The quantification of gender: Anorexia nervosa and femininity

Abstract

The ways in which Anorexia Nervosa (AN) has been described and explained has differed drastically over time although since it was first named in 1874 it has been primarily associated with women and girls it is argued in this paper that it came to be more fundamentally associated with femininity due to certain disciplinary changes in the psy sciences. The influential psychiatrist Hilde Bruch lamented the loss in clarity of the clinical picture that was the result of psychoanalytic interpretations, to remedy this she reformulated AN into a pathology that was the result of the individual being too determined by external influences. Bruch's changes increased the emphasis that psychiatrists placed on the relationship between women and their social context and the lack of individual autonomy that many felt. Feminist writers adapted Bruch's theory to suggest that patriarchal culture was colonizing the lives of women and that social rather than individual change needed to occur. Psychiatrists subsequently developed scales for assessing gender identity which switched the emphasis back onto individuals and rendered gender as an individualised, quantifiable, manipulable object. When reified and individualised in this fashion it became more legitimate to discuss femininity as causative of, and masculinity as a protection against, AN.

An open invitation to productive conversations about feminism and the spectrum of eating disorders (part 1): basic principles of feminist approaches

“…More troubling from a feminist lens, Bruch argued that mothers’ deficient parenting contributes to the development of anorexia in their daughters by “weakening of individual autonomy in relation to socio-cultural influences” ([ 39 ], p. 6). Family-based therapists are particularly critical of the fact that in Bruch’s work “families are viewed as unnecessary, or worse, as interfering” ([ 40 ], p. 275) with the patient’s need for healthy identity-development in the context of individual psychotherapy.…”

“…When assessing the relationship between Bruch’s influential writings and feminist approaches to eating disorders, it is more accurate to assert that aspects of her work were taken up by feminists interested in better understanding distress and dysfunction around food and in bodies. Till [ 39 ] notes that Orbach’s [ 41 ] innovative feminist work on anorexia shares Bruch’s emphasis on exploring how “social expectations of femininity” can contribute to tensions, including contradictory messages, experienced by girls and women about their bodies. This focus on sociocultural strictures, magnified in the intense microcosm of the nuclear family, that keep women small—and desiring smallness—has also come under fire for promoting an over-focus on media ideals, weight stigma, and body weight, shape, and image in prevention, treatment, and research.…”

Psihodinamski pristup razumevanju anoreksije nervoze

“…Hilde Bruh (Hilde Bruch), za koju neki autori smatraju da je dala najveći psihodinamski doprinos ovoj temi u prošlom veku, 3 definisala je anoreksiju kao konflikt između unutrašnjeg (psihičkog) i spoljašnjeg (socijalnog/kulturnog) 4 (Till 2011). Sa pojavom puberteta devojke počinju da se suočavaju sa uticajnim patrijarhalno konstruisanim socijalnim ulogama koje se pred njih stavljaju, te konflikt i ambivalencija, udruženi sa intrapsihičkim sadržajima, bivaju produbljeni.…”

“…Prema njemu, seksualna apstinencija je najčešći uzrok anksioznosti koja je mučila ovu pacijentkinju, što je bilo u bliskoj vezi sa sa anoreksijom. Til (Chris Till) piše kako se s drugim talasom feminizma pojavilo veliko interesovanje za ovu temu(Till 2011).…”