Mealtimes and Milestones

by Barter, Constance

  Constable & Robinson Ltd

  3 The Lanchesters

  162 Fulham Palace Road

  London W6 9ER

  www.constablerobinson.com

  First published in the UK by Robinson,

  an imprint of Constable & Robinson Ltd, 2010

  Copyright © Constance Barter 2010

  The right of Constance Barter to be identified as the author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988

  Author photograph © Tessa Smith Photography, www.tessasmithphotography.com

  All rights reserved. This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, re-sold, hired out or otherwise circulated in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed on the subsequent purchaser.

  A copy of the British Library Cataloguing in Publication data is available from the British Library

  ISBN: 978-1-84901-323-9

  Printed and bound in the EU

  1 3 5 7 9 10 8 6 4 2

  Contents

  Acknowledgements

  Foreword

  Introduction

  The Beginning

  July 2007

  The Diary

  Thursday 9 August 2007 to

  Thursday 14 February 2008

  After Discharge

  August 2009

  Appendix: Useful Contacts and Further Reading

  Endnotes

  IN MEMORY OF CLIVE BARTER

  Dad, you saw me through recovery, but never saw this book.

  You’re the angel looking over me.

  xxx

  A picture that I did in my last Creative Group on my final day

  ACKNOWLEDGEMENTS

  My thanks go to my fabulous mum, who never lost her temper, but more importantly never lost her hope.

  To Broo, Fritha and Phillipa and all the other amazing people involved, who believed in Mealtimes and Milestones and made it happen.

  To my family – Granny and Granddad, Simon and Mandy. Small family. Big love.

  To the professionals around me – from my tutor to my outpatient team, and all the others in between.

  Finally to my friends, who definitely kept the postman busy with all their letters, cards, drawings, photographs, quotes from Friends, prayers, handmade bracelets, surfing books and Sudoku puzzles! It was your plentiful words of inspiration that made me smile and helped pull me through. xxx

  FOREWORD

  I was very pleased and honoured to be asked to provide this foreword. It is always a pleasure to see someone beat their eating disorder, and that pleasure is all the greater when they are able to help others do the same by sharing their experiences.

  With this book, Constance has given a remarkable account of her journey to recovery. We know it takes courage, determination and great persistence – qualities that Constance has in abundance. That she has been able to share her insights in such a forthright and honest way is particularly powerful.

  Beat (the Eating Disorders Association) is the UK’s leading charity supporting people affected by eating disorders and campaigning on their behalf. We provide individuals and their families with support, information and encouragement to seek recovery. We collaborate with leading researchers, and provide professional development for health, education and social care staff. Our web presence is extensive, and broadcasters and journalists turn to us daily for comment and opinion.

  Our message is simple: eating disorders will be beaten. They will be beaten when they are no longer misunderstood, trivialized or seen as something to be ashamed of.

  Eating disorders are a serious type of mental illness that takes a tremendous toll on promising young lives. They can be deadly: 20 per cent of those who become seriously affected die as a result. Eating disorders can affect anyone at any age, including boys and men, but girls and young women aged between 12 and 20 are most at risk.

  Anorexia nervosa is the rarest of the eating disorders, accounting for only 10 per cent of cases; but it is also the most serious in terms of its potential long-term consequences for physical health and well-being if not treated quickly and effectively.

  We are learning more all the time about what causes eating disorders. The causes are complex, and it is a combination of factors that makes some people vulnerable. There is world-class research in this field, much of it conducted in the UK, helping to build an evidence base for understanding this condition and helping effective treatments to be developed. One of the things this research is showing is that more of the risks are ‘hard-wired’ than was previously thought. Our genetic make-up, personality type, brain chemistry and hormones all play a part.

  Beat campaigns to change the way everyone thinks and talks about eating disorders, helping to overcome the stigma caused by mistaken views and outdated opinions. Explaining the scientific knowledge we have gained is part of that.

  We challenge the media to tell the truth about eating disorders. They are not a fad or a phase or a silly diet gone wrong. They are not about trying to emulate celebrities or fashion. We want everyone with an eating disorder to truly believe they can beat it. We know that the sooner someone gets the specialist treatment they need the more likely they are to make a full recovery. We also know that people can be very reluctant to ask for or accept that help – even once they know they need it – such are the feelings of worthlessness an eating disorder produces.

  We want a message of hope – that eating disorders can be beaten – to reach anyone and everyone who needs to hear it. Constance’s story is a hugely powerful expression of that message – that hope.

