Obesity: The Armored Self & Symbolic Significance

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
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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!”
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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
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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.)
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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
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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.
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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
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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
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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
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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
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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
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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
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Green, Andre (1996), Has sexuality anything to do with psychoanalysis?.
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Levenson, Edgar A. (1993), Shoot the messenger: Interpersonal aspects of the
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Miller, Alice (1990). The Untouched Key: Tracing Childhood Trauma in Creativity
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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.
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