The Body As Evidence

I’ve written before about the frustrations of having a mental illness that leaves visual signs on my body, and that it can often feel as if my body is betraying me with its scars or its size. I’ve recently noticed what appears to be a corollary to this and it’s something that gets under my skin (pun intended). For those of us who have mental disorders that result in a physical change, our bodies are used far more often than our own words or mental state to gauge whether we’re ok or not.

This is something that has been criticized for some time now. We’ve heard that “you can’t see whether someone has an eating disorder by their size”. Many people are still convinced that size and weight loss are the indicators of eating disorders. Others are certain that depressed people probably look like vagabonds and don’t wash or take care of themselves. I would hope that we all have enough evidence by now that people of every shape and size can have a mental illness and most of the time it’s utterly invisible.

But there’s another layer of looking at bodies as evidence for mental illness, and this one is more subtle and more insidious. This is the one that comes when someone knows that you have a mental illness and really wants to know how you’re doing. So they pick apart your physical appearance for signs: are there dark circles under your eyes? Have you lost weight? Gained weight? Is there a scar or a cut that indicates symptom usage?

Now of course if you’re nervous or worried for someone it makes sense to try to find evidence of how they’re doing. Where this turns into a problem is when bodies are used as evidence against the person whose body it is. Often, when someone with a mental illness says that they’re doing ok, their body is scrutinized to see if they’re right or not. The individual can’t be trusted to know their own mental state or to truthfully express it to others.

In many ways, I think this plays into the idea that people with mental illness are manipulative or disconnected from reality. For most people, if they said that they were feeling ok, or doing better, or their mood was up, they would be trusted unless there was some glaring evidence to the contrary (muttering, monosyllables, glowering face). Particularly with physical illness, if someone has an injury but says that they feel fine, most people take them at their word. We’ve all experienced having a particularly nasty looking scratch that doesn’t actually hurt and reassuring others that we’re fine. For the most part, they trust us to know whether we’re in pain or not. Even with illness, if someone has some symptoms but reassure us that they’re feeling much better, we smile and tell them we’re happy for that.

Obviously all of us use our common sense to determine whether we think someone is lying to us about their internal conditions, but for some reason those with mental illness are held to a far higher bar than others. Any evidence of symptoms is often construed as evidence that our  mood cannot and is not ok, or that things are going downwards. Particularly for things like purging or self-harm, there is a guttural response of disgust and fear to the symptoms that means outsiders are often convinced that it’s impossible for an individual to be doing ok and still engaging in those behaviors (never ever nuh uh). That means any evidence of symptom use is held up as evidence that things are not ok and if the individual says they are it is a lie.

Maree Burns in Eating Like An Ox says “In cultures where identities are read off the surface of the body, one’s physical state is understood to represent both moral and mental health”. There are intersections here with numerous other oppressions: fatphobia, racism, sexism, slut-shaming, ableism (as well as many others I’m sure I’m forgetting at this moment). The problem with assuming that a body is an identity is that no one can ever convince you you are wrong because they must be lying. There is an odd tension in American culture in which we partially dismiss the importance of bodies (we assert that focusing on looks is shallow, we eat horribly and don’t take care of ourselves, we shame people for having sex, and we typically subscribe to a Cartesian dualism that suggests our mind is our self while our body is just a nice carrying case), but at the same time we are convinced that we can read identity and selfhood off of bodies. Fat people can’t control themselves, people with disabilities are lazy, people of color are Other (scary or dangerous).

We don’t see bodies as selves, but we see them as books on which selves are written, clearly and unequivocally. The tension between the fact that we don’t see our bodies as our selves and the fact that we think our selves are clearly reflected in our bodies can make self-identity a serious challenge, but it also serves to undermine the self that an individual might seek to portray or express to others through means that are not the body. And this of course always impacts those who are already oppressed because we are more easily assumed liars.

My body cannot tell you things about my self, my well-being, or my identity. I may have scars, but I am ok. Someday I will openly wear my scars and smile and laugh and be a walking advertisement for the fact that mental health is not visible. Until then, I will just repeat over and over: I’m ok.

This Is A Rant: My Clothes Are A Lie

Every evening when I get home from work the first thing I do is shed my office clothes and pull on a pair of shorts. It feels amazing. Of course I only do this if I’m home alone, or if I’m not planning on leaving the apartment again. If I’m going to wear shorts out of the house, I make sure to throw on leggings under them. A few weeks ago I went out in a romper without anything underneath and I’m still feeling anxiety over it.

It’s not like I’m a particularly modest person. I wear backless dresses and low cut tops and tight clothes. But my legs have self-harm scars on them, and when people see those they give me a special disgusted face that I don’t feel any particular need to see on a regular basis. Every time I leave the house I have to think about whether there is something that people will learn about me from my body that I don’t want them to learn.

Not only is this a pain in the ass, but it’s also emotionally taxing. I feel like I’m lying to everyone around me simply by wearing clothes that cover things I would rather they don’t see.

