A Thin Body Carries the Most Definition(s)

Reconceptualizing Voluntary Self-Starvation as an Act of Resistance

by Jane Nicholas

A thesis subrnitted to the Department of Political Studies in confomiity with the requirements for the degree of Master of Arts

Queen's University Kingston, Ontario, Canada

copyright O Jane Nicholas, 2000 National Library Bibliothèque nationale 1+1 &,na& du Canada Acquisitions and Acquisitions et Bibliographie Services services bibliographiques 395 Wellington Street 395, rue Wellington OttawaON KlAONQ Ottawa ON KIA ON4 Canada Canada Your fi& Votre refemce

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The author has granted a non- L'auteur a accordé une licence non exclusive licence dowing the exclusive permettant à la National Library of Canada to Bibliothèque nationale du Canada de reproduce, loan, distribute or sell reproduire, prêter, distribuer ou copies of this thesis in microfom, vendre des copies de cette thèse sous paper or electronic formats. la farme de microfiche/fïlm, de reproduction sur papier ou sur format électronique.

The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substantial extracts f?om it Ni la thèse ni des extraits substantiels may be printed or otherwise de celle-ci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission. autorisation. This study seeks to reconceptualize 'anorexia nervosa' as an act of resistance using a postmodern framework. To understand voluntary self-starvation in this manner the history of fernale self- starvatio n, the psy chiatnc-based discourses, and the ferninist challenges wiil be explored- A brief history of fasthg fiom the Middle Ages to the Victonan period shows how the context for the construction of the 'illness' of 'anorexia nervosa' was established. The psy-based discourse will be examined as a continuation of the history fiom the Victonan penod and into contemporary theories of 'anorexia nervosa'. Current constmcts of self-starvation wiii be foiiowed by an overview of promuient feminist challenges to these interpretations. Included in this study are issues of race, ciass, and sexuality as the discourse of 'anorexia nervosa' has long been seen as the exclusive domain of white, rniddle-class women. Part of the vaiue of a postmodern interpretation of voluntary self-starvation is that it can help us to deconstruct traditional assumptions interwoven in medical discourse, medical treatment, and currently accepted reasons of wny women voluntarily self-starve. Table of Contents

I In Silence: The Changing Discourses and Conrexts of Voluntary Self-Starnationfrom the Middle Ages to he Victorian Period ....,...... --.-..--...... ------.- -..-.-..-..--. ... --..--.-. *...... -.-.-...... -...... -....-...... -..- .-.. . . .-.-... .-.... 6

2 It S A Mental Condition... Nothing To Do With Us: 'Anorexia Nervosa ', Medical Model, and Psy-Discipline Discourse in the Twentieth Cenrury...... -..-.--..-.--..- ..-.....- .-.*------..-..+ --..-.-.- ...-.-- -.--..-...... --.--...... 33

3 Grasping the Body. Quiet and Firm: Feminist Interpretarions of 'Anorexia Nervosa' ....-.--...... --..-..-.-.-...... -59

4 Do I Need To Use Words To Tell You a Story?: Reconceptualizing Voluntary Sev-Starvation as an Act of Resistance...... ---..---.---..-.--..-.. - ...... 9 1

Appendix

Bibliography Introduction

A thin body is easily recognizable. The definition of muscles, bones, and veins are created by sharp angles and lines which fom a distinct shape of the hurnan body- The thin fernale body, however, has camed another set of definitions which are not as conspicuous or easily controlled.' These definitions have changed depending on historîcal context and have attempted to explain why some wornen pursue thinness to an extrerne.

There are many different definitions and explanations for voluntary seIf-starvation that shift and change depending on context. Consider, for instance, the experiences of an Irish wornan in Belfast who survived a political hunger strike in prison but, after her release, died of 'anorexia nervosa'.' The expression of the dichotomy between a politicai hunger strike and 'anorexia nervosa' mises a number of questions. How do we differentiate between political hunger strikes and 'anorexia nervosa'? What makes an act of self-starvation political resistance? Where does a politicai hunger strike expressing resistance end and 'anorexia nervosa', as a psychiatrïc 'disorder', begin?3

The creation of the dichotomy between hunger strike and 'anorexia nervosa' is based on a number of other dichotomies incIuding politics/personal, society/individuality,sane/insane, and active/passive. The question becomes how we cm rethink these arbitrary dualities to open up the artificiaI discursive construct of 'anorexia nervosa' to include the possibility of self-starvation in young women diagnosed as 'anorexic' to include resistance?

To atternpt to open this space we need to understand the history of voluntary self-starvation, the psychiatrie-based disciplines' extremely powerful discourse that has been one of the strongest in terms of creating popular explanations, and the ferninist challenge to the psychiauic professions' hegemony. Using the tools of postrnodemist theory, however, the context of voluntary self-starvation cm be changed to include a possibility of understanding it as resistance. In shifting the context from illness to resistance it is necessary to recognize women as active participants in their Iives, The possibility that a postmodern theoretical context provides is to discuss women as active in the construction of their lives nther than as passive victims of active discourses.

The theoretical tools needed to challenge popu1ar contemporary explanations of 'anorexia nervosa' may be found in postmodem theory, specifically in the works of Judith Butler. However, postmodernism provides a number of interesting challenges in discussing voluntary self-starvation as resistance. How is resistance defined?

Could a postmodemist theory of voluntary self-starvation create a more inclusive category that does not deny the existence of voluntary self-starvation in women of colour, working-class women. andlor lesbians? Cs self-

starvation resistance or conformity and how do we differentiate between them?

In chapter one the history of voluntary self-starvation will be discussed from the Middle Ages ( 1 100-1 300)

to, and inctuding, the Victori,m period (1834-1901) with an emphasis on the shifts in the meaning of self-starvation

as they relate to the contexts and consa-uctions of specific periods. The different constructions of voluntary self-

starvation including fasting, asceticism, commercial spectacle, and pathology will be explored to show how

voluntary self-starvation has undergone a number of shifts in its construction. The discursive construction of

'ariorexia nervosa' will be explored in the context of Victorian society in order to develop a clear understanding of

how the 'disorder' came to be entrenched. Issues of class, race, and sexuality will be discussed throughout the

chapter to show the exclusivity of the construction of 'anorexia nervosa' and how this exclusion renders invisible

those women who do not fit the stereotypical prototype of a 'typicai' 'anorexic'.

The second chapter will explore the meanings and consu-uctions of voluntary self-starvation in the

twentieth century as they have been developed by the psy-disciplines, The discursive history of 'anorexia nervosa'.

as it was continually developed by the psy-disciplines, will be discussed as well as treatments that rnay have been

used, The treatrnent of psychiatric 'disorders' of the period provide an important context which helps to create an atmosphere into which wecan place 'anorexia nervosa'. Some of the most popular psychiatric theories of

'anorexia nervosa' are discussed. The explanations for 'anorexia nervosa' in males are touched upon briefly but the focus will remain on the female experiences of voluntary self-starvation in order to reflect the gender bias its construction, Chapter two will also discuss how the constnicted image of 'anorexia nervosa' is race, class, and sexuality specific which rnay Iead to a misdiagnosis.

The third chapter discusses the feminist explanations of 'anorexia nervosa'. The most influential works discussed are: Kim Chemin's The Hungry Se@ Wornen, Eating, and Identiry, Susie Orbach's Hunger Srrike: the

Anorectic 'sStncggle as a Metaphor for Our Age, Susan Bordo's Unbearable Weight: Feminism, Western Cuitrire and the Body, Harriet Fnad's "Anorexia Nervosa: the Female Body as a Site of Gender and Class Transition" and

"Anorexia as Ciisis Embodied: A Marxist-Feminist Analysis of the Household", Morag MacSween's Anorexic

Bodies: A Feminist and Sociological Perspective on Anorexia Nervosa, and Eva Szekely's Never Too Thin. The works will be discussed and critiqued in order to determine a general sense of the popular feminist explanations.

These works provide an important background for discussing voluntary self-starvation as many of them provide a

good analysis of Western culture and the body.

The fourth and final chapter attempts to open space for the discussion of voluntary self-starvation. It is

argued that voluntary self-starvation may be an act of resistance for a specific group of women. In this chapter a

framework for resistance is developed using Judith Butler's theory of 'gender trouble'. The difference between

resistance and conforrnity is discussed. The possibility of resistance through voluntary self-starvation is explained

in relation to the discursive construction of the femde body in Western culture. The active resistance of black

women, working-class women, and Iesbians is demonstrated to show how voluntary self-starvation as resistmce

rnay be more representative of women's actual lived experiences.

I have focused on 'anorexia nervosa' and left issues around 'bulimia nervosa' undiscussed although clinically they are presented by psy -disciplines under the rubnc of 'eating disorders'. Clinical definitions of

'anorexia nervosa' Vary sIightly but there are generally accepted collections of symptorns that constitute each. The

Diagnostic and Statisticai Manuel of Psychiatnc Disorders (DSM IV) is the official diagnostic manual used by the psychiatric professions, Every classified psychiatric 'disorder' is included in this manuai and it is updated as new

'disorders' are 'discovered', or as existing ones are revised or deleted. Where 'anorexia nervosa' is referred to the basic categoncai and diagnostic 'illnesses' that are being discussed are those defined in the DSM IV.

In the DSM IV the diagnostic critena for 'anorexia nervosa' are as follows: (a) refusa1 to maintain body weight above a minimum forage and height (e.g. weight Ioss leading to body weight of less that eighty-five percent of expected weight or refusai to gain appropriate weight leading to body mass less than eighty-five percent of that expected); (6) intense fear of gaining weight or becoming fat even when underweight; (c) disturbance in the understanding of body weight or shape, body weight and/or shape that unduly influences self-evaluation, and/or denial of the seriousness of current low body weight; and, (d) arnenorrhea (absence of at least three consecutive mensmal cycles but menstruation occurs following hormone administration) in postmenarcheai women. There are two identified types of 'anorexia nervosa in the DSM JV and they are the restricting type and the binge- eating/purging type. The restricting type 'anorexic' wornan does not regularly binge and purge (i.e. self-induced vomiting, laxative, diuretic, and/or enema abuse). The binge-eating/purging type engages in binge and purging behaviour (Le. self-induced vomiting) and may abuse laxatives, diuretics, and/or enernas."

The history of voluntary self-starvation combined with the psy-discipline and feminist discourses provides a general sense of the constructions of women's experiences with self-starvation from the Middle Ages to the present. The last chapter uses postmodern thought to provide another possible explanation for the existence of some experiences of voluntary self-starvation. The focus on women's expenences with 'anorexia nervosa' is an attempt to create space in which we can begin to discuss the differences in and arnongst women who self-starve without developing an exclusionary category. 1. I have chosen to focus on the experiences of women and voluntary self-starvation as approximately ninety percent of people diagnosed with 'ûnorexia nervosa' are women, (See the Diagnostic and Statistical Manual of Mental Disorders 4Ih Ed). Men can and do voluntarily self-starve, and will be discussed briefly in chapter two. r Maud EIlman, The Hunger Artists: Starving, Writing, and Impnhrnent, Cambridge Massachusetts: Hanrard University Press, 1993, 1. 3. There is a very specific language used in different discourses describing voIuntary self-starvation and 1 have chosen to differentiate between the medical model's discursive construction of starvation as 'anorexia nervosa' and voluntary self-starvation. The preference for voluntary self-starvation cornes from its open context as it describes an activity without assurning it to be pathological. In addition, it is important to differentiate between the psychiatric definitions and the postrnodernist theoretical possibilities provided here as voluntary self-starvation allows for a heterogeneity of experiences to be discussed. 'Anorexia nervosa' and other medical mode1 terms appear in quotations where psychiatric language could not be avoided. 1 have borrowed the Lem voluntary self- starvation from Liz Eckermann, "Foucault, Embodiment, and Gendered Subjectivities: The Case of Voluntary Self- Starvation," in Foucault, Health and Medicine, Eds., Alan Peterson and Robin Bunton, New York and London: RoutIedge, 1997. 4. Diagnostic and Statistical Manrcal of Mental Disorders 41h Ed., Washington, DC: American Psychiatric Association, 1994,544-545. In Silence The Changing Discourses and Contexts of Voluntary Self-Starvation from the Middle Ages to the Victorian Period

The social, politicaI, cuItural and religious contexts of a specific penod have greatly affected the construction of voluntary self-starvation. Whether it was fasts or pathology, the rneaning of starvation was dependent upon the historicai context; therefore the practices of refusing nourishrnent cmnot be removed from their historical situations. The discursive construction of voluntary self-starvation has consistently been a product of the broader discourses including gender, class, sexuality, and the body- To futly comprehend the changes âround the construction of self-starvation both the major and the transition periods need to be recognized. This chapter wilI examine the different constnictions of voluntary seif-starvation from the Middle Ages (1 100-1300} to, and including, the Victorian period (1 834- 190 1) as it relates to the differences in fasting, asceticism, commercial spectacles, and the emergence of 'anorexia nervosa' as a pathology. The Middle Ages and the Victorian period will be the primary periods of focus since they represent two pivotal moments in the history of the construction of voluntary self-starvation. Each of these will be discussed in relation to gender and class constructions as they relate to specific periods and areas. The history of voluntary self-starvation discussed here will be limited to Western

Europe and America (specifically the United States).

By the time voluntary self-starvation was 'discovered' as the psychiatric disease 'anorexia nervosa,' the construction of a self-imposed extreme fast had undergone nurnerous changes. From the thirteenth century to the fifteenth century, extraordinary fasts by nuns and devout laywomen were considered miracles of God or divinely inspired. However, beginning in the sixteenth century, the construction of voluntary self-starvation began to be removed from a religious context and, instead, became more closely associated with commercial cunosity- From this period until the end of the nineteenth century a slow transformation in the context of self-starvation would occur. The discourse of organized religion was replaced by medicd discourse. An examination of the influential discourses dunng the Middle Ages will begin with a discussion of religious theology, specificaily Thomas Aquinas.

Christian theologians adopted and modified Aristocelian philosophy. As a result, Aristotlean thought became the basis for most of the Christian ideas of the differences between women and men. One of the most influential wrïters, Thomas Aquinas, Christianized Anstotelian thoughts on women defining man as made in the image of God - close to perfection, active and formative. Women were the exact opposite - imperfect, passive and destructive.' The only way for a woman to become an 'honorary man' was to remain a virgin and dedicate her life to ~od-'In atternpting to become an 'honorary man' women first rernoved their bodies from the secular and sexual world, and then they worked at denying their reproductive capabilities. Women of the retigious orders thus became defined by the religious not the biological or sociological constructions of the secular rea~rn.~

The clergy and theologians were not the only theoreticai force in the Middle Ages. The an'stocratic class, a small but powerful caste, constnicted the ideal of an ornamental woman who was subordinate in rank to property?

From the twelfth century onwards, however, the rising bourgeoisie grew in power as urbm life emerged, uade developed and towns flourished. The merchant classes, while not nearly as powerful as the Church or the aristocracy, had a sIightly more appreciative view of women. Taking into account the women who were active in trade, town law of the period recognized that manied women were trading on their ~wn.~The peasant classes, who supported the other classes and the Church, were arguably less affected by the accepted social constructions because the aristocratie classes were not readily available or open to them. Their lived experiences contradicted theological and philosophical constructions. Men and women worked together in the fields and while some work was segregated along gender lines al1 of it was difficult and essential to the home economy. They could not, however, completely escape the religious constructions as the peasant classes "went to their churches on Sundays and listened while preachers told them in one breath that woman was the gate of hell and that Mary was Queen of heaven."

7 The different class constructions and the over-arching and powerful voice of the Church Ied to a number of different ideas about women. The most powerful of these ideas, for women of dl classes, was the dualistic view of woman as either Mary or Eve.

The dualistic construction of woman as either virgin, or lustful sexual object, had ramifications for women of al1 classes and affected their roles in society. Eve, because of her role in 'The Fall,' was evidence for medieval theologians that women were unsuitabte for, and perhaps even incapable of, complete participation within the

Church and s~ciet~.~Women's redemption was through the imitation of Mary, the virgin mother (and Eve's exact opposite). Mary's imitatable qualities included being "docile, subservient, easily controlIed. and apoliti~d."~The characteristics of Mary were those that removed women from politicd power those places that developed and perpetuated the constnictions, such as law making institutions. What is exceptional about voluntariiy self-stanting women of the medieval period is that they, in a rigidly ordered and gendered society, managed to use Mary's qualities in order to gain public and political power.

The ideology that women were naturally imperfect, passive and destructive was represented in the legal and politicai statutes on women. Women of the noble class could not inherit property unless there was no male heir; women could not participate in legal proceedings as they were prevented from becoming judges, sitting on juries or even being summoned to court. Theoreticaily, women could not participate in the military or become knights.

Traditional avenues of political activity appeared closed to women of the MiddIe Ages. However, with an expanded notion of politics historians have shown that women participated in politics through more subversive means. The difference between the political participation of women and men is the difference in the definitions of politics for

"when the distinction is made between what constitutes politicai power or influence and what constitutes political authority, women can be seen as having access to political power and influence while being denied political authority." When women are seen as passive, as having politics happen to them, then their participation in the politicd world disappears. If we reconstmct women as active participants in their own Iives then they emerge as politically active beings despite poIiticd, social, cultural, and economic restrictions. Open displays of power by

8 women were dangerous, especidly in the eyes of the Church, Certain actions of women had to be carefully disguised. So the power women exercised had to be covert and subversive rather than open and direct. The subversive influence of women took many forms and depended on their individual position, women of

the aristocracy would have more access to formal power than a peasant women as women were most often

responsible for chiId care, they could control and shape a son's future, especiaily if that son had the chance of

gaining a politically powediil position. Noblewomen who received a genteel education, usually reading and

writing, could educate their daughters at home since, by this tirne, a 'public' education, particularly at the university

Ivvel, had been denied to thern.1° Another route to political power for women was marriage since it was a political

and economic agreement between famifies. Although women did not have any control over whorn they married, for

the weaithy, it was an alIiance where by families could advance politically and, most imponantly, economically."

For the purposes of this chapter, one of the most important ways a wornan could become politicaily involved was

through voluntary self-starvation.

Voluntary self-starvation became a means to politicai influence because self-starving religious women

were seen as 'empty vessels' through which God could speak, To become a vesse1 for the word of God rneant

depleting the body to Save the soul. Since food was symbolicdly important in the Christian religion, as well as in

Medievai society, one means of punishing the body to Save the soul was through food restriction. The original

meaning of asceticism illusuates the necessity of restricting the diet to Save the virtue of the soul. Voluntary self-

starvation during the Middle Ages is usually referred to as 4asceticism'~Asceticism, from the Greek askesis

(exercise), originally was in reference to the suict physicai training and diet of athletes. From antiquity, asceticism came to refer to "the pursuit of spiritual and virtuous aims, often precisely to the detriment of the body."" Ascetic practices were one factor that Medieval women could effectively regulate as food was an important resource traditionaily controlIed by ~omen.'~

Women had compIete control over the preparing and serving of food and were directly Iinked to feeding the family. Fasting was important in the observance of religious occasions within the family as well as within the religious orderst4 However, the extrerne fasts among devouc laywomen and religious women were given an important place in Medieval society, Fasting arnong religious orders and devout laywomen took on particular importance because of their already heightened position in society as religious wornen, The one way for women to bypass their bodies and gain respect in society was to enter religious orders or devote their lives to God- Food, practically and symbo1icaIIy, was of particular importance to medieval spirituality but, for women, it was more

important to their piety than rnen.15 Not only were wornen responsible for the preparation of food but they were seen as having a natunl physical and spirituai connection to it.

The Eucharist, bread and wine that represents the body and blood of Christ, had specid Importance for devout fasting women. When women in religious orders fasted, they ate onty the Eucharist as a symboI of their extreme devotion and willingness to take part in the Imitario ChnSri - irnitating and taking on the suffering of

Christ.l6 ~owever,for fasting wornen in holy orders the "reception of body and blood was a substitute for ecstasy." l7 This experience of ecstasy was often accornpanied by mystical visions. Mysticd visionaries have been documented as having "Eucharistic miracIes," la With wornen, these miracles were alrnost always associated with food. For example, it was more common for the Euchkst to turn into food, honey or meat, in the mouth of a woman, Another Eucharïstic miracle of vomiting an unconsecrated host or being able to tell if the priest btessing the host was immoral was almost dways experienced by women. Forty-five of the frfty-five records concerning people who received the host from Christ's hand indicate they were ~ornen.'~Comparatively, there are only two kinds of Eucharistic miracles that were chiefly experienced by men and they "underlie not the fact that the wafer is food but the power of the prïest." 20 Therefore the gender difference between Eucharistic miracles are prernised in the difference in men's and women's power and their consuucted relationship to food.

The Eucharist also helped women gain power within Church and society. The women who experienced

Eucharistic miracles often gained priestiy powers, such as the authority to becorne a prophet, to teach and to hear confessions?' Women's Eucharistic devotion also gave women political power as becoming a vesse1 for the word of God alIowed women to escape the construction of femaIe as apoliticai. FemaIe mystics, laywornen and religious women, used their visions to advise political leaders. Caroline Walker Bynum writes that,

[in] the twelfth to the fifteenth century, vre find women having suiking political visions for the assistance of men. Hildegard of Bingen, Elisabeth of Hungary, Catherine of Siena, Birgitta of Sweden and Joan of Arc are the most obvious examples. But less well known figures, like Christina of Markyate in the twelfth century, Mechtild of Magdeburg, Douceline of Marseilles and Margarita of Faenza in the thirteenth, also advised counts and kings on politics and war.*

This would certainly indicate that women were actively involved in the politics of their period. If they themselves were not authority figures they were able to influence those in power as Catherine of Siena did. However, for a

woman to openly resist the official constructions was dangerous as she could be declared a heretic. As a result,

women were often forced to conceai their political authority. Catherine of Siena is one of the most popular

examples of wornen mystics who gained politicai power through voluntary self-starvation, The political activities in

which Catherine was involved included "planning the crusade against the Turks and in the struggle between the

Florentine alliance and the papacy and ...[ she] was active in the campaign to restore the pope to Rome." 23

However, the power Catherine and sorne of her contemporaries gained had to be carefully used and even more

carefully disguised by modesty and weakness symbolised through food refusal.

ReIigious fasting during the twelfth, thirteenth, and fourteenth centuries was respected and considered a

sign of extreme holiness. It therefore became a powerful position as holiness was revered in medievai society.

Those who showed their religious devotion through practices of refusing food were mostly wornen. The increase in

the nse of exueme fasting coincided with the increased nurnber of women entering spiritual life and a rising nurnber

of female saints.24 Fasting was an essentiai aspect to female holiness as religious women sought to prove their

devotion- It also becarne a means of seeming passive and yet taking an active role in religious and secular politics.

Asceticism arnong Iaywornen was aiso popular. It has been suggested that laywornen who practised exueme fasting did so for a number of reasons including the desire to avoid marriage. The legend of St, Wilgefortis has been cited as an example of fernale resistance to gender constructions during the Middle Ages. Legend has it that St. Wilgefortis starved herseIf and prayed that God would take away her beauty so that she did not have to mq.When a mustache and beard grew on her face her suitor withdrew his proposai and her father had her

~rucified.'~The case of St. Wilgefortis shows the relatively littie formal power women had over their own lives and exemplifies a number of interesting points that are important to understanding voluntary self-starvation during the

Middle Ages,

Self-starvation may have becorne a means by which women couId controt their bodies in order to gain control over their lives in a patriarchal society or to resist the limited options offered to women of a marriageable age of a specific class. An unwanted maniage would not have been an uncommon occurrence during the Middle

Ages. Maniages were mnged and, especiaily for the middle and aristocratie classes, were econornic and political cantracts. Through rnarriage farnilies could ensure their class position within the society or increase their wealth.

Refusing a marrïage proposal outright was an impossibility. There are examples, however, of women using their bodies to resist an offer of marriage. Catherine of Siena, for exarnple, avoided rnarriage by cutting off her hair so that she would be considered unmarriageable. Means such as these were necessary because of the patriarchal control in the state and the household. Fathers had complete control over the femde members of the household including their wife, daughters andor servants (male and female). Physicai, emotiona1 and mental abuse was not considered a crime; in fact, the law permitted wife-beating. 27 For a daughter to refuse rnarriage was an extremely dangerous situation- 'Defacing' the body was perhaps one of the few means young women had to resist their familid and social position,

Fasting wornen had to take special precauüons so that their fasting would not be misconstrued as satanic possession. Catherine of Siena made great attempts to eat something every day as she had been accused of being a witch and fed by demons in the nightF8 Another wornan, Columba of Rieti, underwent forma1 trials duting the

Inquisition on charges of witchcraft. The main evidence agsnst her at the trials was her extreme fa~ting.~'Near the end of the Middle Ages extreme fasting becarne a symbol of the devil's possession and while voluntary self- starvation could be a powerful tool it could also be extremely dangerous.

Self-starvation had a positive public construct and it dso provided women with an avenue to political power and religious authonty. The pubiic perception of self-starvation was that these wornen were taking the sins of others upon themselves just as Christ had in the hope of shortening or by-passing purgatoty. Mainly, voluntary self-starvation was seen as an act of complete selflessness as the fasts were not considered the result of self-interest or self-gain.30 The rewards of fasting, however, also helped women gain public power and ailowed them to gain access to careers or positions unavailable to women because of the gender constructions of the penod.

With the ngid duaiistic construction of woman as either Mary or Eve and the little avaiiable political authority to them, some women relied on subversion (using the 'rules' of the order to challenge it) of the constructions to gain political power or influence, Female fasters, from within the reiigious orders, chalienged the social and political orders with their own bodies. The power clairned through the extreme control of the body became a power over the social and political order?' They demonsuated the rigid control of their bodies as a means to enter the public reaim where they could influence both authority figures as well as their contemporaries. The

physical body and the social body were so representative of each other that influence, control, and power in one

could mean the equivalent in the other. The constructions of the physicai and social mirrored each other so that a

physical display of control was revered by society and rewarded.

The contradiction that relipious women were forced to overcome was one between their political power

and the bodily knowledge that allowed them this venue. For, as women, they were defined as 'other,' in opposition

to the nearIy perfect male form. Their bodies were the source of the difference that affected every area of their

lives, However, bodily knowtedge, the type of knowledge they acquired through sharing Christ's suffering and

through Eucharïstic miracles, was considered the Iowest form of knowledge. According to Thomas Aquinas bodiIy

knowledge can barely be considered knowledge at al1 because it is based on senses and "sense knowledge is wholly

inferior to the rest of human knowledge, which is rational knowledge." 32 Women rnystics who gained

considembIe politicai power were, therefore, in the partïcuIarly dangerous situation of resisting the traditional

construction for women and of exercising this power through their bodies. Women's bodies represented both the

path to hell (Eve) and the gate to heaven (Mary). In short, women's bodies were dangerous places. Any power from

the body had to be consmcted so that the body was merety a vesse1 for God and not a location of power. To do so,

women needed to remove themselves from their bodies through voluntary seIf-starvation.

Voluntary self-starvation aIlowed women to escape the reproductive capacities of their bodies - through stopping the menstmd flow- and diminishing the body physically so as to allow the voice of God to sweep through it. The bodies of the self-starving women dso represented the social body. The bodies of fernale "mystics - fractured by self-imposed starvation mirrored society at large as it responded to dangers that threatened it." 33 These female mystics had litde formai power to controi their own bodies or the Iârger socio-political body. The re- inscription of their bodies through self-starvation allowed them to enter their voice into the socio-political world through subversive means such as advising upper-class Christian men. Luce Irigary has gone so far as to say that fernale mystics in the middle ages created a space, the only space of its type in Western history, where they could speak and act in ways that freed them from the patriarchai power~.~~The ironic perplexity of starving one's self to death in order to be heard and gain power is merely representative of the conuadictory constructions of the female body- The self-stmer's "body has already been fractured by dichotomies - reason and desire, public and private,

body and mind-" TO resist through self-starvation showed the embodiment by women of literal, social and

political conflict in a society where one's future was pre-detennined by gender, race, and class and where sexuality

was rigidly controlled,

In the fifteenth and sixteenth century, the period directly folIowing the Middle Ages, ideas of satanic

possession and witchcraft becarne extremely popular in Western Europe. Laywomen and religious women who

self-starved becarne suspects rather than ~aints.3~part of the shift in the ideology of self-starvation occurred

because of the change in the context of the period, but, more importmtly, the shift occurred out of fear. As religious women who starved grew in popuIarity more and more foIlowers attempted this means to power.

However, those discovered as 'frauds' were disposed of prornptly. In 1577 Johan Wier, a Dutch physician, published On Alieged Fasting wherein he describes the case of Elizabeth Barton of Kent. Elizabeth of Barton was thought to have survived eating only the Eucharist which descended from Heaven. Et was discovered that the Host was given to Elizabeth by "accesson'es who let down the Host by means of women's hair" and that she could not go three days without food.37 Elizabeth and the 'accompIices' who aided her were executed in 1534 for their deception. Anna Lamenittia from Augsburg in Germany was executed by drowning in 15 18 for sneaking food after having been acclaimed for her fa~ting.~~As a result of such 'frauds' the Church became concerned about women and extreme fasting and opposed such practices on theological grounds- This, however, was not the only reason that the Church opposed voluntary self-starvation.

The Church had political reasons for opposing voluntary self-starvation. Women who self-starved gained power over the clergy as they undermined the authority of the clergy by partialIy evading them. It was Church dogma that the only way to God was through clergy, who were considered the mediators between God and his people. Fasters claimed a personal and exclusive relationship with God which they shared with people in their communities which threatened the supremacy of the c~ergy.~~The Church may also have been concerned with losing political influence to women untrained in the politics of the Church. This cm be demonstrated using the example of Pope Gregory XI ovem'ding his cardinal's advice and returning to Rome as Catherine of Siena advised him" For tfieological and political reasons the Church began to oppose the public political influence of wounen who voluntarily self-stanred. During the witch hunts the easiest means to remove infiuence from women's hands was to declare her a witch- Women, especially peasant women, were one of the main groups persecuted in the witch hunts4' Practices for which women were persecuted included, but were not limited to, midwifery and Lay healing; both uaditional women's skills. The specific target of women with traditionai skills, power or property "indicates that these women were perceived as presenting a serious threat to the religious order." 42 A cornmon theme in the recent analyses of the witch hunts is that the persecuted represented a challenge to or deviation from the tnditZonai

"male-dominated religious establishment-" Voluntary self-starvers would have challenged both the religious order and the patrixchal legal and political order. The witch hunts were therefore a means to re-establish conuol by the aristocratie and religious political authorities. Voluntary seIf-starvation became a deviation as women who practised it entered the public worfd of politics, To re-estabtish the order and remove this avenue of power voluntary self-starvation became associated with demonic possession and witchcraft which, in turn, made it a crime punishable by death.

