Eating disorders, secrecy, and the media

Due to my current confusion over what I have read (because I didn't write about the books straight away they're now getting mixed up), and having parts of writing back on my other laptop which had broken, but is now fixed, but is at home so I can't get it until Christmas... I think I am going to give the ED books a break for now. Instead I am going to post some of my own thoughts. The below is white as I copied and pasted it as an extract from my diary but then couldn't figure out how to get rid of the white.

Is the media to blame for eating disorders?

This disorder is not influenced by others – it uses others. It does not stem from the media, but it can use the media to back up its’ own manipulations. However if the media does not back up the disorders' rules, then it will ignore it. I do not believe that if ‘fat’ came into fashion, that 'fat' was the look all the celebrities were aiming for, that all the ‘best looking’ girls had, that anorexia would suddenly disappear. It is still a mental illness and it has not been created by modern society. 

The secrecy within Anorexia

One reason people with Anorexia Nervosa often aren’t honest is because no-one can cope with the truth. And people tell me I’m not a bad person, but they can’t see into my head. (Will come back to this another day, can’t think right now).

I think people, professionals, need to start seeing anorexia for what is really is; an evil alter ego. There are two people living inside. People say this is too abstract, too dramatic, perhaps ‘romanticising’ the disorder, that this is a wrong description and identification. ‘Of course there isn’t someone else living inside of you, are you mental?’ Well yes actually, the colloquial meaning of ‘mental’ comes from the word ‘mental illness’ and an eating disorder is a mental illness. I would go as far to say that this other person is as real as a schizophrenics' hallucinations; and they are very, very real. It is so real that I cannot even truthfully say that this ‘other’ person is an analogy, but I let people assume that it is because otherwise people really would think I was mad. Either mad or pretending to be mad. I think the latter would be even worse.

Life without Ed

How one woman declared independence from her Eating disorder and how you can too

By Jennie Schaefer with Thom Rutledge

Thankyou to ally for recommending this book :)

I too would recommend 'Life without Ed' to anyone wanting to recover from an eating disorder, provided you don't mind the personification of this illness as an aid to managing it, and you don't mind a bit of humour. Humour is a controversial issue when it comes to eating disorders, and many sufferers sadly find it offensive. I noticed another review of this book criticised the author for supposedly being insensitive in the way in which she basically laughed in the face of her disorder. I disagree. I feel that her writing is compassionate, and my only criticism of the jokes was that most of them were pretty bad ;), although there was the odd one that made me laugh. The idea behind the jokes was good though.

For a long time I admittedly found it hard to understand why anyone who had suffered from an eating disorder could ever joke about the horrors of such an evil illness. However, I think part of the process of achieving freedom is to finally believe in the saying 'laughter is the best medicine'. Laughter can indeed be found in even the darkest of places. Psychiatric units: you will hear laughter within these institutions (and not just manic laughter), in-between the crying and screaming and excruciating distress. Laughter doesn't undermine the pain, it simply shows a tiny bit of hope that there is still something within that person who is fighting for life. And of course, 'if you don't laugh you'll cry.'

Another criticism which I disagree with was the view that the author made recovery look too easy, with her descriptions of how she overcame each hurdle being so short. I didn't think they were too short; just concise. Plus Schaefer explained to the reader at the beginning that the process was a lot longer and harder than the pages of each section perhaps may indicate, but she wanted to keep the sections short in order to not overwhelm someone who may be struggling to concentrate on the writing. I for one appreciate this as I do go through phases where the ED obsessions/compulsions get so strong I struggle to read anything at all. She made the book accessible to those who need it most. The only down side to this is that the book is shorter than it looks; with the chapters finishing every few pages and leaving most of a page blank, there was a lot of blank space. However this couldn't really be avoided when trying to keep the 'bite-sized chunks of information' structure. 

Although I think this book could help a lot of people to some extent and is worth reading, I am not sure how I personally feel about the personification. The more the eating disorder is personified, the more I cringe. And yet I still do personify it to some extent because it really is the only way of explaining and coming to terms with what living with an eating disorder is like. I try to reduce the *cringe* by referring to my ED as simply 'it'. I can do this without even knowing sometimes, because when trying to explain how I feel to people, I have to clarify that I know that what I am saying is contradictory and illogical. And that I can see things perfectly sanely whilst still acting on fucked up beliefs. The person I am talking to has to understand that they are basically talking to two people, and it's no use telling ME that I am being stupid, because I'm not the one who needs to be convinced... or am I? I don't know, I don't understand. But I guess it makes it ten times harder when you can't separate yourself from the illness at all, and that is the premise that this book builds upon.   

