"You have been told that in order to help cure you of your fear of heights you need to jump out of a plane. You have somehow been persuaded to get on the plane. Perhaps you are an inpatient in a psychiatric unit because of your irrational fear of heights and you know that you have to comply with these ‘treatments’ to ever hope to be discharged. You aren’t actually that sure that you have a fear of heights, but apparently you meet the national criteria for Acrophobia. You actually think that a fear of falling off high things resulting in serious injury or even death is a healthy thing. Too many people are not afraid enough and the cost to the health service of treating the injuries these people sustain is a problem, so more people should be like you. You don’t see why jumping out of a plane is necessary to make you better, couldn’t you just look out of an upstairs window? Heck, you could even open the window if you had to.
Anyway you have reluctantly agreed to get on the plane. It is a twin engine plane, with only basic facilities on board. No nice comfy airline seats, or in-flight entertainment. As the engines start-up it is very noisy and the whole plane vibrates and rattles and you start to feel very nervous about the whole thing, wishing you had never agreed to get on the plane. They buckle you in to your seat.
You start to tense up, holding on very tightly to the edges of your seat, looking around you, trying to see where the exits are. No-one has done a safety demonstration, you wonder how good the risk assessments have been and whether they have checked all the equipment properly. As the plane starts to move you begin to wish you had tried to get off while the plane was still stationary and wonder if it is moving too fast to jump off now. But you know if you do that they will say you are still no better and you will never get discharged.
The plane starts to climb to the altitude necessary, your heart is beating so hard you can feel it in your throat. Your palms are sweaty and your stomach is churning. The person with you is watching you to see how you are reacting so you try to appear calm but it is hard when you feel so scared. They are saying reassuring things to you and you are trying to believe them. They are playing some music over the loud speaker and you try to focus on that instead of the fear.
The assistant starts to unbuckle their harness and you realise with a lurch of fear that it must be nearly time to jump. They come over and sit next to you and start to shout over the noise of the engines instruction about what is going to happen.
It suddenly occurs to you that you have not been shown how to use the equipment. To your horror when you point this out the assistant says “what equipment?” The parachute! You need to know how it works and when to pull the string etc. The assistant says “there’s no parachute, we are just jumping out of the plane”. You realise what you hadn’t noticed before. There are no parachute like bundles in the plane, it is empty except for the odd bit of rubbish and a few old tools. Everything goes into slow motion, the world seems to have paused for a moment, and you take a few seconds to register what you have just heard. No parachute? You must have heard wrong. That can’t be right. No you have heard wrong. You ask them to repeat what they said. It is no better the second time. You heard right, no parachute. Surely they are mistaken. No they say, this is what they have been told to do, it is the current NICE recommended treatment for Acrophobia and is 100% effective at curing people’s fear of heights. Everyone who has done it has not been afraid of heights afterwards. It occurs to you that that is probably because they are dead. When you say this they laugh at what they seem to think is a witty comment.
You point out that they have not done a safety check and that you are not happy about jumping out of an unsafe plane. They say they are happy to get you the log book that shows the plane has been checked and you say that you would like to see it. They show you the relevant page and you ask them to talk you through all the ticks and checks You are not really listening but while they are doing this at least you are not being pushed out of a plane. They have stopped speaking, they have been through it all and are looking expectantly at you. You think quickly and thank them for that information, that it would appear the plane has been checked, but how about the pilot? Are they sure he or she is appropriately qualified to be doing this? After all they have the important job of letting you know when it is safe to jump so could they provide you with some credentials please. They look confused but in the end seem to think it is a reasonable request and go off to the cock pit and come back with the pilot’s license and record of previous jumps etc. You smile politely and thank them for their patience but could they also just double check that this was the right day for you to be doing the jump. You had a feeling it was tomorrow and could they please check. They have realised that you are just stalling for time and say the time has come for the jump so no more questions or checks. You argue that they must be wrong, you ask them to check with someone more senior, you ask if you can speak to the person in charge, you say you no longer consent to this treatment. They say that they are the most senior person on the plane and that the other people are unavailable, but crucially, there is no radio on the plane so communication is not possible. They tell you again not to worry, it is alright they have done this before.
