Abstract
This article explores how desire operates in the daily lives of women with disordered eating. Based on qualitative findings from a South Australian study investigating why women with disordered eating are reluctant to seek help, we trace the multiple “tipping points” and triggers that are central to participants’ everyday experiences. Employing anthropological interpretations of desire, we argue that triggers are circulations of productive desire, informed by cultural values and social relations, and embodied in routine daily acts. We examine the cultural-work of desire and the ways in which gendered relationships with food, eating and bodies trigger desires, creating a constant back and forth movement propelling participants in multiple directions. In conclusion, we suggest that a socio-cultural approach to desire in disordered eating has clinical implications, as cultural configurations of desire may help to understand ambivalence towards relapse and recovery.
It is well known that the course of disordered eating 1 varies widely. Recovery is slow and often includes relapses that require repeated admissions to hospital programs and outpatient care in the community (Fassino, Pierò, Tomba, & Abbate-Daga, 2009; Keel & Brown, 2010). Relapses may occur during treatment, after long periods of remission, or remain a constant struggle, where people vacillate between recovery and relapse (Touyz & Hay, 2015). Due to the highly variable patterns of disordered eating, the reasons why some people relapse while others move to partial or full recovery, or remain entrenched in disordered eating, are unclear (Federici & Kaplan, 2008).
There are a number of psychological and medical studies that have used qualitative methods to gain insight into patient perspectives of recovery and relapse (for an overview, see Dawson, Rhodes, & Touyz, 2014). While these studies provide valuable information about the key factors that help or hinder recovery, and in doing so potentially identify those individuals most at risk of relapsing, they are based on a medical model of the individual that privileges indices such as weight, behaviour and psychological criteria (Dawson et al., 2014). Moreover, they are based on studies that include people already diagnosed with eating disorders and with experience of therapeutic relationships. The aim of our paper is not to dismiss these concepts of recovery and relapse, but to reconceptualise and broaden them within a socio-cultural framework of desire. Desire is a useful analytic tool to explore women’s experiences of disordered eating as it illuminates the constant pursuit of longing, and the potential for productive (and destructive) pathways towards and away from recovery and relapse. We pay close attention to contexts of competing and often conflicting desires, examining everyday practices of desire that are central to disordered eating experiences. These workings of desire are embodied well before treatment is sought, and provide important insights to why and how recovery is so challenging and under what conditions relapse might occur.
In an Australian context where thin bodies and restrictive food-related practices are privileged over others, clinical treatments and expectations of recovery often conflict with people’s everyday understandings of healthy eating and desirable bodies. For example, in clinical in-patient settings weight restoration and high calorie meals are a crucial part of treatment, yet pervasive anti-obesity and restrictive dieting messages in the Australian cultural landscape construct weight gain as undesirable. Key tensions arise concerning a desire to either “give up” or “work on” disordered eating (Lavis, 2016; Warin, 2010).
Desire is a difficult concept to articulate. In theorising desire we begin by examining the ways in which triggering is used as a tool for igniting desire. We draw upon qualitative work that has examined triggering and/or desire in eating disorders (Fox, Ward, & O’Rourke, 2005; Lavis, 2011, 2013, 2016; Warin, 2002, 2010), extending this to position desire as key to disordered eating practices, will for recovery and propensity to relapse. We argue that triggering itself is not desire, but produces movements of desire that are experienced as ambivalent and compelling, and rife with holes, gaps and contradictions (cf. High, 2014).
Anthropologist Henrietta Moore notes the many competing theories of desire (Freudian, Lacanian, Foucauldian, Deleuzian) and states that no absolute definition is possible (2011, p. 29). Common deployments of desire are often treated as self-evident (as a want or “heart’s desire”), and in which the objects of desire are known. These interpretations are often infused with popularised psychoanalytic interpretations of the unconscious in specific stages of a person’s development. Such readings of desire offer a tantalising glimpse of the complexities of desire: “suggestive of sex, psychoanalysis, continental theory and cultural considerations” (High, 2014, p. 9). We agree with High that, despite the plethora of theories on desire, the theorisation of desire itself remains somehow “thin” (High, 2014).
