The Forever Disease

This week, I arrived at my therapist’s office to find them trying to get an anorexia patient admitted to a treatment facility. She was so terrified of her disease that she refused to go home for as much as an hour while they found her a bed. Her malnutrition had floored her so severely that she couldn’t sit up, and yet my therapist couldn’t get so much as a glass of milk into her. She wanted help, but couldn’t bring herself to accept it.

I know that space. I’ve already been there.

Knowing you need help doesn’t magically remove the power of your disorder. If it did, realisation would be the only cure required. Anorexics would see their disease was killing them, eat a peach, and live happily ever after. The truth of mental illness in this particular niche is far more confounding… and we’re especially talented at infuriating the people who love us.

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I went into treatment with the full knowledge that I was killing myself, but I still found a million ways to avoid mealtimes. I was desperate for a cure, but I didn’t want the cure they were selling: I wanted to have enough energy to live a normal life, but I wanted to keep on weighing 40 kgs. I wanted my hair to grow again and my skin to come back to life, but not at the cost of eating real food. In short, I wanted a cure on my terms, and in those days, my terms were very, very sick.

Every anorexic I was treated with struggled with similar denial. We loved the feelings groups and emotional support. We hated the food and the fact that they made us face up to the consequences of our disease. It takes time to excise denial from your system, and in my case, it takes a confrontational therapist willing to piss you the hell off, too.

Counsellors likened treatment to peeling an onion. Every layer of denial they removed just revealed another layer of denial. Eventually, we removed the last layer, but anorexia doesn’t just give up after you beat it. It will return wearing as many masks as it can find. That’s why they call desperation a gift: few other traits are quite as good at keeping you away from your disease as the knowledge that hell and, if you’re lucky, death are the only consequences to relapse.

It’s hellishly difficult, even as an insider, to cope with eating disorder patients. They baffle me because I baffle me. Every so often, though, I watch someone find lasting freedom, and that fuels my optimism with the next batch who seek treatment.

Freedom, though, is a luxury that will be snatched away from you as soon as you let that first layer of denial grow back. Anorexia is forever. So is addiction. So are a host of other mental health issues that follow similar patterns. That’s why I’m forever grateful to those who loved me through it—they did what I still struggle to do: keep on hoping for people who seem beyond it.

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