Anorexia Nervosa: When the Body Becomes a Prison

The signs of anorexia: control taking over

A person may feel hungry while actively fighting that hunger. They may be afraid of gaining weight even when those around them already see them as extremely thin. They may feel that they no longer have any choice. Little by little, the body becomes a place of control rather than a place where one feels truly alive.

Weighing oneself, counting calories, eliminating certain foods, exercising, checking one’s body in the mirror… These behaviours may initially provide a sense of mastery and security. Food control can then take up an increasingly important place in everyday life. Meals become a source of anxiety, rules multiply, and the slightest transgression can feel like a failure.

And the more control increases, the harder it becomes to let go of it.

In anorexia, hunger, fatigue, cold, and bodily sensations may be pushed aside, as though no longer listening to them could make it possible not to depend on the body. The body gradually becomes an object to monitor and control rather than a place of sensation.

The causes of anorexia: what are we trying to control?

There is no single cause of anorexia nervosa. Behind the symptom, there may be personal vulnerabilities, perfectionism, anxiety, relational or attachment difficulties, life events, bodily changes, comments about weight, or social and cultural pressures.

But beyond these factors, another question may be important:

What does anorexia allow a person to experience — or to avoid experiencing?

For some people, controlling their food intake may be a way of regaining a sense of security, feeling strong, keeping certain emotions at a distance, or maintaining a sense of coherence when their inner or relational world feels difficult to control.

This is why, in Gestalt therapy, the symptom is not simply seen as something that needs to disappear. It is also about understanding what the symptom is expressing and what function it serves in that person’s life, here and now.

How anorexia takes hold: the solution becomes the problem

What may initially have been a way of coping can gradually become a constraint.

The person no longer really chooses to control: they have to control.

Eating with others becomes increasingly difficult. So do improvising, going on holiday, accepting an invitation, or simply listening to what the body needs. Their world becomes smaller.

What was once a solution has become a way of functioning that is increasingly difficult to escape.

How Gestalt therapy can help with anorexia

In Gestalt therapy, therapeutic work is therefore not simply about asking someone to “let go of control”. Because very often, the control is protecting something. Instead, therapy can gradually create a space in which the person can reconnect with what has been pushed aside: their sensations, needs, emotions, desires, and also their relationship with others.

Being able to ask:

• What am I feeling?
• What do I need?
• What do I really want?
• What belongs to me, and what comes from the way others see me?

The therapeutic relationship can become a place where these experiences can be explored without judgement, at a pace that respects the person. The goal is not only to restore a healthy weight or a more balanced relationship with food. It is also to rediscover a freer relationship with the body, emotions, needs, and other people.

Recovering from anorexia: inhabiting the body again

Recovering from anorexia therefore does not simply mean “starting to eat again”. It means gradually rediscovering the possibility of inhabiting the body rather than monitoring it, feeling rather than controlling, choosing rather than enduring.

It is the “road of courage” described by psychiatrist and Gestalt therapist Gianni Francesetti, along which patient and therapist move forward together.

Downloadable factsheet: anorexia nervosa, understanding and supporting

Important: Anorexia nervosa can have serious physical consequences. Psychotherapy should therefore be part of a comprehensive approach that may involve a physician, psychiatrist, dietitian, and psychotherapist. If in doubt, speak to your GP first.

If you recognise yourself, or someone close to you, in these lines, I offer support at my Gestalt therapy practice in Paris (8th arrondissement) or through online sessions.