Date: Wed, 6 May 1998 22:27:59 -0400 (EDT) From: Sara J Bailes Too Much Is Not Enough/ Enough Is Too Much: The Impossibility of Ingesting Anorexia Nervosa Food and Performance: Final Paper Sara J Bailes April 1998, Spring Semester Professor Barbara Kirshenblatt Gimblett Contents of an indigestible meal * PROLOGUE - PAGE 3 * INTRODUCTION: LAYING OUT THE FIELD - PAGE 5 * WHAT, HOW, WHERE: BODY OR MIND? - PAGE 7 * PROCESS: APPROACHES AND RETREATS - PAGE 11 * AM I THE AMERICAN DREAM? - PAGE 16 * SUBJECTIVITY, EATING, HUNGER AND APPETITE - PAGE 18 * GENEALOGY AND TAXONOMY: THE NAME/CLAIM GAME - PAGE 19 * ADDICTION/AFFLICTION/RECOVERY - PAGE 24 * HOW DID I GET HERE: MISSINGNESS - PAGE 25 Prologue 'The body is its own biosphere, air entering cautiously through an elaborate filter, food attacked by hostile acids. Nothing from outside is given a long-stay visa. Oxygen is expelled as carbon, even champagne and foie gras are pummelled into turds and piss. The body is efficient but not polite. It uses and discards. Enter a second body and there is some confusion. In or out? Which is it? The curious fact of love is that it overrides the body's rubber-sealed selfishness. Sex and procreation easily fit in with the body's plans for Empire; it wants to extend its territory, needs to reproduce itself. It resists invasion. Love the invader compromises the self's autonomy. Love the rescuer is the hand held out across the uncrossable sea.' (From 'The Fool' Gut Symmetries by Jeanette Winterson) I begin with a quote from Jeanette Winterson, a British fiction writer. In all of her work, Winterson attempts to write the body, to locate it within the text rather than simply describe it. She writes from, of and about the body and in her writing embodies the struggles we encounter as human beings attempting our existence(s) within this given biological form which both locks us in and keeps others out. To be a person is to be a prison. A prison is a cage that both keeps us in and locks others out. The use of this quote for the opening of my paper is by no means arbitrary. For me it does a number of things. Primarily, it establishes my territory in a pithy, biological manner in its description of the body; let us not forget at all times that the subject at the heart of this discussion is a starved and self-abused body. I do not wish to lose sight of its visceral and crude physicality and Winterson gives me a descriptive and simplistic basis on which to build: body as efficient, if impolite, container. The second part of the quote reminds that the most hopeful and perhaps only possible way of extending ourselves outwards in order to be released from within this selfish, autonomous biosphere is love. In my reading for this paper, I impose a third interpretation onto the pivotal axis of this quote: ' Enter a second body and there is some confusion. In or out? Which is it?' Winterson points out the terrifying contradiction love confronts us all with, implicating the entrance of a lover, an other, as being the crisis that then faces the body. Love from and with another can be experienced either as the invader of the self's autonomy or, preferably, the 'hand held out across the uncrossable sea.'. I would like to propose a more terrifying contradiction many women find themselves confronted with by placing a second reading onto 'second body': that is, the body/imposter interpreted as culture, the body at large, society. In or out? Which is it? Will it compromise the self's autonomy and destroy her, or will it integrate and vessel her across the sea into a complete sense of herself as a woman? Food in this, my scenario, is a necessary ingredient, the vessel if you like, the very stuff that will transform her into matter, into body and flesh that she can then feel safe in, or else threatened by. That risk, the dichotomy that Winterson hinges her idea on which is whether or not to allow entry is one every anorectic faces many times every day of her life as an anorexic. It is a risk she cannot afford to take. My research has been an attempt to explore the literature and predicament of this shipwrecked and isolated band of women who filter through from every class and crevice of Western society today, stranding themselves on islands where they cannot be reached through their cessation of eating food. Food comes to represent the culture they wish to deny. There, in extreme isolation, they wither away and willingly die rather than face letting go of their increasingly diminishing land, their skin and bones. Anorexia is, at its simplest, an embodied struggle for power mediated through a pathological control over the orifices of the body. It may sound simple, even logical in its interpretation but it remains highly problematic to treat or cure, and still more difficult to imagine a world now without the condition. Its increasing visibility (for I maintain that it is not a new disorder, just a new naming) has grown out of the fabric and nature of the guiding principles and values of our culture. It is now a by-product and symptom of how we have shaped western society. As we have shaped it, so it now shapes us. Introduction: Laying out the Field Anorexia nervosa is ultimately about an uncrossable sea, one that eventually drowns its female subject as she loses her ability to grasp any metaphorical or literal outstretched hand, be it that of therapist, doctor, friend, lover or, primarily, mother. Love, not food, and above all acceptance of one's self in one's body, is the absent notion in what the content of this essay proceeds to discuss. Food is obsessively present, though like Hamlet's father's ghost it is there as a metaphor of what was once manifest but no longer is. Like the ghost, food acts as a catalyst in the downfall of events, has an undeniable presence, but cannot be grasped and leads to self-destruction. The body for me as a post-anorectic writer (I tentatively claim such a term, for I am not entirely sure you return from an anorexic psychic and physical disposition) is crucial in my discussion, despite the fact that the subject(s) appears to aim ultimately for its annihilation. In my extensive research and reading I have been struck by the absence of the body, descriptive or theorized, and have turned to writers such as Winterson who come at the flesh through text as if they were one and the same thing. This too is crucial in an analysis of anorexia as the anorexic woman is attempting to literally re-write the body, reorganize its infrastructure, its needs and desires in order to reinvent her own archaeology of hunger. Some of the literature on anorexia helps to locate the