Eight Letters in an Anti-Anorexic Journey

Anna, Sara, and Anne Epston

The following records a series of anti-anorexic meetings between Anna, (13/14), her steadfast mother, Sara, and their therapist, Anne.

1 December 1997

Dear Anna and Sara,

Our meeting today seemed a bit chaotic, and lots of ideas were raised but not quite followed through to a conclusion. I must say Anna that I kept addressing you as someone several years older than you really are, and I’m sorry if this confused you.

Before we meet again on Friday, could you please give these questions some thoughts, Anna?

  1. In what ways have you “not totally surrendered” to anorexia/ bulimia
  2. How does anorexia/bulimia promise you that it will further your dance aspirations? Does it claim that you can build up muscles through dancing but through starvation it will trim them down again? Does it offer to be a team-mate in this way? Does it claim that it will work selectively, slimming your thighs but leaving the rest of your body intact? Has it suggested you can dance AND starve?
  3. When does anorexia/bulimia “pre-plan” your daily regime of starvation? When you wake, or before you go to sleep? Does anorexia/bulimia really give you 5 minutes to confirm or disconfirm its plans for you, or does it give you the illusion of choice? What is the connection between anger and compliance with anorexia? Does feeling anger at Sara provide a kind of justification for going along with starvation?
  4. You made it clear that you know intellectually the dangers starvation poses to your body. Yet there still exists a “stumbling-block” between knowing and acting. What is the stumbling-block made of? What turns this from the straightforward “yes/no” decision imagined by others, into something “incredibly difficult”?
  5. Is it fair or appropriate to be “mad at myself for letting this happen”? Does self-blame give you the illusion of choice? Is this one of anorexia’s tricks, to divert your anger from IT onto yourself? If anorexia makes you mad at yourself, does starvation seem then like an appropriate punishment?

I have heaps of other questions to ask, but they can wait for another time. Looking forward to meeting again on Friday,
Yours anti-anorexically



8 December 1997

Dear Anna and Sara,

I’m sorry this letter is a bit late – my plans for prompt writing got interrupted. Last week we discussed Anna’s interest in looking beneath the superficial to discern the underlying substance. As we talked about anorexia and bulimia, did some of their inconsistencies, falsehoods and cheating become more apparent? You report that bulimia’s cost has already started to show itself, as you spit out chunks of teeth, so anorexia sweetly offered itself as “the safe alternative” with a range of promises worthy of a 1950s TV commercial, offering a world of happiness at bargain rates:

– Try anorexia nervosa! Slim those unsightly thigh muscles! Lose unladylike bulk! Reduce weight and dazzle your friends! Be the envy of your dance class! Join the trend that is sweeping the world!

Starvation: the answer to a maiden’s prayer!!!! –
And there’s no packet to show the Surgeon-General’s tiresome warning:

“Danger! Starvation causes low energy, dizziness, irritability, bone fragility, organ wastage, heart failure, infertility, hairy face and arms mood swings, family conflict, social alienation, self-hatred, self-execution.”

Anna, we talked about the anti-anorexia that you preach to “everyone else” while practising anorexia in your own life. In exploring this discrepancy you described how anorexia seems to offer “some benefits’ and makes you feel as if you are in control, the “governor-general” with a casting vote. Anna, the governor-general is largely symbolic; real power is held and exercised elsewhere. Is anorexia lulling you into a false sense of security? Is it pretending to respect your wishes? Is it tightening its grasp by telling you what you want to hear? Is it pulling the wool over your eyes as it oh-so-subtly leads you like a lamb to the slaughter? Does anorexia promise you that you can keep your soul as long as you sacrifice your body? What reality lies beneath this diabolical pact?

Looking forward to meeting with you both on Thursday at 10am. Yours against deception.


11 December 1997

Well I was intrigued to hear that “Anorexia was pissed off with being confronted” at our last meeting! Do you think Anorexia is starting to get the message? Is Anorexia getting nervous that you are beginning to see through its twisted logic and false pretenses? Is Anorexia afraid that you are going to question its assurances that you can starve your mind and body awhile excelling at dance? Does Anorexia dread that you might decide that a slow death is no more attractive than the speedy self-execution you rejected? Is Anorexia beginning to catch on, that Sara and I mean what we say: that we’ll never give up our fight against its lies and tortures?

Anna, do you think Anorexia was shocked and dismayed at the teampower you and Sara wield together? It seems that when your loving Mum puts food on your plate, anorexia slinks off mumbling in defeat. Anna and Sara, what has it been like to reclaim mealtimes as sites of nurturing – talking, co-operating, sharing – a no-torture zone? Do you prefer this to Anorexia’s rule: hypervigilance-mistrust-deception?

