8:00 P.M.
SO MUCH CAN HAPPEN IN A YEAR. A MONTH. A DAY. A MINUTE. Something gigantic can happen in a second, but you are not ready to see it, so—you don’t.
You have an unhappy girl, who doesn’t like the way she looks—but you just think, Well, these are the teenage years. It will pass.
You keep finding packed lunches left on the kitchen table, but you think, She probably just doesn’t want sandwiches. There’s a cafeteria at school. She’ll be eating chips, instead.
Pictures of Amy Winehouse start covering her bedroom wall, but you’re like Well, Back to Black is one of the bestselling albums ever, it would be odd if she did not like this classic album, and her eyeliner is, to be fair, amazing. That’s why she loves her. There’s nothing sinister going on here.
She gives up red meat first—“It gives me a bellyache”; and then all meat—“It’s just kind of boring”; and then fish—“It’s kind of spooky”; and then becomes vegan—“Dairy products are cruel to animals, and there are so many other things to eat.”
And you can’t argue with her choice because this is a popular trend amongst young people, and you’re happy to buy oat milk, and cook with lentils more, and to research and purchase the best supplements to make sure she has everything she needs. It’s just a little cooking challenge—nothing more.
In the mornings, she comes down later and later—so late she has to rush past the breakfast things on the table, shouting, “The bus is coming, got to go, bye!” And you know it takes teenage girls a long time to get ready in the morning, so you start pressing smoothies and breakfast bars into her hand, saying, “Eat them on the bus!”
“I will! Thank you!” she says, smiling, looking you right in the eye.
And then, at the end of the month, you find ten uneaten bars in her bag.
But all you can go on is how she looks, and she doesn’t look unhealthy, and she always tells you everything—you are close, so close!—and it can’t be an eating disorder, because you are her mother, and she is your baby, and you are a body-positive, cheese-sandwich-eating feminist who walks around the house naked saying, “Look at my lovely, wobbly tum-tum,” and telling your daughters that they are brilliant and strong and beautiful, and so how could your baby have an eating disorder? She doesn’t have the genes for it.
“I don’t want to medicalize something that might just be a fad,” you say, in bed with your husband. It’s 1 a.m., and you’ve been talking about this since teatime, when she took her plate to her room—“just want to chill for a bit!”—and then you found it on the floor, outside her door, afterwards: salad eaten, but all the brown rice, Quorn, and bread left untouched.
“I’m just into raw stuff now,” she said. “It’s the most delicious!”
Because the thing is—she’s so cheerful now! So happy! So—progressive! So organized! Every piece of homework done on time; a neat schedule pinned up on her wall; her clothes laid out the night before; her bag packed, just so.
She has lists of what she needs to do; lists of places she wants to go; lists of songs she wants to learn on the piano. She seems totally on top of her life. The unhappiness of a few months ago seems to have burned up—she is now full of energy: a bright, shining energy. It’s as if there is something inside her spinning faster and faster. In almost every way, you would think this is a good thing—she is being a hardworking, happy, model girl.
But you can’t shake this recurring mental image—that, in the center of this shining light, there is a darkness. And the faster the light spins, the bigger the darkness gets.
PETE IS THE first to say it.
“It’s manic behavior,” he says, as we lie there. “I saw it in a friend, at college. This is like manic depression. Or some kind of mental illness.”
I, too, have seen manic-depressive behavior—the revelatory, joyous, Icarus-like flying toward the sun, before your wings suddenly melt and you plummet. And I foolishly believe we can parent our way out of this—of course we can.
“I have a plan,” I say. “It starts tomorrow. We can sort this out. It’ll be over in a couple of weeks.”
I WILL JUST . . . parent her better. If she is worried about her body, I will show her a better, more stable way. I will take her swimming, after school—me and her, playing together—and she will work up a healthy, childlike hunger she can’t deny. And then I will make her something delicious—that fits in with her dietary preferences, but still gives her all the nutrition she needs—and I will positively affirm her eating it, and everything will be better.
That is how you parent a child. That is how you keep them healthy and well fed. That’s how I taught her to eat as a toddler, and how I will rectify this little blip now. It’s not an eating disorder. It’s just an eating . . . blip.
I PICK HER up from school, and she’s happy but a little tired, and she is delighted we will go swimming together.
“Yes!”