  Susan Ringwood

  Chief Executive

  Beat

  INTRODUCTION

  It is both an honour and a privilege to have been asked to provide this introduction to Mealtimes and Milestones. Anorexia nervosa remains an illness that is hard to understand, for sufferers, families and professionals alike, and misunderstandings about it abound. This is not surprising, for it is, by its nature, an illness that causes confusion, mystification, distortion and puzzlement. It is not surprising, therefore, that its portrayal in the media often focuses on superficial and ultimately misleading issues, which in turn often contributes to those suffering from it feeling misunderstood. As those closest to it know, it is not just about food and weight, but strikes at the very heart of a person’s selfhood and their relationship with the world around them, and often leaves them feeling hopeless and alone.

  Although there has been a considerable increase in knowledge about anorexia nervosa over the past two decades, there is still much to learn. It does not matter how many clever and highly sophisticated scientific research studies are done, there is still no substitute for learning from those who know most about the experience of having it: that is, those who suffer from it. This most particularly applies to the provision of treatment. Unless we are aware of the experience of people going through treatment and how it affects them, we are unlikely to develop treatments that will be effective in the long run. Mealtimes and Milestones gives an astonishingly courageous and frank account of one person’s journey towards recovery. In doing this, the author provides profound insights into the way anorexia makes young people think and into the way it can distort their perception of the world.

  One of the most difficult things about suffering from anorexia nervosa, and about having a member of your family suffer from it, is the way it undermines and threatens to destroy hope. The anorexic inner ‘voice’ is so determined not to relinquish control, so determined to maintain its grip, that any sign of hopefulness, or move towards recovery, is mercilessly atta
cked from within. For me, the most important feature of this book is the way Constance describes how she moved from a position of near-hopelessness to a position in which hope was regained and then allowed to flourish. For those who are currently stuck in a position of hopelessness, this book is likely to bring great comfort, not only to them but also to their families. It shows that whatever you think at the time, anorexia can be left behind; that no matter how dark the night, the dawn will come, provided there is someone involved who is able to hold on to hope.

  As I suspect all professionals know, those suffering from an illness like anorexia are much more likely to listen to those who have been through it themselves than they are to listen to professionals. This is not surprising, indeed it is to be expected; after all, most of us find it easier to accept advice from someone if we feel they have personal experience of any particular situation. It is therefore likely that reading this book will play a significant part in helping someone suffering from anorexia nervosa to take their courage in both hands, as Constance has done, and allow themselves the hope that they can and will recover if they are willing to work at it.

  I am extremely grateful to Constance for having the courage and generosity to share her experience with others. I suspect it could not have been an easy decision for her, particularly as her journey is inevitably a very personal one. The fact that she has done so is a testament to how far she has come on her own journey. My hope is that those who read of her struggles, and who are in the midst of those struggles themselves (either as a sufferer or as relative, friend or supporter of a sufferer), will be able to identify with her, and with her courage and tenacity, and that doing so will play a significant part in enabling them to find their own way out of the darkness.

  David Wood FRCPsych

  Consultant Child and Adolescent Psychiatrist

  Clinical Director, The Ellern Mede Centre for Eating Disorders

  THE BEGINNING

  July 2007

  ‘Constance, you’ve lost loads of weight.’

  People are noticing me. My friends have never really seen me before. Now finally I am being recognized by them – and they like me because I am thin.

  This was perhaps the first time I made the connection between thinness and happiness – and I loved this new-found power. Starving myself gave me a power and a real feeling of excitement that I had never experienced before.

  Maybe my eating disorder was a predisposition within me, maybe it was a manifestation of my inner insecurities, or maybe there weren’t any specific triggers. I am now 16 years old, and my anorexia was diagnosed when I was 14, yet I can remember from as young as 11 or 12 years old wanting to be physically fit. I would carry my school bag, sports bag and violin up to school all at once, instead of going on the bus, in an attempt to make myself stronger. At that stage I hadn’t made the connection between exercise and weight loss, and an unhealthy relationship with food didn’t arrive until I was 13, but the foundations were certainly there.

  Thinking back, I can’t pinpoint exactly every part of my life which could possibly have contributed to my eating disorder – and it would be unrealistic to try. But I have always worked to the best of my ability, and even at a young age I would stay up late to make sure that a piece of homework was perfect. Before anorexia overtook my life, it must have been perfectionism and an inbuilt highly driven trait within me that led me to these extremes, because no one taught me or told me to do this.

  I have had a very happy and stable upbringing, and have always been loved and had positive reinforcement, yet I still had many gnawing insecurities about my likeability and talents. I never felt I was good enough, even when I got an A grade. I guess sooner or later these doubts had to reveal themselves, because no one can possibly hide them for ever.

  I was bullied at my junior school, but my current school was the one I have always wanted to go to, and I absolutely loved it. I started off as a day pupil, but enjoyed school life so much that I started boarding one night a week, then two. By the end of the first term I was a weekly boarder.

