Reflecting on Cosmetic Surgery : Body Image, Shame and Narcissism

Reflecting on Cosmetic Surgery: Body Image, Shame and Narcissism By Jane Megan Northrop B.N, B.A (Hons). Submitted in Fulfilment of the Requirements for the Degree of Doctor of Philosophy School of Sociology and Social Work University of Tasmania. March 2010 Declaration of Originality This thesis contains no material which has been accepted for a degree or diploma by the University or any other institution, except by way of background information and duly acknowledged in the thesis, and to the best of my knowledge and belief no material previously published or written by another person except where due acknowledgement is made in the text of the thesis, nor does the thesis contain any material that infringes copyright. All research procedures reported in the thesis were approved by the University of Tasmania's Social Sciences Human Research Ethics Committee. Statement of Authority to Access This thesis may be available for loan and limited copying in accordance with the Copyright Act 1968. Acknowledgements Undertaking a doctoral project has it moments, glorious ups and breathtaking downs, but there are people whose help I consider to have been indispensable to this project reaching completion. My thanks go firstly to my supervisor, Douglas Ezzy, for his support within the faculty of Sociology and Social Work at the University of Tasmania and, in particular, his preparedness to sign off on numerous extensions which gave me the time necessary to think my way through this project. I am deeply grateful to my dear friend and colleague, Trish Laddrak, for her intellectual engagement and friendship during the course of this project and beyond. My thanks are also extended to Neil Apted for the care and attention he directed towards this project in its final stages. I would also like to extend my gratitude to the staff at the Morris Miller Library for their assistance and support over the years. On a personal level I would like to thank my family, my parents Jill and David, for their ongoing love and support, my children Alexander and Magella, for their patience over the many years it took to complete this project, and my partner David, who has maintained a consistent interest in this project. His constructive engagement has made the process especially enjoyable. My final thanks are extended to the women who took part in this study. Their willingness to share their experiences has been foundational to the framing and direction this project has taken, and it is to them that I dedicate this thesis. Abstract Cosmetic surgery is an extreme form of modern grooming. Its growth and progressive normalisation has been paralleled by increased interest, and frequent alarm, from within the academy. Social historians have located cosmetic surgery's ascendancy within the technological trajectory of medicine, set against a social world fascinated with appearance. Feminists have argued cosmetic surgery is a tool of patriarchy which oppresses and subjugates women, while sociologists have examined cosmetic surgery as a medical discourse and a form of consumption. This study took a grounded approach to engage thirty women through in-depth interview to explore how they chose cosmetic surgery as an option. Their accounts frame a theoretical discussion which proposes cosmetic surgery is initiated within the vulnerable and divisive relationship between the self and its poor body image. Participants dismissed the widely held belief that media is to be blamed for distorting the relationship women have to their appearance, choosing instead to locate the source of their discontent much closer to home. Following the work of the psychoanalyst, Paul Schilder (1950), and the sociologist, Charles Horton Cooley (1962), body image is interpreted as an ongoing process constructed in social interaction with significant others. This study examined the way in which these interactions contribute to poor body image. Poor body image and the attempt at its reparation are examined conceptually through shame and narcissism to expand upon a sociological understanding of body image and its relationship to cosmetic surgery. By engaging data and theorists from multiple disciplines this study found that shame constitutes a framework within which we formulate appearance norms and learn the art of becoming socially embodied. Shame exposes the material body and the ways in which we manage its margins. Shame concerns the self, but it arises in response to perceived social phenomena. Through the evaluation and amendment of body image with cosmetic surgery, notions of self and social worthiness are played out. As this study progressed, the relationship between shame and narcissism emerged as increasingly significant. This study concludes by arguing for a review of the way in which we understand narcissism and proposes that shame is directly implicated in its manifestation. Contents: Introduction 1 Chapter One: Evolving Appearance Norms and Cosmetic Surgery 10 Chapter Two: Women, Appearance and Cosmetic Surgery 36 Chapter Three: The Mirrored Self 67 Chapter Four: Shame and the Social Self 95 Chapter Five: Shame and Subjective Experience 125 Chapter Six: Evaluating Body Image 161 Chapter Seven: Shame and Cosmetic Surgery 186 Chapter Eight: Just Look at Yourself 229 References 254 Appendix 263 Introduction Whenever a woman is asked why she has had cosmetic surgery her short answer is very likely to be "I didn't like the way I looked and I wanted to look better for myself." To many people such a response is reasonable enough to not warrant a great deal of further discussion. In a cultural climate where the vast majority of women are less than happy with their appearances, "wanting to look better" barely raises an eyebrow. Indeed, finding women who are entirely happy with their appearance is more unusual. Such women are becoming an anomaly; a minority group who could technically be described as deviant, and to whom other women look with a kind of wonder and, quite possibly, respect. Such women are extraordinarily fortunate since being content with one's appearance inevitably frees up time, energy and money which can directed elsewhere. While women who have cosmetic surgery want to change their appearance they are also aspiring to join that small group of women who are happy with their appearance. They want, more than anything, to be able to look in the mirror and to be happy with what they see. Not insignificantly, as body image dissatisfaction in women approaches the level of norm, body image anxiety has surfaced as the essential variable required by grooming industries like cosmetic surgery to succeed. Moreover, it is to this vast discontent that hugely profitable global organisations market an unprecedented range of grooming products and services designed to redress the problem. Media, with an unnerving and purposive agenda, accompanying us into our bedrooms, bathrooms and seemingly infiltrating our very psyches, is usually attributed blame in distorting the relationship women have with their bodies. Whilst the effects of media are undoubtedly pervasive, how media exerts its impact is far less certain. Like many others who have examined the progressive acceptance of cosmetic surgery, I assumed that tracking down the impetus behind turning to a surgical fix would uncover the role of media, magazines in particular, and of men. That was until I actually started speaking to women themselves and found that this teleological formula did not quite stack up. What I found in their long answers was an angst related to appearances born much closer to home. 1 This study comprised in-depth interviews with thirty women who had engaged with cosmetic surgery on some level, including twenty six who had undertaken surgery. Any suggestion that media may have encouraged them to undergo cosmetic surgery was poorly received. A few were downright insulted, while others appeared irritated or disappointed with the simplicity, or predictability, of such a proposition on my part, which not only roused their indignation but threatened the ambience of the interview. Participants did nonetheless agree that media plays an important role in disseminating information about cosmetic surgery and informing of new procedures as they become available, which, they did concede, has had a cumulative effect in normalising cosmetic surgery as a self-enhancement option. Despite its increasing normalisation cosmetic surgery remains a substantial undertaking. Electing to have a general anesthetic, the recovery time involved and the overall risk associated with any surgery, along with the financial cost means that cosmetic surgery can never be considered as lightly as a cosmetic procedure like a shot of Botox or collagen which might be administered in a doctor's surgery or specialist clinic during a workday lunch break. Choosing to have cosmetic surgery, especially on the first occasion, still represents an extreme in mainstream body modification technology. However, cosmetic surgery is, at its heart, no more than an intentional and committed grooming strategy enacted to ameliorate or improve body image and, as the interviews for this study proceeded, I began to realise that the real opportunity this study availed was not solely to explore cosmetic surgery as an event, rather, it provided an opportunity to examine the underlying body image dissatisfaction which participants undertaking cosmetic surgery overwhelmingly articulated. Pre-surgical body image dissatisfaction was expressed as a consistent theme across all interviews with

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