What it feels like: Anorexia nervosa and trauma

"Not eating becomes your identity. And that identity becomes your witness to what has happened to you," says Natalya Anderson.

Emma Jones 16 minute read December 6, 2021
Natalya Anderson

Natalya Anderson, a Toronto-based journalist, advocates for support and awareness for people youth living with anorexia nervosa. SUPPLIED

CONTENT WARNING: This article contains conversations pertaining to eating disorders and child abuse. 

Natalya Anderson was only ten when she started seeing a psychiatrist, beginning a long journey to be protected from her experiences of child abuse. By the age of twelve, she had been diagnosed with anorexia nervosa. 

Anorexia is a commonly misunderstood eating disorder. The National Eating Disorder Information Centre defines anorexia as a life-threatening mental illness, which is thought to be caused by a complex relationship of genetic, social and psychological factors. Approximately 1 million Canadians live with a diagnosable eating disorder. 

Now 42 years old, and working as a journalist and editor, Anderson tells Healthing.ca about her experiences with anorexia and how closely it is closely intertwined with surviving childhood abuse. 

This conversation has been edited for length and clarity. 

What led to your diagnosis?

My first diagnosis was to have been a child of sexual abuse; it is impossible to speak about my anorexia without [mentioning it]. They’re intricately woven. So, I would have been brought to a psychiatrist for diagnosis around serious mental health issues at the age of ten. Within about, I would say, two years later I would have been diagnosed with anorexia.

While you were working with the psychiatrist to work through the trauma of abuse, were you already experiencing the symptoms of anorexia?

Yes. I would have started restrictive eating around the age of nine [although] that would have been something I didn’t understand as something to lose weight until much later. 

There was a lot less literature around this. It wasn’t something other women or girls talked about and it wasn’t something that existed in the ether because we didn’t have social media.  

I had begun restrictive eating because I was afraid to feel full, and I was afraid to feel full because I was afraid of throwing up. I was afraid of throwing up because when I was being abused, I would throw up or have diarrhea. So, the first thing for me in order to survive what was happening was to say, okay, I can at least avoid the sick feeling. So that’s how it started. 

There’s this misconception that people experiencing anorexia or eating disorders are only teenage girls who want to lose weight.

It’s completely false and it’s something [in] the way that society pits women against each other. I believe that [happens] when it comes to a lot of illnesses that are associated with girls.  

I was a ballet dancer at the time of my diagnosis and trained at the National Ballet School until I was in my teens. You can put girls in environments that seem like they will foster or feed into, pardon the pun, an eating disorder, but it’s really not the case. With ballet, it’s an athletic training environment. Most of the girls that I knew actually ate quite a lot throughout the day in order to sustain the training.

This is an illness. It’s a mental and psychological and physical illness. It’s very debilitating. At its core, at its root, it has nothing to do with I want to look like a supermodel, or I want to look like an influencer. That’s false. Most eating disorders stem from an abusive experience, I would declare that all of them do.  

Is it trauma that’s manifesting in different ways? 

One million per cent. If I could describe it one way, it’s seeking a witness. A physical manifestation that something is really, radically wrong and my body is not able to accept this. My body cannot accept what is being done to it or is being expected of it because it’s so wrong. 

Leading up to your diagnosis of anorexia nervosa, what were some of the symptoms? 

Well, not eating that was the number one hint that something was up, but it’s a gradual thing. The first integral thing for me was not feeling full at any time. That would lead to feeling sick, which would lead to [the feeling] that I would associate with being molested.

As you as you get older and become more familiar with it, people start to remark that you don’t eat much and that you are thin. It was proof that my system was working for me to be told I wasn’t eating enough and that I was thin. Then I started to connect my behaviour with being thin. Well, being thin and dieting into the late eighties, early nineties, meant, no sweets, so dropped anything that I loved. I remember the first thing was brownies. My granny used to make these amazing brownies and I was like, Okay, I won’t have the brownies anymore. Then it was no eating anything in between meals. And then that would be like fats, even if they were healthy fats.  

In the nineties, there was the advent of Kate Moss and heroin chic. [I was] looking at that kind of body, so [I was] just [avoiding any food that had] a hint of fat. And by that time, there’s not much point in eating at all. The train has left the station. It’s full steam ahead, you know? 

It sounds like it turned into a bit of an identity as well. 

Absolutely. Not eating becomes your identity. And that identity becomes your witness to what has happened to you. Because if you have told everyone around you, and I did…Once you achieve something that says, I’m here and something’s really wrong, people start to avoid what’s actually wrong and pinpoint the physical. Oh, you’re not eating. Oh, you don’t look the same as you did. Something’s wrong. Then you’re like, Ah, finally I’ve got a witness. 

If you lose your witness, then you’re alone in the room with the guy who’s touching you and you’re feeling ashamed, you’re feeling dirty, you’re feeling alone, you’re feeling terrified, you’re feeling so sick you can’t see straight. But if you have this identity, all those things can still be true, but at least somebody out there is noticing that something’s wrong. 

