the final essay in a memoir series on normative beauty, illness, and the U.S. culture that sustains both
“Interrupting the flows of social production is anarchic and counterproductive, like all good philosophy: if it works, it helps us stop and see our world in new ways. If it fails, as it often and even usually does, the interrupter is integrated, driven mad, ignored, or destroyed.” —Roy Scranton
How boring that my 29th year was what gave me pause. I was getting older and, like so many of the nutritionists in rehab had warned me, the bulimia had stopped working. Either the body wises up to the ruse or you could die, one dietician at the Tennessee facility told me as I blinked and tried not to stare at her own extremely fit body, the fine-boned jaw. Easy for you to say, lady. What didn’t feel all that easy was how, sometime in the year before 30, I began to notice: The number on my scale was as little as always, but the force of the throwing up hung on my cheeks and around my jawline in ways it never had before, stuck under my chin in weird, tired little lumps. What could I do? There was nothing really to do, and yeah, I cried about it. For months and months, I binged and cried and drank and purged, woe is me, all this pretty and cool I “worked for” is really, truly, finally, pretty and cool no more.
I also distracted myself from my misery through the endless management of my Instagram feed. If my “real” life had started to unravel into threads of illness, violence, and self-harm, posting to Twitter, Facebook, and Instagram offered a chance to pull the threads together again in an endless performance of smart-creative-brave-girl-facing-mental-illness-struggle. I tweeted about frustration over medication changes. I posted selfies of myself in full makeup, somber-eyed, tight-lipped, head knocked against the expertly arranged pillows on my bed.
I copied what I saw other women doing online: Celebrities of the popular, white-lady self-help fame variety, sure, their beach-background, full-haired selfies matched with captions about how the latest meetings with their therapist went, how grateful they were for their switch from one antidepressant to another. Or else super models with I.V. drip photos documenting their journeys through Lyme disease or anorexia. But as a doctoral student in creative writing and critical theory, the sick women I found myself more entranced by were the academics who continuously and precisely editing their social media accounts in similar fashion: Here were critically acclaimed memoirists posing with their I.V. drips, too, the photo part-bright-white filter, part-red-lipstick-glam as the caption gushed with gratitude about joy in the face of pain, before a foray into lyricism gestured toward the immensity of their suffering.
If I had reservations about value of rich white women with large yoga or celebrity empires filling their feeds with narratives of illness, I felt reassured to see writers committed to leftist politics and trained in narrative theory doing basically the same thing. So I did too, except one of my illnesses was tied to trying to fulfill normative standards of beauty, offline as well as on, and my beauty was disappearing, and the dissonance between the well-groomed stories I told about my mental illness online and the grimy violence I lived out in my life became too much to bear.
It is not especially encouraging or brave to say that what drew me away from my illness narrative was that my illness was no longer working for me. And yet, I wonder, too, if illness has become a little too convenient for us, for women, for me, against this weird long backdrop of money and power, misogyny and diagnosis.
At what point does living sick in a world that’s sick get old? At what point does the story of women and illness also necessitate the story of when the convenience of illness overwrites a messier core, or else becomes yet another filter for hearts and likes online? Does a reliance on psychiatric healthcare and psychotropic drugs actually offer relief and recovery to those of us in mental ill health? What’s at stake to ask these questions at all?
At first I was relieved to have diagnoses. Bulimia, with anorexic episodes. Borderline Mood Disorder. Insomnia. Generalized Anxiety Disorder. Depression. Managed with talk therapy and behavior modification, a brief remove from society, once, twice. Prescriptions: Prozac, Remeron, Seroquel, Trazodone. But when things got worse—I began living alone in the middle of nowhere with my parents, or the first heady year of my relationship with Kiernan began to striate under the strain of debt and unemployment, or I had an abortion and got an opioid prescription at the same time the pressures of grad school were ramping up, or I just stopped being able to sleep at night or get out of bed during the day for what seemed like no reason at all—the psychiatric treatment got worse too.
Instead of examining how the shifting circumstances of my relationships, environment, work, and finances might be playing into my mental distress and pain, the string of psychiatrists I saw throughout my twenties found it easier to change a prescription or elevate a diagnosis. Borderline Mood Disorder to Bipolar II. Bipolar II to Bipolar I. Prozac to Lamictal. Lamictal to Lithium. Naltrexone to curb the urge to drink. Klonopin to manage “break-through anxiety.” Yeah, the Klonopin. For all this reliance on charts and medicine, diagnostic categories and pathology, how did the doctors miss the history of controlled substance abuse—my bowel reconstructed as a result of it—how did they think a refillable script for benzos would be the cure that calmed me down, set me straight?
