In 12th-century China, an odd form of willful self-torture gained ascendance: the foot binding of girls and women. For almost ten centuries, mothers willingly broke their children’s toes, bent the foot double and bound it with a strap. The result: a miniature foot that was the only way for a subjugated gender to marry into power.
Today we can look back and understand why the women of ancient China mutilated their feet to try and obtain respect in an oppressive, male-dominated culture. Foot binding was just one of many social conventions utilized to increase a person’s status. But in contemporary U.S. culture, people who intentionally hurt their bodies are not extended the same understanding — rather than being considered “elite,” we are called “insane.” We may starve ourselves or carve ourselves, taking to the extreme culturally-embedded norms like thinness in an effort to fight against marginalization or cope with internalized shame. But instead of obtaining the voice or place in society we yearn for, we are further ostracized.
Susan Bordo has called the body a surface on which the rules, hierarchies, and metaphysical ideals of a culture are inscribed: bodies are a direct “locus of social control.1” For people who grapple with emotions, personalities, thoughts, and ways of being which fall outside the range of what’s considered “normal” in Western society, the struggle to be viewed as citizens deserving of an equal voice and rights can sometimes play out on our bodies, without us quite realizing it.
For me, this ongoing struggle has played out most visibly in starvation and, more intermittently, self-harm.
Psychiatry likes to use medical discourse to turn emotional and existential pain into pathology, branding differentness as “biologically-based mental illness.” As a result I’ve been slapped with a variety of DSM labels over the years, such as “anorexic,” “major depressive” and “treatment-resistant.” However, as feminist and constructivist social psychologists have noted, ruling classes often pathologize or criminalize individuals who are different because our nonconforming behaviors threaten these groups’ powers. Branding non-conformers as “crazy” is often a handy way to obscure the dominant ideology and status quo that ruling classes are trying to protect.2
A recent incidence of self-harm brought into sharp focus how, since acquiring the “master status” of “severely mentally ill” over a decade ago, I’ve turned even more to my body to try and cope with the lost opportunities and status that the erasure of my former, “normal” identity has wrought. Subconsciously, I started allowing mental health labels — and thus dominant groups’ oppression — to take control of my life and my narrative, never realizing I had a choice in the matter. As a person who’s always placed primacy on being an active, contributing and self-sufficient member of society, the seeming loss of agency over my life has brought excruciating existential pain.
The story I’m about to tell, which occurred about a month ago, is about how an act of self-harm I originally perceived as a strident shout that “I’m still here, and I’m still worth listening to,” was anything but. It’s a story of how I came to realize that in trying to be heard — and deal with my emotions — by continually abusing my body, I become an unwitting collaborator in my oppression.
By turning to a healthy outlet (this page) I stumbled upon epiphanies: the parallels between self-harm and anorexia and how, if I continue to resort to these forms of “speaking,” I will continue to be complicit in my own subjugation, just as a millennium’s worth of Chinese women were when they willfully and painfully mutilated their feet to obtain a “status” that was entirely illusory.
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First, a little context:
For most of my adolescence and early adulthood, my “anorexia” was fairly mild and existed on the fringe of my life; it waxed and waned, serving mostly as a tool of emotion regulation for a person who struggled with intense emotions, low self-esteem, a more popular twin sister, an artistic bent and a seeming inability to ever quite meet society’s criteria of “normal” or “success.” The eating disorder was also linked to my former career as a competitive long-distance runner. In the two latter senses, then, anorexia was the social currency that allowed a girl who could never fit in to “succeed.”
In 2004, while working as a reporter at a small newspaper in Oregon, I entered a treatment center in a proactive attempt to prevent what was becoming more of a problem from spiraling out of control and derailing my life.
That decision turned out to be the biggest mistake of my life.
The dehumanizing, infantilizing, and shaming treatment I endured, combined with the multiple DSM labels permanently emblazoned on my chest — scarlet letters announcing to the world my depravity — ignited a decade of cycling in and out of treatment programs where my identity was increasingly reduced to a walking knot of pathology. Back then, I didn’t question the labels; I didn’t know that the doctors and family members who kept telling me I should enter inpatient care might be wrong. I didn’t realize that the way I was being treated for 12 years was what was making me sicker each time I got out.