subject and explore the condition beyond its external features and statistics, to look at it as a cluster of symptoms that grip hold of the psyche and eventually the body. Selvini Palazzoli's book 'Self Starvation' (1985 edition) is an outstanding contribution to the field and one which connects the reader to the interior state of the anorexic world order, one markedly different from others' experience of themselves as living beings in the world. She enables herself, the reader and ultimately her patients to move beyond and let go of the superficial image we frequently get hooked on. She also provides some of the most thorough and insightful interventions into the field, dealing with lesser touched upon areas such as the experience of space and time in anorexia nervosa, existentialism, the cybernetics of anorexia, anorexia and sex, and the reconstruction of body feeling. Palazzoli, a brilliant Italian analyst and theorist whose clinic is in Milan and whose specific area of research has for many years been anorexia nervosa, is also an erudite and rich writer, as Oliver Sacks is in the field of neurology. She composes the book through a series of short essays that combine medical, psychological, sociological and ontological observations, gradually building a topography that allows us to sense the inner world that brings the patient to the state of becoming anorexic. She recognizes how by using the patient's words she can offer more eloquently theoretical exposition than any outside observation of the condition. She uses such examples sparingly and prefers to relay them as they were written/spoken rather than filtered through her own reading. A single line quoted from a patient Liliana, can reveal more than paragraphs of speculative and observational conclusions: 'I no longer have to do anything to prove that I am not dead. Now I simply exist.' Such an example forces the reader to probe more deeply into the condition instead of being caught at the surface. It reveals something of the back to front logic that the anorectic mind gets caught up in and therefore might help us to translate this into a language of the body. While Winterson's quote encapsulates the themes I wish to approach my title presents the problem I want to address. To unpack the paradoxical problem it describes (too much is not enough, enough is too much) will engage in the contradictory terms that disarm the anorectic. From here she finds herself unable to reach out from beyond the bodied state of her condition. She is then stuck, caught in a backward, downward spiral. What is the meaning of the word enough in the syntactical landscape of an anorexic mind? For nothing is ever enough, and everything is too much from an anorexics perspective. Everything that exists outside of the body that is. Even the body itself is too much. Enough holds the promise of the concept of satiation and fulfillment, of sufficiency. The dictionary states 'to put an end to an action, speech, performance, etc.'.1 In terms of the content of this paper, which through its journey explores the problematic nature of attempting theoretical interpretation and writing about anorexia nervosa, the word enough encapsulates and opens out the problem. Enough as a word litters the parlance, rhetoric and literature on anorexia nervosa. In theoretical terms, the enterprise of theory can never own the word enough and neither can the anorexic patient, for it leaves both with nowhere to go thus nullifying the reason for each ones existence, both conceptually and literally. Enough signifies the beginning of an end, the end of the road and a sense of closure that, ironically, neither theory nor anorexia seek or tolerate. Enough is too much and will send the anorexic further into her state; enough and the theorist will inevitably obfuscate her idea and have nowhere to go. All that would then remain is the possibility of nothing, or 'missingness' as I prefer to call it. Nothing implies something while missingness suggests something there but gone, something yearned after and therefore a sense of incompletion. What, How, Where: Body or Mind? Let us look first at the body. Winterson writes from and about the gut. I write around the gut as it is physically and biologically situated at the center of the exhaustive eating disorder anorexia nervosa. I would like to consider for a moment the stomach as a body part, an organ independent from all others and its central role and function within the larger organism: 'The stomach, the organ that accomplishes digestion, provides a particularly intense focus of inwardness because it is the part of the body that makes its needs felt most frequently and insistently. It demands to be filled at least a couple of times a day, and to be emptied at least once. When these demands are not met, the entire organism suffers. The exigencies of the stomach require the individual to confront on a daily basis the thin yet necessarily permeable line separating self and other.'2 (my underlining.) The writer concludes that 'the stomach occupies a central site of ethical discrimination and devotional interiority in early modern culture.' Now to consider the mind's play in relation to this placement of the stomach as such a central site in (early) modern culture. Anorexia nervosa is a predominantly female denial of self-love or, to turn the coin, a manifestation of extreme self-loathing which internalizes the female's sense of rejection and the impossibility of stabilizing herself comfortably in both her own body and the body of society. This implies an incapacity to accept love by and from an other as a consequence of self-loathing. In its fully blown performance, the two (body and mind) working together, it produces a spectacular, obsessive and drawn out denial of food intake that defies medical tenets and belief systems concerning what the body can and cannot withstand or tolerate. It expresses a sub-conscious desire for non-existence within that body that through the bodies' performance makes itself consciously known and visible. An anorexic never declares herself, at least not in the early stages of the condition. (Often later, as the condition becomes chronic, she inevitably learns to name it and may eventually acknowledge it as an illness). It will instead declare her and this secrecy or lack of initial consciousness is one of the traits of the anorexic stance. This is the only fundamental difference between the political hunger striker and the anorectic, for even the impetus in both remains closely connected: a need for personal and/or political power. The hunger strike 3 is a consciously