I also reject therapists suggestions to write a letter to 'it'.
No fucking way, no way is my eating disorder getting a letter. Telling it how much I hate it and that I am a valuable individual without it - it will only laugh in my face and turn me against therapy. Of course, Schaefer says towards the beginning of the book something along the lines of 'If you're thinking this book is stupid, that is probably Ed talking'. And then, before I know it, there is a voice in my head saying 'don't listen to her, of course you don't have voices inside your head!'.... and, that just proves her point :/

The thing is, I define 'hearing voices' as something a schizophrenic would hear, and whatever is in my head is not like that. I don't actually 'hear' anything. So why do so many people with an ED refer to it as 'a voice?' Why do I? It's like... I know what it's said, but I can't remember hearing it. I think the fact it is so subtle is part of why it is so deadly. The bullies that are subtle are the ones that can get the closest to you by pretending to be your friend whilst messing with your head, deeper and deeper. Hence one thing I definitely agree with this book on, and something that I have in the past used to explain to people why I can't let go of my eating disorder, is the 'abusive lover' analogy. However Schaefer goes a bit OTT and writes out a whole divorce document in order to end the marriage to her eating disorder *CRINGE*, complete with witnesses to sign it. If that helped her though, great. 

Why the hell would you refuse to let go of someone who is destroying you inside and out? You will indeed find a none-pathological answer in all those people clinging to abusive relationships. Manipulation, guilt-tripping, LOVE, the words 'I promise I'll change', 'you made me do that, you hurt me, it's your fault I hit you' 'if you leave me I'll kill myself, please don't go' 'You are nothing without me' 'I will always find you'. And some of the most abusive lovers are the most loving, caring and seductive, as part of their cruelty, whether intentional or otherwise. You fight and you nearly leave, but then the kindness and character change makes you stay. You deny to yourself how bad it is. They convince you time and time again that they are worth it. So does the eating disorder. Every time you decide 'I'm going to recover', you pack your bags and leave. But sometimes within just minutes or hours, you're back on the doorstep desperately wanting back the 'safety' and familiarity of 'home', no-matter how painful 'home' is. Even if you realise they are not worth it, you still cannot stop loving them, and love makes us irrational.

It sounds quite sick to suggest that I love my eating disorder. And yet, sometimes I think love is the only emotion strong enough to make me cling to something so damaging. 

Some believe that this voice, that isn't actually a voice, is simply an extension of the 'internal critic' that everyone experiences. But for me I know what my internal critic sounds like, and I still get it, obviously. And I don't link that to my eating disorder, as I know that critic isn't disordered and it would remain even if I made a miraculous full recovery. Just like I believe anorexia is NOT 'just a diet gone too far', I also believe the anorexic voice is NOT 'just the internal critic gone too far'. It is much more sinister than these two theories imply. I experience the critic as being me, and the choice I made to try to eat more healthily I experienced as me. But the 'voice' and illness that then took over, feels more like a disease. A parasite entering my brain and fighting violently to survive, to feed off my body and soul. 

‘I continued reading over the menu. I heard, “Order the highest calorie item – fettuccine Alfredo.” I figured that Ed had some new tactic and was just trying to confuse me. Then I hear, “If you don’t order the fettuccine Alfredo, you are anorexic.” I looked up and saw that someone else had pulled up a chair.’

‘”Counter Ed” is my new dining partner. Counter Ed encourages me to overeat in order to guarantee that I am not under eating… He says, “I am here to help. It’s either Ed or Me.” Although counter Ed pretends to be my ally, he is really just as controlling as Ed.’

