‘scm maces or renal ot eh pt
weccly cars Bess,
1943, 2003
Whose Body Is This?
Feminism, Medicine, and the Conceptualization
of Eating Disorders
By the 1985 meetings of the New York Center forthe Study of
Anorexia and Bulimia, palpable dleeasfaction vas evident
largely among female clinicians —over the absence of any theotel
kcal focus on gender issues. In 1973, when Hide Bruch published
her landmark work Estng Dic, she made ithe se of the
concept of gender inher interpretation of anorexia, Kim Cheeni,
ln The Obsession, was the fist to note tht the vivid descriptions
Bruch provides of the anorectic's “bate against the adult devel-
‘pment of her body consistently lack one crucil element: recog
nition ofthe significance ofthe fot that this isa fre body whose
evelopment is being resisted” Following Bruch, the etiological
‘models that dominated over the next decade emphasized develop-
rental issue, family problems, and perceptual andor cognitive
“dysfunction.” In each the understanding othe role played by the
construction of gender and other socal factors was, atest. shall
tnd uneysemati.
Developmental and family approaches conceptualized interac
ons between mother and child as occuring outside cultral ime
and space; the father’ roe was simply ignored. Prceptualiopni-
tive models theorized the role of “sociocultural fctors” sally in
terms of "the pressure toward thinness,” indoctnation by the
thin ethic” what passed fr cultural analysis were sais studies
demonstrating the dwindling proportions of Pyty centerfolds
and Miss America winners throughout the 3980s. And, In all of
this, transactions were imagined a ocurring only between media
mages and females, o females and other females (peer presse
646 Diu end Contin eBay
conforms rom he mote he vost of men nd
to poplar ager, the canton ote dses and ae
ites the pressures ths trap fo bear on Efe and women,
‘eine ae fatherauger inet wn fox Founder and
{ometow unspenlable secretin the prevang parative.
Inne place wasthe mono the ea of tenderness explored,
etter inthe content of the aoe’ experince ora eral
formation that expreses eas, ates, and socal changes
(come rated to gece, some nt nich deper than the meey
fest ashe ened vo” iea
isn indus" ype were colecvely contacted a thea
nea whimsical and eprcosenemy, copie onder
ing and framing passive and impressionable young gis by
Incas of whatever ager) arbiter decided prose tat
sear, Hy thiness shuld bave bam sucha dominant al
tural teal inthe twentieth century remained unaddressed the
Interpeetition of repecetations wis viewed a culsde te do-
tino lineal lvenigaton
The one lin mode for which genders 2 hey anal
category, the peychoanalyi theorized the anorectic eitance to
developing fomale boi he ers of adona reunism,
as expensing arses and fantasies of + purely peycho-sertel
ttre, suchas ero pregnancyorfatacting the secalaiention
cf men. Treitonal Fendi has teen far moe tuned than
tera the mic me of he scp,
‘ecogizng for example, thatthe fear of fat on stomachs an
trent ha gender acetone that demand interpretation and
rot merely indicative of compulsive very to the nest shin
trond Bot Felon theory nonetheless (nd character a
fled to situate the cata of is analysis ina sociocultural st
ting_toapprecte for erample, tha fear of prgoancy may have
tore todo wih eso domestic entapinen an win cappresed
ect entasis,or hat ate abut the dangers of sea ie
telvemert might bea reise responce tothe disdoure of he
{sive and let ptr tht eal fo common within doe
teat relatonstpe (esc has oosd oo tatoos any
treads hysterics were very Wkly actly seal ebsed, ase
td egal hypothe oncdens of sexual aban ein he
‘eckgound of the scaled fight from tx of many ane
As and in the Histories of bmi a wel?
Me Boy TAS?
Thus, in 1989, gender either was absent or was theorleed in
‘sents terms by the leading authorities on eating dsorders—a
situation that organizers ofthe conference on srorexi and bulla
Sought to rectify. To dogo, they had to ell feminist who had
been working atthe marglas ofthe ofcal establishment wing
for eudiences other than medial professionals, practicing therapy
outside the framework of then-dominant models, and developing
over the preceding ten years, a very tfferent approach fe the
understanding of eating disorders. The theme che forthe 198
‘conference was “Eating Disorders andthe Pychology of Women
and Carol Gilgan and Susie Orbach were invited to be keynote
spenkes,
Giligan’s tak introduced the audience to Catherine Steiner.
‘Ada’sprovoeatve study of high school women, which revealed ¢
Striking association between problems with fod and body image
and emulation of the beaut independent, cool superwoman af
mia imagery.” Susie Orbach's talk was a moving argument,
‘rounded in object-relations theory and situated the soccer
nfext ofthe construction of femininity, tht the anorectic embod.
