When Netflix released 13 Reasons Why in March of 2017, public response was mixed. Many believed the series glamorized suicide, and portrayed parents and school counselors as aloof; while others, myself included, credited the show with raising awareness to acute suicidal states in white, middle class America. Only 4 months later, Netflix is again walking the fine line between glamorizing eating disorders, or depicting them as pervasive monsters with a relentless grip. Again, I exist within the population who believes the film raises awareness, and does everything but glamorize eating disorders.

That I watched the film on its release date of July 14 2017 was not happenstance. I have recently begun treating a 24 year-old client who has fluctuated between Anorexia and Bulimia since age nine, and have enhanced familiarity with binge/purge compulsion, and the voice of a harsh superego capable of reducing the afflicted to chyme.

Marti Noxon, of whose Girlfriends Guide to Divorce I am a fan, directed the film, and Lili Collins, daughter of Phil Collins, is Ellen, whose dysfunctional family not only catalyzes the withering of her body, but of her ego. My goal is not to review the film, but to testify to its accurate portrayal of causes, dynamics, and necessary components of healing. What veers the film away from glamorizing eating disorders is its graphic depictions of their effects on the whole person.

Early in the film, Ellen rigorously executes crunches on her hardwood, bedroom floor. What could otherwise be viewed as an innocuous exercise session morphs into self-abuse when a camera shift to Ellens back reveals a cluster of bruises on her spinal column. The scene reveals injury many of us would not consider when we conceptualize harm done to the body by obsessive exercise. During Ellens physical examinations, our eyes are assaulted by closeups of protruding shoulder blades, and ribs. This is not the stuff of glamorizing. Ellen seizes no joy from her illness; unless joy is defined by self-destruction, and perceived unworthiness born of an absent father and mentally ill, unattached mother .

The film also explores typical unintended ignorance evidenced by a family member who implores Ellen to just eat, and a stepmother who stares at residents in the clinic at which Ellen reluctantly agrees to seek treatment as if they were sideshow freaks. Hopefully, these depictions raise awareness to people in support roles.

Another important element touched upon within the clinic is the phenomenon of patients sharing tricks of the trade more likely to facilitate pathology than healing. For example, one character hides a puke bag under her bed, while another drinks water from a bathroom tap prior to a weigh in. Those revelations mirror what my client has described to me about her own stay in a clinic, and also underscores shame that catalyzes a need for clandestine behavior.

To the Bone further addresses severe implications of eating disorders by portraying a character forced to endure a feeding tube down her throat, and who panics at the revelation the average drip bag contains 1500 calories. Meanwhile, in the films most disturbing sequence, a pregnant patient suffers a miscarries on a bathroom floor mere hours after fellow residents give her a baby shower. Again, not glamorous.

I grew worried the film would succumb to cliche with the introduction of a doctor played by Keanu Reeves. I feared his character would fall into the Robin Williams in Good Will Hunting category; the lone oracle distinguished by his ability to lead patients to a moment of enlightenment, and change. Thankfully, the its not your fault moment never happens. While the doctor does utilize some unorthodox methods, he struggles to promote healing because Ellens family is not there, and familial support is so crucial to the process of healing, and the maintenance of stability.

The notion that healing is catalyzed by resolution of old psychic wounds spurs the bottle scene, the emotional impact of which can only be experienced by viewing. After prematurely leaving the clinic, Ellen receives her wake up call through a dream sequence during which she sees her own emaciation and death. Its a cliched sequence, but serves its purpose as Ellen buses it to Phoenix to confront her pain, and her mother. The scene says everything about the necessity of early object relations, and how connection with a primary caregiver is prerequisite to connection to others. In the scene, Ellen allows herself to feel emotion buried under years of disorder, and although she experiences catharsis, the moment is not a panacea. Ellen still needs to repair her cognitive distortions, if her behavior is to change.

The necessity of said work leads her back to the clinic, this time under her own volition, and leads the film to a satisfying conclusion. Noxon could have fast forwarded to Ellen in full recovery, eating a meal at a healthy weight, but she avoids the trope, and instead lets us know the end of the movie is the beginning of the story. When Ellen returns to the clinic, she is no longer to be a bystander to her life, but is ready to claim authorship of her narrative.

To the Bone is by no means a glamorization of eating disorders, but it does provide viewers opportunity to see the glamour in hope, healing, and human connection. Watch the movie, and keep the conversation going.