Appetizing Loss: Anorexia as an Experiment in Living

This paper turns upside-down the commonly held assumption that anorexia nervosa is inherently destructive or counter-productive. The author delves beneath the façade of anorexia’s main symptom, self-starvation, to explore what refusing to eat accomplishes, psychically, for the sufferer. Featured in this paper are the clinical reflections of contemporary child analyst Adam Phillips who argues that symptoms, such as those in anorexia, are “experiments in living.” In his view, anorexia is a particular way of testing the environment for its capacity to withstand and satisfy one’s desires. Working also with the notion that anorexia is an attempt at compensation for traumatic loss or affective rupture, attention is drawn to both the inter-personal and intra-personal contexts within which self-starvation is pursued. Importantly, this approach recognizes that responses by those around the anorexic individual affect the conditions within which possibilities for recovery are made.

Special thanks to Lesley Biggs, Donald Brackett, Dara Gellman, Marla Gerein, Kelley Lewis, and Melissa White, who commented on a draft of this paper. I have taken up many of their suggestions in its revised version.

Notes

Special thanks to Lesley Biggs, Donald Brackett, Dara Gellman, Marla Gerein, Kelley Lewis, and Melissa White, who commented on a draft of this paper. I have taken up many of their suggestions in its revised version.

¹Phillips’ experience of feeling “stupefyingly redundant” in response to Chloe recalls (another) British psychoanalyst Leslie Sohn’s (1985) account of feeling viewed by his anorexic patient as “a cold uncharitable tin of uninteresting food” (p. 53). Sohn believes that this dynamic emerges out of the anorexic’s need to be disinterested in the analyst as a “potential giver,” so as to refuse any potential for satisfaction or pleasure that might come from working with the analyst (p. 53). He argues that this refusal is a continued effort on the part of the anorexic to “remov[e] any awareness of truth, pain, depression, and dependence” (p. 52).

²While Phillips does not acknowledge the influence of Leslie Sohn here (again), his counter-transferential dissociation in response to Chloe is anticipated by Sohn’s paper, “Anorexic and Bulimic States of Mind in the Psycho-analytic Treatment of Anorexic/Bulimic Patients and Psychotic Patients” (1985). Sohn writes, “There is always a threat in the counter-transference of either bulimic wishes in the analyst that is, a wish to excite the patient to become interested, or anorexic ideas about the worthlessness of the whole process of analyzing. In other words the analyst loses his appetite for work” (p. 52).

³The suggestion here that the anorexic’s symptoms are unwittingly colluded with or supported by the needs of others is reminiscent of Winnicott’s observation that a child’s depressive symptoms are often attempts at reparation for a parent’s depression (see Winnicott, 1948). According to his object-relations theory, the child’s melancholy (denial of separation from the already-lost love object) is as much about the parent’s need to remain psychically undifferentiated from the child as the child’s need to remain “one” with the parent (specifically the mother). In the context of this paper, Winnicott’s theory bears significance in that the anorexic’s “experiment” is similarly understood as a relation between the self and the other—a test of whether the environment (including parents and others) can tolerate or withstand the self’s “demand” or “invitation” as expressed by the refusal of food.

⁴On this point also see Kim Chernin’s The Hungry Self (1984) where she describes the anorexic as living a paradox with respect to the possibility of independence: “Separated from the mother through her slenderness and her stubborn refusal to eat the family’s food, she is yet aligned to her by the failure of her development, her increasing dependency, her exclusive preoccupation with food as a means of expressing herself” (p. 175).