‘I must be willing to give up what I am in order to become what I will
be’
– Albert Einstein
I wish I’d been
able to accept that anorexia nervosa is an illness, right from the
beginning. Instead, I spent over ten
years feeling embarrassed and ashamed; convinced that it was a weakness of
character and completely my fault, that I was ‘crazy’. I could not see anorexia
as separate or apart from me; it was
me. Despite what my family and various
health professionals said, I simply could not liken anorexia to a ‘real’
illness like cancer, a heart attack or meningitis. It wasn’t something that suddenly a blood
test or a scan or a lumbar puncture reveals you have, through no fault of your
own. Rather, it was a place you arrive
at after making a series of conscious decisions. So, instead of an illness, I told myself it
was more of a maladaptive coping style.
I agreed that, yes, people may be ‘predisposed’ to in their
personalities to some degree, but that ultimately they had control over
it.
“What about
non-insulin dependent diabetes?” my psychologist asked me, “Is that an
illness?”
“Of course”
“And how does a
person arrive at that?”
I opened my mouth
and then after a moment shut it again.
Amber smiled. “Mmm.
Genetics may play a part in it but it is ultimately caused by a series
of decisions that a person makes and has control over. Then, like anorexia, it eventually gets to a
point where you are no longer in control and the illness takes over”
I was silent.
Amber kept pressing
me. “Do you want anorexia?”
“No” That was an easy one.
“Did you choose to
diet?”
“Yes”
“And don’t the
majority of teenage girls choose to do the same at some point?”
“Yes”
“And the difference
is, because of your biological predisposition, your personality and likely your
circumstances at the time, you kept going and they didn’t”.
Again, I was
silent.
But Amber still
hadn’t finished, “What about Alzhiemers, bipolar, schizophrenia? Do you see these things as illnesses?”
“Yes” I’m tired
now.
“Just like
anorexia, people with these illnesses don’t have direct control. However, they – and you – do have the choice
of how you manage it. How could it
possibly be true that you are weak or lacking self-control when you consider
how much weight you lost, and the degree to which you controlled your food and
exercise?”
The Oxford
Dictionary defines an illness as:
·
an unhealthy condition of body or mind
·
a disease or period of sickness affecting the body
or mind
Anorexia nervosa is a
serious and potentially life-threatening mental illness; in fact it has the
highest mortality rate of all mental illnesses. Anorexia nervosa is an eating disorder
defined by an inability to maintain one’s body weight within 15 percent of
their Ideal Body Weight. Other essential features of this disorder include an
intense fear of gaining weight, a distorted image of one’s body, denial of the
seriousness of the illness, and—in females—amenorrhea, an absence of at least
three consecutive menstrual cycles when they are otherwise expected to
occur. Scientists have studied the role
of genetics, environment and biochemistry of people with anorexia nervosa.
Although it’s precise cause remains unknown, scientists agree that it is caused
by a combination of genetic and environmental factors. Scientific studies have
shown that certain chemicals in the brain, specifically the neurotransmitters
norepinephrine and serotonin, are not functioning optimally in patients with
anorexia nervosa, something that can worsen in times of malnutrition and
starvation. In addition, the hormones
controlling the body’s response to stressful events, specifically cortisol and
vasopressin, have been shown to be dysfunctional in people with anorexia nervosa.
It was a process, but I can now see anorexia
for what it is. I know that every mind
is different, just as every body is different.
It is okay and normal to think in different ways and to perceive things
differently than others; this is what makes us unique and what makes life
interesting. But when the way you think
starts to harm you physically or emotionally then it becomes an illness. I know that the person I am when I am in
anorexia’s clutches is barely a shadow of the true me – in fact sometimes I
felt like there was no me there at all.
I vividly remember one day during a psychology session a couple of
months into my treatment at Princess Maragaret Hospital. Amber made an off-hand joke and for the first
time since I’d been there, I laughed.
Amber looked at me and blinked, “Hi Kas – it’s great to finally meet
you!”