Is it that you’re finally getting the support that you need, just not for what you need it for? 

I’d say that you may not even be getting the support, but it is somehow part of your survival kit. For me, the most important part for anyone who might read this, [is that] when someone has told someone else out loud that they’ve been abused and nothing is done, that’s how someone stays locked into an illness. The key is someone saying I hear you, I believe you and I’m going to do something about this

Does this lead to issues of self-worth? 

Of course. It leads to the belief that there are no barriers or boundaries around who can touch your body, who can comment on your body, whether your body should or shouldn’t be harmed. For a child, it means you grow up with the inability to put limitations on anything. So, when it comes to measuring time, when it comes to measuring activity, when it comes to measuring how long I should do things, it becomes a very confused world in which you try to measure and account for things yourself. And then you start to push, as you get older, the boundaries of how far you can take things before someone might notice. That spills into very dangerous avenues: how little can I eat before someone might do something about it? Or how much can I hurt myself? Or how much can I clean? How much can I exercise? 

Children need social cues. They need to know that their body is sacred and private. And it is until they are of an age that they can consent to anything sexual, it is off limits to anyone but a trusted family member and that’s just in terms of care, in terms of bathing. Or maybe if they’re unwell, helping them out physically, and a doctor.

What led to being diagnosed with an eating disorder? 

I think I was around 12 when it became more apparent that I just wasn’t eating. A neighbour, a pseudo-mother, put a stop to the abuse because I told her what had happened and she let me stay with her for a bit longer than I was supposed to. She also called me out on the not eating. Her involvement kind of accelerated the rest of the process. She insisted that I see a doctor regularly, and that’s when I started to get weighed and find out what percentile I was in in terms of my age and height. Between age 12 and 14 was a real acceleration into weight loss. I was admitted hospital as a full-time patient when I was 14.  

That must have been scary, being told that you needed to be in a clinic, and you were only 14.

Yeah, I was really scared. It’s a combination of fear and relief. There’s this drive to be the thinnest, to be the hardest working anorexic the world could ever come across. But you are also physically depleted. [When you aren’t eating enough] your heart rate slows down to a rate that just kind of keeps you ticking along literally. Your nails and hair don’t grow. The body will just keep what is essential going. It feels like you are walking through clay. All of it becomes so physically exhausting and so mentally challenging, that by the time you’re admitted to hospital you’re terrified, but also relieved.  

What happens in recovery?  

It depends on where you’re at. The first thing we need to do is get the body some nourishment, and that would probably be in liquid form, like something like Ensure, depending on how depleted [you are]. Or you might be given an IV as well for hydration. It’s all liquid the first week to 10 days — sometimes it’s six or eight weeks — because your body is not going to deal well with roughage and grabby food because it’s gone without it a long time, right? 

Once you’re stable, maybe you’re allowed to go out into the lounge with the other patients and do arts and crafts or read a book. You’re introduced slowly to food — maybe a bagel and apple juice, and as your body is getting accustomed to that, there is also one-on-one primary care with lots of check-in physically, as well as psychological discussions and family therapy.  

You would eventually [be put] on a meal plan, and while you’re still sleeping at the hospital, you are allowed to kind of go out on an activity with the other girls and the nurses. Maybe to the art gallery, or ice skating. You’re learning social cues again, you’re learning about boundaries, you’re learning about why you need to eat in order to exist in any way in society, that eating is the right thing to do, and that you deserve to eat.  

How is the transition out of in-patient therapy? 

It’s very lonely and scary. And [after] you’re 17, there is nothing there really. You are on your own if you have a relapse, and I have had three since the age of 17. You need to find a good psychiatrist, a good psychologist, and a primary care physician who is somebody who is not going to shame and blame you. 

As an adult past the age of 17, you are not sure of who you are. The [teenagers] coming out of the Sick Kids program, they’ve now only just gotten some clue as to what an identity might mean outside of being the anorexic or the sexual abuse victim. They are also going back into a world where other teenagers who aren’t anorexic and have not been sexually or physically abused are dating, having sex, experimenting with drugs. And they are talking about sex, drugs and identity in a completely different language than the anorexic, sexual abuse victim. This can kick off your eating disorder again.

Then you are into your 20s, and maybe you’re looking at university or college, and you’re like, holy shit, like, this is another world, right? What the hell do I do here? Good luck with your eating disorder. You’re always in recovery, you know? How are you avoiding the relapse that leads to death? And sometimes, those relapses happen so gradually that by the time you’re walking through clay again — and you actually have to be walking through it to go, Oh, I’m here again because it happens so gradually and yet so quickly at the same time.