chosen, performative act where the subjective body openly declares denial of food in order to gain agency and political power. The imprisoned body (a prison within a prison) turns itself into a weapon, an ultimate bargaining tool, the body held up for ransom. Conversely, anorexia is a secretive and unstated slide into an altogether different performance where the participant is starving for attention but unwilling or able to ask for it, hungry for love, acknowledgement and recognition but terrified of and by all three. Both anorectic and hunger striker are, however, spectacling themselves. At the same time, the will to live (in both states), to succeed and to supercede is stronger and more determined than when existing in a normalized relationship with food and hunger. So while the original impetus behind these two starving states may be diverse, the process and outcome are very similar, the biological deterioration identical. A common mistake is that one might, at first sight, decode anorexia as a blind death-wish, demonstrating as it does such vehement self-destructive urges and a refusal to live as 'beings of flesh and blood'4. Here is one of the many misunderstandings shrouding the condition. It is not suicide or the depressive state accompanying it that drives any hunger artist in their quest. On the contrary, theirs encapsulates a deep and profound desire to live. Anorexia is most frequently a longing to escape from a female body born into a world that disallows it its own unique place, space (interior or exterior) or quantity other than that dictated by a dominant male culture. It is also a recognition of and refusal to accept death which the body and process of living, bound and dictated to by our stomachs, determines. Selvini is most accurate when she describes anorexia in relation to suicide in the following terms: 'It is, essentially, an unrealistic tension and a rejection of existence qua living and dying in one's body. More precisely, it is a rejection of death as a biological fact, and with it a rejection of ageing, corpulence and existential decay. In short, the anorexic turns her back on the existentially inevitable, on everything that is imposed by, and inherent in, her corporeality.' One of Bruch's patients says 'I am an unknown quantity'5 further endorsing the inability for the anorexic to locate herself either within the body or in relation to the culture that the body is part of. She is adrift, dislocated and lost. How can we begin to interpret the meaning and implications of the performance of an anorexic starving herself to death when too much is not enough, and enough inevitably too much? Starving in a sea of plenty, what does a body of literature, read as a relic of the performance itself in the absence of the body, offer us in terms of furthering an understanding of anorexia's place as a prominent and deeply symbolic performance? Something is missing from our understanding and approach that encourages this disorder to mutate, sophisticate and extend itself way beyond the categorizations and types that Bruch outlined in her early book on the subject 'The Golden Cage' in 1978 (these were mainly white, middle class, perfectionist young girls from often privileged and stable backgrounds). Twenty years on, the condition is more prevalent than ever, reaching younger and older age groups (onset at four and five years old is now not uncommon) and all classes and racial minorities. There is no type; there are simply women. Often too, the condition lasts for anything between a matter of months or a lifetime. I recently met a woman who has been anorexic for thirty years. She feels herself to be both failure and outsider because she 'can't belong to the anorexic culture because I cannot lose the weight. I can't belong and I can't get out.' Once again the idea of a cage emerges through the language and through the body of the anorexic. The woman was tiny, fragile and most definitely trapped. Her movements were minimal, as is the case with many anorexics. Once sneered and tutted at, anorexia now flaunts and parades itself down catwalks and across giant billboards. It is associated with devastating beauty and glamour, much as the cigarette was in the 40's and 50's. If you haven't had anorexia or bulimia, the feeling now is that you have missed out on part of your growing up. It has been normalized to such an extent that out of one problem grows another. Again, I return to the absence of 'enough' accompanied by the presence of a bottomless hunger in the midst of all this. Where will it end? When will we have had enough of anorexia in order to comprehend our own misunderstandings and so put an end to our exacerbating its existence. Equally important to ask ourselves is when did it all begin? Process: Approaches and Retreats My original intention was to enter my delicate topic through some of the mass of literature written on the subject, much of which is repetitive, dealing with the external manifestations of the disorder and providing little or no analysis as to why women, why now and why the steady increase? This is something Susan Bordo fervently takes up in her essay 'Anorexia Nervosa: Psychopathology as the Crystallization of Culture.' Here she addresses the 're-making of the self' from the point of view that psychopathology of any description is the outcome of all that is wrong or dysfunctional in a culture and therefore a place from which to examine what is wrong, what is missing and how to correct or progress towards solution. Women want to literally kill appetite, feeling themselves pursued by hunger day and night. Beyond literary, I have used other sources, as the book does not altogether lend itself to the physical body though describes it, and, in the cases of Bordo, Palazzoli and Ellmann in particular helps us to gain entry to the cage that recurs through this condition. It is an area that is difficult to penetrate for many reasons and here the metaphor of the cage extends itself out even into the live field of practice where living subjects are treated by living doctors, nutritionists and therapists. I wanted to break the 'multidimensional disorder'6 down into components and explore different ways of approaching those components; to look at certain aspects from various angles in order to speculate on the performance of the condition rather than an evaluation of it. This presented difficulties as it is not easy to breakdown or categorize anorexia. It does not group itself in any way, or wish to do so. Above all, it is not possible to work with an anorexic who is in the chronic stage of her condition, only those who are