Embodiment and the Other's look in feeding and eating disorders
Authors: Giovanni Stanghellini
Journal: World Psychiatry (2019)

Feeding and eating disorders (FEDs) are mainly defined on the basis of behavioural abnormalities, yet there is a general agreement that these are secondary epiphenomena to a more basic psychopathological core, i.e., an anomalous concern about one's body appearance and weight1. Theoretical and empirical evidence is increasingly available to better characterize FEDs by specific disorders of embodiment2. To determine the kind of bodily disorder characterizing people with FEDs, we need to preliminarily distinguish between the subject-body as experientially different from the object-body3. With the former we designate the unmediated, first-person experience of oneself as a spatiotemporal embodied agent. With the latter we indicate the body investigated from a third-person perspective as an entity existing in the outside world (e.g., by natural sciences), or perceived from without (e.g., when I look at myself in a mirror). Sight is the sense modality through which I perceive my body from without as an object-body, whereas I apprehend my subject-body from within via coenaesthesia. In addition to these two dimensions, I can apprehend myself as my own body when it is looked at by another person 4. Feeling looked at by another can be experienced as threatening. The Other may threaten me with bodily harm, but he can also be a threat to the arrangement of my world. When I feel looked at by the Other, all of a sudden the world may come on to me differently. No longer comfortably arranged around my point of view, the world is now arranged around the Other's vantage. I feel judged by the Other's look. I may feel ashamed or proud, and those feelings reflect the Other's meanings and values. Yet, I recognize myself in the Other's look. His look defines me, it cuts me to the core. The phenomenon of the look is apparently specific to human beings, yet also non-human primates exhibit signs of corporeal arousal in situations in which they are looked at. Staring seems to be a salient stimulus that arouses tension and induces behavioural responses, e.g. flight or fight. What is specific in humans is that the Other's look is not only a threat to physical integrity, but also to selfhood and identity. I may feel reified by the Other's gaze, and reduced to the external appearance of my own body. My body may take the shape that the Other's look imposes upon it. In our species, the negative effect of feeling a body-for-Others are reification, negation of freedom and reduction to appearance. When I feel looked at by the Other, I feel the negation of my possibility to imagine to be "something else" than the "what" or "mere object" I am. The power of the Other's look may produce an unbalance between the "I-am" and the "I-can" . Under normal conditions, the way I experience my body is the outcome of the dialectics between coenaesthesia and sight. Bodily experience is not only influenced by the way I feel myself, but also by the way I feel looked at by the Others – my being a body-for-Others. As the first-person apprehension of my body is based on coenaesthesia, whereas the third-person one is based on the sense of sight, we may call this dynamic balance between the apprehension of one's body through coenaesthesia and through the Other's look the optical-coenaesthetic proportion – a prerequisite for constructing a safe and dependable sense of bodily self and personal identity. At the roots of the abnormal bodily experience in persons with FEDs there is a disorder of the optical-coenaesthetic proportion. Persons with FEDs experience their body as an object being looked at by another, rather than coenaesthetically or from a first-person perspective5. What they seem to lack is the coenaesthetic apprehension of their own body as the most primitive and basic form of self-awareness6. Their bodily feelings are discontinuous over time and feel extraneous from their own body7. Since their experience of their body from within is flawed or inconsistent, they cope with this by apprehending their body from without through the Other's look. The way they feel looked at by the Others is the principal mode to feel themselves and define their identity8. Their body is principally given to them as an object "to be seen" . It is a body exposed and subjected to the Other's gaze and thus reduced to its appearance. Particularly relevant to understanding persons with FEDs is to envision in the Other's look a kind of visual prosthesis that helps them feel their own body. Feeling one's body as an object being looked at by another has a twofold effect: it makes them feel embarrassment and repulsion for their own body, but it also helps them recover a sense of selfhood, "unity" and "condensation" . This phenomenon is epitomized by the following micro-narratives: "The way I feel depends on the way I feel looked at by the others" , "Sometimes I focalize myself through the gaze of the others" , "Even if I think that the way the others evaluate me is wrong, I can't do without it" . Persons with FEDs are concerned with public self-consciousness, as opposed to private self-consciousness. In our culture, the predominance of sight is claimed to affect self-experience and self-understanding9. Our era can be seen as the time of the optical-coenaesthetic disproportion. An analogous tendency to attend to those aspects of one's own bodily self that are matters of public display (namely bodily appearance), rather than to more covert aspects (e.g., bodily sensations, emotional feelings and privately held beliefs about oneself), also affects persons with a diagnosis of FED. In these persons, the optical-coenaesthetic dialectical proportion is flawed because their possibility to feel themselves is weakened or threatened by coenaesthopathic and emotional paroxysms. These persons feel extraneous from their own body, and their bodily feelings are discontinuous over time. This suggests that the Other's look is not only a source of intimidating and shameful "negation" of their capacity to transcend their mere objective corporeality, but also a longed-for device through which they can finally define themselves – an optical self-prosthesis.