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Global stories, local voices
Portrait Lola

By Lola Bertet

Illustration : Angèle de l’agence Advitam

The time Mathilde spends in an inpatient hospital is extremely violent: for months, she is separated from her family and has no intimacy. Years later, she reopens the diaries she kept at the time and goes through them with Lola.

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Everything that’s private is monitored: to pee, to eat, the interactions between patients; and you don’t have access to the Internet or your cellphone. The only things left were books and TV. There were bars on the windows, which we couldn’t even open.”

Mathilde was admitted to the hospital in May 2011, ten months after she became ill. I ask her which goals her hospitalization aimed to accomplish, which conditions would need to be met for her discharge.

“When you are admitted to the inpatient unit,” Mathilde recounts, “their first mission is to make sure you are medically cleared, which means you have to get physically healthy and regain weight — roughly two pounds a week. They also put you on medication: mood stabilizers, anxiolytics, antidepressants. You don’t even know exactly what you’re given. And you have to stay still; you have to spend a lot of your time immobile.” She mentions the contract established at the beginning: “Receiving visitors, the connection with my family, school work, the things that you enjoy, they call them ‘reinforcements’. When you fail to complete a goal, a reinforcement is withdrawn. If you don’t complete any goals during the week, you won’t get anything at all — no visitors, no phone, nothing.”

Treatment is composed of three different phases. The first step was to put on twenty pounds. For two weeks, she was not allowed to communicate with her family and felt extremely lonely. Her stay in the psychiatric ward of the hospital lasted four months — a time span that she experienced like a prison sentence, or a stay in hell.

“The hardest things there when you have anorexia, are to let go of your rules and rituals, to give up your control and relinquish it to the hospital staff; to go through long periods of solitude; and to eat again, to lose the sensation of emptiness and experience a harrowing fullness in your stomach.”

Alain Perroud tells me more about the challenges that come with regaining weight for patients with anorexia: “It is a very painful process: they are confronted with the fear of losing the control they sought and had, the fear of seeing their body change, of regaining their insecurities. During this arduous part of recovery, it is important that the health professionals take good care of the patients.”

Mathilde describes a typical day in the unit: “You wake up at 7 am and go take a shower. Then breakfast is served; more often than not you don’t get to choose where you sit. They check that you eat all the bread and finish the jam — because if you leave some, then it means that you are ‘not compliant’, which means that you won’t be entitled to the reinforcement that comes with eating everything on your plate. Then you go to your room to rest for an hour and a half — and when I say ‘rest’, I don’t mean doing whatever you like, I mean taking a seat or lying down and not being allowed to move an inch. Then you are supposed to ‘socialize’ with the other patients by doing collage or sudoku. Tea time is at 4 pm, followed by another hour of remaining perfectly still in your room — DVDs basically become your best ally. Dinner is served at 6:30; nurses patrol the room to make sure you don’t discuss topics that aren’t allowed. And finally you get up to take the pills that have been prescribed to you.” Mathilde laughs as she speaks about this, but as she acknowledges herself, it’s a nervous laughter.

For weeks she didn’t have access to a full length mirror. One day, the decision is made for her that she’s ready to see herself in a mirror — to see her body with the newly gained weight. “They just told me to follow them and led me to a mirror. And I broke down. Because when you put on two pounds a week, it is not distributed harmoniously. My legs were skinny and my upper body looked swollen.”

When she reached phase 2 of the treatment, Mathilde was allowed to take part in activities such as supervised cooking sessions. She also had the right to go out and see her visitors in other places than the common room — a walk in the park, going for a coffee… One of the tasks expected from them in that second phase was to be invited for a goûter and prepare one themselves. To make it to phase 3, when she is progressively allowed to spend some time back home, there was another challenge which makes Mathilde laugh: “You had to go to the restaurant with your nurse. They didn’t warn you in advance; they simply came to you like, ‘Girls, get ready, we’re going to the restaurant tonight’. It was such an absurd situation. The girls who come with you aren’t necessarily your friends, see? So you end up in a restaurant with a nurse and three other girls you’ve hardly spoken to before, sharing grim looks while the nurse is trying to put everyone at ease. She was nice that night, but still, we had to eat a whole pizza, a thing we hadn’t had for years and that was basically the devil incarnate.”  