Who would want me if I didn’t falsify what my body is really like? I portray an image of youth, of athleticism, of health, and yet the moment you raise my hemline you’d find that my body is really marked by violence, self hatred, death, and ill health. I have found myself frustrated in the past about people giving off an image of being stable, having friends, being well adjusted, only to find out after becoming enmeshed with them that in fact they are deeply screwed up people.

It’s one thing to be with someone and slowly develop these fucked up scars after you’ve already trapped them. It’s another thing entirely to ask someone to fall in love with you when the moment they look at your body, your real body, your unhidden body, they see clear evidence of instability, violence, and self hatred. Who can love someone like that? Perhaps that is why I marked my body in the first place, to illustrate to people what it is that I actually am when they think they’re falling in love with something else.

But now that I’ve made it clear just who and what I am, made it clear for an indefinite period of time (because who knows when these angry red worms inching their way over my skin will disappear), I don’t know if I am capable of accepting the rejection, the disgust, the confusion, the fear, the pity, the anger. No one simply reacts by saying “yes. That’s you. That’s ok”. No one reacts like they would just seeing a pair of legs. There is no such thing as simply existing when your body is the site of damage.

There is an intensely broken feeling to all of this. Even though I have no desire right now to date or even be desired sexually, it’s really fucked up to feel like the only way someone could want me is if I hide myself. I know that I will always be wanted “in spite of” not because of. How can I feel like any sort of relationship (even a friendly type relationship) is based on openness and honesty and all the values that I care about when every day of my life I consider and carefully cover up certain facts about myself?

What kind of a human being am I if I feel that I have to bury things about myself to everyone I know (except a select few that I feel brave around)? What is wrong with me?

Intellectually I understand that what is fucked up is not me but is in fact a society that says we need to hide every ounce of evidence that we might have mental illness, a society that indicates that someone who self harms is unstable, possibly violent towards others, immature, attention seeking, and completely different from everyone else the world except others who self harm (because seriously who does that it’s so fucked up), a society that polices bodies.

But emotionally, I cannot stop feeling as if I need to expose myself just to see if anyone I know would still treat me the same. I can’t stop feeling this desire to scream to everyone that I have scars, that I’m fucked up, that I hurt myself. My body is not what you think it is. My body is not appropriate. My body is not healthy. My body, simply by existing, fucks with your norms and I don’t know if I’m ok with that because someday, maybe, I might want someone to just look at me and not have questions or fears or emotions, but just see me.

I don’t know that there’s a point to this post, just a fear. A fear of my body and what my body has become, of the permanence of scars. A fear of what people see when they look at me. A fear of the fact that I’m hiding because if there is one thing I hate in this world it is hiding the reality of my self. And somehow, I don’t think it matters how many people do see, how many people I am brave to. Because every time I put on a pair of pants and meet someone new, I’ve hidden something. I’ve chosen not to let them see a truth about me.

I suppose we all do this every time we meet people, but the physical act of covering something brings it home in a way unlike any other, and it’s a way that is intensely guilt inducing. It isn’t simply “not sharing”. It is actively hiding. It’s a choice, every single morning, every single time I change my clothes and I am so sick of weighing myself down with guilt over it.

My Body Is a Trigger

Trigger warning: self harm

I’ve written before about the frustrations of having a mental illness that leaves visual signs on my body, and that it can often feel as if my body is betraying me with its scars or its size. Recently I’ve had a lot of thoughts floating around about scars in particular. Summer is coming up, and I happen to have scarring on my legs and stomach that would be visible in shorts or swimsuits. I’ve had a few incidents surrounding scarring and people’s reactions. I can’t help but spend a lot of time wondering what to do with this body that is visibly damaged.

I think there are two main elements to this problem, that often come together to create a third problem. First, my body can trigger others and that is something I don’t want to do (I do in fact have some close friends who may be triggered by the sight of self harm scars). Second, self harm and the scars associated with it tend to inspire a viscerally negative and fearful reaction from those who have never experienced self harm, in such a way that it causes a great deal of distress for everyone involved. Out of these extremely fearful reactions comes the fact that because my body itself can be seen as a trigger, my mental state is often gauged by whether or not people can see physical marks of self harm.

The question of how to approach my body when it’s probably forever marked with the signs of my mental health isn’t an abstract one: this is something that I imagine many people have to face in a very serious, immediate, and daily fashion. Every day when I choose what clothes to put on my body I have to ask myself how much to cover up, how comfortable I am with my scars, whether I will be around people who might be triggered or hurt by seeing my body as it actually is, and how I can be honest with the people around me while not waving self harm in their faces.

It sucks. My body is not only a trigger for others but also for myself, because every time I look at it I get flooded with that mental calculus, wondering if there are people who would judge me differently if they saw it. I wonder if people would pity me or feel disgusted by me or be afraid of me? And at the same time I don’t want to be afraid anymore. I want to be brave enough to leave my house while wearing clothing that is comfortable to me and not give a second thought to whether or not someone might glimpse my ankles.

