Eating Disorders as the problem of Being | Having

Treating eating disorders proves exceedingly difficult, partially because of the absence of a strong theory that helps understand the psychosomatic substrata of people suffering from these issues. For me, such a theory would revolve around the fraught relationship between Being and Having a body.

I first came to treat eating disorders at the Partial Hospitalization (PHP) stage of substance abuse treatment where disordered eating qualifies as a “process addiction,” alongside gambling, excessive spending, video-game addiction, etc. I frequently met clients, mostly but not exclusively females, who had experienced prior treatments for both substance abuse and eating disorders, though these treatments were also separate, siloed. This separation comes from at least two reasons. First, the physical toll that the body and mind must pay to support an eating disorder, especially in its most severe stages, marks individuals with such issues as needing a “higher level of care” where medical doctors can supervise organ function, nutrition deficits, and the like. Clinicians in private practice, too, will often identify themselves as unqualified to navigate the somatic and psychological needs of Anorexics or Bulemics, often leading them to encourage clients with such needs to find a specialist. Second, and building on the problem of “scope of practice,” the traditional treatments for substance use and eating disorders call for totally different approaches. For starters, the “total abstinence” approach to early recovery from alcohol and other drugs can’t work with eating. People need food. To permit the need for food while treating an eating disorder (again, typically) calls for a “management” approach that addresses eating and meal preparation behaviors. Simply put: clinicians either specialize in and focus solely on the treatment of eating disorders, or else they stay clear of them entirely. 

This separation between substance use disorders and process addictions merely replays the Cartesian dualism of mind and body. It’s one of the signs of neoliberalism’s territorialization of the psychic terrain that occurs in order to legislate “evidence-based treatments.” By moving away from traditional treatment theories, I have come to understand the phenomenon of eating disorders as a symptom of something else, usually a fraught relationship between the subject and society. By “subject,” I mean not only the “I” whom the patient believes themselves to be but also the “I” that the patient believes they should be. 

I draw upon Lacan’s distinction between the “ideal ego” and the “ego ideal.” The ideal ego is the aspirational self one strives to become. The ego ideal is the socially constructed image of the ideal self, a kind of mold into which one seeks to fit oneself so as to attain all the benefits one imagines comes from attaining this ideal. Both are fantasies, but, again, I use that word in its Lacanian sense. Fantasy is the culmination of the Imaginary and Symbolic orders, both a “figment” and a “filament” of what we normally call the imagination: figment in the sense of “something invented, a myth, a fable;” filament in the sense of the incandescent element that lights the lights and enables sight. Treating eating disorders requires attending closely to the construction and apperception of ideal ego and ego ideal handled daily by the individual I’m working with. 

Understanding the fantasy of the self leads back to a more pressing conflict, that of Being and Having a body. Sam McCormick’s parsing of Lacan’s 21st seminar underscores the connection between Lacan’s late and early work, especially in the formulation of the body’s speculative/fantastical makeup. Early Lacan synthesized what he called “the mirror stage,” a pivotal moment in a subject’s development where the experiences of Being and Having strike at each other discordantly. To summarize: new personhood feels awkward, emergent, discombobulated, alternatively uncomfortable and delightfully comforting, and simultaneously unfolds astride a recognition that others see me, interact with me, care for me (or not). Being seen (which can encompass being neglected) begins to imply a wholeness that is incommensurate with the Being one experiences. Viewing oneself in a mirror strikes the gong. I see there in the mirror a whole body, yet the “I” who sees feels unwhole. How are both true? Which one is “I”? These questions never resolve. Rather, they crater out and carve a canyon, one that I like to represent with the diacritical mark |. Being | Having. That’s the result of this mirror stage: I am, and I have this body (that I am). Being and Having never unite. Or, rather, they “unite” mythically in the fantasy of the self. This fantasy is the irremediable differentiation (|), albeit a | wrapped up in the semblance of a whole. | masquerades as I. 

When I say “wrapped up” in the semblance of a whole, I’m thinking of a specific artistic practice of wrapping. The art of treating eating disorders can borrow from the art of painting, specifically as enacted by the 20th-century Polish painter and theatre-maker Tadeusz Kantor. Of his many contributions to the world of avant-garde art, his “emballages” are the most helpful in this case. 

Here’s an excerpt from Kantor’s “The Manifesto of Emballages” to which I often return:

The object has always interested me. I realized that it is unconquerable and inaccessible by itself. When realistically reproduced in a painting, it becomes a more or less naive fetish. The color that tries to touch it immediately becomes involved in a fascinating adventure of light, matter, and phantoms. But the object remains unfathomable. Is it possible to 'touch' it in a different way? Artificially. Through a negative, an imprint, or by hiding it. By something that conceals it. 

