Primo Amore (First Love)

Film Review by Harry Karlinsky, MD, MSc, FRCPC

Director: Matteo Garrone

Anorexia nervosa can be a devastating and chronic disorder associated with significant morbidity and mortality. Its depiction in films is relatively rare, and unfortunately one of the more interesting efforts is no longer legally viewable.

Todd Haynes’ subversive “Superstar: The Karen Carpenter Story” utilizes Barbie dolls to depict an emaciated Karen Carpenter and her unsuccessful battle with anorexia.

As Haynes never obtained the requisite permissions to use the Carpenters’ music, a court order now precludes its public release.

A more recent film dealing with anorexia nervosa is “Primo Amore” or First Love.

This Italian production directed by Matteo Garrone revolves around the relationship of Sonia (Michela Cescon) and Vittorio (Vitaliano Trevisan).

Their first meeting – a blind date – sets the tone for the rest of the film.

When a pleasant and clearly normal-weighted Sonia asks Vittorio whether she looks like what he had expected, a dismayed Sonia learns he thought she would be thinner.

Surprisingly however, a relationship begins and Sonia and Vittorio shortly begin to collude on Sonia’s ever-increasing restrictive diet. Vittorio’s control quickly becomes total. The final scene revolves around Sonia’s revolt in a restaurant and an unexpected aftemath.

One off-putting distraction is that the film’s symbolism is rather heavy-handed. Just as Vittorio molds gold into emaciated and lightweight figurines in his work as a goldsmith, so Vittorio similarly attempts to mold Sonia.

Vittorio’s heavily-barred and isolated homes are visual reminders that Vittorio is attempting to control and imprison Sonia.

Other obvious examples include Vittorio’s “don’t ever disappear” plea to a starving Sonia as well as the wordless lingering scenes of Sonia at work as a nude art-school model, emphasizing the body as object.

In one reclining pose, she is even paired with a skeleton in similar position! Where the film succeeds is in its more subtle depiction of the physical and psychological consequences of semi-starvation.

An emaciated Sonia collapses on a dance floor, can no longer concentrate at work, and experiences perceptual abnormalities – mistaking onions for chicken drumsticks. She begins to continuously weigh her self, precisely charting weights on an oversized graph, and to secretly forage for and hide food. Ultimately she engages in an uncontrolled binge-eating episode.

The most powerful and uncomfortable aspects of the film are viewing the quiet brutality of Sonia and Vittorio’s abusive relationship.

Interspersed between moments of apparent mutual affection and support, it is a calmly menacing Vittorio who – with escalating mistrust and surveillance – increasingly limits Sonia’s access to food and medical attention and who rages when transgressions occur.

Why their relationship continues is not obvious. Clearly Vittorio has significant psychopathology, perhaps partly influenced by the nature of his inherited profession.

We learn early in the film he has been seeing a psychiatrist for some time and has been preoccupied with finding a woman that meets his vision of a perfect body. And for Vittorio, thinner means purer; an ideal woman’s body, like gold, needs to be distilled of all impurities.

Although he acknowledges he would like a woman with a body and mind, Vittorio seems unable to resist his obsession and his need to orchestrate Sonia’s transformation.

The biggest mystery is why poor Sonia appears to willingly submit to Vittorio’s increasing tyranny.

She seems otherwise psychologically healthy, with rewarding work, colleagues that appear friendly, and a very positive relationship with a loving brother.

We do get a fleeting glimpse of a mildly insecure woman during the first date as well as a moment of self-doubt when she views a thinner female bather.

Responding to Vittorio’s leading question, she also agrees to being pleased when she sheds some initial weight. It’s also possible her work as a model could be a predisposing factor for an eating disorder. Yet there are no other clues as to why her self-esteem is so vulnerable that she continues to submit to Vittorio’s control despite starvation and increasingly palpable self-disgust, despair and misery.

In fairness, Sonia’s first reaction to Vittorio’s critical bluntness about her appearance was that she should immediately leave yet she quickly submits to Vittorio’s quietly insistent persuasion.

The power of First Love is that the viewing experience lingers and one continues to wonder about the director’s intention.

Is this a film primarily about abuse, and the collusion that can occur between a submissive slave and dominant master? And is its intention to highlight the very real difficulties of leaving an abusive relationship?

With this interpretation, the eating disorder is secondary. If not food, another focus of control could have been substituted without distorting the film’s central theme.

Or is Vittorio’s obsession with control part of an imaginative and composite depiction of anorexia nervosa.

Although anorexia nervosa is now recognized to have a multifactorial etiology, Baruch and others have emphasized the importance of control over one’s body in this disorder, particularly in the service of self-mastery and autonomy.

Bearing in mind the theme of the mind-body dualism that permeates the film; perhaps Vittorio is meant to represent the cognitive aspects of anorexia while Sonia represents the disorder’s bodily or physical manifestations. Hence the inseparable nature of their relationship.

Regardless of the director’s intent or viewer’s interpretation, the extremely well-acted First Love is an unsettling, brooding and malevolent portrait of a couple’s intense relationship, and well worth seeing.