These lines really hit home with me as I have never heard anyone mention it before, but I too encountered 'Counter Ed/ anti-ana' as I made some progress in recovery. I said to people that it wasn't as simple as not doing what the ED says, but I couldn't explain why. The answer seems to be here; how can I be sure that I'm not listening to Ed when he manipulates everything I try to do? If I choose something that is medium calories/fat, how to I know whether I'm actually compromising with Ed, making deals with him that if I eat that then I can cut out something else later? The only way I was making sure that I definitely wasn't ANOREXIC, was by choosing the biggest most calorific items. But then this would only fill be with resentment, and in the end only make me go crawling back to Ed in tears. And then Ed, or a relative of Ed? would say; deal with that pain of eating all that food, by having a competition to stuff as much food down as you can. I actually remember writing in my diary 'If I shove an insane amount of food down, I can prove to myself that I definitely can't have a fear of food, and I can prove to everyone else that I definitely can't have Anorexia'. It didn't occur to me at the beginning that this was called bingeing, and this in itself was an eating disordered behaviour. I just saw it as a spiteful 'let's use recovery to self harm. If people want me to eat, fine, but I'm going to make sure it is damn painful'.

Another example of the manipulation and mind games that constantly torment you until you wonder whether you are going even more mad in recovery:

‘This far into recovery, Ed has new tactics to keep food at bay. Tonight, it was one of his new favourites, “Nothing here fits into your food plan.” Ed actually acts as if he supports my food plan and uses it against me.’

In my opinion this quote sums up eating disorders quite accurately:

‘Eating disorders are really about excessive control, painful perfectionism, and stubborn self-hatred. They are not about whether or not your thighs touch, the width of your hips, the size of your butt, or the number on the scale.’

In conclusion, I think this book is helpful to stimulate your own imagination in being able to personify the eating disorder in hopefully a productive rather than destructive way. Despite my reservations around talking about Ed as though he/she is a person, I think if only I would stop judging myself for this/ worrying what others think of me for it, I could benefit from it. It actually seems easier to verbalise my thought processes once I use the personification as a prop. That can only be a good thing, right? Some people I have encountered seem to have the view that by doing this you are somehow wallowing in your madness, by creating a fictional character. I get the feeling they fear I may actually start to think this character is real. But they don't seem to understand that this 'voice' in my head couldn't get any more real. It is my reality and the sooner I accept that and stop trying to deny it, the sooner I can be more alert to and prepared to fight its' games.  

P.s. Apologies for the small writing, it seems to be refusing to change :(

Is the negative definition of pro-ana indirectly adaptive?

Here are some of my ramblings inspired by the ramblings of Ednose :P (on one of the support sites I use).

Pro-ana is a very complicated concept. (I am going to receive a beating from the eating disorder for saying the following, but it needs to be said).

An eating disorder is so clever that in order to escape in any way, we need to be one step ahead and trick the tricker. You can't fight it head on; if I go to therapy it realises exactly what's going on and fights back harder. You need to trick it into a false sense of security then sneak up behind its back. What better way to do so than to type 'pro-ana' into the internet, meaning 'pro-destruction'. This is what I did to find PT. The ED thought it was great, at first. The outside package of 'PRETTY THIN - pictures of skinny girls, skeletons, silly teenage girls saying 'keep strong, don't eat'' - this package that society falls for (therefore labelling the site as horrific) the eating disorder also fell for, as ED loves horrific. It settled itself in, but before long it started to get a bit concerned at how much I was talking on there and giving away - how honest I was being about my illness for the first time in my life, because noone was judging me any more - people understood. The ED started to realise that something was very wrong and that this wasn't a pro-destruction site at all - those 'ana is a goddess' members floating around on the surface were all a trap to trick the ED into letting me join the site. The eating disorder was enraged to find that the members who stuck around long-term were there to help ME, not it. But it was too late to go back, because all those emails I received and conversations I had, containing long and carefully thought out messages of genuine support, from strangers who did not need to give me the time of day, but did; made me trust the community just as much as I trusted the eating disorder. I had never trusted anyone as much as the ED before I typed in 'pro ana'. I know that to conquer the ED I need to trust something more than it, ideally put all my trust into my true self. But for now trust in others who sincerely understand has brought me a long way in coming to terms with who I am, what my disorder is and how I can continue to make steps to live my life the best way I can despite it. 

I maintain that we were right to keep the term 'pro ana' in our site address, because I suspect I'm not the only one who was only permitted to join a support site because the words pro-ana pretended to welcome my eating disorder and destructive nature. It didn't realise that there is a difference between 'welcome' and 'acceptance'. 