Anna, when you asked Sara to “be there for me, do what you did for my older brother, Jim -being constant, showing your love and affection” were you starting to pull out the wedge that Anorexia had slipped between you? Do you think it took a special kind of courage to acknowledge your Mum’s steadfastness and anti-anorexic power? What’s it like to know that your Mum can be trusted to know, and teach you patiently, how much food is right, while calmly assuring you that you’ll never be fat? Are you finding that two anti-anorexic heads are better than one?

Anna, I was really interested in your question, “what do I have to do to be healthy for you guys ?” Have you been mulling that one over for a while?

Did you agree with Sara’s reply, ‘to nourish yourself till your periods come back? Has anorexia argued against that as being a bit extreme? Does it think you ask for too much? Does it say, “you can always adopt children, don’t worry…?” What do you think about my idea, that being healthy is living in harmony, with mind and body befriending each other? Or do you endorse Anorexia’s recruitment of the mind to dominate, punish and starve the body?

Would that kind of harmony be something you’d like to convey to the junior dancers next year? Might you be the pioneer who dares to defy the lethal tradition of turning a blind eye to the shocking wastage of dancers’ minds and bodies? Or will you be a Pied Piper, gracefully leading them to embrace starvation? (“Mum, I want to be just like Anna”)

18 December 1997

Dear Anna and Sara,

I wonder if you were as dismayed as I was to experience first-hand the mess Anorexia is making of your lives and relationship. Were you, too, desolated at the contrast between Tuesday night’s beautiful, co-operative and nurturing dinner, coordinated by Anna, and yesterday’s Anorexia-ruled moods driving you to the verge of tears? Do you think anorexia was getting back at you for your dinner of disloyalty? Anna, do you think anorexia was using you to punish Sara for breaking its law of silence? Why, do you think, would Anorexia prefer for Sara to pretend you’re fine, that nothing’s wrong in your life?

Anna, as you writhed and chafed in the grip of Anorexia yesterday, I marvelled that somehow you had rejected its evil influence the evening before. Do you have any idea how you did that? What strengths, what memories, what examples, what ideas did you draw upon? Were you thinking of what it must be like to be Sara, watching appalled as her beloved daughter withers in front of her eyes? Did you summon up your daughterly love to refer to page 8’s “I love you always”? How did you perform this dazzling feat of heart strength? Can you understand why this question is vitally important? Did you have to strike some kind of bargain with Anorexia your jailer, like “If I can have one evening of freedom, you can lock me up in the morning – even solitary confinement…?” What other price did you have to pay?

Sara and Anna, do you think ballet instructor is starting to get wiser about Anorexia’s vampirish hold on Anna’s body, mind and future? Does her advice “Make sure you eat over the holidays..I don’t want you to end up disappearing, getting sick like Carla…” give you hope that she might be recruited to use her power and influence against Anorexia? Sara, might you consider preparing some questions to ascertain her(ballet instructor) depth of awareness and commitment to the struggle?

Anna, you say you respect Carla as a teacher, but claim to find her emaciated appearance “gross”. Yet when you compare yourself to her, anorexia whispers “You’re huge Anna” and so starvation tightens another notch. You say your best girl-friend Tanya has heard that some deadly whisper in her ear, and resolutely refuses to play that lethal game. Where do you think Tanya gets the strength of character and independence of mind to drag herself away from the seductions of invidious comparisons? How has she retained the mindstrength to know that’s a dangerous lie?

Anna, I really felt for you in your anguish and frustration yesterday,knowing well the horrible and isolating experience of being mood-dominated. Is it possible that your struggle to “not get emotional” actually put you deeper into that moodswamp? Is Anorexia trying to turn you into a puppet with no feelings? Is that another of its evil techniques to weaken you more? And is the over-simplification that “to overcome Anorexia you just have to eat” another way of pulling the wool over your eyes? Are you being blinded to the complexity and pervasiveness of Anorexia? Are you being conned into seeing this as a matter of private, individual choice, rather than as the manifestation of a woman-toxic culture where fortunes are made from inducing girls and women to compare, compete, “improve” and hate themselves”

Sara, your constancy is admirable and deeply worth of respect. I look forward to continuing the struggle next year, and will be here from 12/1/98.

Yours faithfully (literally!) The Therapist.