recovering, and even this is difficult. Instead you may work with those who work with her, so the experience is filtered through a lens that is always in any case influenced by one particular approach, be it behaviorist, relational or any of the other number of therapeutic approaches used in treating anorexia. Anorexia is uncannily post-modern in that it denies a linear structure and an approach towards it demands the same. I have drawn from many sources besides those already mentioned, (the written work of therapist/philosopher/writers Selvini Palazzoli, Hilde Bruch, Susan Bordo, and Maud Ellmann). I have studied historical and contemporary biographical accounts. In the latter case I focused on the most recent autobiography 'Wasted: A Memoir of Anorexia and Bulimia (1997) by Marya Hornbacher, a book I find both brilliant and disturbing at the same time. It is an intelligent and extremely well written testimony by a survivor who has made it through both anorexia and bulimia and considers herself out the other side. She is published, married, slim, successful and still only twenty-three. What concerns me most is that Hornbacher's dismissive and ironically understated performance of her anorexic/bulimic past heightened by her style of writing may easily and unwittingly become a role model rather than a warning against a miserable and potentially fatal mental illness that leaves the body permanently damaged and the mind/body negotiations between food and hunger forever dysfunctional. What about her 'story' and its outcome would make any young girl not wish to follow suit? The book itself is a glamorously packaged hardback. She presents herself as cool and (heroin chic) model-like in her stance on the dust-jacket cover and as a leather clad beauty on the inside. Is this a step in the right direction or a step back towards making woman feel herself to be somehow more woman and more satiated through hunger, starvation and bingeing? More perilously, does it not reaffirm the already much believed notion that anorexia is about wanting to be beautiful therefore reducing it to a 'phase' of growing up rather than the harsher internal condition it actually is? If Hornbacher is so successful then surely it can't be that bad is the message that many will read. Nevertheless her insights into her own condition and her ability to articulate this within a wider social context are a great contribution to the field and she definitely opens up that cage to a wider audience. Speaking of a time at school she writes: 'We lived in a larger world where there is also a sense of hunger and a sense of lack. We can call it loss of religion, loss of the nuclear family, loss of community, but whatever it is, it has created a deep and insatiable hunger in our collective subconscious. Our perpetual search for something that will be big enough to fill us has led to a strange idolatry of at once consumption and starvation. We execute "complicated vacillations...between self-worship and self-degradation," the pendulum swinging back and forth, missing the point of balance every time. We know we need, and so we acquire and acquire and eat and eat, past the point of bodily fullness, trying to sate a greater need. Ashamed of this, we turn skeletons into goddesses and look to them as if they might teach us how to not-need.'7 Her invention of the term to 'not-need' is accurate, one that comes only from having visited a certain place. The availability of such well written testimonies (Sheila Macleod's book 'The art of Starvation'in 1981 had an equally great impact) is essential alongside the work of the medics and theorists in the field. I have consulted medical textbooks and compared various treatment models though find little there to reveal insight into the more performative aspects of anorexia. On the streets, in bars and cafes, and in the fitness centers and swimming pools of New York, I have been observing carefully (more so than usual, for I do in any case) the shapes, sizes and ways that female bodies carry themselves. I watch the foods they choose to eat and the dilemmas they go through in making those choices. I have interviewed more than twenty complicit subjects (male and female and of different class and ethnic backgrounds, not all of them U.S. citizens) on what the body means to them, never referring to anorexia though silently noting the distortions and mind/body separation, particularly amongst women, floating up to the surface. I have taken notes, grabbed cards, leaflets and advertisements and foraged through popular magazines. You only have to look around and the problem, or more accurately the distortion, overwhelms you. By that I mean that the image of WOMAN as she is thrust at us via advertising is an impossible distortion for the majority of us. This 'woman' is one which most of us cannot ever hope to replicate or become unless we chop and add, pick and mix and buy into the sickly, billion-dollar industry of cosmetic surgery. My primary live site (the nearest I could get to an 'encapsulated object') has been working in collaboration with Laura Kogel at The Women's Therapy Center Institute (hereafter referred to as WTCI). Laura has been generous and informative with her time and knowledge. For this I am most grateful after my unsuccessful attempt to gain entry into the field at New York Universities' own Eating Disorder's Clinic. Here I encountered suspicion and mistrust. The doctor I met with, who was cool, anxious and uninviting, saw me distinctly as an outsider, despite my attempts to outline for her my personal position and interest in relation to this research project, which to me seemed important if not crucial. The fact that I had lived inside of the condition/cage for so many years makes me feel legitimate and sensitive in how I approach the subject. She felt I would potentially 'increase the anxiety of the patients' (I at no point expressed a desire to work with the patients, knowing full well that this would encroach ethically, physically and psychically upon their fragile selves). I met with resistance and an unwillingness to listen or engage in my project in any way whatsoever. I decided to move on and felt in any case that this was not an environment I would comfortably work in or learn from. This in itself is disturbing, considering this to be the primary source of help available to all students at NYU who may feel that they are entering into some kind of problematic relationship related to their body image, hunger and food. WTCI gave me a different experience altogether. A not-for-profit organization, it runs as a collaboration between seven