To counter this “thinness” we tease out the differing definitions of desire, and situate our analysis firmly within an anthropological framework of desire that is relational and culturally positioned. Anthropologists have long known that activities surrounding food, bodies, eating (and not eating) are not individual acts but deeply embedded in wider cultural values and social structures that are taken-for-granted and give meaning to our everyday experiences (Abbots & Lavis, 2013; Becker, 2004; Counihan, 1999; Douglas, 1966; Lester, 2004; Warin, 2010). We draw upon Deleuze and Guattari’s philosophical writings on the open-ended nature of desire as a social force, and demonstrate how desire operates in cycles of indulgence and control, pushing and pulling people back into and away from disordered eating. In such a social context, desire becomes “‘a constant source of cultural-work’ work” (High, 2014, p. 10) which is cultivated through socially coded practices.
Following a description of the project and methods we present case studies from two participants. We introduce Kelly, who embodies flows of desire as she moves between “bingeing up” and “starving down” phases, and Charlotte, who is actively trying to disengage from her desires, and is constantly pulling back from triggers and the daily enticements of food and hunger. In doing so, we demonstrate how desire is located in everyday practices, and intimately related to social contexts of gender, bodies and health, all of which are culturally situated and produced.
In the final section, we discuss the implications of our findings. Although participants’ experiences with disordered eating vary, they highlight how desire and its associated pleasures, fears, and danger can co-exist as both productive and negative. These contexts of desire are thus ambivalent and beckon people in differing directions, and we suggest that this ambivalence is key to understanding responses to recovery and relapse.
Triggers as movements of desire
Desire has featured in eating disorder literature through psychoanalytic and feminist perspectives concerning the negation of desire, particularly sexual desire and binary constructions of femininity. For example, in classic psychoanalytic texts such as Bruch’s (1979) The Golden Cage, girls and women with anorexia are often presented as wanting their bodies to appear childlike and are said to be resistant to developing a “womanly” figure for fear of sexual attention (Ellmann, 1993, p. 2). Motivations behind disordered eating practices are often reduced to negativity: a “lack of desire”, “desire for control” and a “desire for thinness”. Girard’s (1996) application of “mimetic desire” to eating disorders uses rivalry between individuals as the point where violence develops and is directed towards the self. Desire here is located within the individuals’ pathology and constructed either as a conformity to gendered norms in which feminine bodies must be contained, or as a counter to the perceived excesses of feminine sexuality or consumption.
The problem with this analysis of desire for anthropologists (as already noted by Moore, 2007; Warin, 2010) is the tendency to ignore cultural differences through universalising statements about the human psyche and thus ignoring a culturalist explanation. In constructing desire as self-inflicted (as Girard suggests), in the realm of the unconscious (or in Freud’s case narrowing desire down to sex and the domestic sphere), there is little room for the social or for a deeper analysis of how people interact with desire or how desire may work as an agentive or productive force in people’s lives.
Popenoe’s (2004) ethnographic work on “feeding desire” amongst young Azawagh Arab women in Niger is a prime example of how eating is infused with cultural work of desire. She explores the practices in which young women are prepared for marriage through ingesting large quantities of milk and porridge in segregated village “fattening” huts. In this cultural context, people desire fatness and it is intimately linked to the capacity of women to labour as productive mothers, in which cultural ties of kinship, Islam and gendered ideals of femininity and sexuality are paramount. Through this ethnographically-informed description of desire, Popenoe’s work highlights the importance of situating desire within particular cultural contexts, and the ways in which desire is expressive of gendered constructions of food, eating and reproductive capacity.
In our study locale desire was performed and gestured through a range of embodied experiences and relationships that reached outwards and inwards—constantly in motion—and described as “triggering”. Tamara, a 21-year-old university student described triggering as “like you are standing on [a] cliff and the trigger is the thing that’s either going to make you jump or not jump […] it is something that can kind of bring you to a point where you are likely to engage in the behaviours”. Triggers could be as simple as seeing someone eat, or an off-hand compliment about how they were looking. Triggers were also explicitly sought to help instigate the desire for different bodily states, for example, researching detox diets to achieve a “cleansed” body. Triggering was concerned with moments of desire; it was an intensity that produced pleasure, fear, speed, openings and possibilities that constantly beckoned and threatened.
