Just what it says. There’s nothing I can do except ride it out. It comes in waves and is all engulfing. I am missing my family, my home and the familiar surroundings, my animals and my freedom. A bubble bath, a hug on the sofa watching rubbish TV. I have to be the best version of myself here, to be always in control and it’s exhausting. Saying goodbye after visits is awful and despite being surrounded by people and checked up on every 15 minutes, I feel desperately lonely. Friday night in hospital is not the best fun. Most people have gone home for the weekend and I’m sitting in the lounge waiting for medication so I can then just go to bed, attain a bit of oblivion and dream of home.

Being Friday evening and August the usual staff are thin on the ground and the ward is being run by agency workers who have no idea what’s going on. I had to talk through each dose of medication with the nurse who simply didn’t seem to know anything. It took 35 minutes. I wonder at such times why I am here at all.

Seen better views……

Hotel a la Manger 

It’s taken me 5 whole days to muster up enough courage to write this but I have unexpectedly ‘stepped up’ to inpatient admission as of last Friday. I would prefer to skirt around the reasons why but consequently I am currently having a fun-filled stay in Cotswold House Hotel. I could really go to town on trip advisor, given the lack of bedside lamp, soggy towels, un-openable windows and poor choice of food. At least I haven’t seen any cockroaches (yet). The bathroom facilities are fine but if you need to use them during rest periods it means someone standing outside listening. It’s altogether best to hold on, believe me…

This holiday has also resulted in a significant reduction in activity which I suppose is a good thing but means in consequence a loss of freedom as I can’t go out unaccompanied (or sometimes at all mainly due to staff shortages) or spend time in the garden unless they forget as they did on Sunday. ( I have discovered that there is a fairly easy escape route from the garden over a fence). I am also facing really difficult questions from other patients, who obviously want to know all the ins and outs of everything. This place is a hotbed for gossip as generally there is nothing else to do. Think of Butlins/Hospital/Concentration camp and you won’t be far wrong.

Overall is an almost overwhelming guilt that the timing coincides with the start of the summer holidays; what sort of a terrible mother  would absent themselves at such a time?

I don’t want to turn this into a rant as I know that the staff are all working under a lot of stress, but the inconsistencies in treatment are pretty frustrating. One minute I’m left alone for hours, and the next I am checked up on every 15 minutes. All electrical items have to be PAT tested which can take up to 3 weeks meaning I’m having to leap out of bed at just the right moment of sleepiness to turn off the overhead light, have no phone charger (though I have sneaked one in shhhh) and can’t dry my hair, which is now shaggy style.

Trying to find the positives; I have in fact made a lot of progress weight-wise since last week, which is scary but I feel that the little voice telling me not to eat is receding a bit and so I am hanging on in there working hard on getting better though sometimes I just feel like crying, and others like banging my fists against a door until I can escape.

On the bright side too, as I am no longer part of the ‘eating out’ group, I don’t have to endure the plan of take away McDonalds today! Given a choice, I’d opt for hospital food any day. Instead I had McHospital McCauliflower, McPasta and McIcecream, all while sitting with another patient who is as chatty as a gagged corpse.
Onwards and slightly upwards….

Free Will or Obedience 

So yesterday I learned that in the last 7 days I’ve managed to lose 3 weeks worth of weight gain and thus 3 weeks are added to my recovery time. I am completely baffled as to how this can be the case. Yes I have been some cutting corners with the meal plan here and there, as I have every week, I am after all no saint, but I have been eating at the very least adequately. I can only think it must be down to over-activity, or that the NHS scales were broken. The worst thing by far is that I have not yet been given the opportunity to talk this through properly with any professional and so feel confused and frustrated by the loss of yet another 3 weeks of my life.

I feel increasingly as if I am in a reverse concentration camp where hard labour is forbidden and food is enforced, or perhaps a character in a Kafka novel. I have lost my free will. There is a nightmarish oppressive quality underlying every moment of every day that I am here. It is a setting that straddles a dystopian fantasy and reality. I am hopeless yet full of hope. Recovery is a palace which seems vast and impossible to attain. I am overwhelmed by the sense of impossibility and futility, yet I have an immense yearning and hope. These incompatible sensations all assail me at the same time. It makes me want to run so I can leave it behind.

I need to escape this place for my own sanity yet escape is fraught with danger; I know I need to try and engage with the process for my own good. It doesn’t help that I’ve put myself back by 3 weeks – it obviates the whole reason I am going though the torture, but as Winston Churchill said, if you’re going through hell, keep going.

