A Teleological Exploration of Anorexia Nervosa

This is a “weekly reflection” paper written for my psychopathology class.

What is the experience of an anorexic person? In the case of anorexia, as with other disruptions and disorders, I find this a more interesting and precise question than asking about the origin of the disorder and more useful for transforming it. How is it that the anorectic perceives the world (what sort of a subject is she, and what sort of an objectivity does the world have), and as an extension from this question — as we often ask in class — what is it that she is trying to accomplish/ what is the telos of her disorder?

To get closer to this question, I have been watching video diaries and “thinspiration” (( These show images of very thin women and words of encouragement to support one in her quest to “stay the course” of anorexia. Statements about what one may accomplish by being thin — popularity, power, being a “symbol of perfection” — accompany the images. )) video clips on youtube.com put together by young anorexic women who label themselves “pro-ana.” Their videos have an idealistic, cold, militant tone. Members of the community leave comments on one another’s productions, encouraging one another to keep up the hard work. They speak aggressively about outsiders and “posers” — those who do not meet the criteria for anorexia. I see evidence of the stubbornness Gabbard and Malan describe — the difficulty of establishing and maintaining a therapeutic relationship, her unwillingness to begin to speak, hiding suicidal wishes, etc. They seem to mistrust outsiders and speak constantly of others’ misunderstanding or weakness as shown by their inability to be anorexic themselves. The young women in this community typically have a great deal of knowledge about the diagnostic criteria for eating disorders (which they use to debunk posers) and the medical risks, which are taken as the price one must be willing to pay rather than as deterrents. Accepting these risks is a sign of one’s seriousness. To these anorectics, as if they were spokespeople for the anti-psychiatry movement, anorexia is a lifestyle choice and not a disease equivalent to a cancer on the soul in terms of the freedom and ownership involved for the sufferer. Having anorexia, or rather, being anorexic, is a source of pride and strength.

I sympathize and even agree with them to some extent (indeed, to the same extent that I agree with anti-psychiatry). It does not seem that one can ever experience mental illness as one experiences cancer — as we have discussed, we make meaning from our mental lives, the experience is simply not equivalent, even if a mental illness is similar causally to cancer as a product of biology/ genetics or the environment. As such, this manner of being in the world is worth understanding. (This is another reason why etiology does not interest me nearly so much as, and sometimes even seems irrelevant in light of, a subject’s interpretation of her experience.) However, there seems to be at least one essential misunderstanding at the core of anorexia and simply leaving it unresolved does the anorexic person a disservice and makes it clear that her disease is not so much a matter of choice as a conclusion based on faulty premises.

In the case of eating disorders, as with most (if not all) of the disorders we have discussed in class thus far, there seems to be some kind of a split involved. One part of the patient is not communicating with another part which becomes an unknown influence, one bit of ego is split off and pitted against another bit, or a process has started that was not carried out, leaving part of the patient’s soul lingering in the past, in all cases presenting an un-integrated human being/ soul. An anorectic seems to live under a similar split, and it seems key to bring this split to her conscious attention for her to see that anorexia is not as much a matter of choice or control as she thought and thus paradoxically to stop choosing anorexia.

I am drawn to the “pro-ana” community as a source of understanding anorexia because they display a different side of anorexia than the one I typically hear described by observers (though they may not be representative of all eating-disordered persons). Szekely and DeFazio discuss how most accounts of anorexia “fall into either psychological or sociological reductionism,” (pg. 374) simplifying or distorting the situation. Observers sometimes paint the anorectic as someone who is an utterly passive victim of her society damned to attempt to achieve impossible beauty standards (really, anorexics reach beyond these standards, making a mockery of American ideals). From her side, the anorectic is not nearly so weak — in fact, she is powerful, strong, superior, engaged in a mission few dare to undertake (as I will discuss shortly, this seems to be based on a bad understanding, though this does not seem to mean that anorexic women are passive or weak). Observers also seem to make anorexia into a perceptual disturbance — the anorectic “thinks she is fat” and even “sees herself as fat.” The image here is an emaciated woman looking at an obese reflection in the mirror, as in Seligman’s interpretation of her patient’s distorted self-portrait.

Based on the evidence I have gathered from internet field observations of “pro-ana” young women, they are highly sensitive and aware of how they look and place an enormous amount of significance on it, but do not seem to misperceive their appearances. As one of the anorexic women in Lintott’s article describes it, bony knuckles are a sign of strength. It seems that the anorectic’s body is magnified or distorted in terms of significance, but not that the body is literally seen as fat. This is to simplify the anorectic’s perception.

The misunderstanding for the anorexic person, rather, seems to be based on the divide between the visual/ objective/ symbol-laden body and the felt/ subjective/ personal body. While I find Boss’ essentialism and rigidity in terms of what is normal/ right/ good as disturbing here as I have found it in his other writings, the case histories I read for this week helped me sort out the distinction between the specular body and the felt body, and what seems to differentiate eating disorders from psychosomatic disturbances. Psychosomatic symptoms are displaced from the soul to the body, revealing that the boundary between them is permeable if present at all. “How else could the intestines of our patient have been so completely in accord with her attitude or her world-relationship…?” (Boss, 152). These are disorders of the felt body, the body that is me. Anorexia seems to be a disease of the specular body, or the body that is other — indeed, the disease may be that subject-body is replaced by the object-body.

While some of the readings point to this conclusion in terms of a young girl who does not differentiate into a true subject because her mother is too close to her (superficially, this seems to be the explanation for just about every disorder we’ve studied so far!), Lintott’s Sublime Hunger provided the most help in my teleological examination of anorexia. The body is the source of disease because the appearance of the body is highly important in our culture; it is a carrier of symbols, so overdetermined that one may wish to leave it behind (this is part of my support for internet communication, as I discussed in my last reflection — it actually provides the opportunity for us to abandon or re-create our specular bodies, by which others impugn us with stereotyped identities, so that we might communicate more authentically, for instance, without limitations others impose on our race or gender). As Lintott describes it, anorectics work on their objective bodies. They transcend their bodies and work on them from beyond, disconnected from them and living in a transcendental Kantian realm. The moral rigidity, alexithymia, and perfectionism all point to a beyond-human existence in which the body is “other.”

An eating disorder is purposiveness without purpose: a way of being that is blind to its true telos. As Lintott says in reference to the concept of the sublime from Kant’s Critique of Judgment, “The sublime is not meant to be a way of life” (pg. 6). Forever reveling in the divine disrupts (eventually ends) being. I once asked a friend who had just written his undergraduate thesis on that book what stopped people from staring transfixed at beautiful objects, and he said, “they get hungry.” In other words, earthly needs take over, the body in its mortal/ felt/ subjective sphere commands attention. The telos of an eating disorder seems to be, as Lintott states, “complete perfection — total domination of will over matter” (pg. 6). The impossibility of this telos is the blindness of an eating disorder and the logical error I referenced above. As one of the anorexic women in Lintott’s article states, “’I just can’t win for losing.’” Here is a moment of identification: in a way that she was not before, this woman is her body. Felt body comes to life. She sees that “to use an eating disorder to perpetuate the feeling of the sublime is to foreclose on the future possibility of that feeling” (pg. 6) and “strength and freedom cannot be sustained in a body too frail to hold itself up” (pg. 8). This identification and integration is the beginning of healing.

1 thought on “A Teleological Exploration of Anorexia Nervosa

  1. Pingback: carnival of eating disorders #4 » change therapy - isabella mori

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