Lavis’ (2011, 2013, 2016) UK ethnographic work is an important foundation for understanding desire in anorexia as she attends to the complexities of triggering and pro-anorexic desire in people’s everyday experiences in the clinic and in online spaces. Lavis argues that “narratives of being ‘triggered’ draw attention to informants’ subjectivities of the many and continual—even daily—shifts in the relationship between personhood and anorexia” (2013, p. 46). In her work, desire “cuts across disciplines, inviting an urgent, situated, and sensitive revisiting of concepts such as health and harm, ‘chronicity’ and ‘recovery’ as these are lived and challenged by individuals” (Lavis, 2016, p. 73).
We extend Lavis’ work on triggering and desire from clinical and online spaces to people’s everyday worlds. Here we utilise anthropological orientations of desire (High, 2014; Moore, 2011) that have emerged predominantly from the anthropology of becoming (Biehl & Locke, 2010; Warin, 2002). This latter field draws heavily on French philosophers Gilles Deleuze and Felix Guattari (1987), who focus on desire as both productive and a process, thus offering an analysis of desire that looks to openings and potentiality, rather than foreclosures and what is “done to” people. Desire, these philosophers argue, is generated through assemblages in the political economy (such as capitalism) and is both produced by and productive of wider social, political and economic contexts (High, 2014, p. 11). Desire operates in larger economies and also in the smallest details, in the most routine and mundane daily acts (High, 2014).
Rather than focus on the end points of where triggering and desire may take you, Probyn (1996) urges us to trace the “lines between different points [of desire] to think about the ‘inbetweenness’” that “may point us to moments of [becoming] – like the moment a trapeze artist has let go of one ring but hasn’t yet grasped the other” (1996, p. 42). In thinking about the movements of desire, our attention is not simply drawn to an individual’s desire to lose weight, but to the multiple desires that everyday worlds offer in relation to hungers, cravings, wants and relationships.
Methods
Through a mixed methods approach, 2 including ethnographic fieldwork and psychological evaluation, this study set out to examine the cultural contexts of disordered eating amongst women with the aim of developing strategies for early intervention. Data collection occurred over 15 months (January 2013 to March 2014) and involved 28 women ranging in age from 19 to 52. As the project was primarily interested in why women delay seeking help for disordered eating, the criteria for recruitment included women who were over 16 years of age who had not seen a health professional for disordered eating, had not been given an eating disorder diagnosis; or had been diagnosed but had delayed seeking treatment; or who did not wish to pursue treatment. The central elements of interest were the denial of eating issues and the delay in seeking treatment. Clearly, there are methodological issues with attempting to locate a population that does not identify as having a problem, that faces social stigma, and is reluctant or too overwhelmed by their situation to engage with services (see Musolino, Warin, Wade, & Gilchrist, 2016). Qualitative and ethnographic research methods were therefore critical to accessing the everyday practices and private experiences of such a hard to reach group.
Participants were recruited through purposeful sampling methods from two metropolitan university campuses in Adelaide, South Australia and most were under 30 years of age, university students and of Anglo-Australian backgrounds. Recruitment posters were placed on the backs of toilet doors and pin boards and posed questions such as “Are you continually thinking about your food and your weight?” and “Do you enjoy the feeling of not eating or excessive exercising?”. Privacy was crucial to the locations of the recruitment information due to the social stigma associated with eating disorders and the nature of this study seeking participants who had not previously disclosed their eating issues. As this was a difficult sample to recruit, participants were also recruited through mental health networks and advertising on social media websites such as Facebook groups (South Australian Body Esteem Activists and Supporting Eating Disorders for South Australia).
The study received approval from the University of Adelaide Human Research Ethics Committee (H-2012-069) and the Southern Adelaide Clinical Human Research Ethics Committee (SAC HREC EC00188). Author 1 (a social scientist) conducted semi-structured interviews and observations in people’s homes, in interview rooms at one of the universities, in cafes and in public places. In total, 68 interviews lasting up to 2 hours each were conducted.
