September 20, 2019, by Lexi Earl

Using narratives to understanding eating disorders: an interview with Associate Professor Heike Bartel

Associate Professor Heike Bartel is a scholar in German Literature, based in the School of Cultures, Languages and Area Studies at the University of Nottingham. Dr Bartel’s work explores the narratives of food, health and illness. She is a member of the Future Food Beacon Leadership team. In this interview, Dr Bartel talks to Lexi Earl about her research interests, working with medical practitioners, and the experience of interdisciplinary research.  

Can you tell me a little about yourself, your research, and your background?

I have a PhD in German; I am originally from Germany. I started at the University of Nottingham in 2000. I’ve been here since then. This is quite unusual for me as I am naturally a restless person. But here, when I get restless, I can do U21 things, visiting our partner universities or get involved with international projects, like those within the Future Food Beacon or GCRF projects.

I’ve always been heavily interested in literature, German literature is my field, but more and more I’ve become interested in comparative literature. I’ve always been interested in different perspectives, not the big master narratives but the marginalised ones, like those from gender studies, women’s studies, contemporary women’s writing, postcolonial studies. I am interested in the narratives of illness, health and recovery, stories from the other side of the medical curtain – the patients’, people with lived experiences.

My interest in these narratives has combined with my interest in food, and writing about food, and the wonderful descriptions of glorious feasts but also the history of eating as a history of the German people: shortages of war time, deliberate starving in the concentration camps, the iconic images of starving people, but then coming out of the war, the Wirtschaftswunder, the economic miracle. So not just descriptions of food but food as a mirror of history, of under- and overeating, but also in combination with stories of illness. This has led me to my current project on narratives of eating disorders. Obviously, there is a lot out there in the field of women’s studies, both clinically because the numbers are very high in the Western world; women diagnosed with anorexia and bulimia, and binge-eating disorders are very high, and there is a lot of theoretical discourse. Anorexia as the waning woman, as a woman coming to terms with how much space she can take up in the world, as Susie Orbach puts it.

I became really interested in the other side and looking at male eating disorders which is under researched and underrepresented in all fields, medical and cultural studies. I started reading fictional stories but then also autobiographical writing in German, English, and French, and that led to a successful AHRC networking bid, working really interdisciplinary and stretching really far from Arts and Humanities to Science. I had a Co-I, Nadia Micali, who is a medical expert in clinical nutrition and a psychiatrist at the Great Ormond Street Hospital. The research network gave us a lot of room to brainstorm creatively, and enabled us to get authors, photographers, clinical researchers, charities, and men with lived experiences who are now in recovery.

 

How do you research narratives of illness from a humanities perspective? What is it like to move into that interdisciplinary sphere, and how does that change what you do?

The big difference is qualitative research. I have a few case studies of men with lived experience that are sometimes snapped up by people doing clinical research but it is really the qualitative research of the personal experience and how that is expressed through literature. That is my tool. I can explain through my work as a literary scholar: what perspective we are dealing with? How are stories of illness intertwined with stories of hierarchy? How does the patient talk? How does the doctor talk? Often you have quotations from medical practitioners or whole medical documents quoted. How does that change the dynamic of the story? How does someone who is restrained in hospital and force fed report their experience? How does the doctor comment on that? These hierarchies and experiences are really critical, and I have the tool as a literary scholar to tease out what is happening there and not just saying this is the story of failed recovery but this is the story of struggling with a medical and treatment experience, and that is something that medical scholars are really interested in. If you then put a few together, if you read the corpus of experience on male eating disorders, which is not that large, and you have certain patterns that repeat themselves, that then becomes interesting for medical scholars. Male experiences also differ from the experiences women report. One of the commonly assumed symptoms of anorexia nervosa, of not menstruating, men say well that doesn’t apply to me but then filling that gap with something that is not being talked about and not discussed in medical literature because there are so few studies about that: sexual dysfunction, relationship with fathers, sexual relationships… I can add to that through the literature.

While medical researchers often have a very one dimensional view of a text, for example, the patient said this and we take it as that, I have much more room to manoeuvre. For example, someone remembering as a 35 year old the food they tasted as a six year old, that is not reality as it was. Through my scholarly training in memory studies, you can interrogate that. You cannot take for granted what is happening in that narrative. And looking at the genre definition, what are we talking about? Are we talking about stories of recovery? Stories of illness? Of health? Are we talking about stories of addiction? The blurring between eating disorders and addiction is something that the medical practitioners often keep very divided. If you examine the literary genre they are not that divided. If you are a binge eater, it is often intertwined with stories of addiction. I have a different playing field and when I look at medical articles, I can challenge some of the statements that are made.

How did you become interested in this research?

My starting point is exploring narratives, and an interest in writing about food, and bringing the two together. And not just focusing on the glorious feasts, but food as an expression of culture, of power, of hierarchy. If you look at women’s writing, who cooks what for whom? When? With whose money? Who serves it? Who eats it? Who takes it away? That is a great expression of power represented through food.

