Last week, yet another man in a position of unfathomable power was accused of sexually abusing multiple women over the course of his career. Accusations of racism and bullying were also blasted out across newspaper front pages and television programmes, with some naming the accused – Sir Philip Green – as the ‘ugly face of capitalism’. Nothing has yet been proven so one must be careful what they write on the internet, but I think it’s safe to assume that the spread of sexual aggression and abuse spans far wider than perhaps we first thought. But it strikes me that, all too often, the focus is on the perpetrator; his uneasy marriage, his illegitimate children, his offshore bank accounts…But what about the abused?

The Weinsteins of this the world sail through most of life virtually unscathed, leaving a trail of fragmented female brains (and some male of course) en route.  An overwhelming portion of mental health issues in women can be traced back to experiences of sexual abuse, and if you consider the number of women diagnosed with mental health problems every year in the UK (one in four) – well, that’s a lot of women.  We’re not talking about a rogue high school teacher or creepy man in the woods. It is in middle class town houses in the suburbs; in £15,000 a year private schools; in places of worship; in high-rise office buildings with infinity windows and landscaped gardens.  It is a silent presence in most civil societies, and one which – in my opinion – deserves far more attention than is currently granted…for the victims, that is.

My mental health problem was not rooted in abuse or violence. I did not suffer at the hands of anyone, and for that I count myself exceptionally lucky. Most of those I’ve met during illness and treatment have not been so fortunate. Before I entered the realm of eating disorders, I’d never come across anyone with experience of such unimaginable trauma. It was the stuff of television dramas, something that happened to friends of friends of friends who lived in outer, unknown corners of London. How naive and small-minded I was. It soon became clear, during my treatment, that my case – an anorexia patient with no abuse trauma – was pretty unusual. The more stories I listened to, the more I became incensed; the link was so obvious – why was no one discussing it and, more importantly, offering appropriate support?

“Food was a crutch to counter the chaos and confusion, a way to dull the pain and distract from the humiliation I felt in my ‘damaged’ body”

The research into the issue echoes my observations. One study looking at the prevalence of sexual abuse within an eating disorder population found that as many as 50 per cent of participants had some experience of the sort in their childhood and early teenage years. In comparison, a control group of women who hadn’t suffered with eating disorders were seen to have a sexual abuse prevalence rating of 28 per cent. Another Australian study of more than 1,900 women found that incidences of bulimia were twice as high in those who’d suffered sexual abuse, compared to participants with no history of abuse. Strikingly, those who experienced the trauma more than once were four times more likely to develop an eating disorder than others. The researchers from the University of Melbourne suggest that the reason for the link is to do with ’emotional control’. In other words, the eating disorder serves both as a distraction from the haunting memories of the incident as well as a method by which to deal with the painful emotions. ‘Binge/purge cycles might function as an expression of anger or a symbolic “cleansing” of the self of the abusive experience, thereby allowing an individual to regain a stronger sense of self,’ they explain.

Another study makes an argument for the role of perceived control in eating disorders. The authors suggest that restricting food intake or ‘controlling’ ones’ body provides an antidote from the feeling that your body has been somehow prised from your grasp without permission. There are also theories about the quest to return to a pre-pubescent body state – a desperate attempt to ward off any unwarranted sexual attention from men that an adult ‘womanly’ body might bring. The psychologists pose interesting theories, but as far as I’m concerned, there is no better way to communicate what it actually truly feels like than to hear from human beings who have lived through the stories documented in academic journals. Thankfully, two of these bold, brave and remarkable young women volunteered to share their experiences in a bid to help others dealt a similar raw deal.

Maxine developed Orthorexia aged 20. It was only five years later that she pieced together the puzzle of her life experiences and began to see the woods through the trees; between the ages of eight to 12, she’d suffered sexual abuse at the hands of an authority figure.

Maxine says: ‘ The parallels between sexual abuse and disordered eating are unbearably obvious. The shame and guilt, the lack of control, the isolation and secrecy. As a survivor with a history of disordered eating, the link between these two experiences is impossible to ignore. Even though I was only young at the time, even though I didn’t even know exactly what abuse was never mind that it was happening to me, the need to take defence measures and protect myself from that which I couldn’t understand was immediate. For years after, food was a crutch to counter the chaos and confusion, a way to dull the pain and distract from the humiliation I felt in my ‘damaged’ body.

Another survivor, Sarah*, now understands that her deep-rooted lack of self esteem, which fuelled her eating disorder, wasn’t something she was born with. ‘ I didn’t put two and two together for a long time,’ she says,‘ as a young girl of 8-11 years old I had been sexually interfered with by several men within my parents’ friends circle and family. I remember the day I finally told my mum what was happening and she just looked so disgusted and disappointed with me- she asked me why I had not tried to stop it. It was this, that comment that still impacts me now- I was not good enough then and I’m not good enough.

For Sarah – who now works to help others with disordered eating – the illness acted as an effective numbing cream, exchanging emotional turmoil for physical pain by way of punishment and self-denial.

‘The ED acts as a means of numbing and containing those difficult feelings of loss, guilt, shame and disgust. There is a real hatred towards their body, like its let them down and this also contributes to the need for punishment through restriction and over exercising. Both provide temporary relief; but sadly while it may feel like the solution, in reality it just puts them at a higher risk of long term physical health problems.‘

The answer? Predictably, it’s not easy. But studies show recovery rates to be higher in those who have adequate, professional help to pick apart the painful memories and begin to understand what happened to them. By understanding that the abuse was uncontrollable, unjustified and not – in any way, shape or form – the fault of the individual, people begin to accept their emotions as a justifiable result of the trauma. It’s clichéd, but as ever – they key is talking about it. And as I always say; full recovery is possible for everyone – no matter what you’ve been through.

As Sarah says: ‘Understanding that my abuse has been the root cause of my lack of self esteem has actually helped me to move forwards. While I still have days when that deep rooted discomfort of not being good enough kicks in, now instead of trying to restrict or punish myself, I remind myself of why this is. It has helped me to manage those feelings better. I don’t know if I’ll ever feel completely free and what happened to me but I now know I no longer blame myself and I can hand on heart say that food and what I look like no longer play a role in my life.’

Targeted, specialised psychological support is therefore vital. How are the vulnerable expected to speak without the tools to do so? Here’s hoping someone with their hands on the NHS purse strings just so happens to be reading…

If anyone reading this has been affected by these issues and would like support, please contact  Beat and for more information on the subject of abuse and violence against women, visit the women’s mental health charity, Agenda.