22 January 1998

Dear Sara and Anna,

Again my heart goes out to you both. To you Anna, as Anorexia further eclipses your personality, sucks more flesh off your bones, more joy from your life, and mortgages your future. To you Sara, whose child has been kidnapped and held hostage by Anorexia, as your anguish intensifies and the fear emerges: “How much longer can I go on?” And to your mother-daughter relationship, undermined, distorted and tormented by Anorexia’s relentless assaults.

Anna, was anorexia taking revenge on you both for having experienced the enjoyment and sustenance of a shared cheesecake? How many days of suffering and alienation did anorexia sentence you to? Was hard labour part of your punishment? What other pleasures has Anorexia decreed “out of bounds”?

What does Anorexia promise you as compensation for a life stripped of pleasure and spontaneity?

Anna, you revealed that Anorexia was talking constantly to you throughout your trip South. Was it making the same old promises? Was it using the same old threats? Was it telling you “You look gross” whenever you saw a thinner person? Was it reassuring you that others may be sick, but you’re not? Was it hiding behind its old pretense, that you’re “the governor-general”, making independent decisions about your life? Did Anorexia have anything original to say, that it hasn’t said a thousand, thousand times already, to you and to so many millions of other young women?

Anorexia critiques our meetings as having “nothing new” to say. Anna, dare you evade Anorexia’s supervision for a few minutes to re-read deeply my letters to you? Have I said already that Anorexia is evil in every respect? Have I said that my moral duty is to resist Anorexia forever? For I see not just your future at stake Anna, but the future of many girls and women. What is to happen to those young women whose vampire-sucked bodies make you think “I’m gross”? What is to happen to those joyous young dancers who see your starving body and begin to think “I’m gross”?

Sara, Anorexia describes your persistence as “a pain in the ass”. Please don’t adopt its demeaning language. I believe that one day Anna will come to acknowledge that you saved her life; that you were her eyes when anorexia had blinded her, you were her ears when Anorexia deafened her, you were her breath when Anorexia stifled her, and you were her heartbeat when

Anorexia turned her heart to stone.

Sara and Anna, I am unwaveringly on your side, forever against Anorexia and everything it stands for.

See you soon Anne.

24 February 1998

Dear Sara and Anna,

Can you imagine my relief, after re-reading my last letter (22/1/98) to you, to hear that it no longer described the state of your relationship? It was wonderful to see the renewed closeness and harmony between you, and to learn of the ways in which you have been taking your lives back from the misery inflicted by Perfectionism and Anorexia. Did I hear a new note of certainty in your voice, Anna, when you said, “I don’t like the way Anorexia makes me behave”? Was I right in thinking you shared Sara’s indignation at the unfairness of Perfectionism demanding flawless English assignments from a girl starved of nourishment? Does remembering to blame Perfectionism and Anorexia rather than Anna make it more possible to oppose their narrow perspectives and cruel conformities? Does putting the responsibility where it really belongs remove a wedge from between you?

How much has your consulting your new “laid-back, helpful” G.P., Dr Jones, influenced your anti-Anorexia enthusiasm? What have you learned, Anna, from her suggested experiment in sole responsibility for nourishment? Did this experiment pave the way for your brilliant invention: ‘Reality Checks’? And were you inspired by your trust in Sara’s judgment to enlist her wisdom against Anorexia’s crazy distortions and lies?

Would you describe your teamwork in challenging some of ballet’s previously taken-for- granted pro-anorexic practices as another major development in your anti-Anorexia campaign? Were you inspired by each other, as Sara linked up with your ballet class- mates’s mother to “stir shit” and “stand up to her(ballet instructor)”? and as you, Anna “made a reality check on her(ballet instructor)” and “began challenging the ballet syllabus”? Anna, is it good to be applying your old skills of checking beneath appearances for inconsistencies? Is that how you discovered that your ballet instructor actually prefers your appearance since Anorexia began gnawing at you?

Is that how you managed to dispense with her (ballet instructor) “pedestal” and see her as “a human being with foibles”? Anna, was it your growing capacity to distinguish between ‘dancing for Perfectionism” and ‘dancing for pleasure’ that led to your monumental decision to tell her (ballet instructor)- “I’m not going to put myself through that stress” and withdraw from the big competition?

Sara and Anna, your mother-daughter relationship sounds as if it won a big anti-Misery victory by your triumphant Tongariro crossing, where it seems Perfectionism and Anorexia didn’t even get a peep in. I loved your description of the rolling clouds obscuring your view, then parting to show you magnificent vistas…

And this letter would be sorely incomplete without a salute to your splendidly memorable 14th birthday celebration, in which fun and pleasure ruled the occasion. And led the way for “four great meals in a row” thereafter. Are you getting a taste for freedom from bondage?

