A few weeks ago, I travelled to my father's house in Bristol, where my mother and I recorded an interview about my anorexia for the BBC Radio Scotland series ‘A Life in Limbo'. It focuses on my mother's life, and how it was ‘put on hold' by my illness, and discusses the beginning of my anorexia, what sustained it, and how it ended. The interview is transcribed below.
Clare English: Hello, I'm Clare English, and in this series of A Life in Limbo I hear from people whose lives have been put on hold because of factors beyond their control. Sue Blackmore knows all about that: she spent ten years watching her beloved teenage daughter slowly self-destruct. Emily was anorexic. At one point, her weight dropped to below six stone. But despite the punishment she was meting out on her body, she attained a First-class degree in French and German at Oxford University. The academic achievement marked the physical and psychological pain Emily was inflicting on herself and her mother. Sue seemed unable to do anything to stop her daughter's decline, until she delivered a devastating ultimatum. Both Sue Blackmore and Emily Troscianko are with me now, in Emily's father's home in Bristol. It's lovely to see you both on such a fine day, looking so happy and healthy.
Sue Blackmore and Emily Troscianko: Thank you.
CE: Let's start with you, Emily, right at the beginning, and explain to me when you first slipped into anorexia.
ET: There's a point when I was sixteen; we went on a ski holiday, the whole family, and I got quite drunk on the last night, and felt too hungover the next day to ski with the rest of them, and then couldn't face eating, and there was a long drive, and so on, and I remember just for the first time experiencing hunger as a pleasurable, almost exhilarating, sensation. But then I've looked back at diaries from previous years, and already I was talking about the usual sorts of teenage things: feeling fat, thinking that boys didn't find me attractive, thinking that if I were to be thinner then things would be better, in all sorts of ways.
CE: Sue, it's interesting to hear Emily say that it was really that skiing holiday that might have been the beginning of the realisation that she was going to have a difficult relationship with food. Did it strike you at that point that something might have been happening?
SB: That was a very difficult ski holiday. I had split up from her dad, Tom, not very long before and was with my new partner, Adam, and we were all on this ski holiday but staying in different places. And it was all right, but it was a little bit awkward, and I think Emily getting very drunk and everything was all sort of part of - you know, it was sort of tricky. And I think I was more concerned about, how are we going to get this different sort of family to work than I was thinking, oh, this is the beginning of anorexia. So it was quite a long time, and quite a few small little signals of her being very very peculiar, I thought, about eating at school: refusing to go to the cafeteria and eat proper meals, saying she preferred -
CE: That's normal behaviour - I've got a teenager who does that!
SB: Right, well, then, you know! You don't instantly think ‘anorexia', you think, ah, this is a bit annoying, or difficult; I ought to try and help her to eat properly, but it didn't twig - I don't even know when it did finally twig to me, do you?
SB: Did you tell me? [laughter from both] Did you say, ‘oh mummy, I've got an admission to make, I'm anorexic', or did I - I don't remember.
ET: I don't know whether the people at school started to get worried before you did, perhaps.
CE: Did you actually hate food itself, or what it was doing to your body?
ET: No, I always loved food, I think.
CE: That's quite surprising to hear, from someone who's been anorexic. Explain what you mean by that; that seems like a real contradiction.
ET: Yes, I think it's not true for all anorexics, but certainly for me, increasingly, the point of not eating was to make the food that one did eat all the more perfect: the longer one could go without eating, the more wonderful eating felt.
CE: Was there particular food that you sought out at that point, to kind of reward yourself for the fact that you weren't eating it all day?
ET: Yes, in general it was quite calorific, quite sweet things.
CE: Sue, what are you making of all this?
SB: Well, I was about to burst out, ‘chocolate!' - because I know - she was very very secretive, so a lot of the time I didn't know what was going on, but I knew that she had chocolate late at night. And that seemed so odd to me, because obviously you think people who are dieting, they're going to be eating carrots, and lettuce, and things - but chocolate?! But I understand much better now, why she did that.
