Traveling, Fighting, Dancing: Illness and Recovery Metaphors

In the spring of 2016, a reader, Diana, posted a comment on my post ‘Why control won’t bring you happiness’:

I'm finding it difficult to actually eat more. I know that I am underweight but because it's not by that much I find it hard to accept the need to eat more than I do. I feel like I'm okay because I do eat regularly but I guess not that much though some meals are normal. I don't know how to get out of this situation. Whenever I do eat more I feel panicked and yucky about myself. It passes but it's a horrible process to go through. I'm seeing a therapist and I have support from 3 friends and my husband. I also have two young children. I have suffered from eating disorders in the past and come out of it but this time seems very hard. Perhaps because the situation doesn't seem that drastic, and I am functioning okay. However, I know I'm not living a truly vibrant life. I love my husband and children more than anything but this eating disordered side of me feels like it's robbing me of being fully present.

I am trying to heal myself with yoga and journaling but it's not enough.

My reply was entitled ‘Paths to Acceptance’ and part of it read:

You feel your life slipping past—not being fully present is a great way of putting it. So many women live most of their lives like this—half-living. Having recognized that partial absence is the first step, I think. Many people never even get that far.

The next you've actually already taken too: remembering that the discomfort of weight gain is only ever temporary. As I said, the getting worse is the necessary but short-lived precursor to the getting better. Yoga, diary-writing, mindfulness, and all the other things that can bring real benefits can take full effect only if the mind and body practicing them are well nourished. Anything else is like putting a plant on a windowsill with lots of nice sunlight and giving it doses of special plant food now and then, but always forgetting to water it. It can make use of the other stuff a bit, but in the absence of that most basic ingredient for life, it will never really flourish.

Diana’s description of her situation is a careful, straightforward account of her habits, the things she finds difficult in recovery, the gap between what she knows and what it’s easy to find herself believing, or acting as if she believed. My reply tries to step into that gap and offer first a reiteration of her own insight, then an alternative perspective on her yoga and journaling.

Both of us use metaphors. Mine are more conspicuous than Diana’s, but both of them are doing cognitive work: not just illustrating the points we’re making, but constructing them. Can you spot hers, and mine?

Metaphor can seem like some rarefied classroom technicality, a fancy poetic add-on to ordinary, literal language. But in fact, it’s a basic linguistic feature that infuses almost every utterance we make. It’s a way of making something easier to understand, or emphasizing specific aspects of something, by comparing it to something else. ‘Love is a rose’, sang Neil Young. Bette Midler sang ‘The Rose’, which comes to the same conclusion. ‘My love is like a red, red rose’, wrote Robert Burns. (Strictly speaking, this one is a simile, not a metaphor, because he says the love is like the rose, rather than simply saying it is the rose. But the same basic thing is going on.) It’s a popular choice: the grand abstraction, love, is being made sense of via the concrete everyday object, the rose. The sense-making happens by selection: drawing out some qualities while downplaying others. What springs to mind when we imagine a rose? The delicate petals, the fragrance, the sharp thorns. What about with red? Flesh, blood, fire, maybe autumn leaves. So we focus on these qualities in love: the fragility, the sweetness, the danger and the pain beyond the first glance, the elemental qualities, the temporality of it. Robert Burns insists that his love will persist despite time and space, but the rose makes us wonder. Neil Young reminds us a rose only grows when it’s on the vine. Bette Midler says you are the flower’s only seed. We’re not invited to consider other characteristics: love as an adventure, say, or a learning curve, or a transaction, or a game. (Actually, Midler’s song does make these invitations too but concludes with the rose.) And so the metaphor shapes our thinking, the meanings we attribute to the concept the metaphor was attached to.

These images from poetry and song are overtly figurative, and so, like my plant-on-a-windowsill, the metaphors are conspicuous. But there is no hard line between the metaphorical and the literal: most of our abstract words come from other words which had more concrete meanings, like metaphor itself, which is from the Greek metapherein, to transfer; or conspicuous, from the Latin spicere, to look at, plus the intensifier con. So our language is infused with metaphors, whether we realize it or not.

