Shades of Anorexia: it is a mental illness, not a statement

An eating disorder made Lucy Britton "want to disappear". Here, she responds to Rachel Cusk's article on the "anorexic statement".

This is going to be a hard post to write but I’m so upset by Rachel Cusk's article on anorexia in the New Statesman, and the way in which it conveys eating disorders.  In her article, Cusk represents those who suffer from anorexia as attention seekers: people who wish to become highly visible. She also paints anorexia as a purely female phenomenon. At one point she goes so far as to describe an anorexic person as a “68lb tyrant” who seemingly demands someone must feed her as a means of controlling her support team.

I’ve suffered from remitting and relapsing eating disorders since I was 14 years old. A close family member also suffered from a severe eating disorder and almost died as a result. I do not recognise the descriptions provided by Cusk at all.

There are many reasons why people become ill with eating disorders. Sexual assault is one such cause. Many people wish to desexualise themselves and disappear. The last time I was ill two years ago followed a rape and subsequent period of severe ill-health, possibly aggravated by complications with Pelvic Inflammatory Disease. I felt out of control and vulnerable. Not eating was a secret. I did not wish for it to make me more visible. I wanted to disappear. I was not even scared of the thought of dying, highlighting the extent of my desire to just stop existing. It is true that not eating made me feel a sense of achievement.  I had controlled my body, rather than had that control taken away from me as I had experienced. It was fuelled by self-hatred rather than self-promotion as Cusk seems to imply. Palpitations, constantly feeling cold and light-headed, and the inability to sleep were simply the physical manifestations of the pain I felt emotionally.

I was hospitalised in a psychiatric unit. My attitude towards food was not one of calorie counting. I was scared of eating. Food petrified me. It was quite literally a phobia. They wanted me to drink something called Fortisip/ Fortijuice which are incredibly sweet calorie- and nutrition-laden supplement drinks. Because my mind was aware it was the alternative to food I couldn’t face letting it pass my lips. Even passing the dining hall filled me with panic, the smell disgusted me and made me feel nauseous. They wanted me to drink the food replacement drinks in front of them in my room. The idea of them watching me made the whole situation worse.

Eventually, after weeks of wrangling with my care team, my husband convinced them to allow me to drink them in my room alone. I was supposed to drink four bottles a day minimum. At most I managed to drink half a bottle three times a day, I believe this was the equivalent of 300 calories, and I cried after each one. Once they took me to the eating hall to try an apple. I wouldn’t enter until everyone else had left. It was just me and one nurse. The smell from the previous mealtime overwhelmed me. Before the plate with the apple was put in front of me my legs were shaking in uncontrollable terror. I managed with shaking hand to cut a slither of apple. This was the most contact I had had with food in weeks. The feel of it in my mouth was grainy, like sand or powder. After just a few seconds I broke down. I couldn’t go on. Not eating made me feel like a failure. This was not a tantrum, it was panic. It was not petulant or controlling behaviour. I did not demand attention, I deplored attention. It was the manifestation of a traumatised mind.

Of course my story is only one of many. There are numerous reasons why people suffer from eating disorders, and it is by no means gender-specific. The causes and the experiences are many and should not, as Cusk has attempted, be reduced and universalised. The real life experiences of people with eating disorders far exceed Cusk’s monolithic and seemingly psychoanalytical, and overtly poetic, descriptions. Many eating disorder sufferers cannot neatly be compartmentalised as only possessing a simple diagnosis. Categorisation can be anorexia nervosa, bullimia nervosa, binge eating disorder, or EDNOS (which means eating disorder not otherwise specified, this could be because the person with the ED suffers from both anorexia and bullimia symptoms or does not fulfill the weight criteria of the anorexia nervosa category). These shades of grey seem to become very lost in Cusk’s representation.

The Minnesota Experiment under controlled conditions studied the effects of malnutrion upon a group of 36 physically and psychologically healthy young men. It was found that many of the symptoms and behaviours which are associated with anorexia and/ or bullimia, such as a preoccupation with food, collecting recipes and a fixation with the eating habits of others; hoarding (which has been seen in anorexia patients); ritualistic behaviour around food (Cusk’s “feed me” springs to mind); bingeing; self-induced vomitting; feelings of guilt and shame; anger; and self-disgust inter alia were the result of malnutrition. Cusk’s poetic descriptions of anorexia may look pretty on the page, but clearly many of the behaviours she sees as resultant from a seemingly petulant, controlling and diva-like mind are infact the psychological symptoms of starvation.