CE: It seems odd, because you're a very clever person; you weren't rationalising that actually this made no sense, and it was a really mad thing to do to your body?
ET: No, I knew it was - I knew it was destructive to my body; I thought maybe it was a way of having a sort of intellectually pure life, if you like; I mean, it went along with just becoming increasingly solitary, because I never wanted to eat anything with other people, never really had energy to do things with other people, became increasingly nocturnal, so I couldn't really do normal things in the daytime with other people, so that did leave a lot of time for just working, which became the most important thing after food, really. So I guess the background logic was that I wouldn't do as well at university if I were to live otherwise.
CE: In other words, you had to basically be in that state to be able to concentrate on your work. Is that what you're saying: that you couldn't be a normal person, and eat normally; this was what worked for you?
ET: Yes, because I'd work and work and that would be the way of earning food at the end of it all. Nor could I imagine there being any other pleasure comparable to eating; so when people told me, oh, you're missing out on so much, I would say, well, I can't imagine that anything could beat this - you know, this mouthful of chocolate last thing at night, on one's own in the dark - what could be better than that?
SB: I do remember this precisely being said by my sister, very close to the end, wasn't it - it was the Christmas before everything changed. And we were sitting after dinner, and Caroline - my sister - had a few drinks, and I think loosened her tongue to say things that she'd been wanting to say, that she hadn't dared say to Emily - because you get scared of anorexics; they're frightening people. They're so thin, and rigid, and superior-seeming, and it's difficult to speak - and Caroline just burst out: ‘But think of all the things you're missing! What about all the fun, what about all the music, and the dancing, and the sex - and you're not enjoying any of it!'
CE: And Emily, you were missing out on all that; how did you respond?
ET: I just thought, you don't know, you don't understand what pleasures I do have. I don't care about them.
CE: You were controlling your pleasures; you were deciding what the spectrum was for pleasure.
SB: Spectrum? One tiny little thing: food!
ET: Yes, it just seemed enough, it seemed - all those other things seemed trivial in comparison.
CE: Sue, what did she look like to you? Just describe it to me.
SB: One of the disturbing things is how used to it you become, because you see her every day; and sometimes I would see other people, like a friend would come to visit, and you could see the look on their face when they saw her, and then I would sort of flip back into a more objective view: see it how they see it. But, you know, I would just get used to it. I never got used to putting my arms around her to give her a hug, and just feeling a row of bones. You know, some people you can feel the ribs, here, but the back, no flesh - you're just hugging a skeleton; you feel as if you shake her, it would rattle. And one of the awful things is: we always used to go shopping in the sales, after Christmas, and we tend to like quite a lot of the same clothes, and so we'd try them on, and I'm a very normal kind of size, and I'd look rubbish in something, and she would look absolutely brilliant in it - and you get this awful thing of being torn between: you look awful, you're so thin! and then the fashion -
CE: Admiring her!
SB: Not quite admiring her, but the fashion and the way clothes are cut and so on, they just look nicer on thin people, and so sort of understanding, in a way, that - and then just thinking, oh, but surely it's not worth it!
CE: When people were looking at you, Emily, and doing a second take, did you not feel self-conscious? What did you think was going on with that? Did you think they were admiring you?
SB: I expect she thought they were admiring her, yes! [laughs]
ET: I suppose I knew people would think and see that I was ill - but I wanted that rather than looking normal; because I thought it marked me out as different, and that that was a good thing.
CE: You wanted to be different, even by looking shocking? Did you know you looked shocking?
ET: Yes, but I thought the shockingness was an accurate reflection of how I was, so it seemed - it seemed right.
CE: You're watching your daughter disappearing in front of you; you're beginning to think, I might lose you, you might die, you're getting so scarily, scarily thin now, you're wasting away.
SB: Yes, I don't remember when I first started thinking that Emily might die, but certainly sort of half way through these ten years I was very aware. I mean, you only have to pick up the first book there is to see that anorexia kills, I think after ten years 10% are dead and after 20 years 20% are dead - it's roughly that sort of progression. It's the most life-threatening mental condition there is. So I knew that she might die, and I had to face that. And I asked Emily -
CE: That sounds very matter-of-fact: you had to face that. Weren't you crying, screaming, wailing?
