Alessandra Panizza
My Friend M------
My friend Daniela and I had agreed to meet on London Bridge, but we’d never specified which side. When I spotted her, she was across two lanes of traffic.
We’d met on Instagram. When I’d told my new, tentative housemate-friends this before I’d gone to see her, they’d nodded politely, not querying, though I knew they were, because Instagram isn’t for meeting people. It’s for existing friendships, or quasi-friendships, a place where, at least for me, on my main account, it’s never quite clear who I’m posting for or why I’m posting what I am. But I have a second account – an account I started in secret in my first year of my undergraduate degree, one night on the couch after stalking girls, girls just like me. Anorexic girls. Girls trying desperately to recover, a word that, until then, I’d never heard used in the context of mental health.
Daniela and I had found each other in this subcommunity of Instagram, an online space where a halt in posts from a friend could mean she’d recovered and moved on with her life, moved on from posting pictures of every morsel she dared put in her mouth, or she’d died from organ failure. The girls on there that I know range from ages fourteen to thirty.
Daniela was never anorexic – at least, that I know of. She’s part of the larger, more general subcommunity of mental-health-recovery Instagram. While it was a trend, a few years ago, to list your diagnoses (as well as your number of inpatient stays, and, for the anorexics, your weight) in your bio, this is now seen as gratuitous and counter-intuitive to recovery, and thus disparaged, so I don’t even know, really, what her problems are, though I can guess. We'd become "mutuals" years before I moved to London. I'd admired her and her network of mutuals from digital afar for months, and one day, one of them followed me. In the days following, the rest, including Daniela, followed me too. I was starstruck, and approached carefully. They seemed to like me, think me cool, at least online, but here was Daniela in front of me, we’d walked through the traffic to get to each other, and it was real this time, and she said I was tall, and I laughed and said she was short, and we walked off the road and off the bridge to the markets.
Earlier, I wrote of anorexic "girls trying desperately to recover" – this was a phenomenalisation. The community is also full of girls in quasi-recovery, like I was in the first two years or so that I had my account. I would post pictures of my "recovery wins" – breakthrough moments in recovery, like eating a "fear food" – all the while knowing that I was only able to eat it because it fit in with my set calories for the day, a number that was still far too low.
I’m not sure if there’s an equivalent for anorexic quasi-recovery in broader mental health recovery discourse, but there definitely is the same pattern of in-and-out of hospitals. When I first followed Daniela, this was her – a life of rotation around the psychiatric hospitals of London, interspersed with weeks of real-world freedom, from which she’d post her highs and lows, mostly lows. Whether she’d have her phone while institutionalised depended on the institution. Perversely, I admired her secondments. There’s an epidemic of not feeling "sick enough" in the community, of wanting to be the most ill, the most fragile, for the anorexics, having the most comments under your post telling you that your meal was not enough.
Though we'd walked through the markets, we'd ended up at Leon. I did not offer any suggestions on where to eat, because I am far too anxious to make decisions – especially around food, yes, still – that I could judged for, and Daniela wanted to try their new vegan wrap. I was surprised that someone like her patronised chains.
Daniela described herself to me, there, as a full-time activist. I knew she did a lot of activist work, but I didn’t previously know it was possible for activism to be a full-time job. "Yes", she said. She’d been invited (by whom, I don’t know) to protest during COP26 – and I use "during" here, to avoid writing "for" or "against", because I don’t know where she stands, and where I, therefore, feel I am supposed to stand. I was too ashamed to ask. I knew she was at odds with the Extinction Rebellion, who, she said, were simultaneously doing too much and not enough at all. She’d spent a few nights in some cherry trees to protest their removal, and many nights at a camp at Stonehenge for its Heritage Action Group.
She told me later that she supports herself with sex work. She's only the second person in my life I've known in the field. The first was a girl from my science classes in my undergrad days who told me between drags of a cigarette (edgy for Australia) that she was prostituting at night because of the strict hours of our labs. I was nineteen and shocked. I tried not to show it then, and I tried not to show it then. After lunch, we were going to the Tate Modern.
