Sunday, February 18, 2007

Anorexia as metaphor

Recently I've read seveal memoirs about being anorexic, or books by doctors about eating disorders, that emphasize the metaphoric context of anorexia and bulimia. They talk about anorexics craving emptiness and hunger, the politics of appetite, the power trip of self-starvation.

I can see that for those who suffer from anorexia for a long time--more than a year? more than two?--the natural human tendency to assign meaning and metaphor to biological reality kicks in. When you live with something for a long time, it becomes part of your self-image, a key element in how you see yourself.

Such writers tend to make an important and to my mind unsupported leap, though. They generalize backward from their own situation, years down the line with anorexia, and conclude that the metaphor is what causes girls and boys to become anorexicv. This is the classic pitfall in anorexia treatment, the conventional wisdom espoused by doctors and therapists. And it's wrong.

It's important for parents and therapists and doctors to not get sucked in to the persuasive world of the anorexia metaphor. To remember that the vast majority of anorecxics become sick accidentally, from a diet that takes on a life of its own, an illness, a natural propensity for losing weight that gets pushed too far in some way and takes over a child's physial and psychological life.

To buy in to the notion of anorexia as metaphor is, frankly, to fall under its sway. I think this is one reason why, as Daniel Le Grange told me, even doctors and therapists sometimes make bad decisions about anorexia. "It's as if the anorexia affects the thinking processes of those around the sufferer," he told me.

I think the mechanism he was talking about is metaphor. And that's why I think it's absolutely vital that we de-metaphorize anorexia. We can best help our children--and other people's children--by taking anorexia's power away, both literally and metaphorically. By remembering that anorexia is a biological disease and that its symptoms and consequences are larely the result of starvation. And that the first line of treatment for it is not psychological but physiological: food.

There is time later, after a child is weight restored and mentally restored, to discuss the metaphors of eating disorders, if they apply. But it's a dangerous trap to fall into that conversation right away.


Unknown said...

Here's to the end of anorexia as a metaphor! Well said!

Carrie Arnold said...

My best friend in college was the queen of the metaphor. Even outside of my anorexia, I have to admit, I love metaphors.

But with anorexia, metaphors can turn from describing the experience to actually becoming the experience itself. Like right now, I'm looking out the window and the sky looks like a stormy ocean- all gray-blue and frothing with clouds. But I know it's NOT an ocean suspended upside down.

It's the same thing with anorexia. For me, the only metaphor for anorexia is this: suffering.

Everyone is "starving" for something. Those metaphors don't apply to anorexics alone. I think everyone, on some level, is starving for attention or engaged in a power struggle.

As well, my recollections of being deeply anorexic are colored by my being so severely malnourished. I do refer to those years (thankfully passed) as "The Starving Years." When you are starved of food, you are starved of life. Depression starves you of pleasure, anxiety starves you of peace.

I think we, as humans, want explanations. All societies have some story surrounding creation. When you can't grasp something, you try to explain it. Anorexia, for an outsider, is pretty damn baffling.

Anonymous said...

I agree with you, Harriet. But I also know that when I was suffering from my eating disorder, sometimes I wanted to feel like more than a selfish brat, a person who didn't know how good I had it, a person who should have known what "real" illness and suffering were (these all were characterizations of my self that I picked up on from other people). They too became part of my self image.

Harriet said...

Oh, I am so sorry, anonymous, that you had to go through that.

I had panic disorder from the time I was about 8. And I remember having some of those feelings, too, around my fears and anxieties. It's a terrible thing, and yes, it can become part of your self image. I know I've worked hard (and am still working) to separate myself from my fears. I empathize with you and hope you are no longer troubled by those thoughts and feelings.

Anonymous said...

Thanks for your kind message, Harriet. I have a loving family, but family members, especially my mother, were the source of some of these reactions to my illness. Although I feel that I have a fairly good self image now, I also have become an adult who feels that I should not reveal my problems and concerns to my family, because I "had my turn" when I had anorexia. It makes me very happy to see that you and other "Maudsley moms" refuse to blame your children.