The Church after the Protestant Reformation fost considerable power with the rise of secular society and break up of the Church into a number of different denominations. From the sixteenth century onwards voluntmy self-starvation became increasingly removed from religion. From this period until well into the nineteenth cenrtury starvation became a "commercial spectacle" where the starver became 'a source of incorne.' 44 AS this was happening the rnedicai profession becme interested in the existence of voluntary self-starvation. As voluntary self- starvation became cornrnercialIy profitable voluntary self-starvation becarne appropriated by the medical profession and, eventually became understood as a pathology. 45 The only exception to the construction of self-starvation as pathology was, and remains, political hunger strikes.

Physicians in the rising medicai profession began a transformation of the discourse around seIf-starvaation in the sixteenth century that would continue until the nineteenth century with the general acceptance that volunaary self-starvation was a patho~ogy.~~The medicai profession in the seventeenth and eighteenth centuries began its scientific inquest into voluntwy self-starvation. During this period fasting was no longer seen as a religious mïmcle and was almost completely removed fiom a religious context- A number of factors led to the decline of religioais fasting and increase in the speculation of fasting as a pathology- Joan Jacobs Brumberg writes,

By the seventeenth and eighteenth centuries fasting was on the decline as the result of the breakup of medieval culture, the Protestant Reforrnation, and the scrupulous efforts of religious refonners to disavow traditionai practices such as the worship of saints, During the Reformation, prolonged abstinence was taken as the work of Satan (rather than God) and female fasters were frequentiy regarded as victims of evil delusion or possession- In the postmedieval world, harsh ascetic practices were discouraged and act of autonomous femaie piety - such as prolonged fasting or extra- ordinary food miracles - came under special scmtiny from male clerics. The re- nuniciation of food, once experienced and explained as a form of female holiness, was increasingly cast as dernoniacal, heretical, and even insane.47

The context surrounding voluntary self-starvation quickly changed frorn a miraculous act to demonic or insane conduct. While the context of voluntary self-starvation changed, the act of self-starvation remained. It was however constmcted and understood differentIy than it had been in earlier times.

In the early modem period women continued to voIuntady self-starve for both empowennent and matenal gain.48 The rejection of food became a symbol for a young woman7sdelicacy and p~rit~.~~In the sixteenth and seventeenth centuries there are countless records of young fasting women, in both Catholic and Protestant States, who gained local, national and intemationai attention. Self-starvation became a public spectacle because of these miraculous mai den^.'^ Initially to verify the self-starvation of these young women investigations and watches were started to ensure that she was not falsiQing her fst by taking food, being under satanic influence or extreme piety.

Authenticity was still important as those women who were discovered as 'fiauds' were executed or died from starvation during watche~.~'The most dangerous of these. however, was "radical holiness because it implied autonomy of the women in a society that was fiercely structured and deferential."" Therefore fasting was recognized as a means to autonomy otherwise-restrictedfrom young women. To be autonomous was to resist against a strict and hierarchical church structure that had specific consuucts for women which relied on passivity not activity.

As the written word became widespread in Europe the stories of miraculous maids spread through

Continental Europe, England and America in the sixteenth and seventeenth centuries. Discussions of inedia prodigiosa and anorexia mirabilis becarne a frequently discussed topic among religious men, medicai professionals, and civil authorities. if doctors could find no rnedicai reason for the loss of appetite and the inability to take food rumours spread quickly that the young woman may be a living miracle, Records of such wornen exist, Sorne of the

examples of the period include: Catharina Binder who in 1587 was declared a saint by some because she took no

food or water for nine years; in 1668 Martha Taylor's fasting was considered a sign of God's love and; Maria

Jehnfels in 1728 was considered a "Wonder of Godl'-% These fats becarne increasingly popular and were debated

in treatises.

The case of Martha Taylor illustrates the differences in the 'saintly' fasts of the Middle Ages and the self-

starvation of young women in the sixteenth and seventeenth centuries, In December 1667 Martha TayIor began a

fast that would continue for over one year. Treatises discussing her 'illness' appeared from 1668- 1669.5' Thomas

Hobbes wrote describing TayIor's fast and the described the suspicion that surrounded these types of fasts in the

seventeenth century. He wrote,

Some of the neighbouring ministers visit her often: others that see her for curiosity give her money, sixpence which she refuseth, but her mother taketh. But it does not appear they gain by it so much as to breed suspicion of a cheat. Sd

The relation between money and honesty is strikingly clear in Hobbes' account of Taylor's fast. Suspicion began to

arise as the material weaith of the faster's family increased. While Hobbes seemed to believe in the validity of the

fast others were not so certain. In face, Dr. Nathaniel Johnson suspected Taylor of sneaking food and asked the

Royal Society to petition Charles II to examine her. Since the Royal Society refused the petition of Dr. Johnson

Taylor's fast was never venfied by the medical profession. However, under suspicion of cheating other fasters

underwent examinations and watches in order to verify their fasts. One of the reasons the watches became

important to prove the authenticity of the fasts was because of the money donated to the faster's family.

Some miraculous maidens becarne rnatenally wealthy through their fasting. Frorn passing travellers to royaity and nobility, starving maidens appeded to everyone's curiosity. One Dutch fasting woman, in the surnmer of 1826, had more than one thousand visitors and "even appeared as an attractim in an English traveller's guide,"57

The shift in econornic context from feudalism to capitalism did not go unnoticed by fasting women and their families. Many of these women and their fmilies were close to poverty and often money was offered to the families in return for viewing the starving girl. Therefore money and gifts may have motivated some families and their daughters to display themselves as stories of fasting girls spread and became 'public attraction^.'^' The change

17 from feudalism to capitalism therefore helped to recreate the discourse of voluntary self-starvation and two cases

illustrate how the changing economic discourse affected the constniction-

Both Ann Moore and Sanh Jacobs were farnous in Great Britain and the United States for thek fastssg In

1807 Ann Moore's case of 'anorexy' became public knowledge. Moore, the daughter of a labourer, married,

separated and, then, had two chiIdren out of wedlock with her employer. By the cime her case of self-starvation

went public Moore was receiving a small sum of money from the local Church in order to support herself and her chi~dren.~Initially her self-imposed fast was seen by sorne as "a symbol of her moral reclamation" as it was accornpanied by her "admitting the sinfulness of her past ways, by espousing Christian principles in an articulate rnanner, and by beseeching God and the Iocd clergy for sdvation." '' So while extreme religious fasts had failen out of vogue, voluntary self-starvation had become, when iinked to Christian morality, a means of public repentance for a divorced single mother. However, it was also a means to econornic weIl-being for a woman whose society left her few options. Estimates of her material accumulation range from two hundred to four hundred pounds. Moore's new capital wedth was not a secret to the local cornmunity who viewed it positively as she could then be removed from the lists of the town's poor.62 Her economic increase was not objected to by the society initially. However, when it was discovered that Ann Moore accepted small quantities of nounshment she quickly became seen as a money-seeking fraud.

When Ann Moore was discovered as a 'fraud' she was publicly humiliated and disappeared from the public eye. She was considered an impostor after it was discovered that she had indeed accepted nourishrnent and had continued her menstnial cycle. In a written confession Moore admitted that her daughter fed her every morning through a face cloth wetted "with gravy, miik or strong arrowroot gmel." Moore's mother dso fed her by passing food from her mouth when they kis~ed.~The rniraculous fast obviously was only considered such if the young woman sumived on nothing. The discovery that Moore was a 'fraud' lent the medicd profession a reason for skepticism and a spark to reconsider self-starvation. The legacy of Ann Moore's fast was remembered in the case of

Sarah Jacobs.

Sarah Jacobs' death shows the tragedy of the demands of the miraculous fast. Jacobs was one of seven children who lived on a small isolated farm in nird Wales, In 1867 she stopped eating and within two years she was notonous for her extreme fa~ting~~Sarah Jacobs' starvation became a contested symbol caught in-between religious, medicai and political constructions. Her

condition provoked renewed discussion in the newspapers. Physicians in particular were basicalIy sceptical and called her a case of 'simulative hysteria.' Often people were reminded of the fast of Ann Moore. Others, however, considered her miraculous fast a matter of WeIsh national honour...66

Obviously Sarah Jacobs' fast was no longer hers but, rather, it had been appropriated by doctors. the general public, and national politics. The lingering suspicion left by Ann Moore's fast meant that Sarah Jacobs' fast woutd have to be tested for its validity. Under a careful watch the tweIve year old Jacobs' condition dnmatically worsened and she died eight days after it started on December 9, 1869. Afterwards her parents were found guilty of criminal negligence and sentenced to hard labour. The doctors who performed the watch were not charged. Throughout the entire span of her starvation Jacobs' parents refused to consider hospitalization and continued to believe that God would care For ~arah.~~

Sarah Jacobs' case is very important to the history of self-starvation not only because of her experience as a miraculous maiden but also for her association with hysteria. After her death The Lancer and The Medical Times and Gazette both carried editorials which supported the hypothesis that she suffered from hysteriaea By the 1890s. when hysteria as a concept was accepted by the medical profession, Sarah Jacobs' fasting carne to be seen as merely a sign of her hysterical nature.69 The cases of Ann Moore's and Sarah Jacobs' fraudulent as opposed to miraculous fats completed a trend in which voluntary self-starvation was no longer seen as an unquestioned saintly fast but rather with distrust. This distrust eventually led to the pathologization of voluntary self-star~ation.'~

Sarah Jacobs' fast is of particular importance to the history of self-starvation for a second reason. Her death can be seen as a consequence of the discourse which changed the context of vokuntq self-starvation from religion to medicine. The body had been fully appropriated by medical discourse when Sarah Jacobs began her fast and "its stated goal [was] not welfare but mther surveiilance ...Sarah's body becomes a surface upon which to inscribe the medical discourse and to delimit the realm of the possible: thereby effectively excluding the

Church."" The removal of the Church from the construction of voluntary self-starvation and the replacement of medicai discourse changed more than the language around the act - it may have changed the constitution of self- starvation, If Sarah's standpoint is taken into considention her act of self-starvation radically changes. There were

more than two discourses into which Sarah was situated. It wouid seem her act of self-starvation linked two

different religious discourses. The Church of England was divided into low church and high church. The latter had

the most authority and a stncter religious approach. Sarah was Welsh and Wales was considered low Church

however, her act was overtaken by the Church of England (considered high Church). Further the high Church

celebrated the suffering of the body far more than the low," Therefore her voluntary self-starvation can be seen "as

an embodied strategy that allowed her some small movement across the discourses of her tirne," 73 The

reconstruction of the physicai body allowed Sarah to negotiate the rapidly changing discourses that confronted her even prior to her starvation. Confronting the changes in the understanding of starvation (from religious piety to

medical illness) and the conflicting discourses within discourses voluntary self-starvation becarne a means to

negotiate. Thus, her body rnay have become a means for her to conuol the discourses of her tirne. Her fast also marked the final shift from religious to medical discourse; after Sarah's death there was no mention of relie-=IOUS fasting as a phenornena among young women.

The construction of exueme fasting as a symbol of religious piety to a pathology cannot be examined outside the general context of Victorian society. The medicalization of women's bodies and the evolution of the construction of 'anorexia nervosa' are products of Victorian society and its specific constmctions of rnasculinity and fernininity. However, a number of gender constructions regarding the public and private spheres, sexuality, the body and the household aided in the understanding of voluntary self-starvation as an 'illness* of Ieisure-cIass women,

The nse of the bourgeois family occurred in the eighteenth and nineteenth centuries and helped to construct the polarized gender roles of the period. Three important roles were deveioped during this period: the governing father who was the sole economic conuibutor, the 'angel in the house' domestic goddess wifehother and the child who would be the legacy of the family and the future of ~ociety?~Before this period it was understood, as part of the family economy, that al1 members of the family unit had to be econornicalfy productive in order for the unit to survive. The gender dichotomy aiso created an inability for the genders to communicate on the diffèrences of their bodies. Corporeali ty, physical maturation and menstruation become topics which one initially should not tdk about in the presence of children and which later on are not to be mentioned at dl. Hence, the discovery of the unicity of each human being and of the difference nature of children demands a fairly un- expected ence: man and wife being different or, more exactly, the inabiIity to communicate about that difference?'

The body, its functions, and the perceived differences between men and wornen became 'unspeakables' in the proper Victorian home.

With the rise of industrial capitalism the rniddle class sought to have their social position solidified through visible means. Class constmcts attempted to show that the me symbol of being rniddle class was having a leisured

~ife.'~Thus wornen became symbols of cIass position. The middle class was idedized in society and therefore the middle-class wife was sornething that women of the working class could work towards, aithough most Iikely never achieve. The strict distinction between men's and women's spheres (public and private respectively) coincided with the increasing significance of the role of rnothers, and the emphasis on conforming to the stncr social noms. Any deviations from the idealized roles for women were disciplined. Such disciplinary tools included the hystericization of women's bodies and the pathologization of their minds. These tools were an easy rneans to remedy a situation where a woman had overstepped the appropriate boundaries,

Middle-class women were the measure of polite society and were considered the piliars of the community.

The Cult of Tme Womanhood in America ,which defined the proper roles of rniddle-class women through creating in Iiterature, popular magazines, and religious works, an impossible construction of an ideal woman. It told a woman that she was to "uphold the pilIars of the temple with her frai1 white hand." '13 Of course, middle class success and the constructs of femininity which defined the middte class were implicitly and explicitly designed around the assumption that the rniddle class would be white.

A leisurely wife was reserved for rniddle-class white women who could remain in their 'proper' sphere - the private sphere. To escape the dmdgery of housework middle-class women ventured out into the public realm to use her moral skills to 'clean up' specific areas of the public realm. Cloaked in her virtuous nature they entered the public area to rid it of evil. The targeted areas included "army hospitals, city slums, prisons and poorhouses, and even prostitutes' haunt~."'~The virtues of the Cult of Tme Womanhood were based on women remaining in the private sphere unless they wished to leave it; a luxury unavailable to working-class women. There was little

2 1 opponunity for women, of any class, outside of marriage since their legal, social, and political existence was defined

in relation to men (father, husband. son); to i-emain single meant ensuring a Iife of poverty?'

Four virtues that identified the proper rniddIe-class woman were piety, punty, submissiveness, and

dome~ticity.~'The sum of these virtues was that women were expected to carry the religion of the farnily and the

religious education of the chiidren as men were too absorbed in the capitaiist world. Women, therefore, could

mordize their husband and son(s) after they entered her comforting private sphere from the cold, capitalist, public

realm, Women were responsible for the moral education of children because "fathers, das, were too busy chasing the dollar." The incompatibility of capitalism and morality seems quite clear and ehe good mother, devoted wife, and morally superior being were counters to the evils of ~a~italisrn.~~Society held mathers responsible for bad children because their mistakes were a reflection on the mother's morality and mothenng ~apabilities.~~Mothers, therefore, were modIy responsible for most members of the family as they were expected to create a private sphere that would protect their families from the evils of the public realm. The power women had over their homes was ironic considering that doctors whose power was growing proclaimed that women were bound to the nature of their fragile bodies and minds.

Doctors' power noticeably increased during this period, Physicians emphasized women's biological roles and their physical fragility to the point where women were seen primarily as biologically insufficient beings.

Women were cautioned away from education and sports, dunng and after puberty, in order to protect their reproductive capacities. Even education could be a danger. In fact,

some doctors wamed that the woman who did continue her studies during this crucial stage might welI damage her reproductive system forever, as her vital energies would go to her brain instead of her uterus. Medicai experts encouraged girls to engage in appropnate physical activity, but the sports recornmended were very different from those recornrnended for their brothers. Waiking was good for girls; running was n~t.~'

Even casual reading could be dangerous to a woman's health. Reading novels could interfere with a woman's religious duties especially if the novels challenged the constructions of femininity of the Victorian ~eriod?~The warnings against women reading novels occurred as a result of the rise of the domesdc novel between the 1820s and

1870s which was used as "a vehicle of protest." '' Forma1 education and reading inappropriate novels could also disuact women frorn leaming "the gentle science of homemaking" and could threatem her role of being a good ~ife.~More importantly, education for women could damage her aiready frai1 reproductive system. If educated,

the brain would rob the uterus of essentiai energy. Edward H. Clarke, a Harvard professor, and just one example of

the medical discourse of the period, stated that women could not be both educated and beaIth~,8~Therefore, since

her primary role was to be a wife and mother, women must concentrate on deveIoping their fernale biological

functions rather than their minds.

Being a good wife dso included controlling her and her husband's sexuaiity with her good housekeeping

and moral nghteousness. If the domestic sphere was cheerfuI and well-organized, with a polite and welI-behaved

wife, the men of the household would not be forced to re-enter the public sphere in search of entertair~ment.~'

Women were seen as Iess interested in sexual activity than men who wouId seek it out if they were not controlled.

Sexuai control becarne increasingly important with the rise of venereai diseases among the middle class. Not only were women becoming sterile because of the sexuaily transmitted diseases their husbands were brïnging home but women were being blarned for the failing birth rate and the degeneration of the race?' The contradiction was that a woman had to control her husband's, son's and, perhaps, brother's sexudity whiIe she was seen as having no control over her own sexud function. It was understood that women's gynecologicai system was the downfall of her being. The female reproductive system was believed to have caused a number of psychoIogicaI maladies including neurasthenia, neuralgia, hysteria, convuIsive disease, melancholia and in~anit~.~~It was believed chat women were predisposed to mental iIlness because of their biology. In fact, menstruation was seen as a pathologicai condition itseIf. In the last quarter of the nineteenth century the view of menstruation was not seen as a naturai biologicai function, but rather a physical deficiency with mental rarnificati~ns.~~

Sexuality was almost an obsession in Victorian cuiture. The control and regulation of sexuality and sex was an ever-present topic. For women virginity before marriage was crucial as women's value decreased if she had sexual relations before or outside of marriage.% Women were the legai property of men and so too were the children, and the rigid control of women's sexuaiity was directly Iinked to the pauilineal control of property and wealth. Chastity of the wife ensured the husband's children were undoubtably his children and therefore the inhentors of his narne and, for first born maIe children, possibly his titie, wedth and property. Women of the working classes were seen as incapable of sexual control and regulation. They were juxtaposed against the moral rnother and dornestic goddess as sexually depraved and immodest?'

The 'proper diet,' like sexuality, in the Victorian period was strictIy controlled. An uncontrolled diet indicated unresuained sexuality, physicai unattractiveness, gluttony, and a general lack of self-control." As a result women were especiaily careful to control their food intake and to control their female children's diet. A large and uncontroiied diet camed with it the implication of uninhibited sexuality whereas restricted food intake syrnbolized high moral standards. The association of dass, morality, religion, and food converged upon the rniddle-class wornan's body. A sIim body symbolized the containment of cmal cravings. Hunger, "in any sense, was a social faux pas. Denial becarne a form of mord certitude and refusal of attractive focus a means for advancing in the moral hierarchy." '' The restriction of the diet for rniddle-class wornen was essentiai to their cIass position.

The connection between a resuicted diet and sexuality occurred as the doctor-prescribed starvation diets of previous centuries declined in popularity. Prior to the seventeenth century dieting was often recornmended by physicians as a form of thenpy and a few prominent doctors recommended of starvation diets well into the eighteenth centuq?' Food restriction is "one of the oldest forrns of treatment recommended by physicians; in fact the history of diets is as old as medicine itself." 99 While physicians began to scom the diet therapy during the earIy nineteenth century more and more people began using dieting, not for medicina1 purposes, but rather, as a tool to decrease body mass and weight.'OO Thus the modem diet for the pursuit of thinness was born- The diet became symboIic of class and class, in the Victorian period in Western industrial countries, was the defining characteristic of a farnily. As a leisured wife was one of the symbols of the middle class the new constructions around diet became extremetj important to femaie members of the middle-class household-

Women had littie formai control over their lives, although women found informal routes to power. The one thing wornen were officiaiiy supposed to control was their bodies and their diet, More imponantly, however, rniddle-class wornen, because of the expected constnictions of their cIass, were predisposed to being labeled as 511' or even 'insane.' Therefore the emergence of voluntary self-starvation as a rniddle-class, white, heterosexual woman's disease may be an extension of the Victorian constnictions of proper roles, proper spheres, restrictive diet, and repressive sexuality. The contemporary constructions of the period had wornen at a permanent disadvantage as they were seen to be naturally Iess controlled tban men, and in a permanent state of childhood, with no legal or politicai rights, Her very biology made woman prone to illness and disease and her reproductive system was so

frapiIe that education could destroy it permanently. Since women were measured by, and because of, their reproductive systems they were perpetually reduced to their 'dysfunctional' bodies,

Before the 1870s' voluntary self-starvation was seen as a symptom of any number of different illne~ses.'~'

However. by the 1870s, physicians in France and England had begun to wnte in medical journals on a 'new' condition wherein young women stcwed themselves'. The two men considered the first to describe 'anorexia nervosa*were E.C. Lasegue and W.W- GuIl. In 1873 Lasegue published 'De l'anorexie hysterique' in which he described the cases of eight female patients between the ages of eighteen and thirty-two who self-stat~ed.'~'One year after Lasegue's publication, Gull, speaking of a similar phenomena, coined the term 'anorexia nervosa.' 'O3

The term 'anorexia nervosa' was not initally agreed upon by physicians. From the 1880s until the 1960s the terrninology of voluntary self-starvation underwent many changes. Paul Sollier in 1895 suggested 'mental anorexia*because he felt it better represented "the psychological ongin" rather that a nervous inflicti~n.'~Some

European writers used the tenn 'mental anorexia' well into the 1970s.

The terms and concepts put forth by Gu11 and Lasegue did not initiaily become popular outside of England,

France, and North America. In German speaking countries there was Little interest in 'anorexia nervosa' until the twentieth ~entur~,'~'Part of the reason for the disinterest resulted from Sigmund Freud's initial lack of concern over the 'new disorder.' Nonetheless,

for the first ten years after the 'discovery' of anorexia nervosa in 1873, the German medical litenture shows a remarkabte silence regarding the 'new' illness. This fact is nther striking in view of the many contacts between physicians across the language border.'06

While the tems and concepts were immediately popular in England and France they were not universaIly accepted.

American physicians seemed to have accepted the disorder reluctantly by l89~.'~'However, Amencan asylum supenntendents helped delineate the term.

Refusai of food was common in American asylurns during the nineteenth century, but soon it became evident that there was a special population of young well-educated wornen whose only 'illness' was self-starvation.

Interest in this area peaked during the middle of the nineteenth century as asylums were no longer considered

'dumping grounds' for unwanted citizens but therapeutic institution^.'^^ In addition, this warranted special

25 consideration as mortality statistics from psychiatrie institutions were widely published. Medical journaIs and newspapers canied the mortdity rates among asylums and a high death rate was seen as an indication of the failure of the instituti~n.'~~Since large numbers of patients showed symptoms of self-starvation, superintendents of asylums in both the United States and England became concemed, From this concern "the first classifications for what we now caH eating disorders emerged at mid-century from among the Amencan asylum superintendents and the British dieni~ts.""~

The essential difference between Lasegue and Gu11 was in the use of 'hysterique.' Lasegue used the terrn to show that anorexia was a result of a "hysteria of the gastric centre-" '" GulI, alternatively, preferred 'nervosa' as he believed that "it implicated the centrai nervous system instead of the uterus and aIIowed that the condition coutd exist in males," "'Gu11 and Lasegue both developed similar diagnostic critena, despite their linguistic and biological differences, The 'disease', however was not yet solidified as a psychologicd affliction, but rather, was closely related to a physiological dysfunction, Gui1 refùsed to label 'anorexic' women as insane and further defined it as a 'disorder' to be treated outside of mental institution^."^ Moral, not medical, therapy was Gull's preference.

This included removing the 'patient' from her parents' care and changing her environment- Obviously, the implications of this therapy was that the home environment was part of the cause of the 'dysfunction.' Since child care was the sole responsibility of the mother, she becomes a source of the 'eating problern'. The best solution, according to Gull, was to send the woman to a medical faciiity with doctors and professionai nurses."'

Lasegue, who described 'anorexia' as a symptomatic group under the rubric of hysteria, was the first to explicidy document the importance of the family situati~n."~His description discussed the young woman who self- starved as having experienced an emotional ~hock."~After Gu11 and Lasegue described their respective 'disorders', the discussion of voluntary self-starvation increased drarnaticalIy in medical joumals. Articles and Ietters on

'anorexia' were fairly common from 1873 onwards. The number of explanations also increased. The causes of self-starvation incIuded physiological upset (usualIy of the gastrïc nerves), nervous conditions or emotional upset, and a small number suggested that it was a resuh of cultural pressures of the age. The single most common explanation, which was also seen as a basic characteristic of hysteria, was that these women were seeking attention and sympathy."' This representation upholds the popular construction of women as a perpetual child who is constady in need of a guardian. The lepi sstatus of woman, as equivalent to a child, is reitented in the theoiizing of self-starvation as a means to gain sympathy,

In Victorian England, there needed to be a different classification and treatrnent for young middle class wornen who self-stawed than there was for other 'patients' suffenng from a 'mental illness'. Asylums had horrible stigmas that farniiies did not want attached to their daughters and the3 family narne, As a result young middle class

'anorectic' women becarne an especially lucrative specialized area for doctors as farnilies wanted to avoid the embarrassrnent of having a daughter institutionalized. The 'disease' of 'anorexia nervosa' became solidified as young middle class wornen could not be declared ~unatics,"~The 'othemess' of the middle-class women in comparïson to the stereotypical institutionalized patient (the 'lunatic') rneant that there needed to be an alternative explanation for their self-starvation.

There was more than one construction of voluntary self-starvation during the late nineteenth and earirly twentieth century. Mile a certain class and group of women were seen as suffering from some sort of physicaI or mental affliction other voluntary self-stmers were seen as resisting the legai and politicai forces through hunger suikes. The legal position of women and the newly constructed 'anorexia', came to a head in a Iegal case in 1909.

The case of Leigh v. Gladstone and Others, was not a typicd case of voluntary self-starvation and was not considered a case of 'anorexia nervosa' but, rather, a political hunger strike. Marie Leigh was a suffragette who was arrested and jailed for resisting police. During Leigh's confinement she began a political hunger strike and was force fed by prison oficiais. After being released, Leigh sued for damages arguing that she had been assriulted through force feeding. In addition, Leigh petitioned to court for an injunction to ensure the force feedings could not be repeated. In deciding the case against Leigh the judge stated that self-starvation was a "wicked folly - for it was wicked foliy to attempt to starve thernseives to death."'19 To understand the differentiation between 'anorexia nervosa' and political hunger smkes in women dunng this period the suffragette movernent in England and North

Arnenca needs to be explored.

In the 1850s and 1860s peopIe began to organize around women's issues including education, married women's legal and ecanomic status, sexual and moral constructions, lack of formal control women had over their bodies, low work wages, and the prohibition of women frorn politics."O Suffrage became the central focus for first- wave feminists. In atternpting to win the vote suffngettes engaged in public politicai events that sometimes led to

the wornen being arrested and jailed, It was during these penods of imprisonment that the hunger strikes began.

After 1905 in Britain the Women's Social and Political Union (WSPU) began radical attacks on the British

governrnent that included heckiing politicians, desrroying property, cutting phone wires, and planting bombs.12'

When the govemment began making arrests WSPU prisoners began hunger strikes to keep their cause in newspaper

headlines. Prison officials to counteract the suffragettes' hunger strikes began force feeding them by inserting a

twenty-inch tube down a nostril or the throat.'" The act of resistance was not only against the prison officials as it

was a demonstration against government officials as the suffragettes saw the forced feeding as an attack on the body as well as the rnind. The hunger strike attempted to fight against the government's control over their rninds," In essence, the

control of food becme the expression of deeper political power. Women contested the legitimacy of the government by their refusal to eat. The government's response to this protest in the form of force-feeding is yet another exarnple of the notion that control of the femaie body is not something that resides with its owner, the individual wornan, but is an area to be contested,"'

So while diagnosed 'anorexics' were seen as mentally or physically deficient, suffragettes who entered into hunger strikes were seen to be political actors. Their organized resistmce came to be viewed as a political statement while the individual, private acts of self-starvation were seen as a mental illness. The two different constructions of voluntary self-starvation share some of the same properties and have a few interesting differences that can be seen in the Leigh case.

The first-wave ferninist movement was Iargely developed and controIled by white, middIe class women who, obviously, shared the same contradictory constnictions as the young middle class women who were diagnosed as 'anorexic.' Both were seen as child-like but, for ai1 the simiIarities they shared, the treatment was dramaticaily different. While 'anorexic' women were treated in a quiet, private way, imprisoned suffragettes were forcefully fed. The public nature of the suffragette movement created the difference between their acts of voluntary self- starvation and the private protests of 'anorexic' women.

The construction of voluntary self-starvation underwent a number of changes from the Medieval period to the end of the Victorian penod. In the High Middle Ages, self-starvation among religious and laywomen was a syrnbol and route to political power, authority, and influence. The context of the penod allowed certain women of a specific class to use the constructions of gender and religion to subvaively break the stereotype of women as apolitical. However, as women like Catherine of Siena becarne politically powerful the Church becarne concerned over the influence fasting women had over society.