In just these last two sentences, quite without trying to, I’ve used the metaphors of strictness is hardness (a hard line), a line is a conceptual distinction (a hard line), specificity is hardness (concrete meanings), and language is a liquid (infuse). And probably none of them particularly jumped out at you. All these are examples of so-called lexicalized metaphors, also known as dead metaphors. That is, they’ve become such common parts of the language that they no longer draw attention to themselves as metaphors: they feel neutral, we skim over them and take them for granted. This is the case with the metaphors Diana uses. She describes her situation as a space she would like to escape (‘I don’t know how to get out of this situation’ and her past illnesses as spaces she did escape (‘I have suffered from eating disorders in the past and come out of it’). She describes her past recovery processes as spaces she moved through (‘It passes but it’s a horrible process to go through’) and her current life as lacking in energy and immediacy (‘I know I’m not living a truly vibrant life’; vibrant, from the Latin vibrare, to vibrate). Finally, she separates herself into parts, the disorder representing one part which steals from the other (‘this eating disordered side of me feels like it’s robbing me of being fully present’). I respond with perhaps slightly more conspicuous metaphors of journeying (‘slipping past’, ‘first step’, ‘next [step]’, ‘never even get that far’) before constructing my plant metaphor.

Even when metaphors aren’t drawing attention to themselves, they’re altering and constraining the possibilities for our thought. Diana is using her metaphors to draw parallels between her past and her present (and her possible future), to emphasize the temporal and active aspects of recovery, to characterize a life that has become static, to separate herself from her illness, and criticise the illness. I use mine to echo her spatial constructions and build on them; to reassure her that she has already made progress, even if it doesn’t feel like it. Then after creating a connection by riffing on her metaphors, I turn to something she didn’t make metaphorical (the yoga and journaling habits) and make a provocative and salient metaphor out of them, to draw attention to the distinction between different kinds of nourishment.

Language is our most powerful thinking tool and the ways we do and don’t use it help determine what we do and don’t think. To go back to love; If I talk about winning his affections or resisting his advances, I’m thinking very differently about love from if I say we’ve come a long way together or our relationship is on the rocks. The choice of love is war versus love is a journey not only expresses a certain conception of emotional attachment but shapes what I think and do in my emotional activities, which feeds back into the next metaphor I use. I may be less likely to think of a relationship as collaborative if I stick to the war metaphors, and I might be more likely to seize learning opportunities if I favor the journey structure. The seminal work on what’s known as conceptual metaphor theory was begun in the late '70s by linguists George Lakoff and Mark Johnson, and their book Metaphors We Live By (1980, updated for a second edition in 2003) is a wonderful mixture of the fundamental principles and hundreds of examples you’ll recognise from your own writing and speech.

It’s now well established, too, that how we use and process language is intimately related to our bodily states. For example, if you read the sentence ‘John opened the drawer’ while moving your hand towards your body, you will process it more quickly than if you’re moving your hand away from your body because the congruent physical action aids the conceptual comprehension (Glenber and Kaschak, 2002). This holds for metaphorical uses of language too: if you use your hand to reach out and grasp something before reading the phrase ‘grasp the concept’, your comprehension will be quicker even though the grasping here is a figurative kind: You’re interpreting the concept as an object that can be seized and so understood (Wilson and Gibbs, 2007). And if you’re asked to generate a mental image for a phrase like ‘tear apart the argument’, you’ll quite likely report an understanding of the argument as a physical object which stops existing once it’s been torn apart, and if I ask you to perform, or even just imagine performing, a relevant movement at the same time, you might well experience richer mental imagery (Gibbs, Gould, and Andric, 2006). (See also Gibbs, 2016, for an overview and extension of this research in a literary context.) And not only do our bodies affect our responses to language, but the language we engage with can affect our bodies. For example, when exposed to the metaphor that the past is heavy (‘you must carry your past with you wherever you go’), a book that seems old is perceived as heavier when picked up. Whereas, if the metaphor suggests that the present is the weighty thing (‘you must hold the present with great care’), the new book feels heavier, when, in fact, the two weigh the same (Slepian and Ambady, 2014).

