Mealtimes and Milestones (4 page)

When I got to lunch, though, I just broke down. I couldn’t keep going. I had eaten breakfast and snacks and I just couldn’t face lunch. At first I even found it hard to look at the
plate, but slowly I managed to see that eating it orally would be much less painful than being fed through the tube, and eventually made a start. I was shocked and annoyed, though, that I
didn’t receive any support from the nurse. I don’t know if it was on purpose, but I just found it strange, because she could see that I was crying and obviously stressed. When I asked
for a tissue the student nurse brought them over. She put the box next to me and I took one, but then the nurse said, ‘No, take the box away.’ I got the impression that either she was
seeing what I could do on my own or she was cross with me because she had allowed me to go to church and now I was struggling to eat lunch.

I ate most of it, but I couldn’t get on to my pudding, even though I knew that meant I’d have to have a feed by tube and I didn’t want it to happen.

I tried the wrapping method again at snacks, but I was concerned because I couldn’t see the actual amount of calories on the packet. It has become an obsession. If I don’t know I
become more scared. What if I put something high in calories in my body which I don’t deserve?

I talked with one of the nurses between snacks and tea. I said that I found going to church really helpful because it got me through breakfast, but afterwards I felt a huge burden of pressure to
go on eating to prove that I’d deserved to go, but also pressure from my anorexia
not
to eat
.
I really want to get better, I know I do, but I can’t. I just can’t.
There’s no hope for me. It is pointless trying because it is just going to be another thing on the long list of things that I am going to fail at. It doesn’t make sense when people say
differently.

I was worried about tea because I just kept reflecting on what I had eaten, and it seemed so daunting that yet again I was going to have to force more food inside me. It’s fuel, but also
my poison. The nurse reassured me that I can only do my best, but I didn’t want to let that train of thought make me not eat anything, because I know that it’s just going to be fed to
me through a tube anyway.

It was sandwiches for tea. It was as hard as I expected. I kept adding up all the food in my stomach, all that repulsive, toxic, sickly stuff that you have to put inside you. I didn’t want
my pudding given to me. I couldn’t even look at the food because it terrified me so much. I could see what I had to do. It’s a natural process, but it was all too much. Just the one
sandwich seemed like a mountain on a plate. I have this very strong image in my head which has been with me for a very long time and therefore is deeply planted in my head. It’s of a flat
abdomen – it’s already full of your guts and stomach, so eating just expands it, and that’s exactly why I don’t want to eat.

A letter from one of my school friends

Before evening snacks I got talking to one of the other young people which I really enjoyed and we were able to share our experiences. She finds it hard to go into the dining room, so I offered
to hold her hand, and I sat with her and offered her support. I enjoyed the evening because we could relate to each other and exchange support. It upsets me that such a lovely girl is struggling
with this illness. It’s a stupid, destroying illness which no one should have to go through, but this is what I deserve, so I just have to live with that.

Monday 13 August

It was weighing today. It’s always so hard, but today I was quietly confident that I had lost weight. Even though the hospital didn’t want that, I want to feel
like my efforts of starvation have paid off. And they had, so I finally felt proud of myself, something that I haven’t felt in a long time. I know in the back of my mind that I can’t be
proud of this, but I am, and I can’t help this.

The first activity at Willen Lake was ‘Katakanu’. It’s a six-person canoe. It was really good fun, but it brought back feelings about exercise, and how I’m not allowed to
do much now. I found it really frustrating, because it made me just want to go running and let all my troubles fall away, but I managed to put these thoughts out of my mind and I was just thankful
to be out of the hospital for a day.

We sat down on the grass to have lunch. I hadn’t been to Willen Lake before, and this was my first meal out in public. One nurse positioned herself so people couldn’t see my tube,
which was helpful. I couldn’t manage it all, I couldn’t find the motivation. Technically, because I didn’t eat everything and wasn’t up to date, I wasn’t allowed to go
on the low ropes, but the decision was made to let me go anyway. Although I was grateful, it made me wonder – does it mean I can get away with other things as well?

The low ropes course reminded me a bit of my struggle with anorexia. The whole course was hard, but some bits were so hard that I needed help and support from other people to be able to cross
the bridge and continue on.

We had snacks on the bus back, but I completely shut down. I had eaten enough to be able to participate and now I couldn’t do any more. I feel bad for doing this, though, because I should
still keep my motivation up, and not give up like that. I shut down as well at tea. The nurses had warned me about becoming reliant on the tube, and now it was coming true. I figured that I was
going to be fed anyway, so what was the point in eating and facing all the emotions that come with it? Eating is only there to keep you alive, and I don’t want to be alive.

Tuesday 14 August

We were going to the cinema today, and I felt so much pressure to complete my lunch. Was it really going to be worth it? Is it worth all the anxieties for a few hours
watching a film? I didn’t know, but I had to at least give myself the opportunity. I cried and cried the whole way through lunch. They were tears of frustration, fear, sorrow and pain.

We watched
Evan Almighty.
I had loads of emotions again about going out in public. What would people be thinking about my tube? Would they think that I was dying? It didn’t look
that dramatic, but that’s what I wanted people to think, because that’s what I want to happen.