There is something incredibly painful about knowing that your very physical presence can trigger someone. This is where the two problems overlap and reflect back on the individual whose body it is. It’s possible that I could be walking through my life and simply by existing cause someone I care a lot about to panic, fall into anxiety, want to self harm, or have nasty flashbacks. There are a few things out there that are highly likely to trigger people: guns, rape and comments about rape, graphic descriptions of violence, serious calorie and weight loss talk, and definitely self harm scars. It’s terrifying to be one of those things and never be able to change it.

Self harm scars in particular go one further. I am a walking trigger for people who have struggled with self harm in the past, but scars and self harm cause a reaction of terror, disgust, and discomfort in just about everyone. None of my other symptoms have ever inspired panic in the same way that self harm does (I’m still trying to figure out what it is about self harm that gets at people so emotionally). When the people close to me hear that I have self harmed or see a scar, they cannot control their emotions: they turn into fear driven creatures.

Imagine having a part of your body that if it were seen by just about anyone causes their eyes to widen uncomfortably, they start shifting back and forth and searching for a way out of any conversation, or they simply demand that you explain it to them. You can see the fear in them. They look disgusted and hurt. They never quite look at you the same again.

And this is the piece that brings me to my biggest problem with being a walking trigger: in our culture, people read our lives off of our bodies. Your size tells people whether you’re healthy or lazy or kind or generous. Your clothing tells people whether you’re nerdy or preppy or fashionable or slutty or prudish. Whether or not you smile determines if you’re a bitch or a jerk or kind. And especially for those with mental illness, people look at our bodies to read our mental states. I think I could deal with triggering people, I could talk to them, I could ask who needs what, if only my body didn’t come with the assumption that I’m fucked up and suicidal.

Usually when I identify something that’s really difficult about a certain aspect of mental illness, I try to throw out a few suggestions for ways to make it better. Unfortunately I don’t have any today. This is new for me this year, and I have no idea how to navigate the fact that my own body is a minefield. I don’t understand how to make it ok that I hurt people. I don’t know how to move towards body acceptance when my body is doing things I really don’t want it to (like communicating to others that I’m not ok, or triggering others). I don’t know how to be brave and wear my body proudly.

Some day perhaps I’ll go to a dance event and compete wearing a short skirt, or I’ll be able to go to the beach and wear a bikini. Today isn’t that day.

*note: if you are a friend of mine and you do find scars triggering, please let me know so I can make sure to cover up when I see you 🙂

 

10 Real Reasons Not to Self Harm

Obvious massive trigger warning for self harm.

There are many, many lists and articles and comments and emails and conversations and every other form of interaction out there about why you shouldn’t self harm. If you have ever hurt yourself and anyone has ever found out, you’ve been subject to a litany of reasons. There are many good reasons to not self harm and lots of really stupid reasons to not self harm. Some people find the generic lists on the internet extremely helpful, but I have never been particularly convinced when I’m in a bad place. They come from a place that assumes I believe in my own worth, and when I want to hurt myself I’m rarely in a state of mind that recognizes that. At a guess, I would suspect that I’m not alone.

At this point, I’ve mostly kicked the habit of self-harm, and I think it can be really helpful for those who have been there to share what helped for them. So here is my list of real, honest to god reasons that I have stopped.

 

This post has been moved to my new blog at Aut of Spoons. Check out the list there.

Body Betrayal: Scars and Stories

Yesterday I went to the doctor for my annual check-up. I’m not a big fan of the doctor: you see your weight displayed prominently in front of you, you get naked and have things shoved up your lady bits, and of course, I always have to decide how much to disclose about my mental health. In recent years, I’ve stopped having much of a filter about my eating disorder. I’ll tell my doctor without hesitation. It doesn’t bother me anymore. It’s a nuisance to have to retake depression inventories and explain over and over what treatment I’m getting and that I have a team that’s kept it under control, but in the long run it’s easier than dancing around things.

So I jumped through the hoops that they asked of me and as I was laying back on the table with my body exposed for the doctor, she looked down and asked “Did you do these to yourself?”

It took me a moment to realize what she was talking about. The scars. They’re on my belly and my hips and my legs. I forget they’re there sometimes.

Unfortunately, it’s when I forget that I forget to cover them or explain them. And then they’re seen. And then I must tell the story.

There is nothing quite like being on your back mostly naked with your legs spread while explaining to someone that your self-harm is under control. “Stripped bare” hardly covers it.

But that’s the thing about bodies: they tell your stories even when you don’t want to. Having a physical presence in the world means that others can tell things about you that your mind would rather they not know. This to me is one of the struggles of coming to grips with my own body image.

Scars are stories. Every mark on my body came from something in my life: the scar where they cut me open when I was six, the stretch marks from losing and gaining weight in the midst of an eating disorder, the tattoo I got when I was just 18 and in love with beauty. Some of these stories are ones I chose to tell: when my bones stretched against my skin, it was my choice to tell the world that I wished to be smaller. The ink on my skin is my own story that I put there. Some of these are not the stories I wanted to tell: the scars from where I hurt myself were wishes to disappear, and now they are angry, loud marks that announce me to the world.