I thought about quitting psychiatry so many times in those years, spent whole months refusing to take my meds, missing appointments. Yet I kept coming back, knowing full well I could rely on its tendency toward overmedication the same way I felt spurred on to excess to compensate for lack. For crip writer and activist Johanna Hedva, “crucially, The Sick Woman is who capitalism needs to perpetuate itself. Why? Because to stay alive, capitalism cannot be responsible for our care – its logic of exploitation requires that some of us die.”
Were we using each other, psychiatry and me? The profession needing ladies like me to legitimize its reach, and me needing the profession to legitimize a story about why my life was breaking down around me? I also wanted the drugs, or the search for the right drugs, as a way to provide relief, if only for a little while, if not in the way the more well-meaning of my doctors intended.
Years after I stopped throwing up, stopped fucking around with Lamictal, lithium, Latuda, the ululation of Bipolar medications, capitalism’s logic of exploitation—its manifestation through the complicated interplay between eating disorders, mental illness, social media, and psychiatric healthcare—would become clearer to me through several months of reading several thick books of theory. In the mornings, over coffee and a cinnamon roll from Lincoln’s woman-owned pastry shop, I’d bury myself in Susan Bordo’s Unbearable Weight, hungry for her description of eating disorders as constructed by culture, wondering about the possibility of deconstructing my bulimia the way I had learned to deconstruct a text.
In between teaching sections of first-level writing courses, I’d flip through the pages of Emily Martin’s Bipolar Expeditions, writing fuck, this is true and lol YES in the margins of paragraphs that described how U.S. corporations take advantage of, spur on, and profit from workers’ wild swings in moods, double-underlining Martin’s explicit conclusion that work is making us sick, that capitalism, in and of itself, is part of the etiology of mental illness.
In the evenings, tucked in bed between my dogs, our piles of pillows, and Kiernan, I’d read Angela McRobbie’s Feminism & The Politics of Resilience and Nikolas Rose’s Our Psychiatric Future together, shoving one book under a pillow to wait as I finished a chapter in the other, then switching them out to start the process over again. It felt important, and necessary, to approach their arguments about psychiatry and social media feminism in juxtaposition: Rose, writing just a year before the pandemic, underscores the failures of psychiatric researchers as they attempted to camouflage both the ineffectiveness of psychotropic medication and their own misguided attempts to pin mental illness to specific neuromarkers in the brain. Meanwhile, McRobbie exposes the violence of a neoliberal feminism that attempts to address mental illness through Instagram and Twitter narratives that reinscribe illness and suffering as normal, even necessary experiences for women with ambition.
Sometimes now when I find myself needing to provide a quick account of how I made it through the worst of my mental ill health, I will credit these books. Usually it’s a student, or a grad-school acquaintance, sometimes a mom friend who’s interested in my experiences of suffering, and what they might learn or imitate as they approach their own struggles, or that of loved ones. I offer up these authors, their names light on my tongue, like little gifts, a simple mantra to invoke during brief conversation: Bordo, Martin, Rose, McRobbie. It’s nice to have something to offer. But I inevitably leave these conversations feeling as if I have played a trick, or left the real question unanswered, the one Rose asks at the end of his book: “What of the voices of those who are the subjects of psychiatry: the patients, the users of mental health services, the survivors of compulsory confinement, involuntary treatment, or longterm medication? Should they not be the people who should judge the benefits of psychiatry?”
How do you learn to be judge and jury? When does my voice as a subject of psychiatry resist its punishing norms? When does it reaffirm or capitulate to them? Does an Instagram photo that says “sane” paired with a caption that says “crazy” fuck with the binary, or does it double down on the world’s already gendered understanding of illness?
Throughout the first half of my PhD program, I tweeted and Instagrammed my way through purging and fits of rage I didn’t fully understand: Trump was president, the vomit wasn’t doing its job, and the weight of living under the bipolar and bulimia diagnoses intensified as I swung wildly between staking my claim to these identities and deconstructing them, depending on the season; whatever new feminist book I was halfheartedly browsing; whether I was talking to my parents and sisters or not; my changing moods; the changing number on a scale; the intensity and reality of my nightmares; the scars on my wrists and upper thighs burning and itching and always, always, in spite of their original intent, shackling me to myself.
