My own serious experience with anorexia began way back in the 1970s when there was arguably significantly less understanding and Anorexia was portrayed as an illness that was solely about girls and young women trying to be stick thin in order to emulate film stars and models of the time.

Those big TV shows of the day: Dallas, Charlie’s Angels, Knots Landing – all portrayed women who were so utterly without flesh, and who lived a lifestyle that seemed to include a lot of ‘feminine’ type preoccupations, maintaining a home, preparing wonderful meals, eating out in fancy restaurants, enjoying cocktails by the pool.  There has always been a gap for me here between the reality of how to maintain a figure that is essentially and fashionably emaciated and yet appear on another level to be completely relaxed and non-obsessive about food and exercising.  It was a gap I believe that myself and many women and men I know have spent a lifetime wondering about how to resolve.

This was the pre-lycra, zero calorie generation so everybody wearing jeans had been able to squeeze into them without any of these aids.  It was a time when a boyish, androgynous, ultra lean figure was considered ultra desirable.

As the 70s moved into the 80s, the epitome of desire seemed to be the Julia Robert’s look, the tousled, just out of bed hair, the oversize man’s shirt, the long tanned slim legs and the reckless eating of ice cream from the tub without ever putting on an ounce.

This was a time when celebrities or tv personalities, like the unfortunate Lena Zavaroni and Karen Carpenter, hit the headlines with their unrealistic thinness at the ultimate personal cost, since Anorexia claimed them both at extremely young ages.

At the time, eating disorders were quite stigmatized and considered freakish; Bulimia was barely spoken about and there were few resources to open up understanding in the general populace.

Whilst Anorexia was widely portrayed as ‘fear of eating’ or ‘fear of getting fat’, there was quite a brisk approach endemic in GP’s and health professionals at the time.  Occasionally from the older generation, I did hear the ‘pull yourself together’ type remark coupled with the ‘people in Cambodia are really starving’.  For me, in my developing psyche, it was somehow wrapped up with the mass human starvation and destruction of the holocaust and with the hunger strikers of the IRA, the force feeding of turn of the century suffragettes with the difficult juxtaposition that emaciation somehow equaled prosperity, recognition, wealth, privilege and the esteem of peers.

Whilst I must have known that all those people being beamed into our living room weren’t really living any kind of dream, like many people, I was fooled and wanted to emulate them.  It was only later that I learned that Jane Fonda, who was an icon of aerobics and fitness chic in her day later admitted to a perfectionist streak and an eating disorder.  And of course, Princess Diana was quite a different size at the time of her engagement and succumbed to bulimia soon after her wedding, but there seemed to be more of a payoff in the public mind with being skinny and glamorous than the private psychological distress that was undoubtedly the unspoken root cause; the ‘well, at least you’re thin!’ school of thought.

When I recall my childhood, there was just this absence of any Adele type role models, and with the prevailing fashions of tight jeans and Olvia Newton John satin trousers, Daisy Dukes and Bond girls, where were the real women, who like me, had evolved with a backside to feed their babies in a famine, or a rounded stomach to protect their vital organs in a freezing winter? They were not revered in the same way as these skeletons with Cheryl Cole big hair, driving round in convertibles in the pleasant Californian sunshine, that filled our TV screens. When a woman of a normal size like Jo Brand or Dawn French hit the screens, they were somehow accepted because they were ‘funny’ and therefore somehow sexless and outside that arena in which the rest of us were trapped, that of looking a certain way.

I have spent some time here outlining the background to what is a very personal inner story of how I survived a very serious experience of anorexia in the late 1970s and early 1980s.  Discussion of it is still taboo in my family and I confess to feeling mystified at one level as to how I recovered.  At the time, I received nothing more than bi-monthly family psychotherapy sessions with a psychiatrist whom I was never allowed to see alone, and a strange dietary programme of being forced to drink two milky ‘Build Up’ drinks a day, the justification for which I never quite understood.

There was once a somber conversation in a hospital corridor where I was told that 99% of girls my age had a higher BMI than me, to which I thought, ‘Great! And your point is?’  I wanted to be the thinnest of all, so for me, it felt that I was succeeding.  Unfortunately, by this time, any image of myself was entirely distorted in my mind’s eye; I genuinely still thought I had a few pounds to shift, even as the scales were showing me to be about 5 ½ stone.

This was not my lowest weight by far and I am amazed at how even the distance of years does not diminish some twisted pride in that, but such is this disturbance, such is the hold of the inner voices that dominate your every waking thought when you are living with an eating disorder.

How do you slip out from the grip of these Voices, rebel by eating something you want to eat, without doing extra exercise, or standing up while eating, or having to make eating an apple last an hour, or any of the other mindless practices the Voices may command you to do?

My own recovery cannot be dealt with in this short piece; my treatment was insubstantial and didn’t help and I am sure my parents must have felt desperate at the time, as my weight fell and my behavior became more and more bizarre.  Anorexia isolates the individual on a quest for perfection; it is such an anti-relational disease and it keeps you at a place where you cannot live your life in the world, you cannot make decisions except related to your intake of food; it has been considered a disease with a Peter Pann-esque side to it, a way to delay and pause the horrors that come with puberty.

For some of us, who never felt good enough or sufficiently present or embodied as children, perhaps because we lacked confidence, or found it hard to be accepted in groups, that phase of life carries terrors as our bodies stretch and fill out, erupt in a myriad of different uncontrollable ways.  I have often observed in my practice how many clients do not feel the age they are and I believe that this is one of the neglected facets of this disease; people are not ready always for the physical development that throws them often into a state of body chaos.

Living in a world where now we can conform ourselves within an ‘acceptable norm’, everyone can have hair extensions and false nails, can work out in increasingly more scientific ways, can change the colour of their skin and eyes, mask their complexions with the incredible make up ranges that are on offer today, what hope is there for the people who suffer silently with this personal narrative of not feeling they fit in because their bodies are not the ‘type’ that are most aspired to?

Susie Orbach summarized this so brilliantly in the title of her seminal work, Fat is a Feminist Issue, but body issues do not just affect women; many men are affected by the apparent need to be ‘other’ than they are, and eating disorders and dysmorphic beliefs typically strike when people are at their most vulnerable with their self image. That narrative of self loathing and lack is intensely limiting over time.

I offer you parts of my story here so that you may connect some of what I have said with aspects of your own life or struggles with eating and food, whether it be abstinence, binging, restrictive intake, purging, excessive exercise, eating in secret, or other behaviours that you began seeing as a solution but which you now cannot seem to put down.

Constant and rigid dieting and rituals can keep you locked up and safe from living, if that is what you want or need right now.  I never suggest to clients that they abandon their safety net of evolved practices, but I do offer a safe space in which we can take out and examine all of these practices together and see what learning there is within them.

There is something after all about abstinence at the feast, about having conscious control over how you eat that can be beneficial at the level of self sacrifice if there is a goal or purpose to it.  Once the goal or purpose is lost and you are living at the mercy of persecutory voices telling you to run an extra two miles, throw your dinner in the bin, get up at 5 am to do 200 sit ups or go to bed hungry, it’s time to look at how these punitive measures of self harm can be brought back to a manageable level so that you can live a life in which eating and exercising and being in the world do not revolve around what you ate or how you expended it at the gym.

I hold to the hope that recovery is possible from all of this; it happened for me and what I learned in that time both anecdotally and from my professional training I believe to be of value in an adaptive approach that meets the needs of clients stuck in these punishing spirals of self hatred around food and body image.