In addition, the Eating Disorder Examination (EDE; Fairburn, 2008) (a semi-structured diagnostic interview) was conducted with each participant during the interview phase. 3 In terms of research rigour and our ethical responsibilities, the inclusion of the EDE was important to ascertain if participants might meet psychiatric classifications, to elicit their responses to such evaluations, and to provide them with information about resources and services. Of the 21 participants who consented to undertake the EDE, 19 (90%) met criteria for an eating disorder. Seventeen (81%) of those fell into the Eating Disorders Not Otherwise Specified (EDNOS) category, and two met the diagnostic criteria of anorexia nervosa. Of the total sample who participated in the semi-structured interviews (25), six had a previous eating disorder diagnosis (anorexia nervosa) from a health care professional, and had previously had varying but limited contact with health providers, and no desire to recover (in clinical terms). The other 19 participants had not previously sought professional help and had never received a diagnosis. Despite this, the women described years of disordered eating, which usually started in childhood or adolescence and involved urges to fully engage in a range of bodily practices that steered them around patterns of restricted eating, bingeing, purging and excessive exercise. Following the interview phase, one focus group with 3 women who were in recovery was conducted in order to reflect on some of the preliminary themes which surfaced in the interviews. All three women had had a diagnosis of anorexia nervosa.
Grounded theory principles guided the research methods, coupled with thematic techniques of data collection and analysis (Corbin & Strauss, 1990; Ezzy, 2002). All interviews (including semi-structured and EDE interviews) were digitally recorded and professionally transcribed, and field notes were written up following each interview. Following a process of open, axial and selective coding, the interview manuscripts and field note data were first open coded on a computer in a Word document, and then through the software program NVivo by Author 1. Open coding involved reading the transcripts line by line to identify and develop ideas, themes and issues from the data (Emerson, Fretz, & Shaw, 2011). In the collaborative meetings that followed between Authors 1 and 2, axial (secondary) codes were developed. This stage of data analysis involved making comparisons across the data, so that the final stage of selective coding could occur. Selective coding involved taking core themes and positioning these as key theoretical frameworks for analysis, and critically examining their concordance (or not) with the wider literature.
Participants did not use the word desire (as it is an analytical concept rather than a verb in this context) but repeatedly described triggers that led them towards and away from certain eating or restricting practices. They described the contexts and events that triggered them to act, using metaphors—of “bingeing up and starving down”, of “being full” and “filling up”, of “giving in”, of “holding on”, of “letting it flourish”, of “letting it go”, and cravings of “mouth hunger” and “body hunger”—to describe embodied processes and states of desire. It was these metaphors that we interpreted through a sociocultural lens of desire.
Results
The following case studies demonstrate different trajectories of desire: how triggering initiated different phases of disordered eating, and how desire loomed over recovery and instigated relapse. While each trajectory is different, these case studies reveal the capriciousness of desire, its circulation of pleasures and dangers, and its capacity to transform participants’ relationships with themselves, others, and their social worlds.
“Feasts and fizz”: Kelly’s practices of desire
Kelly, who turned 40 during our project, exemplified the ways in which hunger was, as Lavis suggests, as “much a desired practice as a practice of desire” (2011, p. 79). She had lived with what she called “healthy anorexia” for all of her adult life and has been resistant to professional help. When we first met her, we noticed a small black ink tattoo on the top of her right arm – it was a bass clef not much larger than a 50 cent coin. It was a memento of her time in a band in her early 20s. Kelly disliked the tattoo because it acted as a gauge—the larger her arms got the wider the tattoo became, and the smaller she got, the more it shrunk and became unrecognisable. This was a particular problem for Kelly, as her disordered eating consisted of “bingeing up” and “starving down”, with each phase lasting anything up to six months. With each phase Kelly could be triggered to shift from a bingeing episode to a punishing starve. She describes something outside herself as driving this desire: “It’s like being driven around in a machine that does what it needs to do to make sure that it can fulfil its compulsions […] I don’t know I just ride along I think and analyse, go ‘Whoa’, but the rest of the time, the compulsions seem to have a mind of their own”. Kelly’s active and passive desires produced a fundamental contradiction in which her body was “both a prison and a vehicle for adventure […] not the same day-to-day” (Jenkins, 1999, p. 4).
Kelly laughed as she described her binges as “fantastic […] like a party – it’s so exciting when I feel the turn [because] I know I’m hungry […] and I buy chips, lollies, beer”. Bingeing up consisted of speed, of “hardly even chewing”, “inhaling food in a frenzy like a hoover”, and waiting for the feeling of fullness. When she’s bingeing, she’s “lapping it up and filling up”, driving to the supermarket and devouring the food in her car. This desire to binge with food was similarly described by other participants as a waterfall, a desire of “flows” (Colebrook, 2006, p. 129) that could not be simply stopped. Kelly explained that once she passed through the threshold of bingeing, “the need’s been fulfilled and I can potter on with my day”.
