On Meanings and Metaphor

Most anyone who reads this blog knows I am a huge fan of metaphor. I even have a whole category of posts tagged "metaphor."

One thing I don't believe, however, is that an eating disorder is a metaphor, or even that it has any particular meaning.

Let me clarify: our lives can have meaning- the meaning that we ascribe to them. And an eating disorder is part of my life, and if you're reading this blog, then I'm guessing it's part of yours, too. But my eating disorder has no, real independent meaning. It says nothing about me or my life except for my possible genetic background and the fact that I once lost a little weight and fell into the hellhole of anorexia. I don't find a meaning to cancer, or depression, or diabetes or any of that.

Nor am I saying that a sufferer's experiences aren't important. They are. They very much are. The experience of an eating disorder does not render a person's opinion on treatment and society and recovery irrelevant. Yet these experiences are also very much shaped by the philosophies of caregivers and clinicians.

So I was very intrigued when I saw two papers published this week about women's experiences with eating disorders. One, titled "Anorexia Nervosa's Meaning to Patients: A Qualitative Synthesis" was fairly inconclusive, although the premise was interesting. The authors undertook the meta-analysis "to provide insight into the patient's experience as a means to help clinicians recognize symptoms of anorexia nervosa." I fully support helping clinicians better recognize eating disorders in their early stages, especially since most patients' inability to understand that they are ill tends to hinder diagnosis. I'd be curious to see their exact reasoning.

The second paper, titled "Understanding women's experiences of developing an eating disorder and recovering: a life-history approach" simply made me cringe.

The development of the condition was attributed to a lack of control, a sense of non-connectedness to family and peers and extreme conflict with significant others. Recovery occurred when the women re-engaged with life, developed skills necessary for conflict resolution and rediscovered their sense of self. Rather than viewing the development of, and recovery from an eating disorder as separate and discrete events, the data from the life-history interviews suggest they are better viewed as one entity - that is, the journey of an individual attempting to discover and develop their sense of self. This perspective challenges some current constructs of eating disorders; it is not a condition in and of itself but a symptom of deeper issues that if addressed, when the individual is 'ready' to make that choice, will lead to recovery.

However, perhaps the increased connectedness is a symptom of improving health and not a means of improving health. Nor is an eating disorder a symptom of anything. Anorexia is not part of a journey of self-discovery, even if some self-discovery occurs during recovery. It's an illness. Period.

I don't think my eating disorder developed because I felt out of control (though that might have been true) or that I felt disconnected from people and society (though I always have) or even that I lacked a strong sense of self (I never really gave this one much thought and frankly still don't). My deeper issues? Only strange neurochemistry and a predilection towards anxiety. No, my eating disorder was more like being dealt a bad hand at cards, a hand I didn't know any better than to play. It wasn't in any supernatural being's Plan For My Life. I don't find my eating disorder to have any sense of worth in my life. My recovery is valuable because it's helping me learn to live again, and I am trying to give my recovery some sense of meaning through all of the blogging and writing and advocacy that I do.

I guess I just fundamentally don't understand the navel gazing that people do about the meaning of anorexia. Perhaps it's because I don't look at the illness as a social construct. And it probably don't help that I find no particular meaning in my own experiences.

But a focus on the meaning of an eating disorder seems somehow...meaningless.

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Sarah said...

"My deeper issues? Only strange neurochemistry and a predilection towards anxiety. No, my eating disorder was more like being dealt a bad hand at cards, a hand I didn't know any better than to play. It wasn't in any supernatural being's Plan For My Life."

Ok, COULDN'T AGREE MORE. I have always maintained that my journey into an eating disorder was inevitable. People have asked me "what can we do to stop someone that we see slipping into it?" and I honestly am at a loss for real suggestions. Sure, I will say stupid things like "express that you've noticed, and tell them you're there if they need to talk," "tell their parents," etc., but what would have stopped me? I don't think anything. I feel like my whole life was leading me to anorexia. I needed to crash into it, do it, and then rise from the ashes.

Was there a meaning behind it? I've ASCRIBED a meaning to it as a coping mechanism, and I see factors that contributed to it happening at that particular time in my life, but I feel largely that it was an inevitable and crappy part of my destiny, not some expression of my inner child's torment or my battle with my gender or whatever a more metaphorical psychologist would say.

And I actually have a faith in a supernatural being, but I don't think He/She would have WANTED me to struggle with this disorder, much like I don't think He/She wants anyone to suffer. Based on my understanding of the fallen state of humankind, we are not perfect beings, so we have struggles, problems, and neurochemical issues. God uses these, but doesn't desire or cause them. And if He or She did, I think He or She would be straightforward about it and take credit!

No, I don't think EDs are some innately driven part of our journey towards becoming ourselves or finding ourselves. They just freaking happen, and we can choose to take the opportunity to change some aspects of ourselves and learn to love ourselves through it all, or not.

Sad Mom said...

Sometimes I try to tell myself that my son is perhaps being fire-tested for some future grand purpose and that he will emerge from this hell stronger and equipped for the ordained tasks ahead. It's a lovely fairy tale and evokes a small flicker of hope that there's a reason for this crap. Then I see his aged face and feel his shoulder bones, prominent through his hoodie. Would anyone try to ascribe purpose of self discovery to mutiple sclerosis? Does Parkinson's occur due to a misplaced sense of self?

The authors make it sound like it's a voluntary condition. The improved physical health leads to improved mental health - I can track that myself when he has had some gains. If he loses it all goes to hell again. The ED voice gets louder and more insistent.