We had to have afternoon snacks later than usual; I only managed a few dried apricots. I had decided before that I would only eat that much, and when I do this I absolutely can’t eat any
more because otherwise I will be punished by the voice, and I’d rather not eat anything than be bad and get punished.

After tea my key worker asked me whether I would rather try and make up my intake orally at eight o’clock or just get it tubed now. What a decision. Part of me
enjoyed the tube, part of me hated the tube, part of me knew that I couldn’t and wouldn’t make it up at eight o’clock, but part of me wanted to try. I eventually decided that I
would rather that it was just done now, because then it’s over and done with. So that’s what happened.

Wednesday 15 August

I had a really positive attitude today. I don’t know what changed, but it was just there. I was going to eat everything and get the tube out. It was going really
well until tea, but then the plate of food that came out in front of me was huge, it was too much.

The voice kept talking to me:

‘You can’t do it. If you do eat it you know that I will punish you.’

I cried and cried all through it, and when pudding came it just made it all worse because I had just climbed one mountain and now I would have to climb another one.

I finished, but I just had to get out of the dining room, and I locked myself in the toilet again. I didn’t know what to do, I was being backed into a corner and suffocated by my feelings,
I just wanted to scream, I was breathing quick, deep breaths and my heart was pounding, it felt like it was going to jump right out of my chest. I began to scratch at an area on my wrist until it
was all red. I’ve never done anything like that before, but I was too lost and confused and I didn’t know how else to help myself or let others help me. Punishment is what I need.

I spoke to my case manager
¹³
because she could see that I had been crying. She wondered what staff could do to help me after meals. I don’t know
though, I don’t know anything. I know that I like to be alone, which is true. It gives me a chance to organize myself and drift away. She said that it often wasn’t healthy to be on your
own because you can often just get deeper into your negative thoughts. Especially when I feel so depressed and think that I don’t deserve anything, I’m basically trying to fight a
losing battle because my mind is just so one-sided. So we agreed that I could have my time on my own, but then I should go and discuss my thoughts with a staff member.

I carried on the evening feeling captured and bewildered by my thoughts and kept having small outbursts of tears. I’m due for my first review tomorrow. I keep wondering how it will go.
I’m a bit scared – what are they going to say?

Thursday 16 August

All my feelings came up after lunch, so I went out with one of the therapeutic care workers. We went out of the dining room and sat on the stairs. My feelings about
killing myself were back and I couldn’t control them. They prowled inside my head, and captured any last bit of hope that I had. She was going to talk to someone higher up, to discuss what to
do because she said I needed more support in dealing with my feelings. I didn’t want her to tell anyone, though. I don’t want to get help with my feelings, I don’t want them to go
away. I want them to stay and come true.

I also had my first review today. My parents and out-patient team came in and discussed my progress, and the best way forward for me.
¹⁴
They told me that
they had talked about my tube, and making sure that there is good communication with my out-patient team. I asked how long I was going to be here. They said that they weren’t sure, but I was
ill enough to be in hospital at the moment, and I had another review in six weeks, so it was going to be at least till October.

I had family therapy
¹⁵
afterwards, which I think was really beneficial. We all sat there in silence at first, I didn’t want to say what was
bothering me, but I couldn’t hold it in and I knew it had to be said.

‘I’m sorry to my parents because every time I see them I feel angry, and I don’t know what I can do to stop it, because I shouldn’t feel it towards them, but it just
comes. I know that it is partly because you are quite “lovey-dovey” and I just don’t appreciate it. I know I should, but I can’t accept it. Like on Saturday for example, I
think we exchanged four hugs and kisses. This just wound me up because I’m so self-conscious about my body and I don’t appreciate more physical things than necessary, and I would be
more grateful for a quick good-bye. I want to prove my self-sufficiency and not to be oppressed by my parents.’

We then explored why I can’t accept affection and talked about how sometimes we all need people to fall on in troubling times. Also, why I can’t express my anger, and why I think
that it is such a great sin. I think it’s probably to do with the same connection that I have with ‘thin = happiness’ so that for me ‘anger = bad’. I suppose I need to
somehow change this thought process, but it seems so logical to me.

Friday 17 August

Today started badly after I was told that I was back on observation for an hour after each meal, and after snacks as well if necessary.
¹⁶
I hate it. I don’t want staff to be with me. I don’t want them coming to the toilet with me to make sure I don’t make myself sick, or do something even worse.
I was so angry and upset that I couldn’t face participating in the morning activity.

‘See, even THEY are punishing you now. They are doing this to you because you are talking to them.’

It was true; I am now enraged by myself because if I hadn’t shared any of my feelings then I wouldn’t be in this situation. See, there’s the proof that sharing negative
feelings does mean that you get punished. I was already being crushed by my thoughts, and now the staff were crushing me too.

My coping method is starving myself, so for this reason my motivation to eat was totally cut off, and I didn’t manage any snacks in the morning or afternoon, and had no fluids all day. For
me, eating food is just another thing to worry about, another thing to bombard my head with.

In a key session
¹⁷
I had to go through magazines and cut out words or pictures which I felt related to me, or the way I feel, and then arrange them on a
poster. Things I cut out included: ‘weight-loss’, ‘size 0’, ‘size 8’, ‘In desperate need of help’, and ‘Out of control’. I found this
really effective because without saying anything I was able to communicate, which I often find hard because I can’t put my feelings into words.