- Wiesław Borowski, Tadeusz Kantor, Warszawa 1982, p. 147-148.

Contrary to the common sense that might understand painting to produce objects upon a canvas ex nihilo through the addition of pigment to the white background, Kantor sees objects appearing negatively. Color can latch on to the object, thereby functioning like wrapping paper covering a gifted bicycle. Emballage means “wrapping”: paint wraps the object and reveals it without ever disclosing the object as such. “The object remains unfathomable,” that is, we can’t tell how deep it is, how its material truly is. The result of painting is a touching of the object through artful wrapping, not the disclosure of the object itself.   

The question for a painter, then, is not “how do I produce an umbrella out of colored pigment.” The question is this: How can I artfully conceal or wrap the object so as to touch it and give it sensibility negatively? In Kantor’s famous “umbrella emballage,” a three-dimensional umbrella-like construction becomes the wrapping that conceals the two-dimensional painted umbrella, which, in turn, conceals the object of the umbrella. Through his choice of concealment, Kantor throws into question the “is-ness” of umbrellas as such. Which is more real, a “naturalistic” albeit broken down umbrella made through various materials, or the material idea of the umbrella concealed through this naturalistic wrapping? Even if we don’t have an answer to the question, we have the sense that we’re truly in the presence of Umbrella, though I must now rethink what I thought an umbrella to be.

Psychotherapy can produce the space in which a client’s emballage art can be interpreted and theorized. The client with the eating disorder has wrapped or concealed an object (perhaps the object cause of desire, le objet petit a) within a practice of overeating or restricted eating or some combination of those. The practice, however, has attained the status of habit, and if left to run in the background like a kernel process on a computer the habit will appear artless. Once out in plain sight, this changes. The concealing practice is quite artful. It is the umbrella on the canvas. Wrapped within it is a desire, a fear, a foreclosed encounter. In many cases, the encounter is between the body one has and the body one is.

Sex is also such an encounter, an event during which one’s subjective activity discloses its intimate relationship with one’s object-ness. “I” have sex, but “I” also am the body that the other is having sex with. Something disquieting dwells in the ecotone between self as subject and self as object. Penetrating and permeating the boundary, according to Lacanian psychoanalysis, produces an encounter with the fiction of oneness. Sex does not merge two into one. Sex reveals the impossibility of that. Disordered eating does not ameliorate the fear of this revelation, but it does forestall the revelation by either warding off the sexual (non)encounter or permitting a subject to fully objectivize oneself. The wrapping that comes into focus in the treatment of eating disorders is motivated in equal parts by the desire for unification between being and having a body and also the refusal to encounter the inaccuracy of that desire. 

Wrapping is a geometric art, and subtending the client's practice of concealment we find a strict blueprint—a defensive geometry utilized by the mind to prevent the horrific realization that I am what I have . If we look at the lines of this blueprint through the lens of Lacanian mathemes, we can see that the formulas are not mathematical computations, but the literal markings on the canvas of the emballage.

When the subject is anticipating the threat of the somatic encounter, the wrapper is sketched as I < I | sex, where the diacritical mark (|) acts as the rigid boundary wall of the wrapper, keeping the fragile, pre-sexual subjectivity (I) qualitatively lesser than (<) the objectified body that will be seen and possessed by another . Post-coitally, when the anticipated unification fails to occur and leaves only a missed connection, the blueprint flips its geometry to sex | I > I. Here, the primary “I" inflates itself (>), masquerading as whole and dominant to push the somatic reality safely back behind the dividing line.

In the heat of the experience itself—the state of I ♢ I | sex—the blueprint utilizes the Lacanian lozenge (♢), which serves as the ultimate friction of the canvas. This diamond is the brushstroke of fantasy: it connotes the desperate illusion of gaining something substantive during the encounter (>) choked by the agonizing certainty that the core of the self is being exposed or stolen away (<) . In every variation of this blueprint, the vertical mark of sex (| sex) remains outside, because the wrapper can never fully enclose the gap; sex never crosses the divide to achieve union.

Being | Having, Sex, Eating

Consider how sex and eating each come to mind when we utter questions and phrases like these: 

• Insatiable appetite
• I choose what I put in my mouth
• I control what comes out of my mouth
• What can I permit inside of me?

