Dear friends,
I was recently at a reading at the adorable Head & the Hand Books, where I was lucky enough to share my work alongside a group of excellent Philly/Philly adjacent writers. I was reading from an essay I’d mostly cobbled together that day. It was an excavation of disordered eating in relation to chronic illness, and so it naturally delved into mental health in certain ways. (Though, as with any unfinished work, it didn’t quite get where I needed it to go. I’ll definitely need a few more drafts.)
After the reading I met up with someone and we went out for a drink. While we there, this person asked me more about how this essay relates to the projects I’ve been doing since. I explained that I’ve become increasingly interested in writing about mental health in the last year, post-OCD diagnosis. In some ways I feel like I’ve been “branded” as a chronic illness writer (which, to be frank, is actually very, very cool), meaning that people expect me to operate solely in the realm of the physical body.
I don’t believe in a dichotomy between mental and physical illness, to be honest. It doesn’t make sense to me, when the brain is in charge of the functions of the body and it is the inception point of the mind. There is an inherent connection. I recognize the need to differentiate physical and mental illness for clinical reasons, but I think we should be careful how we put people in boxes when they’re talking about their health. Too often someone will think that because I have a chronic illness I’m only physically sick. The reality is that those diagnosed with IBD, and many others with chronic illness, have higher incidences of anxiety and depression than the general population. Even if I hadn’t been diagnosed with a debilitating mental health condition, I would be remiss not to touch upon the mind as I write about chronic physical illness.
I told the person I was talking to all this, and then I mentioned that I’m beginning to work on a project where I put OCD on the page. Which comes with its own challenges. When I was writing a manuscript intensely concerned with chronic physical illness, I struggled to put into words the somatic feelings that are so deep inside us. We all know pain, but each of us holds pain differently. Like the age old question—are we all seeing the same color blue when we say blue?—we have to ask, are we all understanding pain the same way when we say the word? (The essay I always turn to about this is Eula Biss’ “The Pain Scale,” so be sure to check that out if you’re interested in engaging with this question more.) Similarly, but also differently, I have to contend with how to bring the reader into the OCD experience, while also maintaining space for the fact that like with chronic physical illness each person’s experience will vary, and that the depiction on the page likely won’t be emblematic of most people’s reality with it. What is the most effective way, really from a craft perspective, to create the experience of a mental illness on the page?
The person I was talking to is a psychiatrist so they thought about this for a long time. Then he asked me if I was willing to write a metaphor for it. I told him about the deeply excellent metaphor I read in Bunny McFadden’s The Rumpus essay, “The Big Mangy One.” (McFadden’s essay came out in the same themed month as my story “A Hundred Orbits,” which is about ulcerative colitis. It was Mental Health Awareness month, and I was tickled to see that The Rumpus recognized the link between physical and mental illness in exactly the same way I did.) In the essay, McFadden says:
“Depression is a wooly black dog, curling alongside me in bed. Anxiety is the one who grows legs and scratches at the door, begging to go but bloodshot with nerves. OCD is mangy, covered in raw spots where she can’t stop rubbing her canines against the flesh. To tame a flea-ridden dog, you need to name it. I set to work.”
It’s perfect. It is the perfect way to describe OCD. I think about this metaphor all the time. So it isn’t that I’m opposed to using metaphor to bring people into the experience of mental illness.
But that being said, this is a small moment in the entire essay. A pivotal one, yes, but it isn’t the only way that OCD is being talked about through the whole piece. If I were to use metaphor throughout a whole novel, I worry that metaphor would cease being powerful, and would instead be a technique for obscuring, more making more palatable. What I mean by that more plainly is—when we couch everything in literary technique, we make it artful and significant in a way that I don’t think the body and mind really are. (Though I do think an individual can find significance and meaning in their own illness or their experience with illness, I don’t feel that our illnesses are trying to tell us subliminal messages about ourselves the world around us. Illness is a natural condition for humans, and so any investigation into it, is just as meaningful as writing about love, as Virginia Woolf would say.)
That’s why I’ve always been extremely explicit about blood and shit in my writing about ulcerative colitis. Though I use metaphor throughout stories about it, I never create a metaphor for the entire experience. I always, always try my best to show my sickness in the ways I live it. Which sometimes means being poetic, but more often than not means getting down and dirty with the grossness of my own body.
The psychiatrist I was talking to mentioned that often times metaphor can be useful to patients in OCD treatment. He said that it can be a form of meaning-making. I tried to understand this, especially in the context of Susan Sontag, who argues in “Illness as Metaphor,” that it is better to avoid metaphor in writing about illness, as it often creates a victim-blaming complex where patients believe their sickness has something to do with their personalities or character. But of course, she was discussing TB and cancer, not OCD.
Our conversation drifted away from the topic, but the questions stayed with me. I thought about if I have a metaphor for my OCD, and if I have one for my ulcerative colitis. For the latter, I do not. But for OCD, I have two, neither of them the evocative dog image I mentioned earlier. Often, when I think about my OCD I imagine a security camera swinging back and forth so incessantly it might whip too hard and break. Or I might also imagine an unwanted passenger in the backseat of my car, creeping up as far their seatbelt will let them go, up to my ear, screaming loudly that I am doing everything wrong and that I will be sorry. (I find this one particularly funny and ironic, because I actually do struggle to drive IRL due to my OCD.) The benefit of these metaphors is, in fact, meaning-making. I have a sense of the function of my OCD, as well as how stupidly wrong it is in its behavior.
My chronic physical illness is invisible when someone looks at me, but there are very tangible signs of it (from the diarrhea to the stretch marks on my skin due to my Prednisone). I felt as though writing about those symptoms/signs in metaphor would be erasing the visible contours that so many people don’t want to look at. (Even though, as you can see in the passage I cited above, metaphor is still part of the experience of writing about it. Impossible to escape, some might say, but not the main mode of considering it.)
My mental illness is even more invisible (yes, I do have physical symptoms to my OCD, but it’s far less apparent even to me, unless I’m in a heightened panic state)—so creating an analogue to something concrete is certainly helpful for a lot of people. Maybe even myself. Instead of making a metaphor only so other people can accept the experience of OCD, I’m wondering how a metaphor can heighten my own, and my characters’ understanding of the illness. By creating an analogue of something we can see and interact with, we give mental illness shape, clarity, contradiction in a way that seems exploratory rather than explanatory. It’s something I’m more open to doing because if feelings like adding to an understanding of the illness rather than replacing the real physicality of that illness with a more palatable physicality. So maybe, just maybe, it has something to do with how much you can see, smell, taste, hear, and touch an illness. Maybe that dictates how comfortable I am with a metaphor in that moment.
Maybe? Whew. This has been a doozy. Sometimes craft isn’t just about what you think about the way you should write something, but also how to perceive that subject in itself. For me, this is opening up questions about my perceptions of the variety of illnesses that live inside me. And I’m not sure of all the right answers. But I am restarting my draft with all this in mind. 👀
I’d love to know your thoughts on this one. How are you writing about illness and disability? Where do you stand on the theory of metaphor? Send insights!!
xx,
Eshani
Thanks for reading Surya Means Sun! If you want to connect with me outside of this newsletter, you can always follow me on social media @__eshani. And as a reminder, stay subscribed to this newsletter if you want the most up-to-date info on my book, Ravishing, right in your inbox. 💕