In the film, The Black Swan, Nina obsesses about being a perfect ballerina. Her dancing in a troupe is inextricably tied to her sense of self. To endanger that activity is an intolerable nightmare. To stop dancing or to lose progress toward unapproachable stardom is equivalent with death of her identity.
Anorexic and bulimic women in real life go into weeping tantrums, rages, manipulative arguments and pleading when their eating disorder symptoms prompts family ormedical advisers to suggest even temporary life changes in support of their health and psychological well being.
Life Change Suggestions include:
- dropping out of college or educational program for treatment,
- changing schools to be closer to support systems and treatment,
- cancelling travel plans because they are too ill or psychologically unprepared,
- requiring a less stressful job while doing recovery work,
- leaving routine life of family, work, school, friends to go in-patient for several months, changing priorities to go into private psychotherapy several times a week for months or years.
Their genuine feeling of imminent disaster comes from perceiving a threat to activities that define them to themselves. They will protest using whatever arguments and emotions they feel will convince others that they can take care of themselves. They will make promises about stopping dangerous behaviors and keeping to a recovery plan on their own. They will lie convincingly about whatever they can to convince others that they are or will be fine without any disruptions in how they choose to live their lives.
Nina, like other women with eating disorders, experiences distortions in her thinking that can reach the stage of unrecognized hallucinations. She does not recognize or acknowledge her illness. She rationalizes all actions, events, behaviors, feelings and thoughts to live her limited and controlled life that is maintained by her eating disorder.
She creates strategies to deal effectively with what she sees as realistic threats many of which are unrealistic fantasies created by her own mind. She increasingly loses her ability to discriminate between her fantasies and reality.