THE ARMORED SELF: The Symbolic Significance of Obesity Stefanie Solow Glennon, Ph.D. (This paper appears as a chapter in "Hungers and Compulsions": The Psychodynamic Treatment of Eating Disorders & Addictions", Eds. Jean Petrucelli & Catherine Stuart, Aronson, 2001) While much of the psychoanalytic literature on compulsive eating has addressed the defensive function of the activity of eating and/or binging, less attention has been paid to the psychodynamic meanings of the oftimes resultant fat. In the material that is to follow, I will attempt to show how the symptom of obesity unconsciously serves to symbolically protect the psyche from feared penetration and annihilation. Philip Bromberg (1991) has said that “It is in the nature of the human condition that the experience of “insideness” helps to protect the self from excessive external impingement.” I find myself fascinated by the notion of a self in need of protection from “excessive external impingement.” What does this mean? What is the actual danger that is feared and protected against? Bromberg and others speak of the self or psyche protecting itself from being overwhelmed by affects it “knows” cannot be processed or integrated. That somehow if allowed access to center stage, these affects could annihilate the self. But again, what can this mean? What sort of death or annihilation is being avoided through the defensive maneuvers that we observe so frequently in our offices. Freud’s ideas (1895) about the overstimulation of neurons and their capacity to go on over-load and become dysfunctional is appealing in this context and gives some 1 credence to his conclusion that the psyche is always seeking equanimity, quiescence, safety from electrocution - so to speak. This paper will focus on ways in which the self seeks protection from” excessive external impingement” through the erection of a fat barrier as a symbolic boundary as well as through the more commonly understood act of anesthetizing and shoring up the internal self through the compulsive ingestion of food. In addition I will address the unconscious defensive function of the meanings of being fat that I have repeatedly seen in my practice. It is often thought that compulsive eating and obesity are synonymous. They are not. Although compulsive eating frequently results in varying degrees of overweight, there are patients who do not need to be fat, or are afraid of being fat, who either purge after binges or return to eating normally or sparingly and so never get heavy. These people do not have a need to be fat or, put differently, do not possess a fear of being thin which I have seen in my practice over and over again. Even patients who are afraid of being thin can, after considerable analytic work, frequently differentiate the times that they are binge eating to anesthetize themselves from the times that the eating has been stimulated by some occurrence in their lives that kicks off their fear of getting thin or need to be fat. In other words I am making a distinction between the act of eating as anesthesia and the act of eating unconsciously designed to produce fat and I have found this distinction to be an extremely important one in my work. It has now happened in numbers of cases of long term intensive analytic treatment that patients have lost 30-50 pounds, still have another 30-50 pounds to lose, have been stuck in the weight loss place for a few years, but no longer binge eat, i.e. the eating disorder in that sense is no longer present. They each had never before, even in childhood, been the same weight for any length of time. It was always either gaining or losing, but never maintaining. The work is now focused upon their fear of being thin and they are once again losing weight. One of these patients recently exclaimed, “I could no more cook up a pound of pasta and eat it than I can go to the moon. I am no longer a binge eater!” 2 As stated previously, the act of eating obsessively, as differentiated from the need to be fat, not unlike other obsessive-compulsive behaviors, serves to ward off anxiety, to anesthetize the person to what they unconsciously and sometimes even consciously fear are potentially overwhelming affects that they cannot metabolize, to use Eigen’s (1992) terminology. A patient this week found herself in the subway shaking, feeling extremely pressured and anxious and so stopped to buy a large bagel and two huge cookies. She then described feeling as if she had taken a Valium. One woman has been able to get in touch with a voice inside her that says at such anxious moments, “I gotta eat, I gotta eat” and finds herself in front of the refrigerator indiscriminately taking in anything to push down, or numb the feelings. With each patient the sources of anxiety, the specific affects that are feared (anger, sexual desire, envy, a fear of being envied, competition, a fear of being competitive, etc.) are of course different based on their unique psychodynamic histories. But how does obsessive eating quell anxiety? Patients can fairly readily get in touch with an awareness that they are eating to “push down feelings.” What does this mean? It seems to be a metaphoric representation of affects concretized and able to be physically pushed and kept down and out of awareness by the actual press of food. In addition there is also the metaphoric representation of food filling an internal emptiness or shoring up the “self” by filling the stomach with the food as symbol for nurturance, love, strength, even passion. These phenomena reveal a fascinating interplay of the concrete and the symbolic. The shared symbolic or metaphoric meanings of fat and being fat that I have found in my work may be the major contribution I can make in furthering your understanding and efficacy in working with eating disordered patients. One young woman