Category: Unified Theory

The denial of life.

When I was 14, and sitting in a circle with my mom, my best friend, her mom, and her mom’s best friend, I came to a sudden understanding that has become the foundation of everything I write on this blog.

I believe the occasion was a cookie exchange, and it was something my friend did once a year. Her mom’s friend, who also worked at the hospital with my mom, was called Georgia*.

She was delightful in every possible way – warm, funny, sweet, without a sharp edge anywhere. She put up with wild shenanigans during sleepovers and let us dress like Madonna on Halloween and eat as much candy as we wanted. She always kept cinnamon Graham crackers in the house. She let us coax her onto a giant trampoline once, to bounce gingerly and scream in delighted terror. She loved her daughters openly, broadly, and unashamedly, and raised them to be as wonderful as she was.

Her husband had died suddenly of a heart attack a short time before. He, she, and their entire family were large people — tall, broad, and stocky. They were also, I thought, nice to look at, and comfortable to be around. From what I could tell, they ate and moved and lived their lives just like everyone else. I admired that.

After exchanging cookies, we gathered in the living room and drifted into chat. At some point, probably following some hospital gossip, Georgia recounted to my mom the story of a recent doctor’s visit.

The visit had not gone well. I believe Georgia went in for some reason related to her husband’s death, maybe to get help with stress or grief. The doctor — a slender, athletic woman in her 20s — had, after haranguing Georgia about her weight, asked how her husband died. Georgia answered that he had died of a heart attack, and the doctor snapped, “Well, no wonder he’s dead. He was obese and he was a smoker. What did you expect?”

The mothers in the circle fell into a stunned silence. I looked at Georgia’s face, and she seemed somehow apologetic.

How anyone could say something so cruel to a person I knew to be unfailingly kind and sweet, and whose husband’s death had recently devastated their entire family, was an utter shock to me for about two seconds. And then I knew something, and I didn’t know how I knew it, but I knew it with such angry certainty that it just came out.

“That doctor is scared of death,” I said loudly.

How else on earth could you explain a doctor expressing anger and blame at someone for accidentally dying? And to then vent that anger on his grieving wife? You couldn’t. There was no other explanation but the fear of death, utilizing the Just-world Hypothesis as its conduit.

The Just-world Hypothesis is the cognitive bias that causes people to blame other people for their misfortunes, even in cases where blame is not appropriate or not proven. Because we want to believe that we live in a fair world, and that people get what they deserve. If they do something wrong, bad things happen to them. But if they do everything right, and follow all the rules, nothing bad will ever happen to them.

It’s a mental shortcut we use, a theory that seems to have the power to predict what will happen — because to an animal, the power of prediction is essential to survival. It helps you to avoid the very worst bad thing that could ever happen, which is death.

If you die, the doctor was saying, clearly you did something to deserve it. When you deserve it, death is expected, which should somehow rob it of its terror. And because I, a doctor, am smart enough to avoid doing the wrong things, and actually dedicate my life to doing all the right things, I don’t deserve to die, and can therefore predict that it will not happen to me.

Last night, one of my group members quoted Anne Lamott —

I think perfectionism is based on the obsessive belief that if you run carefully enough, hitting each stepping-stone just right, you won’t have to die.

I tend to agree.

I have discovered, through questioning the lovely people I work with, that at the bottom of every fear of eating too much, or of gaining too much weight, resides the fear of death. In the final analysis, it always comes down to this — the awareness that we have to die, someday, and that anything we do might hasten the inevitable.

Some philosophers claim that entire fields of inquiry, entire cultures and civilizations, perhaps the social contract itself, are founded on the awareness and fear of death, and the simultaneous effort to deny it.

Ernest Becker, in The Denial of Death, calls these “immortality projects,” ways that we attempt to create something that might not only forestall death in the immediate sense, but that lives on after we do to achieve a sort of abstract immortality. Great books are written, tall towers constructed, fame and fortune sought, all in the faint hope that our name will live on, long after our body lies beneath the stone on which it is carved.

Even in the absence of dramatic efforts to achieve posthumous fame, our entire lives and all the decisions we make may be interpreted as coping mechanisms for managing, and suppressing, the fear of death. The cracks we step over on the sidewalk, the locks we check over and over (literally or figuratively), the black cats we avoid, the salt we throw over our left shoulder, the pleasure we systematically deny ourselves for the sake of seeming to purify our one immortal organ, the soul — and the trust we withhold from our body, that traitor, who can’t be counted on to keep any promise but the inevitable one.