CE: You can do something - or can you? - to stop that.
SB: No you can't do that - you can't, no you can't. I learnt that very very early on, and I'm glad that I did, in a way. A very very helpful thing was, a friend of ours, who was also anorexic, suggested I went on a carers' day course about anorexia, and that was extremely helpful - for all sorts of reasons, but the most helpful thing was that when I arrived there, most of these people had really, really put their life on hold - not just in the way that I in some senses had to - but, you know, they'd given up their jobs, they'd spent money they couldn't afford, they'd devoted themselves to trying to help their anorexic daughter or son - to no avail. To absolutely no avail at all. And some of them had done that, and the child was in and out of hospital, and much closer to death, directly, than Emily was. So those things kind of encouraged me in what was natural to me, which was to take it in a matter-of-fact way, as you said: she might die. I asked her - I don't know about many times, but certainly several times, didn't I, Emily: do you want to die, Emily? Because I felt, as a mother, if she genuinely wanted to die, well, that's her prerogative, I shouldn't be forcing her to life - but her answer was always: no, I don't want to die, that's not why I'm doing it.
CE: Why didn't you want to die? Because you were headed that way, weren't you?
ET: Yes - I suppose I just thought there was no need to die; I wanted to continue in this way. I thought I was doing better than the anorexics who seemed out of control because they'd be, you know, in and out of hospital. I had it in complete control: it was always just this very very gradual decline, but nothing drastic ever, and I thought that that was the height of control, not getting to the point where you have to be put on a drip and, you know, other people take over. I wanted to keep it at the point at which no one could really do anything about it. That seemed more powerful than dying, to me.
SB: That's what's so bizarre: that she can be so clear about it. People say: but if they knew what they were doing, they'd stop! No no! She knew absolutely, was perfectly clear about it.
CE: Were you getting a lot of support from your friends, from your peers, at this time, or were you a solitary little individual, just beavering away?
ET: I didn't have many friends, obviously [laughs/sighs] - I didn't really have any energy for them. And the one friend I did have at college, who was also a slight outsider type, really didn't notice, I think. I mean, I always dressed - I mean, one, I was always cold, so I wanted to wear quite a lot; but also I suppose it was a slight secrecy about how my body was - so I'd always look OK, I think. And she was actually instrumental in 2008, finally when I decided to do something about it, in finding the therapy for me, and taking me along to my GP, and sitting with me, and everything. But she, I think, just hadn't realised; she just thought I was one of those thin types who - was like that.
SB: It was extraordinary. Because she rang me - I don't think I've ever told you this, but I guess it's long enough ago now - she rang me, in secrecy, and said: I'm really, really worried about Emily; I think she might be anorexic. And I said: yes, I know! [laughter from ET] And we had a long talk, and I was so impressed: she just dropped everything - all her academic work, for three days, and spent - and rang me, a few times -, and spent those days online, in the library, finding out everything she could possibly find out; located, in Oxford, an experimental programme for comparing two methods of treatment for anorexia; persuaded Emily to go back to Bristol to her own GP there and, you know, got everything in motion. Possibly on its own that wouldn't have been enough, but it was one of the several critical things that came together. So, good for her.
CE: But, you know, it's amazing to think that despite starving herself, Emily gets through all this, and gets an amazingly good degree, and then gets offered a lectureship, and she's written two books with your partner, Adam Hart-Davis, but she's in the grip of this really terrible illness, and missing out on life. Her life is in limbo; is that the way you're seeing it?