It is controversial, but perhaps the magic of that term is reliant on the negative definition of the term, rather than the positive one? Maybe it would actually be a big mistake to change the definition into completely positive, because then... would a mind so severely chained down by the ED mindset really be able to search for support to help themselves, rather than entering support through the back-door illusion of Ed's best friend 'Pro-kill ourselves -ana'? 

Pro-ana appears to provide a way of denying to ourselves that we are seeking help > in denying it to ourselves we are preventing the ED from catching on, in order to prevent the ED digging its heels in and screaming until we reject the support. Secretly we are calmly receiving support behind its back x

Zero

By Diane Tullson

Thankyou to whoever recommended this book - I sadly can't seem to find the comment with the recommendation, but if it was you please let me know :)

This is a fictional novel which I think would be suitable for young teenagers. Bearing this intended audience in mind, I have given it three stars; compared to other fiction for this age-range, such as Wintergirls, rather than comparing it to adult memoirs/novels that are obviously (hopefully) going to have more depth. Compared to Wintergirls I felt Zero was a story I could personally relate to, while with the former I experienced no sense of connection at all.

I think Zero conveyed a basic but accurate portrayal of how Anorexia/Bulimia can sneak up on a person so subtly yet rapidly. I liked the fact that it may help break the often inaccurate assumption of the disorder being driven by the media or societal pressures to 'be skinny'. I found Kas (the protagonist) to be very wholesome underneath the disorder; she comes across as sensible and likeable, which I hope helps young readers to see that Anorexia is not a 'stupid person's disease', or a 'vanity disease' and that it can drive even seemingly well-functioning minds into madness. I also liked the reference to her art work expressing the disorder taking over her mind and body.

What I didn't like about this book is that it seemed... half empty? Strangely I got the same feeling with this book as I did when reading 'The Bell Jar'; every time I thought 'this bit could be really good', the bit never finished. I wanted to add extra pages in to explore the parts I really thought had potential if only they weren't skimmed over. One example is the part where she seems to randomly go to a different town and ends up in a car with a scary druggy man/boy. It is inferred that she slept with him, however it does not go into detail. Perhaps this was due to the young audience? But I still felt that if that was going to be included, it should have been included properly (exploring this experience and her feelings around it in more depth), or not at all. It seemed out of the ordinary for her character to do, so maybe it was demonstrating a bit of teenage rebellion, or an eating disordered self hatred and purposeful intention to harm herself through a disregard for her own safety and feelings?

Another example is Kas' family; we hear about them briefly, but we never actually meet them. I would have liked to have been introduced to more of her background from before she went off to college, or perhaps we could have gone with her when she returned home due to her illness?

I do however appreciate the Author's notes at the back of the book beginning with the statement: 'Whenever authors write about eating disorders, they risk trivializing the suffering of real victims, who live in a world that is unreadable in its horror. In writing Zero, I hoped to give readers a glimpse into the dark world of self-destruction that plagues people with eating disorders.' - I think she did indeed give a 'glimpse' into the dark world of self-destruction, and maybe this was a suitable glimpse for the age group. However for me, a glimpse was not enough. It is a hard one because as the author acknowledges, the reality is so disturbing that perhaps this wouldn't be suitable for a teenage book.

Within the author's notes she details useful to-the-point facts regarding Eating Disorders; I felt this was responsible to do in order to educate young readers on the warning signs and what to do to help with compassion if they or someone they know is suffering.

In conclusion I felt the book was okay for a very light read and a brief introduction to eating disorders, but I found the plot as a whole frustrating with what seemed like lots of hoax starts to sub-plots. In addition, the ending was weak; the story seemed to stop abruptly when Kas starts receiving treatment. Also, her eating disorder symptoms don't really appear to emerge until nearly two thirds of the way into the book. Although I appreciate that it may be important to show how the person's life can start out as pretty normal, I think the book could have been a bit longer to give sufficient time to the eating disorder experience itself.

