That which stirs within, slows or quickens, goes deep or dies out. When I speak of spirit, I am not speaking of something related to or given by a force outside ourselves. I am speaking of the force that is ourselves. The experience of living in this world, bound by a body, space, and time, woven into the fabric of human history, human connection and human life. This is the force that feels, and thinks and gives us consciousness at all. It is the deepest, most elemental, most integral part of who we are; it is who we are.

In her presence, I was reminded again of why I was an anoretic: fear. Of my needs, for food, for sleep, for touch, for simple conversation, for human contact, for love. I was an anoretic because I was afraid of being human. Implicit in human contact is the exposure of the self, the interaction of the selves. The self I'd had, once upon a time, was too much. Now there was no self at all. I was a blank.

I missed him so much that it felt like a physical pain in the area below my ribs. I opened my mouth to accommodate it. I put my hand to it. A hollow, aching, piercing place.

When you are mad, mad like this, you don't know it. Reality is what you see. When what you see shifts, departing from anyone else's reality, it's still reality to you.

In that six months, so much happened that death seemed, primarily, inconvenient. The trial period was extended. I seem to keep extending it. There are many things to do. There are books to write and naps to take. There are movies to see and scrambled eggs to eat. Life is essentially trivial. You either decide you will take the trite business of life and give yourself the option of doing something really cool, or you decide you will opt for the Grand Epic of eating disorders and dedicate your life to being seriously trivial.

The leap of faith is this: You have to believe, or at least pretend you believe until you really believe it, that you are strong enough to take life face on. Eating disorders, on any level, are a crutch. They are also an addiction and illness, but there is no question at all that they are quite simply a way of avoiding the banal, daily, itchy pain of life. Eating disorders provide a little drama, they feed into the desire for constant excitement, everything becomes life-or-death, everything is terribly grand and crashing, very Sturm and Drang. And they are distracting. You don't have to think about any of the nasty minutiae of the real world, you don't get caught up in that awful boring thing called regular life, with its bills and its breakups and its dishes and laundry and groceries and arguments over whose turn it is to change the litter box and bedtimes and bad sex and all that, because you are having a real drama, not a sitcom but a GRAND EPIC, all by yourself, and why would you bother with those foolish mortals when you could spend hours and hours with the mirror, when you are having the most interesting sado-machistic affair with your own image?

I look back on my life the way one watches a badly scripted action flick, sitting at the edge of the seat, bursting out, "No, no, don't open that door! The bad guy is in there and he'll grab you and put his hand over your mouth and tie you up and then you'll miss the train and everything will fall apart!" Except there is no bad guy in this tale. The person who jumped through the door and grabbed me and tied me up was, unfortunately, me. My double image, the evil skinny chick who hisses, Don't eat. I'm not going to let you eat. I'll let you go as soon as you're thin, I swear I will. Everything will be okay when you're thin.

You know those afternoons," he asks, drawing a shaking breath, "where you’re just going along, doing fine, and then afternoon comes and it feels like you’ve just got the wind knocked out of you and everything is wrong?" He sighs and slowly pushes himself so he’s sitting upright. His shoulders are slumped. "That’s all," he says. "It’s just one of those afternoons."We are silent for a minute. Then he lies back down on the couch.I should say I love him. I should say it will be all right. But it won’t.I walk down the hall to my bedroom. I lie down on my side and stare at the wall, the blue-flowered wallpaper next to my nose. Despite my best efforts, I start to cry.I know those afternoons.

Never, never underestimate the power of desire. If you want to live badly enough, you can live. The great question, at least for me, was: How do I decide I want to live?

Some people who are obsessed with food become gourmet chefs. Others become eating disorders.

I get absolutely shitfaced. I am shitfaced and hyper and ten years old. I am having the time of my life.

I have a remarkable ability to delete all better judgement from my brain when I get my head set on something. I have no sense of moderation, no sense of caution. I have no sense pretty much.