Many of us have stories that are announced without our consent, but there are some special difficulties when your body is betraying you in this way. A particularly difficult element of this is body dysphoria. If you feel that your body is reflecting a past that you no longer identify with, telling stories that are no longer your narrative, it can deeply undermine your sense of self, and can mislead others about who you are. It’s hard not to be defensive when you feel you have to explain your body away as something that isn’t true to who you are.

It is the constant struggle between your inner knowledge of self and the outer perception that others have, and the work you must do to reframe your story into bite-sized, palatable explanations. When the stories written on your body are socially unacceptable, you must go above and beyond to make yourself socially acceptable in those lies of omission, spinning of stories, and changes of subject that we learn to perfect.

But there’s also a fear to it: you never know when someone will ask you about yourself, ask you the hard questions. You never know when someone’s face will fall in the way you can’t explain, but you know means they’re writing you off. It’s the impossibility of keeping your secret, even when it’s your deepest, hardest secret, because other people can see it when they look at you. Imagine that: imagine another person being able to look at you and know about your hardest moments and your most difficult struggles. Imagine not being able to choose when to disclose information about yourself, but rather having to always be hiding against discovery.

These are not all my experiences. In the summer I have to watch what I wear. When I was skinnier I had to be careful to show that I was eating around new people. But most of my life I can live without wondering when I will be found out. There are those who have it much harder than I do. When your body tells a story that is personal, you are automatically put into a position of submission, and there are those whose bodies are screaming those stories.

I know that we tend to use what information we have to make judgments about a person, and often that information is immediate and visual. But as someone whose body is spreading lies about me, please don’t listen. I am not my scars. I am allowed to write my own story without anyone else’s perception of my body. I do not have to defend the way I see my body, nor do I owe anyone explanations of my body. But the dialectic is that my body always appears to others, no matter how badly I wish it not to. This, to me, is the challenge of creating positive body image.

Losing Reality

I haven’t spent much time on this blog, or really much of anywhere talking about body image. Obviously I think about it: I don’t like my body and I never have. I have issues with my body that I take out on it through violence and starvation. But body image is simply not one of the aspects of my eating disorder that I find fruitful to write about, and generally when I bring it up in person I just get frustration and straight out disagreement from my audience. While I understand the impulse to tell me “YOU’RE WRONG” when I call myself ugly, there are times when I want to be able to express and explore my feelings about my body without being immediately shut down. This is one of those times. This exploration may not have a clear point, but I think it’s important to give voice to the thoughts and feelings that are a part of the disorder.

 

Lately my bad body image has been acting up quite badly. I’ve increased my food intake and put on a bit of weight. This means discomfort in my clothes, discomfort in the mirror, discomfort when I eat. But the worst part of it is that when I worry about my body image, I often find that I cannot accurately identify reality.

 

No, this does not mean that I hallucinate. I don’t see my body growing larger before my eyes, I can tell that I’m smaller than many people. However despite all this, I cannot understand what the truth is about my body: is it acceptable or not? Is it too skinny or not skinny enough? Is it healthy, or do I need to lose weight or gain weight? Now most people would find it fairly easy to figure out the answers to these questions by consulting a doctor, by looking at their weight in numbers, by assessing their current diet and activity level, and generally thinking about how they feel in their skin. However when I do these things I am left with strong evidence for mutually contradictory things. The scale tells me that my BMI is a certain number. That number is within the healthy range. Certain magazines tell me that the number is unacceptably high. My dietician tells me it’s acceptable but that I’m still not getting enough calories and need to increase my intake. My eyes and emotions tell me that my body is hideous and fat and horrible. My mind flicks between sources, trying to decide who is the most right, who I should believe, what combination of sources are right, where reality is.

 

It’s enough to leave anyone feeling as if they’ve completely lost their grip on reality. When that happens, all I can do is meltdown. When you don’t know what reality is, you don’t know how to proceed. You are left with no appropriate steps. When faced with a meal in this state, every choice feels wrong and every choice feels right. It leads me to a deep feeling of self-hatred that I cannot figure out even the most basic question of whether or not to put food in my mouth. The reason my body image drives me up the wall is not just because it’s bad. It’s easy when it’s just bad. What’s hard is when it disconnects me from any sort of rational thinking. For someone who prides themself on intelligence, skepticism, and clear-headedness, it destroys my concept of self.

 

It leaves me feeling like my concept of myself is a battleground between different messages of what’s appropriate and what’s not. I don’t want to live in a battleground. I don’t want to live in this body.

Intersectionality: Food Ethics and Mental Health

Something that has come up a great deal in my personal life recently has been people criticizing my choices in terms of eating and exercise. As you might imagine this is fairly difficult for me to hear as someone with an eating disorder, but it’s caused me to spend some time thinking about the intersections of mental health and food ethics. America as a culture does not spend a great deal of time focusing on how the way we eat and how we relate to food can affect our mood, mental health, and overall life quality. What we do spend a lot of time doing is shaming each other for our food choices: whether on the basis of health, ethics, or aesthetics. There are debates over vegetarianism and veganism, about health and obesity, and about whether people on food stamps deserve their food. What we don’t talk about is what we can do to make food an experience that enhances people’s lives.

