Anorexia memoirs are not "safe" from triggering readers. Photo: Flickr/Benjamin Watson
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How can a memoir convey the damage done by eating disorders, without passing it on?

Nancy Tucker’s eating disorder memoir, The Time In Between, tackles this problem head-on.

The back cover blurb of Nancy Tucker’s eating disorder memoir, The Time In Between, describes it as “a Wasted for the 21st century”. For the uninitiated, Marya Hornbacher’s Wasted, first published in 1998, sets the standard for no-holds-barred, mesmerising, deeply moving explorations of anorexia and bulimia. While many personal accounts have been published before and since, Wasted is the one that really grabs you by the throat.

Beautifully written and profoundly disturbing, Wasted is a book I still approach with a curious mix of fear and envy, over 15 years since I first read it in my own not-quite-recovered state. I wish I’d been able to immortalise my own suffering in that way; I wish, too, that I didn’t feel so drawn to Hornbacher’s. I haven’t starved myself in years but even now her words can awaken that voice in the back of my head: Go on. You could still do it, you know. Despite all the years of recovery, I am jealous of the person I once was. There are times when I’d rather people looked at me and saw her, not the whole person – the woman – I am now.

In The Female Malady, Elaine Showalter describes how 19th-century doctors saw anorexia as a kind of manipulative performance, an inauthentic illness that could, should the correct pressures be applied, be exposed as “shamming”: “the goal [of treatment] was to isolate the patient from her family support systems, unmask her deceitful stratagems, coerce her into surrendering her symptoms, and finally overcome her self-centredness”.

It’s an approach that is not unfamiliar to me from treatment methods still in use in the Eighties. I’d like to think that now we know better. Anorexia sufferers are not putting on an act. They are not “playing the system”. For far too many, anorexia simply means years of cold, hunger and pain eased only by death. Nonetheless, the disease can still hold an attraction for the sufferer. There is an element of desire as well as hopeless submission. While this is not a reason to withhold sympathy from the sufferer or to treat her with suspicion, it is one of the reasons why writing about anorexia – and reading about it – is so fraught.

Reviewing Wasted for the London Review of Books, Rebecca Mead describes it as “a missive sent from inside a sickness; not just a description of what it is like to suffer from an eating disorder, but an expression of that disorder – a symptom, even”. She questions whether the act of writing about her thinness was, for Hornbacher, “a way of keeping her illness alive”.

Certainly, when Hornbacher claims “I would do anything to keep people from going where I went. Writing this book was the only thing I could think of,” it feels disingenuous. Hornbacher wrote her memoir knowing the power of literature – even bad literature – to fuel the competitive urges and fantasies of perfection that sustain anorexics through day after day of emptiness. She even mentions the main character of Steven Levenkron’s novel The Best Little Girl In The World as providing her with a template for the kind of person she wanted to be: “I wanted to be her: withdrawn, reserved, cold, wholly absorbed in her own obsession, perfectly pure. […] I decided that if I did nothing else with my life, I would be an anorectic when I grew up.”

For me, a similar source of inspiration was to be found in Deborah Hautzig’s Second Star To The Right (and, later, Wasted itself). It is embarrassing to admit to such things (if one really was “perfectly pure”, surely one’s passion for starvation would come wholly from within, not aided and abetted by other people’s stories). Nonetheless, the problem is not that such books exist, or that former (or not-quite-former) sufferers will continue to write them. Like eating disorders themselves, they are offering readers, usually young women, something that they cannot find elsewhere.

Rather than glossing over these complexities or claiming to do one thing while achieving quite another, in The Time In Between Tucker tackles head-on the question of whether or not her own book will have the effect of triggering other sufferers. In the foreword she confesses that her “biggest fear in writing this book – and writing it honestly – was that it would serve the same ‘cheat sheet’ purpose that eating disorder memoirs served during my own struggle”:

I feared it would be thumbed through by others as vulnerable as myself and dissected in search of tips on how to be ill. Why to be ill. Why to stay ill. […] Perhaps it can only be understood by one who has been under the thumb of disease, but there is a voyeuristic something about anorexia which makes sufferers crave its gory, ugly depths. Fainting in public? Yes please. Fur from head to toe? Love it. Nasogastric tube? I’ll take two.

As a way of opening, it serves as a striking “I know what you’re doing” to anyone who is expecting another Wasted. Moreover, Tucker adopts certain tactics with the express aim of making her work less attractive to those in search of thinspiration. The first is to omit all references to numbers (BMI, height, weight, calorie intake), thereby denying anorexia sufferers the cold, hard figures against which to measure their own “progress”. The second is to follow a narrative path which goes beyond the usual route down to lowest weight then back up to recovery. Suffering doesn’t work like that.

It makes for a more unsettling ending but what is important – and what sets this book apart from Wasted in terms of “performance” – is that it breaks the presumed link between lowest weight and greatest distress. After all, if that link were so solid, why would images of emaciation and memories of starvation hold such power over those who ought to know better?