Today, I had to use every last ounce of determination even to drive to the hospital. Once here, I am yet again overwhelmed by the rigid regulations and lack of freedom. It’s slowly but effectively killing my sense of self. I feel both out of place yet part of a disordered and disjointed community.

I skipped the nutrition group this morning because I felt unable to take more of the constant brainwashing and asked if instead I could have a walk. I was allowed 5 minutes but had to leave my bag and keys behind. Every part of me wanted to rebel and drive away but I didn’t- I walked for 5 minutes and returned to the burrow like a good bunny.

Today we are having a lunch picnic in a local park. Let me make this clear, this is not a special treat. Apparently taking sandwiches already made up is disordered. Normal people make sandwiches in situ. Really? Meal deals from Tesco are clearly only for the eating disordered. This picnic has already been the subject of far too much discussion, both formal and informal. Apparently on a picnic you wouldn’t add margarine to a bread roll so we have to eat them dry. We need to make up for this by the addition of a chocolate bar. This edict necessitated a meeting which lasted a whole hour and we still have both the picnic and the picnic post mortem to look forward to later. How can I have come to this?

I desperately want to recover and I acknowledge I need the help to do so but right now i’m not sure I can take much more of the punishment.

Religious belief and anorexia 

I am fascinated by religion. I find it difficult to comprehend how it makes any sense conceptually (though I can see the benefits of having a direct line to a higher authority who doesn’t create conflict by answering back in any worldly sense). I actively seek conversation with those who make a point of wearing their religion on their sleeve so that I can gain some insight or even an answer to the fundamental question; why do you believe in an abstract theory without hard evidence that it exists and proof that it actually does more good than harm in a global sense?
This is clearly a huge question which can’t be explored in any satisfactory way in a blog post but I have begun to wonder at the connections between mental health, eating disorders in particular, and religion.

1. Reward and Punishment

Eating disorders are inextricably linked with the idea of reward and punishment. Food restriction for me at least is a compensatory behaviour for an over-sensitivity to both. It’s not about the search for the holy grail of thinness but if things go wrong, I can restore my inner balance by simply restricting my food intake. If things are good I can reward myself with a meal. This has clear parallels with religion, or at least with spirituality (being the relationship with a transcendent being beyond and separate to oneself). Religion is after all, is all about heaven and hell – the ultimate reward and punishment. And let’s face it, over-eating deserves divine punishment given that gluttony is named as one of the seven deadly sins. At the root of most religions is the idea of self sacrifice leading to a guaranteed fast track to heaven. At worst and most extreme, this can take the form of suicide bombers or driving lorries along pavements in a perverse attempt obtain salvation, at best it amounts to agreeing to arrange the church flowers because you feel you ought to despite secretly preferring to go shopping instead. Basically, a believer gets something out of religion, why else bother? But nothing comes free; there is always a payback. Failing to comply with the ‘rules’ of a religion instigates a guilt which can only be negative and self destructive.

The central teaching of any religion is that you can be rewarded with more love and happiness in the afterlife if you are compliant with its teachings. If you do bad things you will be punished unless you can show remorse in the form of some sort of physically or mentally harmful penance. This may take the form of walking ten miles with stones in your shoes, deliberate social isolation or, guess what….food restriction.

2. Fasting

Fasting is interestingly an important component to all main religions. The idea being that if you restrict your food intake, whether by the more extreme Ramadan or simply by giving up chocolate (funny how people never give up salad) for Lent, then you are punishing yourself to ‘get closer to God’, which is the ultimate reward. Nearness to the deity is partly achieved by the heightened sense of clarity one gets from lack of food. Again, clear parallels with anorexia, where starvation improves mental functioning short term by creating a ‘high’. This is purely a self-denial, and so how can it fail to to be disordered? If God is benign how could he or she approve or even care if you physically torture yourself by not eating or drinking in daylight hours in intense heat for a whole month? This behaviour is something clearly thought up by humans to self-comfort, the theory being that only those who sacrifice are enlightened and rewarded and the outside world does not appreciate the lifestyle choice they have made. It sustains an illusion of exclusivity and importance which is almost addictive.

There is also a link between certain foods and morality. Why else is ice cream advertised with words such as ‘heavenly’ ‘decadent’ or ‘purity’? Eating thistle smoothies is on the other hand can be seen as a form of self sacrifice to the health god.

3. The all important deity

This is scarily close to the idea of people with an eating disorder being ruled by some type of pseudo-deity (in my case, Dave, but I could easily re-name him God). Dave is oddly a spiritual dimension of an illness almost akin to a cult. Does this mean therefore that religion could be a mental illness?