They don’t appear to be taking any notice of your concerns they are speaking to the pilot behind the closed door at the front of the plane to check how long before they are over the target area and if they are at the right altitude etc. While they are busy you unbuckle your harness. You are pacing around the plane, looking out the windows. The plane is extremely high, just looking out the windows makes you feel sick. You say you don’t feel well. The assistant points out that that is because you have a fear of heights. You reply that it’s a fear of death not heights and she should shut up because she clearly has no idea what she is doing and should be struck off. Is she going to be jumping out of the plane? She says no of course not, she doesn’t have Acrophobia. You tell her you actually don’t have Acrophobia and never have done and they have all got it wrong. This gets no response. It’s as if she was expecting you to say that.
You are getting desperate now. You have to get off this plane but not by jumping out. You try telling the assistant you don’t consent. You can’t do it today, maybe you could build up to it. Perhaps today just being up this high is a good start? Would it be enough just to stick you head out of the door? No. What about you whole upper body? Again no. You promise you will do it tomorrow, you just need more time to get used to the idea. This is not acceptable apparently, it has to be today, while they have the plane available. You tell her this treatment is not going to work for you. You actually feel more afraid of heights now than you ever did. It’s making you worse, can’t they see that! You are pleading. Nothing is making an impact. The assistant is still getting ready to have you jump out of the plane.
Your fear reaches a new height. You are entering blind panic. You start to shout and cry. You move to the front of the plane. You are hammering on the pilot’s door trying to get them to open up. You are shouting through the door that the person in here is mad and they are trying to kill you. You are begging them to make an emergency landing, you are having a heart attack, you can feel your heart nearly bursting in your chest. Your chest is burning, you can’t catch your breath. You say they must be too high, aren’t you supposed to have oxygen or something? Your hands and nails are starting to bleed from the banging and scratching at the metal door but you don’t care, the blood seems to represent the horror of what they are doing to you. Maybe the sight of the blood will bring them to their senses and stop this. It doesn’t. The assistant is starting to look a little cross.
She starts to approach you warily. She is calmly asking you to calm down, to breathe normally, to sit back in your seat. She’s saying it’s ok, you can do this. It’s fine, it’s part of what is going to make you better, it’s going to help you get closer to where you want to be – home.
She is clearly insane. You tell her this. In order to make your point you add some heavy duty swear words. She is unmoved. She is clearly used to this. You look around you and pick up the nearest heavy object you can find. Some sort of a wrench. You hold it in front of you. You tell her not to come any closer, to make your point you hit out at the surrounding fixtures and fittings showing what damage you can do. She is still carefully approaching you.
You realise that the noise in the cabin has increased markedly and that everything is being blown around in a great rushing wind. While you were trying to get the pilot’s attention, she has opened the side door and the sky and ground below are rushing past. The noise is worse than ever so that you can barely hear yourself think. You are frozen with fear. She had taken the wrench off you and is moving you closer to the hatch. You know you have lost and what follows is inevitable. You try one last time to push her out of the door first but she has been taught some special moves just for this eventuality and the last thing you see is her receding face mouthing ‘well done’ as you fall.
Now replace the flight with meal time and the jump with food. This is pretty much what it is like to have anorexia and be asked to eat a meal with carbohydrates, fats and protein in it, followed by a nice sweet pudding. Everyone is insane, they don’t know what they are doing, they are trying to kill you (or make you fat which is the same thing). What would you do to stop someone making you jump out of a plane without a parachute? Lie, cry, scream, swear, use violence? So no surprise these are the reactions we see when we ask people with anorexia to eat. The fear is overwhelming.
Of course in the case of the person with anorexia, they find themselves floating gently to the ground landing on both feet in a beautiful meadow where the sun is shining and the grass is green and birds are sweetly singing. Then hopefully the next time they take the same trip, they won’t be so scared until jumping out of the plane will be just a normal part of their day, like eating meals for example."