Looking back now, the idea of putting a teenager with a developing eating disorder in a swimsuit, in a place where lots of other teenage girls are also wearing swimsuits, is, obviously, incredibly stupid. Just because I am happy to wander around semi-naked with my battle-scarred, imperfect, happy, old body, I presume she—unscarred, long-legged, glowingly teenage—would be even more at ease. That she has absorbed the family motto—“Whatever other people think is none of your business”—and feels it in her bones. That she still sees “going swimming” as a joyful treat—like she did as a child.
The fact that she keeps her towel around her until we reach the water’s edge suggests that’s not the case, but I just think, unjudgmentally, Oh. She’s just a bit modest. Fair enough.
All the other teenage girls are in bikinis. She has a sensible black Speedo swimsuit. I see her eying the other girls and mistake what she’s thinking.
“Do you want to get a jolly bikini, like them?” I say. “There’s some nice ones on ASOS.”
“No!” she says, horrified, sliding into the water.
We swim together for ten minutes or so—racing each other—and then I find her, at the end of a length, clinging to the edge of the pool.
“Can we go home?” she says, in a small voice. “I feel a bit tired.”
“Of course!” I say. She seems reluctant to get out of the water, until I realize why and fetch her towel.
She shivers all the way home, even though I hug her tight. “You can have my body warmth,” I say. “And when we get back, I’ve got tea ready, and we can eat it on the sofa, and you’ll have that lovely, tired-but-happy feeling in your legs. It’ll be cozy.”
“I’m not that hungry,” she says, in an odd, distant voice.
“That’s because you’ve gotten too hungry,” I say. “Wait until you see your tea. You’ll get hungry then. It’s a special one.”
I’ve made one of her favorites—lentil soup with a toasted-seed salad and homemade bread. These are all things that she loves.
But when we get back, she looks at it, and says, “Sorry, but I just feel a bit sick. Maybe I’ll eat it later.”
“You probably feel sick because you’re so hungry,” I say.
“Maybe,” she says—in the same distant voice that feels like something I can’t get a purchase on, or find a way into. It’s a curious trick. How can a voice do that?
She goes to her room.
I wait an hour, then bring the soup up at 6 p.m.
“Maybe later,” she says.
I bring it back at 7 p.m.
“I still feel so sick.”
At 8 p.m., I go into her room and leave it on her desk. The delicious smell will, surely, compel her to go over and try it.
At 9 p.m., I find the tray outside her room, untouched.
“Maybe the chlorine in the pool made her feel sick,” I say to Pete, in bed, at midnight. We’ve been talking for two hours now. “I’m a fucking idiot. But she’ll wake up tomorrow starving, and it’ll be okay. It’ll be better tomorrow.”
IT IS NOT better tomorrow. This is the weekend the storm breaks.
She does not eat breakfast—“I still feel sick”; or lunch—“Stop going on about it!”; or tea—“Mom, you’re freaking me out. Leave me alone.”
By 6 p.m., I am determined to sort this out. There will be a reason—a worry, a thing, a single thought—that is making her not eat, and I will make her tell me it, and then I will solve the problem, and then she will eat. This is, surely, the simple logic. She knows why she is too unhappy to eat, and I will make the unhappiness go away. This is what we have done with every other problem in her life.
I go to her room. Her hood is up. She’s just sitting on her bed, rammed into the corner.
“Baby, what’s wrong? You’re not eating.”
She shrugs.
“Just tell me! Whatever it is, we can sort it out.”
I sit on the bed. She shrinks away from me. I hug her—if I hug her long enough, she’ll melt, and then she’ll cry, and then she’ll tell me. That’s how it always works.
That’s not how it works anymore. She becomes stiff, and hard, in my arms.
I let her go.
“Tell me!”
“You know what’s wrong with me.” That distant, cold voice.
“I don’t!”
Maybe I do, but I don’t want to say it, because that might put the idea in her head if she hasn’t thought of it yet—saying it might make it happen.
“You need to eat, or you’ll become ill. If you feel terrible now, it’s because you’re starving. Just eat something—I promise you’ll feel better.”
“You control my life.”
Oh! I didn’t expect this! It’s so wrong I become angry.
“Control your life? That’s balls. You have more freedom than any teenager I know. You can do whatever you want.”
Slyly, furiously: “You’re trying to make me eat, when I’ve told you I don’t want to.”