As much as Kelly enjoyed the physical fullness of her body, she equally enjoyed the fullness—or immanence—that “starving down” offered. Starving down was initiated by upcoming social events and involved a process of prolonged fasting: “I’m a happy little starver”, she said: “I might eat the crusts off the kids’ bread that they leave behind. I might nibble like that ‘cause I’m hungry when I’m starving down. Your stomach’s shrinking, and after that I pretty much avoid food completely”. Starving made her feel light, speedy and energetic. Deleuze in his 1987 work Dialogues (Deleuze & Parnet, 1987) suggests that this becoming lighter and moving faster is an experimentation with the effects of “void” and “fullness”, of stuffing and emptying, of feasts and fizz (Arsic, 2008, p. 37). These are not alternations: void and fullness are like two demarcations of intensity. Or as Kelly described, the flow of bingeing and starving is like “having a romance both ways”. Filling up and starving down were equally experienced as pleasurable, each producing an embodied attunement in which Kelly felt “most alive”.
The way Kelly moved through these different desires was often related to her experiences of triggering. Kelly’s triggers were dependent on which phase she was in at the time, and her relationships and socio-cultural surroundings, in which a trigger (such as an invitation out to a social event or information read in a book on detox dieting) could cause a “turn” from one phase to the other, activating a desire for certain practices and states of embodiment. Triggering interrupted Kelly’s phases and her productive desiring-machine of disordered eating described above, leading to a change in the direction of her practices and her emotional and physical spaces. She described visiting her family interstate over Christmas as triggering childhood traumas of sexual abuse, which led her to turn to starving and losing weight very quickly. “I was a mess” she said, and when “something goes wrong I just can’t eat, and I’ll try really hard but I’ll get nauseous, not induced, self-induced but I can get nauseous, I just don’t feel like eating”. In Kelly’s experiences, triggering was a catalyst that could propel her to the perceived safety of her disordered eating. Starving, she said, was something she looked forward to.
Kelly’s relationship to her body, food and the world around her has in part been produced through her experiences of sexual abuse and gendered objectification as a child. For people who have experienced sexual abuse (widely considered a “risk factor” for disordered eating; Connors & Morse, 1993; Madowitz, Matheson, & Liang, 2015), not being desired often becomes the driver of their practices concerning their bodies and relationships (Madowitz et al., 2015). Modowitz et al. found in their study that “ED patients identify the desire to ‘become unattractive’ to the opposite sex as motivation behind their eating pathology” (2015, p. 287). This happens in culturally specific ways. From a young age Kelly experienced herself as an object of desire, but grew thin and small to escape this desire. Kelly played with her capacity to repel and attract through her body. She explained: “I was an attractive child and I felt uncomfortable with adoration; always been told that I was pretty. So being told that I was disgustingly thin was better than being beautiful”. Becoming thin appealed to Kelly as she was able “to change the focus of the attention that I was attracting”. The wish to disappear, take up less space and evoke disgust through thinness is frequently noted as a strategy to distance the unwanted desire of others (Warin, 2010).
Kelly also demonstrated through her “bingeing up” phases that her relationship with desire changed depending on the social context. Kelly had become attuned to the gendered cultural performances around food and bodies in her social networks. When around other women who were “watching their weight”, Kelly said she would “actually like to go out and look thin and pig out, I think deep down, somewhere in there, there is this ‘oh… [laughs]’ ‘look at me I can eat whatever I like’… I get praised for what actually… is a disease”. This resonates with Probyn’s explanation of “anorexia as an embodied moment of negotiation: as a site which shows up the articulations of discourse, the female body and power” (1987, p. 202). Kelly works with these productive forces of desire to engage in a range of social relationships, in this instance drawing the women in closer to her, knowing that her performance of eating will ignite a desire in them to find out how a woman can eat with unrestraint.