You cannot explain, with the limitations of language and inexperience, why your body can cause such a sudden, fumbling response in someone else, nor can you put into exact words what you feel about your body, explain the thrum it feels in proximity to another warm-skinned form. What you feel is a tangle of contradictions: power, pleasure, fear, shame, exultation, some strange wish to make noise. You cannot say how those things knit themselves together somewhere in the lower abdomen and pulse.

Because I'm not, in fact, depressed, Prozac makes me manic and numb - one of the reasons I slice my arm in the first place is that I'm coked to the gills on something utterly wrong for what I have.

Here's the hell of it: madness doesn't announce itself. There isn't time to prepare for its coming. It shows up without calling and sits in your kitchen ashing in your plant. You ask how long it plans to stay; it shrugs its shoulders, gets up, and starts digging through the fridge.

Forgive me for being chipper, but despair is desperately dull.

At the lip of a cliff, I look out over Lake Superior, through the bare branches of birches and the snow-covered branches of aspens and pines. A hard wind blows snow up out of a cavern and over my face. I know this place, I know its seasons - I have hiked these mountains in the summer and walked these winding pathways in the explosion of colour that is a northern fall. And now, the temperature drops well below zero and the deadly cold lake rages below, I feel the stirrings of faith that here, in this place, in my heart, spring will come again.But first the winter must be waited out. And that waiting has worth.

But new love only lasts so long, and then you crash back into the real people you are, and from as high as we were, it's a very long fall, and we hit the ground with a thud.

Falling in love happens so suddenly that it seems, all at once, that you have always been in love.

My brain sometimes departs from the agreed-upon reality, and my private reality is a very lonely place. But in the end, I'm not sure I wish I'd never gone there.

I was used to sleeping with people because I endlessly found myself in identical situations where it was easier to just fuck them than to say no.

Soon madness has worn you down. It’s easier to do what it says than argue. In this way, it takes over your mind. You no longer know where it ends and you begin. You believe anything it says. You do what it tells you, no matter how extreme or absurd. If it says you’re worthless, you agree. You plead for it to stop. You promise to behave. You are on your knees before it, and it laughs.

We're like little kids. We are little kids, but don't tell us that—we're having a fantastic time. We have our little house, and live our little life. We are the perfect young husband and wife. We have nonstop dinner parties—the glorious food, the fabulous friends, the gallons of wine. I sometimes feel as if I've raced off a cliff and am spinning my legs in midair, like Wile E. Coyote. But I'm fine. It's fine. It's all going to be fine. Crazy people don't have dinner parties, do they? No.

There are a lot of times the heart burrows deeper, goes tunnelling into itself for reasons only the heart itself seems to know.They are times of isolation, of hibernation, sometimes of desolation. There is a bareness that spreads out over the interior landscape of the self, a bareness like tundra, with no sign of life in any direction, no sign of anything beneath the frozen crust of ground, no sign that spring ever intends to come again.

At times it may seem worse - harder, at least - to live through the despair of this loss without the temporary comfort of our addictive behaviour. We cannot drown our sorrows. We must face the fact that we don’t know, really, where we are, how we got here, how long the pain will last, or how to move past it. That uncertainty may be the most painful part of not knowing a God: no one is there to reassure us that a God will take the pain and confusion away. We simply don’t know. And we have no way to numb ourselves or to forget the condition we’re in.

The idea began to sink in, more than it ever had, that I might be crazy, in the traditional sense of the word. That I might be, forever and ever amen, a Crazy Person. That's what we'd suspected all along, what I'd been working so hard to disprove, what might be true. I preferred, by far, being dead.

I relish my life. It’s the one I have. It’s difficult, beautiful, painful, full of laughter, passing strange. Whatever else it is, whatever it brings – it’s mine.

I am mad. The thought calms me. I don't have to try to be sane anymore. It's over. I sleep

Bear in mind you have a life to live. There is an incredible loss. There is a profound grief. And there is, in the end, after a long time and more work than you ever thought possible, a time when it gets easier.