With the witch hunts voluntary self-starvation becarne symbolic of satanic influence and therefore a dangerous practice, However fiom the sixteenth century until the nineteenth century young women continued to self-starve. The fasting women during this period became commercial spectac1e.s who gained local, national, and international attention. For the fmt time rnonetary gain was involved with self-starvation and, for some, it was a means to escape poverty. With the shift fiom fasting saint to demonic possessor to cornmerciai spectacle suspicion arose and the medical community became involved in voluncary self-starvation. During this period the religious discourse of previous periods was slowly disengaged from the act and replaced by the medical discourse. The medicalization of women's bodies and the pathologization of their minds combined with the rigid, contradictory, class-dependent, constructions of fernininity gave rise to a 'new illness' - 'anorexia nervosa.' The independent discoveries by Lasegue and Gu11 officially created the psychological 'i11ness7 but it was not widely accepted until well into the twentieth century,

Two things remain consistent across the time periods discussed - women's voluntary self-starvation and their silence. While there is an amazing quantity of Iiterature from al1 periods on the starvation of women, none of it is written by the women thernselves. Even the letters of Catherine of Siena which mention voluntary self- starvation are written to and for other people.'z5 Voluntary self-starvation has consistently been described and theorized by traditional authorities such as the Church and the medicd profession. Women have never had the pnvilege to theonze and explain their actions with the exception of political hunger strikes. However, the essential difference between 'anorexia nervosa' and political hunger stnkes has been the public expIanation of the action by the starver. The dichotomy of public/private has been upheld in the construction of 'anorexia nervosa-y '-Rosemary Agonito, History of Ideas on Wornan: A Source Book, New York: Perigree Books, 1977. Karen Armstrong, The Gospel According tu Wornan: Chn'stianity's Creation of the Sex War in tlze West, London: Elm Tree Books, 1986,141- 3- Margaret R. Miles, Cantal Knowing: Fernale Nakedness and Religious Meaning in the Christian West, Boston: Beacon Press, 1989'62, 4- Eïieen Power, Medieval Women, New York: Cambridge University Press, 9. '-Power, 10- " Power, 11, '-Christine Owens, "NobIewomen and Politicai Activity," in Women in Medieval Western European Culture, Ed- Linda E. Mitcheli, New York and London: GarIand Publisfiing, Inc. A Member of the Taylor Group, 1999,209- '-Owens, 209-210- '-Owens, 209. 'O- Owens, 215. "-Ibid. iz Wdter Vandereycken and Ron Van Deth, From Fasting Saints t~ Anorexic Grils, New York: New York University Press, 1994, 17-1 8. 13. Ann G. Carmichael, "Past Fasts: Medieval Saints With the WilI to Starve," Journal oflnterdisciplinary History 19(4) 1989: 640. 14. Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 19-21, '5 Caroline Walker Bynum, "Fast, Feast, and Fiesh: the Religious Significance of Food to Medieval Wornen," Representarions 11, 1985: 3. '" Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls ,24. 17* Caroiine Walker Bynum, "Women Mystics and Euchaiistic Devotion in the Thirteenth Century," Women's Snidies 2, 1984: 185. la- Bynum, "Women Mystics and Euchanstic Devotion in the Thirteenth Century," 186- 19- Bynum, "Fast Feast and Fiesh," 3. 20- Ibid. Bynum, "Women Mystics and Eucharistic Devotion in the Thirteenth Century," 193- " Bynum, "Women Mystics and Eucharistic Devotion in the Thirteenth Century," 195. 23- Shulamith Shahar, The Fourth Estare: A History of Women in the Middle Ages Transl, Chaya Gaiai, London and New York: Methuen & Co. Ltd., 1983.59. 24* Walter Vandereycken and Ron Van Deth, Frorn Fasting Saints tu Anorexic Girls, 23. 25- Joan Jacobs Brumberg, Fasting Girls: the Emergence of Anorexia Nervosa as a Modern Disease, London and Cambridge: Harvard University Press, 1988,41. 26- Tilmanc Habermas, "Friderada: A Case of Miraculous Fasting," International Jorrrn@ of Eating Disorders 5(3) 1986: 556. 27- Power, 16. 28- Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 35. "- Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 36. Vandereycken and Van Deth, From Fasting Saints tu qnorexic Girls, 25. 3'- Martha J. Reineke, "'This 1s My Body:' Reflections on Abjection, Anorexia, and Medieval Women Mystics" Journal of the Amen'can Academy of Religion 58(2) 1990: 245. 32 1. Giles MiIhaven, "A Medievai Lesson on Bodily Knowing: Women's Experience and Men's Thought," Journal Of the Amenkan Academy of Religion 57 1989: 358- 33' Reineke, 245. '4 Luce kigary, "La Mysterique," in Speculurn of the Orher Woman Transl, GiIlian C. Gill, Ithaca: Corne11 University Press, 1985, 191, discussed in Reineke, 259- Reineke, 250. 36- Vandereycken and Van Deth, Frorn Fasting Saints to Anorexic Girls, 37. 37- Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 27. Vandereycken and Van Deth, From Fasting Saints tu Anorexic Girls, 28. 39' Ibid. 40. Suzanne Noffke, tmsl., The Letters cf St, Catherine of Siena Vol, 1, New York: Medieval and Renaissance Texts and Studies, 1988, 168, 170,222,266. 41- Julie Hepworth, The Social Construction of Anorexia Nervosa, Thousand Oak, California: Sage Publications Ltd., 1999, 16. 42 Hepworth, 17, Hepworth, 17-18. Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 3 1. Ibid. 46- Vandereycken and Van Deth, From Fasting Saints ro Anorexic Girls, 47-48. 47. Bnunberg, 47. Ibid. 49- Ibid. " Vandereycken and Van Deth, From Fasting Saints tu Anorexic Girls, 48. Brumberg, 48, Vandereycken and Van Deth, Frorn Fasting Saints IO Anorexic Girls, 55. 52 Brumberg, 48, Ibid. "-Vandereycken and Van Delh, From Fasting Saints ro Anoreïic Girls, 49. Joseph A. Silverman, "Anorexia Nervosa in Seventeenth Century England as Viewed by Physician, Philosopher, and Pedagogue," International Journal of Eating Disorders S(5) f 986: 848- 56- Thomas Hobbes, 1668 quoted in Silverman, 849. 57. Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 50. Sa Walter Vandereycken and Ron Van Deth, History Today 43 1993: 42. "- Vandereycken and Van Deth, History Today, 40. Brumberg, 56. "- Brumberg, 56-57. Brumberg, 57. 63. Vandereycken and Van Deth, History Tow, 38. Ibid, Vandereycken and Van Deth, History Tom, 39. " Vandereycken and Van Deth, Hisrory Todny, 4 1. Brum berg, 69. Ibid. " Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 70-7 1. 70. Gordon Tait, "'Anorexia Nervosa': Asceticism, Differentiation, Govemment," Australian and New Zealand Journal of Sociology 29(2) 1993: 201. 71. EIspeth Probyn, 'The Anorexic Body," Canadian Journal of Political and Social Theory 1 l(1-2) 1987: 1 15. f2 Probyn, 115-1 16. Probyn, 116. Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 184. ". quoted in Vandereycken and Van Deth, From Fasting Saints to Anorexic Girls, 185. 76. Issues of cfass and race are important to the construction of voIuntary seif-starvation in the Victonan period as the rigid class structure formed during the industrial revolution (1750-1850) becomes rnost important stnicturing society. In addition, the issues of race and class have not been discussed in the literature on fasting before this period.

** Alison Prentice, Paula Bourne, Gai1 Cuthbert Brandt, Beth Light, Wendy Mitchinson, and Naomi Black: Canadian Women: A History 2d Ed., Toronto: Harcourt Brace & Company, Canada, 1996. Barbara Welter, "The Cult of Tnie Womanhood: 1820-1860," Amencan Quarterly 18 1966: 152. w. Barbara Corrando Pope, "Angels in the Devil's Workshop: Leisured and Charitable Women in Nineteenth- Century Engiand and France," in Becoming Visible 1%Ed., 299- Jane Emngton, "Pioneers and Suffkgists," in Changing Parrerns: Women in Canada Sandra Burt, Lorraine Code and Lindsay Dorney (Eds.), Toronto: McCleiiand and Stewart Inc., 1988. "- Welter, 152. 82 Welter, 172. 83. Pope, 299. Prentice et al., 158. Prentice et al,, 159. Welter 165-166. Mariene Le Gates, Making Waves: A History of Fernirzism in Western Society, Toronto: Copp Clark L td., 1996. Welter, 167. "- Vieda Skultans, Engllsh MMadss: Idem on Insanity, 1580-1890, London &Boston: Routledge & Kegan Paul, 1979,93. 90- Welter, 163. 91. Lucy Bland, Banishing the Bearr: Sexwlify and the Earfy Feminists, London: Penguin Group, 1995.243. 92 ~renticeet al., 159. ''-Vieda Skuhans, 93. Skultans, 77. "- SkuItans, 92-93. Brumberg, 178. "- Bnimberg, 182. Vandereycken and Van Deth, From Fasting Saints to Anorexic Gir ~andereyckenand Van Deth, From Fasting Saints to Anoreric Girls, 108. 'O0- Vandereycken and Van De th, From Fasting Saints to Anorexic Girls, 11 1. 'O1- Edward Shorter, 'The First Great Inmease in Anorexia Nervo~a,'~Journal of Social History 21 1987: 71- Vandereycken and Van Deth, From Farting Saints to Stawing Girls, 157. lo3. Shorter, 72, 'O4- Ibid, 'O5- Walter Vandereycken, Tilmnnn Habernas, Ron Van Deth and Rolf Meennann, "Geman Publications on Anorexia Nervosa in the Nineteenth Cennuy," hternationa[Journal of Eating Disorders 10(4) 1993: 476. '06- Vandereycken et al., "German Publications," 477. "'-Walter Vandereycken et al., "Geman Publications," 487. 10s. Tait, 202-203 . 109. Brumberg, 102-103. iio Brumberg, 103. "'-Lasague quoted in Brumberg, 119. '12 Brumberg, 120. lT3'Brumberg, 125. l14' Brumberg, 123-124. "5 Bnimberg, 127. lr5 Shorter, 74. "7- .Bmrnberg, 142. i 1s. Tait, 202-203. 119. Leigh v. Gladstone and Others, 1909, in Toni Pickard and Phi1 Goldman, Dimensions of Criminal Law, Toronto: Emond Montgomery Publications Limited, 1992. 12*- LeGates, 187. 12'- LeGaies, 227. '" LeGates, 228. Susie Orbach, Hunger Stn'ke: the Anorectic7sStruggle as a Metaphor for Our Age, London: Faber and Faber Limited, 1986,27. '24- Ibid. 12s. See Suzanne Noffke, transl., The Letrers of Catherine of Siena Vol 1. It's A Mental Condition... Nothing To Do With Us 'Anorexia Nervosa ', Medical Model, and Ps y-Discipline Discourse in the Twentieth Century

The emergence of the 'modem illness' known as 'anorexia nervosa' was the result of a number of

competing and compiementary discourses. Religion, science, medicine, and the bourgeois famiIy created specific socio-political contexts that allowed the constnictions of voluntary self-starvation to shift which resulted in the naming of the symptorn as a 'disease.' These contexts, however, did not create the symptorn nor an accurate explanation for it. At the end of the nineteenth century, vo1unta.t-y self-starvation had an offkial medical name but little eIse. No symptoms aside from emaciation were linked to 'anorexia nervosa.' During the twentieth-century this 'disorder' would be further developed by biomedical researchers, psychosornatic medical professionals, psychoanalysts, and social psychologists. The developments of 'anorexia nervosa' in the twentieth century led to a nurnber of currently accepted theories from the psy-disciplines on the origins and progression of the 'disorder."

The psy-disciplined theories inchde 'anorexia nemosa' as a genetic disorder, as an affective disorder, as cognitive dysfunction, as cognitive-behaviourd dysfunction, as Body Image Distortion Syndrome, as a family pathology, and as a psychodynamic disturbance. In the fust half of this chapter the history of the development of 'anorexia nervosa' in the twentieth century will be discussed. An explanation of the widely accepted psy-disciplined theories will follow.

WhiIe there is Iittle agreemem among these professionals, they share a few distinct ideas that were constructed in the nineteenth century; particularly that the symptom of food refusa1 is an individual problem that has

resulted from a deficiency, whether it be biological or psychological, that can be corrected. The competing

discourses within the psy-disciplines and the medical profession becarne quite strong in the first half of the

twentieth century. As a result of the classification of voluntary self-starvation as a 'mental illness' in the nineteenth

century, twentieth century patients received a wide range of treatments dnven by newly emerging theories from the

developing disciplines of psychiatry.' Well into the twentieth century, patients were submitted to a number of

questionable practices with little research to defend the practices. Sadly, some 'patients' became the 'research.'

Frorn 1900 to 1940 there were two different popular explanations for 'anorexia nervosa' - bioiogical and

psychoanalytic. Briefly in the 1930s the psychosomatic medicd movement attempted to join the discourse on

'anorexia nervosa' and added a new dimension that would be popular in the 1930s and 1940s.) The biological and psychoanalytic explanations were not unified in their own theories. In fact, pnor to 1940 there were no fewer than three different biologicai interpretations for the symptom of food refusai. These include: organ related dysfunction,

Simmonds' disease, and gynecological dificulties. However, there were also psychoanalytic and psychosomatic explanations during the period. The competing and confïicting discourses often overlapped or were combined in therapeutic practice. The history of voluntary self-starvation in the twentieth century, as with the entire history of fasting, is complex and multi-directional.

In the 1890s physicians began to experiment with a new treatment that resulted from scientific discovenes in biology. Prior to World War 1, William GuIl (to whom the 'discovery' of 'anorexia nervosa' is accredited) developed a method of treatment that became and remained popular. A high calorie diet was combined with a new development in the treatrnent of 'anorexia nervosa' - hormone therapy. Diagnosed 'anorexies' were subject to oral or injected hormone extracts, which were thought to stimuIate the appetite and affect the metabolic rate.' In France and North Arnerica doctors began organotherapy under the prernise that the dysfunction of glands and secreting organs were the source of the problem.' Therefore it was a biological deficiency that caused emaciation and with organothenpy young women who suffered frorn 'anorexia' could be 'cured' with the examination and treatment of specific glands or secreting organs- Implicit in the biomedical explanations of voluntary self-starvation is the assumption that women's bodies are by nature flawed. Since the number of women who self-starved was far greater than men the assumption was that there is an essentiat difference between men and women and men's bodies are

superior in biological function. The biological explanations of voluntary self-starvation by the 1940s implicated a

number of bodily functions and organs including the thyroid, ovaries, pituitary, and pancreas6 Bioiogicai

explanations became a primary focus during this period and they implicated a nurnber of different bodily functions.

In 19 14 'anorexia nervosa' as a 'mental disease' almost becarne obsolete with the discovery of

'Sirnrnonds' disease.' The reports on 'anorexia nervosa' noticeably declined from 19 14 until the 1930s as a result

of a discovery by a pathologist named Morris Simrnonds. After witnessing an autopsy in 19 14 Simrnonds published

a clinical description of emaciation that was a result of pituitary cachexia,' As Simmonds' disease becarne the

favoured explmation for emaciation many doctors continued to grapple with the difference between voluntary self- starvation and a rare pituitary deficiency, The difference between a rare glandular problern and the conscious

refusal of food was not scientificaIly differentiated and proven until 1942; meaning that from 19 14-1942 many

women were treated with pituitary extracts even though they suffered from no glandular complications."

With biological theories of 'madness' came physical treatments as 'cures.' As medical technologies deveIoped in the early twentieth century they began to dorninate in the understanding and ueatment of 'mental illness.' Psychosurgery and other invasive treatments were discovered in the 1930s and 1940s and were used immediately in the treatment of patients. These invasive physical 'cures' included insutin shock therapy, eIectro convulsive therapy ('shock therapy') and lobotomy? The recorded history of these treatments are not specifically linked to cases of 'anorexia nervosa'. Howeverl given the fiuidity of the diagnostic analysis of voluntary self- starvation during the first half of the twentieth century it would not be unreasonable to assume that these treatrnents were used on voluntary seif-starvers. In any case, the psychosurgical and invasive physical treatments provide a glimpse of the state of modem medicine during this period and therefore they are worth examining if only bnefly.

insulin was discovered in the 1920s and one decade later insulin shock therapy was introduced as a physical treatment for mental illness. Insulin shock therapy meant that the patient was given extremely high doses of insulin in order to produce a comatose state wherein they would be confined to their beds and reduced to a pre- adolescent stage of dependency. A result of this therapy was that the patient had a considenble weight gain." This type of treatment encouraped infantilization of the women being treated. After being brought out of the comatose state women were further degraded through the surrogate motherîng by th:: nurses which included bathing, a diet of

sugar and starch, and constant attention." For some wornen, however, the experience before the comatose state was

the most homfic. For many women, "the worst part was waiting for the several days it initially took for the insulin

level to produce a reaction, Iistening to the home animal cries of the other comatose women, knowing they too

would slobber or grunt, wet the bed, and become ugly and grotesque...""

Late in the 1930s electro convulsive therapy (ECT) was introduced as a form of treatment for 'mental'

patients in institutions and hospitals- ECT involved "the application of electric current to the 'alterior temporal

areas of the scalp'; whilst the patient [was] gagged (to prevent biting of the tongue) and restrained ...in order to

control convulsions.~*'3The use of ECT was not prescribed equally among men and wornen. In fact, to this day

women have outnumbered men by ratios of two, sornetimes three, to one." Almost imrnediately, 'shock therapy7

became extrernely popular in treating depression and continues to be practised today.

Psychosurgery was 'discovered' in the 1940s and used for a decade in the treatment of anxiety, depression,

phobia, obsessive afflictions, and most popularly schizophrenia." The surgery required entering through the eyelid

in order to sever the nerves connected to the cortex or to remove parts of the temporal lobe. This invasive surgery was used on thousands of patients in Great Britain and North Arnerica for more than a decade.16 Alttiough, the treatment continued to be used for many decades it declined in popularity. Lobotomy was, like ECT, more frequentIy prescribed and performed on female patients.l7 The physical treatments for 'mental ilhess' reflects the change in psychiatric discourse during the 1930s and 1940s.

In the 1930s and 1940s these new technological developments brought new interest to nervous diseases.

While the main framework of a pathology rernained intact, scientists began to look for biological expIanations for psychological affliction^.'^ The waning interest in nervous disorders, specifically female hysteria cannot simply be expIained through new scientific technologies. Socially and psychologically most women benefitted from World

War I in that it allowed them to publicly show their strength and prove that they were not vulnerable to mental coIlapse under pressure. In addition, World War I allowed women of most classes to perform work for a wage in the public sphere,I9 At the end of the war women's position in society generally shifted back to Victorian idedism.

Women's employment leveIs returned to their pre-war levels, constructions of sexuality and sexual behaviour reverted, illegitimacy rates dropped, and divorce rates stabilized in the late 1920~.'~Most of the emancipatory gains

made during the war were quickly reversed including the constmction of psychological strength and resistance,

Psychosurgical advancements and newly discovered medical treatments for psychological disorders were partially

responsible for the resurgence of interest in nervous disorders. The deveIopment of psychoandysis and the

popularity of Freudian thought dso aided in the reconnection of women and 'mental illness.'

AIong with the biomedical research, psychosornatic medical treatment began to filter into discussions of

voluntary self-starvation in the 1930s and 1940s. With the advocation of psychotherapy as treatrnent,

psychosomatic medicine began an early fonn of counseling that became immediately populx among those treating

young women with 'anorexia nervosa.'" The new treatment advanced by psychosornatic theory held that

"'anorexic' behaviour patterns could be challenged and then modified by getting to their 'real' cause, through

carefully managed conversation and analysis."~ By the tuni of the century 'anorexia nervosa' was caught in a

number of competing discourses; however, psychological theories became more popular than biological paradigms so 'anorexia newosa' was again discussed as a psychologicai ili in es^'.^ One of the most powerful discourses in reconstituting 'anorexia nervosa' as a mental rather than physical illness was psychoanalysis in that it joined the resurging and emerging discourse that devalued the ferninine.

Psychoanalysis becarne popular in treating voluntary self-starvers and arguably left the greatest impression on 'anorexia nervosa' as it was the fmt to link voluntary self-starvation and sexuality. Sigmund Freud was the first to question the meaning of the 'anorexic'sT hunger strike and attempt to interpret it.> Freud linked fasting to aspects of sexuality which his foIlowers expanded upon. The basis of Freud's analysis was that appetite represented sexuality and therefore, extreme fasting was an undeveloped or repressed sexuality and problems in childhood expressed in adulth~od,~In the 1920s and 1930s Freud published three essays which explained his views on femde sexuality and psychology. Essentidly, to Freud, wornen suflered from anatomicai deficiencies that caused them to develop penis envy, opinions of self-hatred and inferiority, and hatred of the rnother. In recognizing and accepting her deficiencies, known as female castration complex, every young wornan had three choices: sexual repression, competition with rnasculinity and homosexuality, or resolution wherein she changed "affection from femaie to male, repressed her 'masculine, active, ciitoral sexuality,' and finally accepted an infant, particularly a male infant, as a substitute for the phaiIus.""j Freud's theory on femininity, sexuality, and psychology thus renders

women naturalIy deficient in al1 areas. The penis is suprerne and the absence of it causes a number of effects

including self-loathing and mother-hating. In growing towards adulthood, women have three options ail of which

pathologize choices that women may make out of sexual safety or preference. The preferred and proper path for a

woman to take in resolving the castration complex according to Freud was to repress feminine qualities, worship

fatherly ch~acteristicsfrom a distance, reject female relationships, and hope to fulfill her Iife by giving birth to a

son, Freudian theory, in this respect, seems to have taken previous constructions of masculinity and femininity and

protected them from criticism in the cloak of psychology and biological determinism.

In 1920, Freud began to doubt the nature of Female reIationships, and began to pathologize intense and

intimate relationships wornen had with other women. Before this penod female friendships and relationships with

other wornen had been enjoyed. However, in the 1920s and 1930s sexologists, novelists, and those providing

therapeutic ceatments for 'mental ilInesses' had begun to connect abnormality, lesbianism, and feminism while

equating female subrnissiveness and heterosexuality with health," Included in the connection between health and

subrnissiveness in women were other assumptions. Since 'anorexia nervosa' was already established as a 'mental

ilhess', and Freud's influence was so great, the understanding of these issues most likely affected it- These can be

dernonstrated by examining a case in 1920 wherein Freud describes a woman who showed signs of 'lesbian

masculinity*. The woman in the case made no statement about sexual preference or experience but rather was

labeled for her 'masculine* inteIlectua1 quaIities such as acute comprehension, lucid objectivity, and resistant

spirit." Freud described the woman who exhibited 'lesbian masculinity' as "'a spirited girl, always ready for

romping and fighting.""g In addition, Freud declared she was a ferninist, and he scornfully expressed her

unwillingness to accept her position in the family as secondary tc her brother.

The connections Freud drew between heterosexuaiity, passivity, and health created cui interesting dynamic among psy-disciplines. Activity, strength, and homosexuality were connected with deviance in women and so they became objects of psychological study for these qualities as well as for their inferior biology. However, while explanations of voluntq self-starvation that became popular would express women's desire to retreat to a childlike state, this state of exueme passivity was again seen as pathological. Therefore the passive woman was reverting to childhood, the active woman was a social deviant and intellect, lucidity, and spirit were quaiities a woman could possess at her own peril, The constructions that Freud continued, which stated chat intellect, lucidity, and comprehension beyond 2 basic level were masculine qualities, meant that for women to show these intellectuai abilities was to risk being labeled as psychologically deficient,

'Anorexia nervosa,' specificaily, was interpreted by psychoanaiysts in a variety of ways. Freud's writings on psychosexual developrnent and the family have been considered one of the most important and influentid in describing 'anorexia nenosa'. Two main themes in the works of Freud, nutritionai instinct and hysteria, continue to resurface. A debility in the nutritionai instinct, according to Freud, was the result of an inability to appropnately deal with sexual excitement?' Hysteria had a psychological ongin but was aimost aiways associated with women.

Freud explained that the refusal of food was related to childhood sexual trauma, experienced by femde children and perpeuated by male family members. However, the descriptions and mernories of the sexual abuse experienced by

'hysterical' women were disrnissed as sexual fantasies by Freud?' Sex, sexuality, and sexual fantasy were the foundation for psychoanalytic theories on 'anorexia nervosa' as Freudian theory equated al1 appetites with sex drive.

From the 1940s to the 1960s there were a nurnber of psychoanalytic interpretations of 'anorexia nervosa.'

In some instances, the restriction of food was related to sexuai repression where the 'anorexic' woman was described as frigid, sexuaIly maladjusted, and prudish, while others argued that 'anorexia' was a defense against sexual indecency and prostitution?' Still others argued that what self-starving women wanted was the harsh treatment of force-feeding. It was asserted that 'anorexic' women wanted to be force-fed because of fellatio fantasies. In cornparison, a popular explanation stated that these women did not eat out of fear of oral impregnati~n?~One therapist, Jules H-Masseman, went as far as to daim victory over a patient when he got her to admit that she had a "fantasy of eating the analyst's peni~."~It was considered strange during this period when analysts did not mention sexuality or fears of impregnation since, once Freud established a Iink between fernininity, sexuality, and illness, it became an exuemely powerful approach to diagnosing and treating 'anorexic' women.

During the first hdf of the twentieth century the 'anorexie's' sexuaiity was the focus of diagnosis and treatment. With this focus descriptions of their sexuality stated that "they ['anorexies'] were embarrassed by vulgar stories; preferred reading to going out with boys; claimed never to masturbate; and were easily traumatized by un-

solicited overtures or touches by the opposite se^."'^ What was reprehensible about these descriptions of

'anorexics' is the therapists supposed ignorance of the social constmctions of appropriate sexual behaviour by

women during the penod. Women were expected to be modest, shy around men, and the taboo against masturbation

and self-gratification were still very strong. Therefore it would not have been unusud for women to be embarrassed

by graphie stories, touching, or to deny masturbating. Also, it was socially, poIitically, and often, culturally

dangerous for women to declare and act upon their sexuaIity. To do so could bring unwanted labels and a social

stigrna that would be difficult to reverse. Juxtaposed against this image of pathologicai modesty were the theories of

women who secretly fantasized about prostitution. 'Anorexies' were defined by some psychotherapists as

delusional because of reported feus of getting pregnant from semen Ieft on chairs and their avoidance of certain

foods which reminded them of sperm. At the same time, other psychotherapists asserted that 'anorexics' were

exhibitionists and seductresses who starved to avoid labels of prorni~cuity.~~Women, therefore, were seen as frigid,

sexually repressed or secretly lustfuI whores. Regardless of the apparent contradictions in psychoanalytic theory it

was instrumental in shaping 'anorexia nervosa' from the beginning of the nineteenth century to the 1970s.~'

From 1940 onwards, Freudian suggestions increased the popularity of understanding 'anorexia nervosa' as a rejection of, or poor adjustrnent to, heterosexuality. As women's female relationships had come under suspicion the fear of rejection of heterosexuality among women was expressed by those in the psy-disciplines- In a summary published by New York Hospital and the Payne-Whitney Psychiatrie Clinic in 1940 of twelve patients, "the authors observed: 'The patients' own statements indicated a strong repudiation of sexuality ... Al1 our cases had made a poor heterosexual adj~stment."'~~However, 'poor heterosexuai development' was not directiy tied to lesbianism because of political considentions. Homosexuality was an issue that caused immense anxiety in the interwar penod, especially in tems of women and reproduction, and as a result of these theories of 'anorexia nervosa' became skewed by conternporary politics. Nonetheless, the implication of lesbianism was created through statements that required young women to constnict themselves in a way that would show a slight interest in young men, a 'healthy' ferninine appearance, and an avoidance of any peculiarly strong femaie relation~hips.~~

G. Stanley Hall, one of the 'fathers' of psychotherapy, reinforced the link between food refusal and the rejection of heterosexuality. Hall created a theory explaining voluntary self-starvation that became popular during

the interwar period. This theory connected the individual act of food refusa1 to the greater socio-political context

where women's reproductive capacity was very important, Hall, as weil as other health professionals, argued that

the prepubescent body displayed by the self-starver was a psychologicai problem that created a physical body void

of the symbols which were identified with femininity - breasts, hips, and more body fat- The femaIe body that was

starved to avoid these symbols was seen as rejecting the Iife of motherhood and The rejection of the

'natural' position for women of marriage and child-bearing as deviance was the foundation for Hail's theory.

Psychoanalytic theory reshaped 'anorexia nervosa' and conunued to influence some aspects of the

diagnosis and treatrnent of voluntary self-starvation well into the 1990s. At the root of psychoandytic theory are a

number of dangerous and damaging assumptions about wornen, femininity, sexuality, and the female body. Not

only did the Freudian-influenced theones reduce the problem to the individual, and make invisible social, economic,

political, and cultural factors, but it pathologized women's femde relationships and created deviance in female

homosexuality. Women, diagnosed as 'anorexic' and ueated by psychoanalysts, were not allowed to explain their

behaviour and, most importantly because of its focus in these theones, their sexudity. As Julie Hepworth writes,

[wlomen's ideas about sexuality are excluded [in psychoanalysis], and non-normative sexualities, such as bisexuality and lesbianism, are utterly pathologized, reproducing a normative discourse about sexuality, women and relationships within the farnily and broader society."'

Psychoanalysis ensured women's silence in their own ueatment, and made it impossible for women to explain

themselves, because of its privileged discourse and the theory in which every word represented some sexuai act or

had a sexual meaning. In 1956, Falstein and Falstein theorized that food could symbolize breasts, genitals, faces,

poison, parents, or other farnily members whiie eating could represent sexual gratification, impregnation, sex,

performance, physical growth, castration, destruction, immersion, killing, or cannibalism?'

The perceived rejection of heterosexuality, and the resistance towards traditional female roles, eventuaily

led to physiological testing as the field of sex endocrinoIogy developed. The combination of Freudian theory and

sex endocrinology developments meant that, in the 1930s and 1940s, doctors began to test voluntary self-starving

women's sexual and reproductive function. Using these tests, self-starving women were reported by heaith workers as experiencing physical problerns of their sexual organs: small genitalia, degenerative and small breasts, and atrophic sex organs were attributed to infrequent use-43

In the post World War 11 era a shift occurred in the conceptualization of eating disorders which gave greater merit to the significance of food behaviour and the history of the development of the patient. By the 1960s the new direction was sparked by the work of Hilde Br~ch,a psychoanalyst who worked with women with 'eating disorders'. Her theones would become the dominant mode1 on 'anorexia nervosa.' It was during this period that obesity as a result of over-eating wouId be placed within the same category of 'eating disorder' as voluntary self- starvation. Under- and over-eating came under the sarne label as the new psychiatrie concept of 'eating disorder' required both to be treated by mentai health professionals? The new understanding that the link between these

'disorders' created was one where food carne to be seen as equally important to both the over- and under-eater.

Bmch emphasized, for the first time, the relationships between the individuai's personality, farnily and food arguing that certain factors preconditioned specific women to 'eating disorders.' SeIf-starvation, according to

Bruch, was an effort to obtain autonomy, capability, control, and self-respect, The problem of self-starvation occurred when the mother failed to recognize and nurture her child's need for independence. This led to three perceptual and conceptual disturbances in the child: disturbances in body image represented by a continu& over estimation of body size; interoceptive disturbance represented by an incapacity to recognize and respond to bodily sensations; and, overwhelming feelings of ineffectiveness represented by a feeling of loss of ~ontrol?~

The emphasis in therapy was to understand how families related to food issues regarding management and intake? 'Anorexia,' however, was still an individual problem as food was only a tool used to help the individual find her core personaIity which she lacked?' The reason for this inner personality deficit was the flawed mother- daughter relationship where the daughter is caught between the person inside and the expectations of her. In deconstnicting the title, and text of, Bruch's Earing Disorders: Obesiry, Anorexia Nervosa and the Person Wirhin,

Tait argues that Bmch bases her theory on the stmggles and contradictions between the authentic self (the person inside) and cultural expectations of her.j8 Thus the origins of 'anorexia nervosa' are the confiicts between the authentic self and cultural expectations.