fc, in an extreme and painfully debilitating way, a psychological
struggle characteristic ofthe contemporary sivation of women, Tat
situation is one in which a constellation of socal, economic
Pychological factors have combined to produce a generation of
‘women who fel deeply awed, ashamed of thet nee, and nat
atte to exist unless they transform themselves into worthy newt
selves (ead: without need, without want, without bafy)® The
‘mother-daughter relation is an important medium of this process
Butt isnot mothers who are to Blame, stressed Orbach, for they
too are children oftheir culture, deeply annus over their own
‘ppetites and appearance and arae ofthe fact communis in
‘multitude of ways throughout our clture—that ther daughters
‘hilt to “catch man’ willdepend largely on physical appearance,
‘nd that satisfaction in the role of wile and mater wil hinge oe
learning to fed others eather than the semetaphorically en
teal
For Orbach, anorexia represents one extreme ona continuum on
‘which ll women today find themselves, insofar as they ae Va
‘erble to one degre or another, tothe requirementsofthecultural
‘onstruction of femininity. This nation provoked heated extiiom
from the al-male) panel of commentators, two paychintsats ant8 Discs and Conceptions fh Bay
one nicl paychologst. The poll implications of Gligan’s talk
had been mised by herrespondens (and by Orbach’), all of whom
chose to hear the paper solely as a lament for our cultse' nck of
steer forthe “female” valves of connestednest, empathy, and
dotherdiectedness. Gilligan's talk was (misinterpreted (as her
‘work frequently) sa simple celebration oftaditonal femininity
Tather than a a cxitgue ofthe sex division of lor that assigns
“female” values toa separate domestic sphere wile keoping the
publi, male space (and “masculinity” a bastion of auteomous
elves
COrtach’s talk, unambiguows in its indictment ofthe normative
construction of femininity in our caltre, was much more troubling
tothe panelists. I elicited from them 2 passionate defense of “ta
dliinal women” with Orbach the feminist portrayed as unser
nd unmothery and the panels est as sympathetic protectors of
those groups that Orbach had abused. So, for example, David
Garner, cosuthor of Anorecia Newest: A Muliimensonl Pospe-
tive fl cbiiged to defend mothers gait the “same” Orbach had
attributed to them and the “gilt” she had inflited on them for
“choosing traditional values" and being flied by “murring”
Steven Levenkeon, author of The Best Lift Gili the Word, ome
to the escue ofthe anorectic herselt—that “skinny Kd in your
office," ashe called her, whore suffering Orbach had failed to
fpprecite adequately (in suggesting that her pain could be under:
Hood on a continuum with normative female suffering) Here, the
feminist crigue was charged with sacrfcing the care of "helpless,
chaotic, and floundering” chide inthe interests of “rational”
political agenda, The panelists thus represented themselves both
better feminist than Orbach (that i, more concer with aca
‘women’s livs), better ”wwomen” (more empathic, morecaring), ad
a the same tine daalingly masculine Prince Charmings, rescuing
‘women fom the abstract and uncaring politics of feminism.
[Even more provocative than Obach’scritque of theconstruction
‘of femininity, however, wes hee questioning ofthe designation of
tating disorders as “pathology.” Al the pants, while remarking
fon how perfectly her interpretation tallied vith and ituminated
their own clink experience, were uniform in nitizing her ansl-
ysis fr (as Willam Davi put it ts "Tack of specie explanatory
oneeptions” and “indistinct and unconvincing” theorizing. How
Whe Bly TH? gg
‘anitbe that her analysis both explained and filed to explain? This
‘apparent contradiction in the estimation ofthe panel an be ac
‘counted for only by the hidden stipaaton that theory, no matter
how well it luminates a given phenomenon, Is inadequate unless
Italo sets down general criteria to enable se and precise distin
itishing between “normal” and “pathological” members of» pop-
‘hton. This, of course is what Oxtachs theory lacked—o, rather,
contested. AS such, tssueda profound challenge toone ofthe most
basic and most thoroughly entenched premises of the medical
model
Inthe clini erature on eating disorders, the taskof description,
(9)
233- Mary Mohler, “A New Look st Aner” Li Hae fur (Ape
298.
1 See noe, above,
{See Daa Heys interview with Steven Levenson; “Boy Hate.”
Ms iy 989 a3
‘= Midnel Stober, “Anorexia Newoss: History and Package
‘Concepts.”in Browne and Fores, HansoctEnng Dire po
“Brumberg, Fisting Gp.
{4 is templing to conde that Brumberg simpy does nt under
stand what metaphor and analogy sr orp sone such ss tmaecy
Proceso the that or tds ma cry meanings ante or oly
Ain understood by te sabject Bat Beambergs stad eal the mare
perplexing when et, borowing hey fom the fest hewy she
‘ieizes she argues hatte ood renal of Vicon anor shel be
Interpreted as a yb "vl," alent and potent form” orton
git family expectations eins repression, bd ldo setenony
(Geag Gr p. 0).
eso Paes 65-71, 308
45, Beumber, Fasting Git, pp 39-37. Revealing, this ample of
hip hens nken ney ord fr word by Bre om anise
{yan autbr wo wes advocating oe fetngo amore Bt Gad
er, "Treatment Refusal in Annes Novos” ema an ae
ing Dimon no. Bly a9) 30
Nay ba ly
49. Besmbers, Fein Git. 1: Cornel ae Kaplan, “Anora
[Nerrs: Digan Conceptions” pp. apoyt Gin Kala sh
iin pen Fars May Beale Aan “Mss ok Tn, ah
Be Susan Sq, You Tks Woman Can Never To la
Ie se Ie tee
46. Her, even tse who ft nerportd elements of the eins
gue nee fo go lute nthe dreon of ftom polit ant