"Somebody Someday : a discussion with Flora"
On a cool morning in London, I meet with Flora. The air is crisp with the promise of Autumn, leaves are turning the colour of lava and falling on the window. We usually meet on a Tuesday, but today Flora and I are going to talk about something rather different.
Flora comes in with her oversized jacket on, perfect hair, beautiful face. She looks somewhat underweight, but when she takes off her coat apparent is the evidence of a body worn by the fight of Anorexia. However, she is no longer the girl she was. She has, with great will and determination, come out of a specialist Eating Disorders unit in London 8 months ago into private psychotherapy with me, and regained not only to a target weight, but an understanding of her worth, a glimpse at her true self.
I have asked Flora to talk to me about the experience of being in Hospital, how it did work to save her body, and the frustration she feels about how it nearly worked to lose her mind.
Flora tells me her story:
"The first time I went into hospital I was 14. My local health service could not fund me to go to Hospital in my area, so they funded me to go to another private hospital someway from my home. It was an adult hospital, so I was the youngest person there. I was dangerously underweight. I was struggling to eat or drink anything. Being a child I was very upset by the fact that it was a mixed diagnosis ward. There was supposed to be a Unit for eating disorders, but the woman who ran the unit had left just two weeks before. The new staff person who came on the ward had no idea what an eating disorder was. She used to bring me food, and try to make me eat it. She felt sorry for me because I was so young. She was nervous around me, scared to look at me and left in a few days of my arriving."
Flora goes on to tell me that in that particular setting, she got no
specialist help, no therapy, no eating plan. She was 14, alone, and
was doing her utmost to continue to starve. Although Flora did see a
Flora was at this particular hospital for 9 months. She gained enough weight to leave the hospital, but in her words she "gained nothing else".
A month later, Flora was back, discharged herself after 3 months in treatment as she did not want to gain any more weight. She was then 15.
"I was now in the 10th year at school, but I had to drop down a year. You see, in the unit I was not allowed to do school work as I was told it would be to stressful. I did go back to school, but I had no idea how to maintain my emotional world. I then began to lose weight rapidly. I was out of the hospital for just 9 months, and I was 16. This time it was a different hospital."
Flora takes a deep breath. She sighs, and looks down at her feet contemplating her thoughts.
"For me, this was the most traumatic time of my life that I can remember. I was put in an adolescent unit. There was not ED unit, no groups, nothing. It was mixed with every disorder one can think of. All the treatment I received, once again, was around when and what I ate. Anorexia was never about the food for me, it was about hating myself. It is about how I used food to manipulate people, it was about how it felt to be what other people would call normal. It was how I felt special because I was Anorexic. No one ever showed me in hospital how to be anything else, and so I hung on to being Anorexic. Now that I look back it was for me, an appalling place. It was like another world in there, I became institutionalised and being Anorexic was my personality now. I was no longer Flora. Every meal was one to one, me yelling at them that I was not going to eat, them yelling at me that I was going to eat. They threatened to discharge me, but of course I would then eat. I didn't want to leave there. Why would I? What would I have? The meals were all weighted. They told me what the weights were, and I was frightened to eat anything that was not at the same weights or the same foods. By the time I left there I felt disabled by my inability to make any choices. Not about food, not about life. This is the most distressing thing. I felt greedy and awful as I was eating more then anyone in my family, but I was still feeling out of control and chaotic. Being at a normal BMI does not mean I was well. When I was finally discharged, I was no better then when I went in. I had no emotional control, and that's what I so desperately wanted. At this point, the lowest for me, I was sat in a room with my parents where a two way mirror was on the wall. They were given 45 minutes to get me through a meal. A plate of food, mum on one side, dad on the other, willing me to eat. And that was how I was discharged. With enough coping skills to have to ask my mother if it was ok to swallow food, or my dad to cut and weigh toast so it was ok for me."
Flora goes on to tell me that she knows full well that some hospitals do work, and that the main ingredient is wanting it to work. At that sage of her recovery, Flora was now desperate to get better, yet she did not have the skills to understand why she was Anorexic, why she choose this disorder and how to handle eating.
"Upon reflection, my worst moment was when my doctor came into a meeting and told my parents and I that I would never recover. It was my belief, and my parents belief that he was right. Who was I to argue? My parents saw my doctor as the bottom line, and none of us questioned him."
Although Flora did her GCSE's and passed 6 of them, she was readmitted to the Hotel as she calls it. She says it was positive, as it broke the pattern of weighing food and having to be talked into and through a meal. She was only there briefly, but played all the same games to not eat. Filling her sleeves with food, drinking up to 4 pints of water to weigh more and at its worst learning how to stuff a large bag of 7 inch long potato snacks in her mouth and have them coming out of her nose so she did not have to eat them. Flora laughs about this, as do I. "Not a clever party trick", she adds. We both go quiet, and a large leaf hits the window sill.
Flora spent the next 3 years in and out of hospitals, fighting to be a person in what she calls "the nightmare of being a Stepford Anorexic". Then a turning point.
"The hospitals I went to, and mind you this is only my experience, told me time and time again that it was not what they called a privileged program. But it was. Eat, and you can go out, eat and you can do art, eat and you can shower for 5 minutes longer. I wanted to understand myself, I wanted to know what was wrong with me that I simply could not eat. Who was going to help me with that? I wanted to get better at this point. I was desperate to be well, find out who I was under this Anorexia. In my experience, all I was taught was how not to get caught cheating, how to play of sophisticated game of cat and mouse. It was not until my last and final discharge that I made the decision that inpatient treatment would never work for me."
I ask Flora to tell me what her most positive experience of inpatient was. She says:
"I always feel guilty saying that the treatment was awful, they saved my physical life. But it was me that made a choice to save my soul and understand how to care for my body by eating and feeling ok about it. I felt, how do I say this? That it was my choice not to eat, and I know I needed to be safe, and I get why they forced me to eat. But ask anyone who is in a place to have choices about recovery, and they will tell you its not about food. Its about feelings. Teach me how to be a person, teach me how to have an emotional life."
And now that she is in a place to have those choices, and out of the cycle of inpatient treatment, I asked Flora what the future is for her.
"I have 2 sessions a week with an Eating Disorder specialist that
I picked, privately. I see a nutritionist that is amazing, who has tailored
my meals so that I am gaining slowly, but I am gaining. I don't feel
like a Christmas goose stuffed up and on show, I feel like a human being
that has the choice to eat or not eat. If I don't eat, I now know that
I will die. I have learned that Anorexia does not work for me anymore,
manipulating people by starving is not ok, and that I am special for
being Flora, not for being Anorexic. Is it easy? No, it's not. But nothing
that is worth having is easy to get. I always knew I would be somebody,
someday. And now I am."