Family and cultural expectation collide in puberty but the problem actualIy begins in childhood. The child realizes early on that they have deficiencies that need to be hidden at al1 costs. The perfectionism that results from this is praised and reinforced by farnily and community members (Le. teachers) but the action is still a forced or

unnatural behaviour. Therefore "this praise reinforces the anorexie's fear of being spontaneous and naturai, and

interferes with her developing concepts, especially a vocabulary for her mefeelings, or even the ability to identify

feeling^."'^ The perfectionism of childhood becornes disordered at the onset of adolescence. The protection that

the perfectionism provided collapses during the "panic of puberty". This panic combined with the transformation of

sociai rotes and cuItural expectations leave women unprepared, so they defer to their bodies and become

preoccupied with weight,%

According to Bruch, women are predisposed to 'anorexia' when their development has been deficient,

These deficiencies "are manifested by inaccuracy in perception and control of bodily sensations, confusion of

emotional States, inaccuracy in language and concept development, and great fear of sociai disapproval. The

relentless pursuit of thinness can be conceived of as an effort to camouflage these underlying problem~."~'What

this theory really postulates is that voluntarily self-starving women had no control or perception of their own bodies,

were emotionally confked, could not properly use language, and were socially timid and constantly seeking to please. The underlying assumption is that the 'anorexic' is intellectually challenged and has a poor understanding of her own body. Thus it becomes the chalIenge of the therapist to 'educate' her in the needs and feelings of her body and the language that describes it.

The therapeutic technique described by Bruch reafirms the assumption that 'anorexic' women do not know their own mind, bodies, or thoughts. Combined with this is the fact that the assumption that the use of

Ianguage by self-starving wornen is inefficient and incapable of describing what is realty happening. Bruch's preferred treatment is one where the 'anorexic' must be broken to see her flawed ways and then corrected. The

"anorexie's whole life is based on certain misconceptions that need to be exposed and connected in thenpy. Deep down every anorexic is convinced that basically she is inadequate, low, mediocre, inferior ..."5'

After Bruch's theory there was a virtual explosion in the theories and explmations for 'anorexia nervosa.'

However, it was in the 1970s when diagnostic criteria for 'anorexia nervosa' were firmly entrenched. In

the 1970s the nosological map of the cIinical signs and symptoms for a scientific diagnosis of anorexia had been more firmly established by the following criteria: (1) age of onset prior to twenty-five years; (2) witb at least 23 per cent loss of original body weight; (3) the existence of a distorted attitude towards food and eating; (4) no know prior medicd condition which could account for the presence of anorexia; (5) no other known primary affective psychiauic disorders; and (6) at lest two of the following - arnenorrhea, lanugo, bradycardia, ovenctivity, bulimia and ~orniting?~

Along with the plethora of psychoIogicai and medical discussions came public awareness as the 'disease' came to

the forefront of the public conscience, For the fmt time, in the 1970s, the term 'anorexia nervosa' became weIl

known outside of the medical comrnunity- 5J With the announcement of Karen Carpenter's death in January 1983,

national and international attention was focused on the serïousness of voluntary self-starvation. Before this

'anorexia nervosa' was seen as Iittle more than an annoyance?* Most of the explanations of 'anorexia' the public

becarne familiar with were the medical-mode1 and psychiauic-based theories. Even ferninist theories were suII

based in the medical discipline in their use of concepts and Iang~age?~The most influential theories of 'anorexia'

cm be placed into the following categones: 'anorexia' and genetics, affective disorders, cognitive and cognitive-

behavioural dysfùnction, body image distortion, fiunily pathology, psychodynamic disturbance. Theses categones

will be briefly discussed and followed by a critique.

'Anorexia' and Genetics

Since the discovery of 'anorexia nervosa' in the 1870s physicians have speculated that there rnight be a

familial ongin. From 1970 onward, mental health professionais have attempted to prove that some people may be

genetically predisposed to 'anorexia nervosa.' it has been suggested that there is an 'anorexic phenotype' which

stemrned from genetic inheritan~e.~The standard methods used in attempting to determine a genetic predisposition

"are to deterrnine prevaience rates in family pedigrees, in adoptees and their families, concordance rates between

MZ [rnonozygotic] and DZ twins [dizygotic], and finally linkage analysi~."~~However the rnethodology of these studies are over-run with problems. Farnily and twin studies do not differentiate between inherited, environmental or socio-cuIturaI factors and many of the studies have severe flaws in their design.sg Nonetheless, as one author stated, "Although the methodology of the studies indicating the genetic link for anorexia has been greatly criticized, most authorities believe that the evidence indicating some heritability for anorexia nervosa is tri king."^^

Twin studies have been fairly frequent and have attempted to prove the link between 'anorexia nervosa' and genetics. Among patients diagnosed with 'anorexia nervosa' forty to fifty-six percent of twins are concordant for 'an~rexia.'~'However, similar genetic testing done on patients suffering from 'bulimia nervosa' have shown a ciramatic difference in concordance which has led some researchers to conclude that 'bulimia nervosa' is a

'hererogeneous disorde J that has a number of ca~ses.~'The implicit assumption then is that 'anorexia nervosa'

wouId be a 'homogeneous disorder' that could be reduced to one cause or genetic factor. This type of research.

then, can be seen as an attempt to annihiIate other explanations and factors that have been associated with 'anorexia

nervosa.'

The literature on genetics and 'anorexia nervosa' is peppered wirh statements that attempt to show a

genetic connection. However, most of the findings in the literature cause greater suspicion than assurances in

genetic explanations. For example Hsu (1990) cornes to the conclusion that an individuai with a family history of

'eating disorders' (thus an 'anorexic phenotype') is at greater risk for developing one if she starts on a strict diet,63

Affective Disorders

The category of affective disorders is an immense and largely undefined area in the psy-disciplines. It may

include ail mood abnormalities defined in the psy- discipline^,^ Depression and mania are considered the main sub-

categories under the mbric of 'affective disorders' but may also include anxiety disorders, hyperactivity syndrome

in children. attention deficit disorder, agoraphobia, and 'anorexia ner~osa'.6~In some of the medical and genetic

Iiterature 'anorexia nervosa' has been placed within the existing category of depression in order to search for a common path~logy.~~As clinical features of 'anorexia nervosa' overlap with those of depression, insomnia, weight

loss, reduced sex drive, sorne researchers have proposed a genetic link between the two; that is, the sarne genetic predisposition can Iead to either. Other researchers have suggested that a bio-medical abnormality is to blame in both instances.67 Critics against Iabeling 'anorexia nervosa' as an affective disorder have argued that there is actuaily more differences between the 'disorders' than there are similarities. Nonetheless it remains that understanding 'anorexia nervosa' as an affective disorder does little to explain the experience of 'anorexia ner~osa.'~~

Cognitive Dysfunction, Behavioural Therapy, and Cognitive-BehaviouralDysfunction

Cognitive dysfunction as an explanation for 'anorexia nervosa' is based on the fact that 'anorexic' women have systematic errors in their cognitive schema wherein relevant information is not correctly processed.@' Schemas are developed through early Iife experiences and are used to process and integrate new information. Dysfùnctionai thoughts are believed ro cause errors in the cognitive schema which puts individuals at greater risk of developing an

'eating dis~rder.'~~As a result, cognitive therapy attempts to identiw and dismpt the dysfunctionai thought processes?'

It is not cIear, however, whether the error in cognitive schexnas are causal or the result of prolonged starvation. Nonetheless there has been no Iack of theories explaïning 'anorexia nervosa' within this theoreticai model. It has been understood as a Yack of the capacity for abstract thought characteristic of the forma1 operational stage of cognitive development; in terms of poor cognitive performance, and in terms of irrationai beliefs, all-or- nothing thinking, superstitious thinking and ego-cenuic thinking."n

Behavioural therapists are not interested in the orïgïn of the 'disorder' but, rather, atternpt to develop methods to alter the 'pathologica1' behaviouren This type of therapy is most often used in the primary treatment of

'anorexia nervosa' when authorities declare that substantiai amount -f weight needs to be restored (most often during hospitalized in-patient treatrnent)?' Traditional behavioural therapy for 'anorexia nervosa' revolved around a ment system where the 'patient' could earn personal belongings and privileges with weight gain. The traditional ment system starts the 'anorexie' with complete bed rest, no vîsitors, phone calls, television, mail, bathing or bathroom privileges, Ail that is allowed is eating. As weight is restoaed privileges such as bathing or bathroom privileges are granted. However, privileges can be lost if weight drops or remains stable. (See ~ppendix)"

Behavioural therapy tends to ignore the patients' resistance instead, explainhg resistant behaviour as a failure of the method."

The cognitive-behavioud model combines both the theory ofcognitive dysfunction theory and behavioural therapy. First developed in the 1980s as a treatment for '-bulimia nervosa,' cognitive behavioural thenpy has been used for about a decade in the treatrnent of 'anorexia ner~osa-'~~Cognitive-behaviourd therapy has two main pnnciples. First, the 'eating disorder' is seen to be maintained by cognitive dysfunction; and second, al1 of these types of treatment "address both the behavioral disturbances of the eating disorders and the attitudinal disturbances regarding eating, weight, and ~hape."'~The focus of this therapy is to change the attitudes, beliefs, and behaviours of the diagnosed woman as they relate to al1 areas of her kfe. Cognitive-behavioural therapy has a multiple focus that attempts to change thinking patterns and behaviours around any issue affecting eating and weight.

Body Image Distortion Syndrome (BID)

BID consmcts 'anorexia nervosa' as the result of a flawed self-perception of the individual- 'Anorexie' women misperceive their actuai body size so that they see their bodies as overweight when they are actually severely erna~iated.'~ Hilde Bmch was the first to notice a gap between the reaiity of the body and the visuai image seen by the 'anorexic.' According to Bruch, the body image, and the emphasis of it by the 'anorexic'. were the result of a deIusional perspective.8' Researchers have suggested two 'pathways' to BID. Negative internaiized representations of the physical body may be the result of traumatic events such as sexual abuse andor important rehtionships where a significant person in their Iives is overly focused on weight or appearance. The projection ont0 the body of uncomfortable emotions which is performed through an attempt to change the appearance of the body through self-regulation is the second 'pathway,'"

Yet again 'anorexia nervosa' is reduced to an individual flaw; this urne, the misperception of the self- starvers' own body. However, as with most research on 'anorexia nervosa,' there are many inconsistencies among the literature. Wbitehouse et al., discovered that 'anorexic' women overestimated waist size but were accurate in the perception of the rest of the body; and Brinded et al.. discovered that BK) fluctuated, to different extents and in different directions, across and mong patient^.^

The unrealistic attitude towards the body by the 'anorexic' has been used to show the differences between heaithy women and 'anorexic' women; even though studies have show up to seventy five percent of women consider themselves too fat although only one quarter of them were actually overweight and thirty percent were under~ei~ht.8~Other studies have approximated that ninety-five percent of women (none with a diagnosable 'eating disorder') overestimated their body size, on average, by one quarter.s Despite these studies today BID is seen as the most important defining characteristic of 'anorexia nervosa' even though it has been shown to be a common experience arnongst w~men.~~

Family Pathology

The foundation for understanding 'anorexia nervosa' as a famify pathology is that the home environment is somehow dysfunctional. One of the 'family dysfunctions' that has been a primary focus in research and the media is childhood sexual abuse. It is obvious that childhood sexual abuse and traumatic or unwanted sexuai experiences

at any age will cause Iong-term effects and 'disordered' eating mas result; however, it has been difficult to establish

a causal relationship between sexual abuse and 'anorexia ner~osa,'~~Not al1 women who suffered childhood sexual

abuse develop an 'eating disorder' and not a11 'anorexie's' report childhood sexual abuse or unwanted sexual

experien~es.~~

Sorne researchers have also proposed a model for 'the anorexic farnily;' that is, specific fdIial models

that help to produce an 'anorexic.' The main feature of 'the anorexic family' is enmeshed family patterns. Other

features inchde: chiid-orientated, parental hypervigilance of children, excessive concern over the children's

psychologicai and bodily functioning (causing a Ioss of autonomy), over-involvement by child in family, and the

inability of the child to relate to her peer group as a result,gs 'The anorexic farnily' often has other characteristics

iiicluding dysfunctional ideas around diet or over-valuing thinne~s.8~This type of family pattern supposedly makes

the child over-dependent on the approval of the family which makes it difficult for the child to separate her identity

and feelings from those of others. Therefore, within this model, 'anorexia nervosa' becomes a solution for the

diEculties within the farnily relationships.

As with other psy-disciplined theories, 'anorexia nervosa' from the perspective of a family pathology is not

entirely consistent. The weights of parents of 'anorexics' have not consistently shown a difference from the experimental control~.~Attitudes about food, weight, and eating within the farnily may only be representative of socio-culturaI noms and not specific to certain familial patterns.

Psychodynamic Disturbance

The theory of 'anorexia nervosa' as a psychodynamic disturbance is similar in some aspects to 'the anorexic family.' It, however, is more informed by psychoanalytic discourse which sees self-starvation as symbolic of an unconscious fantasy. The psychodynarnic disturbance is located in the early mother-child reiationship as the mother failed to respond adequately to the infant's needs?' The nutritional needs of the child are confused as the rnother feeds the child according to her own schedule and responds inappropnately to the child's wants. As a result the child does not learn how to react to her own bodily sensations and when the child matures she feels an overwhelming sense of ineffectivenessSE in the end, the individual has not developed a sense of self?3 This mode1 largely ignores the cultural and social contexts and, instead situates the motheddaughter

rehtionship in a vacuum against time and s~ace.~It cornpletely ignores the role of other parental figures, father,

grandparents, siblings, and others. In addition, it does not explain why thinness is the chosen pursuit and, like other

medical rnodel theories, does not accurately take into account why this mother/child dynamic most often only affects

female children, The result is an assurnption of a pathological motheddaughter relationship that is reminiscent of

the Freudian pathologization of any close female relationship.

Views of Mental Health Professionals

While the division of theones is relatively simple in theory, practically mental health professionals may combine specific points of different theories in treaunent, As such, the views of mental health professionals provide another layer in the discussion of the construction of 'anorexia nervosa,' Julie Hepworth interviewed eleven mental health care professionals - two psychiatrists, two general practitioners, three clinical psychologists, three psychiatric nurses, and one feminist therapist - to attempt to find out how the mental health professionais in pnctice constructed 'anorexia nervosa'?' The results of her interviews regarding the cause and 'nature' of 'anorexia' are interesting and worth quoting at length. She found:

Health care workers' accounts constructed anorexia nervosa in ways that avoided specifying a causation. The various strategies that hedth care workers' used were 'not knowing' the cause of anorexia nervosa, with an emphasis on '1 don't know if anyone knows' as an appeal to the overwhelming nature of the problem. Anorexia nervosa was constructed in terms of a rnultifactorial causation or rnodel, or a List of the possible causes, including hormonal dysfunction, genetic, socio-cultural pressures and family dynamics, Terms such as 'may' or 'could be' were used to describe and play down the biological bases of anorexia nervosa. The status of anorexia newosa as being 'complex' was a key justification for 'not knowing.'%

Therefore even medical professionals realize that the medical, biologicai, and psychological modek do not accurately reflect or explain 'anorexia nervosa.' In addition, there seems to be a general level of suspicion towards biologicd interpretations and genetic explanations. NonetheIess, the confusion over diagnostic criteria and expIanations hat Hepworth discovered can be seen in articles published by psy-disciplined authors.

'Anorexia Nervosa' in Males - Views from the Psy-Disciplines

While it is generally agreed that approximately ninety percent of people suffering from 'anorexia nervosa' are women, there is still a small body of literature on 'eating disorders' in males. For the most part, the diagnostic critena used in identifying and treating female self-starvers is used in relation to males. The noticeable exception is

menorrhea. Many argue that the exploitation of women by the media has become increasingly felt by menm9' The

pressures, manipulated by the media, that 'modem men' face include issues around appearance (physically fit,

strong, and powerful), financial prospenty, and success in personai relationships which may lead a "more sensitive

man" to face conflicts about his role in society and confusion around hîs personal identity.9' The media is not the only factor in men's developing 'anorexia nervosa'. Family issues, sirnilar in some respects to those described as affecting female 'anorexics', are also an important influencing factor. Interestingly, in relation to the development of 'eating disorders' in men, both the mother and father are seen as playing an important role. (Ln women, the focus largely rests on the mother-daughter relationship and the father, in most cases, becomes invisible.) In 1978, an article by U. Sreenivasan was published in which the author described the 'typical' background of the male

'anorexic'. Sreenivasan argued that

[tlhe mothers, oversensitive and insecure, were partnered by men who project the cultural image of masculinity, including over-indulgence in alcohol. The parents as a whole were over-weight, but obesity was more noticeable in the fathers. The patients were relatively immature and obsessional... The families were skewed, with marital difficulties and overt hostility between fathers and patients on the one hand, and over- dependence between the mothers and patients on the ~ther.~~

Men who developed 'anorexia nervosa', therefore, have a specific familiai pattern wherein they are overly sensitive and overly dependent on their mothers while having a hostile relationship to their fathers. The construction of

'anorexic' men as overly sensitive and too dependent on their mothers is overtly related to the stereotypes of the homosexuality in men. Therefore it should not be surprising that there bave been a number of studies that suggest that male 'anorexics* have a higher tendency to be homosexual or "show some disturbance in the development of their gender identity-"'OO Others have suggested that men experiencing sex role conflict andor gender concerns are at a higher risk for developing 'anorexia nervosa'.I0' Some researchers have proposed that gay men were an at risk group as athletes and dancers are considered. A 1992 study concludes that gay men and heterosexuai women were more preoccupied with body image and had lower ideal body weights that did heterosexual men or Iesbians. The sarne study, however, reported that the overall body dissatisfaction was higher arnong lesbians and heterosexual women than heterosexual or gay men.lm

Criticism of the Psy-Disciplined Theories ALI of the mentioned medical and scientific mode1 theones for 'anorexia' share some important similarities. First, they perpetuate the myth that voluntary. self-starvation is an individual pathology thereby effectively removing the 'anorexic' from her historical, socio-political, cultural context- Any recognition of cultural factors are merely said to trigger or aggravate an existing pathology, Second, these rnodels do not provide an accurate expIanation or theory for why 'anorexia nervosa' has consistently been disproportionately higher among femaies as the generally accepted statistic asserts that approximately ninety percent of sufferers are ~ornen.'~'AI1 of the theories assume that 'anorexia nervosa' is something that happens to women as opposed to a conscious act thereby assuming women to be passive as opposed to active participants in their own bodies, families, and comrnunities. The medical and scientific models do not rnerely diagnose women with 'anorexia nervosa' they create 'anorexics' as "anorexia is not just a question of having anorexia; it is fundarnentaiiy about being an~rexic."'~WhiIe physiological and biologicai afflictions are owned by the affected individual (1 have..,), 'mental ilInesses,' such as 'anorexia nervosa' are seen as embodied by the individual to such as extent that the individual becomes the 'illness' (1 am-..). In addition, psychological models refuse to accept that young women are actively involved in the construction of ideas of gender, race, class, and sexuality. The self-construction has largely been ignored by most psy-disciplines which once again reinforces the assumption that Iife happens to w~rnen.'~*

Two obvious assumptions about the 'anorexic' in these explanations are that the 'sufferer' will be young

(Le. under twenty-five) and female. However, the medical and scientific creation of the 'anorexic' was largely seen as race and ciass neutral. Women are aiso placed into the category of perpetual child with psychological theories.

They are seen as largely disempowered not because of socio-political climates but because of their individual inability to cope with adulthood. Ironicdly, even the family pathoIogy mode1 which recognizes the traumas sorne women experience in childhood do not challenge the notion of 'anorexia nervosa' as an attempt to revert back to a child-Iike state. How could it be said that a woman who has expenenced sexual abuse would find safety in a child's body? The ignorance of the actual lived experience of sexual trauma underwrites the notion of 'anorexia nervosa' as an escape from adulthood, For women who were sexudly abused during adolescence the emaciated body may not be symbolic of a child's body but, rather, a means of de-sexualizing in the body in order to assert control and disallow access to her body. Traditional psychological thenpy enforces a chiId-like state onto the 'patient* by treating her in a

patemal/maternal way. The assurnption is that the professional therapist knows what is good for the 'anorexic'

whiIe the latter does not. In no means is the 'professional anorexic' taken into account; that is, her expertise as the

'anorexic,' her knowledge of her body, experiences, and history are not acknowledged or pursued with scientific inquiry. The distance the therapist has from the 'iIlnessTand the 'patient' is seen as objectivity and given merit while the subjectivity is pathologized. In some cases even the law cannot protect the rïghts oFthe 'anorexic' to refuse treatment, The faw then reaffims the child-like state by taking away the adult nghts of the 'anorexic.' In

Australia in September of 1988 two 'anorexic' patients, one seventeen and one nineteen, lost their case to refuse hospitalized treatment-'"

The practice of diagnosing 'anorexia nervosa' has tended to exclude women of colour, Iesbians, and women from different socio-economic classes. The Victorian construction of 'anorexia nervosa' has changed dramatically in its theoretical explanations but the race, class, and sexuality assumptions remain intact. Diagnostic criteria are underwritten by assumptions of race (white), class (middle to upper), and sexuality (heterosexuality).

Class has largely been ignored in research on 'anorexia nervosa' as it has been widely accepted that the

'eating disorder' is a rniddle-class woman's 'disease.' The assumption in the Iiterature of 'anorexia nervosa' as symbolic of other issues and the biased connection between class and 'eating disorders' reafErms the classist assumption of the middle-class woman as symbolic. HistorÎcally, the rniddle-class wornan was symbolic of farnily and nation. The psy-discipline theoretical concepts of 'anorexia nervosa' reaffhn constructions of the female rniddle-cIass woman who carries the symbols of Farnily, society, and culture. The difference created "between working-class and middle-cIass women reflets the biased notions that middle-class people create symbolic, abstract relations through their action and thought while working-class people relate to the world in litera1, concrete

~ays."'~'When we ignore the issues that working-class women have around food and weight, we reaffirm stereotypes about the syrnbolic nature of women's bodies and their class position.

Using psychologicaI models also expresses specific statements about the differences in the psychological hedth of different women based on class. Middle-class women have traditionally been constmcted as mentally weak and subject to psychological afflictions because of their biology. However, these assumptions are equally damaging for working-class women as they associate the working classes more with the body because of the

physical nature of their work, If the middle-class wornan is biologically afflicted with psychiatrie ilfnesses.

working-class women are seen merely as a body for capitalist labour.

Race has consistently been ignored by psy-disciplined treaunents, Frorn 1975- 1986, for example, one

facility reported ueating seven black or latina women- When finally diagnosed, six of the seven had to be

hospitalized due to the severity of the star~ation.'~"erhaps more striking is the statement made by the United

States Department of Health and Hurnan Services in 1983 which declared, "[tlhere has never been a documented

case in a Black male or female."Tm These types of statements and assumptions have practical consequences as many

mental health professionais will misdiagnose or ignore women who are not white."' Deep-rooted cultural

expectations of weight and body appearance also skew diagnosis and treatrnent- The socid expectations of a fuller

figure for Black, Latina or Native women may mean that food and weight issues are not considered relevant to them

and subsequently ignored. Conversely. the expectation that Asian wornen will be petite may mean that food and

weight issues are ignored cornpletely."'

Like working-class women, black women are often seen as unable to develop a 'mental illness' because of

the historically entrenched belief that black women are bodies. When placed into a dichotomy that contrasts white

women to black wornen, latina and Native women are completely ignored.'" Further. women of colour are seen as

more removed from cultural pressures around weight and food restriction as if they exist in a vacuum against the

'thin is in' ideology. White women with 'anorexia nervosa,' especially before the death of Karen Carpenter, were seen as 'self-absorbed,' 'appearance-orientated,' and 'fiivolous'. Black women are dismissed as incapable of these quaiities and further, this is "linked to the presentation of black wornen as the opposite: as unattractive 'mammies' who are incapable of being thin."'I3 The statistic produced by one hospital recorded that six of the seven black

'patients' admitted were severely emaciated speaks to the deadly consequences of assumptions about race and class.

As most rnedical mcdel theories explicitly assume heterosexuality, lesbian sexudity is completely Iost in this frame of reference. For the most part, this is explained by the ignorant assurnption that lesbians do not develop

'eating disorders' as they "are not interested in or capable of being 'attractive' in the dominant sense of the

~ord.""~Obviousiy, the dominant ideology of 'beauty' and 'attractiveness* are in relation to male-centred preferences. This assumes hat women develop 'anorexia nervosa' in order to better fit into the 'beautiful' category and that voluntary self-starvation is an artempt to gain appreciation from men. Such thinking aIso makes invisible the ways Iesbian communities have "refashioned what constitutes beauty in ways that nurture multiple versions of style, glarnour, and gra~e,""~Lesbians, however, may have been intirnidated to corne forth with a 'mental iilness' because of the historicd associations of lesbian sexuality with de~iance."~

The evolution of 'anorexia nervosa' from the beginnîng of the twentieth century shows the creation and solidification of the 'disorder* through many forms. As the century progressed the theories on 'anorexia nervosa' diversified and multiplied while retaining some basic concepts and assurnptions. The rnedicalization of women's bodies and the pathologization of their minds continued from previous centuries- So too did the assumption of voluntary self-starvation as an individual proolern which resuked from a psychologicd flaw inherent to the person.

For the most part socio-cultural and politicai factors are ignored, removing the woman from her community.

Pathologization of voluntary self-starvation continues the stereotype of women as passive people who have no influence or power over their Iives or comrnunities. Not seeing wornen as formative, at the very least in regards to their own bodies, rernoves thern frorn deveIopmental frarnes of reference and ignores the centuries of women who have influenced and resisted. The assurnption of the passive woman dismisses any resistance by wornen especiaily when practised on an individuai basis.

The nurnerous psy-disciplined theones explain 'anorexia nervosa' in a number of complementing and cornpeting discourses. In effect, the discourse of 'anorexia nervosa' is as rnuch of a contested ground as is the body of the 'anorexic.' What has remained constant from past centuries is the profound silence of 'anorexic* wornen on their own experiences, histories, and bodies. The theones of 'anorexia nervosa' seern not to allow room for the individual as they assume what she is 'supposed' to be even before dieting begins.

Psy-disciplined models have aIso been constructed in such a way as to render invisible women who are not white and middle-class. Working-class wornen, wornen of colour, and lesbians are al1 theorized out of existence in regards to 'eating disorders.' The explanations for why these wornen do not have eating disorders border on the ndiculous and ensure historical constructions based on racism, classism. and heterosexism will continue, The construction of 'anorexia nervosa* has an important history and has affected the contemporary pnctice of diagnosing and understanding voluntary seIf-starvation, As long as psy-disciplined based theories resist

incorporuting socio-culturai factors and refuse to confront the continued histoncal assumptions in the fondation and practice of their work the diagnostic criteria and explanations for 'anorexia nervosa' should be used with extreme caution, 1. By 'psydiscipline' 1mean to incorporate the rnany different sections of mental heaith professionals incfuding, but not limited to, psychiatry, psychology, psychoandysis, and psychotherapy under one tem This is not to deny the ciifferences in and arnongst these but rather to recognize their ability to discursively construct 'mental ÎlIness,' 'normality ,' 'abnormality.' rJulie Hepworth, ïïie Social Conshuction of Anorma Nenosa, Thousand Oaks, California: Sage PubIications, 1999,42, 3Joan Jacobs Brumberg, Fasring Girk the Emergence of Anorexia Nervosa as a Modern Disease, Cambridge Massachusetts: Harvard University Press, 1988,205, 4. Ibid, sBrumberg, 206. &rumberg, 2 12. ~Brumberg,208. dbid. Simmonds' disease may have become popular because it cornplimented the growing authonty of IogicaI positivist science. The domination of biomedicd explanations became popular during this period as psychoanalytic theories did not fit the equation of objective fact and tmth put forth by positivist science, See HeIen Malson, The Thin Wornan: Feminism, Post-Stnrcturalkrn, and the Social Psychology of Anorexia Nervosa, London and New York: Routledge, I998,77- 9Jane M. Ussher, Women's Madness: Misogyny or Mental Health, London: Harvester Wheatsheaf, 199 1,106- 107. iolbid. i imaine Showalter, Female Malady: Women, Madness, and English Culture, 1830-1980, New York: Pantheon Books, 1985,206. izShowaiter, 205-206, 13.Ussher, 107, is.ShowaI ter, 207. 1s-Ussher, 107, dbid. rîShowaiter, 209, rsHepworth, 43. in Showalter, 195. mShowaiter, 196. 2i.Gordon Tait, "Fas ting and the Female Body: From the Ascetic to the Pathologicai," Wornen & Performance: A Journal of Fenzinist Theos, 21 1999: 150. =Tait, 150. uMalson, 77. 24Bnimberg, 21 3. -&id & Ussher, 110. zaShowaIter, 199- nMarfene LeGates, Making Waves: A History of Feminism in Western Society, Toronto: Copp Clark Ltd., 1996, 287, 2s.Ibid. w-Quoted in LeGates, 287. 3o.Hepworth, 48-49. 3i.Hepworth, 49. 3rTait, 150. 33.Ibid. wquoted in Brumberg, 226. ssBrumberg, 224. ~k-~mberg,225. 37.Tait, 150. 3s.quoted in Brumberg, 224. ~~Brurnberg,224. .ooBrumberg, 225. 4iHepworth, 49- aquoted in Maud Ellman, The Hunger Artr'sts: Sranting, Wrirtng, adIrnprisonment, Cambridge Massachusetts: Harvard University Press, 1993,43. 43Bmmberg, 227. ~Bmrnberg,229, 4sJoseph A. Silverman, "Anorexia Nervosa: Histoncal Perspective on Treatment," in Handbook for Treanent For Eanirg Disorders Ed., Eds., David M. Garner and Paul E. Garfinkel, New York and London: the Guilford Press, 1997,7, asBrumberg, 229. 47Morag MacS ween, Anorexic Bodies: A Feminist and Sociological Perspective on AnoreXia Nervosa, London and New York: Routiedge, 1993,323-39, 4s-Tait, 151-152- 49Hlde Bruch, Conversations with Anorexies, New York: Basic Books, 1988,4, soBmch, 5, si.Bmch, 4. sz.Bruch, 6. nBryan S- Turner, Regulating Bodies: Essays in Medical Sociology, London and New York: Routiedge, 1992,S 19, SBmmberg, 258. ssBrumberg, 15. ra~erninistiheories of 'anorexia nervosa' will be discussed in the next chapter. nMaison, 80. rsJanet Treasure and Anthony Holland, "Genetic Factors in Eating Disorders," in Handbook of Eating Disorders: Theory, Treamtent and Research, Eds. George Smukler, Chrk Dare and Janet Treasure, New York: John Wiley & Sons, Inc., 1995,65. ss-Treasureand Holland, 67-69. ao.Kathryn J- Zerbe, The Body Betrayed: Women, Eating Disorders, and Treatment. Washington, DC: American Psychiatric Press, Inc., 1993,283- 61Bid. 6rI5id. ad-KG. Hsu, Eating Disorders, New York: Guilford, 1990,91, 64. ES. Paykel, " Preface," in Handbook of Affective Disorders, Ed. ES, Paykel, New York: GuiIford Press, 1982, 1. 6s. JI. Numberger and E.S. Gershon, "Genetics," in Handbook of Affective Disorders, Ed. E.S. Paykel, New York: Guilford Press, 1982, 133.- asBordo, 49. a-iMalson, 8 1. 68Bid. asMaison, 82, 7oKathleen M-Pike, Katharine Loeb, and Kelly Vitousek, "Cognitive-Behavioral Therapy for Anorexia Nervosa and Bulirnia Nervosa," in Body Image, Eating Disorders, and Obesity, Ed. J, Kevin Thompson, Washington, DC: American Psychologicai Association, 1996, 254. 719ike et al., 254-255. ribfalson, 82. 7s.Salvador Minuchin, Bernice L. Rosman and Lester Baker, Psychosomatic Families: Anorexia Nervosa in Context, Cambridge Massachusetts: Harvard University Press, 1978, 18. 74.Pike et al, 255. 7sMinuchin et ai., 115. 76Minuchin et al., 85. nPike et aI., 255, 7sPike et al., 256. 7gMalson, 83. ao. discussed in Zerbe, 160. mAnn Kearney-Cooke and Ruth Striegel-Moore, "The EtioIogy and Treatment of Body Image Disturbance," in Handbookfor Treatment For Earing Disorders 2"" Ed., Eds., David M. Garner and Paul E- Garfinkel, New York and London: the Guilford Press, 1997,296 & 305, szdiscussed in Malson, 83- s3.Susan Bordo, Unbearable Weight: Feminism, Western Culture, and the Body, Berkeley: University of California Press, 1993,55-56- wBordo, 56- ssMalson, 84, sslbid. m-Ibid. asMinuchin et al,, 59-60. ssMalson, 84-85, mMaison, 85, gtMaison, 87, dacSween, 39- 93MacS ween, 4 1- wBord0,45. ssHepworth, 66. %Hepworth, 88. 979at Hartley, "SeIf-help Groups for People with Eating Disorders: 1s There a Place for Men?" in Why Women? Gender Issues and Eating Disorders, New Edition, Eds., Bridget Dolan and Inez Gitizinger, London: the Athlone Press, 1994, 120. gsHartIey, 120-12 1- 99.quoted in Hartiey, 121. ioo. Rachel Bryant-Waugh, "Anorexia Nervosa in Boys," in Why Women? Gender Issues and Eating Disorders, New Edition, Eds., Bridget Doian and Inez Gitizinger, London: the Athlone Press, 1994, 126. ioi. Ibid. ior I. Kevin Thompson, "Introduction: Body Image, Eating Disorders, and Obesi ty - An Emerging Synthesis," in Body Image, Earing Disorders, and Obesiw An Integrative Guide For Assessrnent and TreaLment, Ed., J Kevin Thompson, Washington, DC: American Psychological Association- 1996. io3Borcio,49-50. 104-Turner,214. iosFor a discussion on young women's involvement in shaping contemporary constnictions see Arnira Proweller, Constructing Female identities: Meaning Making in Upper Middle Class Youth Culture, Albany: State University of New York Press, 1998. losMatra Robertson, Staniing in the Silences: An Exploration of Anorexia Nervosa, New York: New York University Press, 1992, xii- icnBecky Thcmpson, A Hunger So Wide and Su Deep: A Multiracial View of Wornen's Euring Disorders, Minnesota: Minnesota University Press, 1994, 14. ~os.TomasI. Silber, "Anorexia Nervosa in Blacks and Hispanics," International Journal of Eating Disorders 5(1): 125. ioxquoted in Silber, 124. i ioThompson, 12, 1 i Maria P.P. Root, "Disordered Eating in Women of Color," Sex Roles 22(7/8) 1990: 53 1.: i izThompson, 14-15. I 13-Thompson, 14. i rslbid. i rslbid. I dbid. Cvasping ut the Body, Quiet and Firm Feminist lnterpretations of 'Anorexia Nervosa'

In 1968, Naomi Weisstein published the article "Psychoiogy Constructs the Fernale or the Fantasy Life of the Male Psychologist (With Sorrie Attention to the Fantasies of His Fnends the Male Biologist and the MaIe

Anthropologist)" which radically critiqued the androcentric bias in psychology,' Weisstein argued that psychology, as it was then, and biology were useless in attempting to describe women. The social conditions and social expectations that women faced as women needed to be exarnined in order to understand and exphin the behaviour of wornen.' The critique of the psy-disciplines initially came from within the anti-psychiatry rnovement of the

1950s and 1960s. The wrïtings of Thomas Szasz chailenged the psy-order and showed the politid underpinnings of the psy-disciplines, However, in reference to 'anorexia nervosa,' the strongest criticisrn has been from ferninist writers concerned with the reductionist individual approach of psychology and psychiatry. How feminism has traditiondly viewed 'anorexia nervosa' has largely been shaped by Kim Chemin, Susie Orbach, and Susan Bordo.