Anorexia has the
ability to make you feel incredibly alone and isolated. It tricks you into tendencies that pertuate it
and let it grow – you become secretive, resistant to support, withdrawn. It is easy to feel like you are the only
person in the world feeling this way. In
fact, this is far from the truth.
Statistics indicate that one in five women struggles with an eating
disorder or disordered eating and that eating disorders affect 70 million
individuals worldwide. Famous people who
have battled an eating disorder include Princess Diana, Karen Carpenter,
Victoria Beckham, Kelly Clarkson, Lady Gaga, Audrey Hepburn, Sylvia Plath,
Elton John, Janet Jackson, Oprah Winfrey and Kate Winslet.
I realised that I
needed to change the ‘blame’ tape in my head; to remind myself anorexia was not
my fault, I do not need to be ashamed and hide it. I can choose to see it as separate from
me. And I was lucky, because unlike some
other illnesses, I could choose how I
manage anorexia and had the real opportunity to recover from it. The key thing to remember is: there is a choice. And the choice is yours.
My World
I must build a
protective shell
Around me
To keep me safe
From this world.
I need something to
hide behind
A security blanket
An anchor to ground
me
Just in case.
Otherwise I’m left
open
Raw and vulnerable
At the mercy of all
this world
Might throw my way.
Pains and sorrows
Lies and hurt
Dishonesty and
failure
Despair.
Anxiety and worry
Heartache and
unhappiness
Conflict and evil
Hate.
I need a sanctuary
A place of retreat
A refuge
Where nothing can
touch me.
As far back as my memories go there’s been an undercurrent
of fear running through me – an inherent uncertainty and distrust of the
world. A need to find some sort of
safety net, to have something to hold onto.
Mum tells me that even as a tiny infant my forehead was creased with
worry lines and I would cry whenever she left my side. Some babies are born like little pink
squishy angels; I was one of those babies that came into the world reluctantly,
face screwed up, hands in fists, kicking and screaming.
From a very young age Mum became my anchor in the world, the
one person that I could count on to always be there, to hold onto me and keep
me safe. Starting school was a problem,
because I couldn’t have her at my side all day anymore. To help with the anxiety this ignited within
me, I developed ‘rules’ and ‘magical thinking’.
If I could walk all the way to school without stepping on a crack,
nothing bad would happen. If I could
hold my breath all the way up the driveway to the letterbox Mum wouldn’t get
cancer and die. If I could get 10 out of
10 on my spelling test everything would be okay.
As I left primary school and ventured into the exciting
hallways of secondary school and being ‘grown up’ I began to leave some of
these sorts of thoughts behind. I made
new friends, got involved in sports, joined the debating team, quiz teams,
played a part in the school production and generally enjoyed my studies. Although the anxious child in me was still
there, I seemed to manage pretty well to quieten her most of the time.
Sometime during Year 8, I started to become more aware of my
body. Other girls talked about losing
weight or being fat or getting their periods, started meeting up with boys, experimenting
with make-up and reading fashion magazines.
I’d never thought too much about my body, except to enjoy it for the
things it let me do: running, swimming, climbing trees.
I remember very clearly the day of the chocolate
muffin. That was when it all
started. It was a Sunday, and we had
visitors after church. We were all
finishing lunch, and Mum brought a basket of freshly baked double-chocolate
muffins to the table. The delicious
aroma filled the room, and of course no one could resist them. It was when I was reaching for my second that
suddenly, out of nowhere, a thought popped into my head: ‘you can’t eat that’.
I almost looked around behind me the voice felt so real and
close. I retracted my outstretched hand
like a guilty toddler, my mouth watering.
From then on the voice became more familiar. It wasn’t long at all before it was a constant
companion. When I listened to it and
obeyed it’s orders, I felt a sense of acheivement and control. It became a sort of challenge. I began to eat less and less, and started
weighing myself. As the numbers on the
scales dropped I felt a sense of power and security unlike anything I’d known
before. Suddenly I was special, I had a
special purpose and I became better and better at ignoring my bodily urges to
eat. The challenge of denying myself
food and seeing the resulting weight loss became a way to gauge whether I was
‘good enough’ and for the first time in my life I felt anchored and steady:
even if I couldn’t control other things in life, I realised I could always hold
onto this – whatever ‘this’ was. At that
time it was nameless, but later I came to know my new ‘friend’ as ED. ED led me to feeling in control and empowered
in other areas of my life and became my self-worth determinant.