On the other hand, "it is not a condition in and of itself but a symptom of deeper issues that if addressed, when the individual is 'ready' to make that choice, will lead to recovery." Not sure about that, but if it follows from a collection of traits or tendencies that may be common? I'm thinking of Aimee Liu's gaining.

Kara said...

I disagree with you. I think every experience in our lives has meaning, including eating disorders.

Kristina said...

I kind of agree with Kara.
Maybe it's different for each person, and he/she can prescribe reason/meaning or not to any experience.
I would strongly say that my eating disorder developed out of that sense of disconnection to others and a lack of a sense of self and a well-developed sense of self-hatred that seemed to build over the years. Also, my parents were extremely focused on weight and appearances and how 'socially acceptable we were as a family', so I'm not giving them a free pass, particularly not when my mom put me on diets despite the fact that I was a. still developing and b. 'thin' (but not as thin as I had been).
So, yes, I did have to examine my family dynamics and my relationships, and I have come to conclude that my family is, on the whole, quite toxic for me. Yes, it's now in my control as to how I relate to them, but it IS a factor in the fact that I had an eating disorder.
I will say that therapy this time around (after years without therapy) has not focused on my navel or on any other body part, but on the here-and-now and also on my future: how to build the life that I want and that I deserve.
And the eating disorder is NOT a part of that life.
But... I also have a job that I enjoy (and that I loath at times, but it gives me a great sense of purpose), a partner with whom I share my life and myself, and I learned, over the years, to enjoy other aspects of life. So, have these things made it more possible for me to recover? Maybe. Maybe not.
I do think that everyone's experience is different. I didn't go in and out of treatment; rather, I've been a highly-functioning person. Maybe that also makes a difference. I'm not sure. I don't believe that it was a "Higher Being's" destiny for me, but it has been a part of my life.

Maia said...

(I'm a long-time reader, rare commenter)

I have to say I disagree with you on this one-- I believe in the social construction aspect of eating disorders. I honestly view is as more social/emotional than biochemical issue for me, nor do I think it was inevitable and unpreventable. I definitely agree that there is a genetic predisposition, but I think that the way I was raised and the messages I got from others about myself my whole life created a constant desire to punish myself, which was more fulfilled than ever when I slowly began to restrict more and more. For me, anorexia was the outward manifestation of all the inner suffering that everyone else seemed to otherwise ignore. I agree with you, though, that it seemes more likely a person will feel more connected to others after recovery, not as a pre-requisite to it. But then I question the Maudsley approach, which integrates family connectedness with recovery of the physical symptoms, indicating that there must be a psychosocial aspect to it as well.
Either way, food for thought :)

Carrie Arnold said...

I'm not saying our lives are meaningless- just that an eating disorder has no independent meaning. I don't think that having an eating disorder says anything more than having cancer, except for the fact that you have an illness. We can make our lives and experiences meaningful, but that's US and not the experiences.

Every illness has an environmental and social aspect to it- separating nature and nurture is not all that useful. I'm not going to deny that being raised in a culture that promotes dieting is harmful and can trigger an eating disorder. But EDs existed long before the dieting zeitgeist.

And as for the Maudsley approach, it explicitly assumes no pre-existing family dysfunction. Rather, the coming together of the family is to help heal the sufferer and make sure that every meal and snack are eaten.

Kim said...

I think the reason people do this "navel-gazing" about the "meaning" of anorexia is because we have a hard time understanding anorexia as a neurobiological illness. Therapy focuses on anorexia not as a disease, but as a coping mechanism developed because of numerous character traits, family dynamics, experiences, etc. If cancer patients go to therapy, I doubt they get this kind of analysis. Anorexia, like any illness, messes with you emotionally and takes you on a journey of self-discovery (I'm sure cancer patiens learn a crap load about themselves in their process, too). But, with anorexia, unlike many illnesses, there is more tangling. It's hard to see which comes first -- the disease or the "need for control"/reclusion/perfectionism/etc. It's a big tangled mess. I think that's why people ascribe more "meaning" to anorexia. It's still a large mystery to clinicians, because I think it's still a large mystery to some of us who have the disease. We look at our lives and can't help but see things that confuse the notion that it's purely an illness. We see all kinds of contributing factors, we analyze our sense of self and our relationships. We see how it's all related, and we create a "story."

Kjirsten said...

I've read your blog for a while, and I appreciate your honestly and most of what you write and joy reading you blog.
But I do disagree. I certainly believe anorexia has deep roots in one's biology, no mistaking that if you read the literature!
I think it's important for many sufferers to ascribe meaning to their struggle, I've seen it help with motivation for recovery.
I also believe that anorexia is a coping mechanism for many people with the illness (like alcoholism is for other people with that genetic predisposition), I believe that as a person is recovering you need to address the other issues besides just what they are eating and what their weight is (although those are essential things that need to be addressed for any work to get done).
Eh, so those are my thoughts, for what it's worth.

Carrie Arnold said...

Okay, perhaps I am not expressing myself properly. Finding meaning in recovery is something that I support and am trying to do. I don't know if my definition of "meaning" is the same as yours, but I am trying to view this crazy journey of overcoming anorexia as somewhat empowering, and I am learning some valuable skills along the way.

BUT...I don't think that my ED has a deeper meaning. Not in existential terms, and not necessarily in terms of deeper psychological issues. If you want to count anxiety and mood disorders amongst my psychological issues, then I'll agree with you, but I'm not talking about reasons why I'm starving myself. The reason I restricted my food was because I had an eating disorder.

I also am conflicted on calling an ED a coping skill, because I don't know that it actually helped me cope with anything. I think it was a neurobiological response to anxiety and such. The people at UCSD said it much better in this little piece than I could.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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