Cognition Essential Reads

How Your Eyes Communicate With Your Ears

The Philosophical Enigma of Large Language Models

The use of metaphors in the context of bodily health is controversial. The notion that cancer is an enemy to be fought is one of the commonest structures used to talk about it, but many people find it inappropriate because of its implication that if you die, you didn’t fight hard or bravely enough (see one discussion of the subject here). There is currently no systematic evidence that psychotherapy affects cancer survival (Coyne et al., 2007). But many ‘physical’ illnesses do have ‘psychosomatic’ components, via mechanisms like blood-pressure or hormonal or immune responses to stress. We know far too little about the interrelations between mind and body to say categorically that really wanting to live could make no difference to survival. Nor should we ever claim that other, ‘purely’ physical factors like number and size of metastases, don’t have direct and significant effects on survival rates.

In any case, once we acknowledge the undeniable fact that psychology is connected to physiology (after all, it’s just stuff happening in the organism that is a human being), then the relevance of language, and hence of metaphor, is self-evident too. The question then is what language, what metaphor, might have what effect. Is the battle metaphor really the best one to convey and sustain the desire to live? What’s different when we call the cancer experience a journey instead? The answer will depend on context and personality and linguistic heritage. But the difference will make some kind of difference, even if it’s ‘only’ to how this individual lives or dies, with their illness.

So, metaphors matter. Our bodies affect our interpretation of metaphor, and metaphor has effects back on our bodies. Metaphors matter, therefore, in every sphere of our lives, including health and illness and recovery. Different metaphors may feel right or wrong, necessary or dangerous, obvious or perverse, in different phases of illness and recovery. They point us towards different aspects of reality; they prod us towards different attitudes and actions. In all the posts I write, and in my replies to your questions and comments, I’m acutely aware of the metaphors I choose and the effects they might have; I often spend a long time waiting, searching, for the one that feels right, and sometimes wonder after the fact whether a different one might have done a better job: might have lit that touchpaper of conviction and energy which would lead, eventually, to freedom.

Similarly, I’m using hundreds of metaphors, more or less effective, in writing this post about metaphors. You might also like to observe, as you read, how many jump out at you, and what can you learn from that, and from attending to the ones that don’t.

The possibilities are as infinite as language itself. But here I’ve gathered together what are perhaps the most common for talking and thinking about eating disorders (with particular emphasis, as ever, on what I know best: anorexia). I give the basic metaphorical structure in capitals, then some specific linguistic examples in italics, and then a brief sketch of some of the implications of using this structure rather than others: what you’re more likely to be focusing on, or downplaying or excluding, if you choose this one rather than another.

So, the next time you find yourself thinking or speaking or writing about your illness, be aware of the metaphors that spring to mind. Listen critically for those other people employ, especially when they cause you pain. Maybe experiment with what changes if you switch their imagery or your own.

Illness/Recovery Is a Journey

Illness/recovery is a long and winding road
I’m on the path to full recovery
anorexia feels a million miles away now
I’ve left bulimia far behind me
what does it feel like to come out on the other side?
how do I find my way out?
all you have to do is keep putting one foot in front of the other, till you get to somewhere different
I’ve learned a vast amount along the way
this illness kept me trapped
I’m grateful to everyone who helped me keep going
there were many hurdles to overcome
you stumbled, but you did not fall
it’s like feeling solid ground beneath my feet again
it has been, at least some of the time, an exhilarating voyage of rediscovery

Whether recovery is the journey or the destination, this metaphor is one version of the near-ubiquitous notion that life is a journey and I am the traveler. We saw this in Diana’s comment. The emphasis here is on progress, and on change; on the idea that there are two different states (places) that can be linked by movement between them (traveling). This metaphor makes room for notions of personal change (because travel takes time and involves new experiences), but also for the idea of persisting a central agent (the traveler), one who may be supported by traveling companions (fellow recoverers, therapists, etc.) and may meet many obstacles along the way.