I think the hardest thing for me is to handle my femininity, to be a woman. I want to be desired, but when I am, I feel somehow soiled.”

Throughout her hospitalization, Mathilde journaled, making collages and taking notes about her treatment and her illness. She kept the seven notebooks, and today she shows them to me. “I would always write the same things, because everyday always looked the same. When I tried to write, it took so much of my energy; and as I was interested in clothing and received a lot of magazines when I went inpatient, I would make collages of pretty girls or even random stuff. Sometimes I didn’t even know why I was doing it, I wasn’t looking at the pictures, I would just cut and paste them.” She reads an extract out loud — July 3rd, 2011, three weeks into her hospitalization: “I want to work in fashion. I don’t really know how to express my uneasy feelings, so the pictures do just that for me.” Another one: “Anger makes me so tired, sometimes resentment swallows me whole. I want to shout that I’m hurting, that I’m mad at everyone and I want it to show. She comments on this: “I resented everyone: society, magazines, models, the nurse… even the tiny ant that would venture into my room. Inwardly I was fuming; it was like being a fireball inside. That’s why I needed to write. I just wanted to disappear and to be left alone.”

I notice passages written in capital letters, in red: “6 am I’m already awake, as if it was 11. Eyes wide open. Can’t manage to go back to sleep. That’s life. Shower in one hour. I don’t know why I stay here, to pee in jars and be stuffed. 93lb is fine with me.”

 I think the hardest thing for me is to handle my femininity, to be a woman. I want to be desired, but when I am, I feel somehow soiled.”

 “Whether I’m ill or not, I won’t do it, they can go to hell with their 124lb, or else I’ll lose all the weight again when I’m discharged. My body isn’t me; it’s a stranger, an enemy, the thing that binds me to the earth and limits my dreams, my desire to be nothing but thin air. I don’t want to be on the earth but in the sky. I did one hundred and sixty sit-ups, as I felt too much guilt for what I ate. But hey, I think I got caught. Too bad for me. And here’s to hyperactivity.

Eating revives the anger within me — that freaking anger. But why? I’m stuffing my face and not moving, to not burn the calories. But what about in real life? Will we have rest times that last two hours, too? I mean… sometimes I feel like I’m going to lose my mind.” 

I ask Mathilde about what she struggled with the most when she was in the psychiatric ward. She answers straight away: “Being treated like a child and being deprived of freedom. The realization that my free will, my freedom of movement, had been taken away from me. And the absence of privacy. The feeling of being dispossessed of my body and everyday actions.”

And indeed I am really shocked by this system of reward/punishment, of control over everything that's private. I don’t understand the therapeutic benefits of such rules. I asked Alain Perroud about the value of this method. “I’ve been advocating against such practices for twenty-five years,” he admits. “They are traumatic and unhelpful, because they’re both harmful and inefficient. They should have disappeared from the health care providers’ practices a long time ago. Nowhere in the world has any study ever proved that it was useful; and yet that is most of the time how it works in France, in the units offering treatment for eating disorders.”

The weight contract establishes a form of duality between ‘the good doctor’ and ‘the naughty patient’ who is either compliant or non-compliant with what they are asked to do.

I also asked him about the relevance of a weight-based contract established between the doctors and the patient. Once again, Alain Perroud condemns a practice that he finds unhelpful and inhumane. “It became a habit to build this contract on how much weight the patient agrees to put on each week, with rewards if they succeed, punishments if they don’t. These goals are imposed by the medical staff; it all comes from the staff and is hardly ever discussed with the patient. The very notion of a contract is opposed to the foundation of a therapy, which is a cooperation: the patient is fighting against anorexia and the practitioner is fighting with them, on their side. The weight contract establishes a form of duality between ‘the good doctor’ and ‘the naughty patient’ who is either compliant or non-compliant with what they are asked to do.

