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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The end of loyalty: why are we still surprised when politicians betray each other?

There was Labour’s attempted coup, now the cabinet is in civil war. Have British politicians always been so openly disloyal?

Politicians have always had a reputation for backstabbing, but recently Westminster has been a battleground of back, front and side-stabbing in all parties. The shadow cabinet trying to oust Jeremy Corbyn after the EU referendum; Michael Gove abandoning Boris Johnson to make his own Tory leadership bid; and now Johnson himself derailing Theresa May’s set-piece Brexit speech with his Telegraph essay on the subject – and rumours of a resignation threat.

On the surface, it seems Brexit has given politicians licence to flout cabinet collective responsibility – the convention that binds our ministers to showing a united front on government policy.

The doctrine of cabinet collective responsibility was outlined in the Ministerial Code in the early Nineties, but it became a convention in the late 19th century “the way in which we talk about it still today, in terms of people failing to adhere to it”, says the Institute for Government’s Dr Cath Haddon, an expert in the constitutional issues of Whitehall.

It even goes back earlier than that, when the cabinet would have to bond in the face of a more powerful monarch.

But are we witnessing the end of this convention? It looks like we could be living in a new age of disloyalty. After all, the shadow cabinet was allowed to say what it liked about its leader over nearly two years, and Johnson is still in a job.

An unfaithful history

“I think it’s nothing new,” says Michael Cockerell, who has been making political documentaries and profiles for the BBC since the Seventies. “If you think back in time to Julius Caesar and all the rest of it, this loyalty to the leader is not something that automatically happens or has been normal both in history and modern democracies – there have always been rebels, always been ambitious figures who all work out exactly how far they can go.”

He says the situation with Johnson reminds him of Tony Benn, who was an outspoken cabinet secretary under Harold Wilson and Jim Callaghan in 1974-79. “He knew exactly how far he could push it without being sacked, because of the old thing about having him inside the tent pissing out, rather than outside the tent, pissing in.”

Cockerell believes that Johnson, like past cabinet rebels, knows “how far” he can go in defying May because she’s in a precarious position.

“Often if a prime minister is weak, that’s when the ambitious members of the cabinet can parade their disloyalty while still claiming they’re still being loyal,” he says. “Most people who are disloyal always profess their loyalty.”

The peer and former Lib Dem leader Ming Campbell, who has been in politics since the early Seventies, also believes “it’s always been like this” in terms of disloyalty in British politics.

He gives Wilson’s governments as a past example. “There was a fair amount of disloyalty within the cabinet,” he says. “I remember it being suggested by someone that the cabinet meetings were often very, very quiet because people were so busy writing down things that they could put into print sometime later.”

“Fast-forward to John Major and the ‘bastards’,” he says, recalling the former Conservative prime minister’s battle with trouble-making Eurosceptic cabinet members in 1993.

Dr Haddon adds the examples of Margaret Thatcher being brought down by her cabinet (and tackling the “wets and dries” in her early years as PM), and Tony Blair and Gordon Brown’s teams briefing against each other.

She believes “nothing changes” regarding disloyalty because of the way British government works. “The UK system really provokes this sort of situation,” she says of Johnson. “Because we have empowered secretaries of state, we have a sort of federalist structure, and then we have the prime minister in the position of primus inter pares [first among equals].”

The idea of the prime minister being a fully empowered leader in control of a team is a “modern concept”, according to Dr Haddon. “If you go back into the nineteenth century, ministers were very much heads of their own little fiefdoms. We’ve always had this system that has enabled ministers to effectively have their own take, their own position in their particular roles, and able to speak publicly on their perspective.”

She says the same happens in the shadow cabinet because of the nature of opposition in the UK. Shadow ministers don’t receive tailored funding for their work, and are therefore “often very much reliant upon their own team” to develop policy proposals, “so they become quite autonomous”.

How disloyalty has changed

However, disloyalty plays out differently in modern politics. Campbell points out that with politics developing in real time online and through 24-hour news, there is a far greater journalistic focus on disloyalty. “Previously it would’ve been in the Sunday papers, now you get it 24 hours a day, seven days a week,” he says.

Dr Haddon believes pronouncements of disloyalty are more “overt” than they were because of the way we communicate on social media. Platforms like Twitter discourage the “coded messages” of past disloyal cabinet secretaries, and show infighting more starkly.

“There is this immediacy of reaction,” she says. “And that it’s constrained to 140 characters leads people to ever more brief, succinct declarations of their position. We are also living through a period in which, dare I say, hyperbole and strength of position are only exaggerated by that medium. There’s something in that which is very different.”

And even though British political history is littered with attempted coups, betrayals and outspoken ministers – particularly over Europe – there is a sense that the rulebook has been thrown out recently, perhaps as Brexit has defied the status quo.

Collective responsibility and the idea of the prime minister as primus inter pares are conventions, and conventions can be moulded or dropped completely.

“The constitution is open for discussion now to an extent that I can’t remember,” says Campbell. “You’ve got arguments about independence, constitutional arguments which arise out of Brexit, if we leave. In those circumstances, it’s perhaps not surprising that the constitutional convention about cabinet responsibility comes under strain as well.

“If you’ve got a constitution that depends upon the observance of convention, then of course it’s much easier to depart from these if you choose,” he adds. “And in the present, febrile atmosphere of constitutional change, maybe it’s hardly surprising that what is thought to be a centrepiece is simply being disregarded.”

Anoosh Chakelian is senior writer at the New Statesman.