  It was at school that I developed an interest in running, and I ran for the county, but I quickly realized that I could use it to lose weight. Perfect. People would just think that I was training. I set a mental programme for myself. Each week the distance would increase – and the percentage for my enjoyment became lower and lower. It wasn’t for me any more; instead it was for the voice getting louder and louder inside my head, punishing me if I didn’t comply. Eventually I was running around 25 km a week and swimming around 6 km – on only half a yoghurt and a cherry tomato a day. But how did it get to that stage?

  The voice crawled in gradually, but quickly tightened its grip.

  ‘It’s easy,’ it told me. ‘Just do it really slowly and no one will notice.’ A whole jacket potato soon became half, then a quarter. Salad became a leaf or two. I would follow this restricting pattern in the week, but then I would eat ‘normally’ at the weekend, so that my parents wouldn’t notice. It was the perfect plan.

  Finally my lack of eating and excessive exercise became apparent to people around me. They would say that it wasn’t normal to do this amount of exercise.

  ‘Yes it is.’

  ‘Are you anorexic?’

  ‘No, you liar.’

  I didn’t want to believe them. They were lying, they were meant to be my friends, but they were just trying to make me fat. I hate them. I HATE THEM.

  But they knew something was wrong, and were very concerned about how much I was exercising. Eventually they took my running shorts and hid them from me to try to stop me from going outrunning.

  By that time I’d started to faint at school. The first time it happened I had just come back from a run. I was in my room on my own, and my sight became blurred, and black circles took over my vision. The black circles in front of my eyes were like the anorexia on my mind, distorting the truth. Of course I was scared, but I was even more scared to tell anyone.

  ‘If you say anything I will punish you, you’ll regret it, keep yourself to yourself, they don’t understand. They don’t like you either.’

  I fainted again later on in the week, and I was light-headed. I begged my friends not to say anything to the teachers, but they did.

  ‘See … they’ve betrayed you … I would never do that to you. I saw you and befriended you when they didn’t want you.’

  This was true. The voice had picked me up when I was low, and convinced me that I was invincible; why should I think that it was lying to me?

  Later on, the school matron came to see me. At first I was really closed off to her.

  ‘Don’t tell her anything.’

  Despite what the voice was telling me I did admit about the collapsing. She told me to wait in my room and not to leave. I felt angry and alone. And now my one friend was punishing me too.

  ‘Look what you did . ..you stupid, idiot girl. You are nothing. I hate you too now.’

  ‘No, please don’t leave me, I’m sorry, you’re all I’ve got,’ I cried to myself in my room. In a short amount of time I had become reliant on this imaginary, deceiving person, and I couldn’t get out of this loop. It was my one friend.

  I felt that no one could understand me, and I didn’t want to talk to anyone because I was afraid that they would laugh at me. No one could understand what was going on in my head. I had admitted about the fainting, but I was never going to confess about the voice.

  Matron and my house parents told me to go and see the school doctor. He made me feel really uncomfortable and put me completely out of my comfort zone. He weighed me and measured my height. My BMI1 was obviously low and he said that by the end of the next school holidays he wanted me to have put weight on. He also banned me from doing sport. However, this just accelerated the anorexia, because if I couldn’t lose weight by exercising I had to restrict my food intake even more.

  ‘See … they are all betraying you … I am your true friend.’ I began to hate everyone around me. I felt on my
own. In desperation I started to make myself sick. I couldn’t see any other way. The packed lunch would be given to me, and I would open up the packets of chocolate, crisps and sandwiches, to make it look like I had eaten something – and then throw it all in the bin. When dinner came, I ate about half of it – I was so hungry, I hadn’t eaten properly in so long, but then in comes …

  ‘What have you done? You’ve got to get rid of it.’ I had to do it, I had no choice. I went into the toilet and just made myself sick. It was an awful experience. I sank to the floor after I did it and sobbed alone in the dark. I knew this wasn’t normal, but I had to get rid of the toxic food that I had just eaten. There was no other option. The voice even congratulated me afterwards for doing it.

  In a matter of only a few months it had taken over my life. I would do anything for anorexia to please it. It destroyed any hope and inner strength that I had, and it stopped me from accepting help and seeing who I really was, and how physically and mentally ill I was. I continually doubted myself, and many times through this journey I doubted the point of my life. I was never good enough and I always put myself down. I felt like I was screaming out my pain and loneliness, but the sound of my misery was buried and trapped deep within me.

  It picked me up because I couldn’t control this feeling of failure which always followed me, and so the only way I could gain self-confidence was to starve myself. But I sank further and further into myself. I isolated myself from others and was in complete denial that anything was wrong.

  My body was so weak. Every single muscle ached. It got to the stage where all I could do was lie on a sofa and rest. Whenever I tried to stand up I would just collapse. But all I could think about was how this was making me a better person.

  Eventually Mum took me to our local hospital. By this point I was refusing not only to eat but, more worryingly, to drink anything at all.

  ‘Keep going … you’re doing so well’