Like the phantom in The Phantom of the Opera, anorexia nervosa has two domains: what’s outside for everyone to see and what’s inside, hidden not only from others but often even from the sufferer herself.
The visible behaviors and outcomes of anorexia are often shocking, except to people with the disorder. You can easily get lost in the focus on what’s visible on the outside. But as you discover in this chapter, these behaviors are driven by an invisible engine of internal distress — and an astonishing level of determination to overcome that distress through thinness.
If you have anorexia, you may feel that you’re solving what’s distressing in your life with your thinness and ability to control what you eat. Consider that, in fact, the genius of your anorexia is that it takes all that internal distress and turns it into one simple external issue: the daily challenge of avoiding fat and staying thin. Anorexia gives you a feeling of control when you otherwise feel helpless in life, and it makes you feel worthwhile when you so often doubt your worth.