experienced therapists who work with the public, that is, patients, and in addition run the first three year post-graduate psychoanalytic training program which specializes in their own developed 'feminist relational psychoanalytic therapy'. Their aim is to treat and cure women with eating problems. They organize a yearly 'Speak Out' in May, (this will be the 9th year) providing a rare and safe space for women where they/we are invited to 'reclaim our bodies, our hunger, our lives'. In their collective approach, hunger is situated at the center of the work and body image/eating problems are seen as inseparable issues to be worked on hand in hand. Dieting is the arch enemy and the process and relationship between patient and therapist is usually lengthy as they aim to treat the cause and not the symptom. My interviews with Laura infiltrate this paper in many different ways and in accompanying field notes. Finally, and where useful, I use autobiographical instances. The topic is overwhelming, but I hope that in circling around the subject I illuminate the 'enough/too much' impossibility I opened with and will raise more questions than answers about the performance played out in the tension between these two on and in the body of the anorectic female. I hope already to have clarified certain misunderstandings and discrepancies relating to how the condition is perceived and received in society. Am I the American Dream? At the beginning of April I went to a 'CRUNCH OPEN DAY.' Crunch, one of New York's' largest and most aggressive gyms, is situated on Lafayette. Outside it is adorned with gigantic purple flags waving, whooshing and tempting passers by in to squeeze, cut and burn up their excess fat in a condensed and multi mediatized space. Ironically, it is situated next to the yoga center where I go to seek out a pocket of peaceful internal space and relax physically and mentally when I can find the time. Crunch is always jam packed, day and night, with running, pummeling, pumping, stretching bodies, male and female, all staring blankly into space or at television screens, reading or listening to personal stereos. The cultural input into the body as it pushes and drags itself through this fake indoor exercise regime is intense; the sweat pours out and presumably the calories drop off. Crunch advertises itself and its products (clothing, videos etc.) on a postcard. It has an image of a lithe, pretty, young American female entwined around what at first appears to be a giant soft, toy bunny but is actually a man in a bunny costume with paws and a giant rabbit's head. Above are written the words: 'I am the American Dream'. Faced with this image, I ask myself a number of questions: who or what is the American Dream in this image? Crunch? The woman? The man disguised as a bunny-rabbit or all three? I do not have an answer though find the absurdity interesting but once again disturbing. Perplexed as I am, I move through the frantic space. I know I cannot stay long because it is too much input for my senses to bare. I am here on a mission, not because I wish to become a member. The first thing I was asked to do at Crunch was weigh myself in order to detect the ratio of my body fat in comparison to my size and weight. I experienced a private moment of panic; I can always look away, I thought. I used to weigh myself about fifteen times a day in order to 'know my quantity' and my heart beat still increases when I see a set of weighing scales. I never go near them. I go ahead as if this is perfectly normal, which apparently it should be, though I notice that there are no men in the line. I am informed that I have only 13% body fat which is 'at least 3 - 4% below average for a woman of my size and weight.' Apparently, by the grin on the man's face who reading off the back of a box out of which the machine came, I should be pleased about that. I asked him 'what woman is that?" referring to his mention of the 'woman of my size and weight.' I of course received no reply; it was in any case a rhetorical question. The next woman shuffled forward anxiously and stood up to face the scales. You could see the anxiety written all over her face. I underwent various other brief tests and minute-long massages, endured but avoided the hard sell, swiped an apple and quickly escaped. I felt terrorized and exhausted, almost sick by the time I left and went to a yoga class to try and find a space and put myself back inside my body, something I have to consciously work at. Crunch forced me, in my most uncrunched body, to enter further into the realms of this paper and to literally revisit the experience of the overwhelming relationship between anorexia and the frantic physical and cultural bombardment our bodies are faced with on a daily, hourly basis as we inhabit and navigate through our Western metropolises. I am constantly self-reflecting as I write on what my approach as a recovering anorexic, performance studies' scholar brings to a discussion of this culturally induced mental and physical illness. Nobody is born anorexic. They become so. At least fifteen percent of those who become so die; they do not make it back across that uncrossable sea even if they want to. I can make certain connections and configure it in such a way as to rescue it from its 'out there-ness' bringing it back firmly and concretely into a culture that has so violently vomited it out, rejected it and, to an extent, disowned it.. This has been Susan Bordo's project, one which she palpably illustrates in her book 'Unbearable Weight: Feminism, Western Culture and The Body.(1993) Bordo looks to the social and political meaning behind the symptomatology of the disease, and at the rules that have governed and constructed gender and female subjectivity. She provides us with a number of simple clear axes and examples that illustrate how anorexia is situated at the heart of a culture that constantly reinforces and creates industries out of it, particularly those of cosmetic surgery and dieting. The problem is compounded by the degree to which it has now been accepted and main-streamed, the gaunt and often mutilated 'heroin chic' appeal of the nineties sprawled across the cities of America and Europe. What woman does America dream of and how can the woman fit the dream? Shouldn't women be able to dream of America rather than the other way around? Subjectivity, Eating, Hunger and Appetite Paradoxically, I write about a topic I know inside out yet still find difficult to coherently and systematically document. My problem is simply the same one I am tracing. I repeat to myself 'what is there to say that can