“That’s because I know how sad being hungry can make you. I promise you’ll feel better if you eat.”
She’s silent. Then: “Why don’t you know the right things to say?”
“What are the right things to say?”
“You know.”
I don’t know. I really don’t know. I promise you, I don’t know. Or: I’m too scared to say them. I don’t want to say it. I am in charge of this silence.
THE SCREAMING STARTS an hour later. I’ve never heard her scream before. It’s ungodly—it sounds like something trapped, even though she roams around the house, locking herself in the basement, then the bathroom, as Pete shouts, in panic, “What are you doing in there?” and tries to kick the door down. We’re both, suddenly, very frightened. When she finally comes out of the bathroom, she bolts down the stairs and tries to run away into the street. Pete grabs her, and she roars, “YOU’RE HURTING ME! HELP! HELP!” as we drag her back into the house.
She finally collapses, sobbing, in bed, at 2 a.m.—repeating, “I’m sorry, I’m sorry,” over and over, crying, as we watch Absolutely Fabulous on my laptop, and I wince every time Edina Monsoon says, “I’m so fat.”
“I love you,” I say. I love you means a million different things. Here, today, it means: Please don’t be unhappy. Please don’t be ill. Please tell me what’s wrong. Please don’t leave us. Does she know this? Does she know that this is what “I love you” means, here in this bed, as I hold her?
“I love you too,” she says, and falls asleep, holding my hand.
I wake next to her, on Sunday morning, and stare at her face. Asleep, she looks—perfect. Serene. Everything in her body looks right. The problem is in her beautiful head—where one tiny synapse misfires, one neuron sparks too hard. Something the size of a grain of sand, in some tiny electrical root, buried deep in her head, is causing all of this. I imagine being able to put my hand inside her head and remove this tiny thing—just as I have splinters of wood or glass from her feet. One tiny thing wrong. But it’s somewhere I cannot reach. The calls are coming from inside the house.
SHE DOES NOT eat today, either. She walks around the house with dark smudges under her eyes—eyes which look different today. They seem oddly glittering, snakelike. She looks like she’s seen a vision or is hearing other voices. I am more scared than I have ever been in my life.
At 7 p.m., we google “eating disorder specialist.”
God bless the NHS—at 8 p.m. a doctor rings us back, and says, “Bring her in as soon as possible.”
WE ARE SEEING a doctor now, which means we will be safe, and this whole thing will end soon. Maybe it will take a couple of weeks, but she will be well by Christmas—at the latest—and we will look back at these bad couple of months and laugh.
“Remember when you didn’t eat for three days!” I will chuckle, as she eats her turkey, and she replies, “Yeah—that was so weird. Not like me at all! Soz! Another sausage, please!”
In my mind, the biggest, hardest thing has happened—we have admitted she has an eating disorder, and we have sought professional, official, medical help. They’ll know exactly what to do, and they’ll fix her fast—because we’re us, and she’s her—and things will go back to how they were.
In reality, we go to a hospital that seems like a huge gray Soviet Bloc with clusters of cancer patients smoking in the rain by the doors. Why would you place a children’s mental health unit inside a building that seems designed to inspire terror, and hopelessness, in a child? Does benign architecture cost that much more? Over time, it would cost less, surely, than the cost of missed appointments—for, the first two times we go there, My Girl balks, weeping at the idea of entering somewhere so sinister and grim. I cannot blame her—it terrifies me, too. It feels like, once we cross the threshold, everything will change. We will, officially, be a problem.
On the third attempt—after another week of weeping—we finally make it into the building and see a serious doctor, who tells My Girl that it sounds like she has a problem. He then passes us on to a nurse, who is very kind and helps My Girl write a list of all the food she should eat in a day: three meals and three snacks. We are to come and see this nurse every week—to “check in”—and we are on the waiting list for therapy.
I wait, throughout the appointment, for a prognosis, a schedule, a plan, some firm advice—the bit where they go, “And, ta-da: here is the cure!”—but . . . it all seems so vague.
“But what do we do?” I ask, in the end. “What happens?”
“Well, we don’t know her story yet,” the nurse replies, kindly. “We have to wait, and find out.”
On the way home, My Girl stares at the piece of paper they have given her, with her “Eating Plan” written on it: porridge, toast, or cereal for breakfast; a sandwich and a yogurt for lunch; sausage, mash, and broccoli for tea; pudding, biscuits, or cheese for snacks.
