It's arrogant to say anorexia is a personal choice rather than a mental illness

A response to Rachel Cusk's New Statesman article "The anorexic statement".

In November 2010, almost exactly two years ago today, a 28-year-old French model called Isabelle Caro died from complications arising from anorexia. A few years before, in 2007, she had risen to increased prominence after appearing in an advertising campaign to raise awareness of eating disorders within her field. Stick-thin, with vertebrae clearly on show, she stared straight out of the billboards that lined Italian cities and were later (controversially) banned. The image was undoubtedly shocking; some even found it outright traumatic. Its accompanying message - "No Anorexia" - made a clear statement about the fashion industry when it was pushed out to the Italian public during fashion week.

If you’re looking for an "anorexic statement", then Caro’s is as close as you can get. She suffered from the disease from early adolescence, and she spoke about being in its grips as a personal struggle. She talked publicly of how she wished to be rid of the crushing mental illness, right up until the two months before her death. The "No Anorexia" campaign was about drawing attention to the downright ugliness of a body destroyed by an anorexic life, the ironic lack of glamour in an illness that pervaded industries priding themselves on allure and desirability. And these reasons are why, for many, Rachel Cusk’s recent article on anorexia in this magazine hurt so much.

Does every woman’s body make a statement? Cusk thinks it does. She claims that the anorexic state "returns the woman to the universality of a child", a pre-pubescent state wherein she doesn’t have to think about menstruation or lactation or childbirth or sex. She paints the sufferer of anorexia as a narcissistic martyr of the modern age, obsessed with her image, privileged enough to impose an illness upon herself, sitting "screaming about a spoonful of peas" while other people just get on with the practicalities. Needless to say, sufferers and former sufferers of the disease, as well as their loved ones, didn’t take kindly to this reductive and convenient analysis.

Why is such an analysis convenient? Precisely because mental illness is infuriatingly inconvenient in its individuality and nuance. Treatments and causes are varied and often inexplicable. Personalities are, by their nature, all very different. By positing an "anorexic type", Cusk makes the problem of anorexia wonderfully simple: it’s just a "sickness of the modern age" manifested in a certain type of defective personality. If they’d stop indulging themselves for one pea-eating second, or experienced some real type of hardship, then they’d snap out of it once and for all, right? If Isabelle Caro had really sat down and thought about it, then she could have saved herself the massive setback of dying during her anti-anorexia campaign.

Even aside from all of this offensive hypothesising, it’s strange enough that Cusk maintains throughout her article the idea that women speak with their bodies, but men don’t. She talks about periods and childbirth as physical states to escape from as if men are beings wholly removed from such concerns (because blood is a problem, but semen is supposedly totally cool.) And feminists have fought for a long time to remove the basic assumption that women are "naturally decorative", "speaking" through their bodies alone, expressing their complaints about society by getting thinner and a little bit childlike, while men are naturally intellectual, objective, and altogether more adult. We suppose that the last fifty years of feminist thought have passed Cusk by, as well as the fact that male sufferers of anorexia exist, unfortunately, in substantial numbers. 

Indeed, Cusk appears to have done little research about the illness, instead relying on verbose rhetoric. At one point in her dense treatise, she implies that anorexics of craving visibility. The "anorexic statement", as she so coldly calls it, seeks attention. And yet, so many sufferers speak of wanting to disappear. This does not compute. Cusk speaks with the authoritative and detached voice of a scientist, but she is no scientist. Her overwrought prose serves to raise her essay up to the status of literature, concealing her crass generalisations beneath "sophisticated prose". And yet, it is lacking in any of the perception or insight associated with that term. Her continual use of "the anorexic" throughout the essay makes her seem emotionless and removed, and she seems to forget that this is a disease that affects real people, not simply medical cases whose motives must be dissected and speculated upon in florid prose.

