Separating the Person from the Problem

DAVID EPSTON

 

Few problems have the comparable capacity to ‘make over’ one’s identity as completely as anorexia. To those who have known and loved these young women all their lives, they can become estranged, almost unrecognizable and at times lost or disappeared. Many anti-anorexic women have accounted for this by descriptions of having their lives lived in a servitude that only allows for robotic obedience to tormenting requirements. Others, on regaining themselves, recall a sense of having their ‘life’ drained by a vampire blood-taking or parasitized until they become insubstantial at best and zombie-like at worst. Others have talked about being ‘replaced’ or ‘substituted’ for by anorexia. Anorexia first ‘entwines’ or ‘tangles’ them up and gradually restricts their movements. Fran (aged 46) combines stalker and prey, parasite and unwilling host in her account:

‘Anorexia is an energy somehow rootless and without foundation, like a will-of-the-wisp or a shape shifter that moulds and remoulds itself according to the condition or state of mind of the prey. It is nebulous and coreless – and it tries to find a core by eating out the core of its prey. Bloody parasite! And it tries to create a seemingly symbiotic relationship with its prey when in fact it is parasitizing it. It then maneuvers the prey into thinking it cannot live without it’. (Private correspondence, June 28, 1998).

Finally, not a movement or a gesture is sensed to be their own; everything they say or do belongs to anorexia. Anorexia has now ventriloquized them and is it any wonder that friends and family often wonder to whom they are speaking.

Anti-anorexia, in contrast to this fusion of the person and the problem, presses the separation to its logical extreme in what I refer to as a radical externalizing conversation. It is this very conceptual distance that allows for a) the historical tracing of the anorexic occupation and b) the resistance to it. In doing so, every critical and oppositional opportunity is taken. There are profound differences between seeing a person and a problem as separate than identifying them for all intents and purposes as conflated. In fact, one might conclude that an anorexic occupation is completed when any pre-anorexic identify claims are so obscured as to be forgotten. And if you were to assist such a person to remember them, they find such memories to be so beyond belief that they have to assume they are fabrications. The pre-anorexic past is dismissed as something akin to a dream, a figment of their imagination. This past no longer has any status whatsoever as their ‘truth’.

By conceptually and linguistically pulling the problem and the person as far apart as possible without breaking their relationship, there are many openings. Needless to say, anorexia will do its utmost to suppress these and close the gaps. The anorexic invasion first conquers and then colonizes to the extent that the conquered cannot recognize themselves any longer. They can only see them ÿselves through the ‘eyes’ of anorexia, if they were allowed to look anorexia in the eye. Rather they are required to defer and either look away or more commonly, down.

Many of the medical/psychiatric/psychological discourses that intersect construct anorexic subjectivities as forms of pathology, disease or disorder often such diagnostic identifies are sought after by such women in order to tell them who they are at the same time as signaling obedience and loyalty to anorexia. Some have told me of doing so even though they were fully aware that they were being taken ‘prisoner’.

Anti-anorexia makes available a variety of anti-anorexic subjectivities, there for the taking up and trying on. Questions are asked to have people resonate with either what’s available or to extend the range:-

• what sort of person are you trying on lately?
• how does it fit you?
• is it comfortable or is it too tight and hurt?
• does it go with your purposes and causes for your life?
• is it your size?
• are you finding some measure of yourself in trying this new lifestyle on?
• would anorexia have you fit in rather than out-fit yourself?
• does anorexia size you up rather than you finding your own measure of things?
• what’s your preference here – measuring up to anorexia’s lethal measures of you? Or finding your own measure of your self and your relationships?
• if you dared to design your own subjectivity, would anorexia try to refuse you that right?
• and if such a design sat comfortably with you and you didn’t feel anorexia’s pinch¸ how would anorexia try to rule that out for you?

Although there is an interest in the history of how one was ‘seduced’ and ‘betrayed’ by anorexia, there is a far greater concern in the conscientious objection and resistance and repudiation of an anorexic identity. If anorexia demands – ‘You are me! I am you!’, anti-anorexia would enquire ‘How do you want to make yourself up?’ ‘What are your likes and dislikes?’ ‘Your desires and passions?’ ‘Your causes and calling?’ how can you be sure these are your preferences rather than anorexia’s, masquerading as yours?

Anorexia according to Estroff, (1993) is an ‘I am’ illness which involves what she refers to as the ‘transformation of the self’ which is occasioned by the joining of the Problem and the Person. ý This occurs according to Estroff “at one end of a continuum of subjectness/objectness of their illness along which each person locates their illness in relation to self . . . that is how closely linked to one’s self the illness is considered”. She goes on to differentiate between what she refers to as ‘externality’ and ‘internality’.

“Externality is frequently associated with pronounced objectness of the illness; internality often accompanying illness experienced as subjectness…. alternatively, referring to an injury or condition as an ‘it’ or with verbs of possession (e.g. have) indicates a more conceptual distance from self, and we would locate that person toward the illness-as-object end of the continuum”. (259-260)

Kathy, aged 30, a linguist in her own rights had this to say about this manner of speaking:

“Anti-anorexia twisted the very words by which we spoke together. I felt things staring to turn around. Firstly, I turned away from feeling powerless. Before, I just felt like mush inside. There was nothing – no strength, no depth and seemingly not even any marrow in my bones. This way of talking made me able to tackle. Secondly, there was a complete shit in the relationship between the ‘therapist’ and ‘sick person’ and instead we became interviewer-interviewee. And through this, I felt valued. I’m real and not a pathetic person with a pathetic eating disorder. It was a really powerful situation, enabling trust to develop. Thirdly, this new language made everything acceptable. In fact, the way you asked the questions made bulimia real. And I no longer felt like a freak. Sure, I’m exactly the same person I was before but now I can see myself as ‘natural’. Fourthly, this therapy helped me start opening OUT rather than opening UP. By ‘opening up’, I suppose I mean confessing. This is working because I now think anti-bulimically, or in other words, opposite to a bulimic way of thinking.

This has enabled me, for example, to see that my boyfriend may not be right for me rather than me trying to be someone for him that I’m not. When I thought bulimically, it was – ‘I must …I have to.’ Bulimia was disciplining me. Within its constraints, there was only pass or fail – and strange as it sounds, my failure was inevitable.

Bulimia has no words for freedoms. Talking anti-bulimically replaced the passive with the active. That’s what it’s all about. And there were no ‘goals’ in this therapy. And you never asked me ‘have you vomited?’ And you didn’t talk about food. That was brilliant because it enabled us to get into the nitty gritty. I found it enlightening too when you told me where you stood on eating disorders. It made me feel we were on the same level. We were tackling this problem together. I had never felt like this before with professionals.

Now as far as bulimia was concerned, ‘the ball was now in my court whereas before, I was in bulimia’s court’. That’s how I started feeling free because now I was doing the serving whereas before I was completely under its control and direction. I was in a kind of linguistic trap – there was absolutely no way out for me. I felt like a dead person in a dead end”.