Then you get married or you are living with a significant other, and perhaps you have a child. [I’m healthy] enough to get pregnant, to carry my child to term and to give birth to a healthy baby. I did something right. But then what you don’t account for is that you are now going to watch your own childhood play out before your eyes through the years as your own child grows. But this time, what you’re trying to do is protect them from what you went through. You start to see how vulnerable a child is at each age and you recognize how vulnerable you were at that age and how little the people around you did to help. 

**Editor’s Note: Anderson has previously written for Healthing about needed support for adults with eating disorders The way I see it: Our system is failing youth with eating disorders 

Is this how you felt about your son? 

Yes. When I gave birth to my son almost 10 years ago, the initial experience of having a doctor all up in my business was hugely difficult…These are massive triggers for relapse. 

I had a major relapse [shortly after giving birth]. And then again, just about three years ago. Fortunately, I recognized it both times and I kind of know what to do. I don’t mess around. I have a great primary care physician who I really like and have been completely open and honest with — I talk to her every week. And I have a fantastic psychologist now, who I am also in contact with regularly.

I advocate for my health in every way. I don’t care if I’m the annoying person who calls for an extra checkup. I don’t care if I’m the annoying person that calls for my results 50 times. I want to know. 

What advice do you have for other mothers who share your experiences?

I can’t say this enough — you are not a terrible, disgusting, worthless mother. You are a person who, at the age of your own children that you are watching grow now, was abused [and made] to feel worthless by people who should have been protecting you. And you are now reliving those years through parenting. It is virtually impossible to carry the weight. You deserve help and you have to advocate for it. You must. It’s literally the difference between life and death. 

You mentioned that you have to remember to forgive yourself while you’re re-experiencing these emotions. How? 

It’s ongoing, and there’s no one day or one moment where you feel you can give yourself a medal at the finish line. Like, you did it, you’re fine, congratulations, you win the emotional relay race today. You just keep on going.

It’s accepting the emotions and accepting it’s not going to be perfect. Even if you don’t have a full-blown relapse, the temptation and the thoughts [are] normal. It’s okay. 

The second part is accepting the chaos of those feelings while living your actual life. It is not something that you can manage on your own any more than a person who goes to work every day and has to run the whole company by themselves, right? No, they have a boss, and they probably have a manager and a project manager. Imagine recovery from [an] eating disorder as a job that requires a lot of different employees, and you’re just one of them. You need to access those other employees in your workspace. You need to be able to reach out to those people and say, I’m struggling with my thoughts about sexual abuse history today. Who am I looking for? Ah, my therapist. Okay. Today I’m a bit worried I didn’t meet my calories and I feel like that’s been a theme the past three to four weeks. Who do I reach out to? Ah, my primary care physician, she deals with my physical stuff, right? That is how I have to look at things every day to keep things in check.

So, you’re dealing with all of this, plus you have a full-time job, plus you’re raising a child — what led you to want to get involved in advocacy? 

Because nobody involves eating disorders patients in the decision-making processes [around care for eating disorders] any more than anyone involves sexual abuse victims in the decision-making process, and that’s a big problem. In developing solutions, don’t you think you should have someone with some experience? Why are we not having more people with eating disorders coming from abuse backgrounds in social policy decision making?

For me, I feel that if I don’t get involved, no one’s going know what [anorexia and trauma] is like — no one’s gonna speak for the kids out there who are going through it right now. No one is going to help people understand that those kids turn into adults and they look just like me. And I’ll tell you, it’s not as cute. It’s a much bigger drain on the medical system to have a 40-year-old struggling to cope mentally with a billion different thoughts and feelings and nightmarish mental health and physical ailments. It’s a lot cheaper to listen to what they’re saying and put the right programs in place.

 What things do you love in your life right now? 

Well, I love my husband and my son and their incredible strength, resolve, resilience in helping me in my daily life. I love our ability to talk so openly, even though it can be very grotesque, the things that I have lived through and how they have become a part of our lives. But it has also been rich and rewarding in terms of my son, who understands not to be ashamed of his body and how to set boundaries for his body. He is also able to talk about feelings and thoughts, even if they’re frightening.  

I’ve been able to kind of revisit my creative writing as well — I’ve won international awards for my poetry and stuff. I did a Master’s in creative writing in Cambridge in England and that allowed me to do some incredible writing, so I love being able to do that.  

I have also been able to reconnect with some incredible dancers with the National Ballet of Canada here on home soil — that’s been great. And mostly, just watching my son thrive and explore life and learn about the things that he loves and just be completely open and not be held down by an idea of who he used to be — like what I have been.

It’s sort of a different world if you will. 

Canada has strict reporting requirements for signs of child abuse. Learn more at Justice Canada’s website, and the Canadian Child Welfare Research Portal. 

Readers looking for more information or support on eating disorders can go to the Centre for Addiction and Mental Health website, the National Eating Disorder Information Centre, and the Eating Disorder Foundation of Canada. 

Emma Jones is a multimedia editor with Healthing. You can reach her at emjones@postmedia.com or on Twitter @jonesyjourn.