Their works make up a substantial portion of the 'classic' feminist literature on 'anorexia nervosa'. Bordo has included in her work criticisrn of postmodemist theory and has chdlenged its usefulness in understanding 'anorexia nervosa', which makes her work of particular interest.

The disenchantment with psychological explanations came from within the psy-disciplines with the anti- psychiatry movement. However, before this movement women were using autobiographical novels and poerns to describe their experiences within psychiatric institutions as metaphoricai of their place in society, Therefore, while

the anti-psychiatry movement would occur in the 1960s and be atûibuted to men, women had already begun

questioning the nature of psychiatry and its ueatment of women.

In 1964, Aaron Esterson and R.D. Laing published Saniry, Madness, and the Family, in which they

determined that schizophrenia was not an organic disease but a social process wherein the 'illness' was a response

to farnily patterns? According to Esterson and Laing, the 'illness' was not rooted in individuai pathology but

familial pathology. Laing's colleague, David Cooper, gave 'anti-psychiatry' its name and defined the principles of

the movement- Cooper ''connected it [ad-psychiauy] with an attack on psychiatric power in institutions, on the

hierarchical authority structure of the doctor-patient relationship, on psychosurgery and shock treatment,"'

However, the criticism of psychiatry was not gender specific and the discourse of the 'new' movement did not

chalIenge the gender bias in the diagnosis of specific 'iilnesses'.

Feminist writers recognized the failure of the anti-psychiatry movement and took the conceptuai strategy

offered by the movement to analyze women's relationship to the psy-disciplines. As Simone de Beauvoir stated:

"At the bottom of anti-psychiatry is still psychiatry. And it doesn't really address itself to women's problerns."s

Thus women confronting psy-disciplined based theones were doing so using the basic tenets of a movement that

was firmly rooted in the exact theones they wished to challenge. Women wrote of the symbolic nature of

psychosurgery and invasive treatments as a means to punish women for rejection of domesticity, intellectual

aspirations, and sexual independence? However, these texts were not feminist protests against the use of the

treatments but, rather, they were "guilt-ridden accounts of institutionalization as a punishment for transgressing the codes of ferninine behaviour, docility, and affection."' Nonetheless they show that women recognized that the treatment they received was less for psychiatric deviance and more directly focused on the perceived social deviance.

Thomas Szasz, a psychiatrist who was part of the anti-psychiatry movement, questioned whether or not

'mental illness' existed at a11.8 Szasz concluded that 'mental illness' is a myth and 'insanity' was actually a social probiem but rendered an 'illness' in order to Iegitimate the authority of the medical profession. Like the women who wrote novels and poetry, Szasz Iinked social deviance and 'mental illness' insofar as to Say that people are declared to be 'insane' because they challenge and break society's rules. The diagnostic criteria and the frameworks

of 'mental illnesses' are used to blame the individual and pass moral judgement? Szasz, while challenging the

existence of the very category of 'mental illness', did not confront the gender bias in the psy-disciplines, diagnostic

criteria, or treatment until much later. Again, iike others in the anti-psychiatry movement, Szasz created a platform

that feminists could use in the criticism of the gender bias in the psy-disciplines.

In discussing Stephen Trombley's critical work on the idsanity of Virginia Woolf, Szasz made an

important point about 'anorexia nervosa'. Szasz's criticism of Trornbley's understanding of 'anorexia nervosa' couId be applied to any work that maintains voIuntary self-starvation as a psychiatrie 'illness'. He writes, "we cal1 self-starvation, 'anorexia nervosa', a hunger strike, a suicide attempt, or some other narne, depending on how we want to re~pond..,"'~The discursive construction of voluntary seIf-starvation, in any form, is always informed by how society wants to acknowtedge it. This point destabilizes every psy-disciplined and ferninist rheory OF 'anorexia nervosa' that does not recognize the politics of 'anorexia nervosa,' its diagnostic criteria, and the outcome of the implied or explicitly stated treatrnent. Even the dominance of the treatment of 'anorexia nervosa' by medical professionals is political in that the maintenance of 'anorexia nervosa' as a bio-medical psychological affliction obscures social, economic, and political components of voluntary self-starvation. The medical society's unchallenged claim of 'mental illnesses' in general, and 'anorexia nervosa' in particular, is based in a physiological aetiology that claims a difference but interrelationship between the mind and the body." The classic feminist texts on 'anorexia nervosa' from the 1980s remain focused on medical mode1 explanations but incorporate the probiems with the gender bias in psy-based treatment and feminist theoretical perspectives such as patriarchy and control.

Classic feminist texts, for the most part, are those published in the 1980s and early 1990s that, for the first tirne, brought feminist discourse and perspectives to discussions of 'eating disorders' and 'anorexia nervosa.' The major works discussed here are: Kim Chemin's The Hungry Se& Women, Earing. and idenrity, Susie Orbach's

Hunger Srnke: the Anorecric's Struggle as a Metaphor for Our Age, and Susan Bordo's Unbearable Weight:

Ferninism, Western Culture and the Body." With the exception of Susan Bordo, who uses postmodem tools cxitically and suspiciously, the works are wntten ffom a radical feminist theoretical perspective in which 'anorexia nervosa' is discussed as "an issue of women's position in a patriarchal cult~re."'~There are, of course, numerous other important works on 'anorexia nervosa', some of which will be discussed, tfiat use these works as their

foundation. These are: H-et Fraad's "Anorexia Nervosa: The Fernale Body as a Site of Gender and Class

Transition," and "Anorexia as Crisis Ernbodied: A Marxist-Feminist Analysis of the Household," Morag

MacSween's Anorexk Bodies: A Feminist and Sociological Perspective on Anorexia Nervosa and Eva Szekely's

Never Too Thin-'' From this smalI sarnpIing of the ever-growing body of feminist andysis of voluntary self-

starvation a distinct sense of feminist explanations can be discemed.

Kim Chernin: The Hungry Self

In The Hungry Self, Chernin explores three themes necessary in understanding and 'de-coding' 'eating

disorders', These themes are: the meaning of a "troubled relationship with food," the "profound rnother/daughter separation struggle," and "unresolved developmental issues". For Chemin, these can explain the difficult relationship wornen have to food and can"unravel" women from their past~.'~Women's reIationship to food, therefore, is symbolic of a problematic motherldaughter relationship that needs to be explored in addition to unresolved developrnental issues (which again implicate a problematic rnother/daughter relationship) around food.

Chemin argues that the 'epidemic' of 'eating disorders' cm be directly associated with identity and the creation of an identity in a modem world. The 'anorexic' uses food to hide social difficulties she faces in a time where, Chernin argues, women are challenging traditional notions of Femininity and womanhood and "stepping out' into the world, Chemin asserts that social and political barriers have been removed and that wornen have the social and psychological freedom that no other generation of women has had.I6 Not only do these assumptions deny and yet again obscure the cornplexity of wornen's history but it assumes that wornen in the 1980s were the first generation of women to enter into the work world and escape the lirnited choices of the private sphere.

The prirnary thesis of The Hungry Selfis that 'anorexia nervosa' is an identity crisis where women are confused by the meaning of female liberation and have developmental difficulties as a result. In the section on

"Identity" Chernin uses Betty Friedan's The Ferninine Mystique as a fmework in explaining her own understanding of 'eating disorders.' 'The problem that has no narne' has undergone a metamorphoses in which the problem that was based in sexuai difference has, for the modem 'anorexic,' become a problem of identity. The self-destruction of 'anorexia nervosa' is therefore in response to the struggle against the ferninine mystique and, as a result of the confusion of the second-wave femÏnistmovement, women are now left baffled at the prospect of

womanhood."

Chemin makes a brief gesture at understanding 'anorexia nervosa' as language through which women

communicate with their bodies their frustrations and concems. However, this conceptualization is stilI grounded in

the ideoiogy of psy-disciplines and the concept of 'anorexia nervosa' as an individual psychologicd fiaw but in this case emptiness, feelings of loss, restlessness, confusion, and dissatisfaction result from a fundamental developmental crisis.'' An 'eating disorder' momentarily fieezes life and bnngs to end development in such a way that a woman retreats from basic aspects of social life and instead focuses on food issue^.'^ So eating is the outward sign of a woman overwhelmed and unable to undenake the roles offered by modem life which occur because of an essential developmental flaw. Chemin writes,

[elating disorders express our uncertainties, our buried anguish, our unconfessed confusion of identity. So far, in our stmggle for liberation, we have become women dressed in male attire and not yet, by any means, women clothed in the full potential of female being."

This culturally imposed resistance to being fernale is the problem with creating and maintaining a female identity and the disguise is a preoccupation with eating, food, and exercise." However, this is caused in women by a developmental cnsis that is based in a struggle between mothers and daughters.

The basic asumption that Chemin understands to be at the root of the mother/daughter conflict is that the daughter, who has a lifetime of opportunity because of the political and social gains made by the second wave is in stark contrast to the unfulfilled life of the mother. Daughters feel guilt at the possibility of surpassing their mothers.

Even the irnaginary is a source of the conflict between mothers and daughters. Chernin argues that daughters carry with them images of women role-models that their mothers did not have. The conflicting images between these role-models and their rnothers causes 'food issues.' Women of their mother's generation Iacked role-models and therefore were lirnited in development. For a woman with food issues "the image of a fat mother hiding at home, a sacrifice CO an earlier generation's conception of worrianhood and appropriate fernale destiny" is the image that dominates."

Chemin asserts that women develop 'anorexia nervosa' as a way to ensure they do not surpass their mothers by attempting to stop development. Modern women feel an inability to develop and surpass their mothers because the feminist movement has slowed- As "she [the voluntq self-starver] is no longer fighting in the name of

al1 women, the wornan of today who responds to new sociai opportunities cannot seek from within herseIf the

sustaining sense that what she does with her life. as a woman, will implicitly and symbolically benefit her mother.""

The answer to this is to use a feminist analysis so that they can understand that the "broken drearns, failed promises,

the hardships and sacrifices" their mothers experienced were not individual expenences but rather the "fate" of al1

the women of her generation."

According to Chemin, the mother/daughter smggle is also spiked with resentment as the mother is angry

that she sacrificed her Iife for her daughter and was therefore doomed to iead a Iife unfuIfiIled as a stay-at-home

mother. As the daughter reaches adolescence and is preparing to enter the public realm that rejected her mother's

generation she fears her mother's envy and resentment," Therefore the daughter retreats from development and her

mother's envy and resentment through self-starvation. Male children do not have this experience because they do

not wish to challenge or contradict rnatemity because it benefits them whereas female children dread having to make

the sarne sacrifice their mothers made. Chemin argues that male and female children have oral aggression towards

the mother but the developrnent of female children is exceedingly diffîcult because she faces the possibility of

matemal sacrifice (sacrifices of exhaustion and depletion by infants) and, at the same time, daughters experience a

feeling of an overwhelming sense of guilt at her dread.'6 The daughter develops an 'eating disorder' in response to

the relationship with her mother. The

eating obsession cornes into existence so that the need, rage, and violence of the motheddaughter bond can be played out in a symbolic form that spares the mother. That is the basic idea we must grasp if we are to appreciate the reasons an eating obsession has such tenacious hold upon self-development."

Therefore voluntary self-starvation is a regression to stop development and reso1ve the motheddaughter conflict that arises when the mother's unfulfilled life conflicrs with the opportunities provided to her daughter.

In surn, Chemin States that a woman who voluntarily self-starves blames herself for frustrating her mother's life instead of recognizing the role of the patnarchd culture. 'Anorexia nervosa' is a means by which women can appropriate a male body and thereby escape the certain fate her mother experienced. Food is symbolic of the mother and the 'anorexic' associates food with the lack of ambition and shame of the rnother. Therefore refusing food is a symbolic transformation away from the mother.'* Critique of The Hringry Self

Chemin's work is problematic as it assumes a shared history of women and pathologizes the

mother/daughter relationship. Fist, Chemin recognizes that women of a11 ages can develop an eating disorder yet

she assumes rnothers are all from a specific era of oppression. This oppression Chernin sees as having been undone

by the second-wave that eradicated historicd oppressions so that modem women no longer face the sarne gender

challenges their mothers did. The assumption that mothers of 'anorexic's ' Iead an unfulfilled life is equally

difficult to believe. It wouId not be unreasonable to question the notion of fulfillment from previous em. How do

we measure fulfilIrnent? How do we measure the historical advancement of sornething so personai?

Chemin again assumes a rniddle-cIass bias by implicitly constructing the mother as a dutiful housewife in

the private sphere and the daughter as a wornan working in the public realm. The cIass and race neutral analysis that

Chemin attempts to put forth denies the history of wornen of colour and working class women. Women have always

worked and Chemin's assumption once again faIls prey to the middle-class bias of 'anorexia nervosa' and the

liberal and radical second-wave feminist movernents. In addition, even if Chemin's analysis pretends to be cIass-

neutral, rniddle-class women have had astonishing work experiences this century alone. Consider, for example, the

mass entrance of women from al1 classes into the work force during the First and Second World Wars. Even though the work during these periods of crisis by women were, for the most part, temporary they show that wornen, even

middle-class women to a lesser extent, have worked for a wage in the public sphere. Chemin assumes that women of al1 races and classes would not be fulfilled in the private sphere instead of recognizing that for some women it would be a luxury. For "it is the very fact that Young, educated, white Western women are in a specialized position both in terms of gender, 'race,' and class that access to the publidmaie sphere has become an issue for thern."'g

Chernin assumes that the private sphere is oppressive by construction, where the choice of deciding to enter the public sphere is a privilege. For working cIass women, or women of colour, not working has rarely been an option.

In addition, women who remained in the private sphere did work, it was jjut that their labour was not recognized as such. Chemin reinforces the capitalist bias of women's unpaid work as invaluable.

Both in historical and contemporary periods, Chemin refuses to recognize the multiplicity of women's oppression, insread she declares a second-wave feminist victory over patriarchy- In her work Chernin simplifies or ignores women's subordination in patnarchal society ideoIogically, politically and econornically. Chemin also does

not recognize the patriarchal control of women's bodies3' Further, the contradiction Chemin proposes of an

oppressive patnarchal society and an inherently deviant motherfdaughter relationship is difficult to understand.

Instead of recognizing women's oppression by patriarchal culture. society, and state she revers the explanauon

towards a pseudo-psychoanalytic theory of a faulty relationship between mother and daughter which, in turn,

reduces the problern to an individuai psychologicd flaw. Not onIy that, Chemin's thesis actually reaffirrns a.

individual flaw in that it does not explain why women do not develop 'eaung disorders.'

Susie Orbach Hunger Strike

In Hunger Srde, Susie Orbach attempts to combine aspects of social construction theory and psychologica1 theory in explaining 'anorexia nervosa'. Orbach argues that 'anorexia nervosa' is a Ianguage that

women use to protest the conditions of being female in a patriarchal culture where they are unabte to articulate their resistance. Regarding 'anorexia newosa' as a hunger strike opens the 'eating disorder' to the political sphere where

voluntary self-starvation cm be seen as active, and empowering.3' Upholding the dichotomy between a political hunger strike and 'anorexia nervosa' is to obscure the political nature of the 'anorexic's' protest and create a hierarchy amongst levels of protest. The 'anorexic's'

cause is no less irnperative than that of the overtly political hunger striker. The resolve of her cornmitment is equally intense. The political prisoner who ernbarks upon a hunger stnke does so to draw attention to the injustice of her or his incarceration and the righteousness of her or his cause. The anorectic woman on hunger strike echoes these themes. Her self-denial is in effect a protest against the rules that circumscribe a woman's life, a demand that she has an absolute right to exist."

The 'anorexic' therefore passively dernands to be seen and heard with the same means as the hunger striker. Self- starvation in both is intense as it draws attention to the injustice faced by the starver. Orbach argues that the protest is similar and the means of 'speaking' the sarne. What differentiates the 'anorexic' from the hunger striker is the cause of the seIf-starvation.

Part OF this socio-political cause is the rise of consumer society since Worid War II. Orbach argues that from the middle of the twentieth century onwards Western cultures have become consumer societies which has had a profound effect on femaie sexudity and the femaie body. Women's bodies are used to sel1 commercial products in such a way that sepamtes women from their own sexuality but associates women's bodies and sexuality with commodities and prod~ction?~As a result, wornen view their bodies as commodities, andor objectiQ their bodies

as commodities through which they negotiate with the society-" According to Orbach, women identify with their

bodies through cornparison of female images in popular culture and through early Iife experiences. The first means

of identification is the result of the consumer society that commodifies women's body and sexuality to sel1 products;

the second, Orbach argues, is the result of a shift in parenting in the Iast forty years.

Parenting styles have changed noticeably in the last seventy years as women who entered the work force

during the First and Second World Wars were forced back into the home or continued their work out of economic

necessity- Both situations, Orbach argues, were difficult. Women who re-entered the private sphere Iacked

economic independence that recreated a hierarchy based on waged work within the home?' Wornen's unpaid labour

was not seen as productive as housework and child-rearing was seen, by nature, as the woman's role. In the public

sphere, women faced issues of discrimination and were made to feel guilty as working mothers were accused of not

being good rnothers?" Orbach does, briefly, discuss the difference between white and black women's relationships

to work- The two basic differences Orbach illustrates are around the (white) ideological creation of the myth of the

black family and the blame black women faced. The stereotype that black wornen could handle work, child care,

and ,-d parenting were created not to show the suength of women but rather her ernasculation of the black man.

As a result the black woman was blarned for issues around unemployment, poverty, and the dissolution of the

traditionai family.37 Therefore the shift in parenting after the Second Worid War was not exclusive to white women.

This shift in 'parentirig* however is focused on mothering insofar as it relates to the development of 'anorexia

nervosa.'

Orbach upholds the notion of the rnother/daughter reiationship as a pnmary factor in the development of

'anorexia nervosa.' Mothers are soIeIy responsible for the gendering of children because "a mother directs her children's development in gender-appropriate ways, both at the Ievel of socialization and in terms of the formation of psychic structure."38 Orbach explicitly assumes that the mother has accepted her situation in the patnarchai culture and raises her daughter(s) to accept subordination. In addition, mothers create female children who cannot fully separate themselves psychologically as they do not encourage the femaie child's initiatives. These mothers are dso unable to provide "adequate or consistent gratification of early dependency need~."~~lndeed Orbach continues Chemin's line of reasoning by suggesting that mothers bring hostiIity to their relationships with female chiIdren in

that the mother rejects the daughter's dependency needs yet, at the sarne tirne, stifles her daughter's hopes for

autonomy. The daughter, therefore, becomes 'anorexic' to show the "ambivalent relationship to physical and

emotiond needs which she has learned from her mother.'* The father is conspicuously absent as if the father carries patriarchy but the mother passes it on.

Orbach believes that by adolescence young women have developed a psychology of femininity that is the framework for women's eating and body image issues. Young women who have successfully developed a ferninine role have come to meet three basic demands of the patnarchal society, These are: deference to others, anticipation and fulfillment of others' needs, and self-definition by connecting to others?' The cultural pressure of dieting and thinness are seen as a rite of passage into the teedadult world and as the answer to the flawed mother/daughter relationship and the psychology of femininity. The "psychic insecurity" from early development "is now addressed by the modem panacea - diet and contr01."~' Fear of desues, the constant relationship with and care of others, and the use of the femaie body and sexuaiity as a cornmodity are responded to with a controlled diet. The body is seen as something to be controlIed because young women have developed a separation between the mind and the body both as a result of the motherldaughter relationship and because of the contradictory images of bodies in popular cuIture.

Orbach, in her other work Fat Is a Feminist Issue, argued that the diet and advertising industries were strategic in their focus on continually smaller femde bodies?' The push for women to diet and the increasingly smalIer public images of women occurred at the exact moment when second-wave feminists were dernanding public space. These industries responded by shifung the focus from women's rights to women's bodies. In Hunger

Strike Orbach reiterates this point in explainhg the symbolic nature of slenderness. Thinness crosses age and race as it is an "expression of rnisogynist tendencies", an attack on the female body itself, and exueme thinness is an escape from real life and a badge of honour.* For some middle-class women 'anorexia nervosa' is a means to resist the image of the lnzy, middle-class housewife Orbach assumes they have as mothers. Nonetheless, Orbach understands 'anorexia nervosa' as a representation of the body where the woman purposefully attempts to contest traditional ideas about women, thinness, and fe~nininity."~The 'anorexic' woman is overly sensitive to cultural messages because she hears them louder than 'normal' women. The exaggerated response is a result of the

"enormous receptivity to culturdly sanctioned messages about physical femininity."46 These women respond through voluntary self-starvation because they have a particularly fragile inner self that they feel they need to hide.

As early dependency needs were not met the continued separation expected during adolescence does not occur smoothly. According to Orbach, this combined with the necessity to hide a flawed inner self creates 'anorexia nervosa.'

Critique of Hunger Srrike

Hunger Srrike is an exuemely important work as it began the discussion of 'anorexia nervosa' as a political protest and made attempts to show similarities between political hunger strikes and 'eating disorders.' The ferninist analysis of culture, production, and the commodification of wornen's bodies is an important break from the anaiysis of 'anorexia nervosa' as individual pathology. However, Orbach does not make any attempt to break from most of the psy-disciplined theories of 'anorexia nervosa' and instead adds a feminist dimension to the study." This is immediately apparent in her continual and unproblematized use of the tems 'anorexia nervosa' and 'eating disorder.' More importantIy, in this situation. is her reinforcement of the pathologizatiori of the motheddaughter rehtionship.

While Orbach understands voluntarily seif-starving women as entenng into a hunger strïke similar to political prisoners, this is tempered by the fact that Orbach assumes a flawed psychologicai nature that Ieads to

'anorexia nervosa.' For as much as Orbach challenges the false dichotomy between politicaI hunger strikes and

'anorexia nervosa', she continues its existence through her analysis of the motherfdaughter relationship and the psychology of femininity. Orbach does not recognize the interrelationship of poIitics and psychology in both acts of voluntary seIf-starvation. Instead she chooses to recognize and emphasize the poIitical nature of hunger strikes and the psychoIogicai nature of 'anorexia nervosa.'

Orbach denies women's self-construction and continually insists that women onIy identify with external sources. While this is far better than previous biologïcally detemiined arguments, it remains that women cannot and do not negotiate and filter the messages they receive. The idea that 'anorexic' women receive and take in cultural messages to a greater degree than other women reaffiims the idea that 'anorexic' women cannot negotiate and recognize depding cultural signds- Therefore 'anorexie' women are seen as somehow without political or social consciousness and unable to be both voluntary self-starvers and ferninists.

Like Chemin, Orbach continues the motheddaughter relationship as an essential psychological fault in the development of 'anorexia nervosa,' Again the pathologization of female familial reiationships is racked with difficulties if the îheonst is attempting a feminist analysis. While Orbach does mention women of colour and working-class women, she does not challenge the middle-class assumptions in her description of the motheddaughter relationship. It is implied that her 'mothers' are wornen who do not work for a wage and who have a wage-earning male partner (aithough fathers are never implicated in the dysfunctional parenting in early development that result in 'eating disorders'). Orbach places al1 women into a traditional femaie role denying the very second-wave feminism she supports. The assumption is that the mother/daughter relationship is dysfunctiond when the rnother does not work and has no feminist consciousnessl Even the idea that women develop a female psychology is based in unprobIematized essentialism that reduces women to a position of 'other' while maintaining men as the standard. The nom in psychology is the male stereotype against which the stereotypicai femaie behaviours are measured. Therefore, it seems that only female psychology is a social construction that is consistently compared to an unproblematized masculine nom.&

Orbach, &ter analyzing social causes of 'anorexia nervosa,' stiIl reduces it to an individual pathology in her recommendation of individu& therapy. While she does suggest that greater social and political actions are necessary to improve the sociai feelings and representations of femininity, these actions are presented as secondary to the individuai woman accepting the needs of her body and examining the difficulties in early de~eloprnent.~~

Orbach also continues a biologicalIy deterministic and essentialist argument by discussing women's 'naturai' hunger and 'natud' connection to their bodies as well as their 'natural' inner self. The naturalness of women's bodies and connection with them then negates differences amongst women and allows wornen who do not fit the tight restrictive category of 'normal' to be dedared deviant and pathological. This obscures the fact that Western culture is phallocentric and the differences between men's and wornen's connections to their bodies are constructed as such because of patriarchal society. The reduction of women's bodies and their actions to 'nature' is embedded within the dichotomy that asserts that men have bodies but women are bodies. Susan Bordo Unbeurable Weight

In Unbeurable Weighr, Susan Bordo details a comprehensive and complex understanding of the social, political, and psychological underpinnings of 'anorexia nervosa7, Bordo7swork is an exuemely valuable contribution to the body of Iiterature on self-starvation as she makes numerous links between society's attitude towards women's bodies in Western culture and the developrnent of 'eating disorders'. By impIicating the advertising, media, political issues of reproduction, and ferninism, Bordo effectively dismpts the 'anorexie'/ 'non- anorexic' dichotomy. Bordo challenges the construction of 'anorexia nervosa' but yet still associates the development of it with psychological disharmony in the individuai-

Bordo uses postrnodern thought in her expIanation and theoretical framework of 'anorexia nervosa'.

However, she tempers her use of the tooIs of posunodernism with a critique of its limitations. Bordo argues that with its disembodied existence and rejection of location, postmodemist theory can be counter-productive although the tools of postmodernism - heterogeneity, discontinuity, displacement, and destabilization, can be applied to "real elements of contemporary e~perience."~~In the essay "Feminism, Postmodernism, and Gender-Skepticism," which has been interpreted as an attack on postmodernist feminism, Bordo confronts postmodemist thought and its rejection of materiality?' For Bordo, mareriaiity should be the point of departure and not the primary theoretical concern. Underlying her use of Foucault, and poststnicturdist theory in general, is that the body is produced through interrelated practices and experiences that are not exclusively discursive. Rather, Bordo focuses on

"practical, historical, [and] insututional reverberations" in addition to Ianguage. Bordo insists on contextualization of discussion in an attempt to reject what she calls postmodemist philosophy's 'dream of everywhere-"" The lack of contextualization, the 'dream of being everywhere', is one of postmodemism's theoretical flaws. Bordo argues that the body be situated in a defense against postmodemism's "'stylish nihiIismWTthat treats the body as a pure te~t.~~Women should use the authonty of their experiences from theu locations to provide a critical discourse that speaks to the multitude of our experiences."

