Sometimes I look back on my youth and wish I’d had more problems. Been raised in a war-torn country, sent scavenging for food on the streets. That way, whatever else I’d endured, at least I’d have avoided suffering an eating disorder. As it is, I’m stuck being the kind of narcissist who wastes decades of her life on anorexia and bulimia (still, unlike some I know, I’ve not yet been self-centred enough to starve to death).
At least, this is the impression of eating disorders given by Joan Bakewell in a recent interview, in which she suggested that anorexia among young people “arises presumably because they are preoccupied with being beautiful and healthy and thin”. “No one,” she argued, “has anorexia in societies where there is not enough food. They do not have anorexia in the camps in Syria. I think it’s possible anorexia could be about narcissism.” Thanks, Joan. Good to know we only put ourselves through it because we’re worth it.
In fairness to Bakewell, I don’t think her viewpoint is particularly uncommon. For instance, Julie Burchill once made a similar argument, only using the image of a desert island rather than a Syrian camp. Some former sufferers have themselves come close to saying the same thing. The actress Celia Imrie has described anorexia as “a selfish illness”: “It takes incredible willpower to stop eating, but I am proof that the same strength of character can get you out of it, too.” As though those who remain stuck in the mire really must try harder.
It’s a view of anorexics I’ve even encountered in the medical profession, too. I was first hospitalised in the late 1980s, when treatment was still punitive, based around force-feeding and the withholding of privileges, such as books or visits, subject to weight gain. Placed on an ordinary children’s ward, I was routinely reminded by members of staff that none of the other patients had brought their illnesses on themselves. I’m not sure whether I was expected to say, “Yeah, actually, you’re right”, and promptly head out for a cheeseburger, but, needless to say, it didn’t work. Anorexia is a complex illness. To expect sufferers not only to fight it, but to offer a moral justification for having developed it to begin with, seems to me unfair.
Perhaps to some people, anorexia cannot be a 'real' illness because young women lack the depth and complexity required to know 'real' suffering. They can be dying before our eyes and still we’ll dismiss them as vain
Following complaints from eating-disorder charities, Bakewell swiftly apologised for her comments. I think she is right to do so. While it is neither illogical nor unnatural to feel bafflement, doubt and even resentment when faced with sufferers of mental illness, these are feelings we need to challenge internally or, failing that, keep to ourselves. The image of the anorexia sufferer as just some spoilt, vain little girl who refuses to grow up has had a genuine impact on the care that many sufferers have received. To diagnose narcissism from afar risks doing genuine harm.
It’s not just that this is a misrepresentation of sufferers, who do not all meet the stereotype of being young, white, middle-class and female. Plenty of sufferers remain just that and it is no excuse to withhold sympathy. Indeed, it has often struck me that both youth and femaleness are associated not with privilege, but with having one’s feelings trivialised and not being believed. Perhaps to some people, anorexia cannot be a “real” illness because young women lack the depth and complexity required to know “real” suffering. They can be dying before our eyes and still we’ll dismiss them as vain.
Still, the question remains: would I, and countless others, have developed anorexia if we’d grown up in a different place, at a different time? Would I have wanted to starve myself even if feasting had not been an option? I think the answer to this is “probably not”, not that it really matters. Of course, mental illnesses develop in particular environments, in response to particular stresses, manifesting themselves in different ways in accordance with the outlets we have available. Does that make them any less real? I don’t think so. To muse on whether the anorexic on a desert island continues to be anorexic in any meaningful sense seems to me just some cruel, pseudo-philosophical self-indulgence.
I’m not in a position to tell you what the “real key” to my anorexia was. Nor can I tell you that I’m most definitely not a narcissist. But what I can say is eating-disorder sufferers need support, not condemnation. It’s the least we can offer.