SB: It just comes back... Remembering - we tried to have a rule - Adam got exasperated, and we tried to have a rule that she had to be up by lunchtime, even though we knew she wouldn't eat lunch with us; and even that, she didn't seem able to manage. So imagine the depths of winter, in the city: we've got up at seven, or whenever, and been working, and had our lunch, and by sort of half past three, four o'clock we've done most of our day's work, we're having a cup of tea, Emily finally wakes up. She goes out in the - it's already getting gloomy, in December or January; she goes out on her bike, she's terribly terribly thin, puts on layers of clothes, and you know she's still going to be freezing cold and need me to rub her hands when she comes back - and she goes out and bicycles for an hour, with no food in her; and then she's back at five o'clock or whatever it is, and her whole day is starting then, in the dark.
CE: Can you believe that was you, when you hear your mum describe what you were like then?
ET: Yeah, I can believe it, but I don't know how I did it for that long [laughs].
SB: I sort of can't believe it. It's only hearing her saying that - you know, being forced by this discussion to think about it, it comes back; but it's hard to believe that somebody can be voluntarily living that way. They don't have to; there's nothing making them live that way other than their own determination to do so.
CE: You decided to move to Devon, which is quite a bit away, and you've got an opportunity to change the way your life is, as well, and the way you're living it; but you arrive at an absolutely devastating conclusion, when it comes to Emily.
SB: Yes, what happened was: we had found this, I think absolutely wonderful wonderful house, old house, absolutely lovely; it was actually a barn conversion, and Emily didn't like it at all. But we were down there on one occasion, and we were driving back to the station - it's one of those sort of flashbulb memories, when I can see where we are on the road to Totnes - and she was talking about, oh I'll have to find a local doctor down here, and oh I'll bring my bike, or shall I bring my other bike... And I'm thinking: she's thinking of this new house, which she doesn't even like, that is going to be her home - not just her parents' home, where she'll come to visit, but where she is going to dig herself in, with a doctor, and a bike, and everything. And I just thought: I don't want that. And I said: but think, at your age, Emily, you're 26, you would have been then, wouldn't you? Isn't your home going to be in Oxford, where you're doing your studying? You know, this isn't going to be your home. Think of your brother: he's got his own house in Birmingham, where he's studying, and he comes home for holidays, he's got a room, you'll have a room, but it's, you know - and I got myself in a - and I thought, oh shut up, don't say anything. Thank goodness we arrived at the station about then, and it was fine, and she said goodbye and so on. And that really stirred me up, so I spent some time thinking over what I'd said, what I meant, and I realised something else, which was: for Adam, whom I'd met after Tom and I'd split up - we'd lived together by then for thirteen, fourteen years - but all of that time had been in my house in Bristol. He had been wonderful with Emily - I mean, not every other man coming into such a situation would have been so patient - and I suddenly thought: this isn't going to be my house; this is going to be our new life together. This isn't fair on him! And the next day - and again, I remember this absolutely clearly; and I have checked my diary to make sure I'm not making it up later on! - Emily rang. And it was one of those phone calls - something went wrong, and we were both sort of awkward on the phone. And Emily said, well what's the matter. And I said, I'm sorry, I'm sorry, I'm not thinking clearly. I suppose what I'm trying to say is: your anorexia is not welcome at our new house. [pause] And it just came out. I hadn't thought about it in advance. If you read the books it's probably the sort of thing you ought to say, but it wasn't planned; it was one of those spontaneous things that just came out. And all she said at the time was: I thought that's what you meant [grumpy tone]. And we went on to talk about something else. So it was a moment - and yet, as it turned out, as the following days and weeks emerged, it was a real turning point.
CE: So it comes to a head, Emily, and something has to give. Was this a turning point for you, this amazing sort of statement that just came from the heart, and was just spoken over the phone?
ET: I guess it was one of several, or even many, turning points. It certainly made me reconsider my relationship with Sue, and by extension with Adam as well. So I sort of wanted to reject them completely, I think, and just escape, and - just physically everything was getting worse: cold, weakness, dizziness, particularly also, towards the latter stages I'd begun to get obsessive compulsive disorder, which I gather is a common feature of very low weight.
CE: How was that manifesting itself?
