“Two Worlds” – a guest piece by Victoria Johnson
I survive in two worlds. To an outsider, and even to some of the people who know me, they seem to be dichotomous realities. One world is that of a fully independent, working, single woman in her mid-20s, with two degrees in her name. This woman appears to have her life together and receives positive feedback from others for having achieved so much in her years. She is the “bright”, “functional”, “responsible”, “peppy”, “hardworking”, “caring”, “together” woman. The other world, however, reveals a woman who is much more broken than she initially seems. This world is that of anorexia. An often hidden, silent world that easily goes unnoticed, especially when an individual is trying to recover, maintaining weight for the most part, and so functional in society.
I have struggled with anorexia for over a decade of my life, formerly diagnosed at age 17 when my body was so emaciated that those in my life could no longer deny I was ill. I have battled anxiety, depression, and self-harm even longer. Through all these mental health challenges over the years, I have remained surprisingly functional (which, ironically, has resulted in additional challenges). I graduated high school, starving in brain and body, with the highest grades of my graduating class and a perfect attendance record. Despite being told I needed to take a year off school to be in the hospital for an intensive inpatient eating disorder program, I stubbornly refused; instead, I went off to university, hours away from home and with no support lined up except my false reassurance to my doctor and parents that I would follow-up with health and counseling services at the university. I graduated with my B.A. (Hons.) four years after that, this time with the second highest grades of all students graduating with a B.A. (Hons.) that year. I took a year off to work before getting accepted into an ultra-competitive clinical psychology graduate program and completing my M.Sc. two years later. I turned down a tri-council doctoral fellowship and the Ph.D. that was expected in my graduate program, and I ended up with a respectable full-time job in my field the month after finishing my master’s.
These external achievements seem incompatible with the view of someone struggling so intensely with an eating disorder or other serious mental illness. Indeed, this ignorant view posits that if one is very deep in an eating disorder or other mental illness, he or she must not be able to function; conversely, if one is able to engage in such functional, responsible activities of daily life, then he or she must not be “sick enough”. For a girl whose own worthlessness is so profoundly rooted, sharing these accomplishments feels narcissistic and shameful. But I share them anyway, in the hope of challenging some common beliefs around being “too functional to be sick”.
The discouraging reality is that this high level of functioning too often seemed to negate the unbearable hell I have endured over the years as a result of mental illness. In my experience, high levels of functioning, particularly when combined with a weight-restored body, have equated to “not sick enough”. This combination has been incredibly dangerous in my life. Various medical and mental health professionals I have encountered over my decades of struggle, both while actively engaging in the eating disorder and while trying to recover from it, have at times seemed to take me less seriously because I am so functional, A few years into the anorexia, my family doctor explained to me that certain mental health programs refused to accept me because I was still too medically unstable, yet she laughed in confusion since I was still performing so well while away at university at the time. Later, when I managed to restore my weight during university with the help of a therapist (whose care and dedication has been all that’s kept me alive some days), my body no longer reflected the torment of my brain. My outsides no longer matched my insides; the internal pain was no longer visible on my ravaged body. Because my functional life and my now-healthier body did not match my decaying brain, various other professionals from whom I sought additional support no longer appeared to accept the severity of my eating disorder. I repeated over and over during day hospital treatment how desperately I wanted to relapse and die, but I was sent away after my 8 weeks because my weight now met their BMI requirements and behaviourally, I was doing what I was supposed to do. A perfectionistic people-pleaser my whole life, following structured behavioural rules was something I could do. However, the deep-rooted pain, darkness, and anxiety that the anorexia numbed were still all-consuming. Yet, my functional behaviours and weight-restored body suggested that I no longer needed intense hospital support. The amount of times I have been told to just “hang in there” and “keep holding on” in response to my desperate urges to relapse and die, has been infuriating. So many people have told me that I do such a “good job” at coping that I feel like the proverbial girl who cried wolf when I speak of the intense torment still occurring in my brain. Consequently, I end up feeling that both my illness and my recovery must not be legitimate; they are not real or justifiable. I fall into the trap of believing I must not be sick enough at all, and certainly not sick enough to warrant support or treatment. A few years ago, I even consciously relapsed, returning to the anorexia I had never fully left, in order to be “worthy” of more intense hospital treatment that I avoided in my teenage years.
When denial is a symptom so characteristic of the illness itself, it becomes extra challenging when medical professionals also enable those thoughts of denial, feeding the sick brain’s insistence that “I’m not sick enough”. Even when I’ve come across guidelines for hospital admittance for patients with eating disorders, and knowing I once met several of these criteria, my ill brain still manages to convince me that I wasn’t actually sick enough. Flaws in our healthcare system are somehow twisted by the eating disorder to indicate my own “failures” at anorexia. Paradoxically, they also are twisted to indicate my “failures” at recovery. If I am coping so well behaviourally but still feel tormented by the mental illness after so long, then I must really be failing at recovery.
It is extraordinarily difficult to continue trying to recover from anorexia despite so many conflicting internal and external messages about my high levels of functioning. So many challenges ensue when one is existing between the functional body in the “trying to recover world”, and the sick brain in the “still tortured by mental illness world”. When now I only have my words to reveal the extent of my emotional pain and psychological turmoil, and yet so many messages I receive seem to reinforce the belief that I am only seen and heard if my inner torment is visible on my starved, scarred, broken body. Some days, I still want to scream in frustration. Why is my voice not taken seriously? Why does my body get more attention than my spoken words, no matter how articulate I’ve managed to become in matters of psychology over my years of education and therapy? Because when externally I appear so functional and healthy, no one sees the internal battle. No one notices the internal fight to get in a snack or a meal. None of my coworkers see the whispered curses and silent tears at my desk over the task of eating breakfast some mornings; none of my neighbours see me bristle at their praise of my exercise habits. Some days, the anorexia world is consuming and I am the girl who still cries at the thought of eating a granola bar. Some days, the recovery world is a little more present and I am the woman who can go out for a normal lunch with her colleagues. These realities may be contradictory, but they are not mutually exclusive in my life.
I survive in two worlds. My hope is to one day live in just one world: the world of recovery.
