We are all struggling. But for people with eating disorders the effect is compounded by both practical considerations and the impact on mental health. It’s anxiety provoking, hugely challenging, and really tough.

For a start, being underweight means that my immune system is supressed, and I am more at risk than healthy individuals. I am angry at myself for being in this situation, and struggling to give myself the compassion that says that this is an illness, and one I am working hard to fight. I’m washing my hands regularly, keeping away from people as much as humanly possible, and doing my best to limit contact with any object outside my house. But the concern is still there.

Like many people with or in recovery from an eating disorder, I have quite a limited diet. There are the foods I feel comfortable with – my ‘safe’ foods – and those I find more challenging – the ‘fear’ foods. I am terrified of going into a supermarket and finding the shelves stripped bear of those safe foods that enable me to get through the day. Whilst I would like to think that I could be more flexible if this situation occurs, really I fear I would use this as an opportunity to cut back even more, unable to face a challenge. We are being told to only shop for essentials. It’s very easy for the anorexic voice to convince me that my food is not an essential, and it would be perfectly justifiable for me to spend months hidden away with only cereal bars to eat.

The supermarket is a daunting place for me at the best of times. With panic buying, lengthy queues, product restrictions and militant frontline workers (who are doing a brilliant job) the anxiety is made worse, and the experience far from easy. One thing that is good is that supermarkets are streamlining their ranges a little, so the anxiety that comes from an overwhelming choice is lessened – as long as that streamlining doesn’t come from removing my ‘safe’ foods.

When in the weight restoration phase of anorexia recovery, individuals need much more to eat than people of a ‘normal’ weight – often thousands of calories. What might look like stock piling is actually only food for a few days. The voice telling me I’m greedy and overeating is exacerbated and amplified, the idea that I shouldn’t be eating so much reinforced in my head.

I have come a long way from the days when only an intense and lengthy gym session or run would allow me to let even a meagre portion of food to pass my lips. But I do still rely on my daily walks, just as much for mental health as to allow my body to move a little. Despite protestations from the public, we are still under a fairly limited lockdown in the UK, and allowed out for daily walks. I worry this freedom will be curtailed as people flout the rules and take advantage of our freedom (is sunbathing and having a picnic in the park really necessary?) and am terrified that I might not be even allowed out for my regular amble around the streets near where I live.

Social distancing, which whilst entirely necessary, isn’t helping. In recent months I have been doing really well at trying to go out for dinner and drinks with friends. Now I am at home, and those challenges ceased. We are having regular video calls and checking in, but it’s just not the same. The great steps I have taken feel like they are being curtailed.

If you’re in treatment and used to seeing a therapist or nurse regularly, all this will have stopped. Most therapists are doing online or phone check ins, so that people have some continuity of contact. But a lot of the benefit that comes from sessions is the in person relationship, some of which is lost online. And monitoring of weight and physical symptoms through blood tests can’t happen, so there is a risk that any deterioration will not be noticed.

Diet culture is all pervasive, even at the best of times. But at the moment there are numerous posts and memes about gaining weight and overeating during lockdown. The idea that this would be the worst thing to befall us doesn’t help with the notion that weight gain is bad and being thin is good, which, whilst not the cause of my anorexia, certainly doesn’t aid in my recovery. Everyone is doing home workouts and bragging about it, and it would be all too easy to fall down a rabbit hole of home exercise videos. That is something I need to steer away from.

Having anorexia at any time really sucks. It’s the biggest killer of any psychiatric illness. It ruins lives. But during a global health pandemic it’s even harder. I know I have to keep fighting, to be healthy and strong during this period, and to come out of it able to keep on going, working on my recovery. Maybe I can use this opportunity to be forced to be more flexible, adapting my meals, challenging myself, and working on what matters to me.

But right now, it all feels a bit much.

Eve Simmons and Laura Dennison set up Not Plant Based to help debunk some of the myths around healthy eating. Both of them have had eating disorders in the past, and they saw the danger of some of the misleading messages that the wellness brigade and healthy eating police were putting out there. Not Plant Based’s mission to help you love food again. The principle is very simple: eat what you like and don’t worry about it.

And that’s also the premise behind their new book How to Feel the Fear and Eat It Anyway. Each chapter focuses on an area of food and health where myths prevail and common sense needs to be brought to the fore, such as sugar, exercise, and fat. Alongside the no nonsense presentation of the evidence and personal stories are recipes thrown from the likes of Ruby Tandoh, The Angry Chef, The Hairy Bikers, and Angela Hartnett.

It’s a joy to read, especially when we’re faced with so much sadness and shame around food. Taking as its standpoint the enjoyment of food, it offers a bright and radical (it shouldn’t be radical, but it feels it) approach to fuelling our bodies and feeling great about it. Letting go of the hangups around food won’t be easy, but if it lets you live life to the full, it’s totally worth it.

Published on 17 Jan 2019 by Mitchell Beazley.

A ‘haystack of buttered toast’ as in Great Expectations, Graves’ eve of battle mince pies, rich full milk like Hardy’s Tess, Virginia Woolf’s hot tea and currant teacakes, the ‘stuff of life’ bubble and squeak from The Wind in the Willows – these were all experiences lost to Laura when she was ill. They were ones that her favourite authors wrote about with ‘giddy extended encomium’ but that anorexia wouldn’t allow her.