Food is often an extremely emotional experience. It combines taste, smell, sight, and texture into what can be an extremely intense experience. However unlike most experiences that deeply engage our senses, it is something that is required of us every day. It’s easy to write it off because we spend so much time doing it. But truly good food experiences can change your life. Many people try to approach food simply as fuel for their bodies and nothing else, but food can be incredibly powerful.

Food has cultural connotations, and often it’s part of the glue that brings people together. Food can be an extremely important part of memory, and is often plays a role in memories that hold special meaning. We use it for celebrations and for rituals, as reward and punishment. For most of us, food is emotional, and for those who take all the emotion out of food, it can seem like it’s missing something. The emotions of food are part of friendships and families, and you can miss out on a lot (like a dessert with a sweetheart or a dinner with your family) if you try to excise emotion from food.

For some reason, these emotions often get ignored when we talk about how people should eat. If anything, we look on these emotions as negative: we make fun of people who “eat their feelings”. There appears to be a stereotype that having an emotional relationship with food is inherently negative. However there are absolutely healthy ways to feel emotional about food, and loving food does not mean being unhealthy. Too often we hear about health or ethical implications without any mention of the actual experiences of eating. This is not a culture that celebrates how fucking delicious it is to bite into a piece of warm chocolate cake, or how comforting it is to smell the scent of a childhood meal.

And when we’re looking at mental health, this is important because these internal experiences are often what sets someone with a mental illness apart from anyone else. When we talk about the ethics of food and the ethics of health, we often forget that the experience of food can be powerful, and that when someone has a mental illness, this is something extremely important to take into consideration. We ignore the potential emotional benefits we can gain from eating, and we ignore the potential harm that can appear when we guilt or shame someone or deprive them of food they love.

Now there’s one really obvious example which is eating disorders. When you’re trying to recover from an eating disorder, if you can eat a reasonable amount without feeling guilty, you do it. This is a matter of your health and potentially your life because every piece of food is a struggle. If a piece of bacon or a slice of cake is what entices you today, everyone better fuck off on telling you that you shouldn’t eat it because that piece of food could be the only thing you’re willing to eat today. This is not a choice, this is a jerkbrain doing things to you. If someone is trying to recover from an eating disorder and you try to tell them which foods are appropriate for them to eat or not to eat, all I can say to you is go fuck yourself. You’re asking that individual to put themselves in harm’s way by cutting out more food and creating new food rules. You’re asking them to prioritize something over their own safety and health. This is a clear place where food ethics need to be flexible to allow for someone’s health and happiness.

But there’s more to the intersectionality of mental health and food than just eating disorders. Because of the emotional nature of food, it can either be used as an incredibly helpful tool for managing emotions or as an intensely negative coping strategy that damages the individual. Now this is different from using food to hide from your problems, but as part of a larger program of dealing with the root causes, including good food and good food experiences in your treatment can be really useful.

I’m going to use an experience from my own life because it’s what I know best. I try my best to eat vegetarian, because ethically I feel it’s the right decision. For eating disordered reasons this isn’t always possible. However when I do eat meat I eat ethically raised meat. I have one exception to this rule. When my dad makes spaghetti sauce from his family recipe, he almost never uses ethically raised beef. I eat the spaghetti sauce anyway.

For a lot of people this looks like I’m selling out on my values. Many people have told me that it’s inappropriate and that there is no excuse for not being vegetarian or even vegan. It looks like I’m prioritizing my own enjoyment of food over the life of another being. But here’s the thing: one of the few times that I feel safe, comforted, whole, and welcomed is when I am with my family eating the same food we ate when I was little. From the perspective of someone in my position, this is far more important than you might think. My depression and anxiety are very real and very life-threatening, particularly because they come with a side-helping of self-harm. Finding moments in my life where I can qualitatively feel like an acceptable human being is extremely difficult, but very important. When I don’t have these moments I start to become dangerously depressed, sometimes to the point of suicidal ideation. Taking away my ability to share this experience with my family is taking away one of my best coping skills to keep myself from potentially putting myself into the hospital.

This is where understanding the emotional and internal experiences of food can go a long way towards understanding intersectionality and towards having compassion towards people who don’t have your privileges. It may seem insane to someone who does not have a mental illness to consider the idea that a delicious mocha could be part of combatting suicide. But when you’re in the experience, you understand that the little things are the most important. The danger of mental illness is real. Mental illnesses do lead to death, injury, and pain. When we ignore the intersectionality of mental illness and food, we go a long way towards removing some of the most basic resources that the mentally ill have.

For people not in these situations it might seem selfish to prioritize your enjoyment of a steak over the life of a cow. However one of the messages that’s incredibly difficult for those with mental illness to internalize is that our own self-care is important, and often integral to our health. Allowing ourselves to make the choice to eat something that nourishes us mentally as well as physically can be a huge step, and when we’re told to cut out many parts of our diet, we lose out on the ability to easily do this. Asking us to give up simple pleasures, or criticizing the arenas in which we can find joy is asking us to prioritize other things over our own ability to function or even our own life depending on our disease.