Kelly demonstrates the ways in which desire continually produces and moves, through and with the person, contracting and flourishing in different social contexts. Tracing desire through what Deleuze and Guattari coined “lines of flight”, these movements of desire are “fuite” (translated to “flight”), meaning “not only the act of fleeing or eluding but also flowing, leaking, and disappearing into the distance (the vanishing point in a painting)” always becoming part of something else (Deleuze & Guattari, 1987, p. xvi). Deleuze and Guattari’s concept of desire allows us to capture the multiple and conflicting experiences of disordered eating. Desire here is not just a “natural” urge, a physiological or pathological compulsion: it is interactive, and is created and maintained through bodily affect, social relationships and Kelly’s social world.
Charlotte’s mouth hunger and desire: The gendering of appetite
Like Kelly, 32-year-old Charlotte described the meticulous attention to managing desires and triggers in her own living spaces, yet in a different modality. Her experiences highlight the difficulty and complexities of recovery, as she moved back and forth between relapse and recovery, the ebb and flow of her desire for disordered eating pushed against her desire to be released from what she described as intense suffering. Having lived with anorexia nervosa for most of her adult life, Charlotte developed rigid rules around food and eating and the spaces that food occupies, and she worked hard to keep a distance between herself and certain foods. The space between herself and food was a liminal and risky space (cf. Eli, 2018), with cravings and anxiety towards her desires growing with closer proximity. Charlotte explained that after social gatherings in which there was birthday cake, she would often give her piece of cake to her parents rather than eat it in front of everyone. Recalling such an occasion she said “Dad, can you take home a piece a cake for [me], because I can’t have it tonight, but I’d like to enjoy it sometime when in a space that I can”. Charlotte said she would collect the cake when she was ready to eat it, and therefore when she was in a “space” that the cake won’t trigger negative emotions or restrictive practices. This was a private space that she had prepared for and created—and if she stuck to a structured eating regime, she allowed herself a moment of pleasure.
In Charlotte’s pantry and her fridge she kept only what she needed. She would often buy food in bulk for fear a staple food might run out and kept most of it at her parents’ place a short distance away. “I store it at my parents’ and bring it home a bit at a time, a serving at a time […] I don’t keep stuff in my house that puts me in that kind of position, because I’ve learnt”, she said, “to avoid eating too much and the drastic practices which may follow, like extreme restriction or vomiting and feelings of shame and self-loathing”. Charlotte demonstrates Fox’s contention that “our appetites and our desires play a part in structuring our waking lives” and that “these desires not only affect our thoughts and feelings, but also how we are motivated to act on a daily basis” (Fox, 2012, p. 106). The intensity of these motivations for women with disordered eating is amplified.
Charlotte explained how she used desire for food as a mechanism to manage everyday triggering. She did this by labelling food according to how safe it was to eat. Safety for Charlotte meant measuring foods according to their blandness, consistency and nutritional value. Her pre-emption of triggers and categorisation of safe and risky foods was not idiosyncratic to her disordered eating, but culturally informed by restrictive diet and self-disciplinary, body-work regimes (Musolino, Warin, Wade, & Gilchrist, 2015) (including her participation in a personal trainer course). The food she eats is for body maintenance and sustenance; keeping the body going without causing too much emotional pain or pleasure while eating—pleasure itself often the cause of pain. Charlotte was fearful of the pleasure of food and her appetite. She explained that “if something tastes too good or you like it too much you know that it’s going to trigger wanting to have other things and then you’re going to have to deal with those cravings”. She was wary of “the cravings that it incites”, explaining that “then you have to sit with them or you’re not strong enough to sit with them and you cave and eat more and then the rest of that day and most of the next day are nightmarish in terms of dealing with the ramifications of that”. Safe foods for Charlotte included a can of baked beans for dinner and a liquid breakfast of “Up and Go” or porridge for breakfast. She explained: My default dinner … pretty much my dinner every night is a tin of baked beans. Because it’s relatively healthy, in a can. I know pretty much what energy’s in it. It’s got a high level of protein, which is better for satiety and stuff. It doesn’t initiate cravings in the same way that some other foods and breads and things do. It’s all just so overwhelming and you get dizzy … It’s like the world starts spinning and you’re about to cry and it’s just too hard … Confusion of not knowing what the right food is to choose … the fear of, if you get it wrong, you’ve only got one chance, because you’ve only got X number of calories to spend. So if you get it wrong and are left with, or it triggers other cravings or it, you know, then the anxiety around that is really big and it makes choosing really hard. So you end up limiting your repertoire to ones that you know are safer.