said about her compulsive eating and intermittent obesity, “The fat barrier protects me from me and me from the outside world.” If we stop and think about this statement it might be a good jumping off place into the part of this talk that I most eagerly want to communicate and which is most difficult to 3 articulate. To quote her again, “the fat protects me from me” (the anesthetic function of eating-keeping feelings down and out). That is, the anesthetic function of eating keeps feelings down and out, and the resultant fat symbolically provides protection from occurrences that threaten to kick off feelings that could be overwhelming or annihilating. I am suggesting that there is a metaphoric or symbolic way in which the literal, concrete fat exterior of the body, a thickened outer layer, if you will, is experienced by the person as a thickened outer layer of their psyches. Now, this cannot be literal, it is clearly irrational. They are speaking metaphorically for sure, but it feels literal and we as therapists “know” what they are talking about. The internal experience of self feels overwhelmable by affects. Many patients who have been violated sexually, physically or psychically (through invasive, narcissistic parenting) are ever watchful of their outer barrier, their moats against further penetrations. Their psyches frequently accomplish this mechanism of defense by coating their bodies with fat so that they symbolically experience themselves, their psyches, as reinforced, impenetrable and are therefore able to go out into the world in their armor of fat. Now if we think about this mechanism, we can clearly see that it is a symbolic representation of a desired inner state of protection. Fat cannot literally protect one’s psyche, but it feels like that -unconsciously. I often find myself picturing a one celled animal, a paramecium or amoeba whose boundary or protective membrane is in danger of being punctured and its life contents in danger of spilling out. I once saw a film of such an organism as it recoiled from a needle probe and it is my experience that the interpretations that I make with this metaphor in mind have been the most powerful- are virtually always understood and responded to by the patient and produce a bonding between us based on my having articulated something for them that they have always “unthought known”. (Bollas,1987.) 4 It is intriguing in this context of speculating the existence of an internal “onecelled psyche” to think about the following quote of Richard Feynman, the nuclear physicist. Feynman (as quoted in Gleick 1992) was asked if all scientific knowledge were lost in a cataclysm, what single statement would preserve the most information for the next generation of creatures? How could we best pass on our understanding of the world? He proposed, “All things are made of atoms- little particles that move around in perpetual motion, attracting each other when they are a little distance apart, but repelling upon being squeezed into one another.”Is it possible that our psyches operate similarly, like atoms being attracted to and needful of one another, but requiring the necessary distance or boundary to survive, remaining always vulnerable to the intrusion of noxious affects produced by noxious, interpersonal happenings in our lives, dissociated affects that do not fade, do not go away, that may, according to Alice Miller (1990), live in our cells? Interpretations that are informed by this way of thinking frequently lead to the patients’ understanding the irrationality of their behavior, why they do what they do when consciously they so desperately want to be thin, to wear lovely clothes, engage in physical and sexual activities, i.e. to have a normal life. However, like with all interpretations, they may be accurate and may make intellectual sense to the patient, but cannot be integrated until the fear of the attendant affects and fear of being overwhelmed by affects is lessened. And, as with most patients, this mainly occurs through an in vivo, affective experience with the analyst. In this connection I think of Ed Levenson’s quote (1993), “Ultimately, the patient does not learn from us how to deal with the world. The patient learns to deal with us in order to deal with the world.”I also have found Winnicott’s The Use of the Object (1969) and Fear of Breakdown (1974) papers to be especially useful. Many of my patients have in fact experienced a severe trauma that constituted a breakdown in the psyche that they have already lived through but are terrified, unconsciously, that affects surrounding that trauma will be kicked off 5 again, or emerge full blown for the first time and be overwhelming. And this is the unconscious raison d’etre for the need of some of them to anesthetize themselves from their affects and to coat themselves with fat as a symbolic protection from reexperiencing the old traumas. The psychodynamic, defensive function of blocking affects, either stuffing them down with food, or symbolically protecting oneself psychically with a fat barrier serves, as I’ve now said numerous times, to protect the psyche from feared affects or invasions that will kick off affective responses. But when the affects are successfully defended against or are never allowed to “formulate” a la Donnel Stern (1987) the person is left with a depleted inner life and frequently feels and is experienced as “deadened”. Ogden (1997) writes about this in his recent book. He says,although not specifically about people with eating disorders, “..........I believe that the analytic task most fundamentally involves the effort of the analytic pair to help the analysand become human in a fuller sense than he has been able to achieve to this point. This is no abstract, philosophical quest; it is a requirement of the species as basic as the need for