Please do not believe Cusk’s thickly worded and damning descriptions of people with eating disorders. “We” are not one-size fits all. We are not all women. We are not all attention seekers and we do not wish to lash out and harm everyone around us. There are so many nuances it is impossible for Cusk or I to come up with a universal “Anorexia Statement”. Many people with anorexia aren’t trying to say anything at all. I had no message for the world. Anorexia is a mental illness not a “statement”.

For Lucy, even trying to eat an apple had her legs shaking in uncontrollable terror. Photo: By vauvau on Flickr, via Creative Commons
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Air pollution: 5 steps to vanquishing an invisible killer

A new report looks at the economics of air pollution. 

110, 150, 520... These chilling statistics are the number of deaths attributable to particulate air pollution for the cities of Southampton, Nottingham and Birmingham in 2010 respectively. Or how about 40,000 - that is the total number of UK deaths per year that are attributable the combined effects of particulate matter (PM2.5) and Nitrogen Oxides (NOx).

This situation sucks, to say the very least. But while there are no dramatic images to stir up action, these deaths are preventable and we know their cause. Road traffic is the worst culprit. Traffic is responsible for 80 per cent of NOx on high pollution roads, with diesel engines contributing the bulk of the problem.

Now a new report by ResPublica has compiled a list of ways that city councils around the UK can help. The report argues that: “The onus is on cities to create plans that can meet the health and economic challenge within a short time-frame, and identify what they need from national government to do so.”

This is a diplomatic way of saying that current government action on the subject does not go far enough – and that cities must help prod them into gear. That includes poking holes in the government’s proposed plans for new “Clean Air Zones”.

Here are just five of the ways the report suggests letting the light in and the pollution out:

1. Clean up the draft Clean Air Zones framework

Last October, the government set out its draft plans for new Clean Air Zones in the UK’s five most polluted cities, Birmingham, Derby, Leeds, Nottingham and Southampton (excluding London - where other plans are afoot). These zones will charge “polluting” vehicles to enter and can be implemented with varying levels of intensity, with three options that include cars and one that does not.

But the report argues that there is still too much potential for polluters to play dirty with the rules. Car-charging zones must be mandatory for all cities that breach the current EU standards, the report argues (not just the suggested five). Otherwise national operators who own fleets of vehicles could simply relocate outdated buses or taxis to places where they don’t have to pay.  

Different vehicles should fall under the same rules, the report added. Otherwise, taking your car rather than the bus could suddenly seem like the cost-saving option.

2. Vouchers to vouch-safe the project’s success

The government is exploring a scrappage scheme for diesel cars, to help get the worst and oldest polluting vehicles off the road. But as the report points out, blanket scrappage could simply put a whole load of new fossil-fuel cars on the road.

Instead, ResPublica suggests using the revenue from the Clean Air Zone charges, plus hiked vehicle registration fees, to create “Pollution Reduction Vouchers”.

Low-income households with older cars, that would be liable to charging, could then use the vouchers to help secure alternative transport, buy a new and compliant car, or retrofit their existing vehicle with new technology.

3. Extend Vehicle Excise Duty

Vehicle Excise Duty is currently only tiered by how much CO2 pollution a car creates for the first year. After that it becomes a flat rate for all cars under £40,000. The report suggests changing this so that the most polluting vehicles for CO2, NOx and PM2.5 continue to pay higher rates throughout their life span.

For ClientEarth CEO James Thornton, changes to vehicle excise duty are key to moving people onto cleaner modes of transport: “We need a network of clean air zones to keep the most polluting diesel vehicles from the most polluted parts of our towns and cities and incentives such as a targeted scrappage scheme and changes to vehicle excise duty to move people onto cleaner modes of transport.”

4. Repurposed car parks

You would think city bosses would want less cars in the centre of town. But while less cars is good news for oxygen-breathers, it is bad news for city budgets reliant on parking charges. But using car parks to tap into new revenue from property development and joint ventures could help cities reverse this thinking.

5. Prioritise public awareness

Charge zones can be understandably unpopular. In 2008, a referendum in Manchester defeated the idea of congestion charging. So a big effort is needed to raise public awareness of the health crisis our roads have caused. Metro mayors should outline pollution plans in their manifestos, the report suggests. And cities can take advantage of their existing assets. For example in London there are plans to use electronics in the Underground to update travellers on the air pollution levels.

***

Change is already in the air. Southampton has used money from the Local Sustainable Travel Fund to run a successful messaging campaign. And in 2011 Nottingham City Council became the first city to implement a Workplace Parking levy – a scheme which has raised £35.3m to help extend its tram system, upgrade the station and purchase electric buses.

But many more “air necessities” are needed before we can forget about pollution’s worry and its strife.  

 

India Bourke is an environment writer and editorial assistant at the New Statesman.