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 attacked 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