Fear of physical pleasure, and fear of the seeming bottomlessness of our physical appetites, are disguises for the fear of death.

Responding to your body requires admitting, first of all, that you have a body, that you are a body, that your head does not float on a metaphysical balloon somewhere just north your body, untouchable. This admission requires you to acknowledge that bodies die, and that you will die too. The separation of mind and body, soul and body, spirit and body, is itself a coping mechanism, a sort of immortality project.

All of this would be well and good if it did not cause us to make such tragic decisions during our uncertain, finite, and invaluable lives. Decisions that cause us, effectively, to deny life itself. The fear of death, and the denial of the few concrete things we can touch and cling to as real and worthwhile, can lead to wasted lives. People wrung out and demoralized, lives spent and used up, running on a treadmill toward a mirage that never comes any closer.

How then shall we live?

Health can be redefined as the manner in which we live well despite our inescapable illnesses, disabilities, and trauma.

-Jon Robison

My proposal is that we live in the way that best reflects how we most want to use our precious time, right here, right now. My proposal is that we live well despite our inescapable fear of death. Our time is valuable in more than one way, both in quantity and quality, and neither one should be sacrificed for the sake of the other.

We may instead try, as best we can, to strike a balance between the two, and not go to extremes in an attempt to escape what we all know is coming — but neither to hasten it purposely by squandering what little we do have in a blaze of reckless glory.

This means, then, that I would never suggest running out to smoke and drink yourself into oblivion. Or to gorge yourself on food that makes you feel like shit, even if it tastes like anything but. Or to avoid exercise at all costs, out of a stubborn refusal to (again) admit that you have a perishable body and that it requires a certain measure of care — and in doing so, to deny yourself your life.

Do the things you can reasonably do, without unduly burdening yourself, to be a good steward of the gift of life.

I equally would not suggest that you force yourself to eat food you hate, or eat too little of the things you enjoy and feel deprived, or slog away at life like you’re putting in your time at a dismal job, waiting for the blessed release of quitting time. That you mortify the body to purify the soul. That you sacrifice yourself, your invaluable time, doing things that you hate, hurting yourself mentally and physically, to prove yourself worthy of escaping death, somehow superior to the weak mortals living their pathetically finite lives around you. In short, to live a delusion — and in doing so, to deny yourself your life.

If you genuinely enjoy marathons, run them. If that would be torture to you, don’t. Find something else to enjoy. If you love salad, eat it. If salad is punishment, for God’s sake, there are a million other foods to take its place. Food that isn’t enjoyed isn’t worth a damn. Find something better. You deserve it.

If you feel unfit, if you feel tired and exhausted and find it difficult to move, be good to your body. Feed it good food, give it fresh air and light, and move it gently and compassionately until it is stronger. When it is strong enough, use it to do things that inspire, excite, and even scare you.

Do something that makes you scream in delighted terror.

This is a limited time offer — don’t deny it. Make it count.

*Not her real name.

Pictures of you.

If all you ever saw were daisies, being confronted with a rose might freak you out.

I’m thinking today about body image. My body image, to be specific, and the way I feel when suddenly confronted with photographs of myself taken by other people, showing my whole body.

The experience is one of immediate shock, often followed by a weird cognitive dissonance. My body doesn’t Look Right. Because apparently there is a Right Way for bodies to look, and whatever I’ve constructed in my head as that Right Way sure as hell has nothing in common with the photographic evidence of my squat, round, rather sticky-outy body.

Bodies, in my head, are supposed to be straight up-and-down, to have clean, spare lines and angles. The head should be a particular size in proportion to the rest of the body — not too large, or, in my case, too small. The feet should not be too long in comparison to the length of the legs; the shape from the front of the thigh to the back of the calf not such a dramatic S-shape.

And, for the love of all that’s holy, the whole thing should not be so damn big.

After the emotional reaction, I have to start thinking rationally again. That’s when I realize: hardly anyone spends much of their time daily considering images of themselves, especially not full-body images. Hardly any of us are constantly taking full-body self-portraits, or are surrounded by full-length mirrors. We don’t spend a few hours here and there watching video of ourselves.

We are too busy being in our bodies daily to spend more than a few minutes confronting how we actually look in them.