theoretically contribute to our over-determined and misguided understanding, our supposed knowledge and contextualizing of the dis-ease anorexia nervosa? What, in all this theorizing and writing, can alter a problem so complexly and virtually situated in the body?' I want to blow discussion open and extrapolate holes, reveal dead-end roads and pull back the skin on the living, embodied dichotomy of this dreadful condition. I want to get to the starving bodies, though cannot go near them, in the hope of demonstrating the complexities and devastating cultural implications of anorexia. It is essential that we begin to look at a cure from the inside out instead of the other way around. We should confront the breeder, man(un)kind, instead of repeatedly absolving ourselves of responsibility while statistics continue to rise. It really isn't over and my fear is that there is no final place, no point reachable where we ever will or can say 'enough'. Thus eating, hunger and satiation may become further separated by the work being done in the field. Hegel speaks of appetite, Marx of hunger while both agree that eating is essential to the integration of the self, but only if food is voluntarily ingested. Force feeding, Maud Ellmann points out, demolishes the ego. Adding Freud to this (male) trilogy, all agree on the fact of eating as the origin of subjectivity, the very need to eat exposing the 'nothing' at the core of subjectivity. Marx' conclusion is I am what I eat: 'Hunger is an acknowledged need of my body for an object which exists outside it, indispensable to its integration and to the expression of its essential being.'8 By ingesting the external world then, the subject establishes her body as her own, distinguishing between an inside and an outside. When hunger is denied, the self goes awry and the subject literally falls apart. Genealogy and Taxonomy: The Name/Claim Game Anorexia nervosa is not a new disease, as many seem to think. The term does no justice to the psychological world it creates, illustrating only the faade and exterior while ignoring the interior condition. A historical perspective of some sort is useful (though I am more interested in its now-ness) and a more incisive questioning of how it has become part of the advertising machine that we accept as part of our healthy, standardized modern-day living. Anorexia has existed for thousands of years though has constantly been named and renamed. Witchcraft, saints, sinners, visionaries - all can be considered to have embraced in some way, or been touched by what became medicalized in the 19th century and then called anorexia nervosa. The term's definition as an illness evolved in the 1860's. Bordo and Vandereycken and Van Deth9 in their (separate) studies elaborate on its formation as a 'syndrome'. Bordo notes that a certain medic W.W. Gull in Oxford gave the first description of it as a syndrome, which corresponded to the taxonomy of the time. In 1868 he then called it 'Hysteric apepsia' thus implicating that it was a psychically oriented but physically situated syndrome. Six years later it was then called Anorexia Nervosa, a term I will return to for it is misleading in its definition and implications. The original use of the word 'hysteria' immediately links us with Freud's work which adopted and expanded on the term hysteria at a later stage. (Freud's now famous paper 'The Aetiology of Hysteria was first delivered in 1896.) Thus anorexia has always been associated with weak minded or hysterical female behavior hence its direct link with the idea of woman as 'too much'. The question arises as to whether this 'too much' refers to a physical or mental description. Within an anorexic mindset there is little distinction. Anorexia has gathered momentum since the 60's but its roots are sewn stubbornly and irreversibly in ink in the writings of the Bible (Genesis 2 and 3, The Fall into Sin). Its apparent manifestations have twisted and turned, named and renamed themselves throughout history according to the taxonomy and trends of each age. Since the early seventies, anorexia has gained visibility thanks primarily to the work of therapist/writers Susie Orbach and Hilde Bruch. In addition, the shocking death from anorexia of such a publicly known and popular figure, the singer Karen Carpenter, began to bring about the realization of the seriousness of the condition. Still, we have rudely rejected and disowned it as some 'bizarre and fascinating disorder' 10. >From such descriptions we feel that it might have arrived from beyond our planet like a plague, a virus, an imposter. The imposter, of course, lies within the world anorexia spirals out from, Dominant Culture (a new god for our searching age?). Dominant Culture both constructs and deconstructs woman and her image, the constantly changing mirror it holds up a perpetual lie and threat of non - completion. The body is inevitably experienced as a defective and imperfect carrier. Woman is caught in a double bind with this food thing: no matter what or how little or much she eats, she will always be too much for the too much relates to her hunger and not to her size; her hunger for more than just food. No matter who or what size she is, she will never experience her self as enough because she is constantly compromised. These are ontological not simply aesthetic concerns and I refer to them as such. Woman is both depleted and obese at the same time, denied a place by the very culture that cultivated and created her. As far as the anorexic female is concerned, she is therefore left with one clear-cut choice, one sure exit: keep your mouth shut, don't make a sound and resist the impossible place you are in any case denied. And so to the term itself. Anorexia nervosa. Its very name sends angular, bony shivers through my own body. I encounter much difficulty despite the abundance and variety of literature and viewpoints on the illness, condition, disorder or, we might simply say, 'problem'. Laura Kogel and her practicing colleagues at the WTCI, New York, categorically refuse to adopt the word 'disorder' (possibly the most commonly used term when addressing any dysfunctional relationship a woman has with food and/or body image, the two usually linked and inseparable problems). In the opening to the preface of their collectively written book 'Eating Problems: A Feminist Psychoanalytic Treatment Model' they state: 'In our title we intentionally used the phrase "eating problems" rather than the more common term "eating disorders". Disorder connotes personal pathology and medicalizes the etiology of eating and body image problems. But when 