Heft

Moore’s novel explores the ways severe health conditions—physical, mental, and psychological—impact individuals living with them. Her characters’ struggles with obesity, agoraphobia, lupus, and alcohol dependence allow Moore to examine the real-world comorbidity of these conditions. By setting the novel in the early 2000s, Moore explores Arthur’s agoraphobia in the context of the rise of the Internet and e-commerce—a time when services like online grocery delivery were just becoming mainstream—facilitating his reclusiveness. Arthur notes, “Because I no longer go outside, I have become very good at ordering whatever I need online” (14). His agoraphobia and tendency to self-soothe with food are enabled by a cultural shift that allows him to retreat completely from a world he feels will judge and reject him.

The rise of telecommuting and remote work, especially in the wake of the COVID-19 pandemic, makes it possible for many who suffer from chronic physical conditions or mental health conditions, such as agoraphobia, that make travel outside the home difficult, to support themselves without needing to leave the house. In The Atlantic, journalist Lenika Cruz reflects on the origin of the term agoraphobia “first used in 1871,” also “known as ‘locomotor anxiety’ and ‘street fear’ [because] modern wide boulevards first emerged in Paris in the 1870s and, around the same time, technological breakthroughs such as extended railroad networks and long-distance commercial steamships had just begun to allow for the possibility of higher-speed, long-distance travel” (Cruz, Lenika. “Working from Home Made Me More Anxious.” The Atlantic, 17 Sept. 2014), giving rise to growing anxieties about space and expansion. However, medical research suggests that while advances of the digital age and e-commerce make it possible to live and work without leaving one’s home, that level of isolation actually increases the symptoms of anxiety. Clinical psychologist Dr. Kilianne Kimball notes that “Avoiding anxiety-provoking stimuli tends to both perpetuate our anxiety and erode our self-confidence, thereby worsening our anxiety” (Cruz). In Heft, both Arthur and Charlene’s experiences reflect this idea, as their mental and physical health decline the longer they remain reclusive.

Moore’s novel implicitly links the mental illness and self-imposed isolation of her characters to their personal pain, shame, and childhood trauma. The physical pain and complications that Charlene experiences as a result of her physical illness, lupus, are exacerbated by her depression and alcohol dependence—a connection supported by medical research from the Lupus Foundation of America, which notes the high incidence of depression and substance use among patients. Arthur’s agoraphobia is initially triggered by the shame of appearing before his university’s ethics board. Moore positions his habit of self-soothing negative emotions with food as learned behavior from his mother—a shared way of dealing with the trauma of his father’s disdain and abandonment.