On Choice (Again)

I think the least controversial way that I could possibly start a blog post is by saying that Anorexia Nervosa is a rubbish, awful, horrible illness. I would go as far as to say that it is so awful; so destroying, that it is generally understood that Anorexia is neither a choice nor a desire.

Choice in mental illness is an area that interests me: there is little of it, officially. Where you live dictates what sort of treatment you get; how quickly you get it; whether you are eligible for inpatient care or must battle through as an outpatient.

When I was very poorly, I thought that I didn’t have any choice. I thought that Anorexia was part of me and part of the course of my life. Sometimes I believed that it was my future and that Anorexia and I would always and forever one and the same, it having more claim to my body than I did.

I remember talking to a tutor at Uni one day. She had some understanding of mental illness, and had been a vital source of support to me during my final year. We were talking about what was going to happen to me after I’d finished my degree. At the time, I’d been given an ultimatum by my consultant psychiatrist: start eating or be admitted to hospital, and I was bemoaning the upcoming unavoidable admission to the tutor.

She asked me why I couldn’t just start eating. I think, at this point, that I stood up and flounced out: she couldn’t possibly understand me, or how Anorexia ‘worked’. I couldn’t just ‘start eating’ because I had an illness.

I wonder, now, how much this belief was one given to me by Anorexia. It’s possible, of course, that I was so depressed and fed-up of being ill that I had given up. However, it’s also highly possible that Anorexia, an illness which relies on the manipulation of thought in order to continue, instils the idea that it is impossible for someone to simply ‘start eating’ – isn’t that, after all, the mainstay of the illness: a complete absence of self-belief to the extent that one believes that they do not have even the ability to feed themselves?

Now – and I’ve said this before so please bear with – the best part of my life is knowing that I am powerful enough to have the choice between starving and eating.

Whatever happens – and this, I believe, is the fundamental truth that many people with Anorexia, including myself, refuse to believe -, there is absolutely no reason that someone with Anorexia Nervosa cannot eat.

My brain was sharp enough to create obstacles as quickly as I needed them: anything so that I didn’t have to eat. Of course, I could have started to eat as much as I wanted at any point in time, but I also had Anorexia, which meant my brain was overtaken by a rabid desire not to. Food would be the wrong type; the wrong colour; the wrong shape. It would be too late; too early to eat. The cutlery would be wrong; the people at the table would not be the ones I wanted to eat with. The protective rituals, painstakingly designed to make eating as unlikely as possible, building a wall to keep other people out of our (mine and Anorexia’s) secret starvation pact, because – where plenty of people will wade in and tell you that food is necessary and won’t make you fat – most will not meddle in intricate compulsions and increasingly irrational behaviour.

There was a long time when I tried to convince people I was trying, but it was just so difficult because of the other things happening in my head. Being brutally honest, I was hiding behind that. Yes, those irrational beliefs about ‘other stuff’ did exist, but only because I was desperate not to eat.

They were my safety smokescreen.

What inpatient treatment – and my wonderful key nurse – taught me was that I didn’t have to hide anymore. I was allowed to choose to eat and I was allowed to look forward to life without Anorexia.

What they also taught me was that that wasn’t just going to happen.

Nobody was going to remove my smokescreen for me. I could keep it there for as long as I wanted, but I would also remain ill for that time.

I – and this is the important bit – couldn’t have it all: there was no way I could be Anorexic and happy.

And there was my choice. Cut away all the rubbish that I had built up to protect myself and eat or face a lifetime of misery, confounded by the rituals that were hiding the stark reality that I could eat if I so chose.

And, eventually, it had been long enough and I had to make my choice.

Slowly, very slowly, I began with one lunch. And then it was one lunch and one tea; a day’s worth of eating; a week’s worth; a month’s.

It wasn’t perfect, and I’m not perfect and there are times in my life when I let my guard down and the belief that I do not have a choice; that there is something special about my brain that means I cannot eat, slips back in.

And it is difficult. Because it is hard to recognise and swallow the idea that I can be manipulative and self-sabotaging. It is difficult to accept that I am not eating not because I am helpless, but because I am making the choice.

But knowing that the choice is mine is powerful.

It means that I can get better.

And what is more powerful than grasping your own future with two hands and fighting for it?


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