85% of American women diet chronically and 75% feel humiliated by their body size and shape, as current estimates suggest, it is important first to identify the cultural pressures as pathological.' What Kogel and her fellow analysts are stating is that the 'problem' (anorexia nervosa in this case) is not the problem but rather the product, (I would say symptom) of a cultural problem that has pathologically problematized the female body and her relationship to food. Anorexia is a slippery subject, disappearing as it does both literally and metonymically. A common terminology to describe it is never agreed on from one source to another, be it autobiographical account, self-help manual, feminist critique, medical textbook, magazine article, video or documentary (to mention some of the available sources for research). It is called syndrome, condition, sickness, illness, disorder, obsession, disease. It evades and darts constantly between writing fingers and defies, repeatedly, concrete definition. Everybody wants to talk about it in this current Age of The Confessional, but it is never clear as to where discussion of this topic wishes to move us or what it wishes to achieve in doing so. Anorexia is on the increase, despite its naming, apparent recognition and understanding. It is not simply since I enrolled in the Food and Performance class that this disorder, a unique performance of self-elected/inflicted starvation smoke screening a much more convoluted and complex set of ideas, made me want to contribute to an understanding of its place in our culture. My interest dates back to my own slow, painful emergence, eleven years ago, after eleven years in my own delicately constructed cage, from what Bordo accurately describes as a 'multidimensional disorder',11 from 'intake restriction', though the commonly used term for the condition continues to be anorexia nervosa. The term is misleading for, literally translated form the Latin it means 'lack of/or absence of appetite of the patient, of a nervous origin'. This is a gross misunderstanding and contradiction and I believe has been the cause of much conflict and confusion in the way the disorder has been approached in terms of diagnosis, treatment and understanding within the medical field and the larger culture it is embedded in. Because of this misunderstanding, there has been little or no sympathy for anorexics as the disorder has been viewed as selfish, vain and self inflicted. People tend to think of it as an extension of dieting, the diet out of control. This is almost the antithesis of what occurs mentally for the person who becomes anorexic. The anorectic does not experience a lack of appetite; quite the contrary. The pursuit is not for thinness but for self-control. Thinness, the result of abstinence from food, enables the patient to manifest and revel in such self-control where no other situation or circumstance will. So instead she is unable to stop thinking about her hunger and appetite in her efforts to deny food entry into the body. She will ultimately, as a 'successful' anorectic, override those two fundamental biological desires and needs. She will defy medical text books and rip through societies' fabric and social structures; she will become apparently self-sufficient and omnipotent, self nurturing and independent. But hunger, or appetite as it is referred to here in the translation of the term anorexia nervosa, will never be absent or lacking, will never be far from her conscious thoughts. It will instead replace food. It will become the most consuming and consumable thing in her life while food in reality, food as material object to be eaten rather than dreamed about, thought of or imagined, will never enter her body or her world. If it does, it will be immediately expelled either by self-induced vomiting or else rapidly and violently through the overabuse of laxatives. Symbolically, the perfect anorexic is she who returns to the Garden of Eden, resists the serpent's temptations and never takes a bite of that or any other apple. Returning to the Bible, I remind us of that most crucial of moments, the Fall into Sin leading to expulsion from the Garden of Eden: 'And when the woman saw that the tree was good for food, and that it was pleasant to the eyes, and a tree to be desired to make one wise, she took of the fruit thereof, and did eat, and gave also unto her husband with her; and he did eat' (Genesis 2, v.6) Then God reproaches the serpent and then Eve, saying: 'Unto the woman he said, I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children; and thy desire shall be to thy husband, and he shall rule over thee. And unto Adam he said, Because thou hast eaten of the tree, of which I commanded thee, saying, Thou shalt not eat it: cursed is the ground for thy sake; in sorrow shalt though eat of it all the days of thy life.' (Genesis 3, v.16 and 17) After almost eleven years of (self-imposed) imprisonment and exile within the complexities of this state where I felt cocooned in its apparently safe but self imposed tyrannical rules, I finally put down my laxatives. I began to nibble, then munch, then eat. I went from private bites to public eating, from night time forays into the fridge to day time participation at meal times and, most importantly, decided that I actively wanted to live. This is the singular and most important fissure in the anorectic mind and bodyscape that needs to be addressed and restored. The state is one you remain in, the template always there, but it is possible to live perfectly well as a recovering anorexic as it is with any previous addiction. Addiction/Affliction/ Recovery At the heart of anorexia lies a component of addiction that is as impenetrable and euphoric as that experienced by a heroin addict. Much research has been done comparing and contrasting the two as psychopathological addictions and, I believe, much of this work has greatly enriched our understanding and acceptance of anorexia as a disorder that must be treated physically and mentally. The anorexic's addiction, her own self-produced stimulant, becomes another highly problematic component in dismantling the overall picture. Self-starvation becomes 'self-medication against unbearable anxiety and depression'.12 Endorphins, triggered off by the starved state, mitigate the dreadful low and isolation that brings a woman to starvation in the first place. Recovery must then involve a period where the benefits of the endorphin rush are exchanged for the dull return to reality, and, with that, weight gain. We must address it not from symptom back to origin, but from its origins outwards into