Mathilde went through the three phases and was finally discharged from the hospital. Soon enough, she noticed that instead of simply going back to her life as she expected, she was feeling deeply disconnected from the world. “I was tired all the time. I no longer knew how to be, how to behave normally.” It took a bit more than four months for her to be able to go back to her ‘normal life’. But the way she experienced her daily life was not ‘normal’: she found herself struggling, haunted by her time in hospital. “I wasn’t used to being around people anymore,” she says. “I didn’t know what to say to them. And I was constantly afraid of being punished. At home, if we didn’t eat at 12:00 sharp, by 12:15 I was in tears. I was scared that, if I didn’t follow the strict schedule I had been taught to follow in the hospital, I would have to go back there.”

“It’s almost as if, in the hospital, I was deprived of my free will, I had reverted to being a little girl. It makes me anxious. I am the opposite of what anorexia turned me into. I am swollen, depressed, scared of everything — scared of what I might say or do. I’m scared of the label they put on me: anorexia nervosa. I’m not so much scared of my illness so much as I am scared of the treatment, of feeling imprisoned.”

“I didn’t know what to say,” Mathilde goes on, “because I was just coming out of a very long day, a day that had lasted four and a half months. It had been so monotonous and still it was so difficult to talk about. I didn’t want to let the people I loved know how hard it had been for me.”

In her notebooks, there isn’t much content about the time that followed her release from the hospital. I know she attended a day hospital and briefly worked as a salesgirl in a clothing store. She was on antidepressants, anxiolytics and mood stabilizers, which made it hard for her to concentrate and to feel her emotions. She tells me, with a tad of guilt in her voice, that it didn’t last long until she decided to stop taking her meds. She felt gradually better and readjusted to her daily life; but it was only after eight months following her discharge that she was able to make plans for her future.

“I decided to resume my education and found a work study program in a field I really enjoyed — film and audiovisual. But within two weeks after getting back to school in September, I realized that it was impossible for me to stay focused in class for more than one hour. I really wanted it to work, I really tried to study, but it wouldn’t work. I went back to see the doctors and they told me it was the consequences of what the illness had done to my brain. We’ve talked a lot about my body, but the impact on the brain is equally important. The brain needs fat and sugar to work. Neural pathways that had been lost needed to be rewired. It would take time for me to recover my concentration and memory. And so I was really struggling mentally as well as academically, and slowly, without even realizing it or trying to control it, I began to lose weight again. And that’s when I realized it was really an illness.” Like many people suffering from anorexia, Mathilde experienced a relapse. “In November 2012, I got sick — caught a cold or something — which caused me to drop a few pounds in no time. I didn’t gain them back and my weight started to slowly decrease back to where I was the first time. I decided to call the hospital, even though I was still having nightmares about my time there and didn’t want to go back — because for the first time I acknowledged that I really needed help.”

For the second time, Mathilde is admitted to the inpatient hospital. She says this one was the worst, because she had been so sure she wouldn’t relapse, she wanted so badly not to disappoint anybody. The relapse added to the feeling of failure for having to drop out of school once again. At this point, Mathilde had no clue about what she was going to do with her life; she says, “I didn’t think it would take so much time to recover.”

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About the author

Portrait Lola
Lola Bertet
More stories

Born in Paris in 1993, Lola developed a passion for stories early on. After her studies in theatre focused on dramaturgy, she discovered the world of podcasts. She launched her first one in 2016, titled "Dans la Loge" ["Backstage"], a series of interviews with female performers. She received training at Radio Campus Paris, Longueurs d'Ondes before going back to university to complete a master's degree in Journalism. In 2020, she self-produced a podcast called "Déplacement(s)" ["Shifting"]: life trajectories turned upside down consequently to the Covid-19 crisis.

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