See you before too long, and yes I’d be happy to see Anna alone if that’s what you both think a good idea.

Yours in appreciation,



2 March 1998

Dear Sara and Anna,

Well was that a breakthrough or what?? Was it turning 14 that prompted you to exclaim, “I hate these false pretenses! I hate the deceit!”? You explained that “telling the truth makes life easier…life turned around when my older brother became honest too.” Anna, has your expertise in scrutinising surfaces and depths for signs of inconsistency helped shape your preference for honesty and consistency? Has Sara’s unswerving allegiance to honesty been a beacon in the darkness of Anorexia-deception?

Do you think that Dr Jones’ trusting and gradual approach helped spur you into leaping forward into true anti-Anorexia? If, instead, she had harassed you to move at a faster pace, would Anorexia have convinced you to rebel and dig your toes in stubbornly? Is it possible that Dr Jones could see you had reserves of maturity and determination that might respond to a respectful, rather than coercive, approach? Anna, when Anorexia told you to despise your doctor’s advice, how did you do an about-turn and start to despise Anorexia’s advice? Was that more difficult than any pirouette ballet has ever required of you? How did you begin to see yourself through your own, and Sara’s eyes, and not through Anorexia’s eyes? How did you drown out Anorexia’s usual lie- “You’re gross!” with your own truth- “I’m starving!”??

Was there something about seeing the truth written down on your good chart that showed lies and deception up in all their falsity? Did writing things down, e.g. the food chart; my letters reflecting your story, make the hollowness of a fake lifestyle more solid and real? Did Sara’s relentless pursuit of truth, her refusal to turn a blind eye to the food-chart’s horrifying record, turn the spotlight on to anorexia’s hideous tortures?

When Sara said- “I’m sick of Anorexia and its effects!”, did that free you up Anna to say, “I’m sick of it too!”? And to make your ‘solemn promise’- “I’m going to tell you if I want to be sick or feel uncomfortable at any time.”?

Was vowing to embrace Truth what excited you to say, “I’m going to beat this..there are so many things I can eat”?

Anna, did telling your other wonderful girl friend, Jill, that “I’m going to eat this” act like a promise? Did it strengthen your resolve? Did her hug confirm you had another ally against starvation? With Jill as a witness to your “excitement, happiness, determination , will power to eat and not to eat”, were you reclaiming friendship in opposition to Anorexia’s policy of isolation?

Since those momentous declarations, Anna, it sounds as if you have turned your back on a torture lifestyle, enjoying food, and preferring to read a good book than take part in sports days. When we talked about trying not to believe Anorexia’s taunts, you became really sad. It sure is sad to have been tricked into sacrificing a year of your youth to Anorexia’s deathstyle. No doubt strong feelings will revive as you nourish yourself enough to grow, think and feel emotions fully. But your loving Mum is on hand to help you through. Meanwhile, with your after-maths-test pride, you are starting to reap the rewards of a normal life. Keep reminding yourself, “Why should I have Anorexia’s body?

My body is Anna’s body!”

Would this be a good time to sit down together and revise the book you wrote for Sara, reconfirming its messages? Would this be a good time to review my past letters, since Anorexia would hardly have allowed you to concentrate fully on their ideas and questions earlier? Might you consider writing an (imperfect) account of your anti-Anorexic journey?

Yours for solidarity, Anne.

29 April 1998

Dear Anna,

Thank you very much for your letter with its poetry and graciousness, and for your splendid flower drawing. I keep it on top of my anti-anorexia resource file, where it warms my heart and revives me.

I have just looked back at the notes of our first meeting on 21/5/97, not quite a year ago. In that meeting you related to me the story of your “turnaround” against the influence of anorexia/bulimia. This, you explained was due to your “determination” and “hardworking” nature. And it was prompted by your having learned “how much I meant to my friends and family and how much they meant to me.”

At our second meeting on 29/8/97 you denounced this story as having been “a pack of lies.” I remember talking to David about this, and we decided that we wouldn’t adopt this description as the whole truth of the matter. Instead of a “liar” we would consider you a “clairvoyant.” Instead of a “lie” we would believe the first story to be a true one that hadn’t yet happened. It would be my responsibility to help that true vision of the future come to pass.

I am so happy that the wheel has turned full circle and that time is now. You and Sara have been, and still are, enormously inspiring to me. Although I didn’t record this, I remember suggesting you might translate your victory into dance, by choreographing your anti-anorexic journey. I still think the world of dance needs that! But if you’re too busy having a good time, that’s much more important.

Keep enjoying your life, Anna. Lovingly,