the skeletal body mass of symptoms in order to allow the patient to feel safe enough to let go of this complex and performative structure of symptoms, her carefully constructed and designed golden cage that, ironically enough, is keeping her alive. These symptoms are now the only thing which support and protect her against a culture that has rejected, punished, forced, distorted and denied her the possibility of literally growing into her own body. She is prohibited from developing into the shapely woman she was genetically programmed to become. To rip this, her cage, away from her, can have fatal results. They, the symptoms which constitute this framework, must instead be 'respected as defense mechanisms' and seen as the 'best possible solution to inner problems'13 At the Speak Out, one of the therapists on the opening panel said: 'We speak in tongues, a language of self-hate and critical concern - our mother tongue. For twenty years I've heard and worked with women in this garbled code. As a feminist therapist, I have come to understand that eating problems are the way women speak about what they do not fully know or cannot, dare not, say more directly.' She further described ingestion as toxic to the patient, and purging as a way of flushing away pieces of ourselves we have not learnt to listen to, tolerate or accept. 'Incest, abuse, battering, homophobia, racism; we are eating and starving about what is too hard and oppressive to put into words or digest.' How did I Get Here: Missingness How has anorexia nervosa become the disorder it is and what are the future implications of it in relation to the society in which it has sophisticated and perfected itself these last twenty to thirty years and which has allowed and encouraged it to do so? Begging for less when there is more than enough (the more never being enough) we are left with a mobius strip performance to decipher. Where does it begin, and more importantly how can it end? I have no final answers but many questions and, as I have tried to illustrate, an understanding of what is missing. This paper has a meta-narrative shadowing it, which reflects the central ideological problem I am trying to theorize and write about. Enough. Nothing I can write and no research or field notes can do justice or fill that gaping hole. Nothing will be enough. To bring this to a close and conclusion is painful, for my subject is still there in her missingness, disappearing slyly through the chinks between the contradictory roles expected from women as we steam head on into the next millenium. The uncrossable sea. With so many outstretched hands, writing, holding, touching and nourishing, are not enough. The hunger is too great and has produced a famine made up of female human bodies. The anorectic is, in the words of the poet Stevie Smith, 'not waving but drowning.' I would like to use a final quote from Palazzoli's book (chapter 6, page 35) where she succinctly sums up (originally in 1974) what is still pertinent today: Today, in fact, women are expected to be beautiful, smart, well groomed, and to devote a great deal of time to their personal appearance even while competing in business and the professions. They must have a career and yet be romantic, tender and sweet, and in marriage play the part of the ideal wife cum mistress and cum mother who puts away her hard earned diplomas to wash nappies and perform other menial chores. It is quite obvious that the conflict between so many irreconcilable demands on her time, in a world where the male spirit of competition and productivity reigns supreme, exposes the modern woman to a terrible social ordeal. For me, the process of writing this paper has given me the experience of conducting research and fieldwork in an abundantly barren land, taking me between the book and the body and back to the book again. I am hungry and my own body has shrunk and recoiled in the very process of writing. It is not a hopeless situation. But as I stated at the beginning, something is missing in our culture, in our understanding of anorexia nervosa and in our inability to confront its ugly and awkward physicality staring back at us. It is she, the anorexic, who is the mirror. She is the foodless ghost, a living but missing presence in our midst. We are frightened, maybe haunted by this presence, but we should not turn our backs, shut off our ears or look away. Her body, as much as any other, is a metaphor for culture, a surface on which rules, hierarchies and metaphysical commitments are inscribed, to paraphrase anthropologist Mary Douglas. The anorectic body is a text in itself to be read, a locus of social and self control. I want that we continue to read the body and the books, but the body and its internal strife must be recovered and prioritized if we are to make headway through the stormy seas. I, despite all this, am still starving. 1 The Collins Paperback English Dictionary, 1987. 2 From Michael Schoenfeldt's essay 'Fables of the Belly in Early Modern England' included in the anthology 'The Body in Parts'. 3 I take as my example the Irish Hunger Strikers in Northern Ireland, 1981, which resulted in death by starvation of 10 male prisoners and use Maud Ellmann's 'The Hunger Artists' as my source in this particular aspect of my discussion. 4 Chapter 11, 'The Problem of Death and Suicide in Anorexia Nervosa', Self Starvation - Selvini Palazzoli 5 From the chapter 'Body Image and Self -Awareness' in 'Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within (1973) 6 Bordo uses this term in her essay Anorexia Nervosa: Psychopathology as the Crystallization of Culture'. 7 Chapter 3, 'The Actor's Part', page 119 in Wasted. 8 Karl Marx 'Critique of the Hegelian Dialectic and Philosophy as a Whole.' 9 Chapter 8 in 'From Fasting Saints to Anorexic Girls' 10 Such terms are adopted in a Study Guide accompanying an audio cassette produced by The American Dietetic Association in 1978. The introduction to this guide further points out that working with patients with the disorder is 'taxing but rewarding, yielding knowledge and self -knowledge an exercise in control and self-control.' 11 Bordo uses these terms in her essay Anorexia Nervosa: Psychopathology as the Crystallization of Culture, included in her book Unbearable Weight: Feminism, Western Culture and The Body. 12 Endorphins, Eating Disorders and Other Addictive Behaviors, Chapters 2 and 4,. Hans F. Huebner, M.D. 13 From interview (1) with Laura Kogel, March 19th, 1998, WITC. 2 ---------end----------- as I said, bibliography is on its way: i want it done properly and it's dense........ goodbye for real this time! sara