After that first meeting with Daniela, she posted a story advertising a new Instagram account – whether she’d made the account or not was unclear. It was called the Campaign for Psychiatric Abolition. I have to scroll down far, now, to reread the caption of their first post, where they announced themselves as "a group of psychiatric survivors working together to fight all forms of policing, incarceration, and state violence."
In their third-ever post, they lay their beliefs clearly in an infographic, that hot commodity, with a bold red header titled "Our Beliefs". "We are fighting for the full abolition of all forms of incarceration, policing and surveillance. This includes the police, prisons, psychiatry, detention centres, and borders."
I’ve understood for years the need for carceral abolition, though the cognitive dissonance from my unassuming years remains. I’d never considered psychiatry as an extension of this. I didn’t dismiss it, but I exited the page.
When we’d finished eating, we walked to the Tate Modern. Outside the structure of a meal, our talking was more sparse, more stilted. At the entrance, a worker told us we had to book (free) tickets to get in. We did this on our phones and the lady scanned our QR codes. Inside, Daniela put on her mask so I put mine on too.
"The History of Psychiatry", another of their infographics is titled. "We are often taught that psychiatry is a benevolent and caring institution… However, when we look at the history and roots of psychiatry, it is clear that nothing could be further from the truth. Since its inception, psychiatry has been a tool of harm, not healing, used against oppressed people."
The post continues to list psychiatry’s damning links to racism, sexism, and queerphobia. It reminds us that these links still exist – asylums from the 1800s are still standing and functioning, for example, and "black people are sectioned at a 4x higher rate".
Under each of the posts are comments from both Daniela’s main and mental-health account, replete with emojis. As I scroll up on the page’s posts, the comments from other accounts multiply. They have 2,379 followers at the time of writing, a thousand more than the last time I checked.
I went voluntarily, on the request of my psychiatrist. My entire stay, I was Stage 1: minimal risk. I went on walks amongst the kangaroos, made Tik Toks. I kept my belt and laces. I recall, hazily, an Instagram story on Daniela’s account from before COVID, describing her secondment in Slovakia during a holiday, where she was chained to her bed. It’s gone now, I can’t refer to it.
In that big, wide lobby, I asked Daniela, awkwardly, where her accent is from. She’d probably told me her history years ago, but I’d forgotten and she’d forgotten. It was a loaded question, as it often is. I am frequently asked the same thing, but my answer is not that I was adopted from Spain and moved to France where I ran away from home and came to England undocumented. Even here, I could have the details wrong: her history is so complex that I am reconstructing it broadly and shoddily. How, then, she got to Slovakia without a passport, how she continues to travel, I will not articulate here.
An anorexic girl called Pip, from, I think, Manchester, jumped in front of a train one morning a few years ago. I didn’t know her, but I have friends that did.
On the 14th of February 2022, Ruth, surname unknown, passed away while inpatient at the Huntercombe Maidenhead Child and Adolescent Psychiatric ward. It’s not known how she died, but a patient of the hospital, in a petition she created to shut the institution down, claims it was due to "certain staff negligence". Since then, all patients have had any mode of contact with the outside world confiscated. The Care and Quality Commission watchdog last year rated Huntercombe as "requires improvement". It has a rating of 2.1 out of 5 stars on Google Reviews.
I went to the Wellcome Collection on a particularly bad day, the kind of day where nothing besides the frenzied writing of Ingeborg Bachmann makes sense to me, to read Michel Foucault’s History of Madness. This was particularly ambitious, because I don’t think I could read Foucault normally. I read pages 463-467 on the history of the asylum, I retained nothing. I switched to Wikipedia, retained nothing.
I went to the Wellcome Collection on a better day, a day where I did not jaywalk daring cars to hit me, to read Cracked: Why Psychiatry is Doing More Harm Than Good by James Davies – it's on the @cpabolition Instagram's "Psychiatric Abolition Beginners' Reading List". I read it cover to cover in the five hours I was there.