Until, slowly, the shackles of anorexia loosened, Laura’s strength was rebuilt, and she managed, like her mother told her, to eat enough to keep ‘body and soul together.’

A far more voracious reader than she ever was eater, it was words that proved to be Laura’s saviour. Anorexia manifested itself for Laura as an illusion of control. Reading was escape from the confines.

She both lost herself in them when the anorexic voices got too loud, and found her own voice in them as they strengthened her.

The book does describe the wonderous and marvellous meals that Laura and the characters in the novels devour. But it’s more about the experiences that those novels are part of that matter. About the friendships, evenings with family, holidays, long walks and relaxed evenings that food is such a part of, and a starved body and miserable mind can never have.

Laura is a detailed writer, and whilst not overtly triggering, some of the accounts of how her illness manifested itself could prove tricky to read. She’s honest. She still struggles and has to maintain her weight and food above that tricky spot where the voices – which she calls a ‘Jabberwock’ – take over her mind and body.

But the book is hopeful. It’s a reminder to keep on fighting. Because there’s a whole library of reasons to live.

So sometimes we all need a little reminder to just keep going. And visual tools are a real benefit. Francesca from Motivational Tattoos had her idea back in 2011, laying suicidal in a hospital bed in Charing Cross in London. She had optic neuritis and was losing her sight, but determined to keep going she would write notes to herself. The experience has left her with nerve damage and pain, and whilst it was never a ‘good’ experience, one positive outcome has been the birth of Motivational Tattoos. ‘I started making tattoos for myself, and shared them on my blog, and a few people left comments asking if they could buy some. I started selling them online, and it’s just snowballed from there.’

With a background in both psychology and design Francesca was well informed about her ideas, and she uses psychological studies to inspire the creations. One study found that temporary tattooing may help adolescents alter self-harm behaviours and counter negative body image.

But despite being rooted in research, she’s clear that the products ‘are not medical devices, they are a mindfulness tools. They are not a replacement for seeking medical advice from a trained healthcare professional. They are just little pick me ups to help when you’re having a bad day!’

Response has been amazing from the mainstream media, but it’s the short letters of thanks that really matter. ‘Almost every day I wake up to messages in my inbox about how my tattoos have helped them. It’s really touching, and it keeps me going!’

We just have to keep going.

This book, edited by Theo Stickley, associate professor of mental health at the university of Nottingham and expert on mental health, arts and health, counselling or nurse education, brings together three rather nebulous and difficult to define concepts – qualitative, art, and mental health – with the aim of proving, at least until the ‘common sense’ argument prevails, that the arts are good for people and should be valued and embedded in practice.

As well as definitions, arts for mental health faces a systemic difficulty. When it comes to healthcare, data is key. Funders and policy makers want evidence, and the form this tends to take is figures, laboratory testing, randomised control trials and money. But not only are creative and arts based interventions difficult to measure in this way, the individual patients and services users do not see the impact in terms of statistics but the effect on their own quality of life.

This book presents eleven key examples of arts-based projects that have sought to promote mental health. They include visual arts, craft making, writing, film-making and performance, and are given the term ‘participatory arts’.

Theo Stickley offers up diary extracts from his early days in the field, when as a mental health nurse in a ‘bleak…limited’ environment where people were ‘stripped of…independence and dignity’ when he set up a creative arts programme that went on to become Nottingham’s Art In Mind.

Asking the question ‘Is art therapy?’ Langley Brown explores the difference between art as therapy and non-clinical activity, and the role of the patient within this. The evolving programme in Liverpool is explored by Julie Hanna and Polly Moseley, with collaborative commissioning being identified as a key area for focus, and four schools are looked at by Edward Sellman and Anna Cunliffe, in a balanced report addresses dangers as well as benefits. Mick McKeown et al. and Shaun & Marian Naidoo both look at the role of film, one as an art form, and one as a research tool.

The final chapter by Helen Spandler and colleagues was undertaken as part of a national study to assess the impact of participatory arts provision for people with mental health needs, 20 and explores how arts can contribute towards a ‘recovery’ approach. Fostering hope, creating a sense of meaning and purpose, rebuilding identities and improving resilience are the hardest to standardise and measure, ‘yet may be the most profound and significant outcomes of participation in such projects’. Helen Brooks and David Pilgrim also consider the distinction between ‘transactional’ and ‘transformational’ change.

Effective art practice should not involve patients as subjects to do something to, but active creators along with artist facilitators, and so many of the chapters look at the perspective of the latter and their own experience. The research examples use various qualitative methods to capture the contexts and meanings of arts practice, with the aim of reflecting the voice of the participant through narratives discourse, ethnography or participatory action research. Researchers are by nature curious, and this curiosity should extend to exploring new methods of inquiry that are flexible and reflexive, truly reflecting the experience of the subject – but seeing that subject as a human being.

This, if anything, feels like the noble goal of Theo Stickley’s Qualitative Research in Arts and Mental Health: Context, meaning and evidence. To view art as a human experience in which the experience of humans matters. Identity, hope and resilience are all important attributes of a person’s life, whether they are deemed to have health problems or not, and arts based approaches offer a ‘unique and life transforming contribution to mental healthcare.’ this collection of research and documentation is one valuable step towards its recognition as such.