Then it occurs to me that all those articles decrying the apparent fat-person curse of Being In Denial of One’s Fatness are actually just restating the obvious: when you’re not spending all day staring at yourself, but do spend a considerable portion of your day observing media depictions of bodies that are not much like yourself, isn’t it natural that the part of your brain dedicated to constructing the Platonic composite of How Bodies Look will be mostly filled with images of sparse, clean lines, slenderness, and a particular head-to-body ratio?

Won’t you go through your day, in your body, almost implicitly assuming that it looks more-or-less like the definition of Body you have mentally constructed, based on the images and people you’re constantly surrounded by?

And won’t you then experience a cognitive dissonance when confronted with an image of a body that breaks all those Platonic rules — especially when you realize that it belongs to you, that it is, in fact, you?

Of course. Of course you will. Not because you are a stupid fat person in denial about your fatness, but because the culture we live in has erased fatness (and other forms of physical variation) from most of its artwork and entertainment.

If you’re like me, and fatter than about 97% of the population, you’re also not going to see a whole lot of other people like yourself in daily life. Most people you see, even the relatively fat ones, are going to be a bit less sticky-outy, have proportionally-larger heads, etc. You will also incorporate those impressions into your little Platonic file cabinet, along with the much thinner media impressions.

And your first reaction on seeing a photograph of your body will be one of shock, possibly horror, and an indefinable sense that Your Body is Wrong.

The secret, of course, is that there is no Right Body, no matter how hard our culture tries to define one. There is no Platonic Body floating in indisputable ether — only real bodies that exist in the real world, available in an extravagant assortment of shapes, colours, sizes, and conformations. None of them wrong or right. All of them just are.

And now I can understand that the experience of cognitive dissonance and disgust with how my body looks is an artifact of my cultural training, not a Real and Inescapable Truth About Me, requiring a dramatic gesture of repentant food restriction and mortification of the flesh through exercise.

If anything, the dissonance is a reminder that, because my body is different and even somewhat rare in this world, I must take special care to fill my Platonic File Cabinet with images that make sense to me, that I can identify with. That my own indisputable body shall now be the starting point for my definition of Body, and that I can spend a few minutes daily filling the file cabinet with pictures of me.

Food you like is food that feels good.

French version of this post here, courtesy Stéphanie Potin-Grevrend.

break50

One of my most scandalous messages is that you should eat whatever you want, in whatever amount you want.

What scandalizes me is how people often interpret this message. Over and over again, this is how people respond:

“I can’t do that because I would eat cake 24/7.”

“But you’d overeat all the time!”

“I’d eat such an unbalanced diet I’d make myself sick.”

And I can only figure that when I say, “Eat food. Stuff you like. As much as you want,” what people actually hear is:

“Eat food that makes you feel like crap, in crappy amounts.”

This interpretation says some pretty breathtaking things about our culture’s assumptions about food.

For one thing, it says that we believe tasty food and healthy food are not the same thing. And that, if you were to eat exclusively tasty food from here on out, you’d be eating a nutritionally reprehensible diet for the rest of your life.

To which my internal peanut gallery goes, “Buuuuh?”

Not only does every food, including junk food, contain useful nutrition, but more importantly — nutritious food is often bloody delicious. If this is not your experience of food, then one of a couple of things might be going on:

Maybe you need to reassess what “nutritious” means to you by learning a bit of Nutrition 101 — What’s a carb? What’s fat? What is protein? Where do you find them? (A: anywhere there is something edible.) And what do they do for you? (A: pretty much everything.)

Or perhaps you haven’t ever encountered “healthy” food in anything other than a guilt-ridden context — and thus have always felt resentful toward it and, as a result, your primary nutrition concern is to either be on the wagon, or off it and eating as rebelliously as possible.

Maybe you’ve truly never learned to enjoy more than a very few foods, and your palate needs expanding. Maybe you’re under some kind of therapeutic restriction that you haven’t yet been reconciled with.

Or maybe you only allow yourself to eat when you are desperately hungry — in which situation you are more likely to reach for calorically-dense “bad” foods because you’re at the bottom of the pyramid. And, at that stage, getting enough food = getting enough calories.

Any way you spin it, something is interfering with you and your food.

For a second thing, those assumptions indicate that we believe everyone wants to overeat, all the time. I don’t know if this is an assumption borne of a lifetime of restrained eating and constant hunger, or a misunderstanding of how much food it is actually appropriate to eat (A: however much supports your health and leaves you feeling satisfied, regardless of weight), or a belief that food is addictive, or whether it has a moral underpinning, but either way — it’s an inaccurate and pretty crappy thing to believe about humanity (and food) in general.