Andrea's Voice: Silenced by Bulimia

By Doris Smeltzer with Andrea Lynn Smeltzer

This heartbreaking story is told from the perspective of Andrea's mother. Scattered between these writings are excerpts from Andrea's diaries, including her poetry. Although I can acknowledge the beauty that others find within poetry, I am someone who doesn't really appreciate it myself. I wish I did, but I can't seem to help it. Although I like 'deep' prose, for me a poem has to be very clear in its meaning in order to hold my attention. I also find diaries hard to read, as diaries by their very nature are usually un-organised and rambling. Therefore merely personally, I found it difficult to keep reading through every word of poetry and diary at times, although I made sure to do so in respect for Andrea's memory and talent. Admittedly the diaries were needed to express Andrea's character and experience in her own words; as the title says, her 'voice'. Perhaps the very fact that diary form was the only way we could hear her voice, was testament to the fact that she didn't live long enough to carefully craft a book herself which maybe she would have done had she recovered.

Overall though, I learned a lot from this book regarding the reality of just how quickly an eating disorder can kill a sufferer, seeing it from a parent's point of view, and gaining some understanding as to how someone deals with grief in such a circumstance. Nowadays I seem to be more emotional anyway, perhaps due to therapy and no longer numbing every single thing, however it still takes me by surprise when a book manages to cut through my still often present detachment. Even though I knew from the start of the book that Andrea would not survive, reading the words describing her death hit me hard, and the tears flooded out even though I have no connection to this family. I was deeply touched, also by the solidity her family showed in trying to help her. 

 ‘All the “experts” agreed – Andrea would heal. We caught the behaviours early. Again, we heard that we had nothing to worry about.’

 ‘Andrea died in her sleep approximately six hours later [After the last phone-call with her mother]. Her body was found lying in bed with one leg on top of her down comforter, the right corner pulled down in a triangle, and one arm resting under her head. She never made it home to open her report card. She had earned straight A’s that semester.’

I think the ultimate message that I took is that with all the care, love and determination in the world, even with jumping in quick and paying out for therapy, an eating disorder sometimes still cannot be beaten. From this I don't think we can conclude that it isn't worth trying, quite the opposite; That professionals and society should take it seriously and treat the patient as soon as possible, because this is a killer disease with claws just as strong as a malignant tumor invading the body at a rapid pace. Not being hospitalized or able to function in every day life does not make you immune to sudden death from an eating disorder.

 

‘For those who survive, it can often take an average of four to seven years for a sufferer to begin the healing process in earnest' 

Again, the above quote is a fact which professionals mainly deny, if not in words, in action, by the fact they prescribe as little as 6 CBT sessions for treatment (or nothing at all), and then that is it; the message is you should be better after that, or rather they will twist it with the feeble justification 'you need to take responsibility for your own recovery'. You wouldn't justify refusing to continue giving chemotherapy to someone who is likely to die without it, with that sentence. I suspect that average of years to begin healing is true. At least, I can relate to that average almost exactly in my own recovery; After coming out of hospital I denied for 4 years that I had any problem at all. During the 5th year I sought treatment myself but still did not admit I was not recovered to my family until the 6th year, when my seeking of treatment from the government still hadn't gotten me any at all. It was finally time to ask for moral and financial support, and with that had to come the admittance that I was finally ready to start healing. Until I could admit that openly, even though I was no longer lying to myself, I still didn't have any real conviction that I was ready. Today, that conviction continues to go and come as the disorder gets stronger and weaker, sometimes by the hour.

‘‘In the treatment of Hodgkin’s Disease or Leukemia, waiting around for the individual to get sicker would be considered outrageous and unethical, yet it is done every day with anorexia (and bulimia)’- Marcia K. Ove, “The Evolution of Self-starvation Behaviours Into the Present Day Diagnosis of Anorexia Nervosa: A Critical Literature review’. 

 ‘I denied to myself that Andrea could lie to us as bold-faced as she lied to herself. I knew nothing of the manipulative nature of eating disorders, or of their deceptive, chameleon-like ways.’

There is a cruel irony in the fact that those with eating disorders often have a personality in which there is a relatively clean past record of lying. The eating disorder uses this to feed on; the trust that family and friends may have in what the sufferer claims to be the truth. But many also fail to realize that it isn't just they who are being deceived by the illness, but the sufferer themselves. The guilt the true person underneath the illness feels gives rise to a defense mechanism, being that of, in some dimension of the psyche, believing their own lies. How can a deluded person appear so sane and convincing to someone on the outside who thinks of themselves as rational? The very fact that people with eating disorders can sometimes appear so healthy and 'with-it', makes it all the more dangerous.

