Tuesday, January 19, 2010

Dis-ease





A couple weeks ago I ordered the book Feeding Anorexia: Gender and Power at a Treatment Center by Helen Gremillion.

Feeding Anorexia challenges prevailing assumptions regarding the notorious difficulty of curing anorexia nervosa. Through a vivid chronicle of treatments at a state-of-the-art hospital program, Helen Gremillion reveals how the therapies participate unwittingly in culturally dominant ideals of gender, individualism, physical fitness, and family life that have contributed to the dramatic increase in the incidence of anorexia in the United States since the 1970s. She describes how strategies including the meticulous measurement of patients' progress in terms of body weight and calories consumed ultimately feed the problem, not only reinforcing ideas about the regulation of women's bodies, but also fostering in many girls and women greater expertise in the formidable constellation of skills anorexia requires. At the same time, Gremillion shows how contradictions and struggles in treatment can help open up spaces for change.

The book came today, so I haven't started reading it yet. The topic interests me though; over and over again, through my own experiences and those of so many other women I know, I have seen how treatment has been ineffectual and sometimes harmful. There has to be a better way. I remember reading about in Hunger Strike by Susie Orbach the ways in which the treatment of anorexia is very similar to that of the "hystercial" women of Freud's time. Of course no one wants to hear from someone so visibly starved that force-feeding is not helpful. "Our discomfort may be such that we will wish to fight the anorectic, to stop her making us feel so uneasy by taking away from her the control she has fought so hard to exercise over her food intake. In forcing her to surrender, professionals relieve themselves of the burden of having to examine her pain and the discomfort her starvation induces in them."

I have never strived for recovery on my own. Hospitalizations were forced on me, and maybe they were necessary; it's hard for me to judge. What I do know is that none of them made a difference in anything except my weight. It made everyone else feel better to look at me, but anyone I know who has recovered did not do so with the help of a hospital. The hospital for me is just a competition of who is the sickest, who can get away with the most, or get the most attention. All it ever did was reinforce that I need to be ill to be cared for, make me feel like an incompetent and powerless child, and use my body and behaviors to be heard because no one listened to my words. It taught me new behaviors and created a safe place where I could continue to use anorexia as my identity.

I can't imagine myself ever going back voluntarily. ED treatments centers and psych wards are all too comfortable for me, but I can't choose to go, I don't care enough about myself and things are never "bad" enough. Sometimes hospitals are all I really want out of life, when I need to know that I matter, at moments when I believe I can't be good at anything other than being sick.

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