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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There's nothing Luddite about banning zero-hours contracts

The TUC general secretary responds to the Taylor Review. 

Unions have been criticised over the past week for our lukewarm response to the Taylor Review. According to the report’s author we were wrong to expect “quick fixes”, when “gradual change” is the order of the day. “Why aren’t you celebrating the new ‘flexibility’ the gig economy has unleashed?” others have complained.

Our response to these arguments is clear. Unions are not Luddites, and we recognise that the world of work is changing. But to understand these changes, we need to recognise that we’ve seen shifts in the balance of power in the workplace that go well beyond the replacement of a paper schedule with an app.

Years of attacks on trade unions have reduced workers’ bargaining power. This is key to understanding today’s world of work. Economic theory says that the near full employment rates should enable workers to ask for higher pay – but we’re still in the middle of the longest pay squeeze for 150 years.

And while fears of mass unemployment didn’t materialise after the economic crisis, we saw working people increasingly forced to accept jobs with less security, be it zero-hours contracts, agency work, or low-paid self-employment.

The key test for us is not whether new laws respond to new technology. It’s whether they harness it to make the world of work better, and give working people the confidence they need to negotiate better rights.

Don’t get me wrong. Matthew Taylor’s review is not without merit. We support his call for the abolishment of the Swedish Derogation – a loophole that has allowed employers to get away with paying agency workers less, even when they are doing the same job as their permanent colleagues.

Guaranteeing all workers the right to sick pay would make a real difference, as would asking employers to pay a higher rate for non-contracted hours. Payment for when shifts are cancelled at the last minute, as is now increasingly the case in the United States, was a key ask in our submission to the review.

But where the report falls short is not taking power seriously. 

The proposed new "dependent contractor status" carries real risks of downgrading people’s ability to receive a fair day’s pay for a fair day’s work. Here new technology isn’t creating new risks – it’s exacerbating old ones that we have fought to eradicate.

It’s no surprise that we are nervous about the return of "piece rates" or payment for tasks completed, rather than hours worked. Our experience of these has been in sectors like contract cleaning and hotels, where they’re used to set unreasonable targets, and drive down pay. Forgive us for being sceptical about Uber’s record of following the letter of the law.

Taylor’s proposals on zero-hours contracts also miss the point. Those on zero hours contracts – working in low paid sectors like hospitality, caring, and retail - are dependent on their boss for the hours they need to pay their bills. A "right to request" guaranteed hours from an exploitative boss is no right at all for many workers. Those in insecure jobs are in constant fear of having their hours cut if they speak up at work. Will the "right to request" really change this?

Tilting the balance of power back towards workers is what the trade union movement exists for. But it’s also vital to delivering the better productivity and growth Britain so sorely needs.

There is plenty of evidence from across the UK and the wider world that workplaces with good terms and conditions, pay and worker voice are more productive. That’s why the OECD (hardly a left-wing mouth piece) has called for a new debate about how collective bargaining can deliver more equality, more inclusion and better jobs all round.

We know as a union movement that we have to up our game. And part of that thinking must include how trade unions can take advantage of new technologies to organise workers.

We are ready for this challenge. Our role isn’t to stop changes in technology. It’s to make sure technology is used to make working people’s lives better, and to make sure any gains are fairly shared.

Frances O'Grady is the General Secretary of the TUC.