42 pages • 1 hour read
Clare B. Dunkle, Elena DunkleElena Vanishing
Nonfiction | Autobiography / Memoir | YA | Published in 2015A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more.
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BetaThemes
The Physical and Psychological Experiences of Living with an Eating Disorder
Content Warning: This section of the guide includes discussion of disordered eating (anorexia nervosa and bulimia nervosa), self-harm, mental illness (including psychosis), rape, cursing, and pregnancy loss.
Anorexia nervosa is classified as a mental illness. It begins as a psychological state, but its symptoms manifest in both physical and psychological ways, and Elena Vanishing draws attention to both sides of the experience, including the ways they intersect and impact one another.
For Elena, the psychological side of her anorexia stems from her need for self-control and the fact that she blames herself for negative experiences in her past. Elena attributes her initial exposure to anorexia to peers at boarding school, who taught her methods of controlling her eating. She observed other girls her age fasting and purging, and she copied their behaviors. Elena admired those girls because she saw them as strong and disciplined, and she wanted to give the same impression to the world. In keeping with the fact that anorexia often involves a lack of insight into one’s own illness, these tendencies have deepened by the time the memoir opens. Elena constantly worries about her appearance, is suspicious of compliments, thinks people are pitying her, and downplays her accomplishments: “They hug you and cry and call you brave, when what they really mean by that is damaged” (3). Elena also has extreme discipline, counting her steps and calories constantly. She sees the world in absolutes, believing that a person is either overweight or thin, with no in between.
Elena Vanishing also highlights the physical and psychological effects of eating disorders. The dissociations and blackouts she experiences are both an indication of trauma and another manifestation of her estrangement from herself. Physically, Elena experiences constant fatigue, stomach pain, and develops a weakened heart and damaged ribcage. Amid all of this, she often feels isolated and hopeless.
Another facet of the experience of anorexia is its impact on interpersonal relationships. Elena is constantly in and out of hospitals and treatment facilities, all while dealing with pressure from her concerned parents. While she does develop friendships and find community within the treatment facilities, she lacks trust for the professionals who work in them. Well-intentioned treatment can exacerbate the isolation of people with eating disorders; for instance, Elena sometimes wants to help other patients but is discouraged from doing so. At the same time, Elena’s dissociation from reality, as well as her overall anger toward herself and the world, causes a rift in her relationship with her mother. Recovery therefore requires not only that Elena heal herself but also that she mend her bonds with her family and adjust her view of professional help.
The Desire for Perfection and Total Self-Control
Elena’s mindset during her illness reflects a strong desire for perfection and self-control, rooted in deep emotions and self-hatred. Elena states that “envy is the best of all” (3), because she relishes the experience of others being jealous of her discipline and what she interprets as self-control. She believes that by being thin and restricting what she eats, she is demonstrating that she is in control of herself. Elena thus sees her attempts to be thin as a positive goal and gloats about her accomplishments in this regard: “My friends and I were doing a three-week juice fast, but I was the only one who made it. I think about the willpower I exhibited then and feel a glow of pride” (36). This obsession with appearance goes beyond a fixation on her weight: She constantly worries about how other people see her, like whether the nurses in the hospital notice she isn’t wearing makeup, or how much she weighs from day to day. Elena doesn’t even look in the mirror, because what she sees is not perfect, and it does not match up with the vision she desires for herself.
In fact, Elena aims for perfection in all areas of her life, if especially in terms of her appearance: “Every hour I am forcing myself to do things that don’t come easy is an hour when I am building perfection” (125). Ultimately, this obsession with perfection is about hiding her pain and anything that she views as weakness: “Can anybody tell the black hole is there? What do people see? What do I look like?” (24). She doesn’t want people to know that she is hurting; she wants everyone to see her as strong and perfect.
After her miscarriage, Elena’s perspective on her eating disorder changes, and she starts to understand the full extent of the damage it is doing to her body. In therapy, Elena learns that “ambition and perfectionism go hand in hand with the anorexic mindset” (133), which explains why she experiences both. Complicating matters further, this perfectionism has become entangled with the trauma of sexual assault: Elena always blamed herself for being raped, because in her mind, the thought of something so awful being out of Elena’s control was more terrifying than taking responsibility for it. This cycle of blame fed her disorder. Eventually, Elena works to shift her goal from perfection to a desire for stability. As she does, she begins to recognize her eating disorder as a period in which her life was out of control—an ironic twist given Elena’s motivations throughout her illness.
The Patient-Practitioner Relationship
Because anorexia nervosa is both a physical and psychological condition, treatment involves a close relationship with nurses, therapists, and other trained professionals. In Elena’s view, these trained professionals are not there to help her but are instead there to manipulate her, hate her, or otherwise attack her. She doesn’t trust them or their motives: “You asshole therapists sit in judgment of us. All we are to you is sick. We’re not people. All we are is a case” (228).
Due to Elena’s resentment toward her health-care team, Elena does not recover for years and instead gets worse as time goes on. Elena’s view of the psychiatric field is not entirely founded in her own biases, as she does experience discrimination and mistreatment at times. Examples of this include when the nurse yells at Elena for throwing up her feeding tube, or when girls are punished with food at Drew Center. Other problems in the field are related to treatment terms and insurance; many of the girls that Elena bonds with cannot stay in treatment long enough to recover because their insurance refuses to pay for it. As a result, many relapse, and one girl dies. Elena also finds that doctors often talk about her like she isn’t there or that they patronize and threaten her. This fuels Elena’s hostility toward them, which in turn does not help her recovery.
For many years, Elena leaves treatments, resists help in hospitals, and refuses to see her illness for what it is. However, once Elena finds a treatment center that understands her and makes her feel safe, she begins to shift her perspective toward professional help. She engages in the exercises, opens up honestly and fully in therapy, and reflects on her early experiences that shaped the development of her disorder. Elena learns to trust her therapist and to lean into treatment because it is her chance at survival. By the end of the memoir, Elena is not “cured” of her eating disorder, but she is learning to understand herself better and is benefiting from having a healthy relationship with the health care professionals in her life.