If you are like most human beings, you probably seek pleasure and avoid pain, within certain moral constraints — you like to feel good and you dislike feeling bad.

When it comes to food, at least in the immediate term, it’s pretty obvious that people like food that tastes good, and dislike food that tastes bad. But there is more to food than just our immediate experience of it.

Those of you with lactose intolerance, especially, will understand when I say:

How food makes you feel is often as important as how it tastes.

If you’ve never, ever stopped to think about how food makes you feel after eating it, maybe you’ve been so caught up in the shame-spiral of restraint and disinhibition that you haven’t had much mental real estate to devote to the idea. Or maybe you’ve been eating according to externally-imposed nutrition rules and guidelines without really pausing to notice how you actually feel when you eat that way. Or you’re in the midst of the great divorce. And you’re not alone.

But learning how food makes you feel, both immediately and a little way down the road, is a fundamental part of learning how to care for yourself.

In my mind, food that makes you feel weird or off — no matter how good it tastes right now — isn’t food you can unconditionally love. Amounts of food that make you feel bad aren’t amounts of food you actually want to eat. And if you find yourself continually sacrificing your well-being for the lovely, immediate feel and taste of food, it’s a sign that something has gone wrong.

I eat, without reservation, basically whatever I want. Having a really relaxed attitude toward food, and unconditional permission to eat it, has allowed me to stop thinking so much about what I should or shouldn’t eat, and instead to notice how food tastes, as well as how it makes me feel. Here’s a brief sample of the observations I have accumulated, as a result:

I like the taste of Coca-Cola a lot. But it also makes me feel thirsty and a little weird sometimes, so I drink it occasionally, along with food, and often along with plain water and lots of ice. I feel better if I eat a high-fibre breakfast that contains a good dollop of fat (in the form of butter or cream) — it’s more satisfying, tastes better, and stays with me longer. I feel better, more energetic, less run-down, and more satisfied if I eat vegetables with dinner. I need a good serving of protein with lunch and dinner. If I don’t eat an afternoon snack, I feel sleepy. I feel and function better when I drink at least two big glasses of water each day. I really like strawberries, and I prefer eating them whole, fresh or frozen. Aside from strawberries, I don’t much like eating fruit all by itself because simple sugars alone make me feel funny. Adding cheese or nuts makes it work better. Sugar-sweetened cereals taste really good, but don’t satisfy me and often scratch up my mouth. So I think of them mostly as snacks or desserts, instead of as breakfast. I love chocolate and it leaves me feeling fine, so I eat it when I want it, but I rarely eat enough to make me feel ill or uncomfortable. Light popcorn pops up better and is crunchier than extra-butter flavour popcorn. If I want more butter, I’ll melt some real butter and add it after popping. And I really, really dislike the feeling of being either desperately hungry or uncomfortably full.

These observations allow me to eat what I want, in amounts that I want — which means that I get to eat food that both tastes good and feels good. I get to satisfy my hunger without disrespecting my satiety, and I take care of myself with food instead of hurting myself with it.

To me, “wanting” something means more than just liking how it tastes — it also means considering how it makes me feel. The two variables comes together in a sort of split-second cost-benefit analysis, each time I eat, to answer the eternal question, what do I want?

No matter what I end up choosing in any given situation, the answer is always the same: I want to feel good.

As always, remember that mental health is a part of health. And, if you’re not a jerk, why not leave a comment?

Meals, or The appropriate use of discipline.

I define structure as the space within which things can happen. And I think discipline (or “willpower” or “control” or “forcing yourself”) is best applied in the service of creating structure.

It seems to me that everyone has a little tyrant living inside them. The tyrant, if it cannot be exorcised, must be exercised — much like a two-year old must be worn out (with safe activity, away from uncovered electrical sockets) in order to let you have a moment’s peace.

My tyrant has, in the past, been a touch…overbearing. Especially during The Great Diet of ’00, wherein the Tyrant allowed me to eat a strictly allotted portion of calories spread over a strictly allotted assortment of food groups — preferences and cravings be damned.

I’ve seen other Tyrants playing fast and loose with other people’s diets. The Tyrant who disallows Suspicious Ingredients. The Tyrant who eschews fat in all its forms. The Tyrant who cannot countenance pepperoni, much to his ardently pepperoni-loving host’s despair. The Tyrant who insists you must eat salad, even if you hate it. Especially if you hate it.

