SESSION FOUR

‘I didn’t realise how hard I was on myself,’ I said the next week. ‘Every time this week I thought about how stupid or ugly or useless I was, I imagined myself saying it to me when I was 11 and it broke my heart.’

‘How often do you think those things?’ Bjorg asked. She was wearing jeans and jangly earrings I could just see poking out from behind her hair – they gave me something to look at when I couldn’t quite meet her eyes.

‘Nearly constantly,’ I replied. ‘And they’re always such awful things. I make one tiny mistake that I wouldn’t even notice if someone else did it, and I tell myself I’m pathetic and worthless and yeah, I’m horrible to myself.’

‘Do you think they’re true things?’ she asked.

‘Huh?’

‘The awful things you usually say to yourself.’ She looked up at me suddenly, her pale blue eyes like searchlights. ‘Do you think they’re true?’

‘Well, yes,’ I said, hesitantly. I knew I was being led into a trap, but I couldn’t quite see how to get out of it. ‘And I know, I know, bad thought patterns, making assumptions, all the stuff that CBT tells you, but CBT tells you to find evidence for all your thoughts and I can find evidence to back up the fact that I’m stupid and embarrassing and no one likes me.’

‘And do you think they’re true about the little girl you spoke to in the other chair last week?’ she asked chirpily. I closed my mouth, pressing my lips together to try and stop the choking feeling in my throat.

‘No.’

‘Huh,’ Bjorg said. She furrowed her brow, gently puzzled. ‘But if that little girl is you, and she’s not all those terrible things, then how can you be all those terrible things?’ She twisted her mouth and frowned, looking for all the world like she was genuinely trying to figure out how such a thing could be true. Unwittingly, I barked with laughter. She’s such a dick!

‘Yes, okay, I take your point,’ I said, dryly. She quirked the corner of her mouth in satisfaction. ‘And it’s interesting, trying to think about little Amy as being inside me, as someone I still am. It’s made it easier to look after myself this week.’

‘How so?’

‘Well, making sure I get enough sleep, enough rest, that kind of thing. I thought about how I’d want to look after an 11-year-old and, kind of, did that. Although –’ My stomach started squirming. ‘– I still find it hard to eat properly.’

‘What do you mean “eat properly”?’ Bjorg asked.

‘I still feel so much … uh, so much guilt over whatever I eat,’ I explained falteringly. ‘I can’t remember the last time I just ate, a time when I wasn’t trying to eat healthily or purposefully trying to eat unhealthily to … I dunno, prove a point … Or trying to comfort myself, or punish myself or something. And it all feels so, excuse the pun, weighted. Whatever I’m doing, I feel terrible over it because I know that I should be better.’

‘Says who?’

‘Says everyone!’ I exploded. ‘The NHS, the news, my friends, my parents … No matter how much I try to listen to the people who say it’s okay to say I’m okay at whatever size, there are always 100 more people talking about how that’s wrong and it’s bad to be fat, and that my stupid fat body is disgusting and bad and probably going to kill me one day.’

I took a handful of my dress and started squeezing it, twisting it round my fingers. ‘And I’m reminded of it constantly – whenever I eat, whenever I get dressed, look in the mirror, see someone wearing an outfit I like, and realising I’d never be able to pull it off, all the time. It’s constant. And especially … especially when I’m feeling so miserable.’

My eyes and throat were burning again. I took a breath, pushed the pain back down to my chest once more, where I could cope with it. ‘I got a handle on my eating and my body, and then I got fat again when I was depressed, and now I can’t shift either of them. I feel trapped in this body, trapped in my depression. I hate that I’m so obsessed with my body, when realistically I know that it’s, like, the least important thing about me. I hate that I gained weight when I was depressed. I feel like …’ I swallowed. ‘I feel like I destroyed my own chances of being happy.’

‘Okay,’ said Bjorg, mildly. Leaning forward, she plucked a tissue from the box on the table and handed it to me so I could press it against my wet cheeks. She settled herself back in the chair and, when I managed to clean myself up and look at her through red, swollen eyes, she smiled softly at me.

‘You know, I see a lot of people, and they deal with their low moods and anxieties in all sorts of ways,’ she said. ‘Some people drink alcohol, some people take drugs. Some people look for ways to distract themselves, like gambling or having an affair, or something like that. And not always, but sometimes, these things become an addiction.

‘As well as having to cope with their depression, they have to attend meetings to help them cope with alcoholism, or go to rehab to break their addiction to drugs. Some people break up their families, get into debt. By the time I see some people, they’ve hit rock bottom and destroyed the lives they had before. And it’s terribly sad, and they have to do some really hard work to get out of it.’ She looked straight at me and smiled more gently than I think she’d done in the past four weeks. ‘All I’m saying is … Amy, yes, you over-ate to cope with your depression, and it changed your body in ways you don’t like, but believe me, there’s worse things you could have done than get fat.’

The words hung there in silence, and a few more tears wriggled free of my eyes. I didn’t wipe them away, they fell into my lap and made two damp spots on my crotch. We both pretended not to have seen them.

‘Yes?’ Bjorg prompted.

I nodded, not entirely sure I could speak.

‘Okay,’ she said quietly. ‘I think, let’s leave it there this week.’ She glanced at the questionnaire I filled out at the start of the session. ‘So, just to confirm – you’ve said you’re still having suicidal thoughts, but do you have …’

‘I have no intention to end my life or hurt myself. As always.’

‘Good. See you next week then.’

‘See you next week.’