ET: Just very very tedious repetitive behaviours: so when I went out - I would often go to the loo block, which was a little way down the track from the boat on which I was living, and then come back and there would be cars parked along the track, and I would have to memorise all the numberplates; and -
CE: It sounds exhausting, Emily!
ET: Yeah - and that would make everything - because it was already a massive problem how late I was going to bed, and that would just delay things by another hour or whatever [laughter] - and they really angered me, because they sort of belied the illusion that I had that I was in control; it was - clearly these were just compulsive, horrible - I called them whores, because I hated them; and yet I couldn't do anything about them.
CE: How did you climb out of that, then?
ET: I saw the director of the eating disorders unit, and had a talk with her, and she weighed me as well. And she told me that I wouldn't be able to be accepted on the programme in my current state, because my weight was too low [laughs] - which I just thought was -
CE: Too low, for an eating disorders clinic! That must have struck you as kind of ironic!
SB: This was the most extraordinary moment. I think this was probably more of a turning point in a way, because I was with Emily at the time, and I sat there, and Emily said: what do you mean, too low? Ridiculous... [arrogant tone]. You say I'm too thin to go on a programme to make thin people fatter?! [laughter from CE] And very patiently, the therapist explained that they had ethical approval to treat people with a BMI between 15 and 19, and that's Emily's was 14.2, and that at that BMI, it was so dangerous, so medically threatening - she could either just have a heart attack and drop dead, or have any kind of medical emergency - and they were psychotherapists, not medically trained; they could not take responsibility for somebody that ill. Well you can imagine, hearing that - I wasn't surprised, actually; I was kind of relieved in a way, to sit there with Emily, hearing this: look Emily, it's not just me, this is how ill you are. And the woman then said, well, we're only taking people for another seven weeks. You would need to put on six pounds to get up the weight that we would accept you. Realistically, the most anyone can put on by eating good food and in a reasonable sort of way is a pound a week; you've got seven weeks to do six pounds. If you can do that, we will take you. And you could hear in her voice, I don't believe you'll ever do it - but you know...
SB: And? [laughs]
ET: It just became clear that there weren't really any other options. I just felt really really trapped in everything, and decided: I have to just start eating again, I have to try it, at least. So we agreed that the next morning I would start eating breakfast - because I was told that if I wanted to put on a pound a week I had to eat 500 extra calories every day. So we went and found two things, I think a custard tart [laugh from CE] and - that was for tea - and a pain au chocolat for breakfast, which made, I don't know, 495 or however many [laughs]. Yeah, I chose foods that I suppose I'd just longed for for quite a while. And I was really scared that night, but also I felt I was on the brink of something exciting, and that at last something was going to change, and I couldn't quite believe I was going to do it, but I knew I was, somehow, I think, once I'd made that decision.
CE: And were you able to eat that quite simply the next morning? The first time in how many years - ten years - since you'd had breakfast.
ET: Yes, I got up as usual, I think it was just about morning, because on the boat trip with Sue I'd been having to get up a bit earlier. And it was sunny, I remember, and it just tasted - it just tasted amazing, and it was just such a pleasure - a real pleasure [sighs] - and I felt I could have eaten ten of them [laughing and tearful, laugh from CE]. And I ate the custard tart that afternoon, and kept on doing that for, I don't know, a week, until that supply had run out, and then [breaks off] - sorry...
CE: It must be incredible to think back to that time - this huge change, for you.
ET: I think having made the decision, that was really the hardest part, and after that - you know, my body was so longing for food that it wasn't really a hardship to keep eating those small things. And indeed in the first few weeks, the problem in fact was the extreme hunger - I mean, I'd been hungry for all those years, but I'd never felt anything like that. It was, I suppose, just a different sort of hunger, because I'd decided now to eat, so hunger didn't seem like it was my choice; it felt like something uncontrollable. And it was just - just all the time - I was just starving -
SB: One thing I must say was how helpful some of what the therapist said was. They showed me a graph of weight gain, and they said, most of the problems that your daughter has are entirely weight-related. We are not going to delve into her past, her family, her love affairs, whatever, because actually, all we need to do is help her, with cognitive behavioural methods, to eat more, to cope with all the things that will inevitably happen, which did, and Emily told me about - the things that scared her, the times that were suddenly - somebody would say something about food and it would upset her; how to cope with those, literally just to put on the weight. And they showed me this graph and said, at this point, the obsessive compulsive things will disappear, at this point this will happen, at this point - and it almost always did.
