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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Brexit is an opportunity to rethink our economic model

Our industrial strategy must lift communities out of low-wage stagnation, writes the chair of the Prime Minister's policy board. 

With the long term fallout of the great crash of 2008 becoming clearer the issue of "inclusive growth" has never been more urgent.

Eight years after the Great Crash, it is becoming clear that the long term impacts of the crisis profoundly challenges the model of economy - and politics - we have become used to. Asset inflation and technological revolutions are entrenching untold wealth for a small global elite.

This sits alongside falling relative disposable incomes for the many, and increasing difference in the disposable income of different generations. Meanwhile, a cohort of "just-about-managing" citizens are working harder than ever simply to get by, despite falling rates of savings. All of this – along with a persistent structural deficit in pensions, welfare and health budgets - combines to create an urgent need for new economic thinking about a model of growth and 21st century economic citizenship that works better for all people and places in our country.

The main political parties have set out to tackle these challenges and develop policy programmes for them. Theresa May has set out a bold new Conservative agenda of reforms to help those of our fellow citizens who are working hard but struggling to get by: to build an economy that works for everyone, and for the people and places left behind.

But this challenge is also generational, and will need thinkers from all parties - and none - to talk and think together about fresh approaches. This is why this cross-party initiative on inclusive growth is a welcome contribution to the policy debate.

The Prime Minister leads a government committed not just to deliver Brexit, but also to the fresh thinking and fresh solutions to the scale of the domestic challenges we face, which clearly contributed to the scale of the Leave vote last June. As she has said, it's clear that as well as rejecting the EU, voters were rejecting a model of growth that wasn’t working for them.

The UK’s vote to leave the European Union was one of the most dramatic and significant political events in decades – for this country and potentially for Europe. It changes everything: our economic model, our long term economic prospects, the assumptions and mechanisms through which we run most of our government and the diplomatic and economic status of the UK internationally.

Delivering a successful Brexit – one which strengthens our global security, our united kingdom, our economy and popular trust in parliamentary democracy, and a model of political economy that works to these ends, will dominate this political generation.

This is a challenge. But it is also an unprecedented opportunity to reform our model of political economy to tackle the causes of deepening domestic political disillusionment and put our country on the path to long-term recovery. 

Brexit provides us with a unique chance to address two of the most important public policy challenges facing our country.

First, the need to enable and enhance the conditions for creating and developing greater enterprise and innovation across our economy, in order to increase competitiveness and productivity. Second, the need to tackle the growing alienation of so many people and places from the opportunities of globalisation, which has in turn entrenched attitudes towards welfarism. I believe these two challenges are fundamentally linked. 

Without social mobility, and the removal of the barriers holding back national and regional participation enterprise, we will never be able to tackle the structural challenges of productivity, public service modernisation, competitiveness and innovation. 

It's becoming clearer to more and more people that a 21st century "innovation economy" both requires and drives an "opportunity society". You can't have an enterprising economy with low rates of social mobility. And the entrepreneurial spirit of economic aspiration is the fuel that powers the engine of social mobility.

For too long, we have run an economic model based on generating growing tax revenues from an ever smaller global elite, in order to pay for the welfare costs of a workforce increasingly dependent on handouts.

Whitehall has tended to treat social policy quite separately from economic policy. This siloed thinking – the Treasury and the Department for Business, Energy and Industrial Strategy for "growth" and the Department for Work and Pensions, Department of Health and Department for Education for "public services" - compounds a lack of the kind of integrated policymaking needed to tackle the socio-economic causes of low productivity. The challenges holding back the people and places we need to help do not fall neatly into Whitehall silos. 

Since 1997, successive governments have pursued a model of growth based on a booming service sector, high levels of low-cost migrant labour and housing and asset inflation. At the same time, policymakers tried to put in place framework to support long term industrial renaissance and rebalancing. The EU referendum demonstrated that this model of growth was not working for enough people. 

Our industrial strategy must be as much about lifting communities out of low-skill and low-wage stagnation as it is about driving pockets of new activity. We need Cambridge to continue to grow, but we also need to ensure that communities from Cromer to Carlisle and Caithness, which do not enjoy the benefits of being a global technology cluster, can participate too. That means new measures to spread opportunities more widely. 

The Great Crash and its aftermath - including Brexit - represents a chance for a new generation to think these problems through and tackle them. We all have a part to play. Six years ago, I set up the 2020 Conservatives Group in Parliament, as a forum for a new generation of progressive Conservative MPs, regardless of increasingly old-fashioned labels of "left" or "right", or where they stood on the Europe debate. This is a forum to discuss new ways to tackle the current problems facing our country, beyond the conventional silos of Whitehall. Drawing on previous career experiences outside of Parliament, the group also looks ahead strategically at the potential longer-term social and economic challenges that may confront us in the future.

I believe that technology, and a new zeitgeist for public sector (as well as private sector) enterprise hold the key to resolving the barriers that are currently holding back the development of new opportunities. With new approaches, better infrastructure and skills connecting opportunities with the people and places left behind, better incentives for our great innovators, and new models of mutualised public/private partnerships and ventures, we can build an economy that genuinely works for everyone.

The government has already set about making this happen. Through the industrial strategy, the £23bn package of investment in new infrastructure and innovation announced by the Chancellor, Philip Hammond, we can now be much bolder in developing a 21st century knowledge economy infrastructure that will be the foundation for economic success. 

The success of inclusive growth rests on a number of core foundations - that our economy grows, that social inequality is redressed; that people are given the skills they need to pursue a career in the new economy and that we better spread the opportunities of the global economy hitherto enjoyed by a segment of our workforce to the many. 

This can only be achieved if we recognise the way in which enterprise and opportunity are interdependent. Together, politicians from all parties have a chance to set out a new path for a Global Britain: making our country the world capital of innovation and opportunity. Not trickle-down economics, but "innovation economics" where the private and public sector commit to a programme of supporting each other for mutual benefit.

An economy that works for everyone is an economy in which the country unites around the twin pillars of opportunity and security, which are open to all. A country in which "shared values" are as important as "shareholder value". And in which both are better shared by all. A country once again with that precious alignment of economic and social purpose which is the hallmark of all great civilisations. It's a great prize.

This is an edited version of George Freeman's article for All-Party Parliamentary Group on Inclusive Growth's new "State of the Debate" report, available to download here.The APPG on Inclusive Growth's "State of the Debate" event with the OECD, World Economic Forum, RSA and IPPR is on Tuesday 21st February at 6.30pm at Parliament. See www.inclusivegrowth.co.uk for full details. 

George Freeman is the MP for Mid-Norfolk and the chair of the Prime Minister's Policy Board.