When you live with a mental illness, often your entire life becomes about survival. This means that choices which seem to be easy or low cost for others are choices about self-defense for us. Every time we choose something that brings us joy, support, or a feeling of safety, we are choosing our own life. When you tell a mentally ill individual that they should abandon something that helps them feel good, that they should feel guilty for eating something that makes them happy, it reinforces to us that we don’t deserve good things.

Food is incredibly personal and incredibly emotional. It can be used in intensely positive ways and intensely negative ways, and we don’t always get a choice in what foods bring up what emotions for us. For the mentally ill, this can mean that shame and guilt around food is even more damaging than it might be for any other individual, and can have serious consequences.

While many of us want to make our society better and healthier by encouraging good eating, ethical food choices, and positive food culture, it would do us good to remember that these conversations may have different consequences for someone struggling with a mental illness than for anyone else.

The Disgust of Dirty Food

Note: this post has a lot of thoughts packed together that have not been clearly pulled apart. I’m really intending to write more about this, and a lot of these thoughts are preliminary attempts to work through some ideas that I think are extremely important. Any insights are welcome.

 

In my DBT group we’ve been talking a lot about emotions recently: how to identify them, what they do for us, how to regulate them, etc. One of the emotions that we went over which was a little surprising to me was disgust. I suppose that somewhere in my mind I knew that disgust is an emotion, and actually a fairly common one, but as I looked at the prompting events of disgust, the physical symptoms of disgust, and the interpretations of disgust, I realized that disgust is a hugely important element of eating disorders, and that there is a wide body of literature that discusses some of the roots and backgrounds of disgust that never gets touched on in eating disorder treatment. It’s pretty clear that people with eating disorders often feel disgust towards themselves or disgust towards food, but what is disgust? Where does it come from? What purpose does it serve? And what can this tell us about eating disorders?

 

So what is disgust at its most basic? In general, disgust is the feeling we have towards things that might contaminate or poison us. Likely we evolved this feeling for a really good reason: to avoid things that would kill us if we ate or touched them. In many ways, disgust has to do with bodily boundaries. You want to keep the good things on the inside and make sure that the bad things remain on the outside. We are disgusted by things that break down our boundaries: things that can come in through our mouths or ears, things that come through our sexual organs, things that break our skin and leave us without a boundary, or things that can get inside our body through our skin in some fashion or other. The purpose of disgust is therefore beneficial: it can keep us safe from potential pathogens, from sexual fluids, or from things that may invade our bodies. We want to remain pure, because purity will keep us safe and keep our boundaries intact.

 

However disgust has expanded from these origins into moral and religious contexts. Particularly in the Abrahamic religions, this moral tint to disgust came from Judaic purity laws, which mixed together the disgust emotions of purity with other moral issues in order to strengthen both. Judaism extended conceptions of purity and boundaries from literal filth into things that they believed would keep them spiritually pure, as well as keep their society as a whole safe from contaminants. Holiness was equated with purity, because purity is health and safety. If you look at Leviticus or other law books in the Old Testament, most if not all the laws are about keeping different things from mixing together, or from keeping impure and bad things out. A clear example of this is that a woman on her period is expected to remain separate from the community, and anyone who touches her must ritually cleanse himself (Leviticus 5:19-20). In general, blood is considered a pathogen. It’s not something you want to touch. However in order to enforce that boundary, religious law was invoked to create an ethical and moral consequence to becoming impure.

 

So early religions often had purity concerns as a way to enforce this sense of disgust and keep individuals safe. However these purity concerns grew into much more than that, and they took the sense of disgust and expanded it to apply to anything that was considered unethical. Again however we see a lot of questions about purity. When someone lies, you are not likely to feel a whole lot of disgust (even if it’s about something pretty horrible). When someone is raped, or brutally murdered and mutilated, or even humiliated, we feel a great deal of disgust for the perpetrator. These are instances in which someone’s boundaries are violated, either literally with rape, or their body’s boundaries are destroyed in the case of mutilation, or their boundaries of self-respect and self-identity are violated in the case of humiliation. This might be part of the reason we find sexualized immorality more disturbing and disgusting than other sorts of violence or crime: because sexuality is nearly always associated with penetration of some sort.

 

So we have these conceptions of boundaries, and this idea that we need to keep certain things in and other things out, and when things get inside our boundaries or threaten our boundaries we feel disgust. What does this have to do with the disgust of an eating disorder? In my opinion, everything. Eating disorders are all wrapped up in the concept of disgust. If you’ve heard someone with an eating disorder talking about food or about how they feel after they eat, they tend to use words like sick, gross, icky, nasty. They are words that connote disgust. Many eating disorder patients act as if food is unsafe or will hurt them in some manner. These together seem to indicate that people who are avoiding food they deem disgusting to keep themselves safe are concerned with keeping their bodies pure.