4. Power and control 

Another important dimension to religion is the pursuit of power. By being involved in a belief system that is in fact out of your control with the ultimate goal of satisfying that all important being which is both part and apart from yourself, then there must be an element of self sacrifice giving you a sense of control over something which is merely an abstract concept. Simply put, by self sacrifice you are gaining a physical manifestation of what was merely conceptual and you therefore are gaining some individual control over what, in fact, does not encompass the individual. Fasting is a form of control, an attempted taking back of power by the individual, which is exactly how anorexia manifests itself.

Like an eating disorder, religion can therefore reduce the sense of self and identity which is subsumed into the all important deity.

5. The delusion

Religious people often say that they will ‘pray for you’. This is not a substitute for actually taking action. Praying can often be a convenient avoidance technique for facing reality. The religious often pass a problem over to a higher authority so they are somehow absolved from responsibility. This does not in fact help the intended recipient, however well meant, unless it is followed by tangible action. Similarly, the sense of control and well-being of having somehow absolved oneself from taking the responsibility of self-love sometimes felt particularly in the early stages of an eating disorder are illusory. It’s a form of self deception either way.

It could be argued that the eating disordered and the religious cannot be directly compared as they have different motivations. Cleary, all religious people do not have a fear of weight gain. Many people with eating disorders also embrace and obtain solace from religion and I totally respect that. However, I feel that in either case this is permitting an idealogical mindset which creates obsession and control whatever it’s root.

Rosie the super-hero and the amazing shrinking skeleton.

So had a temporary hiccup and consequential lapse of reason / loss of sense of humour at the beginning of this week upon receiving the results of my bone scan, which I had already decided in my head would be fine. I genuinely did not expect the degree of bonelessness that it revealed which has been a huge wake up call. This illness has now become potentially life changing and not in a good way. I honestly believed I was invincible so the confirmation of inner fragility was quite a shock. Plans for going skiing this winter and my goal of finally buying another horse when I recover have clearly been scuppered for now so I am now devising alternative methods of conquering the world. Hopefully the osteoporosis may be reversible to some extent though I am walking around at the moment fearing I may trip and part of me fall off.

Since forever, when stressed my go-to comfort has always been to skip meals (who needs food when they are a super-hero?) so I have fallen off the tightrope a bit this week, though am now feeling tentatively better. On that theme I thought I’d reinstate the stiff upper lip and visit some positive thoughts:

Reasons to eat:

1. Social interaction. Self isolation and anorexia go hand in hand and at my worst (and this persists on a bad day) , it takes far too much effort even to reply to a text message, crazy though it may sound. Last week, the farrier came to trim the ponies’ feet when I was at home, and rather than calling someone else when I saw him lurking by the back door, I went out to see him, caught the ponies and we had a 45 minute conversation about politics. Sounds like such a small thing but significant (for me) nonetheless. Later in the week, I spoke to someone at the practice nets in the village rather than diverting around 2 fields and through the graveyard to avoid them. I am usually quite sociable, and at work, client contact is the part of my job that I enjoy the most, so this compelling desire to avoid people is both contrary to my personality and torturing.

2. Restoration of health meaning life can be resumed as normal as much as possible including pushing the boundaries simply for the fun of it. (Climbing mountains in flip flops, galloping horses on a beach, sledging round trees, running out of control down a hill….)

3. Being able to watch a film or TV programme all the way through without lapse of concentration and ending up not knowing who killed who and why.

4. Being able to sit down comfortably. Boney bum + hard chair = ouch.

5. Not having to cover all parts of body in hot weather because they look truly awful.

6. Being able to go back to work so I can feel useful and not simply be a parasite.

7. Being able to buy clothes without worrying I may get fat and grow out of them.

8. Not spending half my life in a hospital. Six weeks is already six weeks too long.

9. Being able to plan ahead more than a few days, and not having to ask permission to wee, have a drink of water, have one measly paracetamol, go on holiday……

10. Being able to eat without considering the calories. (Though the last time I did this was probably in the 1980s)

11. Realising I can still have fun without running round at full pelt (see below)

12.  Throwing away the bathroom scales because I JUST DON’T CARE..

Vegetable patch (or slug party venue)

Family fake tattoo night

Makeshift croquet lawn (sorry ponies, you’ve been marginalised)

Apart from this, I have had my first 6 weekly review this week which helped me feel more positive as it confirmed that I am making some progress (woof, pat on the head). I know from the numbers on the scale that this is the case but it somehow helps when it is verbalised. Bit frustrated that holiday plans for August were not given the go ahead, partly because 2 weeks away was not recommended by the team for recovery (looking ahead does not seem within their capabilities) and partly because having a huge waiting list, they couldn’t keep my place open that long which is more understandable but still annoying. It may be that I am recovered enough to be discharged by then anyway but we can’t take the chance and book flights right now which only adds to the guilt of the effect this thing is having on the family.