 

‘After patiently listening to me rant for over twenty minutes about how I could have saved my daughter if only I had tried harder, the wise counsellor had asked “Do you really believe you are that powerful, Doris?”... I could finally hear the words – that when we look back at the “should haves” and “if onlys” we tend to see them in a stagnant, one dimensional realm.’

Unbearable Lightness

By Portia De Rossi

It's scary that's it's been over six months since I last wrote here. I'm back at university. I'm failing. I don't want to talk about it. I'm still reading 'Fasting girls'. I find it quite heavy going compared to these memoirs. Below are the quotes I can relate to the most within 'Unbearable Lightnness', but since I got a bit carried away with discussing them I will summarise what I thought of the book first:

Surprisingly good. Due to Portia being a model, actress and celebrity, I feared that this memoir would come across as being a book written for the sake of writing a book, purely to make the person even more well-known. If this was the case it worked; I had never heard of Portia De Rossi before now. However I do not think this was the case here. Her writing came across as refreshingly sincere and there was no material that appeared to be there merely to provide extra padding. If it wasn't for the fact that her everyday work would appear on TV screens and she had to dodge the paparazzi, Portia appears to be a 'normal' person. By normal I guess I mean that she has the same fears and worries as everyone else, and stardom hasn't gone to her head. She also dedicates adequate space to describing the binge eating side of the disorder/another disorder, which can often occur alongside, pre or post-AN, but does not get as much attention paid to it in the literature.

I think the only downside is that it could be triggering to those currently suffering from or vulnerable to developing an eating disorder as she describes her exercise in quite a lot of detail (relatively), plus precise numbers are used to describe her food intake and weight changes. However I personally do not have a problem with this. I found the exercise description and feelings/the compulsion as something I could relate to which like binge eating, other books appear to skim over. 

P8 ‘When it’s quiet in my head like this, that’s when the voice doesn’t need to tell me how pathetic I am. I know it in the deepest part of me. When it’s quiet like this, that’s when I truly hate myself.’

People seem to think that the voice will get quieter if I ignore it. They think that will be a sign that I'm getting 'better'. But actually Portia is right in saying that when the voice gets quieter and goes silent; that is when it doesn't feel the need to shout any more. If I do start making progress, or let any therapist in to my thoughts, it shouts, throws things around my brain, trashing everything, it gets louder and louder until the SCREAMS of agony make me petrified. I lash out with the anger of the raging inside me, but also in fear. The pain is beyond any physical pain I could imagine, way beyond the pain of cutting through the layers of skin in my arm until I can see bubbles and bubbles of fatty tissue and can look deep inside the hole. It is like when Voldemort's diary is stabbed with a Basilisk fang in Harry Potter (this reference has completely ruined the serious nature of this description, but it does provide quite accurate imagery if you've read/watched it). It screams because it can feel people trying to kill it. That's where my rage comes from. That's the way it felt when I was 13, and that's the way it still feels now. You can't see it, but at the times when I can no longer keep it from piercing my mind through to everyone else's reality, it's using my lungs to scream and my limbs and force to punch and throw my body at walls like a rag-doll. Added to that racket is my own terror. It is as though someone has grabbed you, they have a knife and you're fighting for your life. I try to kill them. I try to smash this monster's skull against the wall until it breaks and the source of this pain, that brain, is crushed and lifeless. That is my head. That monster is me.

Hence the following statement I believe also to be true:

P279 ‘Gaining weight is a critical time. The anorexic mind doesn’t just magically go away when weight is gained – it gets more active. Anorexia becomes bigger and stronger as it struggles to hold on, as it fights for its life.’

I'm too tired to discuss the rest of the quotes, but they're probably pretty self-explanatory so I'll just type them down:

P241 ‘I sometimes saw a teenage girl with no breasts and no curves that would turn her into a woman with desires and complicate her perfect, sterile life.’

P278 ‘I was diagnosed with lupus. I had osteoporosis and was showing signs of cirrhosis of the liver. My potassium and electrolyte balance were at critical levels, threatening the function of my organs. I no longer felt lazy, like I was giving up because it was too hard, I felt defeated. I felt as though I simply didn’t have a choice.’