In conversation, Tucker is bright, funny and extremely open about her experiences. She admits to having had to fight with various people along the way, who felt her book would not work without the inclusion of weights. Her first agent told her that readers needed “some way of telling that you’re declining,” as though the description of the subject’s feelings alone could not possibly suffice. But as Tucker points out, “weight isn’t that barometer […] there were periods when I was overweight and in a lot more mental distress than when I was very underweight.”

While it is known that for many sufferers, anorexia can alternate with bulimia and binge eating disorder, such truths are uncomfortable and disruptive (while Hornbacher describes episodes of bulimia at the start of Wasted, she shifts to anorexia effectively enough to create a neat narrative spiral down to near-total self-annihilation; The Time In Between ends far more messily, with flesh regained seen through the prism of loss – “I have gained weight, but lost myself” – as much as hope).

The “time in between” of the title refers to this stage of disorientation, when one is not visibly anorexic but not mentally anything else (“How can I explain that inside I remain an anorexic, but trapped in a fat suit?”). It describes a period leading up to the near-present day, with Tucker switching from anorexia to bulimia and swiftly moving from underweight to overweight. She describes it as the most difficult part to write, “not so much in wanting to get it right but because it was so painful”:

People want to be able to see proof that you’re ill and then of course they want to assume that if you’re gaining weight you’re getting better because people want you to be better. So when I was tipping into this horrendous bulimic period, I felt fraudulent because I was gaining all this weight and people around me were quite happy about it and I felt like, but it’s not real, it’s not me recovering, it’s me being just as sick as ever in a different way.

It’s a feeling I can identify with very strongly and I’d have liked to see more of this section, which only really kicks in towards the end of the book. But then, as Tucker points out, “it was impossible to explore it in the depth I wanted to explore it without going back to the beginning first and understanding the path that had brought me to that place.” There are times when that path does seem a little lingering (do we need to know whether or not it was possible for the subject to “slide [a circle out of middle finger and thumb] from wrist to shoulder”?) but nothing is presented out of context.

Moreover, one thing that bolsters her efforts to minimise harm is Tucker’s impressive sense of the ridiculous, never losing sight of just how bizarre and frankly comical many of the rituals of anorexia can be. A particular highlight is her staged representation of competition amongst anorexia sufferers receiving inpatient treatment, with its shades of Monty Python’s Four Yorkshiremen (“By the time I was admitted I didn’t even exist!”). The idea of anorexia can be seductively pure; the experience rarely is.

The assumption that anorexia sufferers recover mentally upon weight gain has some validity (since constant starvation clearly affects mental processing), but it overlooks the degree to which the anorexic’s suffering is related to her social status and the expectations that surround her (and it is not insignificant that most sufferers are female).

In Hunger Strike, Susie Orbach describes the way in which refeeding programmes – although less commonly used today – betray a desire to “normalise” women not just physically, but socially: “The general consensus is that the patient has recovered when the normal weight is reached and appropriate sex role functioning is achieved.” Yet, she goes on to point out, “if the body protest statement could but be read – be it one of fatness or thinness – it would be seen to be one of the few ways that women can articulate their internal experience.” Indeed, one of the biggest problems in tackling anorexia comes from the fact that in its own twisted way, it works. Comparing starving saints and “fasting girls” to modern-day anorexics, Hilary Mantel highlights the fact that starvation might offer girls an escape route:

Anorexia itself seems like mad behaviour, but I don’t think it is madness. It is a way of shrinking back, of reserving, preserving the self, fighting free of sexual and emotional entanglements. […]  Anorexia can be an accommodation, a strategy for survival.

In conversation, Tucker describes how realising that all she had to worry about was being thin “felt like the best moment of my life”: “It was like I’d been going along this path at 100mph and suddenly I realised I could step off it and there was a side exit and I didn’t have to do it anymore.” This strange plus side to anorexia – the exemption from womanhood, which isn’t all it’s cracked up to be – comes through even more clearly in the book, particularly in the later descriptions of longing for a return to former thinness:

… for all its cold, cruel torture, anorexia was safe. It was controlled, and it was safe. The denial of my need for nourishment allowed me to renounce my status as a Living Thing, and escape from the whole messy business of Being Human. I had discovered a glorious, ingenious ‘get out of jail free’ card, and the more I flashed it at the prison wardens the gladder I became of its presence in my arsenal.

This should not be a world in which teenage girls wish to escape from the pressures of being human, but it is. Moreover, it’s one in which we’re reluctant to listen to their stories unless they’ve showed us their bare bones first (Tucker ruefully considers how “it’s not fair for me to look like this – it doesn’t properly reflect my inner pain”).

Tucker doesn’t make promises regarding whether or not her book has the power to trigger others:

I wanted to write a book which conveyed the devastating damage caused by eating disorders, but not one which passed on this damage. To give people something to think about, but not something to emulate. Have I managed it? I suppose that’s up to you.