Illness Is Down, Recovery/Health Is Up

this illness dragged my whole life down with it
I started to spiral back down into obsession
having fallen so far, the climb back to where I was seems impossibly hard
just the tiniest upset could make me slide back
one skipped breakfast can be the start of a slippery slope
there’s nothing to be done but bootstrap yourself to somewhere better
it’s all downhill from here

This is a variant on the previous metaphor, with recovery still a movement from one state (place) to another, but here with the valuation of the two made explicit. Good is up and bad is down are powerful and prevalent metaphorical structures, and here the good is defined as health/recovery and the bad as illness. The movements between the two might be linear (falling, climbing, sliding) or circular (spiraling), but the upwards movements (against gravity) are associated with extreme effort, while the downwards ones are what happens when those efforts fail. Interestingly, the poles can be reversed, as in the final example, which can either mean things are about to get worse or that it’s about to get a lot easier to make progress. Natural language use is teeming with such contradictions and ambiguities.

Source: James Anderson, used with permission

Illness Is Dark, Recovery/Health Is Light

the ten dark years of my anorexia
she pushed back the curtain and stepped, at last, into the bright light beyond
illness and recovery are like night and day
glowing with good health
her eyes clouded with weakness
all that was dim and indistinct is now clear

Some of these examples are more variants on the idea of a journey, this time not from down to up but from dark to light, another pervasive pair of associations with bad and good respectively. Others deal with static attributes: a person is defined by light or dark. When you speak of darkness and light, you emphasise the qualitative difference between the two states (places); you also imply other differences like night and day, coldness and warmth, which in turn have their own figurative associations but also literal relevance to health and illness (living nocturnally, being too thin to stay warm, etc.). You can also create links (as the last example does) to another classic metaphor, that of seeing as understanding.

Illness Is Blindness, Recovery/Health Is Sight

why can’t you see what you’re doing to yourself?
the illness blinded me to all the suffering it was causing
recovery was a process of learning to see clearly again
observe the tired old thought patterns as they arise
dare to look anorexia directly in the eye, and say to it: this far and no further
don’t shy away from the lies, stare them down
the veil was lifted
cool, calm observation is your greatest weapon
I was too blinkered before even to see the blinkers
all the insight I had gathered came into its own once I started eating again

Understanding is seeing is a time-honoured association (I see what you mean, we clarified the issues, he was blind to the complexities involved…), and its transfer to the realm of health and sickness is another way to structure the value judgements of health as positive and sickness as negative: recovery involves not a neutral physical process of increasing health, but a value-laden psychological and epistemological process of increasing insight. The links to the light/dark sphere and all that entails (the greater dangers associated with the night, with not being able to see, or understand, clearly) add to the force of these constructions.

Illness Is a Person

this is just one more of anorexia’s lies
MIA was whispering to me so seductively
the devil on my shoulder was so hard to silence
it’s important to distinguish your own thoughts and beliefs from those of the disorder
I know this is the anorexia talking
the ED keeps calling to me to give in and stop fighting it
you are welcome in our new house, but your anorexia isn’t (said my mother)
it’s like I’m possessed by something bigger than me

Many of the visual metaphors in the previous category involved treating the illness as something visible: an object that can be observed, examined, and so understood. Some of them also made this object animate: the illness becomes another person or creature whom one can look in the eye and say no to. This makes for another overlap between categories: between perception and perceptual agents. Interestingly, the prototypical examples in the "illness is a person" category are maybe auditory more than visual. This might be because of those associations of seeing with knowing, which may derive from the fact that vision is direct perceptual access: once you see something, you can typically identify it, you know what type of thing it is. By contrast, hearing is indirect: it’s common to hear a sound which you can’t identify the precise source of (and you would usually look in the direction the sound came from if you wanted to do so).