Anorexia is a complex, awful, terrifying disease, the causes for which are a constant topic for research by medical professionals. Its causes do not fit neatly into a single tick-box, and thus lumping all its sufferers together into one group is supremely unhelpful. As a commenter who had reached recovery noted beneath the original article, "no book or article that I read has ever explained how I got there". To presume a statement on the part of another belies supreme arrogance. Cusk has projected that "statement" onto women and girls who are suffering from a life-threatening illness, women and girls whose friends and family may be reading Cusk’s words in between hospital visits. That she should imply that mental illness is a choice is verging on the unforgiveable as far as anyone who’s ever suffered one is concerned.

At one point in the piece, Rachel Cusk refers to the male gaze. She blames what she calls "the preponderance of male values", and yet there she is, judging these women’s bodies, projecting her agenda, her pseudo-psychoanalysis onto them. In other words, it is not their bodies speaking. It is not their story. Isobel Caro’s "anorexic statement" was just that because she, the sufferer made it, and no one else. In light of this, we should be aware that the only statement that Cusk is making in her article is applies to herself.

The advertising campaign featuring French actress and anorexia sufferer Isabelle Caro. Photograph: Getty Images

Rhiannon Lucy Cosslett and Holly Baxter are co-founders and editors of online magazine, The Vagenda.

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Who will win in Copeland? The Labour heartland hangs in the balance

The knife-edge by-election could end 82 years of Labour rule on the West Cumbrian coast.

Fine, relentless drizzle shrouds Whitehaven, a harbour town exposed on the outer edge of Copeland, West Cumbria. It is the most populous part of the coastal north-western constituency, which takes in everything from this old fishing port to Sellafield nuclear power station to England’s tallest mountain Scafell Pike. Sprawling and remote, it protrudes from the heart of the Lake District out into the Irish Sea.

Billy, a 72-year-old Whitehaven resident, is out for a morning walk along the marina with two friends, his woolly-hatted head held high against the whipping rain. He worked down the pit at the Haig Colliery for 27 years until it closed, and now works at Sellafield on contract, where he’s been since the age of 42.

“Whatever happens, a change has got to happen,” he says, hands stuffed into the pockets of his thick fleece. “If I do vote, the Bootle lass talks well for the Tories. They’re the favourites. If me mam heard me saying this now, she’d have battered us!” he laughs. “We were a big Labour family. But their vote has gone. Jeremy Corbyn – what is he?”

The Conservatives have their sights on traditional Labour voters like Billy, who have been returning Labour MPs for 82 years, to make the first government gain in a by-election since 1982.

Copeland has become increasingly marginal, held with just 2,564 votes by former frontbencher Jamie Reed, who resigned from Parliament last December to take a job at the nuclear plant. He triggered a by-election now regarded by all sides as too close to call. “I wouldn’t put a penny on it,” is how one local activist sums up the mood.

There are 10,000 people employed at the Sellafield site, and 21,000 jobs are promised for nearby Moorside – a project to build Europe’s largest nuclear power station now thrown into doubt, with Japanese company Toshiba likely to pull out.

Tories believe Jeremy Corbyn’s stance on nuclear power (he limply conceded it could be part of the “energy mix” recently, but his long prevarication betrayed his scepticism) and opposition to Trident, which is hosted in the neighbouring constituency of Barrow-in-Furness, could put off local employees who usually stick to Labour.

But it’s not that simple. The constituency may rely on nuclear for jobs, but I found a notable lack of affection for the industry. While most see the employment benefits, there is less enthusiasm for Sellafield being part of their home’s identity – particularly in Whitehaven, which houses the majority of employees in the constituency. Also, unions representing Sellafield workers have been in a dispute for months with ministers over pension cut plans.

“I worked at Sellafield for 30 years, and I’m against it,” growls Fred, Billy’s friend, a retiree of the same age who also used to work at the colliery. “Can you see nuclear power as safer than coal?” he asks, wild wiry eyebrows raised. “I’m a pit man; there was just nowhere else to work [when the colliery closed]. The pension scheme used to be second-to-none, now they’re trying to cut it, changing the terms.”