The Time In Between is a tremendous achievement, particularly from someone so young and still so close to experiences of disordered eating. Nonetheless, anorexia memoirs will not be “safe” until women are free to tell their own stories of vulnerability and refusal while still clinging on to their female flesh. It should not be necessary to reject one’s body and halt one’s growth to make others see the person inside. There has to be a space where need can be articulated without an accompanying display of self-denial. Tucker’s work offers the beginnings of this. One hopes it will leave potentially vulnerable readers hungering for more. 

Glosswitch is a feminist mother of three who works in publishing.

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"We repealed, then forgot": the long shadow of Section 28 homophobia

Why are deeply conservative views about the "promotion" of homosexuality still being reiterated to Scottish school pupils? 

Grim stories of LGBTI children being bullied in school are all too common. But one which emerged over the weekend garnered particular attention - because of the echoes of the infamous Section 28, nearly two decades after it was scrapped.

A 16-year-old pupil of a West Lothian school, who does not wish to be named, told Pink News that staff asked him to remove his small rainbow pride badge because, though they had "no problem" with his sexuality, it was not appropriate to "promote it" in school. It's a blast from the past - the rules against "promoting" homosexuality were repealed in 2000 in Scotland, but the long legacy of Section 28 seems hard to shake off. 

The local authority responsible said in a statement that non-school related badges are not permitted on uniforms, and says it is "committed to equal rights for LGBT people". 

The small badge depicted a rainbow-striped heart, which the pupil said he had brought back from the Edinburgh Pride march the previous weekend. He reportedly "no longer feels comfortable going to school", and said homophobia from staff members felt "much more scar[y] than when I encountered the same from other pupils". 

At a time when four Scottish party leaders are gay, and the new Westminster parliament included a record number of LGBTQ MPs, the political world is making progress in promoting equality. But education, it seems, has not kept up. According to research from LGBT rights campaigners Stonewall, 40 per cent of LGBT pupils across the UK reported being taught nothing about LGBT issues at school. Among trans students, 44 per cent said school staff didn’t know what "trans" even means.

The need for teacher training and curriculum reform is at the top of campaigners' agendas. "We're disappointed but not surprised by this example," says Jordan Daly, the co-founder of Time for Inclusive Education [TIE]. His grassroots campaign focuses on making politicians and wider society aware of the reality LGBTI school students in Scotland face. "We're in schools on a monthly basis, so we know this is by no means an isolated incident." 

Studies have repeatedly shown a startling level of self-harm and mental illness reported by LGBTI school students. Trans students are particularly at risk. In 2015, Daly and colleagues began a tour of schools. Shocking stories included one in which a teacher singled out a trans pupils for ridicule in front of the class. More commonly, though, staff told them the same story: we just don't know what we're allowed to say about gay relationships. 

This is the point, according to Daly - retraining, or rather the lack of it. For some of those teachers trained during the 1980s and 1990s, when Section 28 prevented local authorities from "promoting homosexuality", confusion still reigns about what they can and cannot teach - or even mention in front of their pupils. 

The infamous clause was specific in its homophobia: the "acceptability of homosexuality as a pretended family relationship" could not be mentioned in schools. But it's been 17 years since the clause was repealed in Scotland - indeed, it was one of the very first acts of the new Scottish Parliament (the rest of the UK followed suit three years later). Why are we still hearing this archaic language? 

"We repealed, we clapped and cheered, and then we just forgot," Daly says. After the bitter campaign in Scotland, in which an alliance of churches led by millionaire businessman Brian Souter poured money into "Keeping the Clause", the government was pleased with its victory, which seemed to establish Holyrood as a progressive political space early on in the life of the parliament. But without updating the curriculum or retraining teaching staff, Daly argues, it left a "massive vacuum" of uncertainty. 

The Stonewall research suggests a similar confusion is likely across the UK. Daly doesn't believe the situation in Scotland is notably worse than in England, and disputes the oft-cited allegation that the issue is somehow worse in Scotland's denominational schools. Homophobia may be "wrapped up in the language of religious belief" in certain schools, he says, but it's "just as much of a problem elsewhere. The TIE campaign doesn't have different strategies for different schools." 

After initial disappointments - their thousands-strong petition to change the curriculum was thrown out by parliament in 2016 - the campaign has won the support of leaders such as Nicola Sturgeon and Kezia Dugdale, and recently, the backing of a majority of MSPs. The Scottish government has set up a working group, and promised a national strategy. 

But for Daly, who himself struggled at a young age with his sexuality and society's failure to accept it, the matter remains an urgent one.  At just 21, he can reel off countless painful stories of young LGBTI students - some of which end in tragedy. One of the saddest elements of the story from St Kentigern's is that the pupil claimed his school was the safest place he had to express his identity, because he was not out at home. Perhaps for a gay pupil in ten years time, that will be a guarantee. 

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