In discussing her cravings for solid and more flavoursome foods, Charlotte referred to the sensation of what she termed “mouth hunger”. Mouth hunger is an intense desire she said, that is “rarely satiated by what you give it. It always wants more”. We asked Charlotte how “mouth hunger” works. She explained that “sometimes it just happens … my understanding of it is more that the body’s asking for something that you’re not giving it”. However, other times mouth hunger was triggered, “it’s prompted by seeing [something], so you’re at someone else’s house or party and they have out all of these foods that you know that you really enjoy the taste of and that kind of stuff, but can’t cope with on another level”. It begins with “your mouth salivating when thinking of food, thinking of tastes”, she said, and can lead to an episode of “overeating and bingeing”.
Charlotte’s “mouth” represents a desire that Scala argues “is ultimately the desire for desire’s continuance, a complex means by which human beings work to sustain a state of engaged wanting” (2013, p. 50; cf. Musolino et al., 2015). The potentiality of desire was used by Charlotte to negate, direct and create assemblages to maintain her practices without causing harm. How Charlotte engaged with her desires and surroundings had implications for her journey to recovery. Her attempts at dampening her cravings and the unknown possibilities they represent in the hope of remaining in safe and familiar spaces is “like a rhizomatic line that always turns into something else, the vector of food leads into other areas” (Probyn, 2000, p. 62) and thus becomes a never-ending endeavour at chasing and pre-empting desire. Charlotte’s daily endeavour of keeping her disordered eating at bay through her work of managing desire could be all-consuming and risky, and at times led to relapse.
In these examples, food and eating are used to direct desire into a particular sequence; symbolic and bodily connections between hunger, pleasure and food are made and re-made into a familiar, safe space. This sequence is culturally patterned, as the expectation that women will control their appetites, manage their bodies and deny their own needs and pleasures is a key component of normative femininity in Australian and Euro-American cultures (Musolino et al., 2015, 2016; Schwartzman, 2015). Charlotte’s appetite refers not just to eating but to a “much broader constellation of hungers, longings and needs” (Knapp, 2003, p. 2). As key scholars have already noted (Bartky, 1990; Bordo, 1993), this appetite is highly gendered and regulated, in that Charlotte would only allow small pleasures of eating in private, and she denied herself the sensory pleasures of taste in her choice of bland foods, and avoiding situations that would trigger the dizziness of desire and potential for displays of voracious appetites and bodily excess.
Discussion and implications: The ambiguity of desire in the context of recovery and relapse
In this analysis we have given primacy to how desire plays out in participants’ everyday lives. As outlined earlier, much of the work on desire positions it as a lack, located in specific stages of individual development or another word for what people “want”. Our analytical approach departs from these traditional explanations of desire. In using anthropological theories of desire, and drawing upon Deleuze and Guattari’s philosophical understanding of desire, we have explored the productive nature of desire and its circulations of movement that draw participants in multiple and sometimes conflicting directions, which can challenge healthy paradigms. These narratives point to the complex and ambiguous relationship people with disordered eating have with recovery and relapse.
In our analysis desire is thus not an object; it is not simply a desire for a thin body. While it is well recognised in popular representations of eating disorders that the motivation to binge and starve may be related to a desire to be thin, to disappear, or to compete in a culture that elevates the status of thinness, our use of desire does not locate it in the end point of an outcome to be achieved (Lavis, 2016; Warin, 2010). Thinness is but one part of the cultural context, but if this thinness is achieved the desire does not disappear. Disordered eating practices don’t stop when a particular goal of thinness or number on the scale is reached. On the contrary, desire fuels the continuation.
Knapp’s memoir of her own experience with disordered eating highlights this generative and open-ended nature of desire. In what she describes as a cruel yet ongoing hope for control, success and safety that disordered eating promises, she states: “appetites, particularly as they are experienced by women, have an uncanny shape-shifting quality … one battle segues into the next, one promise proves false and another emerges on the horizon, glimmers and beckons like a star” (Knapp, 2003, p. 10). Desire is generative and never-ending; it is never finished or complete in itself (High, 2014, p. 176). This was demonstrated by both Kelly and Charlotte, whose attempts to navigate triggers led them on multiple paths of desire. They both demonstrate how maintaining disordered eating takes continuous effort (Lavis, 2016), or what we refer to as “a constant source of cultural-work” (High, 2014, p. 10).