In Unbearab!e Weight Bordo argues that 'anorexia nervosa' is part of a continuum on which women are placed in relation to weight, eating, and exercise. This placement is a result of Western culture's fascination with the female body exposed through media advertising and cultural constructions. The subtitle of Bordo's chapter on 'anorexia nervosa' succinctly describes her theory - "Anorexia Nervosa: Psychopathology as the Crystallization of

Cuiture." Bordo argues that the ferninist/cultural paradigm has problematized notions of psychopatholo~in the cause of voluntary self-starvation, Instead, this paradigrn has included sociological, cultural, and political factors to show how aspects of 'eating disorders' are comrnon among women in Western cu~ture.'~Women who develop

'anorexia nervosa' are on the same continuum as women who do not in that there is a pervasive ideology around thinness and hunger restraint. Western culture creates women who control their bodies through restricting food and who largely rnisperceive the size of their bodies. 'Anorexia nervosa,' then, is not an individual pathology but, rather, an exaggeration of current cultural 'noms.' This cultural bilIness' (Le, 'anorexia nervosa') refIects and cdls attention to social 'ills' such as "our historical heritage of disdain for the body, to our modern fear of loss of control over our future, to the disquieting meaning of contemporary beauty ide& in an era of greater female presence and power than ever bef~re."'~

Bordo groups 'hysteria,' 'anorexia nervosa,' and 'agoraphobia' under the rubric of "pathologies of female protest" wherein these women exaggerate expected cultural noms of fernininity. However, Bordo rebuffs the idea of these 'pathologies' 3s representative of a political consciousness or political resistance. She writes,

But we must recognize that the anorectic's protest, like that of the classical hystencal symptom, is written on the bodies of anorexic women, not embraced as a conscious politics - nor, indeed, does it reflect any social or political understanding at all. More- over, the symptoms themselves function to preclude the ernergence of such an understanding. The idée fixé - staying thin - becomes at its farthest extrerne so powerful as to render any other ideas or life-projects rneaningless."

Accorciingly, 'anorexia nervosa' is an unconscious protest written on a body of the wornan that can only be interpreted by others with a socid or political consciousness. Thinness is the goal of the voluntary self-starvermd any statement made by her body is not a conscious one. Bordo argues that it is impossible to see 'anorexia nervosa' as a feminist protest as it is counterproductive. The time and energy necessary to pursue thinness, according to

Bordo, cornes at the expense of "inner developrnent and social a~hievement."~'So while the 'anorexic' body makes a statement for those privileged enough to have the power to interpret it, the 'anorexic' lacks 'inner developrnent' as a result of her focus on thinness and diet to constmct her own meaning. To assume that the 'anorexic' protest is counter-productive, and that 'anorexic' women do not have the social consciousness to interpret their own experïences silences both the body and the voice of the voluntarily self-starving woman. Bordo identifies three axes of continuity where cultural currents intersect in 'anorexia nervosa' and where

"its farnily resernblances and connections with other phenomena emerge-"59 These axes are: the dualist ais, the

control axis, and the gendedpower axis. With each of these Bordo attempts to combine historical and philosophical

aspects of Western culture and connect thern with the body of the 'anorexic.' The dualist axis is based on the

Cartesian mindhody duality wherein the body is alienated, experienced as a Iiability, and viewed as an enemy,

Bordo attributes these interpretations of the experience of the body to Plato, Augustine, and Descartes who, in

Western culture, created a hostility toward the body where the absolute goal was (and indeed still is) to Iive without the body.m The 'anorexic' who denies her hunger and food desires embodies these philosophical anitudes by creating an emaciated body, thus representing a uiumph over it, The control axis shows the powerlessness of

'anorexics' who find secunty, control, and independence in food restriction. Diet becomes a means of control because contemporary culture is viewed as sornething that cannot be controlled. Therefore, control over the body fulfills a need for order that an increasingly disorderly society cannot provide. For the 'anorexic' her life and feelings of hunger are perceived as being out of control after the individual has felt the superb and publically acknowledged feelings of conuoI and accomplishment after a period of weight 10~s.~'To regain these feelings extreme dieting must continue. The gendedpower axis recognizes that the body image distortion that is seen as pathological in the 'anorexic' is continuous with cornmon fèrnde misperceptions about their bodies. The fact that ninety percent of people diagnosed with 'anorexia nervosa' are female shows that the 'disorder' is not gender neutral and may in fact be a continuation of 'normal' female behaviour, For Bordo, gender and power are interrelated on two Ievels. Bordo believes that there is a "fear and disdain for traditional femaie roles and social limitations" and "a deep fear of 'the Fernale,' with al1 its more nightrnarish archetypal associations of voracious hungers and sexual in~atiability."~' The fernale body then is perceived as 'in excess' both in historical and contemporary Western societies.

The 'unbearable weight' is fien the pressures of Western culture, the fear of fat, the disgust of al1 that is not sleek and smooth. This new 'unbearable weight' has mots in centuries of intellectual thought that attempted to provide means to transcend the body or to project this 'weight' ont0 genders, races, classes of less social pri~iIege.6~

The body which mediates culture and society becomes in regards to 'anorexia nervosa' a voice that speaks of the cultural pathologies of the body in conternporary s~ciety.~

Critique of Unbearable Weight

Susan Bordo's work represents an incredible advance in the Iiterature on 'anorexia nervosa,' The thought-

provoking analysis of Western cultural media messages provides a new levef of analysis to the discussion on

vohntary self-starvation- Situating 'anorexia nervosa' in Western society, culture, and politics in an atternpt to

create a political discourse on the body is a quantum leap from the arguments that presume an individual pathology.

Bordo's criticism of psy-disciplined treaunents is interesting if somewhat contradictory as the terminology from

medicai discourse is continuaily used in an unproblernatized fashion. In addition, instead of rejecting facets of the

medicai model, and their arbitrary creation, Bordo simply extends the symptoms to the entire Western fernale

population- The difficulty with this is that it alIows no explanation for wornen's recognition of their oppression and

their conscious resistance to cultural messages.

Like most ferninist work on 'anorexia nervosa' Bordo continues to use the medical discourse with no

recognition of the problem with the language. While it is almost impossible to fully escape using rnedicai rnodel

language as it is ingrained in society, the hidden assumptions and historical baggage of the terms and their relations

to the medical paradigm need to be explored. Above all, the medicd model language should be used with extrerne

care - a point that Bordo neglects completely. Generaily, feminist interpretations of voluntary self~starvationhave

not challenged the use of 'anorexia nervosa' nor have they "altered the understanding of severe fasting amongst

young women as a 'sickness' or an 'epiderni~'.~This statement is particulary applicable to Bordo's work as, in

Unbearable Weighr. Bordo continues to use medicai model language, and indeed aspects of the inedical model

itself, and simply re-negotiates the causes of 'anorexia nervosa.' This type of explanation allows only one rnega-

theory that attempts to explain voluntary self-starvation in a single way. By doing this differences amongst self-

starvers are rendered invisible (Le. race, class, sexuality, religion) as is their resistance to cultural noms-

Bordo's discussion of 'anorexia nervosa' is insightful in that it brings cultural, social, and political aspects to the medical model discourse. However, Bordo's rephcement of voluntary self-starvation as a 'cultural disease' as opposed to a 'mental disease' does not address the concern about whether 'anorexia nervosa' is st 'disease' at ail-

Sirnply addressing cultural concerns shifts the focus from individual psychopathoIogy to cultural pathology and once again renders the actual lived experiences of self-starvers invisible- WhiIe Bordo does use other theorists'

interviews with self-starvers, most notably Hilde Bruch, these do not bring the body nor the experiences of women

into view. Unbeurable Weight does not include an analysis of how experiences of the body rnight differ for

different women; nther Bordo assumes that, "almost al1 women - regardIess of age, race, or ethnicity - are

suffering from varying degrees of this cultural di~order."~~This lack of recognition of difference in women's

experiences with/in their bodies is striking given Bordo's insistence that theory be socially and culcurally situated.

Do dlwomen by virtue that they have female bodies expenence the body in the sarne way? The focus on a

homogeneous Western culture denies the cultural diversity and the many sub-cultures in what is actually a remarkably heterogeneous culture. Social class has disappeared from Bordo's work completely.

The view of Western culture as homogeneous negates the possibility of resistance to hegemonic values and cultures. To proclaim rhat al1 women suffer from a "cultural disorder" is to assume that al1 women accept the negative images and presentations of their bodies. Arguing that women cannot discriminate between images and resist them is to argue that women blindly accept the ideals of Western culture. Bordo "does not consider the extent to which adolescent girls and adult women engage in resistance to cultural beauty ide al^."^' In presenting such an argument in connection with 'anorexia nenosa' Bordo disallows wornen's interpretations of their bodies, actions, and symbolisrn,

Bordo's presumption that 'anorexic' women have no poIiticaI or social conscience in relation to their act of self-starvation, and her assumption that the goal is thinness and that goal is 'counterproductive', is to preclude any discovery of a political or social consciousness. It also assumes that the body cm be brought into politics but only as a stable, static object of inquiry and not as a site of political inquiry. Not seeing political aspects renders them invisible, and leads to an over-emphasis of pathology in the discourse on 'anorexia nervosa.' To assume the goal is thinness is to appropriate and disperse the 'voice' of the 'anorexic' woman in favour of interpretation from others.

Thinness may be the outward pursuit; that is, the one we see and interpret. It may, however, be secondary, or not rank at dl, for the woman. To argue for the 'anorexic' is entirely different than arguing from that exact position.

Bordo maintains that the theorist (her) can interpret the syrnbo2ism of the 'anorexie's' body (other) in broad theoretical terms. To discount and disarm the physical 'voice' of the self-starving wornan is to appropriate her body and argue that the theoretically trained cm examine and expiain the symbolisrn of the 'anorexic' body, The

voluntary self-starver is no longer the 'expert' on her own body. 1s it surprising that control is an issue amongst

voluntq self-starvers?

Harriet Fraad Anoraia Nervosa: The Fernale Body as a Site of Gender and Class Transition

Harn'et Fraad argues that 'anorexia nervosa' is a rneans by which women negotiate the class and gender

transitions of the modern period. The current 'epidemic' of voluncary self-starvation is a result of revolutionary

class and gender transitions that are played out on women's bodies6' For Fraad, it is a 'disease,' a rebellion, a

desire for control and autonomy, and a result of women's alienation from their own bodies. The eclectic mix of

explanations Fraad presents is a result of her understanding of the human body. Since the body, for Fraad, is a

combination of biology, ideoIogy, politics, economics, and "unconscious forces," 'anorexia nervosa' factors in each

of these sub-sections. For 'anorexia nervosa' to develop certain gender, political, socid, psychological, economic,

cIass, and racial conditions must be present. The combination of these factors at the specific historical moment

when class and gender are in transition, and where contradictory messages bombard wornen, creates 'anorexia

nervosa.'

Fraad identifies a specific 'type' of woman who is likely to develop 'anorexia nervosa.' Women who develop 'anorexia nervosa' have sufficient food supplies so food has symbolic importance instead of just a

necessity of survivai. In addition, Fraad argues,

anorexia strikes women preparing to become 'modem wornen,' moving out of the uaditionaI female household gender roles, young high-school students, usually arnbitious excellent students; college-age women facing a changed female envir6n- ment at college; women entering professions or competing in what were once male professional spheres; and older women returning ro school or the job market. Anorexia often afflicts women with ambitious educational plans or accomp~ishrnents.~~

'Anorexia nervosa,' therefore, emerges to act out the contradictions between traditional roles and 'new' roles in the household and the marketplace. The 'attack' of 'anorexia nervosa' on a specific class of women who are for the first tirne entenng into untraditional areas, professions, or patnarchai structures is used to 'discover' why the current

'epidemic' of 'anorexia nervosa' is occumng.

Fraad believes that women are besieged by gender roles which alienate them from their bodies as they are taught to view their bodies as if they were male spectator~.'~Objectified by Western culture, themselves and the media, women rebel against their flesh for a number of reasons- Fraad argues that fat is seen as a failure as a result

of the social pressures of thinness and that 'anorexia nervosa' may be an attempt to meet these culturai standards.

However, women's bodies are so symbolic of food and nurturïng that the 'anorexic' body may rebel against

depnving itself of femalc physical characteristics (breasts, hips) and reproductive functions (represented by

menstruation)?' 'Anorexia nervosa' may also be a rebellion against the dangerous gender politics whereby women

are socially controlIed through rape, violence, pomography, incest, and the restriction of abortion and birth control.

These patriarchal social controls make women's bodies dangerous places to Live. Therefore the 'anorexic' actively

attempts to escape from the dangers of her body.

The social sexual controls exhibited in a patriarchal culture over women's bodies are part of what Fraad

identifies as the social and political contexts that help create 'anorexia nervosa.' Under this category Fraad

appropriates Orbach's use of the hunger strike in an atternpt to explain women's rebeIlion against "this culture's

push [of wornen] into a predatory pubIic sphere."" The 'push from the household' that Fraad describes has

occurred without the necessary social and politicai supports to facilitate such demands. Conversely, the ideology of

individuaiism has created women as 'other;' that is, needy and dependent. Therefore, self-starvation is a rebellion

against being pushed into the public sphere while at the same time solely associated with the private realm.

Regarding psychological pre-conditions for 'anorexia nervosa', Fraad closely follows Orbach's theory of a

Freudian based flawed motherfdaughter dynarnic. As fernale children are not offered the same opportunity to

'separate' from their mothers that male children are afforded this results in a number of psychoIogicaI afflictions.

As a result, daughters feel more intensely their mothers suffering of loss of subjectivity and agen~y.7~'Anorexia nervosa' results from feelings of guilt whereby the daughter feels guilt over being the cause of her rnother's suffering. In addition, 'anorexic' daughters fear that their mothers will not sunive separation if they become in de pend en^'^

Economically women remain in a secondary position in jobs and eamings. Women are still primarily responsible for child-care and women are more likely to be working in part-time, low paying positions that offer few if any benefits. This combination means single women with children are far more likely to be living in poverty than women with partners. As a result of this, Fraad argues that "women's attnctiveness, defined in terms of slenderness, becornes an economic condition of female e~istence."~~This combined with the billion-dollar a year

industries of dieting and advertising convince women that slenderness and beauty are precursors to economic success or, in fact are part of it,

'Anorexia nervosa' is a means whereby women can avoid the class systems in the public and private spheres which seek to denipte women. Fraad begins with the assumption that most 'anorexies' are products of traditional nuclear families with a wage-earning father who supports a dependent mother and her children.

However, Fraad recognizes the increasing 'double-burden' on women where they are expected to take on wage- earning work in addition to their work in the private sphere. For the 'anorexic' this implies that wonen are creating themseives to be syrnbolically fed to other~.'~ Frorn this position the 'anorexic' protests against "being trapped in two untenable, contradictory, capitalist and non-capitdist class position^."^

in a later edition of her essay, Fraad corrects her oversight of racial conditions in her previous work. Fraad argues that racisrn combined with other social processes creating a social situation where women of colour are becoming 'anorexic'. The Reagan-Bush administration, and its overt racisrn, disintegrated what was left of the organized, public civil rights rnovernent. In addition, the modem period hcis increased the number of roles that women of colour are expected to take on. Fraad recognizes that many wornen of colour have never experienced the pleasure of not having to work in the public For women of colour the double-burden was not new.

However, Fraad argues that with the "small new window of opportunity" for economic success wornen of colour are now under greater pressure to provide a higher standard of living for themselves and their families. Again, educated wornen are more likely to deveIop 'anorexia nervosa' regardless of their race. The women of colour that have

'anorexia nervosa,' Fraad argues, are most likely to be women "who aspire to professional suc ces^."^^

In sum, Fraad views 'anorexia nervosa' as a means for women to negotiate the contradictions of class and gender in a transition period. The contradictions between gender, political, social, psychologicaI, economic, class, and racial constructions create a confusing matrix which women have tc carefully negotiate. 'Anorexia nervosa' is the chosen metaphor for women who, reduced to their bodies by society, act out the contradictions of race, class and gender on the body.80

Critique of Anorexia Nervosa: The Fernale Body as a Site of Gender and Class Transition Fraad's analysis provides new insights into the multiplicity of forms and causes of 'anorexia nervosa' and

bnngs into the discussion the possibility of protest and rebellion by the body to gender, social, politicai, economic.

class and racial constmctions. The realization of the differences in 'developing' 'anorexia nervosa' and its causes

are an important development but, Fraad continues to use the single term to describe the multitude of causes and

variations. Fraad also continues to use the language of the medical mode1 and sirnply incorporates the gender,

social, political, psychological, economic, class, and racial factors into it. Like most feminist theorists, Fraad does

not challenge the term 'anorexia nervosa' and, more irnportantly, continues the assumption of a white, rniddle class,

heterosexual woman in her analysis both implicitly and explicitly. The absence of race in the first published draft of

the article is a definite oversight that is not fully corrected in her bief analysis in the second publication. The

unquestioned heterosexual assumptions are glaring. While Fraad recognizes the difficulty in negotiating issues of

race, class, and gender, she ignores issues of sexuality which rnay fûrther complicate social meanings for wornen.

The invisibility of sexuality in FraadTswork may be representative of the traditional psy-discipline construction of

'anorexia nervosa' that has a strong heterosexual bias.

The predse that the 'modern' world brings new contradictions and new roles for women is ahistorical and

denies the experiences of women of colour and working class wornen. While Fraad recognizes that for women of

colour nurnerous roles in the public and private sphere are not new she does not recognize that for wornen of

different classes these 'new' roIes are not in fact 'new.' Through this Fraad continues the stereotype of white,

middle class, female 'anorexics' and renders invisible women who do not meet this category. The idea that women are not entenng the public sphere, for the first tirne, is race and cIass specifîc. FG~women of colour and women of

the working classes the public sphere has continually been a part of their experiences as women.

Fraad generdly glosses over the points she raises about 'anorexia nervosa' and rebellion/protest. It seems remarkable to mention 'anorexia nervosa' as a 'hunger strike,' as 'rebellion,' and as 'protest' but to conspicuously deny it as resistance, Fraad even States that "the anorecuc's private protest against the future offered to her reflects the relative absence of the public social protests that a militant women's movement had earlier made possible."*'

While it is debatable that the 'protest' is private and that the 'protest' is toward an impossible future, Fraad opens the possibility for a discussion 03 resistance-'' Morag MacSween Anorexic Bodies

In Anorexic Bodies, Morag MacSween attempts to develop a fully sociologkai expIanation for 'anorexia

nemosa' as opposed to simply adding aspects of sociology to psychological explanations. In doing so MacSween

pursues an explanation of voluntary seIf-starvation that does not assume a deficiency in the woman's psychoIogy

that predisposes her to sociaI pressures and the development of 'anorexia nenr~sa-'~~In this strict sociological

explamtion MacSween argues that voluntary self-starvation is the symptom of an attempt to merge contradictory

consuvctions in the positions of women (dependent on class, race, and sexuality) through creating the 'anorexic

b~dy.'~The 'anorexic body' is primarily an atternpt to resolve the conflict between gender and individuality (a

concept that MacSween believes is inherently masculine) through the creation of a gender neutral body. In essence,

'anorexia nervosa* occurs in response to socid meanings of desire, hunger, and the body, dl of which are gender

laden. It is also a response to the situation that ttiree decades of "public feminism" has created; that is, the challenge

created by feminists to reject what MacSween calls the "female posture."g5 Meaning, according to MacSween, is

produced through the 'anorexic' symptom and not through psychological interpretations of it.

The body is culturally and historicaily constmcted as a result of the ways that the body and the self are

understood in history and culture. In addition, histoncd ideas of the body and the self contain within them key

aspects of their culture.86 MacSween links these constructions to class society and historicaIly analyzes differences

in understanding the female and male bodies under feudd and capitalist systems. Through a history of the body

MacSween determines that the twentieth century body for the first time is explained as a purely biological organism

that is an instrument to be used against their en~ironment,~~MacSween argues that

the central conceptual shift was from the medieval understanding of the body as one element in a hierarchically interlinked cosmology to the bourgeois perception of the body as instrument, used by the self to act on an environment seen as fundarnentally ~eparate?~

The conception of the body changed from an integrated member of the hierarchy to a weapon used against it.

Throughout this history, the body has remained consistently divided by gender in such a way that the female body is presented as a derivative of the male body. The dichotomy is set so that the masculine body exhibits and characterizes specific qualities that are in opposition to the qualities which descnbe the female body and these qualities exist on a hierarchy where male qualities outrank female. In relation to her anaIysis of the difference between feudal and capitalist systems, MacSween argues that

the dichotomies of difference arranged by gender in the Middle Ages were differences of degree and not End,

Under capitalism, however, the dichotorny becomes increasingly rïgid and the previous degrees of difference now

becorne fundamental differencesJ9 The constructed gender dichotomies, for MacSween, are not organized in that

the difierence is measured in relation to a normal standard but rather that they are created in opposition to each

~ther.~As a resuIt, under a capitalist system, women becorne bodies for male consurnption and must place great

care into .the body's emotions, sexuality, and appearance. Women rnust attempt to create an illusion of physical

integrity that is perpetually undercut by the construction of the female body as open. To be a person is to be male

and physically closed; therefore, "the impossibility cf ever really becoming 'persons' must stay hidden in the

continua1 struggle to be both person and ~ornan."~'This is the essential contradiction that the 'anorexic' body

atternpts to synthesize. The dernands of individuality and fernininity are articulated through the 'anorexic body' in

its control of appetite and eating which are related to feminine ~exuaHty.~The 'anorexic' according to MacSween

identifies and explains her appetite - animalistic and overwhelming - in the exact sarne way as conternporary culture

describes femaie sexuality.

'Anorexic' women attempt to control their appetites because feminine desire is created under patriarchal

order as a threat of Thin is safe as fat threatens the male space. The impossibility of reconciling femininity and individuality in a capitalist, patnarchal culture is what 'anorexia nervosa' attempts to resol~e.~The

'anorexic's' resolution is predestined to fail simply because of its individualization, For as MacSween argues, "the ultimate strategic failure [of 'anorexia nervosa'] is explained by its very individuali~ation,"~~

Critique of Anorexic Bodies

Anorexic Bodies represents an important shift in the theorizing of voIuntary self-starvation. MacSween's history of the body and of the term 'anorexia nervosa' provides new insights into the sociology of self-starvation. In addition, MacSween begins a politicai discourse of the body in that she brinps the fernale body as it is re-written by voluntary self-starvation to the discussion of 'anorexia nervosa,' Most importantly, however, is that MacSween, in writing a fully socioIogical analysis of the body, completely removes 'anorexia nervosa' from the psy-disciplines.

The exception is, of course, with her unproblernatized use of the psy-disciplines terminology of 'anorexia nervosa.' It is impossible to completely reject the psy-disciplines construction of 'anorexia nervosa' while unprobIematically

retaining its vocabulary, if for no other reaqon than it automaticaIly assumes many of the constructions and images

MacSween is arguing against.

MacSween recognizes that "anorexia has a strong middle-class bias," however, the central discussions in

Anorexic Bodies largely neglect issues of race, class, sexuality, and age. The institution of heterosexuality is

mentioned as a critique of other ferninist theorists but not taken up in the work. What remains unexarnined is how

the socioIogy of the body differs given different social positions- The question then becomes does the sociological

body differ, and by what degree, given the individual's position on the social matnx? From this there needs to be

developed an understanding of the difference in the sociology of the body depending on how the body is perceived;

that is, is the body, from a sociological standpoint (Le. accounting for race, class, gender, sexuality, and age) an

object or subject? Further, does the 'anorexic' woman view her body as object or subject or can she see/feeI her

body at dl?

While MacSween's work neglects specific socioIogical issues it does provide a valuable frarnework to

understand voluntary self-starvation apart from the psy-discipline models. To create a fulIy sociological analysis is

a great advancement in the discussion of voluntary self-starvation. However, the underlying assumption of

'anorexia nervosa' as an ineffective tool or an inappropriate response is still at work in Anorexic Bodies.

Eva Szekely Never Too Thin

Eva Szekely in Never Too Thin attempts to blur the rigid categories defining some women as 'anorexic'

and others as 'normal' through a discussion of the politics, sociology, and econornics of the body in society.

Szekely includes throughout her analysis a discussion of the problematic use of language around both the body and

'anorexia nervosa,' Never Too Thin is an extremely important work in that Szekely forces the reader to constantly

situate the body in the theory and to never lose sight of the body as it is lived. Recognizing the limitations of

language to describe the body and understanding that speaking in any detail about it shifts the focus away from the body, SzekeIy still attempts to recover the body from theoreticai frameworks of 'anorexia nervosa' that have rendered it invisible.

The premise from which Szekely works radically transforms the relationship of the 'theoristTto the 'subject.' By placing herseIf within the context that she is discussing, Szekely begins to break down the dichotomy

between 'anorexic' and 'non-anorexie' in a way that does not argue a 'pre-anorexie' psychology. In doing such,

Szekely recognizes that it is the Iived experiences of the body that creates and perpetuates voluntary self-starvation.

She writes,

...1 began to recognize that anorexia was not sornething that happened to other women. 1 have seen certain practices that 1 share with the women 1 interviewed. I have caught a glimpse of the social relations that have shaped my own Iife and helped me live it in a rnanner that thus far has not necessitated the practices, nor given rise to the kind of relationship to my body, that Simone has, for example. Under different circumstances, however, 1 could have experienced my body in much the smeway that she bas%

The interaction between the interviewer (Szekely) and the interviewee (Simone) made SzekeIy realize that 'anorexia

nervosa' was an experience of the body in reaction to the circumstances presented to it. The continuum that Szekely presents is different than that of Bordo's as Szekely does not extend 'morexic' behaviour to the entire culture but problematizes the differences of bodily experiences that make voluntary self-starvation an option. The practices of

'anorexia nervosa', that of dieting, exercise, and weight loss, are related to the experience of the body as it is positioned within society. For the body is always in society and social relations are canied within it?'

Since the body can never be separateci from society and the social relations embedded within it, the body of the 'anorexic' cannot be placed within a category that depicts the woman as ndically different from other women and their persona1 struggles. To argue that women who attempt to compete with and create a 'superwoman* image are engaging in a stmggle with political, economic, and cultural implications, and then use a language for 'anorexia nervosa' that expIains these women has cognitively challenged or mentalIy deficient is to obscure the same social implications. The separation of women into categones such as these obscures the politicai, economic, culturai, and social roots which, in mm,creates an image of women isolated, and suuggling on an individual bais?'

Szekely argues that to 'interpret anorexia' we need to understand the body as both subject and object in an effort to understand "the social constitution of out bodily expenence~."~Activity and interrelationships between subjects and objects need to be central to any categorical understanding of the body. Describing the history, physiology, biology, or psychology of the body cannot explain 'anorexia nervosa'; for even though there may be some cornmon denorninator to the practice it is far too simple to locate 'anorexia nervosa' within the body as described by these categones. To do this is to understand 'anorexia nervosa' as it relates speculatively to everyone

and concretely to no one,Io0 Theories of 'anorexia nervosa', for Szekely, need to start with the actual practices of

voIuntary self-starvation.

In exarnining the practices of 'anorexia nervosa', Szekely argues that it is essential to address the differences amongst women who voluntruily self-starve, most importantiy, class differences and the effects of capitalist ideology. Women's relationship to capitalist ideology and their relationship to the ideology of individuaIism are keys to underst'mding the comection between wornen and voluntary self-starvation. Szekely argues that wornen are an under-class who receive few of the benefits of capitalisrn in relation to men. Wornen are used as markets (Le. the multi-billion dollar fashion and diet industries), as cheap labour and as an unemployed reserve labour used during periods of crisis. According to Szekely wornen do not directly accumulate the benefits of capitalism but, rather, benefit indirectly through men (Le. father, brother, husband, son).'0' Women, as a result, face contradictions between the theory and practice of iiberal democracy and capitdism. The false notions of equdity, the continued prsictice of systemic racism, biased immigration practices, class differences and sexism produce contradictions as they divide and oppress people while sirnultaneously demanding their lab~ur.'~'?For many women, the reality of their Iives cannot be removed from these factors and, further, they cannot be separated from their relationship to their bodies. Therefore the 'relentless pursuit of thinness' must be placed within the contradictions depending on their place in the social matrix. The capitalist system is a precursor that determines women's relationship to their bodies and is a factor in voluntary self-starvation.

For Szekely, the difference between 'anorexic' and ‘non-anorexie' women needs to be challenged. As a society, "we need to stop talking about the weak, vulnerable or otherwise deficient personality of the anorexic, and begin to acknowledge openly that their experiences and pnctices point to conflicts and contradictions that are ail of our pr~blerns."'~~The voluntarily self-starving woman creates a space for discussion around the economic-political situation of women as individuals but also as a colIective. These questions cmhelp us examine what socidly brings women to see thinness as a pursuit.

Critique of Never Too Thin

Never Too Thin is an extremely valuable resource in the discussion of voluntary self-starvation. By challenging the dichotomy of 'anorexie' and 'non-anorexic' Szekely opens the discussion to criticism of the

discourse on 'eating disorders' in which she challenges the language used to describe the act of self-starvation and

the 'symptoms' of 'anorexia nervosa,' Viewing voluntarily self-starving women as a coIlective SzekeIy turns her

analysis towards the econornic and politicai systems in order to understand how they shape and explain the female

body. Like MacSween, Szekely attempts to question the psy-disciplines' theoreticai supremacy in explaining

voluntary self-starvation. The explanation focuses on the body in society and the difficulty in perceiving, living,

describing, and theorizing it as well as explanations which include economic and political aspects. Theorizing

'anorexia nervosa' as a collective, depsirting from the ideology of individualism cmopen spaces for discussion

around social, politicai, cultural, and economic contexts.

Szekely brings forth a frarnework for understanding voluntary self-starvation as an act of resistance but

leaves the possibility unexamined. Since women recognize their position within the capitalist system and

understand how it affects their bodies, could resistance not be possible at the level of the body? SzekeIy, instead, tends to focus on the relentIess pursuit of thinness and does not deconstruct the meaning of thinness or what it

means to be a thin body in society. If the body and its labour are currency within the system how is the body treated, given 'weight' so to speak, depending on its size? How does excessive thinness change the currency of the body? These are extremely dangerous questions, however, because implicit in the question is an answer that requires the 'illness' of 'anorexia nervosa' to become a metaphor for society and socio-political regimes. So while the body cm show resistance and is created and placed on a social mauix we rnust be carefui not to appropriate it for political purposes that lose sight of the woman in favour of using her body.

