Bitchbusters: on externalising eating disorders
Should we really "separate the person from the illness?"
CONTENT WARNING: eating disorders, sexual abuse
When a loved one is diagnosed with an eating disorder, one of the first directives you can expect to receive is to separate the person from the illness. Distinguish the human you love from the faceless thing that has attached itself, parasitically, to their body, taken up residence in their brain — a devil on their shoulder, a gremlin along for the ride. Some people like to give it a name – Ed or Ana, for instance. A matter of personal preference. Of course, your daughter (son, sister, brother, friend, mother, special other) isn’t psychotic. Or possessed. No need to hunt down an exorcist (ha) – though it’s an analogous case, to be sure. What is achieved by the separation of human and illness is the externalisation of the eating disorder. In turn, treatment can be framed as a fight against it, rather than an assault upon the individual or their bodily autonomy. The patient has an illness. The illness is the problem. The person is not the problem.
In group therapy, I am asked to describe my eating disorder. “She’s a fucking bitch,” I blurt, and the other attendees laugh. “Real bad news, that one. Sadistic as all hell.”
The therapist — today it’s Lynne — nods encouragingly. I shift, wishing I no longer had the floor. Such discussions, I know, can quickly become heavy, loaded — can escalate from zero to a hundred in seconds. Overshare, get emotional, say the wrong thing, and the dominoes are set in motion. Soon enough you’re crying, the person to your left is crying, the person on your right is awkwardly patting your arm, so-and-so across the room is tight-lipped and pale (triggered), old mate sitting by the door is indignant because why-should-she-have-to-sit-through-this-she’s-done-the-inpatient-program-x-number-of-times-already, the group facilitator is gaping like a fish and half the group have gone back to crocheting or reading or filling in sudokus manically, because group is a waste of time and what is the point in talking about it, coping skills don’t work, CBT, DBT, ACT, it’s all psycho-babble bullshit. We’re all irreparably fucked up anyway.
When I speak at last, it’s only to fill the silence. I’m not saying anything groundbreaking or revelatory. It’s not something any other anoretic, bulimic, or EDNOStic couldn’t tell you.
“The bullshittery is unrivalled.”
For your reference, here is a brief history of every eating disorder ever, according to any person ever to have held an opinion on the matter. The first thing to remember, to whip out and brandish whenever invited (or not invited) to offer your perspective, is that eating disorders are about control. They’re a comfort object, a security blanket. In the same way a toddler will self-soothe by sucking their thumb, an individual with an eating disorder will renounce the practice of eating and/or acquire an all-consuming preoccupation with food and eating. Of course, an eating disorder is also a repudiation of adulthood and adult responsibility, an attempt to teleport oneself back to childhood by rewinding growth and development and reassuming a prepubescent body. Eating disorders are an articulation of undivulged trauma, of unverified or unverifiable injury, of unaired suffering. Oh, and here’s another staple: eating disorders are the domain of whitewealthywomen. It’s a woman’s prerogative to change her mind, and it’s a woman’s prerogative to starve or feed herself into obscurity. Indeed, this is a phase most women go through. See also: female hysteria. An eating disorder is a cry for help, a diet gone wrong, a bad habit, like chewing one’s nails, or picking one’s nose or dirtying one’s dress hem. A lack — or perhaps, excess — of order; hence, disorder. Now we’re gathering pace, do try to keep up. You may know it as the pursuit of thinness or cleanliness (next to godliness), perfectionism, people-pleasing, internalisation of patriarchal attitudes and misogyny and unrealistic beauty standards. A defence mechanism, an invisibility cloak — are you getting all of this? A middle finger to one’s parents, one’s swim coach, one’s music teacher, one’s agent, one’s boss, who pushed too hard and asked for too much. If not, you might like to try shorthand. Try: a feminist statement, an anti-feminist statement, masochism, asceticism, selfishness, vanity. Genetics. Environmental factors. Nature versus nurture. Because she felt lonely and ashamed, because she was chubby as a kid and Tommy in the third grade called her thunder-thighs. Because her older sister had depression and was always in and out of the local psych ward, and her little sister had behavioural issues and she felt pressure to be her parents’ anchor. Because she ran too much, too many laps, too many reps, too many races on an empty tank. Because chronic illness was all she knew and why not have the body to show it. Because she didn’t want a masc/fem body, or a body at all. Because nobody ever really took the time, because the one teacher in high school who did was actually grooming her, and because that teacher is still the only person she’s ever loved, and no one spoke up, and no one said anything and no one said anything why didn’t they say anything
For eating disorder sufferers, there is a question that pulsates, flashing feebly à la broken neon sign. The question aches, groans, whines and twinges, like a perpetually pulled muscle. It forms the soundtrack to recovery, though it is also there, an unwavering hum, throughout relapse, remission, relapse, treatment, neural rewiring and nutritional rehabilitation. It’s there, later still, during quasi-health, quasi-recovery, life in a bigger body, life in a smaller body, kgs up, kgs down, two-steps-forward-one-step-backs. For good, better, worse, better, worse and beyond.
Is it worth it?
What are we — ED sufferers, the medical profession, psychotherapists — doing when we refer to the aberrant force or voice inside as “the bitch”? When we give the thing a face and form — that of a demonic female creature — and insist that it (she) must be expelled, blacklisted, sent packing indefinitely? How can we fail to notice the link between these discursive practices and existing strategies that work to alienate, pacify and police the “inferior sex” in our society?
In creating new entities to blame, we condone the masculinist assumptions that underpin current treatment models, therapeutic philosophies and cultural understandings of eating disorders. While externalising the illness can be a useful strategy and means of interpreting eating disorders in therapeutic contexts and beyond (maintaining a sharp distinction between individuals and their problems and avoiding the placement of blame upon the individual) externalisation tends to distract from what is, in substance, the real issue. After all, it is our culture (media, lifestyles, economic systems, institutions, families, friends, teachers, workplaces) that legitimises projects of self-destruction (including self-starvation) that masquerade as “self-improvement.” We need to recognise that there is something fundamentally wrong with the way we as a society have been conditioned to view, use, measure, and evaluate our own, and others’, bodies — women’s bodies in particular. Only then can we entertain any hope of comprehending and reducing the incidence of complex bio-psycho-social illnesses like eating disorders.