So in this category, the motivations, thoughts, and beliefs, associated with the disorder are clearly heard, but (as in Diana’s comment about the disordered ‘side’ of her) they are attributed to an agent whose identity may remain ambiguous (even if it’s sitting on your shoulder, it’s hard to get a good look at: it sees what you see, but you feel and hear more than see it). This kind of separation between yourself and the illness tends to be encouraged in therapy, as a first step towards conceiving of your life without it, and towards replace the disordered ways of thinking and behaving with healthier ways: if you believe them to be inseparable parts of yourself, it may be much harder to motivate yourself to attempt such changes. (See Svenaeus, 2013, for an exploration of people’s use of these kinds of metaphors in illness and recovery.)

Illness/Recovery Is War

I waged war with my appetite every minute of every day
every day was an ordeal
my mind was at war with my body

it’s been a long hard struggle to get to where I am now
you have to just keep battling on
somehow, I seem to have survived anorexia’s many onslaughts
I’m not sure I have the strength or the stamina to win this battle
recovery is about wielding that same iron will, but in the opposite direction
the disorder will exploit the tiniest chink in your armour
the importance of shoring up your vulnerabilities in moments of calm
knowledge is one of our greatest weapons in the fight against anorexia

When it comes to recovery, the battle, the warfare, can follow on helpfully from identifying the disorder as a separate entity. First, you separate yourself from it, then you do battle with it. The battle also converges with the journey metaphor: stamina is needed for both, the fighting may move across many battlefields (indeed, a struggle is somewhere between a journey and a fight). In this category, the warfare may begin with the start of recovery, or it may predate that, with illness reducing life to a struggle. In illness, the warfare may often be conceived of as taking place between different parts of the person (e.g. mind and body). In recovery, the conflict is likely to shift: now it is between the recovering person and their illness. Now the endpoint of recovery is construed as victory, with the disorder the defeated enemy.

Illness/Recovery Is a Skill

reading those books just helped me master all the tricks of the anorexic trade
making himself ignore his hunger felt like the only thing he could be good at

listening, and responding, to what your body really needs is the most important skill to be relearned
another effective recovery tool is conducting experimental tests of the anorexic beliefs
by the end of all this, you’ll be an expert in yourself
it takes quite a bit of dexterity to separate out the fear from the exhilaration
I’m putting my mind and my body back together again, brick by brick

Here, the weapons cede to tools and the conflict becomes construction. In illness, there may be a sense of developing expertise in how to ‘do the disorder well’, ‘be a good anorexic’, or similar. This may be substituting for a lack of self-perceived ability in other realms. In recovery, the handiwork is conceived as resulting in a functional and beautiful endproduct: you don’t need to destroy anything, what you need to do is build what you already are into something more stable, resilient, robust. Both violent warfare and skilful construction can be valuable spheres of association at different points. The skill in question may be understood as an intellectual skill (with the emphasis on gathering knowledge), but is more often construed as practical expertise: the kind that requires you to get your hands dirty, wield a tool, use your body differently. The warfare metaphors can imply this too, of course, but here the stress is less on the body (and mind) being strong than on them being capable.

Illness/Recovery Is Art

starvation is an art that takes years to master
the ascetic man is the man with the higher tastes (Steinhauer, 1962)
he has to starve in order to perfect the work of art (Ellmann, 1993)

the complex art and science of learning to listen to your hunger again (what this blog tries to explore)
the artistry of balancing life’s many competing demands
recovery is a play in five acts
getting better is a dance with many partners, both familiar and strange
the healthy body is the most beautiful of artworks

Recovery as artistry extends the notion of skill further into the realm of creativity. The emphasis might lie in the creative process: the development and practicing of new skills, the aesthetic qualities arising in the act of creation. Or there might be a sense (as in the last example) that the aesthetic achievement is realized only once the work of art is complete, i.e. once health has been created. This idea of health as a static completed object may be a problematic one, when the illness was perhaps so intertwined with bodily aesthetics too, but in this sense it isn’t too dissimilar from the dominant versions of the journey and the war metaphors: in these too, the destination or the victory are conceived of as distinct points in space or time. The difference is that on a journey, you reach one destination and then, after stopping to rest, move on to others; likewise, the point of war is to achieve lasting peace in which to do things other than wage war. With an artwork there is a less inbuilt sense of natural progression beyond recovery to the life that follows on from it: you create it and then it hangs on your wall or sits on your pedestal. But this kind of implication is less common than the process-orientated idea that recovering is just one part of the ongoing aesthetic act that is living.