P280 ‘Recovery feels like shit.’ (The process that is, she is referring to, not the end product)

P281 ‘Being diagnosed with Lupus was like a pardon; it granted me the freedom to give up... I could no longer starve or I’d die. Therefore, it was essential to eat. So I did. I ate everything in sight... The floodgate had opened.’

P281 ‘Just because I’d stopped starving didn’t mean I didn’t still have an eating disorder. My eating disorder felt the same to me. It took up the same amount of space in my head... It was still there. It was the other side of the same coin... I went from 82 pounds to 168 pounds in ten months.’

P283 ‘Despite the fact that I thought anything other than anorexia was a second-class eating disorder not worthy of attention, when I was being treated by Carolyn I was severely bulimic. I was grossly overeating. The pendulum had swung the other way, and I was sicker than I had ever been in my life.’

P284 ‘I knew that I should work out again to combat the amount of food I put into my body, but because being fat caused me to be depressed, I didn’t have the energy. That’s the feeling of pulling away from anorexia. The anxiety of feeling fat turns into depression about being fat, and the lethargy and apathy that depression brings make it impossible to get off the sofa.’

P287 ‘I never wanted to think about food and weight ever again. For me, that’s the definition of recovered.’

Life Inside the "Thin" Cage

A personal look into the hidden world of the chronic dieter

By Constance Rhodes

Shall I start with the good points or the bad? I think I'll start with some observations then go on to the bad and finish off with the good ;) ... All in my personal opinion of course.

Okay so firstly, I'm still not sure whether this book is about eating disorders or not. The author suffered with a subclinical eating disorder and describes EDNOS as being in the middle of a continuum; with anorexia, bulimia and binge eating (serious disorders) at one end, and healthy eating at the other. From this we can conclude that the diagnosis of EDNOS is subclinical and not seen as an extreme problem. Before reading the book I did not realise that EDNOS was classed as a subclinical disorder, because in my view; just because someone has eating disordered behaviours which are not 'specified' in the criteria for anorexia or bulimia, it doesn't mean to say that their behaviours aren't as extreme, or life-threatening or not worthy of being classed as an actual disorder. To me, 'Not otherwise specified' doesn't imply 'mild', it merely implies that the DSM isn't advanced enough to label the disorder properly.

So, I think the author's intentions were good; to shed light on EDNOS and how being labelled with this puts you in a rather difficult position; It is as one professor she quoted said 'A wastebasket term' - Dr Harry Quirtsman.

I do not doubt that the author suffered from an eating disorder herself, however I do feel that the book gives people completely the wrong impression about what an eating disorder actually is. In my opinion, 'chronic dieting' is not part of a mental illness. I did work experience a few years ago at a hospital, and at lunch times I ate with the staff who were women aged perhaps between 20 and 40. There they were contantly comparing lunches, telling me they were allways on a diet and quizzing me about my skin and food intake. My mum says it is the same in her work-place. But my mum also says that she sees no parralells between the behaviour of the chronic dieters at work, and my behaviour as someone with a mental illness. I said to her 'maybe you just don't know what's going on behind closed doors?' However I suspect that she is right; An eating disorder is not a diet gone wrong.

'Life inside the "thin" Cage' seems to confirm the stereotype of eating disorders that the media flaunts; that EDs are just vain cultural values magnified; Starving to have sex appeal, to feel wanted by men, to make other women jealous when you enter a room, that 'thin' equals success. I can't speak for everyone and I know some people say their eating disorders are driven by this, but if this is true I feel it is the exception rather than the norm. I think emphasising this encourages people to believe that eating disorders in general are not a proper mental illness, and therefore not worthy of treatment.

That said, the book did make some very true and important points. For example the author acknowledged that the typical approach to treating eating disorders; making food diaries and weight charts, can in fact be detrimental to recovery, depending on the person. The author suggested a variation on intake recording which I hadn't thought of before; Instead of tracking the precise amounts of food ‘...I focused on tracking which food groups I was eating. I found this approach to be much more helpful and less likely to trigger obsessive thinking.'

Something she said which I think is helpful to apply to life in general was ‘The trouble with seeking to impress is that it requires so little of our heart and soul. But to inspire... that must be the greatest of accomplishments, for inspiring others allows us to be a part of something so much bigger than ourselves.’