Before too long, Mum noticed my weight loss (I’d always been
slim anyway) and became concerned. She
started packing my school lunches and then checking I’d eaten them (which I
hadn’t) when I returned home. I became
panicked when she started demanding that I ate more – it was my daily challenge
to get through the whole day at school eating only an apple and the very
thought of going back to eating anything more than this filled me with
panic. Although I’d always been totally
honest with Mum, I started throwing my glad-wrapped salad sandwiches and home
baked cookies in the rubbish bin at school.
Soon it wasn’t just Mum who was concerned. People started making comments, my swimming
coach pulled me aside and asked if I was okay, and one day Mum told me a lady
at church had asked her if I had cancer or something?
I was now seriously underweight, and intent on losing
more. I weighed myself daily, and the
dial on the scales became my gauge of whether it was a good day or a bad day,
whether I was a good or a bad person. I
had always loved running and physcial activity, and realised how exercising
helped me to lose weight even faster. I
pushed my willpower to it’s limits – running for as long as I could and only
stopping when I got so dizzy I thought I’d pass out, limiting my daily food
allowance to a piece of fruit for breakfast, one apple during the day and as little
of dinner I could eat in order to keep Mum off my case. I restricted calories every possible way I
could think off – I stopped using toothpaste and refused to lick
envelopes. I became obsessed with food
and thought about it every waking minute: I’d pick up magazines, flick straight
to the recipe section and oogle over pictures of cakes and pasta dishes and
plates filled with crispy potatoes, fresh crumbed fish and lemon sauce… I
became tranfixed on what other people ate, and while the types of food I
allowed myself to eat dwindled rapidly, I made long lists in my diary of all
the things I would love to eat if I could.
I opened containers in the fridge and smelt the contents,
fantasising about what it would taste like (this didn’t last long as ED soon
convinced me that I could absorb calories through my sense of smell). I became distressed when Mum or my sisters
cooked or baked, and made sure I was as far away from the kitchen as
possible. I even dreamt about food – I
remember one time waking up in the middle of the night sweat pouring down my
forehead and my heart thumping in my chest because in my dream I’d eaten a
piece of chocolate cake and it had felt so real.
One day I read somewhere that being cold used up extra
calories, so when winter came I would ‘forget’ my jersey and spend the day at
school shivering, and even started sleeping without blankets.
It was around this time that I realised I wasn’t in control
anymore; that in pursuing control so relentlessly I had, infact, lost it. ED was now bigger and stronger than me, and I
felt powerless, like it was no longer me choosing to act like this. I felt like a puppet on a string, like I was
being swept along in a tidal wave.
What’s more, I was ashamed of the way my body now looked and felt; my
ribcage and shoulder bones jutted out, my spine was dotted with bruises from my
morning sit-up routine, my hands always seemed to be purple, I was cold all the
time, I’d developed a downy fuzzy hair on my back and my face and I was the
only one my age without my period.
But it wasn’t only physical changes I was noticing; I
couldn’t concentrate on anything for a prolongued period of time, I laughed
much less and dissolved into tears most days for no particular reason, I felt
tired all the time, I kept forgetting things …
Soon I found myself, Mum, Dad and a psyciatrist in an office
at the Child and Adolescent Mental Health centre. I’ll never forget Dr Bramble's cool clipped
tone as she looked up from her clipboard: “Katherine has anorexia nervosa”.
I didn’t really know what that meant but her words both
chilled me and filled me with a sense of relief. Someone knew what this was. Maybe I could be fixed and I could go back to
how I used to be.
After being assessed by a paediatrician Mum and Dad were
told I should be admitted to hospital.