I am now being increasingly affected by the attitude of other patients in the clinic and what at first was a novelty is becoming a never ending repeat of the same old issues. I’m seeing this as a sign that I’m getting better, but listening to fully grown people complain about the outrageous selfishness of others when it comes to yoghurt flavour choices has become more than a little tiresome. I fear institutionalisation because without the support I was failing to recover but the clinic environment creates a false sense of security by cushioning me from the reality of the world and this is something which is not sustainable. Nothing happens overnight so I just have to chalk up every meal as a win and get on with eating my way out!

And the Crash….

I am currently flat out on the sofa after another fun filled day in the hospital. The physical effects of recovery from anorexia are well documented but it has still come as a shock to the system. Six days on a weight gain diet and my body thinks it’s Christmas. Despite all the eating, ironically I have less energy, am experiencing more dizzy spells and so bloated I feel like I’m carrying twins. Hopefully it will pass eventually but this evening the sofa is my new best friend.

Apparently it’s normal to experience an initial rapid weight gain which is then lost again when your metabolism is kick started. Basically, if you keep restricting your intake, you are simply keeping your body in a state of starvation in which it needs less food to maintain a given weight by reducing nonessential functions (such as thinking clearly). Eating more means that the body will start using that energy for other things. I’m just waiting for it to grant me the courtesy of being able to walk upstairs without feeling like I’m about to die.

Mentally though, I am hanging on. Today was a day of group sessions which provided plenty of entertainment and made the day go by more quickly. I won’t be too boring with the detail but I have been able to make one or two observations. I attended a nutrition group which is a structured course run by a dietician designed to challenge and discuss attitudes to food. This I found surprisingly useful in terms of factual information, if not from an emotional viewpoint. The first task was to grade how essential food is on a scale of one to ten. Half the room, including me, thought this a no brainier, surely the answer can only be ten? I am left wondering whether this was in fact the healthy response. There are some very clever, Oxford graduate types amongst the patients who clearly enjoy a philosophical discussion, and I am perhaps currently underperforming in a cognitive sense, but surely you can overthink this question. Where is the ambiguity? If you believe food to be anything less than completely essential and are from a personal, rather than a general viewpoint, ranking it below other functions such as socialising or thinking then presumably the wish to die is greater than to eat which provides a paradox. If you don’t eat guys you can’t live. I unfortunately didn’t manage to keep my head down and stay out of trouble. I challenged someone’s assertion that no one in the room was ‘normal’ by stating that in fact I believed I was. I was told that this was an unhelpful contribution which left me feeling slightly chastened and bemused. It is unhelpful to me that I view myself as normal or should I not let on to everyone else that I am normal? 

Next in the diary was the ‘business meeting,’ or the reading and discussion of anonymous comments placed in the suggestion box over the week. Basically giving free rein for self expression without any chance of reprisal. Which is about as mad as it sounds. The one I liked best asked all patients to pick up their feet as the constant sound of shuffling was extremely irritating. This was met with a stony silence during which I struggled not to laugh. Whoever had written it had actually got a point. There is an awful lot of shuffling going on.

The day was not without its food challenges. The milky drink to be consumed for morning snack with my banana was to include 3 teaspoons of nesquik. I am still finding my feet in the dining room as I have not been granted the privilege yet of being able to serve myself but this rule appears not to apply to snacks. I duly waited for my drink only to be taken from the room and interrogated for my failure to help myself. I was then watched carefully while I heaped into my milk my prescribed 3 teaspoons of nesquik but obviously not carefully enough as I was then told, ‘no, that is THREE  teaspoons’. Now given that we were in a room of 20 people this was akin to making a loud complaint in a restaurant whilst other diners look on. I catagorically did put three teaspoons into my drink but clearly the nurse in charge could not count. Finally, I wasted another £1.50 of NHS funds, threw away my drink and started again, this time counting loudly and clearly. 

Later in the day I shuffled off to the relationship meeting. Everyone had to speak in turn and describe the relationship they were having with 1, themselves, 2, each other, and 3, people in the outside world. There were some replies with variations on the theme of 1, I hate myself, 2, nobody really likes me and 3, difficult. I was surprised that this response is still maintained by some people who have been in the unit for many weeks. Maybe it’s unhelpful to examine these thoughts too closely. I do wonder whether the ‘treatment’ that is currently prescribed might well be discredited in say 20 years time but it’s the best we have come up with for now and admittedly so far it seems to be working for me, though it’s early days. I think the key is to keep an open mind, keep positive and above all keep a sense of humour.