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He is 15 or 50; he is white or black; his hair is blond, brunette, streaked with gray; Like the anorectic, he may be a she.

Anorexia of the Soul

Anorexia of the Soul

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"It hurts."

"How long?"

"Yesterday, and the day before that, and the day before that. Forever."

"What makes it better?"

"Exercise. Running, sit-ups. Can I do sit-ups?"

"No."

"Why?"

"You're in pain. You're starving."

"Oh, that. It wasn't so bad at first. And you're right, it hurts, and oh!" She writhes on the bed. "Oh, it's happening again! Do something!"

"Let me see."

She hesitates. Then, as gingerly as if she were releasing a newly hatched chick, she uncups her hands from her abdomen. She looks like an inmate from a concentration camp. Her abdomen is concave, gutted like a melon. Her ribs protrude; her limbs are as thin as dry twigs. A fine down coats her cheeks, because her brain thinks she's metamorphosing into a fetus. Moaning, she grits her teeth, pitted, brown and scarred from the acid that bathes them every time she vomits.

She is 12 or 40, blonde or brunette, white or black. She may be a he. Her decline has been gradual: a caprice, a diet to lose a few pounds. She's adept at pretense, at loading her plate with food and pushing it around. Then she dumps it, flushes it, gives it to the dog. Or she hides food under her bed, in shoes, above the acoustical tile of the hospital's ceiling. As her flesh melts away, she is drawn, as inexorably as a moth to a flame, to mirrors, to windows, to pools of water into which she will gaze at herself, noting this flaw and that. Eventually, she'll immolate herself. She'll eat herself up. And she has forgotten hunger. In the life of almost every anorectic, there comes a day when hunger has no meaning and the ability to know hunger vanishes.

I place the drum of my stethoscope on her belly. There's nothing, and then there's a faraway tinkle, and I see that she's nodding frantically to tell me that's it, that's when it hurts.

"You're having hunger pains."

"Hunger pains?"

"Yes. You're hungry. That's why you hurt. Your body knows it, but you have to listen. You need to eat." She acts as if I'm speaking Swahili. "Eat? Food?"

"Yes."

"Oh, no, you don't understand," she gnaws her chapped lips until they bleed, "I couldn't possibly do that."


"It hurts." He bunches his fist over his heart. "Here. A long time. A year, maybe ten. Forever."

"Can you put a name to it?"

"You know the way a crow does when it's picking at a squirrel that's been run over? Like that. Stabbing."

"What makes it better?" The question confounds him. He looks out the window, as if the answer he seeks, so elusive, lies everywhere but within himself.

He is 15 or 50; he is white or black; his hair is blond, dark, streaked with gray; he wears an earring, or eschews jewelry. He's fit, or has a paunch. Like the anorectic, he may be a she. But let's call him a man, and let's say he's Jewish.

His life that he thought was going so well is not. Oh, he's successful. He's been accepted into a great college, is about to finish his PhD. He owns his own business, or thinks his boss is a jerk. He is married, cruising, divorced. His wife is wonderful, his girlfriend cheats, his lover is seeing someone else.

When he's not busy, there's an ache. But his ability to articulate why has deserted him. Like the anorectic, he believes he has willed his emotions into non-existence. Transforming his hunger into something else altogether, he suffers from a peculiar delusion: that he is self-contained, separate. But he still hurts. He suffers from a certain anorexia of the soul.

Finally, he speaks. "Better? I dunno. But when I see a beautiful painting... for a moment, I'm perfectly happy. And I want to paint."

"And then?" He grins ruefully. "Then I look at the next painting."

"Why don't you paint?"

"There's always something else, something..." He breaks off. I wait. He says, "When I was a kid, I used to walk by this synagogue. We didn't go, don't ask me why. Saturdays I went with Mom to the grocery store, and we'd walk by, and I remember people coming out, and the men talking, and the kids laughing, and the women together..."

It seems he needs to look everywhere else but at me. "I thought it'd be nice to be with them. That's when the pain would come, and I'd feel..."

"A hunger?"

"Yeah. Like wanting to paint. And the more I thought about it, the more it hurt." He clears his throat.

"Dumb. There's no point?"

"What do you mean?"

"The religion... it's just something people make up to fill the void."

"An emptiness of the soul?"

"Yeah. Like sitting on a mountain, looking at a sunset. That feeling of awe... of, wow, how did it happen? That's where G‑d comes in, why people pray. Because they know that they're small, that they'll die. But if they pray, they're part of something bigger. Maybe when they pray, they find that little piece of G‑d inside. And the pain stops."

He halts, shocked by what he's said. The minutes pass. Then I ask, "What are you thinking?" He laughs without mirth. "Lunch. But I'm not hungry. But I thought about that merger, and this exhibition at the museum, and a new restaurant downtown. But the pain's not in my gut." Again, he puts his fist over his heart. "It's here. I'm empty, and I keep trying to fill myself up, but I can't."

"Do you try?"

"I do a lot."

Anyone can be busy, but are you fulfilled? You eschew nourishing your soul, but I'll bet you never forget to exercise, read the paper, watch the news, eat dinner, close that stock deal, have a drink, catch ER. Like your body, your soul needs its vitamins and, like your body, your soul probably won't realize how famished it really is until you listen to it and feed it. You want to paint, but you walk on. You see a synagogue, but you won't go in. You're amazed by the world and think there's G‑d, but you can't pray, won't pray. Yet you're hungry. But rather than feed your soul, you lose yourself in planning your merger, where you'll have lunch, where you'll go this weekend. You'll do anything but allow yourself food.

"Why do you starve? You said the people in synagogue were happy. You're busy, but you're unhappy. Why won't you eat?"

"You mean," he fumbles a moment, "you mean, go?"

"Pick up a brush. Go. Learn."

He stares, as if I've lost my mind. "Go? Me? To synagogue?" He looks ready to leap from his chair. "Oh, no, you don't understand. I couldn't possibly do that."

Dr. Ilsa J. Bick is a psychiatrist in Fairfax, VA, and the author of numerous articles on applied psychoanalysis and film. She rediscovered her Judaism through the pioneering Cyberspace outreach of Rabbi Yosef Kazan, of blessed memory
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Gitel Chana Levin New Haven, Connecticut January 19, 2012

I am also a psychiatrist and thoroughly enjoyed your article. So many people have true chemical disorders...but many others in the waiting room lack not serotonin but purpose and meaning.
You brought this out so nicely. You are a great writer! Reply

susan new city, n.y. June 29, 2004

I so enjoyed your essay. It was very powerful. So many people go through their whole life searching for happiness and never finding it because they have been searching in all the wrong places. The soul needs to be nourished and the big house and fancy cars and vacations still leave the soul starving. The soul needs to relate and have a relationship with its creator. That's the way to inner peace. That's the way to true happiness and serenity. and I thank all my friends at chabad who taught me that at the tender age of 40. and most of all I thank the Rebbe for giving me a truly loving relationship with my creator. Reply