the illness was Goliath – but I had a weapon.
The weapon began with exercise. I have read how people are, in hospital, confined to their beds and forcibly re-fed. I can’t comment on whether this is effective for other people, but for me, exercise gave me a ‘deal’ to offer the illness. ‘If I exercise, then you have to let me eat’ (this is different from the idea that people are forced to eat and then have to exercise it off: I made eating/exercising a positive). I began swimming in the nearby University swimming pool, rising before dawn and having the grey light and the cool water to myself. I wrote notes to myself and put them on the inside cupboard door: ‘rest’, ‘sleep’, ‘laugh’, ‘enjoy’ – all the fundamentals that the illness had taken away. In this way I became my own therapist (and now I emphasise to my clients that I can support them, but the fundamental work can only be done by them; honestly and carefully).
There were milestones: the first time I could eat a potato was a revelation – little suns exploding in my mouth – it showed me the food my body craved. The combination of negotiating with the illness – ‘I’m going to have this food so I can swim later’ – and positive impressions helped bring me back to life. My family left me alone, so there was no external pressure: I
had all the space and time I needed. Within six months I was well enough to get through life without the disorder and I got on with my life. It was only when I was confronted, in 2005, but a publication on eating disorder research that I reflected that what was missing was my sort of experience.
Since then, beginning by using my own experience as a guide, and then by research and working with my clients to see what is helpful in recovery, I have used my own experience to inform my work. I now say to clients ‘It’s a mechanism. It’s not you. The reason it prevents you eating (or for overweight, the reason why food becomes the answer to all of life’s problems) is that it’s what I call the EDM: Eating Disorder Mechanism’. Some people virtually attack the person with the disorder, forcing them to ‘eat properly’. I don’t work like that. From my own experience, I now how frightened the mechanism is (a seeming contradiction. It’s very powerful – but it’s also frightened because it is a mechanism. So when it’s attacked, it retaliates by making the person’s relationship to food even worse). Instead I say ‘little by little: something small and real, every day, that’s what builds up, and over time you can take the energy back from the mechanism – and in that way the recovery will be permanent’.
My experience of being first overweight and then anorexic has shown me that an eating disorder is not some alien infestation – and it’s not the person doing it for attention, out of spite, or to punish their parents. What happens is that because the individual does not have a fully functioning set of psychic defences, the ‘illness’ activates to fill in the gaps: it is actually a psychic defence mechanism. By focusing on the issue of food and exercise, by
making them the most important thing in the world, the EDM seeks to keep the person ‘safe’ from the rest of life. But because it is a mechanism, it can’t just stop when the person is weak and ill. It’s like a robot that’s out of control. That’s why recovery is about getting the energy back. So I will say to a client: ‘When the mechanism talks to you – when you hear that voice saying ‘don’t eat this/something terrible will happen’ – talk back to it. Say, inside your head – ‘No, that’s not helpful. I need the food in order to get on with my life. And I need you to give me back the energy’. Clients report that when they do this, they feel a little more free of the illness, and if this process is maintained, eventually you have recovery.
I work privately, from my home in London. I have occasionally contacted people who head up eating recovery units. So far the feedback is that they believe they already have the answers. This is although the rates of recovery, let us say, could be better – in fact, if even one person is lost to an eating disorder, wouldn’t it seem that exploring every recovery avenue is necessary? If only for the good of the patients themselves? Whatever: I continue to work with the clients who find their way to me. I continue to explain my model and clients continue to say they benefit from understanding that it’s not them, it’s the eating disorder mechanism that’s effecting/ruining their lives.
Email address for correspondence: firstname.lastname@example.org