My anorexia now serves a function quite different than it did originally (as does my occasional self-harm, which did not begin until I was in treatment). It is now more an expression of the self-hate and shame I harbor as a marginalized, worthless member of society: an unemployed, chronically “mentally ill” person who seems not only a failure at life in every conceivable way, but a heavy burden to her family. When engaging in self-harm, it, like my anorexia, is my way of saying I not only feel undeserving of life and nourishment, but that I feel very deserving of punishment.
Yet simultaneously, my anorexia and self-harm are also subconscious attempts to be seen and heard — in a society which no longer recognizes me as a valued citizen — by shouting, through my body, “Listen to me, because I am not ok.” The two behaviors intersect in that they both express a futile attempt to exert agency over my life in a world where I am consigned to a marginalized minority group. And, embarrassingly, within the anorexia still lingers vestiges of a superficial attempt to be “successful” in at least one remaining way: by being “thin.”
It came as somewhat of a shock when I found myself engaging in a prolonged and rather extreme act of self-harm one recent Friday night, as it was the first time this behavior had occurred in two years. In retrospect, I realize the feelings that led to it had been building for months. They took root when I was denied a speaking opportunity at a major eating disorder conference in May, and were exacerbated after I started publishing a series of investigative articles about the eating disorder “treatment-industrial-complex” on my website. While thousands read the stories, and hundreds of former patients thanked me for raising the curtain on this issue, the treatment industry itself – and the advocacy organizations which fund them – returned my meticulously-researched stories with silence. No major news outlets picked up the story; no public health or regulatory agencies voiced concern; no legislators responded to my calls for reform.
Combine the returning feelings of disempowerment with extreme financial stress and sleep deprivation and I was near my breaking point. But what really sent me over the edge, that Friday, came from a “friend.” A long-time, “socially progressive” friend who considers himself a champion of social injustices, and who wrote to me about the frustration I’d expressed that many people close to me weren’t reading stories I’d poured my heart into.
My (now former) friend said I can’t expect people to be interested in writing of such a routinely “dark” nature. In a day and age where the media reports hourly on stories of human suffering, I can’t expect people to be eager to read more of such “harsh truths.” He then went on to list a litany of evils the media bombards us with — things like ethnic cleansing in Darfur, and the plight of children in war-torn Syria. Thus implying that 1) my struggles pale in comparison, and 2) the fact that he “cares” so much about these social injustices absolved him from lifting a finger to help redress the social injustice experienced by someone he actually knows. He then slipped complacently back into his white, upper-middle-class and privileged life to enjoy a Friday evening with his wife and two children, inside his expensive home.
I, on the other hand, spent my night beating, burning and starving myself. I did this for hours as I sobbed — in howls befitting the depraved being I felt this man and the general public think I am — in a closet I had locked myself into, trying desperately to find some way to express the unbearable emotional pain and existential meaningless I’d allowed my friend’s words to engulf me in.
When I woke up Saturday morning, those emotions had begun to transmute into anger. I spent the rest of the day composing a carefully constructed rant, which I posted on my website along with two photos of the bruises and burns I incurred. For an entire feverish day I tried to write my way out of the pit of shame, self-hate and hopelessness I had let my friend’s remarks send me plummeting into.
The post (which I later took down, and kept hidden from my friend) admonished him for denying my right to have my experience as an oppressed, “mentally ill” individual heard, pointing out the hypocrisy of supporting other civil rights movements but not supporting mine. Make no mistake, I am enormously inspired to see the gains being made in the U.S. today by movements such as #BlackLivesMatter or the fight for transgender acceptance, and I truly admire the movements’ leaders. But, I asked in my initial blog post, how is raising awareness about the way in which society treats people like me any less deserving of notice than the “dark” and “harsh” truth of how other minorities are living and dying?
I explained that, through my stories, I was narrating an equally legitimate tale of oppression and, moreover, that giving voice to this tale is the only thing keeping me alive.
“We are the true lepers of this country, America’s ‘untouchables,’” I wrote. “All I want is merely the opportunity to have the same things you take for granted. I want to be considered just as legitimate a citizen as you are, instead of the 3/5 of a human being I’m pretty much considered today.”
