Self-harm Gap Fills Up

I have been self-harming for 10 years, since I was 16. During this
time I have had periods lasting up to 18 months without cutting
myself. At the moment, I am going through a spell where I am not
self-injuring. While this is good news, the inevitable result is
that I am more food-obsessed.

My anorexia started at the same time as my self-harm. From then on,
cutting and dieting ran in parallel. When one failed me I would
resort to the other. When I lose control of what I eat, the one way
I can accept this is by cutting myself. I was in treatment for
anorexia for five years and have overcome that very strict phase of
controlling food. But the remnants of it are still there and have
surfaced in the past few months.

I now eat 1,100 calories a day. I read slimming magazines and adopt
dieting tips. I have lost a stone despite being a healthy weight to
begin with. My day revolves around food and I go into food shops,
without the intention of buying anything, but just to look.

Dieting serves many purposes. By eating less, I make what I have
more special. I can then look forward to “allowed” food. It gives
me a sense of control, and I feel I am achieving in something I am
good at. I feel I have more self-discipline than other people when
it comes to food. The preoccupation with food replaces thoughts
about harming myself. I can look out for physical changes as I lose
weight just as I would look at the results of my cutting on my
body. But it has its negative side. I feel my life would be fuller
without the food obsession – it is just that it is what I have
known for so long.

There have been developments that give me time out from the food
thoughts. I am on the patient consultative committee for West Kent
NHS and Social Care Trust. This meets once a month in Maidstone and
is chaired by a non-executive director from the trust and a service
user. People from the trust give presentations; the most recent was
on the availability of psychological therapies. Any carer or
service user is welcome. Everyone gets the chance to have their say
about services, and the trust responds to all issues raised.

Also my voluntary work at a citizens advice bureau has changed. I
now fill out disability living allowance forms for two afternoons a
week. This gives me a sense of achievement and I am pleased when
clients are awarded the benefit.

Social care staff need to be aware of the link between self-harm
and eating distress. They should explore the meanings food has for
a person. This is better than producing diet plans and expecting
someone to stick to them. Follow the client’s lead in how much they
want to talk about their eating, and see the feelings that drive
someone to control food.

Alex Williams is a mental health service user and
volunteer

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