Dr. Elizabeth McNaught joined us for an interview on her book, Life Hurts: A Doctor’s Personal Journey through Anorexia. What follows are our questions in italics, and Dr. McNaught’s thoughtful answers.
Early in Life Hurts: A doctor’s personal journey through anorexia you state, “When you live with anorexia you fight your own thoughts and fears, your own self, every second of every minute of every day.” Can you please share some of these thoughts and fears?
When you are living with anorexia you experience overwhelming fears that make you see the worst in everyone and everything. Just before the life-saving admission to hospital, when I was very ill, I remember my mum offered me a glass of water and a thought immediately rushed into my mind: ‘She’s stirred sugar into that, it’s full of calories, don’t touch it.’ So, I didn’t. At that time, the anorexia had such a control over my mind that I had eaten and drunk hardly anything for days. I couldn’t even brush my teeth because of intrusive thoughts telling me that toothpaste has calories in it.
You note the shift from you controlling your eating to your eating controlling you went quickly. What would you like people to know about this aspect of anorexia nervosa based on your experience?
The evidence is very clear that early intervention is crucial for bringing about a sustained recovery. This is because the negative thought patterns that lead to anorexia very quickly become established in a person’s brain. Anorexia is not primarily about food, it is about thought processes. One such process that is common to many is the need to have some sense of control. If a person feels out of control in important aspects of their life (such as, for example, being bullied) then they might start to restrict food intake as a means of having control over at least one part of their life. However, that food restriction soon leads to dreadful feelings of guilt when they do eat, and this guilt then starts to control them.
Thank you for highlighting the reality that an individual does not have to be very thin to have anorexia. Please tell us more.
I was delighted to see that the new guidelines for doctors in the UK, which NICE (the National Institute for Health and Care Excellence) published in May, explicitly state that Body Mass Index must not be used as a sole indicator in isolation when diagnosing anorexia. The guidelines list thirteen other signs and symptoms that should also be considered. The fact is that someone who does not appear thin could actually be dangerously ill because of food restriction which affects the balance of electrolytes in the blood that could result in dangerous arrhythmias and can ultimately trigger a cardiac arrest.
What do you regard as essential components for recovery?
Anorexia is a complex and multifactorial illness, so everyone’s journey is different. For me, I recognise three factors that contributed to my recovery: the care I received from professionals, the support of my family, and my faith. One aspect, however, that I think is essential for everyone’s recovery, is to recognize that anorexia is a deceiver, a thief, that steals your life. And, crucial to beginning recovery, is to refocus on your life goals and recognize that anorexia, far from being your friend, is in reality an enemy who is taking those goals away from you. For me, my goal was to continue my education and qualify as a doctor. But for others their goal might be very different: to travel or go to music festivals. Whatever a person’s life goals, refocusing on them is crucial to the process of beginning to fight against this illness, rather than fighting the professionals and others who are helping you to overcome it.
You discuss the distress and suffering the entire family of a member with anorexia experiences. How would you like people to think of mental illness/mental health?
We don’t live our lives in isolation. We are part of families, friendship groups and communities. So, our ill health affects others, and is affected by them. Mental health is not just about an individual person, it is also about the people with whom they share their lives.
You developed a relationship with God. How did this impact your recovery?
I began to see how my faith in God could change my perception of myself, and the world around. For so long, I had been so focused on food and weight, as if that was all that life was about, but now I began to gain insight into the fact that, in God’s eyes, those issues were tiny compared to the opportunities to live for him and make a difference in the world. I began to see that, if God loved me whatever I was like, then what would it matter whether other people liked me or not. Gradually, I even began to learn how I might be able to love myself again. I began to change my focus from the weight I could lose in my body to the good I could do in the world. I began to regain a positive vision for my life. And I recognised that I could not achieve anything of any value if I kept starving myself.
Can you please comment on the impact of the “humanity” others shared with you?
I will forever be thankful for the health professionals who helped me. I am thankful for their knowledge and expertise, for keeping me alive when I had the emergency admission to hospital, for helping me to see how my thoughts feelings and actions are inter-related and how I could turn them from a negative spiral to a positive one. But, when I look back at those who cared for me I know that those who had the greatest impact were not just highly trained and experienced professionals. They were also real people with a genuine humanity and compassion. I have carried that experience through into my life as a doctor where, as I have learned the necessary facts and developed the required skills, I have also sought to retain my humanity and develop my compassion.
About the author:
Dr Elizabeth McNaught (Lizzie) is a medical doctor with lived experience of eating disorders, diagnosed at age 14. The author of Life Hurts: a doctor’s personal journey through anorexia (www.LifeHurts.net) she now combines her clinical work as a hospital doctor with broadcasting on TV/radio and research for a PhD on protective factors against eating disorders.
Nick Pollard is Lizzie’s father. Despite his own undergraduate and postgraduate studies in psychology, he did not initially recognise and respond appropriately to Lizzie’s illness. He now speaks openly about his own failings and the insights he gained which became instrumental in Lizzie’s recovery. He is a social-entrepreneur, author of 10 books, and a popular conference speaker.