I asked my friend to consider whether he is “Sanist,” so to speak — someone who tolerates every form of human diversity except diversity of the human mind. I believe this is what most of the U.S. population is today: unapologetic Sanists. And the worst part is most people don’t even know they harbor this prejudice.
Foucault, who influenced Bordo, states that society’s ruling classes do not maintain power by wielding it from above, but instead through the subtle practices of daily life which regulate our construction of space, time, desire and embodiment. “There is no need for arms, physical violence, material constraints,” Foucault said. “Just a gaze. An inspecting gaze. A gaze which each individual, under its weight, will end by interiorizing to the point that he is his own overseer, each individual thus exercising this surveillance over, and against, himself.3”
I think it is valid for me and others to talk about the oppression we experience as members of an invisible minority group, and to ask our friends and colleagues to examine whether they — however innocently and unintentionally — might harbor subconscious attitudes toward the “mentally ill” which play into our stigmatization. Because I think it is fact that we live with the only form of prejudice that is completely sanctioned, and never questioned, by nearly every sector of American society.
I think it’s critical to ask people to consider this form of unintentional prejudice, because the ways in which people act (or fail to act) as a result can make them complicit in our oppression. And unless unfounded beliefs about the “mentally ill” change, people like me will never have the privilege of reaping the opportunities that “normal” citizens do. It’s also important because the denied opportunities the “different-minded” are forced to live with can exacerbate the painful aspects of our interior experiences (depression, for example), resulting in reliance on unhealthy but seemingly necessary coping mechanisms — or in worst-case scenarios, even suicide.
Many of us “mentally ill” individuals eventually realize that people of all political persuasions often have a narrow, binocular vision — an unconscious shudder response — with us, because when we speak and act in ways that run counter to conventional norms, it scares them. It’s scary because it challenges not only the status quo but the values by which most of the Western world defines itself. Therefore much of the Western world automatically mutes and marginalizes us — branding us with diagnoses, locking us up in prisons or psych wards, increasingly limiting our rights — in order to shield ideologies they prefer to leave unexamined.
I believe, as Aldous Huxley once wrote, that it is society that is “profoundly abnormal,” not us, and that it is an extreme form of injustice to reduce the psychologically different to pathologized beings who are considered unfit to fully participate in the most powerful sectors of American life, including employment and politics.
But it wasn’t until I started writing this piece that I realized I have to own up to my own complicity in my oppression as well.
I originally posted the photos of self-harm because I wanted the world to gaze upon a visible symbol of the invisible pain and self-loathing I experience as a member of a disenfranchised minority group. But I have since come to realize it was not the outlet of self-harm or its visible results that enabled me to climb out of my pit of self-loathing, much less find an audience receptive to discussing “Sanism.” It was writing about my anger and oppression that provided the first, tentative steps toward renewed emotional stability as well as liberation from my internalized and externally-imposed prejudice.
Perhaps, back when I was trapped in the eating disorder treatment system and living in a highly-controlled, emotionally abusive environment, self-harm was at that time a regretful but necessary behavior that allowed me to hold onto some shred of my former self, fight against my oppressor, and affirm my right to define myself and be heard, through the only means that seemed available.
But I live in a more free environment today. Things have changed.
Now that I am outside that treatment system, when I intentionally hurt myself — whether it’s through self-harm or anorexia — I become an unwitting collaborator in my oppression. In effect I affirm, by such acts, society’s ostracizing of me. I let the powerful people who say I’m “less-than” win; through such behaviors I agree with them, even if I don’t realize it at the time. Most people who’ve engaged in anorexia know that it can produce feelings of being in control; the excessive restriction feels like an act of power and self-mastery, because you are demonstrating a degree of willpower few can sustain. One often feels, as Bordo aptly captured it, “untouchable, invulnerable, liberated.” But she also wrote, “to feel autonomous and free while harnessing body and soul to an obsessive body-practice is to serve, not transform, a social order that limits [our] possibilities.”
