The one with the screaming.

Yesterday definitely wasn’t my finest hour. 
Yesterday I lost it completely and screamed at the lovely food psychiatrist. I screamed so loudly that people came running to make sure he wasn’t under attack. I screamed a scream that, I think, had been inside me for a very long time.

I am deeply, deeply ashamed about that, and this is me trying to work out how I got there. 

The day started like any other term-time Wednesday, with a lot of hustle and some nagging to get the girls out of the door and into the car by eight. If we leave after eight, we run the risk of being late for school. 

After drop-off I headed to my weekly GP appointment with the help of some very loud Elvis Costello, trying not to think about the scales that I knew were compulsory. 

At the surgery I settled to wait in my usual corner. My amazing GP gives everyone as long as they need – I was once in with her for an hour – and that means she never runs to time. Her regular patients know this and don’t mind at all. We exchange shrugs and smiles.

When it was my turn, we went through the usual routine: a quick scamper through sleep, eating, drug regime, hallucinations and self-harm. We do pulse and blood pressure and, if they’re not good, the stupid muscle-strength tests and referral for blood tests. I answer a barrage of mood-screening questions and, based on that, my GP decides how many days of medication I can be trusted with. At the moment, a week’s worth is a win. Then it’s time for weighing and, without words, my GP fiddles with the scales while I drag out taking off boots, scarf and cardigan. 

The walk to the scales can take some time although, in reality, it’s only a few steps. I know it has to be done, but I don’t want to face the numbers because – no matter what the scales say – my head howls at the result. If the number goes down, it’s never enough. If it stays the same, then I’ve been too lax. And if it goes up… well the shock and horror can make me dizzy. I have even passed out. 

My lovely GP chooses her words really carefully after weighing and gives me a chance to gather myself a little before making a plan for the week ahead. Today she printed out a graph of my weight over the past five years to take to my appointment with the food psychiatrist, complete with today’s weight, to save me having to do weighing twice in one day. I stuffed it in my bag so I didn’t have to look at the shameful highs and equally shameful not-low-enough lows.   

The recriminations in my head were deafening as I went to Starbucks to get a latte. So, on my way to therapy, I tried to drown them out with equally loud music. Erm, a big sorry to all the pedestrians who got a bit blasted by boom as I went by. 

Still in a daze, I took a brief detour to get another coffee – only realising when I got back to the car that I hadn’t finished the last one. Armed with coffee and a bottle of Diet Coke, I walked round the boarded-up front of the old mental asylum and went round to the back where a large, sprawling building still houses mental health services. It’s a self-conscious route: one minute I’m just a normal person, walking along the pavement and then – bam! – I step onto the path to the hospital and I’m a person with issues. Does it show? Do I somehow hold myself differently? I don’t know. But I feel the label being hung around my neck. 

Art therapy doesn’t contain much art at the moment. I just draw little boxes and it frustrates the hell out of me. I should be able to draw more and it should provoke insight – it used to. Now, though, I’m so tightly sewn into my rituals that are designed to keep me balancing on the tightrope of life that I can’t let go. My subconscious is bound and gagged in a dusty attic somewhere and we have to rely on plain old talking. We recap the week and my art therapist has always read the latest version of my notes, which means I don’t have to go into every little detail and also makes sure I can’t omit anything important. 

This hour a week is why I do everything I can to live a sensible, ordered, safe life. This hour is the only chance I have of anything changing, of finding a way to make living bearable. And for this hour to continue, I have to be able to keep the focus away from risk and safety, and I have to hold a weight high enough that I’m considered able to function cognitively. 

I don’t think I can bear to put the details of my precious hour down here. It’s like crooking your arm around your work when you were in primary school so no-one else could see. I’m not sure it would even make sense to you, anyway. But it stroked the depths of my frazzled head and helped me decide exactly what I needed to lay out in front of the food psychiatrist. I usually leave therapy feeling lighter, just for a while. 

More loud music and a lucky parking-space find later, I was heading for the eating disorders unit. It’s a weird feeling, going back to the hospital. It feels uncomfortably like home – particularly when I walk one of the 15-minute supervised exercise routes on the way to the unit. 

I hate the waiting room. I know the terrifying conversations that are coming and I’m surrounded by the smells and sounds that take me right back. Busy feet clipping on hard floors. The click of heavy doors opening with pass cards and then slamming shut, locked. Familiar voices having familiar conversations; in an eating disorders unit nothing is ever new and every agony has happened before. Yesterday I arrived just after lunch so the corridors stank of institutionalised fish. 

I sat, foot jigging, waiting. Other people came in and, from their chat, I realised they had come for a group. I tried to focus on the carpet to keep my mind under control – but it went there anyway, comparing my size to theirs. I know size is no indication of sickness. I know that. My head though, isn’t so educated. 

The food psychiatrist never rushes. He walked into the waiting room and shook my hand. Then he picked up my bag and we strolled down to his room while he asked about my girls. 

The last time we met I’d felt caught in a professional snare of appointments; eating had been way down my list of priorities and I hadn’t wanted to talk or listen. 

This time I was there with an agenda. 

I explained how the rituals were closing in, making it impossible for me to eat until nine o’clock at night. I spelt out how I have to clean the kitchen thoroughly before I can start preparing my food, and how it has to be put together in exactly the right way. That nothing can touch. That I have to time the toast perfectly. Weigh the spread. Heat the beans for precisely two minutes and ten seconds. Count the beans on each spoonful. Cut the toast into twenty squares. The rules go on and on. And they’re increasing. 

With a mixture of shame and embarrassment I asked him what I should do with the hunger that had arrived, roaring, out of nowhere. It had taken me weeks to work out what this gnawing gripe was under my rib cage. Sounds ridiculous, doesn’t it? But I have no recollection of ever feeling hungry. Really, ever. I never understood the wild excitement of children over the treats at a party tea. And I was that awkward child who could never be bribed by sweets. 

Hunger feels like the lowest blow the body can come up with in this war. I’ve let it have more nourishment than it has had for years. I’ve let the calories crawl all over my skin and I’ve sat with that. I’ve let the numbers on the scale creep up until my brain can function properly again. I’ve let the body demand and demand and I’ve placated it – and this is its reply. 

I explained the deep, deep abiding shame. I asked if it was the drugs. I asked how to make it go away. 

And he said it was the body fighting for survival against starvation. That I should learn to listen to it so that its tightly-coiled spring could expand relatively gently, rather than exploding. That it was a consequence of being underweight for so long. And he offered me a bed on the unit for support while it happened. 

I felt the fat crawling all over me. I felt the too-large space I was taking up in the world. I saw the weight graph with that day’s point at a pinnacle rather than a valley. I boiled with shame. 

That was when it happened and I screamed, “I’M NOT FUCKING STARVING” into his face. 

Calmly, he looked me in the eye and said, “Oh yes you are”.  

Then there were people in the room to make sure he was okay. He was kind and reassuring, but I couldn’t really listen. I’ve blocked out the rest. And I don’t know where this leaves me.