Derek Bone, a 51-year-old who has been a storeman at the plant for 15 years, is equally unconvinced. I meet him walking his dog along the seafront. “This county, Cumbria, Copeland, has always been a nuclear area – whether we like it or don’t,” he says, over the impatient barks of his Yorkshire terrier Milo. “But people say it’s only to do with Copeland. It ain’t. It employs a lot of people in the UK, outside the county – then they’re spending the money back where they’re from, not here.”

Such views might be just enough of a buffer against the damage caused by Corbyn’s nuclear reluctance. But the problem for Labour is that neither Fred nor Derek are particularly bothered about the result. While awareness of the by-election is high, many tell me that they won’t be voting this time. “Jeremy Corbyn says he’s against it [nuclear], now he’s not, and he could change his mind – I don’t believe any of them,” says Malcolm Campbell, a 55-year-old lorry driver who is part of the nuclear supply chain.

Also worrying for Labour is the deprivation in Copeland. Everyone I speak to complains about poor infrastructure, shoddy roads, derelict buildings, and lack of investment. This could punish the party that has been in power locally for so long.

The Tory candidate Trudy Harrison, who grew up in the coastal village of Seascale and now lives in Bootle, at the southern end of the constituency, claims local Labour rule has been ineffective. “We’re isolated, we’re remote, we’ve been forgotten and ignored by Labour for far too long,” she says.

I meet her in the town of Millom, at the southern tip of the constituency – the opposite end to Whitehaven. It centres on a small market square dominated by a smart 19th-century town hall with a mint-green domed clock tower. This is good Tory door-knocking territory; Millom has a Conservative-led town council.

While Harrison’s Labour opponents are relying on their legacy vote to turn out, Harrison is hoping that the same people think it’s time for a change, and can be combined with the existing Tory vote in places like Millom. “After 82 years of Labour rule, this is a huge ask,” she admits.

Another challenge for Harrison is the threat to services at Whitehaven’s West Cumberland Hospital. It has been proposed for a downgrade, which would mean those seeking urgent care – including children, stroke sufferers, and those in need of major trauma treatment and maternity care beyond midwifery – would have to travel the 40-mile journey to Carlisle on the notoriously bad A595 road.

Labour is blaming this on Conservative cuts to health spending, and indeed, Theresa May dodged calls to rescue the hospital in her campaign visit last week. “The Lady’s Not For Talking,” was one local paper front page. It also helps that Labour’s candidate, Gillian Troughton, is a St John Ambulance driver, who has driven the dangerous journey on a blue light.

“Seeing the health service having services taken away in the name of centralisation and saving money is just heart-breaking,” she tells me. “People are genuinely frightened . . . If we have a Tory MP, that essentially gives them the green light to say ‘this is OK’.”

But Harrison believes she would be best-placed to reverse the hospital downgrade. “[I] will have the ear of government,” she insists. “I stand the very best chance of making sure we save those essential services.”

Voters are concerned about the hospital, but divided on the idea that a Tory MP would have more power to save it.

“What the Conservatives are doing with the hospitals is disgusting,” a 44-year-old carer from Copeland’s second most-populated town of Egremont tells me. Her partner, Shaun Grant, who works as a labourer, agrees. “You have to travel to Carlisle – it could take one hour 40 minutes; the road is unpredictable.” They will both vote Labour.

Ken, a Conservative voter, counters: “People will lose their lives over it – we need someone in the circle, who can influence the government, to change it. I think the government would reward us for voting Tory.”

Fog engulfs the jagged coastline and rolling hills of Copeland as the sun begins to set on Sunday evening. But for most voters and campaigners here, the dense grey horizon is far clearer than what the result will be after going to the polls on Thursday.

Anoosh Chakelian is senior writer at the New Statesman.