CE: It all happened!
ET: I just didn't believe it. I was very very sceptical, and just thought I would try this because, as I say, there was nothing else really left to try. And nor could I imagine ever getting to the line on the graph where anything was meant to change because [laughs] -
SB: [laughing] Yes, I remember you looking with complete horror - I'll never be there!
ET: No. But they were right - I mean, very quickly the obsessive compulsive things faded away, which I was delighted by, and then gradually, my whole thinking became less rigid, and I could start to think about other things more. They say that particularly around a BMI of 19 is just crucial, in that sense of one's thinking becoming flexible enough that one can contemplate making serious changes to how one eats.
CB: Do you feel as if you have now got that rounded life; do you now regret how much time was wasted - well, not ‘wasted', it's the wrong word - but how much time elapsed before you got to the point where you could change things?
ET: I do feel terribly sad looking back, about - partly about how much pain I caused to other people, and partly, yeah, just how dark those years were, when they should have been - should have been wonderful. Partly I wish it hadn't taken so long, but I think partly the reason I was able to recover so fully is I think that I'd done it for so long, I'd done it so well, that there aren't any questions left in my mind as to what if - if I should try it again, would it make things better. I went as far as I could with it - and it gave me all the answers it could, and in the end, it was just a dead end, so there is no need to go back to it now. So for that reason I don't regret it.
CE: Sue, it sounds like you've got your daughter back. Is it that simple?
SB: Yes, yes. I think in the end, that's the oddest thing to me. We're only, what, two years on - scarcely, not even that - and yet it almost feels like to me as though - not that it didn't happen, but that it wasn't like ten whole years out of - more than a third of my daughter's life. It doesn't seem to overwhelm anything any more. Which is kind of hopeful, isn't it - I mean, hope to other people, that sort of realisation that you can have all that, and I'm not looking back with huge anger, or resentment. Sometimes I wonder why, I think - hearing Emily talk here, I've thought: yes - when she said about hurting - she said something about regretting how much hurt she'd caused to other people. It was terrible hurt; it was awful, awful pain, to lots of people. But now it's gone. And now here you are, Emily, my daughter [laughs] - yes I've got my daughter back. But you know, new daughter every day, and life's moving on, instead of just being stuck, like it was.
CE: Emily, Sue, it's been absolutely extraordinary hearing this story, and thank you so much for spending so much time talking about it.
SB: A pleasure.
ET: You're very welcome.
Two footnotes to the above:
1. In the section where I explain how I decided ‘I have to just start eating again', the ‘we' which I refer to in the following sentence refers not to me and my mother, but to me and a friend of mine, who came to Oxford the evening after the eventful appointment at the clinic, bought me wine, and talked and talked to me; he talked, with me, tirelessly around and towards the decision that had to be made. He then came to the supermarket with me, and bought the food for me, when I couldn't bring myself to, and carried on coming up by train and buying me food, for as long as I kept needing, it, whenever my supplies ran out. I am perpetually grateful to him for that and much else.
2. Explain whores: I don't explain very well here my term for the obsessive compulsive behaviours, the ‘whores', and don't feel entirely comfortable with it now - as I suspect some women might find it offensive. I meant nothing in particular by it, except to express my sense of powerlessness and lack of dignity in the experience of OCD. It was a term another friend suggested, I think, to convey the seduction of those compulsions to check, to memorise, and to repeat; to convey the indignity I felt in succumbing to them, as if I were ‘demeaned' more by them than I was by any of the equivalent habits/compulsions of the anorexia proper. Not a very PC label, but one that stuck, in my angry and impotent state back then.