Without it, I risk losing a lot of weight, becoming very ill, being hospitalised and, more than likely, dying. Not only has it helped me build a life, it now helps me manage anorexia so that I can live this life and go about normal things (going out to work, seeing friends etc). Without it, I could not fight anorexia. And if I can’t fight anorexia, I know what will happen. Anorexia will kill me.
With this in my mind, whatever ‘it’ is, whatever ‘it’ is that has saved, and is saving my life, you would think it would be common sense that I keep it, to continue helping me on my journey of recovery. Surely something that is preventing anorexia from killing me should be unquestionably accepted? Well, it turns out it’s not. I have had to fight to keep ‘it’, to keep ‘it’ from being taken away because I know what will happen if ‘it’ is taken away. A choice between ‘it’ and death? It has to be ‘it’ and why I had to fight for this actually beggars belief.
This ‘it’ that I am referring to is a Community Treatment Order (CTO). I have spoken about CTO’s before in my blog but for those that don’t know, a CTO is basically like being sectioned when you are in hospital (you have to have been sectioned to be put on one), but you are allowed to live out in the community, live a ‘normal’ life, but you have certain rules you have to follow and if you break those rules, you can be immediately sent back to hospital. The rules that have to be followed will be different for each person. For me, my rules outline a weight that I cannot go below. If I do, I can be immediately sent back to hospital.
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The CTO has enabled me to complete my undergraduate degree at Loughborough |
I have been under a CTO since my last discharge in the summer of 2011. Every year it comes up for renewal and it has to be considered whether I still need it or not, and an independent panel of people review my case. And this summer of 2018, when I was coming to the end of my 7thyear on the CTO, it was reviewed whether I should stay on it for an 8thyear. I acknowledge that I have come a long way in those 7 years, but when I was thinking about the possibility of being released from the CTO, anorexia started to run wild. I was imagining all the weight I could lose and how thin I could get again. How no one would be able to stop me. And whilst the anorexic side of my head loves this thought, the other side of my head, the side that has started to build a life and do normal things, that side is terrified. But I knew, without the CTO, I would not be able to fight the anorexic side of my head. So, it made sense to me, to my parents, to my community nurse, that I stay on the CTO. I am not yet ready to fight anorexia without it.
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The CTO has enabled me to go out with friends |
But the independent panel had different ideas. Firstly, they thought being on it for 8 years is too long. Well, why should there be a time limit on it? If it is keeping me safe and well, and I need it to keep safe and well, surely the issue of time should be irrelevant? If it turns out that actually, I need to stay on a CTO for the rest of my life in order to prevent me succumbing entirely to anorexia, then what is the problem with that? I hope that I don’t need the CTO for the rest of my life but if I did, then I can’t see what the issue would be if it is allowing me to live the life I otherwise wouldn’t with my anorexic head.
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| Going out with friends |
Secondly, they viewed the fact that because I have gained weight and haven’t needed the CTO to recall me to hospital, this suggests that I don’t need the CTO. However, the fact that I haven’t lost weight and needed the CTO to send me back to hospital is proof that the CTO is working well for me, not proof of the fact that I don’t need it. Because of the threat the CTO brings, I have been forced to maintain my weight. And by maintaining my weight, over time, this has allowed me to realise that I want more from life, that I don’t want a life completely dominated by anorexia. The CTO has allowed me to experience life and realise I want more from it. The CTO has eliminated the option of weight loss, so I have been able to start to build a life. But without the CTO, when weight loss is an option, I know I would not be able to fight this. And the seven years I have worked so hard to try and build a life would be completely lost. So, whilst I haven’t needed the CTO to recall me to hospital, I do need the CTO to help me continue building my life.
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The CTO has enabled me to complete a Masters |
Thirdly, the independent panel have to consider the “least restrictive option”. And, as you can imagine, a CTO is considered, theoretically, to be quite restrictive. However, for me, it has not been restrictive at all. The only restriction it places on me is preventing weight loss. This is a restriction to my anorexic head, but a life saver to my other head. And, as I explained to the panel, living with a CTO is far LESS restrictive than living under the dominance of anorexia, where every waking minute is spent slavishly obeying its orders; exercising, restricting food etc. There is nothing more restrictive than anorexia and actually, the CTO has been liberating.
The independent panel, quite bafflingly, were not interested that the serious weight loss with anorexia posed a huge health risk and risk of death.
“We are not here to protect your physical health”, they said, “we are here to protect your mental health.”
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| I have been able to go on holiday |
To them, it didn’t matter if I lost weight, it only mattered how my mental state was. However, as I explained to them, a deterioration in my physical health is a representation of my deteriorating mental health. If I were losing weight, this would be a sign that anorexia was taking over. I couldn’t quite believe that they couldn’t understand that if I were becoming a walking skeleton then my mental health would also be significantly declining.
After hours of discussion and arguing from myself, my mum, and my community care team, the panel reluctantly agreed to renew the CTO. The fact that my life actually lay in the hands of that decision is quite scary. That those 3 numpties on the panel, who were not open to listening and who had their own fixed ideas, that they were basically going to decide whether I continued to live or die, my god it is terrifying. And also, it was incredibly hard for me to actually admit that I need the CTO and go against my anorexic inclination to try and get the CTO removed so I can do what anorexia wants and lose lots of weight. And for them to turn around and argue it should be removed was very hard to deal with. If I am explaining to someone that I need the CTO to prevent anorexia taking over my life, that I know what will happen if I don’t have it, that I know I cannot resist anorexia’s temptations without it, then surely there should have been no question or debate.
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The CTO has allowed me to do go out and experience things |
As I said earlier, the CTO has saved, and is saving my life. And I believe it could save many more who suffer with eating disorders. I’m going to fight for my CTO for as long as I need it. And I also want to fight for greater use of them within eating disorders. When used properly, they can safe lives. Everyone deserves a chance at life and a CTO can give this chance.