Additionally, in terms of the biologically female body, there is a known causal relationship between restrictive eating, purging, and the cessation of a regular menstrual cycle. To “control” what goes in and out of one’s mouth, then, is also to manage the processes supporting fertility. In each case—analogous phrases and managing fertility—the mouth reveals itself as the site of the oral drive, which is to say the pleasure of the mouth. The mouth is an orifice marking passage between inside and outside of the body. Whether through speech, eating, or oral sex, we can seek what we desire. We can seek, but we do not attain. This is because, for Lacan, the drive is that which cycles endlessly around the void of desire. There is no comfort in the satisfaction of the oral drive; rather, there is a compulsive missed encounter with desire. Even to “eat nothing” is to engage the oral drive, albeit negatively. Eating (the) nothing over and over again conserves the distance between drive and desire, thereby accentuating the anxiety produced by the desire itself. Abstaining from sex thus rhymes with eating nothing in that two orifices are engaged negatively in a compulsive prohibition. Alternatively, a mandate to abstain from sex coupled with anticipatory anxiety about the eventuality of a sexual encounter may transfer the erotic drive from typical erogenous zones (e.g., vagina) to the mouth. As a result of the transfer, binge eating followed by purging resembles the sexual act insofar as it brings food into the oral orifice and then expels it through the same orifice, thereby satisfying the oral drive.   

The Being | Having conflict returns at this point. If I am yet to have sex but also understand that to have sex is part of my passage into adulthood, and if I fear the vulnerable ritual that supposedly occurs with my body during sex, then “I” run into a problem. I have a body that will be engaged in sex, yet I do not want to be that body. To have a body is to retain some critical distance from this body I have but that I am not. Binging, purging, and restricting food intake all become ways to rehearse the collapse between the body I have and the body I am that will take place during sex. 

Recall that each person has been stuck in a rehearsal of the collapse between the body they have and the body they are since the mirror stage. Which one is “me”? “I” am the difference between the two, the irremediable distance ( | ) between the speculative “me” that others see and the corporeal “me” that I feel I am. If we add in the social process of objectification through which a person loses idiosyncratic subjectivity and becomes, say, an object to satisfy others’ desires, then I wrestle with the question of which “me” shows up during sex. Am I the object another wishes to have, or am I going to be me corporeally? Anxiety or phobia or even certainty about the sexual encounter may lead me to control, through my eating, not what I am but what I have, the object body distinct from my subjectivity. Of course, in doing so I will overlook that by treating my body in this way, I end up negatively controlling what I am insofar as the corporeal body withers and weakens. This overlooking is where the distress comes in. The problem of the eating disorder is the overlooking of the confused distinction between being and having a body.

Why suffer the consequences of gaining control in this way? To answer that, I would need to look at what I am actually controlling. “Disordered” eating is actually a highly ordered maintenance program that monitors and manages entrance to and exit from my body, which is to say oversees the boundary between the speculative body I have and the corporeal body I am. To order and oversee in this way produces pleasure, but pleasure with a Lacanian valence. Think of this pleasure through the frame of a typically “old-fashioned” form of punishment. A father catches a son smoking a cigarette. To punish the son, the father doesn’t forbid cigarettes; instead, he mandates an excess of smoking. “You like smoking, huh? Well then smoke this entire carton of cigarettes in front of me.” The son sits down and smokes until he becomes nauseous. Our superego, the part of the Freudian intrapersonal psychic apparatus regulated by moral principles, acts much like this fabled father. “You like controlling what goes in and out of your body, huh? Very well, do it over and over again until your body starts to fail.” “You’re fascinated with sex, huh? Very well, shove all sorts of things into you.” “You enjoy eating ‘nothing’ do you? Very well, eat ‘nothing’ forever.” Pleasure, in this sense, is the quasi-sadistic fulfillment of the injunction to enjoy. 

Through this perverse enjoyment, a fascinating reversal reveals itself at the literal gate of the teeth. Mastication—the physical chewing of food and the psychic "chewing over" of thought—is twinned with its opposite: a deliberate, defensive ignorance. Binging becomes a form of hypnosis through which critical thought is severed from the somatic control process, a temporary anesthetic against the split of Being and Having. Purging, then, acts as a literal purgation—an attempt to clear the subject of the crime of consumption, to wipe the canvas clean. But here the trap snaps shut: this clearing does not liberate the subject. By expelling the crime to regain the ability to think, the subject merely restores the sterile order required by the superego. The canvas is emptied only so that the sadistic injunction to "eat nothing forever" can begin its cycle anew. 

In a recent piece on Psychiatry at the Margins, Awais Aftab invoked Lacan to remind us that “Desire is the Desire of the Other.” For the modern mental health clinician, this “Other” is often not a person, but an apparatus—a complex web of diagnostic codes, insurance metrics, and a neoliberal “Regime of Sustainability” that demands we return the patient to “normalcy” at any cost. In my forthcoming work, The Psychic Apparatus and the Regime of Sustainability, I argue that we have reached a crisis point that Aftab’s “Twilight of the Psychopharmacologists” only begins to touch. If the era of biological reductionism is waning, what is replacing it? Too often, it is a “Behavior Factory” where therapy is sold as a commodity of repair, designed to conserve social antagonisms rather than resolve them.