In order to live with the Tyrant, I’ve decided to put him to productive use. Namely, I’ve used his seemingly boundless energy and unbreakable rigidity to build structure around my eating. Then, once erected, I’ve barred him from entering the tabernacle, the holy abode of my body’s wishes and wants.

Simply put, I do this by eating meals.

To the beginner, it helps to think of meals not so much as meals, but rather as “eating appointments” — defined times or intervals during the day kept sacred to the act of feeding oneself. No matter what eating may or may not occur outside of these appointments, the appointments must be kept. Sitting must occur, and a single bite or drink of something placed in the mouth.

But whether the plate is balanced, according to the Food Guide, or looking more like Sunday brunch at Willy Wonka’s chocolate factory — in this the Tyrant has no say. If I eat one bite or go back for thirds, it is entirely my choice.

If building structure is defining the space within which things can happen, the appropriate use of discipline is to build and maintain that structure — and then let go of what happens within it.

Showerings of parade candy or rotten tomatoes, as always, gracefully received in comments.

Don’t be poor (and other New Year’s resolutions.)

Diabetes death rate drops — primarily among rich people.

This is my SURPRISED FACE. Especially since, in 1995, the World Health Organization identified poverty as “the biggest single underlying cause of death, disease and suffering worldwide.”

In a hilarious-because-it’s-sadly-true list posted to the Wikipedia article on the social determinants of health, a typical list of “lifestyle” tips for better health is contrasted with a list of socially determined tips for better health:

The traditional 10 Tips for Better Health [69]

    * 1. Don’t smoke. If you can, stop. If you can’t, cut down.
    * 2. Follow a balanced diet with plenty of fruit and vegetables.
    * 3. Keep physically active.
    * 4. Manage stress by, for example, talking things through and making time to relax.
    * 5. If you drink alcohol, do so in moderation.
    * 6. Cover up in the sun, and protect children from sunburn.
    * 7. Practice safer sex.
    * 8. Take up cancer-screening opportunities.
    * 9. Be safe on the roads: follow the Highway Code.
    * 10. Learn the First Aid ABCs: airways, breathing, circulation.

The social determinants 10 Tips for Better Health[70]

    * 1. Don’t be poor. If you can, stop. If you can’t, try not to be poor for long.
    * 2. Don’t have poor parents.
    * 3. Own a car.
    * 4. Don’t work in a stressful, low-paid manual job.
    * 5. Don’t live in damp, low-quality housing.
    * 6. Be able to afford to go on a foreign holiday and sunbathe.
    * 7. Practice not losing your job and don’t become unemployed.
    * 8. Take up all benefits you are entitled to, if you are unemployed, retired or sick or disabled.
    * 9. Don’t live next to a busy major road or near a polluting factory.
    * 10. Learn how to fill in the complex housing benefit/asylum application forms before you become homeless and destitute.

So I guess we can all revise our New Year’s resolutions somewhat.

Now, of course, I’m not trying to be fatalistic, and I wouldn’t ever want to take away someone’s feelings of hope of what they can achieve, nor their sense of bodily autonomy — but the trick here is to remember, whenever you’re making “lifestyle” changes for the sake of improved health, keep the bigger context in mind.

Do a sound cost-benefit analysis before embarking on something you don’t enjoy, solely “for the sake of your health.” Keep in mind that certain changes represent only a drop in the bucket of your overall health, and that if something isn’t worth doing for its own sake (intrinsic motivation, remember?), then maybe it’s not worth doing at all.

That said, I’ve made a few…let’s call them “atypical” resolutions of my own — to work hard in therapy, to get better at understanding my limits and boundaries, to speak up when I need help, to work hard on the business-thing, to deliberately build pleasure into my daily life, and to remember that doing all of the drudgy housework-things is part of taking care of myself.

If I had the money and time, I’d add “take a ballet class” to that list, but since that’s not possible for me right now (don’t be poor!), I’ll work on figuring out some alternative. I know it sounds weird for a fat (and fat-accepting) person — particularly one who says “fuck” as often as I do — to be interested in ballet, but I’ve always been a study in contrasts and ballet has always appealed to me.

The idea that it might also be subversive for me now, given my fattitude, only enhances the appeal.

A fat ballet dancer from The Big Ballet

a fat ballet dancer from The Big Ballet

Any atypical resolutions to share?