It became hard to turn away from everything that was not, in fact, working: the medication I took for moods, the drinking for pleasure, the hangovers for a focus on the present moment. The question I was left with one random morning that spring, as the last of Lincoln’s snow finally melted into mud, was: What do I do? The light was bright, and cold, doing that dappling thing it does as it hit the spine of a never-read tarot book on a high shelf. Jessa Crispin’s The Creative Tarot. My stomach hitched up into my throat, like both gut and esophagus were trying to lift their skirts. I opened to a random page: “I almost wanted pout. You mean, I was going to have to actually take responsibility for what was going on in my life? Admit that I was responding to changing circumstances by walking into the middle of the street, rending my garments, and yelling, ‘Help, I am dying!’ when I was actually pretty fine?”
Crispin was describing her reaction to a tarot reading that changed her life, and the language of it—humor, questioning, self-critique, a desire to try something different—shocked me. I was used to women labelling any discussion of responsibility in mental illness as patriarchal bullshit, internalized misogyny. I was used to sentimentality, tragedy, drama. Hashtags and humorlessness. What was it that gave Crispin this sense of humor, its bite, its ability to soothe? I opened the deck of tarot cards that had been shoved in beside the book, searching for the knight cards she had referenced in her own reading, finding armored, earnest figures astride anxious horses, my own chest slick under my sports-bra, my ribcage bumpy with an apprehension, a knowing, even though I didn’t know what it was all about just yet.
I read The Creative Tarot. I read everything else of Crispin’s I could find in print, online. I remembered: I liked to read. I deleted Instagram from my phone. I started in—for real, in earnest—on the theory I’d been neglecting for my degree program. I began to think about illness narrative as tool, as history, as future. I began to think about illness differently, as Roy Scranton, another favorite writer, thought about death: as a starting point, something impossible to escape, and yet something that could inspire a radical devotion to being here and getting better anyways.
I read illness memoirs I hated, ones that seemed obsessed with doing what I had been doing, deferring to diagnosis, performing suffering on social media. I read ones I loved, ones that helped me contextualize or reimagine my own experiences: Marya Hornbacher’s exploration of the interaction of family and self in her own struggle with bulimia and bipolar diagnoses; Elizabeth Wurtzel’s chaotic look at class and privilege, depression and desire in Prozac Nation. I read and taught Johanna Hedva’s manifesto, “Sick Woman Theory,” to my composition students, watched them talk about the interplay of sickness and protest, terminology and oppression. Considering Hedva’s call “to take on the historically feminized and therefore invisible practice of nursing, nurturing, caring,” my students seemed most anxious about the idea of “invisibility,” about what it meant to be unseen, misinterpreted, or too busy to be concerned with the suffering of others, visible or not.
“The reality of this world I feel like is often hidden by an image of ‘freedom,’” one student said. “People often think that if you are depressed that you are just lazy and do not do anything.”
But what does Hedva want from me, another student, who self-identified as a “white, middle-class, 21st-century woman," seemed to be asking. “While I agree with Hedva’s political concerns of those more ‘invisible bodies,’” she said, “I myself am unable to stand in place for [them].”
Another student, a boy whose class participation would stutter then falter almost completely after a semester battling long covid symptoms, spoke to feeling like an invisible body, and the pull to internalize his illness as a sense of worthlessness: “Anything or anyone that deviates from the norm of ‘well’ is seen as ill, useless … to me this is something that is taught to us, ingrained in us, even though I am part of the ‘unwell.’ How do we change that, especially now in a time where every idea, good or bad, has a platform to reach thousands?”
Like other writers I followed online, like myself at times, Hedva’s illnesses made physical protest impossible for them. But rather than directing all of their energy into the work of posting to social media, transforming their pain into yet another product to be consumed, Hedva focused on writing, teaching, and building out an online community of care, protest, and mysticism.
For Hedva, the question was not whether or not sickness had become useful to women. For Hedva, the question was why women wanted to filter that experience, make it palatable for profit: “Do we really want corporations to start using our languages, knowing about our identities?”
Most of all, in my own private attempts at understanding my pain, I read the tarot cards themselves, flipping them over every morning, telling myself new stories about my bad dreams, my desperation for vodka, the rush I felt kneeling over a toilet with flecks of old funk stuck to the bowl. What did it mean to call my nightmares PTSD, and what did it mean to call them the Nine of Swords, clues from my subconscious about my own confusion of desire and responsibility, self and community? Why did I get the Seven of Cups on the mornings I most wanted to drink, or to binge, or to purge, or shove a fistful of pills into my mouth to see what worked? And why, when I chose to write and study and read, instead, did I pull The World: recognition, vulnerability, openness, arrival? The Chariot, too, a sense of being on track, a sense of being able to unravel illness from identity, to hold those threads separately, one reign in each hand, mirroring the little figure on the card.
Why wasn’t my psychiatrist talking about the possibility of divesting from the narrative of the “bad brain?” Why did my shrink only touch on it after an hour of listening to me tell the same old stories: I did this, I did that, they did this, they did that, I can’t, I won’t, I don’t know, I need.