The Tautology of “Normalcy”

Therapists are currently caught in a trap. The clinic—in all the ways this topos manifests today—functions as a site where we “repair” individual pathologies while silently conserving the very social conditions that produced them. We tell the client that x = x—that their identity is a self-same unit to be stabilized. But as Lacan (and Aftab’s recent explorations) suggests, the truth of identity is that x ≠ x. The subject is inherently “lacking,” and by trying to sustain or conserve a fictional wholeness, therapy becomes a state ideological apparatus.

From Clinical Repair to Performance Philosophy

If Aftab is right that we need a pluralistic and transdisciplinary future for psychiatry and all domains of mental health counseling, then we must move far away from “Behavioral Health” and even “Mental Health” to a Performance Philosophy, a mode of extemporaneous being that thrives on a diversity of ways of relating. As an ongoing thought experiment, I often return to a fictional persona that I’ve named “Marina,” a 28-year-old struggling with what the DSM-5-TR labels “Borderline Personality Disorder.” In the current regime, Marina is a broken machine to be fixed. But what if we viewed Marina’s symptoms not as pathologies, but as artworks? What if her “anxious attachment” is actually a performance of a dashed hope—an encomium for a loss that the language of clinical medicine cannot name? In this thought experiment, I don’t function as a technician of the soul; rather, I become a second in battle, a companion for Marina and her forays into the fraught landscape of the social. We need a social antidote to the DSM, where diagnoses like ADHD or Bipolar are reimagined as forms of social strife—modes of conflict embedded in society itself.

The Art of the “No”

The future of therapy calls for an “Art of the No,” a rejection of the administrative control of the living. Any cure produced within an exploitative wellness industry is no cure at all; it is merely a successful recalibration of the psychic apparatus to better endure exploitation. If we are to move therapy from “asociality” to a radical “A-Sociality,” a place-making practice capable of locating anideological subject positions, we must stop trying to make people “sustainable.” We must instead embrace the “ruthless criticism of all that exists.” Only then can therapy stop being an obstacle to social transformation and start being a site of genuine liberation.

Why We Need a Performance Philosophy of Therapy

It is often said that therapy is a "helping profession," a self-evident pursuit of relief and betterment. But what if therapy’s apparent self-evidence is exactly what prevents it from working?



In my own clinical work, I’ve often been struck by two related questions: What actually produces change, and why does therapy so frequently seem to fail to produce sustainable well-being? The uncomfortable truth may be that we are working within an apparatus that demands a return to "normal"—a conservation of the very status quo that produced the suffering in the first place. Without critical interrogation, therapy risks becoming a mere "behavior factory," an ideological adjunct that helps us cope with exploitation and structural exclusion rather than challenging them.

The Generative Problem

To rethink therapy, we must first rethink what we mean by a "problem." Usually, we see a problem as something to be eliminated by a singular answer. Instead, I propose viewing problems as "generative tilth"—the matrix from which thinking sprouts. Consider the acorn: it is the "problem" of the oak tree. The seed doesn't disappear; it actualizes into the growth it was meant to become.

Each client who enters therapy is a unique "acorn". The "problem" isn't a pathology to be cured, but a site of emergence for a new kind of thinking.

Performance Philosophy as Practice

This is why I advocate for Performance Philosophy Therapy. Unlike traditional models that rely on manualized treatments or purely mind-centered idealism, this approach views therapy as an "artful practice" and a "performance thinking" event. It understands that meaning is not readymade; it reveals itself only through our social and embodied language usage.

By bringing philosophers like Adorno and Horkheimer into the room alongside science fiction and the arts, we can begin to see symptoms not just as distress, but as "artworks" or "encomia for loss". Performance philosophy allows us to transgress the boundaries of the clinic and ask better questions:

• What does this way of thinking do?
• How can we free therapy from its "already-knowing-what-it-is-ness"?

Therapies Yet to Come

We are currently living under a "Regime of Sustainability," where "repairing" the individual often serves to silently conserve social antagonisms. To break this cycle, therapists must become theorists and speculators. We need to imagine "therapies yet to come"—future time-spaces where therapy is not a tool for maintaining the status quo, but an anideological practice that frees us to relate to ourselves and others differently.

Change will not occur by merely teaching "coping skills". It occurs when we allow the therapeutic encounter to become a radically open field, a dazzling collection of "wildflowers" unique to every contact between therapist and client. It is time to unsettle the givens and build the therapy we actually need.

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