 

Food is one of the few things in our lives that we have to put into our bodies. We feel disgust towards eating things that might be a danger to us, and many religions have put purity taboos on certain foods. Food is all wrapped up in questions of boundaries and what is acceptable to put into our bodies. Particularly in modern America, there is a narrative about good food/bad food, which paints certain foods as toxic. These could be foods with chemicals or foods with fats or foods with sugars, but the language around them generally labels them as poisonous. In conjunction with this, there exists the idea that women in general need to be pure. They need to be saintly. They must be morally good, sexually good, and they absolutely can’t let bad things into their system because it could ruin their beauty and worth. If you look at the sheer number of cleaning commercials aimed at women, you might have some indication of how cleanliness is apparently the basis of our self-worth.

 

For many people with eating disorders, the food becomes a question of worth, of morality, and of saintliness. The less you eat, the better you are as a person. The more saintly you are. The more pure you are. This rhetoric makes perfect sense in the context of disgust: we feel disgust at things that come inside us, at things that are foreign in our bodies. If you begin to identify food as something foreign that you can choose to let into your body or as something that you can keep out, you begin to think that you can keep yourself safe, just as religions with certain food rules do, by keeping the bad things outside of your body and by being in control of the boundaries of your body. That sense of bodily integrity is one of the most important feelings of control that we get as human beings. The most important thing we can control is how our body interacts with the world around us: what we put in it, how we keep others out. These are the most important for our safety, as well as for our sense of individual identity. When these things are violated, of course we feel disgust. And when you’re barraged with the idea that the world outside of you is dangerous, dirty, and bad, and that you need to be clean, this feeling of disgust can get out of control.

 

If an individual is feeling as though their boundaries are violated often, or they feel as if they have no control over the safety of themselves as an identity or as an individual, they may take radical action to make themselves feel safe by keeping out the bad. This can take the form of an eating disorder. And the feedback loop on it is strong: you feel disgust towards something, you don’t eat it, and you feel safe and secure because you didn’t die. This is also given a moral element by stories of asceticism. Keeping the whole world out of your body has come to be equated with spirituality, with purity, and with saintliness. It apparently makes you better than other people if you keep your body clean from anything associated with the world (because the world is dirty). Restricting taps into this cultural conception, and allows you to feel morally superior for every time you skip a meal. It also tells you that you’re protecting yourself from anything that is unclean or dirty.

 

We don’t often think of America as having a strong purity culture, and our purity rules are not clear: we have a variety of different rules that are not always consistent. It’s no surprise that many people feel confused about what is appropriate with food and purity. It’s no surprise that with all the shaming that happens around food, some people feel that the only way to be safe is to cut food out entirely.

 

I believe that there are important insights to be gained from the disgust towards our own bodies as well, and that these might have ties to sexuality, sexual morality, boundaries, and the world as dirty. I’m hoping to do two follow up posts to this one, on identity and purity, and on sexuality and purity.

Follow-Up: Further Thoughts on Self-Harm

Ok, this is not going to be a well thought out or organized post, but I’ve had a lot more thoughts since the previous post about self-harm and I’d like to just throw some of them out there:

Tim brought up the interesting point of stigma being there because self harm necessarily involves harm. I think this is potentially true, however I think there are two important things to consider about this:

1.What constitutes harm?

I posed this question on twitter: would you consider a cut to be harm? Many people answered not necessarily, and that it depended on how serious it was. Let’s take a couple of examples-

a.You’re walking in the woods and you accidentally run into a tree branch. It scratches you/cuts you and you bleed a little. You shrug it off and you continue walking through the woods. You get home and everyone probably ignores it. Few people would say that you had been harmed, unless they take a definition of harm that suggests ANY pain is harmful.

b.You intentionally cut yourself and you bleed a little. You shrug it off, and go downstairs. Everyone freaks out and asks you why you would harm yourself. Are we sure it’s more harmful in this case?

I would propose a definition of harm that generally includes keeping someone from doing what they want to do, or keeping someone from functioning in their life as they so choose. Some people might include subjecting someone to any amount of pain in this definition, but I’m not sure I would go that far.

2.There are other things that we do, which we believe are good, which necessarily involve harm. Most medical care falls under this heading. Therapy. If we include pain in the definition of harm then every time you work out you’re harming yourself (my new argument to be lazy!). So while there may be a distinction between say rock climbing and self harm (it perhaps wasn’t the best example, although I do think that rock climb automatically comes with some pain), there are other examples we could look at that are praised when we do a cost/benefit analysis and decide that the necessary pain is worth it.

Beccy mentioned that there is a good deal of bias against self-harm and so it could be harmful to cut simply because of the attitudes of other people and the crap you’d get from them. Also an important consideration, I think generally subsumed under the first point I made in my other post. I personally would tend to weigh this slightly lower because I don’t really care too much about the opinions of people who are biased against those with mental illness.

So what do you think? How is self harm similar to and different from other forms of harm? What about BDSM? What constitutes “harm”? Does a small cut really count as harming if it does nothing to impinge on someone’s life?