SzekeIy, Iike most feminist theorists, uses 'anorexia nervosa' as a symbol of modem culture; of the state of the body in society. However, mega-theories such as these that attempt to use 'anorexia nervosa' as a metaphor appropriate shocking numbers of women's bodies for their own purposes. How can you explain the sheer number of women's silent voices in one way? Using the illness as a metaphor creates a mythology about 'anorexia nervosa' that gathers energy and allows us to escape the reality of it. While interviews with women exist and the ntuals and practices of 'anorexia nervosa' are discussed in Never Too Thin, a mythology forms that at once glamorizes and demonizes the act of self-starvation. Mythology is dangerous here because it has authority over the actual voices of the 'anorexics' which are used in Szekely's work but a step removed from the theoretical process. The myth asks the questions, waits impatiently for an answer, and, then, interprets what the Ianguage has left out. The language of

'anorexia newosa' should be what is 'co-experienced;" that is, a translation from the body rather than a language of what was supposed to have been experien~ed.'~

Conclusion

In surn, feminist theorists have made a number of dramatic theoretical advances in the discussion of

'anorexia nervosa* that have opened new spaces for new theories and discussion. While the critique of the psy- disciplines initially came tiorn within with the anti-psychiatry movement of the 1950s and 1960s. including Thomas

Szasz, women aIso continuaIly challenged the psy-disciplines and showed the political underpinnings of the psy- disciplines- However, the means and tools available to women were limited in the early part of the century and not taken as senously in the male dominated anti-psychiatry movernent. With the second-wave feminist movernent suong criticism of the theory, diagnoses, and treatment of 'anorexia nervosa' came from feminist writers concerned with the reductionist and individualistic approaches of psychology and psychiatry. How feminists have traditionaiilly viewed 'anorexia nervosa' has Iargely been shaped by Kim Chemin, Susie Orbach, and Susan Bordo. However, other writers such as Harriet Fraad, Morag MacSween, and Eva Szekely have provided new insights.

The works of Kim Chemin and Susie Orbach are far more problematic than later works as they still rigidly hotd ont0 psychiatrie theoretical arguments and criteria. In addition, they pathologize the motherfdaughter relationship and interpret it as a major cause in developing 'anorexia newosa.' Not only is the work largely ahistorical but it is also extremely dangerous in that it reaffirms stereotypiial notions of pathology as they relate to femininity. Works by Susan Bordo, Harriet Fraad, Morag MacSween, and Eva Szekely al1 add layers of analysis and context to the discussion of 'anorexia nervosa.' However, with the exception of Bordo and Fraad, al1 use theones of or informed are by the psy-disciplines and still render the problem as an individual one where the person has some inner fiaw. Both mother- and 'patient'-bIaming remain in the works.

To fully escape the psy-disciplines construction of 'anorexia newosa' the language descnbing and defining voluntary self-starvation needs to be analyzed and problematized so that assumptions of developmental flaws and problem characters of the individud are revealed. Words such as 'grotesque,' 'epidemic,' 'illness,' and 'disease' need to be examined and re-exarnined to show how they alter our understanding of vohntary self-starvation and, possibly how they obscure ernphasis- We need to challenge dl aspects of the constmction of voIuntary self- starvation including concepts and effects of race, class, sexuality, and age. Instead of arguing that wornen Iack

'self, or have troubled deve10prnent.s~we need to understand how they are engagin~gseff-starvation at various levels of the body and why, In addition, feminist explmations must stop assuming a dictaotomy between ferninist and

'anorexie-' Into the repertoire of ferninisms we need to add 'anorexics' instead of assuming the impossibility of voluntary self-starvation existing within femïnism As Takayo Mukai &tes, "I I a recovered anorectic. And 1 am a femini~t.""'~ 1. Naorni Weisstein, "Psychology Constnicts the Fernale, Or The Fantasy Life of the Male Psychologist (Witb Some Attention to the Fantasies of His Friends the Male Biologist and the Male Anthropologist), Seldom Seen, Rarefy Heard Women's Place in Psychology, Ed. Janis SI Bohan, Boulder Colorado: Westview Press, Inc., 1992 z Weisstein, 75. 3. Showalter, 220-221 & Jane M- Ussher, Women 's Madness: Misogyny orMental Illriess?, New York: Harvester Wheatsheaf, 199 1,16 1. 4. Showalter, 221. r quoted in Showalter, 246. 6. Ussher, 131. 7. Ussher, 131-132, S. Thomas Szasz, The Therapercnc State: Psychiatry in the Mirror of Current Events, New York: Prometheus Books, 1984,40. 9. Ussher, 133- IO Kim Chemin, The Hungry Se& Women, Eating, and Idenrisr, Toronto: Random House, 1985; Susie Orbach, Hunger Strike: The Anorectic's Struggle as a Metaphorfor Our Age, London: Faber and Faber Limited, 1986; Susan Bordo, Unbearable Weight: Feminisrn, Western Culture and the Body, Berkeley: University of California Press, 1993. i 1. Chemin, x-xii, 12 Harrïet Fraad, "Anorexia Nervosa: The Fernale Body as a Site of Gender and Class Transition," Rethinking Mamisrn 3 (3-4) 1990:;Fraad, "Anorexia as Crises Embodied: A Marxist-Ferninist Analysis of the Household," in Bringing It All Back Home: Class, Gender, and Power in the Modern Household, Eds. Harriet Fraad, Stephen Resnick and Richard Wolff, Boulder, Colorado: Pluto Press, 1994; Morag MacSween, Anoraic Bodies: A Feminist and Sociological Perspective on Anorexia Nervosa, London and New York: Routiedge, 1993; Eva Szekely, Never Too Thin, Toronto: The Women's Press, 1994, 13. Elaine Showalter, The Female Malady: Women, Madness, and Erzglish Culture. 1830-1980, New York: Pantheon Books, 1985,210. 14. Showalter, 2 11. 1s. Chemin, 12, 16. Chemin, 16-18. 17. Chernin, 21-23- 18. Chernin, 21. 19. Chemin, 36-37. zo. Chemin, 37. 21- Chemin, 45. u .Chemin, 60. 23. Chemin, 64. 24 Chernin, 88,91. 2s- Chernin, 126-127. 26. Chernin, 130. z. MacSween, 57,59, 2s. MacSween, 6 1. 29- bid. 30. Orbach, Hunger Strike, 102. 3 I. Orbach, Hunger Strike, 107. 32 Orbach, Hunger Strike, 34-35- 33. Orbach, Hzinger Strike, 36- M. Orbach, Hunger Strike, 39, 35- Ibid, 36. Ibid. 37. Orbach, Hunger Strike, 43 3s- Orbach, Hunger Strike, 45. 39. MacSween, 76. 40. Orbach, Hunger Stnke, 43. 41. Orbach, Hunger Srrike, 47. 42 See Susie Orbach, Fat 1s A Ferninist Issue: A Self-Help Guidefor Compulsive Earers, New York: Berkeley Books, 1978. 43. Orbach, Hunger Strike, 76, a. Orbach, Hunger Strike, 95- 45. Orbach, Hunger Stnke, 149. 56. MacS ween, 8 1. a MacS ween, 85. a-MacSween, 82- 49. Bordo, 279. 50. Susan Hekman, "Matenal Bodies," in Body and Flesh: A Philosophical Reader, Ed. Donn Welton, Malden Massachusetts: BIackwelI Pu biishers Ltd., 1998,62, siBordo, 54. 52 Bordo, 292, 218. 53. Susan Hekrnan, BookReview. Hypatia 10(4) 1995: 151. w. Bordo, 95. 55- Bordo, 139-140. 56- Bordo, 159. n. Bordo, 160. 5% Bordo, 142. 59- Bordo, 144-145. cio. Bordo, 148-150- 61. Bordo, 155. 62. Bordo, 154. 63. JacqueIyn Zita, Book Review Signs 21(3-4) 1996: 792. 64. Ibid. 65. Gordon Tait, "Fasting and the Fernale Body: From the Ascetic to the Pathological," Women & Performance: A Journal of Feminist Theory 21(11: 1) 1999: 134, 6s. Mimi Nichter, Book Review, Contemporas, Sociology 24(I) 1995: 42, 67. Nichter, 42, 68. Fraad, "Anorexia Nervosa," 79. 69- Fraad, "Anorexia Nervosa," 82. 70- Fraad, "Anorexia Nervosa," 83-84. 71. Fraad, "Anorexia Nervosa," 84-85. n. Fraad, "Anorexia Nervosa," 89. n. Fraad, "Anorexia Nervosa," 9 1,93. 74. Fraad, "Anorexia Nervosa," 94. 75. Ibid. 76. Fraad, "Anorexia Nervosa," 96, TI. Fraad, "Anorexia Nervosa," 97. 7s- Fraad, "Anorexia as Crises Embodied," 127. 79. Ibid. 80. Fraad, "Anorexia Nervosa," 98. si- Fraad, "Anorexia Nervosa," 9 1. sz I disagree with the protest as 'private' for a number of reasons, First, given the amount of iiterature, media speculation, and magazine artides etcetera on the issue it would be impossible to discuss anything around 'anorexia nervosa' as 'private,' The public interest has made 'anorexia nervosa' a public issue Second, and more irnportantly, is the public nature of voluntary self-starvation in that it transfomis the body to an undeniabIe state wherein the body, at fist sight, becomes public in interpretation, diagnoses, and treatment-

83. MacSween, 2. 84. Ibid. 8s. MacS ween, 4. 86- MacS ween, 1 13. sr. MacSween, 147. 8s. MacSween, 157. 89. MacS ween, 158- 90. MacSween, 159. 91. MacSween, 192. 92 Ibid- 93. MacSween, 249. w. MacSween, 252. S. MacSween, 254. %- Eva Szekely, Never Too Thin, Toronto: The Women's Press, 1994, 182- m. Szekely, 19. 9s- Szekely, 68. 99. Szekely, 186, 100- Szekely, 189. rot. Szekely, 193. rm Szekely, 197. 103. Szekely, 200, 104- Takayo Mukai, "A Cal1 For Our Language: Anorexia From Wi thin," Women 's International Forum l2(6) 1989, 613. 105. Ibid- Do 1 Need To Use Words To Tell You A ~tory?' Reconceptualizing Voluntary Selfitavvation As An Act of Resistance

Psychiaüic and psychological theories on voluntary self-starvation continue the Cartesian mindlbody dichotomy. Traditionally, these disciplines have explained various 'eating disorders' as a 'rnentai defect' that is displayed on and by the body but conuolled by the rnind. Feminist scholars have fought to bring the body to theory and have begun to develop an epistemology of the body that includes discussions of 'anorexia nervosa'.'

Within this rubric, 'anorexia nervosa' has been discussed and presented in a number of ways. However, very few have challenged the essentiaiist dichotomy of 'anorexic' versus 'non-anorexic' and have continued to add a feminist anaiysis to psy-disciplined constructions and theories. In order to theorize voluntary seIf-starvation apart from the psy-disciplines, a theoretical frarnework is needed that can integrate the heterogeneity of wornen's Iived experiences without establishing a single prototype, or 'typical' self-starver, that al1 women will be measured against. Thus, the provocation of postmodemist thought is that it can create new spaces for possibilities that challenge these traditional ideas. To discuss voluntary self-starvation as an act of resistance is to open space for discussion rather than provide a concise alternative theory. Ultimately, theories of voluntary self-starvation need to corne from the voices and bodies of women who self-starve. What is presented here is a reconceptualization of space and a challenge to the existing possibilities.

The objective of this chapter is to describe how postmodernist theory, specifically the FoucaultlButler problematic, can provide another possibility in explaining food refusal that allows for a heterogeneity of experiences arnong wornen and views them as active in their lives. Using postmodemist theory we can perhaps

begin to look at how women tell stories of resistance and struggle with their bodies through recreating them as

works of art that express contradictory cultunl orders. There is no single act of resistance that can be presented

as the possibility, rather, there are numerous acts in relation to self-starvation that may be viewed as resistance,

The attempt of this essay is to explain a few of these possibilities rather than to resolve conclusively the

potential meanings of voluntq self-stmation. Therefore, the focus wilf be limited to the discursive

construction of the body and its possible resistance to the discourses of discipline through parody and

subversion. The accs of resistance and the possibility of successfu1 resistance wilI be explored in reIation to

physical and psychic discursive constructions of the body. The difference between the subversive strategy of

resistance and conformity will be explored in relation to race, class, and sexuality, As we understand how the

stereotypes of women used in the construction of 'anorexia nervosa' rnay preclude any understanding of

wornen being active or capable of resistance, the focus will be on how possibly to reconceptualize voluntary

self-s tarvation.

Foucault, postmodemism, and ideas on voluntary self-starvation

Postmodernism within the social sciences has challenged the authority of scientific and medical

knowledge of the body.3 These challenges to the authority of psychiauy suid psychology have been exuemely

important in reconceptualizing self-starvation and challenging the creation of the disorder 'anorexia nervosa'.

Michel Foucault's work on hysteria is frequently cited by a variety of authors discussing 'eating disorders'

because of his challenge to uncontested knowledge of the mind that the psy-disciplines clairned as weIl as the discursive production of the hysterical body." The historical emergence and the 'discovery' of 'anorexia' by the psychiaîric profession, like hysteria, have had implicauons for the psychiatric classifications that were created as a result. This 'discovery', as Foucault pointedly demonstrated, comes out of a specific set of social practices with political implications. As a result, many of the ernerging discussions on 'anorexia nervosa' use postmodem theory as it has been informed by the works of Michel Foucault.

What is most inuiguing in using Foucauldian theory in attempting to understand sorne of possibilities of voluntary self-starvation is the rejection of absolute 'tnith'. The 'truths' put forth by psy-disciplines build a discourse about 'anorexia nervosa' and 'wornan' but, in doing so, established the 'anorexie woman'. Foucault 92 argues that discourses do not objectively descnbe existing objects or subjects but, rather, create them.5 The establishment of the 'anorexic woman' has been creatcd by the 'objective' psychiatric discourse that atternpted to explain the syrnptoms but concluded by discursiveIy developing the 'anorexic'. Thus the psy-discipiined discourse on 'anorexia nervosa' has helped to create the 'anorexic' since the discursive construction of

'anorexia nervosa' subjectively irnplicates and depends on the 'anorexic.' When developing and setting diagnostic criteria for 'anorexia nervosa' the psy-disciplines discursively created the 'anorexic'. By determining and setting criteria for 'anorexia nervosa' the psychiatrïc professions construct the actions, symptorns, and constructs of what is expected from 'anorexics'. Therefore in constructing 'anorexia nervosa' these disciplines assume and create the expectations of the 'anorexic' since 'anorexia nervosa' is dependent on women exhibiting 'anorexic' syrnptoms.

The discursive construction of the 'anorexic' body has shifted in the last decade or so with the introduction of Foucault's work in the understanding of voluntary self-starvation. The greatest identifiable change has been the understanding of the identities of self-starvers as multiple, shifting, and c~ntradictory.~

Elspeth Probyn, for example, argues that voluntary self-starvation is a means that certain wornen use to negotiate between and among discourses to force us to consider the possibility of contradictions.' For Probyn, this is an example of Foucault's 'technologies of the seIf, wherein people can affect certain aspects of the operations of their bodies to self-create a different understanding of thernselves. This point is reiterated in a different rnanner by Ecüerrnann who argues that the 'anorexic' recreates her body as a work of art that is confronting and undeniab~e.~Prîmarily, what authors such as Probyn and Eckermann atternpt to gain by using

Foucault's theories is a context that moves beyond previous explanations of 'anorexia nervosa' as caused, for instance, by the farnily, and the media? Instead, using Foucauldian theory, they began to study the discursive practices in Western culture that continudly engage women in specific disciplinary practices of the body. In understanding sorne of these discourses of discipline that create the modem woman's body we can begin to show how women may resist arnongst these discour~es.'~Foucault's concept of multiple, shifting, and contradictory identities is useful in attempting to identiQ the creation of the starved body as it negotiates between contradictory discourses. In opening new spaces in the discussion of self-starvation we may allow women to speak of and theorize their voluntary self-starvation as separate Frorn the discourses of 'anorexia

Postrnodern theory chalIenges aditional discussions of 'anorexia nervosa' because it allows for

individu&, although they are discursiveIy constnrcted, to be capable of resistance to conuadictory socid

positions, The subject, in postmodern theory, can be viewed as capable of resistance to positions and practices

that conflict. The subject is seen as having the ability to recognize the discursive relations which produce her and society and the ability to decide from the available possibilities." To see women as having the ability to create themselves as rebellious subjects may dIow others to see their behaviour as resistance. For instance,

Eckermann interviewed a self-staving woman who consciously used aspects of her seif-irnposed starvation CO display power. The woman discussed:

[the] power 1 felt when asked by Dr K. to register on the body size metre how large I thought 1 was. As 1 rnoved the lever a ridiculous distance out I watched his reaction from the corner of my eye. His expression was 'Boy this kid is wacko!' and dl the tirne 1 knew what 1 was doing manipulating him and it gave me enormous pleasure."

What this wornan expresses is a consciousness of her ability to control and regulate ideas about her through voluntary self-starvation. Thus postmodem theory enabIes the inclusion of the possibility of seeing women as active beings with the ability to recognize social constmctions, discursive relations, and the contradictions in between them. It aIIows for the possibility of subject to be created and recreated as resistant.

What these explanations provide is a useful meaning and appropriation of Foucauldian theory to explain certain dynamics of seif-starvation; however, they do not adequately provide a framework that can be used to explain voluntary self-starvation as an act of resistance. For this direction, Judith Butler's theory of

'gender trouble7 provides the necessary structure and needs to be explored in order to develop a context into which voluntary self-starvation as an act of resistance may be expanded upon. However, resistance is mostly left undefined by Butler. So while Butler's work provides the structure it is not unprobIematic. As such, after an explanation of Butler's theory a discussion of some of the possible definitions of resistance wil1 follow.

Judith Butler's Gender Trouble: A framework for resistance?

In Gender Trouble, Judith Butler uses the Foucauldian concept of the body as a cultural text to argue that any ferninist political project must not assume materiality.'3 Gender theorists have frequently argued that sex is biological and gender is a social construction produced by history. society. and culture. Butler argues

that we cannot assume a 'natural', pregiven sexed body is the basis of gender as sex cannot be apoliticd nor

ahistorical. Gender, for Butler, helps create sex which, in turn, establishes gender. The two are logically

inseparable, ButIer writes,

.,,gender rr.ust dso designate the very apparatus of production whereby the sexes themselves are established. As a result, gender is not to culture as sex is to nature; gender is dso the discursive/cultural means by which "sexed nature" or "a natural sex" is produced and rstablished as "prediscursive," pnor to culture, a politicdly neutral surface on which culture acts.""

The body therefore cannot be a neuual apparatus on which gender, as well as other social constructions are

written but is itself a cuItunIly established text. Materidity cannot be left unquestioned, unexamined, or

hidden by its strictIy 'biological nature' because there is no body that exists before culture encodes it. 'Natural

sex,' for Butler, is a false construction and is merely a product of the discursive ends of gender that reinforce it.

Figurïng the body as an "instrument*' or "medium" denies the possibility that the body cornes into existence

with the inscription of gender." Gender is simply not the social construction placed upon a natural sex, but,

rather, is the construction itself that precludes my biological sex.

Butler explains the notion of 'gender trouble' as a subversive performance that requires the

contingency of gender in order for the act to be ~seful,'~The difficultyis, of course, in measurîng the

differences between contingent gender acts that are useful in subverting gender roles and those that uphold the

order. The measure for Butler would be based in materiality. If the project becomes performing 'gender

trouble*in order to discover a pre-given body, as opposed to the culturally defined text, then ferninist theory has

lost its grasp on the contemporary struggle. If the project(s) of 'gender trouble' "is a life of the body beyond

the law or a recovery of the body before the law which then emerges as the normative goal of feminist theory,

such a nom effectiveIy takes the focus of feminist theory away from the concrete terms of contemporary

cultural smggle."" Feminist theory should focus on postmodern subversions and not on the discovery of

'natuml sex'. For Butler, the focus should be on how to understand the discursive constmction of materiality and its effect on political discourse. However, does this annihilate any possibility for discussions that recognize but move past the discursive constructions of materiality? By shifting the focus from Butler's discussion of materiality to her discussion of subversion it may well be possible to discover the answer to this question.

ButIer's argument rests on the premise that subversion can corne from within the existing parameters of gender. These acts happen within the system of gender and possibilities for resistance occur almost spontaneously when the order tums against itself." Gender is fluid and must be enacted and repeated incessantly; however dunng the repetition gender changes, permutations occur, and it is during these periods of change, which occur frequently, bat subversive parody is possible. Since "gender is something that one becomes - but cm never be- then gender is itself a kind of becoming or activity, and that gender ought not to be conceived as a noun or a substantiai thing or a static cultural marker, but rather as an incessant and repeated action of some ~ott."'~The underlying goal is not, then, to discover the underlying 'naturai sex' but rather to dismpt the repetition of these actions in a way that confronts the construction of the order. The discovery of

'natural sex' is impossible since there is no stable self-identified body beyond linguistic discourse.

In "Contingent Foundations" (published in Ferninists Theorize the Political), Butler argues that

'gender trouble' does not require a stable subject. To argue that it does is to encapsulate the political in an attempt to protect it from criticism. Butler writes,

to require the subject means to foreclose the domain of the political, and that foreclosure, installed analytically as an essentid feature of the political, enforces the boundaries of the domain of the political in such a way that en- forcement is protected from political scnitiny. The act which unilaterally establishes the domain of the political functions, then, as an authontarian ruse by which political contest over the status of the subject is summarily silenced."'

Contingent subjects, arguably, would then open the political spaces and destroy the authontative artifice that protects specific spaces from criticism. To open these spaces using contingent subjects is to require that the body is not "prior to politics itse~f."" The prernise that the body is the shaping force behind politics needs to be deconstructed in order to discover the exclusive way in which potitics is protected.

If the body does not exist without culturai inscription, that is if the body is simply a text, the body must be capable of being re-inscribed by acts of resistance. Since we have materiality, recognizing that it is constmcted, do we have the ability to re-create it? Or do we have the ability to perform the body in defiance or in ultimate compliance with the gendered inscription? To answer these questions positively is to show that the body cm actively show resistance. In Ercirable Speecfl, Butler argues that resistant performance produces social effects that are related to the discourse of the gender order but still have power, The point is that "the efforts of performative discourse exceed and confound the authorizing contexts from which they emerge.""

Therefore it is possible to recreate from within the discourse. Butler's example of a subversive act, drag, has al1 the necessary characteristics to be defined as gender resistance. Drag confuses the distinction "between inner and outer psychic space and effectively mocks both the expressive mode1 of gender and the notion of a true gender identity."" Butler's idea of social performance is extremely useful in understanding voluntary self- starvation as an act of resistance as she argues that the "performauve is a crucial part not only of subject formation, but of the ongoing political contestation and reforrnuIation of the subject as well."" Consequently, the question of matendity need not be fully resolved before a discussion of subversive practices cm begin.

In place of a politics that relies on a natunl sexed body, resistance can be forrned through parody and performance from within the order by exposing its inconsistencies. The expected noms of gender prescnbed by culture cm be stirred through an immediately identifiable bodiIy act which, through the constniction itself, parodies it." The performance causes a disruption at the level of the social construction, using the apparatus of gender. The difficulty with such parodies, however, and ButIer points this out, is that they may reinforce the order and subvert the sub~ersion.'~

The possibility of effective resistance is not clearly discussed by Butler. The subtle differences between the recognition of an act as resistance and conforrnity are for the most part left unexplored. Susan

Hekrnan interprets the difference as a disruption that does not simply recreate an imitation; she writes that

since there is not radical repudiation of a culturally constructed sexuality we must construct our resistance by asking what forms of representation do not constitute a simple imitation, reproduction and hence consolidation of the law,"

However, whiIe Hekman's commentary does provide further definition it does not yet clearly demarcate the difference between resistance and conforrnity. The difficulty in discussing the difference in relation to voluntary self-starvation is that the subversive act, assuming that it can be identified as such, has previously been constructed as a pathoIogy wherein the only resistance discussed was resistance to therapy. CouId this be the defining difference between conforrnity and resistance? Could it be that the woman who is resistant to give up her tool of voluntary self-starvation is using a strategy of subversive resistance while the woman who cornes 97 to therapy willingly, to seek relief, was conforming? Using Butler's work it is difficult to tell- However, as we

shall see in a later discussion of the differences among women on the basis of race, class, and sexuality. there

may be clearer rneans by which the difference cm be articulated.

if women show resistance by performing their bodies (gendered) in an attempt to enhance the

contradiction(s) of a culturally mediated gender on the individual this does not necessarily enhance the

destruction of gender as an order. Gender was never consuucted for individuais - they are secondary to any

organizing theory. Resistance rnay require repudiation by a number of individuals. This is not however an

argument for solidarity but, rather, a want for a recognition of the possibility that subversion rnay have the sarne

signs from different effects. The desired effect, emaciation, rnay be caused by a number of different sources

that allowed for the possibility of using voluntary self-starvation as an act of resistance. There might be a

heterogeneity of reasoning behind the performance although the visual effect is the sarne and there must be

caution exercised in establishing commonaIities as they rnay build false cornmunities- A sign or symptom

represented on the cultural material text may require a substantial number for recognition; however, if the community is based on symptomology it must allow for heterogeneity. For, if it does not, it simply replaces one

false category ('anorexia nervosa') for another. Any theory must open space for the voices and bodies of the women who are affected. mile relying on individuals performing their own consmictions rnay be problematic, it is still their understanding, their personal position on the matrix, that affects their resistance.

Voluntary seIf-starvation, when effectively removed from the explicit construction of a pathology, rnay not resist the construction of an internalized gendered core. However, it may be seen to express and mock the contradictions in the ever-changing constructions of a fernale identity. It rnay re-arùculate gestures and performance so as to be undeniable. The theoretical question arising from reading Butler's work is whether or not voluntary self-starvation cmbe 'gender trouble' or if it is a resistance to socio-political and historical constructions or, perhaps, both.

The contradictions among constnictions provide a space for resistance and subversion. The construction of the bodies can therefore lead to a constructed resistance within the paradigm that may prove to be effective. Individuals resisting in a sirnilar manner to a number of different constructions rnay show a number of contradictions in constnictions and how different constructions prove to be oppressive to different 98 people. This heterogeneity of experience is seen as a mass individual pathology because of the Iack of

consistency in reasoning. However, if we see these bodies in resistance and acknowledge the heterogeneous

manner in which women were brought to a sirnila- point, we can corne to understand the political construction

of voluntary self-starvation. WhiIe Butler focuses almost exclusively on questions of gender, issues of race,

cIass, and sexuality need to be expIored in reIation to voluntary self-starvation as they change the constnictions

of the body and produce different cultural searns thereby changing the avenues of resistance.

Connections of resistance through bodies and histories: race, class, and sexuality

Traditionally explained as 'anorexia nervosa,' voluntary self-starvation may not be a pathology but, rather, a form of resistance for a specific group of women. For it to be seen as resistance. voluntary self- starvation needs to be understood as an expression of the contradictions in and among discourses where women, in a dominant gendered order, where their power is unequd depending on a number of factors, are created with voices constructed as lesser than, This cmbe seen in the very construction of 'anorexia nervosa' which was made meaningful to the medical professionals on the basis of a specific, but not consistent, set of symptoms of the body but was never made meaningful to the women who self-starved. The emergence of

'anorexia nervosa' was, therefore, developed as an "abnormality by a discourse which was privileged to define what was The seemingly 'ilIogical', 'unreasonable', and 'irrational' symptoms of self-starvation were created as meaningful to a medical community who fded to include in their discourse the untainted voices and ideas of the women thernselves.

The body has taken a number of different and contradictory forms dependant on gender, race, class, and sexuality and, historically, different bodies have been constructed as pathological because of their gender, race, class and/or se~uality.'~To put forth and reconstnict 'anorexia nervosa' as an act of resistance we first must understand the body as a place where politics are performed; that is how the politicai constnictions of race, ciass, gender and sexualiiy are shown on and through the body. Resistance, however, also has a history among specific groups that have been excluded from the discourse on 'anorexia nervosa'. When the frarne of reference is changed from one of pathology to resistance the historical acts of these women are made visible. In addition, the framework of voluntary self-starvation presumes that no specific communities of women are exempt frorn cultural discursive constructions of the appropriate body solely on the fact that they are perceived 99 as in opposition to the white, middle-class, heterosexual nom," However, before we can begin to discuss the possibility of resistance, a succinct definition of resistance is needed so that we can begin to question whether or not the body can be a site of resistance and subversion,

The term resistance has had, and contiriues to have, a number of different denotations- Even within specific discourses the idea of resistance has different appIications. For example, in Freudian psychoanalysis resistance can refer to the obstruction of psychoanalysis, hostility towards the theory of psychoanalysis, or a rneans for the psychoanalyst to judge whether they have reached a repressed neurosis?' For the purpose of the following discussion, resistance will be defined as a chailenge or challenges, by an individual or a colIective, to dominant cultural constructions of the femaie, femininity, and woman as tiiese relate to race, class, and sexuality. Resistance rnay be a means of (re)cIairning power and control through devices readily availabIe.

For different women at different times voluntary self-starvation rnay be the resistant process of becoming visible to a society that bas rendered them not worthy of viewing. The gaze of others has denied their existence and so voluntary self-starvation rnay become a rneans of appeating and displaying the body. The contradictions in self-construction (the ability to aid in the construction of their selves) may render certain wornen invisible when the construction of their bodies contradict stereotypical notions of what they are supposed to be. Excessive thinness, therefore, cm be a step towards conformity where the accepted and culturally approved body weight uumps other constructions and creates a culturally acceptable body. If the pursuit of thinness is culturai confonnity and acceptance it is difficult to view it as resistance. However, when the culturally appropriate body is not the goal and when wornen attempt to integnte rather than separate their contradictions in their construction it may be resistance. Women who use self-starvation to 'speak' with their bodies as to the effects of contradictions and invisibility of parts or al1 of themselves, and when women use the searns in constructions to challenge the noms of the order, then it rnay be seen as resistance.

Asserting the contradictions between expected cultural constmctions and self-constructions rnay place the body within a dangerous space. Women often face ridicule and violence in reaction to their bodies if they assert thern in a means that is deemed culturally inappropriate. Nedhera Landers, for instance, descnbes the contradictions she faces in being a black lesbian who is "fat," she writes,

[m]y mere existence shows up society's lies in great relief. Being Black (and a chick) 100 would eliminate my being fat. But since 1 am fat. young and childless, that must mean I'm a whore out of desperation for a man, But, since I am a lesbian and men aren't central to my life, that would eliminate my whore status- So, according to the current myths, 1don't exist- MenI assert my presence and insist that 1 am indeed fully present, 1 become an object of ridicule?'

While Landers is not a self-professed voluntary self-starver, her description of the facts that render her invisible

show how cultural constructions for wornen who do not or can not, by virtue of their position on the social

matrix, fully subscribe to them are left without recognition of their existence. To assert the self through voluntary self-starvation is to resist against cultural constructions as they render the individuai woman invisible.

The woman takes in, confronts, displaces, and then parodies the cultural constructions using the seams or fault

[ines in hem to show her existence through a starved body.