For an author from Oxford, the book begins simply, childishly: "Little did Spitzer know at the time that his appointment as Chair of DSM-III would ultimately make him the most influential psychiatrist of the 20th century." It makes me wonder who Davies (and publishers) think his readers are, how much they know, and how much they will depend on his words.
But maybe I am being a bitch, because the book intensifies, and with it my attention. It begins by expounding the flaws of the DSM, the psychiatric bible that lists every diagnosable mental disorder. Despite popular belief, there is no traditional scientific basis behind the conception of such disorders, because there is no known biological phenomenon that has been established as causal or even correlational. As Davies puts it: "the DSM committee did not actually discover mental disorders, at least not in any traditional scientific sense. Rather, they contrived them", using consensus between psychiatrists to create arbitrary disorders that grouped certain comorbid symptoms together. These are terms like "depression", "anxiety", "bipolar disorder", "borderline personality disorder" that we use every day, that some of us used to put in our Instagram bios.
"What is striking about the construction of the DSM is that the procedures it followed often had very little to do with 'science' as most people understand the term, because, in short, the evidence was lacking… when you don't have evidence to decide the issue for you, people's opinions, beliefs, hopes and prejudices begin to intrude". This reminds me of the Algorithms of Oppression that Safiya Noble wrote about – how, because they are man-made, internet algorithms are racist, sexist. Because it is a man-made construct, psychiatry is too. As Davies notes, homosexuality was only removed from the DSM as a mental disorder in 1973.
A month or so after meeting Daniela, and after three to five months of not taking my medication, I had a breakdown, my first London trip to A&E, which led to me being placed as a patient under the Camden Mental Health Crisis Team. They sent me off, one day, to a drug and alcohol rehab centre in Kentish Town to pick up some free medication in the hopes that I’d start taking it again. I gave my name to reception and a nurse came to get me. When we got to her office space, she started speaking in technical terms and showing me where things were.
When I looked confused, she asked, "are you not the new hire?"
I didn’t look like someone who needed to be there.
I don’t like art galleries. I hadn’t mentioned that to Daniela when she’d suggested we go, because I didn’t want to be disagreeable, and also because I feel like I should like them – especially the Tate Modern, now that I was living in London.
I particularly don’t like going with other people. It’s always an awkward dance about how long to stay in front of one work of art, whether to read the plaques or not, whether to talk about the art or not and how to talk about the art. And your feet always ache. Daniela and I didn’t talk about the art in any capacity, except for when she said, "this place is really fun to come to when you’re on acid." I didn’t doubt it.
Often, I found myself looking at Daniela looking at the art instead of at the art itself. Our silent, awkward walks from one work to the next killed me. I thought about the Daniela’s stories from the year before: checkered alternatively with proud declarations of numbers of days clean from heroin, and with accounts of relapse. Though I’d messaged her encouragement during, from Australia, here in person we did not mention it.
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I am scrolling through Daniela’s account to see what hashtags she uses, and I realise that unlike me, she never used any. While I scroll, I see my comments on her posts, encouraging things, conspiratorial things, things I really didn't know anything about and definitely don't anymore. I see, with shame, a comment of mine from 2018 on the bad English in a warning letter she received from an institution and I resist the urge to delete it. It reminds me of the flickers of admonishment I give myself when I am scrolling through @cpabolition and reflexively feel like their spelling and grammar errors discredit them.
On Instagram, though her name in the "name" section of her bio is "i put the tipsy in antipsych", Daniela goes by her self-given surname, M------. She’s a huge Oscar Wilde fan. She refers to her home online as "M------ Manor", but when I asked her as we sat by the Thames drinking coffee what she preferred to be called, she said, "you can just call me Daniela." After years of thinking of her as M------, I still struggle to say Daniela, and when I refer to her as I type this, my finger often goes instinctively to the "M" key.