What’s the Harm in Self Harm?

MAJOR TRIGGER WARNING: self-harm and suicide

 

My dear friend Elly/Lux/awesomepants mcgee posted a really interesting question on Facebook earlier today, and I was of course compelled to answer and then blog about it. She asked “This might just be due to my fucked up brain, but am I the only one who doesn’t see non-suicidal self-harm as an entirely bad thing?”

 

And oh my do I have Thoughts about this one.  Most people shudder and get extremely freaked out by the thought of self-harm. That’s completely understandable, as it goes against our most basic instincts: stay alive as long as possible and avoid pain. It’s confusing and sick to many people why someone would want to hurt themselves. However there are some good reasons why some people self-harm. Self-harm is a coping device. It can help you to feel in control again when the world feels out of control, it can numb pain or provide the only sensations when you are feeling numb, it can be a form of self-punishment when you’re feeling guilty and assuages those feelings, it can be a release when you’re feeling too much to handle, it can help you feel more clarity, it can relax you and relieve anxiety…there are all sorts of reasons why someone might want to hurt themselves, and the end goal of pain and injury is rarely the root cause.

 

So self-harm serves a purpose. It can be very helpful for people who are struggling. It can be what gets them through the day. If the injury that they cause to themselves isn’t serious, what’s the problem? We wouldn’t be getting this upset if they tripped and scraped themselves up. The person isn’t in danger, they aren’t damaging themselves, most of the time the cuts won’t result in any sort of health risk, they aren’t impacting their own quality of life (in fact they’re likely trying to improve their quality of life), so what’s the downside?

 

Well there are a few things to consider as the downsides of self-harm, and that would impact your health and quality of life.

 

1. It makes relationships hard. People who care about you don’t want to see you hurting. Generally if you’re using cutting or self-harm as a coping strategy, it means there’s something that needs to be coped with, and so the people around you become worried and anxious about how you’re doing. They want to help and solve the problem, but they’re also hurt by the fact that you’re hurting. This generally means that you get secretive about it. It can lead to lying or hiding, and you also tend to isolate when you self-harm because you think you have your problem under control and don’t want anyone to take away your coping mechanism. People can become very defensive when they think someone might take away their ability to self-harm, and they also feel judged. Overall this leads to a loss of communication, a loss of openness, and a loss of relationships.

2. There is ALWAYS the potential to do more damage than you intend. No matter how careful you are, no matter where you cut, there is always the potential that your hand slips or something happens and you land yourself in the hospital. When you self-harm, you are always putting yourself at risk in an extremely direct way. You are literally trying to get as close as possible to serious injury or death without quite moving past the line. Now many things in life involve risk, but generally we see things in a cost/benefit analysis way and weigh the risks with the benefits. It’s very possible that there are less risky ways to get the same benefits.

3. It rarely deals with the root of whatever you’re trying to cope with. It’s more of a band-aid than a fix, because it doesn’t teach you the skills to solve your problems. Whatever situation is making you feel like you need to hurt yourself will not go away because you hurt yourself. In many ways, it might exacerbate the problem because it allows you to tolerate for a longer period of time instead of changing the bad situation that you’re in. It’s a strategy that allows you to handle whatever is going on without working on whatever is going on. If you need a fix to get you through something you can’t change, then it might be very effective, but in the long run it’s not.

4. It usually escalates. Like anything else that gives you a kind of a high, you begin to get numb to it. Whatever adrenaline you might have gotten from a few scratches before dulls as your body gets used to it, and now you need to cut more or deeper in order to get the same relief. And the more you escalate, the higher your risk of serious injury or suicide is. Just like drugs or alcohol or whatever, you go further and further, and I think that for many people it does become addictive or obsessive. I know some people who can’t fathom going a day without cutting. When you can’t live without your coping mechanism, it probably is not actually helping you cope anymore. When it has lost its function, it’s simply unnecessary risk.

 

So there are clear benefits to self-harm. You get calm or relief from it, it helps manage emotions, and it can be a way to get through a difficult situation without breaking down. However there are also a lot of risks and downsides to it, like potential serious injury and lack of long-term effectiveness. Given these pros and cons, I think that each individual should be left to their own devices to decide if the pros outweigh the cons for them (up until the point it becomes seriously dangerous). What doesn’t make entire sense to me is the out of proportion reaction that many people have to self-harm. There are all sorts of hobbies that are risky and dangerous. Take rock climbing for example, which is also something I do and love. It’s probably at least as dangerous as self-harm, and doesn’t directly provide benefits in the same way that self-harm does (I mean it is good exercise and good stress relief, but it’s not nearly as effective as self-harm). There is no logical reason why people should see self-harm as inherently worse than other potentially dangerous hobbies and practices, but there is a huge stigma against it. Despite the fact that there are downsides to self-harm, they don’t warrant the panic that seems to appear at the mere mention of self-harm. It’s not inherently worse than any other injury or risk simply because it’s self-inflicted.