This research has implications for conceptualising how the person with disordered eating is positioned in clinical understandings and treatments for eating disorders. In this broadening of desire as productive and socio-culturally cultivated, Kelly and Charlotte are not positioned as passive bodies, or reduced to a set of clinical categories, but rather their agency in managing disordered eating is brought to the surface. This is demonstrated in the way participants described their relationship to triggering and their acute understanding of the consequences of their practices.
Triggering is animated by ambivalent desires that experiment “on and with borders” (Arsic, 2008, p. 34); or as our participants described, of “standing on cliff edges” and “sitting on fences”. Ambivalent desires were produced through participants’ concurrent needs and wants: through desiring to be well but actively maintaining practices that made them unwell; desiring to meet clinical eating disorder criteria (of being “sick enough”), but denying a label of illness; striving to reach the low weight needed to be admitted for treatment but also rejecting treatment; enticing desire for food through producing cooking smells but exhibiting restraint from ingesting it and throwing (or spitting) it all in the bin. These examples demonstrate that while people with disordered eating may be perceived as having a desire for thinness as an overriding goal, their desire is located in their everyday affective and bodily dispositions, not just in their cognitive processes.
Despite acknowledging the harm caused by disordered eating many participants articulated an ambivalence towards recovery and changing their practices. As Warin (2002) and others (Knapp, 2003; Lavis, 2011) have already noted, experiences of disordered eating are replete with ambiguity (Warin, 2010) that presents a bundle of deadly contradictions. The sociologist Bauman (1991) suggests that ambiguity and ambivalence are two sides of the same phenomenon—both premised on double and multiple meanings. In Bauman’s extensive writing on the subject, he takes an analytical rather than an implicit or taken-for-granted view on these concepts, arguing that ambiguity constructs knowledge that designates opposing states, and ambivalence directs action that pulls and propels people in multiple directions. This pairing of ambiguity and ambivalence, of “having a romance both ways”, is at the heart of desire.
Through a cultural lens we can examine the multiplicities of desire—its productive, negative and ambiguous properties—in action. The case studies of the women presented here demonstrate how they held together competing and complex meanings of bodies, food, health, illness, recovery and relapse, which affected their decisions to seek or delay treatment. Tracing the multiplicities of desire helps us to understand the many ambiguities and ambivalences that disordered eating entails (of denying and concealing disordered eating practices in order to continue them). Moreover, it challenges the current diagnostic criteria for eating disorders, through highlighting how people’s behaviours and practices do not fit neatly into clinical categories, but rather move and shift in accordance with different socio-cultural contexts.
As desire is so central to people’s experiences we suggest cultural and embodied manifestations of desire be incorporated into understandings of recovery and relapse. This will assist health professionals and those caring for people with disordered eating to be cognisant of the challenges and triggers that people face as they move through familiar and unknown spaces, and in their daily interactions with food, eating and bodies and social relations. Bauman’s commentary on ambivalence encapsulates the contradictory flows of desire that pull people back and forth between pleasure and danger, relapse and recovery. He states that “the struggle against ambivalence is both self-destructive and self-propelling. It goes on with unabating strength because it creates its own problems in the course of resolving them” (Bauman, 1991, p. 2). This is the ever-continuing project of desire, in which, as one participant succinctly described: “the disorder will look for things that it [can] feed off of …”, constantly beckoning, seeking new avenues to produce and connect, which can lead to further suffering. Acknowledging women’s embodied desires and the constant culture-work that it entails could be incorporated into treatment models as a way to support women in navigating their everyday worlds.
Footnotes
Acknowledgements
We thank the participants who generously shared their time with us, and our research partners SA Health and Flinders Medical Centre. Thank you to Professor Tracey Wade from the School of Psychology, Flinders University for your support and expertise. We would also like to thank Dr Anne O’Shea from the School of Psychology, Flinders University, and Kate Parsons and Loraine House from the Eating Disorder Association of South Australia (EDASA) for their knowledge and support. Thanks to the anonymous reviewers of this paper for their helpful feedback.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by an Australian Research Council Linkage grant (LP 110200179).