Food plays an important role in culture both in historical context and in relation to the legacy of specific histories. In the historical contexts of sIavery, consumption of food became a means of resistance- For biack women in North America the cultural meanings around food and eating may be representative of the numerous resistant acts performed by black women on an everyday ba~is.~~Dyann Logwood describes food as a "guest of honour" and as resistance. She writes

[elating with zest and abandon was like tuming centuries of oppression upside down. What's known today as sou1 food was once our sole food - scraps rejected by white plantation owners because they were considered unfit for consumption. That these recipes are now considered cuisine testifies to the ingenious ways that African Americans have always 'made a way outta no ~ay.'~

Therefore, for black women using food as an act of resistance has a history. The consumption of food was resistance in a specific context whereas the rejection of food and subsequent starvation may be an act of resistance in a different histoncal context.

The relationship between class and the body has almost aiways been an intimate one. As chapter one iliustrated, the industriai revolution (approximately 1750-1850) helped to develop specific meanings and symbols which connected the body and cl as^,^^ The construction of 'anorexia nervosa' as a 'disease' of middle-class women is linked to the dichotomy between the middle and upper classes from this penod onwards-

While the working-classes were assumed to be unrestrained in their bodily indulgences, the rniddle class was constmcted as morally supenor, and virtuously res~ained?~As a resuit, working-class women may have been excluded frorn the discourse on 'anorexia nervosa' because they were seen as generally incapable of the 101 restraint required. The body has dso frequently been the carrier of the syrnbols of class, The gestures, movements, posture, and bodily activities, joined together under the rubnc of bodily decorum, have almost always become symboIic of ~lass.3~Therefore, the expected symptoms of 'anorexia nervosa' excluded working-class women since they were assurned to be rnorally loose and unvirtuous, and not expected to cmfor their appearance, While rniddle-class women were constructed and assumed to be appearance obsessed, working-class women were seen as incapable of developing 'eating problems' because they were assumed to be continuously hungry, unattractive, and too preoccupied with work to care about their appearan~e.~'Working- class women may also have been marginalized because of the assurnption that they are 'fat'. As a result, working-class women have been rendered invisible in traditional notions of 'anorexia nervosa' and continue to be today, However, when voluntary self-starvation is understood as an act of resistance working-class wornen, who have a long history of participation in resistance rnovements, corne back into focus.

The term sexuality implies a number of sexualities, however, for the purpose of this paper the lesbian existence wiIl be the prirnary focus because of its general neglect in the study of 'anorexia nervosa', its historical association with deviance and pathology, and the resistance connected to it- The construction of definitions of lesbian have been political acts as 'lesbian' has almost always been a part of a sexually stigmatized gro~p.~~AS chapter two illustrated, the medical attention that 'lesbianism* received during the beginning of the twentieth century resulted in the pathologization of women's relationships and the association between lesbians and psychological deviance. As a result, some theorists, most notably Adrienne Rich, reject the term 'lesbianism' because of its histoncal attachment to pathology and de~iance.~'Instead, Rich discusses a

'lesbian existence' which confirms the consistent presence of lesbians in history and the continuai redefinition of the meaning of this presence?' Explicitly implied in the meaning of lesbian existence is the possibiIity of continual resistance. One of the characteristic patriarchal powers Rich identifies is the denial of women's sexuality including lesbian sexuality; however, Füch also understands that the presence of a lesbian existence both indirectly and directly assauIts the masculine right of having access to wornen?~orthe lesbian existence is simuItaneously the deconstruction of a taboo and the repudiation of compulsory heterosexuality; as Rich argues, the lesbian existence may in fact be an act of resistanceJ3 In the constmction of 'anorexia nervosa' Iesbians have continually faIlen out of the frame of reference because of a number of factors related to the history of the pathologization of Iesbian relationships and the history of resistance, A powerful assurnption that lesbians are unwilling to or incapable of conforming to the dominant ideals of attractiveness means that voluntary self-starvation is largely viewed as an irnpos~ibility,~In systematically denying this possibility, the discursive constnicts of 'anorexia nervosa' also render invisible the resistance that sorne Iesbian communities have established in attempting to broaden definitions of style, attractiveness, and glarnour. In many ways, some lesbian communities have attempted to reconfigure and nurture the multiple constitutions of 'attracti~eness.'~~in addition, because of the histoncal construction of iesbian as 'deviant' many women may be fearful of disclosing their voluntary self-starvation. The histoncal stigma associated with a Iesbian existence may cause hesitation in women corning forward to declare that they self-starne46 The male-dorninated focus and heterosexism in the medical models may also render invisible lesbians because of the assurnption that since they were not interested in appeasing the male sexual tastes they wouid have no reason to self-starve. This type of assumption is challenged when voluntary self-starvation is discussed as resistance.

While black women, working-class women, and lesbians have continually been ignored as voluntary self-starvers this Iargely reflects a bias in the discursive construction of 'anorexia nervosa' as an 'illness' of white, middle-class, heterosexual women. However, when discussed in reference to acts of resistance it seems obvious to inchde the previously excluded experiences of these women into a discussion of resistance.

Black women, working-class women, or lesbians may use voluntary self-starvation as an act of resistance because while they face the sarne social constructions as dl other women these are compounded by issues of ncisrn, classism, and heterosexism. The somaticizing of psychic resistance through voluntary self- starvation may be stronger in specific women as a result of the stress associated with challenging the assumptions in the construction of fernale, Nonetheless, it is impossible to presume that entire groups of women are not subjected to cultural imperatives that help to construct social definitions of femininity.

Providing the possibility to discuss the Iived experiences of women who have been traditionally rendered invisible is the most important aspect of a postmodem framework. There is ao body (black, working cIass, lesbian) distinct from social construction of the female body unless the individual woman chooses to 103 deconsmct the social impositions and related contradictions?' However, given the exchsion of specific

groups of women and the history of their resistance, the psy-discipline explmations are far from adequate.

Thus the postmodem framework may provide the freedom to reconceptuaiize voluntary self-starvation apart

from identified biases of race, class, and sexuality.

Voluntary self-starvation as an act of resistance

Butler's theory on subversive bodily acts is crucial to understanding starvation as a political

performance. It is possibly a form of resistance working from within a hegemonic structure, It is the ultimate

'grotesque' parody? Voluntary self-starvation temporarily disrupts the sipified femde body as it relates to

patriarchal oppressicn. Butler argues that resistance deveIops to redefine the conuols, signifies, codes, and

disciplines of the body in a way that reorganizes them to show the gaps and seams in cultural constructions of

the expectations and subsequent degradations of the female body. This is a result of the numerous (Iitedly)

unspeakable atrocities women's bodies experience and symbolicaily display on the body.J9 At the root of the

violence and ridicule that degrades the fernale body (which is ofien cornpounded by racism, classisrn, and

homophobia) are the numerous dichotomies that present the passive fernale body in opposition to the active male body. As a result, the femde body faces degradations on physical and psychic levels. The body of a voluntary self-starver may be a culmination of atrocities at physical and psychic levels that are the result of false dichotomies which are woven into cultural constructions.

Defined in opposition to the ideai mascuIine body, the 'anorexie' body may expose and challenge the false dichotomies in Western society; those of: male/female, mind/body, appropnatelinappropnate,

and colonized/colonizer. The voluntary seIf-starver resists in challenging these dichotomies, most obviously, the healthldeath construction. Hovering at the brink of death yet becoming, for a moment, the picture of

Western ideals of health, the voluntary self-starver denies medical science by living for extended periods without caloric intake. She rnay de@ the knowledge of the body that medical science articulates through parents, teachers, friends, and medicd profession al^.^^ Everything that publically proclaims the body as female

(hips, breasts, rounded stomach, fleshiness) is obliterated obscuring the difference between male and fernale-

As with al1 the above mentioned dichotomies, the voluntary self-starver may situate herseif as hovering in 1O4 between, contradicting, and fluidly shifting between each of them- She creates an androgynous figure that is

recognized both for the body it becomes and for the willpower of the mind necessary to create it. By becoming

androgynous she confuses traditional notions of how young heterosexual women are supposed to present

thernselves (as beautiful objects for consumption) as she attempts to become both asexual and, in sorne cases,

disturbingly sexualized. (In some cases, the self-starver rnay dress andor behave in a way that offends

traditional notions of the expected feminine sexuality. In a way she rnay perform herself by creating the body

as a sexual object.) At the same time, she challenges and acquiesces to the dictates of nature (you must eat to stay alive) and culture (the appropriate body is the thin body) while sabotaging the paradoxes in both.

Becoming both an autonomous person and a rnetaphor for society, the self-starver rnay create herself as both subject and object. In addition, the voluntary self-starver may be viewed as resisting becoming colonized by becoming the brutal dictator of her own body.

According to Butler's Iogic, the starved body rnay become a parody of the disciplinary society of the twentieth century that has created a frenzy around diet, control of food, and demonization of 'fat' in relation to the female body. It is the discourse of discipline that rnay have given nse to the constructed rnateriality of thinness which allows for the possibility of voluntary self-starvation as an act of parody and resistance. The excessively thin body rnay parody the disciplined discourse of the body and rnay resist against the discourses of rnedical professionals, scientific experts, and authority figures that have built a specific frarnework for the operation of the female body, The expected passivity of the femde body rnay be disrupted through the parodied discipline that voluntary self-starvation requires and performs what is considered to be masculine cultural consuucts as defined by the numerous dichotomies listed previocsly. The cultural definitions of the male body as hard, controlled, and linear are appropnated by the fernale self-starver in that she rnay create a controlled, linear (but not masculine) body that confuses the assurned bodily differences between masculine and ferninine. By doing this, however, the thin body is created as inappropriate although it takes on appropriately masculine qudities while retaining, sometimes to an extrerne, feminine beauty ideals and qualities. In essence the thin body rnay atternpt to challenge false dichotomies through the very structures of discipline that they extol and rnay create an unstable image that is abIe to negotiate social relations both sexual and politicai. Voluntary self-starvarion may not be the only destructive action on the body that women can possibIy use in an act of resistance. In discussing aIcohoIism as an act of resistance in women Melinda Kanner explains how alcoholism can be seen as a strategy of subversive resistance. Kanner writes,

... a wornan's alcoholism gains its homfic potency precisely because it disrupts, threatens, absorbs, re-distributes, and defines the tems of control. Her alcoholism functions as a political strategy, challenging the prevailing social order and providing temporary access to hidden meanings ... Yet, however costly, the alcoholism of the women considered here does effectively (although momentarîly) rearrange the relations, the signifiers, and the distribution of cultural power?'

The sarne construction of voluntary self-starvation is possibte, First, in many psy-disciplined based texts and articles a relationship between 'anorexia nervosa' and alcoholism has been disc~ssed.~'Kanner notes that wornen's alcohoIism is more cIosely related to discursive constructions of 'hysteria*, 'anorexia nervosa,' and

'bulirnia nervosa' than men's dcoholi~m.~~Further, the issue of conuol has ken central in the discursive construction of the 'anorexic' and Kanner's strategy of resistance recognizes the possibility of control as an area of power within the redefinition of its terms not simply as a symptom. The voluntary self-starver rnay use the redefined controI as a means of negotiating and interpreting competing cultural discourses in a way that challenges and illuminates assumptions and constructions of gender, race, class, and sexuality. While there is a huge personal expense, physicdIy, emotionalIy, mentally, and socially, in vo1untariIy self-starving, the benefit of momentarily controlling, changing, and reconswcting the meanings of the body are, for some, worth the persona1 costs. For as long as the self-starvation is continued the self-starver removes herself from various constructions of some expected roles of wornanhood, narnely mother, wife, andor monogamous sex pamer.

The ail-encompassing focus on starvation and the extreme weight loss create, both literally and symbolically, a body that is seemingly disqudified from these roles. Amenorrhea, for example, enswes the improbabiIity of pregnancy and therefore mothertiood. Like women alcoholics, voluntary self-starvers redefine the appearance of control so as to increase it and thereby redraw boundaries that deny access to their bodies and resist control by others.- Some voluntary seIf-stmers may render themselves so physically unattractive and iil so as to make it impossible for others to show interest. This resistance, however, may be ineffective in relation to the physical violence they may be confronted with as a result of the physically weakened state. Nonetheless, the 'anorexic' may attempt to Iimit access by establishing a body that Iooks ill. Thus, the voluntary seIf-starver, like the female alcoholic, take existing discursive constructions, and through the tools available to thern begin a subtle

subversive process in which they resist aspects of the patriarchal social order that have been acted upon their

bodies in any number of unspeakable auocities.

The end of the resistance cornes with the reappropriation of the new discourse which speaks for it

rather than from the position of it, The resistance ceases to be when the patnarchal discourse of medicine and

psychiatry interpret the new discourse and replace it with their own. When the order is replaced, or the seif-

starver is so weakened as to not be able to fight it any longer, the resistance ends. (However, for some, in non-

traditional therapy, the process of recovery offers a possibiiity to continue the resistance through alternative,

arguably more effective, means.) The subversive suategy of resistance is brief for, under current constructions

of 'anorexia nervosa', the recreated symbols of the starved body are quickly appropriated and theorized by

hegemonic medical modes which establish emphasis and meaning without consulting the woman, In re-

establishing patriarchal control through the psy-disciplines the body of the self-starver is, at once, a medium of

expression, a battie-site, and a currency of exchange?' As a result, the conflicts in discourses are not lessened

through the re-establishment of the social order but rendered invisible within the paradigm presented by the

psy-disciplines discourse.

How we use our bodies (as weapons, shields, swords, or tools) depends on the historical discussion of

the appropriate body. Beyond discourse Our bodies do not exist for the very 'nature' of our bodies and our

reactions to them are conuolIed anci created by the ever-changing discourse on the body. Consider, for

instance, the body in the twentieth century - its assumed conquering nature and yet the recognition of the body

as colonized and the clash between conqueror and colonized being in the self. The difference is that we now

see our bodies as both masterful and conquered, colonizer and colonized, or both, depending on Our

discursively and materially constructed social position- To become a body, to be a body, is to be discursively constituted at any historicaily significant or insignificant moment where we are told what our bodies are and how to use them. From within this discourse the 'anorexic' body emerges as the challenge and resistance to becorning a colonized and conquering body - a body that is both enabled and disabled dependent on its social position. It can be viewed as a rejection of the gendered meanings of the body, the institutionalized heterosexism, the rigid class and race institutions that define the body in a place where discourses collide and 107 contradict themselves. The thin woman recreates her body and may momentarily control discourse in a way

that is both chdlenging to the order and complicit to it.

The voluntary self-starver displays and perfonns the contradictions of her sociai position in a manner

that creates a confronting visual image- The resistance is both glaring and subtle, obvious and hidden. What

remains and has continued from the Middle Ages into the contemporary era is the resounding silence of the

actual women who seif-starve. Their meanings of the body have been appropriated by a number of different

discourses including religion, psychiauic, and feminist. While the feminist movement has challenged the

hegernony of psy-discipline discourse, it has continued to use the basic premise of 'anorexia nervosa' as an

individuai pathology. Therefore to be able to discuss voluntary seIf-starvation as an act of resistance we need

to remove it from the psy-discipline context, More importantly, however, is that we need to be able to view

women as active participants in their own self-construction, Resistance does not have to be effective or long-

Iasting. It can, however briefly, disrupt, darnage, deconstruct, parody, or subvert interfering socid and cultural orders to provide a glimpse of the hidden meanings and contexts. It can challenge strict dichotomies and defy

traditional knowledges in creating a disruption of the signified by the signifier.

The fleeting moment of resistance is only such because of the strength of specific discourses. These powerful discourses redefine the resistance so as to make it meaningless, frivolous, or self-indulgent. The resistant process ceases when the woman loses the ability to negotiate the discourse of her body that she has helped to create. However, giving a language of resistance, essentially a possibility to explain in their own words, to voluntary self-starvers may aIlow them to re-enter the discourse about them. Language and articdation are a privilege, as is having a knowledge of a specialized discourse, but do we only have to recognize the spoken word as rneaningful? Would it be possible to value the articulation of the body? Do 1 have to use words to teIl you a story? 1. The titIe ofthis chapter cornes from an essay by Takayo Mukai in which she, in describing her personal experiences with 'anorexia nervosa,' argues that a shared language around voiuntary self-starvation is needed in order for wornen to develop a discourse of the body that accurately reflects and describes their experiences. See Takayo Mu kai, "A Cal1 For Our Language: Anorexia From Within," Women 's International Forum 12(6) 1989: 613-628, 2 See Susan Bordo "Bringing Body to Theory," in Body and Flesh: A Ptiilosophical Reader, Ed- Donn Welton, Maiden Massachusetts: Blackwell Publishers Ltd., 1998. '-~ulieHepworth, nie Social Comrmction of AnorexzÜ Nervosa, Thousand Oak, California: Sage Publications, 1999,9. 4. See for exarnple, Hepworth, HeIen Malson, The Thin Woman: Ferninism, post-structuralisrn, and the social psychology of anorexia nervosa, New York and London: Routledge, 2998; Matra Robertson, Starving in the Silences: An EXploration of Anorda Nervosa, New York New York University Press, 1992. s. See Michel Foucault, The Archeology of Knowledge and the Discourse on Lunguage, New York: Pan theon Books, 1972,49; and Michel Foucault, The History of Sexualiw Vol- 1, New York: Penguin, 1979, 100- 6- Liz Eckermann, "Foucault, Embodiment, and Gendered Subjectivities: the Case of Voluntary Self-Starvation," in Foucaulr, Healrh. and Medicine, Eds, AIan Peterson and Robin Bunton, New York and London: Routledge, 1997, 153-154, 7. Elspefh Probyn, "The Anorexic Body," Canadian Journal of Political and Social Theory 1l(1-2) 1987: 116, a Eckermann, 151 - 9- Eckermann, 167- IO. The discourses of discipline 1 am refemng to in relation to the ferninine body include discourses on diet, beauty, and attractiveness, Sorne theonsts have discussed the possibility of redefining and opening spaces within these disciplinary discourses that allow for active constructions of attractiveness by women. Liz Frost argues that these disciplinary discourses can be subveaed through the creation of new spaces within them that contradict the silencing discourses of vanity, abnormaiity, superficiality, and unsisterliness, Frost argues that patriarchai controls, such as psychiatry, are part of ths disciplinary discourse in that it reinforces both traditional gendered passivity in women and traditional gendered presentations of the self. See Liz Frost, "'Doing Looks': Women, Appearance, and Mental Health," in Women's Bodies: Discipline and Transgression, Eds., Jane ARhurs and Jean Grirnshaw, New York: Wellington House, 1999. i 1. quoted in Eckermann, 165, iz quoted in Eckermann, 157. 13- Susan Hekman, "Material Bodies," in Body and Flesh: A Philasophical Reader, Donn Welton (Ed.). Maiden, Massachusetts: Blackwell Publishers Inc., l998,6 1, 14- Judith Butler, Gender Trouble: Feminism and rhe Subversion of ldentity, New York: Routledge, 1990,7. Butler, Gender Trouble, 8. '" Butler, Gender Trouble, 38. 17- Butler, Gender Trouble, 38. '" Butler, Gender Trouble, 93. 19- Butler, Gender Trouble, 112. '"Judith Butler, Contingent Foundations: Ferninism and the Question of "Postrnodernism", in Fenzinists Theorize the Political, Judith Butler and Joan Scott (Eds.). New York: Routledge, 1992,4. 2" Butler, "Contingent Foundations," 13- Judith Butler, Excitable Speech: A Politics of the Perforrnative, New York: Routledge, 1997, 158-159. "- Butler, Gender Trouble, 37. 24- Buùer, Excitable Speech. 160. u. Helunan, 66. 26. Butler, Gender Trouble, 160. n-Hekman, 66. 2a Matra Robertson, Starving in the Silences: An Fxploration of Anorexia Nervosa, New York: New York University Press, 1992, xiv, 29. For the purposes of this paper 1have limited my analysis to gender, race, class, and sexuality but 1recognize that these are only a few of the possibilities 1 could have explored, A more detailed account would have included others including, but not limited to, age and able-bodiness- In addition, these categorîes cannot be 109 viewed as separate from each other, The presentation of them as such in this paper is to provide clarity but 1 recognize that they overlap and intersect, 30. Janet Walker, Couching Resistance: Women, Film, and Psychoanalytic Psychiatry, Minnesota: Minnesota University Press, 1993, xvii. 31. quoted in Becky Thompson, A Hunger So Wide and So Deep: A Multiracial View of Woomen's Eating Disorders, Minnesota: Minnesota University Press, 1994, 11, 32 FrequentIy, and possibility incorrectly, it is argued that women of colour do not, or cannot, develop 'eating disorder' because they are not effected by, or are 'naturally' resistance to dominant cultural constructions of beauty and attractiveness. For lesbians and working-class women the same argument has been applied- 1 have chosen for the purposes of this paper to focus on black women- For a more inclusive discussion of women of colour see Thompson, 33. Dyann Logwood, "Food For Our Souls," in Adios Barbiez Young Women Write About Body Image and Identity, Ed- Ophira Edut, Seattle, Washington: Seal Press, 1998,97- 34- Mary Kinnear, Daughters of Time: Women in the Western Tradition, Ann Arbor the University of Michigan Press, 1982, 116, 35. Jane Arthurs, "Revolting Women: tbe Body in Comic Performance," in Women's Bodies: Discipline and Transgression, Eds. Jane Arthurs and Jean Grirnshaw, New York: Wellington House, 1999,138. 36. Arthurs, 137, 37- Thompson, 14. 3s- Juanita H, Williams, Psychology of Women: Behavior in a Biosocial Confext 3d Ed-, New York and London: W.W. Norton & Company, 1987,392. 39. Adrienne Rich, "Compulsory Heterosexuality and Lesbian Existence," in Feminist Theoy A Reader, Eds- Wendy K Kolmar and Frances Bartkowski, Mountain View, California: Mayfield Publishing Company, 2000, 305. 40. Rich, 305. 41. Rich, 304,305. 42 Rich, 305. 43. The frequent description of the ernaciated body of the voluntary self-starver in feminist and traditional works of 'grotesque' is interesting given the discussion of the mind (male)/body (fernale) dichotomy. Understanding and viewing the body as 'grotesque' irnrnediately places the 'anorexic' body in the categories of 'deviame' and 'illness.' The term 'grotesque,' however, goes beyond other medical mode1 language in that it has an interesting connection to the 'anorexic' body. 'Grotesque,' originaily grotto-esque, is a derivative of open cavernous, earthy spaces that are represented by and as the female body. Mary Russo argues that: "The grotesque body is the open, protruding, extended, secreting body, the body of becoming, process, and change." The 'grotesque' body, ferninine and excessive, is then created in opposition to the classical male body which is closed., hard, defineci, and controlled, The current meanings of 'grotesque' inchde: "comically or repulsiveIy distorted or shockingly incongruous or inappropriatel' Describing the voluntary self-starver's body as 'grotesque' illuminates the assurnption of the body as uncontrolled, dthough there is a false sense of controllhg the body. The feminine is implicitly implied in that no rnatter how controlled, closed, or unferninine the thin body becomes it can never escape the gendered body, Even in the seerningly gender-neutral definition the thin body, the 'grotesque' body, as 'cornic,' 'inappropriate,' or 'repulsive' implies that the 'grotesque' is the passive outcome of a fast- To reclaim the ernaciated body and the 'grotesque7 body we need to recognize that the 'grotesque' is the parody of its own original meaning; that is, it is the very denial of the open, earthy, spacious, secreting, ever-changing body that is resisted through the emaciated form. The 'grotesque' is it's own paradoxical resistance, It disrupts, contradicts, and exposes the very contradictions within the discursive constnictions of the body. See Sonya Andermahr, Terry Lovell, and Carol Wokowitz, A Concise Glossary of Feminist Theory, London and New York: Arnold, a member of the Hodder Headline Group, 1997,91; Oxford Concise Dictionary, 627. 44- Thompson, 14. 45- Ibid, 46 Ibid, a-Thompson, 11-12, 4s. Diane Griffin Crowder, 'Zesbians and the (Re and De) Cons tmction of the Female Body," in Reading the 110 Social Body, Eds., Catherine B, Burroughs and Jeffrey David Ehrenreich, Iowa City: University of Iowa, 1993, 65. 49. Eckermann, 152, so. Melinda Kanner, "Dnnking Themselves To Life, Or the Body in the Botue: Filrnic Negotiations in the Construction of the AIcoholic Fernale Body," in Reading the Social Body, Eds., Catherine B. Burroughs and Jeffrey David Ehrenreich, Iowa City: University of Iowa, 1993, 158- si-Kanner, 158. n- See, for example, Barbara P. Kinoy Ed., Earing Disorders: New Directions in Treatmenr and Recovery, New York Columbia University Press, 1994; Kathryn J, Zerbe, They Body Betrayed: Wornen, Eating Dhrders, and Treatment, Washington, DC, American Psychiatrie Press, Inc.,1993. For a historical example see P. Lionel Goitein, "The Potentiai Prostitute: The Role of Anorexia in the Defence Against Prostitution Desires" Journal of Criminal Psychopathology 3 1942: 359-367. n. Kanner, 158. S. Kanner, 160, 55- Kanner, 159.

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113

This reproduction is the best copy available. Conclusion

Voluntary self-starvation has undergone a number of significant changes fiom the Middle Ages to the contemporary penod. Fasting religious and lay women during the Middle Ages gained political and cornmunity influence through their self-imposed starvation. By the sutteenth century, voluntary self-starvation became a commercial spectacle where starving women could be viewed in remfor money or gifts. For the fmt the, monetary gain was possible through voluntary self-starvation and, for sorne, it became a rneans to escape poverty.

From this period until the nineteenth century, the commercial spectacle of starving women was lucrative but extremely dangerous. The religious discourse of the Middle Ages that controlled the meaning of fasting was

,gpduaily replaced by medical discourse from the sixteen* century onwards, As a result when women were suspected of fraudulent fasting watches ensued to ensure the fasts' validity , Voluntary self-starvers who'were caught taking any nourishment were considered 'frauds' and this often had severe consequences. For example,

Sarah Jacobs lost her life when physicians watched her fast to ensure its validity, Before their eyes she starved to death,

In the nineteenth century, the medicalization of women's bodies and the pathologization of their rninds combined with the rigid ,often contradictory, and class-dependent constructions of femininity gave rise to 'anorexia nervosa'. Physicians interested in explaining women's voluntary self-starvation began to treat food refusal amongst white, rniddle-class, heterosexual young women as a pathology. In France, in 1873, E.C. Lasegue described eight cases of 'l'anorexie hystenque', while in England W.W, Gull coined the terrn 'anorexia nervosa'.

Throughout the twenueth century the construction of 'anorexia nervosa' has undergone a number of shifts.

The numerous biological and psychological discourses have created a number of current explanations of the

'illness'. However, the anti-psychiatry movement provided a stem critique of the psychiatric professions. Women also began to publically criticize the psy-disciplines and started to create a discourse of resistance to the various treatments they suffered. Nonetheless, the psy-disciplines continued to establish and maintain an almost irrefutable discourse of voluntary self-starvation.

With the second-wave feminist movement, there began a feminist critique of traditional psychiatric explanations which sought to explain voluntary self-starvation using feminist rhetoric. The works of Kim Chemin, Susie Orbach, Susan Bordo, Haniet Fmd, Morag MacSween, and Eva Szekely al1 explain 'anorexia nervosa' in terrns of women's position within a patriarchal Western culture, However, these feminist explmations of 'anorexia nervosa' continue to understand self-starvation arnongst women as an individual pathology and continue to uphold the dichotomy of 'anorexic9/ 'non-anorexie'. In addition, few challenge the racist, classist, and heterosexist understanding of 'anorexia nervosa' as a white, middle-class, heterosexual woman's 'disease*. In doing such, they render invisible women who do not fit this stereotype.

Altematively, using the tools of postmodem theory, we rnay begin to reconceptualize wornen's expenences of voluntary self-starvation and provide important challenges to the traditioad psy-discipline and ferninist explanations. To recognize the possibility of voluntary self-starvation as an act of resistance is to view women as active participants in the construction of their own Iives. To do this we have to see wornen as capable of reco,onizing, understanding, and negotiating the contradictions they face as a result of a confusing social matrix. If we use Judith Butler's theory of 'gender trouble' then we can begin to see how voluntary self-starvation rnight be resistance. It may, if only briefly, dismpt, confuse, subvert or parody the various constnrctions of gender, race, class, and sexuaiity that women experience. WhiIe the resistance rnay not be completely effective, it does momentarily disrupt signifiers and parody some of the prevdent dichotomies in Western culture. The resistance ends at the moment where it is discursively appropriated by psy-disciplined discourses that rerider invisible the activity and resistance of wornen.

While not al1 women rnay voluntarily self-starve as an act of resistance, we should not exclude the possibility that some rnight. To give women a language of resistance, to allow their bodies to be heard, and to allow them to explain their self-starvation is to recognize the heterogeneity of Iived experiences. Women, however, rnay share expenences but if their voices are denied these women may not discover a shared language around the body which rnay allow them to discuss both differences and sirnilarities.

The Irish wornan in Belfast who began a hunger strike in prison, was released, and then died of 'anorexia nervosa' rnay never have ended her political resistance. Her resistance, however, outside of the confines of a cell, became a 'mental illness' because the discourse explai~ngher behaviour shified fiom active to passive, resistance to 'disease'. The description of her voluntary self-starvation speaks to the greatest difficulty we face in understanding voluntary self-starvation as an act of resistance - the silence, What has remained consistent is the lack of women's voices in the construction of voluntary self-starvation as they have largely remained silent or, more probably, been silenced. Tvpical Behaviour Therapv Treatrnent Program Du~~PHospitalization '

Weight gain of 2ûûrng or more

1. May wdk around unit, go out.into hail to make phone cails, down to fxst fïoor with parents or nurse 2, May go out of the hospital for lunch only when weight gain is progressive and patient seems stable

Weight gain of 100mg - Bed rest with bathroom privileges

1. May answer phone when someone calIs but rnay not go out to rnake phone calls 2. May have visitors 3- May watch T-V., receive mail, bathe in bed

No weight gain or Ioss - Bed rest, no bathroom privileges

1, No phone calls, but may know who called 2- May have visitors 3. May watch T.V., receive mail, bath in bed

Weight loss of IOOmg - Bed rest, no bathroom privileges

1. No phone cails, but may know who called 2. No visitors 3- May watch T.V., receive mail, bath in bed

Weight Ioss of 200mg - Bed rest, no bathroom privileges

1. No phone calls 2, No visitors 3- No T.V. 4, May receive mail, bathe in bed

Weight loss of 3ûûrng - strict bed rest

1. No phone cals 2. No visitors 3. No T.V., mail, bathing 4- MAY OhTY EAT

I. From Salvador Minuchin, Bemice L. Rosman and Lester Baker, Psychosomatic Families: Anorexia Nervosa in Contexr, Cambridge Massachusetts: Harvard University Press, 1978, 1 15. Bibliography

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