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All that glitters...


This week Emily T. Troscianko, Knowledge Exchange Fellow at the Oxford Research Centre in the Humanities, and member of the Medieval and Modern Languages Faculty at the University of Oxford, writes about anorexia for our series of accounts by experts-by-experience. Emily (pictured above) also contributes to Psychology Today with a blog called A Hunger Artist.

If there’s any mental illness that offers the sufferer an illusion of having it all, it’s anorexia. The twin towers of that disingenuous promise are thinness and control, bedfellows familiar from pop psychology and the diet industry. No other mental illness gets under observers’ skins (incomprehension, fear, anger, envy) quite like anorexia, and that’s because none other is quite so physical. And it’s in the interplay between the mental and the physical that the hollowness of anorexia’s illusions gets exposed.

In the early days, the heady ‘hunger high’ gets you hooked, the admiring comments about your weight loss keep you hooked, and very soon starvation has kicked in, and then all its profound psychological effects, and all the tenacious feedback loops between the physical and the psychological, make it extremely hard to get unhooked. Take hunger, for example – a powerful nexus of some of the central paradoxes of anorexia. It’s extremely rare for anorexia to involve a consistent absence of hunger. In the vast majority of cases, hunger is an achingly constant companion, and the moments of endorphin-fuelled exhilaration grow rapidly rarer.

Hunger is the thing to be denied – to yourself and to other people (no thanks, I’ve already eaten). Hunger is why you starve yourself – what higher proof of control than shutting your ears to that screaming bodily need, day after day? But hunger always risks stopping you starving yourself – the closer you get to total control, the closer you get to its opposite, in this case bingeing. Hunger is why eating is the most important thing in your day, to be controlled to perfection and indulged in with ecstasy. Hunger distracts you from other pain, and is the ultimate distraction from anything more meaningful. And because so often denied and debarred, and because of the stomach shrinkage and digestive lethargy that come from denying it often enough, hunger deserts you and nausea attacks at the critical moments when you really want to try, and try to want, to eat: on your brother’s birthday, in exam season, when you embark on recovery.

Most of anorexia’s apparent paradoxes can be explained with reference to the feedback between mind and body. And of course it’s this feedback that unravels all the seductive promises, topples the towers: thinness can buy you, for a while, the illusion of having your life under control (doesn’t everyone know self-control = not eating quite enough?), but soon it becomes clear that the thinness is the source of all the frightening opposites of control: the depression, the anxiety, the obsessive-compulsive thoughts and behaviours, the constipation and night cramps, the need to work ever longer hours with ever less concentration or overview, the inability to give time or energy or joy to being with other people, the hunger and the cold and the losing of all sense of self beyond them.

Each of these can dress itself up as a silver lining: if I never go out I’ll get more done, if I spend hours hunting the supermarkets for the cheapest margarine I’ll save money, if I memorise all the word counts in all the documents I have open before I shut down – well, for me, that was where the illusion crumbled. The OCD was the most damning revelation of the extent to which the anorexia controlled me rather than vice versa. It kicked in when my weight dropped below a threshold it had hovered at for years, and it melted away again at the point in weight gain where my therapist had said it would.

All anorexia’s many silver linings turn out to be tinfoil. Their shininess makes it very easy to get very ill very quickly, and can make it hard to get more than semi-well in recovery; they keep catching your eye and making you turn back, still a little bit enthralled. But once you’ve seen it for what it is, and lived through enough of its whispers, that seduction is anorexia’s death knell and its saving grace. It’s what makes you seize your slice of cake, laugh in its face, and reject both thinness and control as nothing but the punchline of a very dirty joke.

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