Thirty-five years ago, Susie Orbach was shocked by how many women hated their bodies – but now that almost seems like a golden age. And so the author of Fat Is a Feminist Issue is making yet another attempt to shake things up
It is an interesting experience, interviewing a psychotherapist. There are, to begin with, two people in the room who are used to being the watcher, watching each other; two people accustomed to the veiled and not unpowerful position of listener, listening to each other. Listening for the ideas and arguments, definitely – but also, from the interviewer's point of view, for what the psychotherapist might reveal between her sentences and in her body language. Meanwhile, the psychotherapist is trying to control what and how far the interviewer might get. In Susie Orbach's case, there is yet another layer: the version of her arguments and private life that has danced through the newspapers and radio waves since Fat Is a Feminist Issue was published 35 years ago – even if she insists it bears little relation to what she is actually like.
Orbach lives in Hampstead, just up a mansion-lined road from the Tavistock Centre, a specialist mental health trust, and round the corner from the Freud museum. Her consulting room – a public space in her private home – is high and bright and lined, along one wall, with books. Trim, well-manicured, she takes the chair she usually sits in to treat her patients. She has an extremely expressive face; when she makes a point her head thrusts forward, top first, as though she's ramming her point home with her gaze. Her eyes, at the same time, seem to draw lines and boxes; the American-inflected "right?" at the end of many sentences is less a question than a full stop – that's all you're getting, and that's the end of it. I imagine that this steeliness, combined with an undeniable warmth, might give people who come to her for help a sense of safety, of boundaries. It is, in fact, as she describes it, an important part of her role: "The analyst's psyche operates as a kind of ... something to hold on to while somebody's going through therapy, if they're deconstructing their own psyche, if that's cracking up in some way, or dissolving. In the same way that the body – the body of the therapist – can be in that position, as the person tries to give up, or reposition [their own body]."
The latter is, in hopefully slightly less woolly terms, a subject that she will be discussing at a major summit in London next week: the extent to which women in the western world, and increasingly elsewhere, are becoming divorced from their own bodies, judging them and adapting them and mutilating them in a kind of epidemic of self-hatred. A billboard campaign has been launched – a distinctly beautiful blond baby and the caption, "Is this the happiest she'll ever be about her appearance?" – and there are events scheduled in New York, Buenos Aires, Melbourne, Sao Paulo.
What will this achieve, apart from a lot of well-meaning talk? "I suppose we want to change consciousness. If you want to be very basic, you can't do much without changing consciousness. If you think about 4x4s no longer being acceptable, or smoking, or green politics in general, these ideas about how outrageous certain practices are take a very long time." But consciousness seems already to have been raised – London fashion week has rolled around again, with its now obligatory hand-wringing about skeletal models. "Yes, but it's taken a long time to make that discussion be there. It's still very tokenist." On a concrete level, the organisers of the Endangered Species summit hope that attendees will pledge to actually do things: introduce a variety of images, if they work in advertising (once an adviser on Dove's real women campaign, Orbach defends herself from accusations of selling out on the grounds that at least Dove did something when no one else would); reassure women, if they are health visitors, that it is not a moral failure to be a bit flabby after the birth of a child; convince young girls, if they are teachers, that all kinds of bodies can be beautiful, and so on .
But wasn't it always like this? Hasn't the pursuit of beauty always carried the possibility of being a destabilising, mutilating thing? "I think that it was always an issue for a certain class, for a certain number of years. OK? So whether it was the Victorian 18-inch waist, or ... Rembrandt, it didn't matter – there's always been a standard. But we didn't have the democratisation until the last 40 years. OK, we had Hollywood, which began it, but nobody expects to be a glamourpuss for the whole of their lives. So it's a phenomenon that's happening now. That you're introduced to your body as already something to display, and you have women in old age homes still not eating because they've got body issues – no, that is new."
Furthermore, "what was considered really psychopathological when I started to work is now the norm". You mean anorexia? "I don't think anorexia is the norm but being hysterical about eating, eating only on the weekend, throwing up, hating your body, not ever feeling you can be relaxed in it, looking at yourself from the outside – those kinds of things would have been a pathological category. Whereas, actually, I think if you take any class of girls, sadly that's where an awful lot of their energy is going."
She has said, arrestingly, in the past, that many of the girls she sees as patients are so consumed by controlling and managing their body image that they are "much more involved in a production of the self than in living. There are so many young women who tip over into being a facsimile: they don't really inhabit their lives or their bodies." How does she go about treating that? What does it involve? Some kind of process of reintegration, reconnection? "I wish it was. I think that the situation is so serious – I think that when I wrote Fifi" – her gratingly twee nickname for Fat Is a Feminist Issue – "it might have been a process of reconnection. I think that now, bodies can be so disturbed from early on" – because mothers, in Orbach's view, exist in a state of permanent anxiety about their bodies – "there isn't necessarily a safe place to reconnect to."