When the different-minded express our marginalization by resorting to anorexia, self-harm, substance abuse or other hurtful behaviors (“pathology as embodied protest,” as Bordo puts it), these behaviors undermine the goal by rendering our bodies fragile, weak and abused. An unwillingness to express oneself directly through words, or civil protest, results in an “inchoate, counterproductive protest” — the attempt to be seen ironically results in producing a body (and agenda) that is increasingly un-seeable.
Bordo emphasized that power is “constitutive” — it requires voluntary participation by both subordinator and subordinated to maintain. Power, she wrote, is not merely possessed by one group and leveled at another; inequality remains entrenched only in so far as the disenfranchised voluntarily buy-in to society’s normative practices and thus, our subjugation.
So I now realize I have a responsibility to take steps to empower myself, and to no longer be complicit in my oppression: to start, by taking steps to end my self-harming behaviors. And to stop “buying in” to the messages that those who hold prejudice toward the mentally ill direct toward us — not letting them fuel my self-hate and hopelessness.
Those of us who have extricated ourselves from traditional psychiatry can now choose which labels we want to be called by, can write our own identities, and — perhaps most importantly — we can choose how to be heard and how to fight for our civil rights. In other words, we can choose to do so in ways that are self-affirming and healthy, rather than self-abusing, as that will help not only ourselves but will far more effectively advance the fight for civil rights.
One healthy way to fight and move beyond oppression is to re-write the “master narratives” that Western psychiatry (and society) have tried to impose on us. In Beyond Anorexia, Catherine Garrett demonstrated — based on a qualitative study of more than 30 women in recovery from the disorder – how re-storying can be a powerful way to resist the dominant narratives traditionally used to reduce us to a bunch of diagnostic codes.4
Most of the women in Garrett’s study achieved recovery because they created new narratives to make sense of their personal history, current inner life, and the world at large – narratives which represented their lived experience rather than the deficits psychiatry told them they possessed, and narratives which drew on the great myths of humankind. These women “developed their own healing methods to recreate what was destroyed by trauma. Traumas resulted from oppressions of class, race and homophobia; so it took political, economic and social solutions to make recovery possible. Narrative helped participants place their experience in a wider framework.”
In a world still dominated by Sanists but where alternative paradigms of “mental illness” are nonetheless gaining slow, but increasing, acceptance — particularly in forums such as Mad in America — we all have the opportunity to re-write ourselves, to resist our oppression in healthy ways. And that is what I am attempting to start doing now, as I inscribe, here, symbols on a page, instead of carving them on my body.
And I call, just as urgently, on those of us who identify positively as “Mad,” ex-patients, psychiatric survivors, ex-inmates, or other similar terms, to unify in a more cohesive fight for civil rights. Like the anti-psychiatry, Mad liberation and disability rights movements of the 1970’s, we should follow in the footsteps of pioneering activists like Judi Chamberlin, Leonard Roy Frank, Howie the Harp, and Eleanor Riese, take to the streets, raise our voices and fists, and demand the “normal”-minded afford us the same opportunities and rights they afford themselves.
As Patrick Corrigan, who helped found the National Consortium on Stigma and Empowerment, wrote at the conclusion of a 2005 book, invoking Dr. Martin Luther King, Jr.’s “I Have a Dream” speech:
“Some readers might blanch at using Dr. King’s noble verse to make sense of the vision needed to overcome mental illness stigma. But for many advocates, the prejudice related to psychiatric illness is no less insidious or heinous… I dream of a time when people are judged by the merit of their character, not by the diagnosis in their chart or the symptoms with which they struggle.5”
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1Bordo, S (1994). Unbearable Weight: Feminism, Western Culture, and the Body. Berkeley and Los Angeles: University of California Press.
2Brown, L. and Ballou, M. (1992). Personality and Psychopathology: Feminist Reappraisals. New York: The Guilford Press.
3As quoted in Bordo (1994).
4Garrett, C. (1998). Beyond Anorexia: Narrative, Spirituality and Recovery. Cambridge, U.K.: Cambridge University Press.
5Corrigan, P. (2005). Mental illness stigma as social injustice: Yet another dream to be achieved. In P. Corrigan (Ed.), On the stigma of mental illness (pp. 315-320). Washington, DC: American Psychological Association.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.
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