In a modern society where “God, I need to go on a diet” is now a phrase used daily, it seems that eating disorders are perceived as cases where everyday weight management has gone wrong. It is thought, simply, that patients show these abnormal behaviour and thought patterns as a result of their extreme desire to be thin. However, where has the wish to be thin come from? Is the physical aspect all there is to an eating disorder?
It seems like most ordinary people understand eating disorders this way, as a purely physical concern. Instead, let’s think about it this way: many people have experiences where they get frustrated and despair under a swamp of emotions that they can’t do anything with and they can’t see a way out. Such states can be triggered by various things including betrayal by, or parting of, close people; family disharmony; continuous failure in study or work, etc. So, let us consider the possibility that patients with eating disorders try to express their inner pain using their body as a kind of symbolic media, with minds so subtle to be easily seen or acted on. Perhaps they are an attempt by sufferers to express their psychological states via a more simplified, visible form. Ultimately, we should be thinking about why eating disorders are considered psychological disorders rather than health problems.
The fear of the formless
When negative emotions go beyond a certain threshold, willpower loses its effect. What we do first in such a situation is to let ourselves be, while we remain unsure of what to do with our negative feelings. This thinking can be applied to eating disorders, since sufferers are surrounded by negative emotion and do not know how to label their desperate state. Thus they replace it with a wish to be thin, and commit themselves to this ‘clearer’ strategy, chasing away the real origin of their suffering.
Obsession with thinness and the ensuing eating disorder is a way for sufferers to, subconsciously, attempt to solve the difficulty in their lives. The “real problem” might be something whose origin is hard to grasp because it is deep-rooted and may not arise in the conscious state because it’s hard to accept. This might be a feeling of guilt or shame, but is usually something that has been consistently ignored and suppressed, or something that is difficult to recognise and solve, for whatever reason. Whatever its identity, the problem is not apparent to the sufferer as a definitive image because it has not been analyzed and sorted to any great extent. This is because the solution or the path to the solution does not exist in a definitive form. In a situation with this much uncertainty, people often convert the psychological into the physical. What patients with eating disorders desire over all else, is to be able to give a label as well as a face to their emotions, so that they can better control them.
Facing emotions in a modern society
There also exists the matter of dealing with the emotions underlying eating disorders. In a society where reason, rationality, and competitiveness are highly valued, those who listen to their emotions and ‘go with the flow’ are sometimes considered as immature and irritating, compared to people who always appear rational. In a situation where sufferers’ inner-world can be the object of disregard and derision, people who are highly in touch with their emotions hide and suppress themselves. People who suffer from emotion deeply rooted in ‘difficult’ memories will commonly withdraw even more from sharing their experiences and feelings. As such, they learn how to turn a blind eye to their emotions, rather than learning how to unravel them, interpret them and integrate them into their experiences. However, whatever it is inside them that has not been dealt with properly, has also not disappeared and will at some point start to make itself known. People who have not learned how to handle such a situation can become suddenly frustrated when all they know is denial and evasion. Indeed they do what they can, but diet and body step into in the coping process.
Converting the psychological into the physical
Diet and body become a good platform onto which people can project their inner problems, for they are clearer and easier to handle than their unidentifiable emotions. In addition, by being thin in a society where maintaining a slender physique is considered a necessary element of self-management, sufferers can show the world that they are successfully controlling themselves. The beauty and confidence expected to result from thinness are irresistible rewards, which can sound attractive to those who are desperate to figure-out and control their emotions. In addition, by committing oneself to a strictly controlled diet and exercise plan, one can ignore inner confusion and pain.
In the process of clinging to thinness, sufferers’ cognition becomes slowly distorted to the extent that they believe their problems will completely disappear when they become thin enough. For patients with eating disorders, a change in diet can put not only their body, but also their lives and happiness at stake. Despite this, they believe that all attempts to be thin are for their own good and their weight loss is evidence that their lives are flowing smoothly without issue.
Sometimes, strict anorexia can turn to a sudden bout of bulimia. This usually happens when the patient subconsciously realises that thinness is not the real solution to their confusion and emptiness. When the patients feel none of their issues have been solved, they think it’s because they are not thin enough and they push themselves harder. Sometimes they fail to fight against impulse, against feelings of devastation and the wish to give everything up. This is when they exhibit bulimic acts such as binging and purging. Then they reproach themselves against their “weakness” and corner themselves into the anorexic mode once again. Like this, the vicious cycle of an eating disorder goes on.
Giving a face and a name to the formless
Hopefully, patients will eventually become able to confront the underlying problems that have triggered the disorder and can begin to process them, for a substitute is only a substitute. The act of staking one’s life on a false objective such as thinness, loses its power in the face of unavoidable truth. Nothing can be solved until the original problem has been brought to the surface.
As the treatment continues, patients should start to realise that their problems – previously simplified by obsession with thinness and food – are much more complicated and immense than they thought. Although an eating disorder is itself a painful experience, the pain is much less than that which arises when patients confront the lcomprehensive inner movement whose origin and identity has been hard to grasp. There will come a crack in the fragile feeling of comfort gained from obsessing over diet and body, as the treatment process threatens the rigid and false assumptions that have been sustaining the eating disorder and life of the sufferer. Thus, patients can become uncooperative at times. However, we cannot just let the devastated mind and body be, and should continue to try until we reach the origin of the problem.
Correcting the exaggerated evaluation of the importance of thinness or the distorted perception of body shape, can help to a certain degree. However, the real treatment starts when the patients become aware of their hitherto unaccepted emotions and intuition and can attempt to integrate them into their experiences. The treatment concerns handling the fear of the formless by searching for a real face and a label that can explain them.
If you want to understand an eating disorder better, I would recommend books on abnormal psychological conditions as written by psychiatrists and professors. Books used as core texts in psychology classes are a good start, since they explain various psychological theories that can be utilised in interpreting the behaviour and thought patterns of patients with eating disorders. However, if these are deemed insufficient because they are too abstract and vague, I would recommend reading autobiographic essays by patients (or ex-patients) in order add some flesh to the knowledge provided by academic texts. These can help ordinary people to gain an understanding of the background and development of eating disorders in real life. Documentaries featuring both experts and patients will also help. However, one should be careful, since there are several problems associated with some of the books and documentaries featuring patients and ex-patients, though this is a topic for a later discussion.
Text: Yeonwoo Baik