food and air. The effort to become human is among the very few things in a person’s life that may over time come to feel more important to him than his personal survival.” And to become “human” means to be more affectively responsive, more able to be in the present. Andre Green (1996) has said that there is in all of us, along with the need for self protection, a desire/drive toward experiencing. And experiencing, after all, means affects. Without affects there is no experience . Mike Eigen (1992) says “Our productions far outstrip our ability to handle them. We are taxed by the inner and outer worlds and must grow capacities to handle our creations.” And Bion (1963) notes that ”The human race is ill-equipped to tolerate its own experiential capacity.” Thus we see our patients, eating disordered and others, utilizing whatever mechanisms are available to them as defenses against, feared to be lethal, affects, but paying the life robbing price of feeling unreal or deadened in the present. 6 Clinical Illustrations: An obese woman, about seventy pounds overweight with whom I am working 3x a week (once in group and twice individually) for 3 years, in a session begins to tell me about not having yet heard the outcome of a job interview. For perhaps the tenth time she tells me how much she wants this new job, how it will bring her back into the city from the wilds of Westchester. I begin to feel myself numbing-out, and getting annoyed with this very verbally effusive and affectively disconnected woman. I think how in the world could she be telling me this again, since this cannot be information she is imparting (since she has to know I know). What could she be doing?. I decide to ask her. I interrupt and say, “Do you really think that I don’t know how much you want to return to the city? How many times do you think you have told me exactly what you have just said.?” The patient is somewhat stunned, but I continue. “Why do you think you do this?” “Well, my mother never listened, so I repeat myself. Other people have told me that too.” But this , though true, is also a repetition, many times she has used this formulation to explain her verbosity and repetition, often utilizing the same words in the same paragraph - and she does speak in paragraphs. I suddenly remember her reaction in the group the previous evening, her admission that she hates silences, that they scare and make her extremely uncomfortable. And in fact, in the group, she rarely lets a silence persist. I say to her that I think there is a relationship between her discomfort with silences and her need to fill the air with verbiage, verbiage that is not in the service of communication. Now this is a very intelligent woman who has by now developed a trust in my not wanting to hurt her. So, non-defensively, she asks what do I mean. I say that I think her fear of silences is related to a fear of being invaded, penetrated, as she repeatedly was by her mother, and that words serve the function of keeping people away- since they are not communications that would draw them near to 7 her. Similarly, I say, "I think that your being fat serves the same function, to keep people away and to protect yourself." She is stunned into the first truly long lasting, introspective silence that I have experienced with her. This is a woman who has the most egregiously invasive, infantalizing mother I have yet heard of. A mother in another city who still buys and sends her 49 year old daughter cans of tuna fish, toilet paper, underwear, matzohs for Passover, i.e. care packages for a high powered executive who makes 230,000+ a year. This mother also never knocked on a door, including bathroom doors (my patient says she did not know that people were supposed to knock on doors until she went to college), and each day chose the clothing and dressed the patient until she was 14 years old. This patient is so sensitive to invasion, that she cannot allow a cleaning woman into her home for fear that her things will either be touched, moved or broken. She has had anxiety attacks when the super has entered her apartment to fix something without her knowledge. When repairs were going to be made on the outside of her building and she was advised to keep her windows closed and blinds down so that construction dust and debris did not enter her apartment, she emphasized the severity of her depression and the out of control eating that was connected with it. When I interpreted her reactions to these “invasions” as feeling like internal penetrations, from which she protects herself with the act of eating and the external barrier of her fat, she associated to her mother’s not knocking on doors thus making the connection between her fears about being psychically violated and her apartment being entered, doors not being protection against invasion etc. - all symbolic representations of psychic penetration and the resultant feared loss of self. This woman has only had one sexual experience in her life at age 25 which ended with her returning home at l0 P.M. to her “hysterical” mother who, over the telephone, had threatened to call the police if she did not come home. Just as there are people who use the ingestion of food as an anesthetic, but do not psychically need to be fat, there are people who eat in order to get heavy but 8 do not psychodynamically experience their external boundary of fat as a symbolic protection from psychic invasion. Their overweight can instead be the result of an unconscious desire to solidify their internal, psychic selves through body size. I have found this symbolic meaning of body size to be a less frequent, though no less powerful, psychodynamic than the unconscious utilization of fat as insulation. Here you will find the patient, through the large size of their body, feeling rooted to the ground, strong, and in