'Thin' - Lauren Greenfield (2006) - Film Review

Thin – Lauren Greenfield (2006)

Review by Katie Findlay

At first encounter, Thin, the 2006 documentary by Lauren Greenfield, seems aptly titled. ‘Thin’ is the word that leaves the lips of the women the film follows most frequently; it is what they are, it is what they aspire to be, and it is the mantra that directs their lives. However, the crux of Greenfield’s project, shot in the Renfrew Treatment Centre in Florida, is not the struggle of four young women against their eating disorders, but rather the incapability of the American healthcare system to treat their complex illnesses. By the end of the documentary one realises her title is misleading, but it is succinct, memorable and sums up these women’s lives in a word.

“Her capillary refill is good” observes a nurse, “but her nail beds are more blue”. The patient seems only half alive, referred to in the third person despite her presence. We see the women emerge as shadowy corpses from their bedrooms, shuffling down sterile corridors to rooms where they are weighed and their vital signs checked. Greenfield’s choice of audio clips from the nurses are powerful, especially when placed alongside long shots of the women waiting, bleary-eyed, for their medical screenings in the metallic interior of the surgery. We feel that the centre, where they have come to seek treatment for diseases that are taking their lives, is removing the last few scraps of their humanity. In this clinical world the women have no voice, they put up no struggle; they seem truly unwell.

Although Greenfield includes all the classic images of stark spines and angular elbows, it is the meal-time scenes that are hardest to watch. We see, at eye level, the painstaking reluctance with which the women place morsels of food into their mouths. What they are eating is as clinical and unappealing as their medical exams; Greenfield makes no effort to make the meals look appetizing. There is a saddening moment as Polly faces her birthday cake, seemingly in front of an audience, and hollowly ‘thanks’ the chef for his handiwork. The scene cuts quickly away to her crying on the shoulder of a friend, heartily regretting what she’d had to eat. Although Greenfield’s depiction of the birthday is probably not the true sequence of events, we are left with the nagging feeling that Renfrew is doing little to change these women’s difficult relationships with food. If anything, it’s making them worse.

In contrast to their medical exams and regimented meals, the pastoral care offered by the centre appears unprofessional and disorganised. ‘Bekah Bardwell, Evening Councillor’ we are informed on-screen as a woman hands out cigarettes. ‘Family therapy with Shelley’s mother’ appears whilst the voice of Shelley’s mother emanates from a phone; the object in-shot acting as a glaring symbol of her absence from the session. We receive little information about the care the women receive, and what we do is sporadic and uninformative. The audience is left to fill in the gaps themselves, giving the impression that there is no useful, linear care programme in place at the centre. If this was her message, Greenfield presents it well.

The question goes unanswered when Shelley asks the same therapist “So why should I tell you?”, highlighting another subtext that Greenfield develops: the complete lack of trust between the patients and staff. Whilst we speak to the women one-on-one, getting to know them personally, Greenfield does not create this same dialogue with the care team. All we know is that they are there, and they are not to be trusted. What’s more, they openly discuss the patients in group meetings. Although presumably this is a part of the women’s care programme, the choice of sequences does not present the staff in a favourable light. “I don’t trust [Shelley] as far as I could throw her’ – a common colloquialism becomes a bout of petty unprofessionalism when quoted with little context.

Alongside their clinical treatment, struggles with food and uncaring staff, Greenfield includes documentary on the relationships between the women. Shots of friendships, fun, and schoolgirl-like rebellion present a much needed escape from the emotionally-charged silences of counselling sessions. “I used to have a personality” Shelley says quietly to her therapist. “I don’t have any friends” Alisa confesses; statements which prove wildly untrue when the women are seen turning somersaults onto Polly’s bed or smoking contraband cigarettes against a bathroom fan. Learning how to build relationships seems to be the best therapy these women are getting, portrayed by Greenfield like breaks of sunshine in the otherwise dreary atmosphere of the centre.

Greenfield’s choice to follow Polly’s story is evidently directed by her interest in the women’s inter-personal relationships. She is portrayed as the most spunky, most rebellious of the group, although it is her personality that eventually causes her to be evicted from the centre. There is a harrowing scene as the team and Polly speak to her mother by phone, telling her that Polly is to be discharged. As her mother begs the councillors to re-consider, Polly breaks down like a child. “I’m so sorry mom”, she sobs. Meanwhile the staff look on, unmoved.

This is a recurrent theme in Greenfield’s choice of subjects – being discharged from the centre before they are ready. Polly for her rule-breaking, and Alisa, Shelley and the young teen Brittany because their insurance refuses to pay. We are left with little hope that these women are going to get better, as they have not really been cured. This is confirmed when Greenfield includes documentary taken after Alisa’s discharge; she picks over a salad in front of her children, then purges the meal behind their backs at home. The follow-up text at the end of the documentary accompanied by the same haunting music heard at the beginning presents a bleak image; all of the women continue to struggle with their eating disorders. Nothing has changed during their, and our, time at Renfrew.

Overall, Greenfield has created a harrowing documentary of the struggle of four women against their eating disorders, and against a healthcare system that provides very little in the way of support. Her short cuts and uneven camerawork give the documentary an authentic, honest feel, adding power to her message. She re-humanises the patients by recording their friendships and rebellions, restoring their personalities and highlighting the everyday battles that the Renfrew Centre, and the American Healthcare system in general, seems to care so little about.