We all know she will not eat this. This is Chamberlain’s piece of paper held by a hungry, sad girl. We all know what she should eat. But neither she nor we know how she should.
NOW, YEARS LATER, I know how mental health services work. To be brutal, wherever you are in the world, they are swamped. Child and adolescent mental health is a booming, dark phenomenon in the uncertain twenty-first century, and in the building we walk into, there are children who look like skeletons, or who have made multiple attempts on their lives, or who live in chaos with parents who are also mentally ill. In the tiny, cramped waiting room, we sit with children with NG tubes; children with bandaged arms and scarred faces; children who fight and run away; or else just sit there, quietly crying. Several are on their own—I can’t begin to imagine what their stories are.
In this Pandora’s box of unhappy, pained children, My Girl—who is eating less than 600 calories a day, or else nothing at all; My Girl who is screaming; My Girl who is not sleeping; My Girl who is ringing from school at 11 a.m. in the midst of a panic attack, begging to come home—is not at the top of the list for help. I can see how desperate the situation is—on three separate occasions, during appointments, our doctors have to excuse themselves for an emergency in the Eating Disorder Ward. The looks on their faces tell you something the seriousness of these emergencies—these are the children who will not drink water in case it makes them fat, or who have smuggled blades into the unit, crept into the bathrooms, and quietly shredded their arms.
The mental health unit is like a tiny rescue boat in a sea filled with drowning children. It is the ones who are repeatedly slipping under the waves—the ones who are minutes from death—whom they must attend to first.
In this world, My Girl—who turns up to every appointment so politely and quietly; who says “please” and “thank you”; who listens attentively, and never argues back; who is still able to walk—is a low priority.
She needs—I find out by ringing the eating disorder charity Beat, by talking to a friend who is a child psychologist, and by reading every book I can get my hands on—a dietician and cognitive behavioral therapy (CBT). The hospital has just lost their only dietician, and the waiting list for CBT is more than a year long.
In the meantime, what we are left with are the weekly “check-ins” and a list of foods she will not eat. For three meals a day, seven days a week, we are on our own with this illness.
We have help, but yet we must wait for help.
“Why won’t they help?” she sobs at 2 a.m. “Help me. Help me. Help me. Help me.”
HERE ARE ALL the things you can do while you are waiting for the professional psychiatric help that will stop your daughter from being scared of food and, by association, life. Here are all the ideas you will come up with to make the days better!
THEN THERE ARE the different phases of tactics you employ, to make this sad, angry girl eat.
WE BEGAN WITH a simple logic: She is not eating because she is unhappy. Therefore, we must make, and keep, her happy. Then, she will eat.
We began by being parodically cheerful—greeting her with an overly lighthearted “Oh my God you’re home!” as soon as she came through the door, then bombarding her with the evening’s schedule of carefully planned joy: “I’ve run you a lovely bubble bath, then you’re going to put on your snuggliest pajamas, and I’ve set up an obstacle course for the rats, and we’ll teach them tricks! How cool! I’ve made your absolute favorite dinner, and we’ll watch High School Musical on the laptop while you eat, and then I’ll give you a relaxing foot massage while we look online for pretty dresses.”
This was all done with the best possible intentions, of course—but when a girl trying to step into adulthood whilst in the throes of a mental illness sees her parents suddenly acting like they’re on The Truman Show, she will, obviously, find it all quite unsettling.
Sometimes, the enforced jollity helped—she would meekly bathe, dress, and be snuggled, exhausted by the day. But, more often than not, she would understandably retreat to her room—issuing forbidding “I just want to be alone, thanks” to the cartwheeling, fucking clown knocking on her door and saying, “Daddy’s got Buckaroo! out, darling—you love Buckaroo!”
Buckaroo! with two jazz handsing parents is not—I can tell you now—the cure to an eating disorder.
WITH HER RETREATED to her room, we embarked on Phase Two: Intellectual Reasoning. She’s a clever, clever, girl, and we’re reasonable, modern people—we could simply bombard this illness with explanations and chase it out that way!