that sense experiencing themselves as less internally fragile, as if their outer physical size were a symbolic representation of their inner or psychic self which is experienced unconsciously and concretely as either being big and strong or vulnerable and weak depending upon the size of the body. Another dynamic has to do with the unconscious and sometimes conscious idiosyncratic meanings attached to being fat or being thin. For example, a lesbian woman believed that if she were thin, other women would “hit on her”, and she would not be able to resist . She would thus be in danger of losing her highly significant relationship in which she felt loved for the first time in her life. She knew that her relationship would not survive if she were not monogamous, so she rapidly gained weight from the time they decided to have a marriage ceremony. She blew up to over 300 lbs. Another woman, an uncommonly beautiful woman who often reminded me of Snow White, knew from experience that if she were thin, men would pursue her avidly and if pursued, she would risk kicking off her mother’s envy and malevolent power (not unlike the evil step-mother in the story). So she gained weight until men stopped expressing interest in her. She had to be over 250 lbs. for that to happen. And it did. The psychodynamic explicated in these examples is different from the need to be fat as a protective barrier against feared penetrations, although some of these patients also ate to anesthetize and also unconsciously used the fat barrier defensively . I am emphatically stating though, that I have found that this careful titration of the 9 differing dynamics of eating and obesity, even in the same person, to be crucial to the understanding and eventual change in their symptomatology. I want to emphasize once again that the work with the patients I have written about here, is technically speaking no different from my work with other patients. I am always listening for derivatives having to do with what’s going on in the room between us; I am always monitoring myself for reactions to my patients that can help me understand how they are feeling and how they are reacted to in the world. Since I firmly believe that immediate experience constitutes the major component of therapeutic action and is the route to overcoming a fear of experiencing affects I am always looking and listening for the transference/countertransference choreography as it develops and plays out between myself and my patients. I have not gone more deeply into transference and countertransference issues because I wanted instead to focus on the multiple psychodynamic and symbolic underpinnings of the specific symptoms of compulsive eating and obesity that have greatly informed the contents of interpretations that I make, including transference interpretations. I also wish to emphasize the effectiveness of these interpretations, especially those involving symbolic thought. It is interesting to think of Feynman’s description of atoms always being attracted to one another but repelling upon being too close, when listening to this statement from a patient during our final session. This patient though not obese was l5-20 lbs overweight at the beginning of our work, had been seriously alcoholic, was no longer drinking, had lost the weight and had secured a fulfilling, creative, high powered job in the field in which she is gifted. In response to my asking her what she thought had been most effective in our work together, she said, “I was transformed by being heard or listened to with such carefulness without being either suffocated or feeling like I was with an impersonal, clinical non-human being. I felt, feel, liked but without any expectations of what I should do or not do.” I was so pleased by this assessment and wrote it down verbatim not only because it was narcissistically gratifying to me, but 10 because I thought it so well illustrated the crucial importance, as in the case of Feynman’s atoms, of the balance, the dialectic between distance and presence in the analytic engagement. References Bion, W.R. (1963). Elements of Psycho-Analysis. London: Heinemann. Quoted in Eigen, M. (1985) Toward Bion’s starting point: between catastrophe and faith. International Journal of Psycho-Analysis 66 : 321. Bollas, Christopher (1987). The Shadow of the Object: Psychoanalysis of the Unthought Known. New York: Columbia University Press. Bromberg, Philip. (1991) On knowing one’s patient inside out: the aesthetics of unconscious communication. Psychoanalytic Dialogues l(4): 399-422. Eigen, Michael (1992) Coming Through the Whirlwind. Wilmette, Illinois:Chiron Publications. Feynman,Richard. Quoted in Genius; The Life and Science of Richard Feynman. Gleick, James (1992), p.39. New York: Pantheon Books. Freud, Sigmund. (1895) Project for a Scientific Psychology. Standard Edition. vol.1 (1966), 281-397. Green, Andre (1996), Has sexuality anything to do with psychoanalysis?. International Journal Psycho-Analysis 76, 874. 11 Levenson, Edgar A. (1993), Shoot the messenger: Interpersonal aspects of the analyst’s interpretations. Contemporary Psychoanalysis 29, (3), 396. Miller, Alice (1990). The Untouched Key: Tracing Childhood Trauma in Creativity and Destructiveness. New York: Doubleday. Ogden, Thomas (1997). Reverie and Interpretation: Sensing Something Human. Northvale, New Jersey: Jason Aronson. Stern, Donnel (1987), Unformulated Experience. Contemporary Psychoanalysis 19:71-99. Winnicott, Donald (1969). The use of an object. International Journal of PsychoAnalysis 50: 711. Winnicott, Donald(1974). Fear of breakdown. International Review of PsychoAnalysis 1:103-107. This paper appears as a chapter in "Hungers and Compulsions: thePsychodynamic Treatment of Eating Disorders & Addictions", Eds. Jean Petrucelli & Catherine Stuart, Aronson, 2001. 12