Of course, then there’s the opposite pole, illustrated in the first three examples: illness as art. Indeed, this is perhaps the more culturally dominant, as illustrated in these quotations from academic publications about Kafka’s 1992 short story ‘A Hunger Artist’ ('Ein Hungerkünstler' in the original German here, and in translation by Ian Johnston here). The story no more justifies these readings than Goodfellas can be described as a film about a lot of jolly decent chaps. But (as I discuss in Troscianko, 2014) critics fall into it because the associations of thinness and not-eating with the beautiful and admirable are so deep-rooted. These are the implications I hope you don’t take from my own blog title; I talk in this post about them and the ones I hope you will instead. The continuing appeal of the ones I try to counter, though, leads on to the next category.

Illness Is (Moral) Purity, Recovery Is Impurity

fatty foods make me feel dirty
I keep my body unpolluted by processed foods
a flawless absence of appetite
he does not exhibit for these corrupt souls [the adults who get bored with him], but for the pure children, who may one day restore fasting to its former glory (Steinhauer, 1962)
[the hunger artist] is a man who is all spirit and no flesh – and surely we can all admire such a man as a seven days’ wonder (Steinhauer, 1962)

This category applies more straightforwardly to anorexia (and orthorexia) than to the other eating disorders, since the concepts of purity and cleanliness tend to be bound up with eating less and eating restricted types of food. Switching the poles and suggesting that recovering is like rejecting the moral impurity of illness, feels much less plausible, even though many people’s recovery is beset by guilt at the suffering their illness has caused to others, by the supposed selfishness of their disordered way of life, i.e., by moral judgements of their illness. Perhaps these feelings are so raw they tend not to get easily converted into a figurative form, but remain as stark self-judgements: I was weak, I was selfish, I don’t deserve to be happy. And this takes us on to...

Illness Is Strength/Courage, Recovery Is Weakness (and vice versa)

it took every ounce of strength I had to resist/eat that cake
I hate myself for being so weak: why couldn’t I just have said no/yes to the last spoonful?
I don’t have the willpower to be anorexic / to get better

Here, the two variants are neatly balanced: many people’s experience of anorexia will encompass both, from the days when the desire to eat more is overwhelming to the days when eating more seems the last thing that could ever be possible. This category is clearly related to illness/recovery is war, but with less of a cognitive overview, and less personification. This isn’t so much the big picture of the battles that make up the war, or the agents pitted against each other; it’s more the moment-to-moment self-judgment as worthy or unworthy, success or failure, in control or out of it.

Illness Is a Cost, Recovery Is a Reward (and vice versa)

being ill / trying to get better is taking such a toll on me
is it really worth the cost?
what price do you put on health and happiness?
do anorexia’s rewards justify the asking price?

This is another category where illness, recovery, and health can all take up both valuations: as a cost or as a benefit. Like strength and weakness, cost and benefit/reward convey the dynamics of self-assessment, the constant weighing-up of priorities for one’s life, which become more acute the more severe illness becomes, and reach their height in the moment when the decision as to whether or not to embark on recovery comes to seem it has to be made. Ultimately, a tiny fragment more of a reason for change than against it may be enough to give the long, strange process of recovery its mandate; for very few people is there anything approaching the total certainty that involves no fear, no clinging to what is known in favor of the vast unknown. But once the scale tips even a millimeter in the direction of recovery, an odd kind of conviction can nonetheless emerge: an almost ironic, yet powerful, understanding that recovery may be shit, but it can’t really be any worse than all this. In this moment, an odd impression can arise that it isn’t really you making the decision.