Perhaps it seems weird to talk about responsibility and self-annihilation, will and surrender, a devotion to tarot and woo as part of the interruption to my illness narrative, but it also feels true. The cards gave me permission to trust in the mysticism of the first moment I encountered them, to believe, as Simone Weil believed, that to approach god was to surrender my “I” for a while. The idea that I might reframe pathology as what led me to mysticism, and mysticism as what led me, paradoxically, back into a capacitated self, also hinted at what it could mean for me, with all of my private pain and fear of public interaction, to be in community.
This was something I had not gotten from psychiatry, or social media or school, or by running my mind over my theorist touchstones who helped me critique psychiatry and social media and school. Bordo Martin Rose McRobbie helped me learn the diagnostic failings of the DSM manuals, the violent intent of the perfect, online feminine, the overdetermined cultural meaning of the skinny body, and the explicit fact that neoliberal capitalism itself is inextricable from illness, particularly bipolar disorder with its work-bender highs and self-hating lows.
But what if illness was also something other than capitalism, or culture, or science? What did it mean for me to think of my “self-undoing” as the very starting point for the idea that “care” could, in fact, be defined by ambivalence and contradiction rather than binaries?
If psychiatry’s ableism glances sideways at the historical entanglement of madness and genius, illness and woman, and frets over its trouble at pulling the two apart, mystical forms of meaning-making—astrology, tarot, divination, witchcraft—worry less about embracing their mess. Just as feminist, queer, and crip theory seek to collapse dualistic views of the world, practices like astrology and tarot offer up a world rife with multiplicities, as well as a complex language that seeks to describe the self’s convergence with social, political, economic, generational, and personal forces.
Canonized by the polytheistic, pre-Christian Ancient Greeks, astrology, in particular, enjoyed centuries as one of the dominant forms of medical knowledge and practice, until it was outlawed by the Enlightenment leaders in the 1700s. Official histories ascribe the illegalization of medical astrology to its primitive, un-scientific claims, but books like Silvia Federici’s Caliban and the Witch, Ioan Couliano’s Eros and Magic in the Renaissance, and John Gray’s The Soul of the Marionette connect its delegitimization to a concentrated effort to vilify women healers, midwives, and herbalists. For Federici in particular, science, as much as Christianity, was responsible for forcing women into the subservient roles of domestic laborer, reproductive object, and mad woman. She writes, “across ideological differences … the identification of women with a degraded conception of corporeal reality has been instrumental, historically, to the consolidation of patriarchal power and the male exploitation of female labor.”
The language that astrology and tarot gave me to describe my experiences of panic attacks, anxiety, suicidality, addiction, and being a body in need helped me become less afraid during these episodes. And in becoming less afraid of them, they also began to happen less. And in happening less, I began to appear to the world less sick, itself an ambivalent position of privilege and confusion.
Some notes on ambivalence (I keep getting confused in paragraph form. I’m anxious I won’t get it right):
1. Much of the resistance to ableism’s demand that we all strive for unattainable, “normal” standards of health, mental or otherwise, has to take place online.
2. As a space, the internet contains within it the radical potential to act as a mediator between private pain and public care.
3. As a space, the internet carries the potential for a community based in complexity, depth, and difference rather than in convenience, proximity, family, or institution.
4. As a space, the internet has been colonized by dominant forms of power, and therefore colonizes people according to those structures.
5. Ableism, as Johanna Hedva notes, remains one of the most insidious of these systems, precisely because it remains so unchecked.
6. The proliferation of mental illness narratives on social media seems like a participation in number 3, but more often falls in line with numbers 4 and 5.
7. Part of the problem is structural. Social media, owned, managed, and surveilled by the most powerful corporations in our society, transforms suffering into a product.
8. Part of the problem is individual. Users (of psychiatry and social media) gain money, attention, dopamine, a sense of control from posting about their suffering. These things stand in for community but mostly aren’t.
9. Because they mostly aren’t, the “high” of posting dissipates quickly. A vicious cycle ensues, following the idea that suffering is what makes an individual interesting, and therefore the individual must continually groom herself to be legible as a person in pain so her story continues to be consumed, her loneliness managed through remaining stuck in illness, or the stories of past illness told over and over again.
10. On the internet, everyone is transfixed. Everyone is sick.
11. Some of the most powerful assertions of crip resistance—that none of us are “well,” that there is no “normal” standard of health, that concepts of wellness and normalcy only serve corporate interests and power, that a radical orientation toward not only our own, but everyone’s fragility can help change the way we think about care and community—become co-opted by ableism’s new neoliberal stance: Everyone is transfixed. Everyone is sick. No need to stop spiraling, you might as well tweet about it.