Every time I’ve mentioned anorexia, I’ve only talked about girls. Of the hundreds of anorexia recovery accounts I’ve come across the past six years, only two of them have been boys, and one of them non-binary. But the gym-bro discourse that takes up another side of Instagram is just as obsessed with numbers as we are.
In the last third of his book, Davies focusses on @cpabolition’s preoccupations – psychiatric abuse and the uncertain future of psychiatry.
"As soon as you're assigned a diagnosis of 'depression' or 'anxiety disorder' or 'attention deficit disorder' you become a protagonist in a larger myth – you now have a mental disorder that marks you as patient. You have entered into a social contract in which you are now socially positioned as dependent on psychiatric authority."
I was never formally diagnosed with anorexia. One day at seventeen, in the shower, that fraught place, I realised that if I admitted to myself the facts of: my weight-loss, my despair at and fear of eating, the over-exercise, the loss of period, then I'd be classified as mentally ill, something I wanted, something I already knew, before the other diagnoses, that I was. Not long after, I made my second Instagram account and started using the hashtags. Now, "anorexia nervosa" is in my permanent records.
"Cannot much suffering that is now medically managed often be a necessary call to change… or the organism's protest against harmful social conditions… or a natural accompaniment of our psychological development…?... And if so, in what way is the idea that we can consume our way out of psychological difficulty a myth that is economically convenient not only for psychiatry and the drug industry, but for the wider capitalist system in which we all live?"
I wonder how much of Daniela's institutionalisation for mental illness was actually incarceration for her undocumented status, her homosexuality, her sex work, her drug addiction, her activism – if not directly, then causally.
Davies quotes from "Psychiatry Beyond the Current Paradigm" by Bracken et al. As I read it, its claims – that the current medical, or "technological" model of psychiatry has failed, and that a new social model must be implemented – mirrors @cpabolition’s demands exactly. "We believe that there is mounting evidence that good practice in psychiatry primarily involves engagement with the non-technical dimensions of our work such as relationships, meanings and values." And yet I am only truly believing this when I read it in a journal, and not when I hear it from my friend.
While they both agree that psychiatry has failed, the authors of the article believe that psychiatry (perhaps because it is their source of income) can be reformed, while the CPA has "abolition" in its name. @cpabolition’s latest pursuit is the creation of a "Comrades Care Team". This is a support system of civilians who agree to come to each other’s aides when one member of the group is experiencing a mental health crisis, rather than involving paramedics and the police. They have a meeting at the Dalston Solidarity Café, but I do not go, I have work.
It didn’t take long for my London friends to find my second account, thanks to Instagram’s algorithms. Whereas when I first created my account, my friends finding it was my worst fear (I found out, last year, that they all knew I was anorexic anyway), now I don’t react to their follow with a block. I don’t care that they might not understand that in the community, hashtags are not a faux pas. I follow back. I have over a thousand posts on the account, and now that I am as recovered as I think I can ever be, my posts are no longer food or long soliloquies on recovery, but more interesting things, like outfits or pictures from my daily life. Some new followers don’t even know I was ever anorexic.
Instagram saved me, maybe from organ failure, or maybe from a lifetime of miserable restriction. I found the recovery community by searching the #anorexia hashtag that no longer exists, looking morbidly for pictures of girls on the brink of death. Instead I found a self-governing ecosystem, with its own vocabulary and rules and discourse, with no leader, where I learnt, without a psychiatrist, how to heal myself. And yet, as I said goodbye to Daniela at London Bridge station, her squatters’ cutlery swinging from the back of her backpack, I wondered if I’d ever see her again.
About the author
Alessandra Panizza is a Singaporean-Australian writer with a background in the scientific discipline, primarily computational biochemistry. Her main literary preoccupations are the integration of the arts and the sciences, and the trepidatious footing of social media into the everyday. She currently lives in East London and is working on a novel. She has a blog, saintaquilia.com.