I am still haunted by the look on her face when we would both knock on the door and come in, like the fucking Logic Squad, to explain to her why she shouldn’t be ill anymore. Sitting on the end of the bed, wearing the faces of Enlightenment philosophers, we would TED Talk our sad thirteen-year-old girl: “This could turn into a really serious problem, love—so we need to nip it in the bud. You need food for energy; you need food so you don’t get depressed. When you’re starving, your brain function drops, and your cortisol levels rise, leading to this anxiety we can see is so bad for you, sweetheart, so—eat! It’s very simple!”
Oh, those explanations! Pete and I, sitting on her bed, lecturing her for hours—lovingly, rationally, firmly—on the logical solution to her problem. The more sullen and unhappy she would look, the longer our illustrative anecdotes, colorful metaphors, histories, and reference points. We called on the history of nuns who fasted and hallucinated and experiments that were conducted on prisoners and dogs. We talked at her for hours—as she shrank, smaller and smaller on the bed. Oh, we believed in common sense! Oh, we believed in our power as communicators! Oh, how we crushed her—steamrolled her with all our thoughts and beliefs! Oh, how hurt we were when she nodded, in the end—“Yes. I see”—but then still. Refused. To eat. Her message: Fuck you, Wikipedia. I am sad.
A WEEK LATER, I am in the chemist. I’ve spent five minutes pretending to buy deodorant. I finally walk up to the counter.
“I need—my daughter has cut her arms,” I say. “I need dressing for razor cuts to her arm. What should I get?”
I can’t believe I’m saying these words out loud. I expect the whole room to fall silent. This feels like an aberrant, and awful, admission—something outside the normality of this small, local pharmacy. I’m not sure the chemist will know what to do. I’m worried I’ll upset him. Or that he’ll throw me out of his shop, or call Social Services to report me for being so bad a mother my daughter has self-harmed.
Instead, the chemist calmly walks over to a shelf, and says, “Here—you need medical tape, sterilizing spray, and sterile dressing pads. We’ve sold out of the small ones—we’ve only got the large ones left.”
He gives me the things.
“There’s a lot of it about,” he says, matter-of-factly, shrugging.
THE BIGGEST PROBLEM when you have a child with an eating disorder is this: Every tactic you have ever used in parenting is useless. Worse than that: It’s wrong. You can’t get through it on instinct, or logic, or emotional appeals, or punishments, or anecdotes, or rewards—everything you’ve used since the day they were born. What you need, urgently, to do is forget about being a parent and become a mental health professional instead.
There are very specific things you should and shouldn’t do—specific words and phrases you must employ, accurately, without deviation or improvisation.
There is a script you must follow that, over time, and if adhered to, can effect what feels like a miraculous change: Each word, said in the right tone, undoing some small patch of anxiety and horror in your child’s head. There are things you can say before a meal, during a meal, after a meal, on the way to a hospital appointment, and when they cannot sleep, which do the thing you so desperately want: to make you seem, to your child, as if you are a calm, wise, endlessly loving person who is gently leading them somewhere safe—where all this will, one day, be over.
Unfortunately, at this time, I do not know these words. I have not yet found the books, or received the advice, in which they reside.
Instead, my head is full of what I read last week, in one of the books I was searching through, for this spell: “Eating disorders have the highest mortality rate of any illness. The average length of an eating disorder is between five and seven years.”
Five and seven years. Her whole adolescence up in flames, like that. What you had fondly imagined to be full of parties, proms, carefully prepared-for exams, bicycles, sleepovers, driving lessons, and a slow unfolding into adulthood will, instead, be this: the hospital, twice a week. Bandages. Hiding all the knives. Weighing every meal. Sitting with her until 2 a.m. Searching her sleeves for hidden food. Casually folding sheets on the landing when she goes to the toilet, in case she’s making herself sick. A new to-do list—but this one the most important, the most crucial of all: a list of things that will keep her alive.
A week later, we are in the hospital for one of our appointments—my child now bandaged, like so many others. We have come, finally, to ask for Sertraline—“It might help her get her head above the waves for a bit,” a psychiatrist friend advised, when I rang her, weeping at 11 p.m. “It sounds like she’s going under.”
On one of the tattered magazines on the table, someone has written in the margin in a shaky, childish hand: “Nobody gets better here.”
I cover it, with my bag, before she can see it.
And still, I do not say the simple, simple thing I should: “I can see how unhappy you are. It’s okay to be unhappy. I’m not scared of it. I’ll stay with you until it passes.”
Instead, we keep trying to make her make it go away. And she can’t. She’s ill.