I want to begin to make sense of how I stopped spiraling but the words on the page always make it seem easy: I quit my psychiatrist. I stopped listing my diagnoses as natural addendums to my name. I bought a journal and filled it with dreams. I still threw up for a while, still drank for a while too, but the need was weaker and the relief of hunger and drunkenness felt smaller, a cheap prize or party trick I knew all too well and had tired of.
I had a dream: My bulimia came to an end simply because I stopped. I woke up one morning, I set an alert on my phone and decided that no matter what happened that day, I would not throw up. When I woke up, I set an alert on my phone and decided that no matter what happened that day, I would not throw up. I would not eat my way through an entire bag of bagels. I would just be. And I just was, that day, and the next day, the next week, month, year, two, through personal and global tragedies, birth and death, overwhelm and, sometimes, hope. It’ll be six years without bingeing and purging this summer, the anniversary exact when the nasturtiums fill the planter by the back deck, orange and yellow, abundant and red.
You’ve come out of a depression, was the consensus of my therapist and the psychologist who led the Harm Reduction group I attended every Wednesday for a while. Doesn’t it feel good? When I am alone, I sometimes turn this question over and over in my head, worrying at what it does not get at, and worrying that I was never really sick, that I was only ever a liar, or that I just willed my illness away. What that would even mean.
But there is will, and there is will.
There is William James, father of psychology, Capricorn like me: “My first act of free will is to believe in free will.”
There is Lauren Slater, in her illness memoir Lying, on wisdom drawn from James, what she calls Will A and Will B: “Will A is what we all learn, to hold your head high, stuff it down, swallow your sobs, work hard kind of will. Will B, while it seems a slacker thing, is actually harder to have. It’s a willingness instead of a willfulness, an ability to take life on life’s terms as opposed to putting up a big fight.”
When I question the value of psychiatry, of currently legitimized stories about mental illness, I do not mean to suggest that mental ill health isn’t real. When I ask that women divest themselves from wholehearted compliance with the “long arm of psychiatric healthcare,” I do not ask that we divest ourselves from speaking about pain. When I critique the way we have staked our understanding of ourselves to pain, I do not deny that the stakes exist, that our lives are contoured around them and our struggle to name or identify their shape. When I say that my purging came to an end, or my madness, or my drunkenness, or my addiction, outside of the control-care-categorize-surveil nexus of psychiatry, I do not mean that the pain ended, or the confusion, or the fear, or the desire. Most mornings, I still wake up and weigh myself. Most evenings, I still crave a bottle of wine instead of a glass. Some days, before I teach, I have panic attacks in the bathroom, shaking until my vision is nothing but fog. My moods will always be shaped according to an emotional season that makes little logical sense to me. I expect that, sometimes in my life, I will need medication for relief. Perhaps I will need professional surveillance again sometime, a remove from life, a care that Kiernan and books, friends and motherhood cannot provide. “A body in mysterious discomfort exposes itself to medicine hoping to meet a vocabulary with which to speak of suffering in return,” Ann Boyer writes in The Undying, “If that suffering does not meet sufficient language, those who endure that suffering must come together to invent it.”
To invent it, yes, and to protest, too, the narratives of suffering forced upon us by the medical industrial complex and consumed eagerly by our timelines. It was not just that I stopped bingeing and purging and washing my breakfast down with booze and benzos. It was also that I stopped distracting myself from my pain by tweeting about it, by rendering it into sad-noble-smart-girl captions on Instagram. The need to tether my identity to psychiatry as a paradoxical way to advocate for attention and support, diversity and inclusion has gone.
I don’t want the performance of mental distress, or the filtering of anguish. I want to get at the complexity of it, the strange headspace of striving to live while wanting to die. I’d rather examine these things, through my writing, through my life. I’d rather live and think differently.
I’d rather live than die, though the wanting to die is there, too, sometimes every day.
I want an illness narrative that does not let me off the hook, but that doesn’t leave me hanging there by myself either.
WHEW, this is incredible thinking-through. Thank you for sharing the process and the weaving and connecting these dots.
This all so so resonated with me but particularly this -- “The need to tether my identity to psychiatry as a paradoxical way to advocate for attention and support, diversity and inclusion has gone.” -- I know we’ve touched on the convoluted heaviness of The Bipolar Diagnosis before but as someone simultaneously trying to untether myself from its missteps and normalize it for myself, the internet is not always a safe place to nurture any willingness to take responsibility and agency for ourselves/our behavior. I so appreciate your perspective on this, as always