Illness/Recovery Is an Internal/External Force

I felt untouchable as flame in my infinite hunger
the illness swept through me, sparing nothing
whenever I tried to be calm and just eat, the age-old resistance in me grew stronger than a hurricane
I felt conviction that this was the time for change swelling in me like a wave
the tide was finally turning
there seemed nothing left to do but accept that it was now or never, and give in to the momentum that was carrying me

The imagery of natural forces—of air and water and fire, of storm and tide—dominate here, since the feeling is one of being subsumed in something greater than oneself, whether the universe is sweeping one deeper into illness or away from it. But the metaphor may also (as in the last example) be more neutral, more indeterminate: a vaguer if equally strong feeling that there is some indescribable momentum at work: that it isn’t up to me to do the deciding: that something has already been decided.

In a sense, this is no metaphor: there is no absolute, metaphysical freedom of will, separable from all the relations of cause and effect that resulted in you being right here, right now, in this corner of the universe, about to do what you are about to do. That isn’t to say it doesn’t feel like something to make a decision, to seize control or to lose it. But the reality that no decision is plucked out of a vacuum of unfettered possibility can be reassuring as well as disorientating or humbling. For me, certainly, there was an interesting gap between the long evening of making the decision to get better and the decision itself, which seemed, by the end of the evening, to have formed itself somehow aside and apart from the rituals of talking and talking and assessing and agonising—as if perhaps what was really happening was not me making a decision but ‘me’ accepting that a decision already existed.

In any case, this category’s connections with the natural world bring it into proximity to our penultimate category…

Illness Is Starvation, Recovery/Health Is Nourishment (and vice versa)

not-eating fed some deep-seated need in me
as my body dwindled, my mind seemed to blossom – for a time

it was time to nourish my body back to health, at last
rest is now a sustenance nearly as important as food

When we switch the polarities here, from conceiving of illness as nourishment to recovery as nourishment, we move from the metaphorical to the literal. Nourishment in its most literal form is at the very heart of recovery from anorexia. The psychological change from believing the reverse (that not-eating is in a genuine sense nourishing) to accepting this (that eating is literal, but also more than literal nourishment) is a momentous one. It involves reuniting the long-divorced non-opposites of mind and body, and acting on the insight that what food gives you is, yes, absolutely a body capable of functioning optimally, but also a mind that works flexibly and creatively, the capacity to care about the body and also about other things, the possibility of being me, whoever I am, not just being ill. Diana described trying to heal herself with yoga and journaling, but concluded ‘it’s not enough’. It isn’t food. And so, this one is perhaps the most profound of all our metaphorical categories for anorexia and recovery, precisely because it hovers so close to not being a metaphor at all (even though conspicuous metaphors like my houseplant can be made of it). And its literalness brings us to our very last example of all:

Illness Is Death, Health Is Life

recovering was coming back to life
it was as though the ten years of my illness had never been
she is back from the dead

This, for me, is the one that subsumes all the rest. It says everything. Even more powerfully than dark and light, or night and day, death and life are more profound opposites than any other the human mind has the capacity to imagine. Indeed, grief is so all-encompassing because death eludes our mental grasp. How is it that the person we love and hugged and laughed with is now in that ugly plastic pot from the crematorium? Having an illness is not, of course, quite like being dead. But sometimes it leads to death, and even when it doesn’t, its difference from being well can be hard to convey in any other terms. Whether coming back to life feels like a long slow process, or an instantaneous change upon eating the first meal in daylight or drinking the first sugary alcoholic cocktail, or like both at once, the great strength of this metaphor is perhaps its reassurance that it’s OK not to be able to imagine life after all this: even more than imagining being hot when you’re cold, or not thirsty when you’re thirsty, imagining life from even half-death is simply beyond our powers.

So, take these metaphors, explore them, knead them, roll your tongue around them, feel what they make you feel, and ask what they might have made you feel last year. Use them to understand where you are, and to help others understand. Be skeptical of your own metaphors, and other people’s, as well as embracing them when they deserve it. Let them speak through you, and create in you the desire and the capacity for healing. Do not underestimate their power, nor overestimate it. Keep talking and keep writing but remember that eating is even more important. Remember, above all, that even body and mind are really just metaphors for a unity we don’t yet understand.