My weight was dangerously low and this was now affecting my cardiac
function. After begging and crying and
making endless promises, Mum and Dad took me home. I was to be on bedrest, to start on a strict
meal plan including high calorie nutritional supplements, and to have regular
follow up with the paediatrician, psyciatrist and a psychologist named
Jan.
That was the beginning of my long road to recovery, and my
long relationship with ED.
So, since I was eleven, anorexia nervosa, or ‘ED’ as I came
to call it, has been a part of my life.
Sometimes in a big way, sometimes in ways that I’ve been able to
completely hide from others. Despite
the harm ED has done to my body, soul, relationships and freedom he has been a
constant companion – a friend – something I can always rely on, something that
makes me feel in control and serves as a gauge of whether I ‘measure up’ and am
‘enough’.
As I came to truly realise the functions of anorexia and how
futile it is at truly serving any purpose I realised I needed to disentangle
myself from it. After three hospitalisations
throughout my teens I finished school and completed my nursing training, whilst living at home. I graduated at the end of 2012, aged 21 years
old. At the start of 2013 I moved to
Westport – a rural isolated town on the West Coast of the South Island with a
population of approximately 5000 people.
To my great excitement, I had been offered a new graduate position as a
district nurse. At that time I was
battling ED somewhat (as usual), but I was at a relatively healthy weight and
managing pretty well. I saw it as an
exciting opportunity to break free from my home town and what I’d been my whole
life and to start a new chapter. It was
an adventure, and one that I was determined was to be the start of a new me.
At first things went well; I loved my job, met some amazing
people, enjoyed the small town atmosphere, settled into a flat, made a network
of friends, met a nice young man, explored the beautiful outdoors the area had
to offer and joined the local Catholic church.
ED settled into the background somewhat for a time.
But, after several months the honeymoon period wore off, I
started to feel homesick and missed being around people who had known me my
whole life. I felt isolated and empty
and alone. This was exacerbated by
breaking up with my boyfriend. I settled
into familiar coping mechanisms of restricting my food and compulsive exercise
to help numb my feelings and give me some sense of control. Of course, I started to lose weight. Winter set in and I came to realise the downside
of living in a beautiful old wooden house – we had hardly any heating, no
insulation and it was freezing all the time.
One evening when I was sitting in bed reading in my beanie, bedsocks,
flanellette pyjamas and two jerseys there was a big gust of wind and the carpet
in the centre of the room literally moved as the wind blew up through the
floorboards.
The battle with ED heightened over the winter months, and by
September I was in a terrible space. I
saw my GP, was referred to a psychiatrist and within the space of a couple of
weeks ended up in the specialist eating disorder unit for the South Island at
Princess Margaret Hospital. This was a
real turning point in my journey with anorexia.
By now, I truly wanted to let go of ED. I had had enough.
But before I could let go, I desperately needed an answer to
the question that had ultimately kept me in ED’s clutches for the past eleven
years: what is the point? Why are we here on this earth? What is the purpose of life?
This was the pivotal thing in my mind that held so much
importance. I didn’t want to live in a
world without knowing ‘the answer’. It
was simply too frightening. If I didn’t
use ED to give me a purpose, to make myself feel in control and gauge whether I
was enough (which I did not want to continue doing due to my realisation of how
truly futile it was, and vowed I would rather not live at all if this would be
the case), and if I didn’t have the answer, then I simply couldn’t concieve how
I could live in the world.
I had my first session with the Amber the psychologist, and
although she was lovely, after we’d talked for a while about how I was feeling,
where I’d been, the skills I’d learnt in the past for managing my feelings and
the fact that I just simply didn’t want to even try to get better if I didn’t
have an answer to my question, she said to me ‘there’s not a lot I can say to
help right now is there?’. I agreed that
no, as much as I wanted there to be, there wasn’t unless she could give me the
answer to what the point of living was.
She did give me an answer, but not the kind I wanted to
hear. It was an answer that I’d heard
before and already knew deep inside:
‘Katherine’ she said, looking at me seriously with her big
chocolate brown eyes, ‘that answer is something you have to figure out for
yourself’.
At the centre of your being you have the answer;
you know who you are
and what you want
– Lao Tzu
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