In her 2009 book Bodies Orbach has argued that our culture is bad at acknowledging how psychological distress affects the body, and expressed a hope that one day "we will be able to propose a more fully psychosomatic theory of human development".
Unhelpfully, she won't be drawn on what that might look like, saying she is conducting research now at the New School in New York. All right. So what are the basic misunderstandings, in her experience, of how the mind affects the body? A long silence. "The examples that I gave in Bodies are, it's not that I want one to supersede the other, but if somebody has eczema the automatic thing is, 'Oh, they're so stressed, they get eczema.' OK? And with a derogatory edge in it. Which I find offensive. Whereas, I'd want to be thinking, 'Wait a minute, is that eczema not just about the soul weeping, or the heart weeping?'"
Orbach, 65, also argues that much of the problem lies in our increasing inability to manage desire. In that sense anorexics and compulsive eaters are two sides of the same coin: the former so afraid of appetite and desire that they try to deny it; the latter eating, as she puts it, prophylactically, before they get into the unbearable position of experiencing need. And they are doing so in a culture in which advertising, TV and obsessive attention to possible lifestyles multiplies needs and wants exponentially. "Yes, and you have to deny it, or satisfy it, that second ... it's not that we've got an impulse-driven culture, but we have commercial things pressing on us to always respond, or deny."
And it's always expressed as if it's going to make you happier? "Yeah," she answers. "As though happiness is an important criterion. I mean, what is happy? One of the things that I find so disturbing is this synthetic, sort of MSG version of happiness. I mean, you go into a shop in New York and you're told to have a truly wonderful day. And actually the impulse is to say, 'Can I just have the damn day I'm having, thank you?'"
Increasingly, it seems that there is an external definition of happiness, just as there is an external definition of what a beautiful body ought to look like (tall, slim, aquiline, pneumatic) and this, too, is producing a kind of psychological crisis. "I think what's very interesting recently, in a disturbing sense, for me, is that I see young women – and a few young men – who come in with a notion of, 'I've really worked hard, I've got this degree, I've got this scholarship, I've got this job, I've fixed my body, I've got the boyfriend. I feel empty. I've done all this stuff – which is the stuff that's supposed to be about happy — but I don't know how to live inside of myself.' And I think that's a disturbing rise. I never saw that until, say, five, 10 years ago."
To some extent, this echoes Orbach's own experience – her mother was an American who, when she moved to the UK, expected to be able to train as a lawyer. "She was so naive," Orbach once said. "She didn't understand that you had to come from the right class." Her father was a Labour MP who once advised Nasser and died on the day Thatcher came to power; her childhood "the classic cliche for the shrink … so miserable I didn't even know how miserable I was". Orbach took the reverse journey, heading for New York, where, having left a degree at the School of Slavonic Studies in London, she tried city planning and the law before plumping for women's studies and eventually psychotherapy. She returned with a friend, Luise Eichenbaum, and, establishing the Women's Therapy Centre, found that they had hit a nerve, and a need. The experience fed a book, Bittersweet: Love, Competition & Envy in Women's Friendships. A professional public profile ended, for her, when the tabloids discovered she was treating Princess Diana for bulimia – interviewers, as she tells it with a somewhat naive outrage, began to dig for personality, gory details, and be affronted when she refused to oblige.
Most recently, the gossip columns have been thrilled to find that after the end of a four-decade relationship with a male psychotherapist that produced two children, she was now with the novelist Jeanette Winterson. Is she still? "Mmmhmmm." She seems a lot more willing to talk about it than you ("I am in love," Winterson has said, "and I don't care who knows it"). The answer is quick, sharp. "Well, she's not a psychotherapist – she hasn't got to protect anything."
This is, give or take Winterson's involvement, her standard answer, and while it can seem like an easy get-out, there is a serious point, because, in therapy, such information in the public domain is "not without consequence". While "there is no such thing as a neutral therapist," the idea is not to turn patients away, or to complicate the terrain too much, such that she finds herself "trying to track what people imagine, see, want, dislike, are able to bring up, because of what [fame] means for them. Years ago," when she had a column in this paper, "I had people who wouldn't even open the Guardian if they saw my face on it." Then again, "Other people have no idea about me being any kind of public figure – they think I'm just a nice lady in Hampstead."
For more information about the summit, go to endangeredspecieswomen.org.uk. The main UK event is at London's Southbank on Friday.