At the moment, we are quite unique in thinking about male eating disorders. We have a Twitter account– @ConsiderMaleEDs – as a message for GPs and practitioners. Very often male eating disorders are not seen and so we are targeting the GP audience. At the moment we have a group of seven men with lived experience, all in recovery, and all talking openly about their struggles. We are working together with an animation team called WovenInk, who have done work in the field of eating disorders before, and we are currently translating those experiences of men into a training animation for GPs. Questions we put to these men were: Why was it so difficult to disclose to the GP or practice nurse what you thought or guessed was wrong with you? What would’ve helped? What definitely did not help? Hopefully the film will find its way as a training tool into modules for GPs and charities.

 

How do you go about researching these difficult topics? Food can be very emotive so how do you navigate the spaces of food, and illnesses that are linked to food?

The good thing is that food is such an easy topic to talk about. Our project is called Hungry for Words. It is about articulating, communicating, and understanding issues around food. We held several Hungry for Words cafes as part of the Being Human festival. We just had a few cards with words associated with food – hunger, fat, family – and a few empty cards and we invited adult males in various cafes all across Nottingham to sit down and talk to us for as long as a cup of coffee, about their experiences of food. I think the myth that men don’t want to talk, and don’t want to talk about their troubled experiences is not true. We couldn’t shut them up! It is emotive but probably because it is emotive people talk about it a lot. I find when I work with schools, and I bring texts about disordered eating, little poems or a novel  – The Year I Didn’t Eat by Sam Pollen – the students can talk a lot about that. They can identify a lot of the patterns, be they obsessive compulsive behaviour, anxiety, or family relations. I make a point of having a counsellor from our partner charities, First Steps Eating Disorders, based in Derbyshire, with me when I work with schools because talking openly about these topics for the first time can kick loose a lot of stuff, and I want students to be able to take that somewhere. It is more a chat about good mental health than food. Mental health is often framed as negative, ‘mental’ is a swear word, and getting young people to consider good mental health is important. You’re looking after your body, how do you look after your mind?

One of the other aspects I am interested in is food in colonial stories, and postcolonial contexts. Germany is very interesting because it is not one of the big former colonial powers but still has a colonial history, and that still plays a role in some texts as an undercurrent. Cultural elements are picked up by writers. Turkey, for example, was not under the colonial control of Germany, but some parallels to postcolonial studies can be drawn. Turks came after the war in the 1960s as guest workers to Germany, and were encouraged to come. They then stayed and became a minority in Germany, and brought with them a lot of food that is now a staple diet of German food. But there is also the aspect of using food to reinforce stereotyping and marginalising. I find in particular, the history that comes with food from foreign places, the exotic fruits that are associated with equally exotic women. This is very rich pickings for a scholar in contemporary culture. The glorification of certain foods to devour is often mirrored in a stereotype of the female coming from a foreign and exotic place, assumed ready for male consumption.

What are your future research plans?

In the future I would like to do something around stories of health, illness, recovery, and the role food stories play in that. That can be very patient oriented, or it could be stories of displaced people and the longing of food and memory, of nostalgia. I am also excited to see what the Beacon is doing, to bring in the medical and health humanities, and work on obesity questions, and to explore how the analysis of food stories might fit in there. I think literature and the arts and humanities has the power to pull everything together. For me literary philology and literary scholarship is the interdisciplinary approach to understanding the world.

What is the argument you make to ordinary people about the importance of arts and literature for the wider world?

It is not always an easy argument to make. I sometimes take a practical approach. See what happens when you do a creative writing workshop with some school children, asking them about writing different little chapters, changing the perspective in each, and how they reflect differently on different characters. I love poetry and I think poetry works so well in so many settings. If you take for example poetry slams or rap music, which is deeply lyrical and poetic, that can engage people in the genre who may not usually ‘go for’ poetry. Here in particular I don’t believe in the division between high and low culture. I look at every type of literature, and other forms of expression. I find animation really fascinating at the moment.

How do you explain what you do to ordinary people?

I am interested in stories, and stories that present very different perspectives. The perspectives of children, perspectives from people that are poorly. So not the parent’s stories but the children’s stories. Not the doctor’s stories but the patient’s stories. Stories of disability. There is a huge wave of books for children about people with disabilities who cannot express themselves verbally perhaps, but write beautifully. Stories from unusual perspectives that tell stories that are very often not told but are so important.

Do you have a greatest career moment?

I loved it when I was trusted with the interdisciplinary AHRC research network. The moment when I got that because it was a very bold move to bring all these different ideas and people together. I found it really scary but that was a great career move because I was being forced out of my comfort zone and I like that. We have now secured a follow-on-funding grant from the AHRC, so the story continues.

Do you have any advice for younger scholars?

I think the field of interdisciplinary studies is really important, particularly for younger researchers. Obviously, get a good foundation in your field, but then go further. In interdisciplinary work, with the mixing of disciplines, methodologies and approaches, the hierarchy goes a little bit out of the window and that is a really nice starting point for all. From my experience that also creates a nourishing environment for young researchers where they really get an opportunity to shine, and colleagues listen to their ideas because they are relying upon them, that fresh input. It does not come with the fixed pathway of one discipline. Go for everything. Say yes more than you say no.

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