|
|
 Photo by Heather Hill Helen Gremillion, in her presentation "Gendered Bodies and Psychiatric Power: Anorexia Nervosa in Cultural Context" March 24, shows slides illustrating how cultural messages influence the development of anorexia. "Media images of female beauty don't cause problems with dieting and self image," she said. "But I think they participate in the problem." Gremillion's lecture was the inaugural in the Peg Zeglin Brand Chair in Gender Studies Lecture Series.
|
Why is anorexia nervosa distorting the identities of so many girls and young women in our country?
Helen Gremillion, the Peg Zeglin Brand Chair and assistant professor of gender studies at IU Bloomington, believes the answer lies in studying the cultural and social influences surrounding the disorder.
"Many, if not most, young women and girls in the U. S. today are preoccupied to some degree with calorie counting and body weight," Gremillion said. "I believe that anorexia is best understood in this light--as an extreme form of normal behavior. Clearly, anorexia is not the same as dieting, but there is good evidence that anorexia and chronic dieting exist on a continuum, and that anorexia is shaped by our particular cultural and social milieu."
Before the 1970s, said Gremillion, anorexia nervosa and other eating disorders were rare. Since then, anorexia's incidence has more than doubled--at the same time the diet industry and fitness movement took off.
Also, anorexia appears only in market economies where elaborate consumer cultures have flourished. In these societies in the past few decades, and particularly in the United States, a new cultural ideal has been created: the ability to control and manage consumer desire by controlling and managing the body. This ideal enables anorexia and other eating disorders.
Finally, said Gremillion, anorexia is shaped by gender, class and ethnicity. More than 90 percent of cases occur among women and girls. Anorexia is almost exclusively a middle-class phenomenon and occurs among Euro Americans at a ratio of greater than four to one.
"Increasingly," said Gremillion, "we are all under pressure to define important aspects of personal success through an ability to control our body image and size. This cultural ideal is thought to be particularly difficult for women and girls to achieve. They are diet industry targets whose bodies are constantly threatening to go out of control. It's also important to note that dieting is predicated on failure--upwards of 95 percent of dieters regain the weight they lose."
Given that anorexia has an approximately 10 percent mortality rate--the highest of any psychiatric illness--and that most patients who live never fully recover, it's important to find new ways to understand and treat the disorder.
a n o r e x i a n e r v o s aIs anorexia nervosa best understood as a psychological and biological disease, an abnormality? Or is it possible that anorexia, a disorder of self-starvation usually accompanied by rigorous exercise, is an extreme form of normal behavior in a culture that emphasizes dieting, exercise and bodily control?
http://www.indiana.edu/~gender/webstaff.html
|
"I found," she said, "that some of the same cultural influences that shape anorexia also shape treatments for anorexia. Clinicians often participate unwittingly in certain cultural themes that actually enable the problem."
Gremillion said that in our culture, we tend to think of biology and psychology as separate from culture. "But what if this approach to problems is actually our own particular cultural construction? What I found is that traditional approaches to treatment reinforce these views, which in turn, reinforce a cultural preoccupation with individualism and bodily control.
"Anorexic patients already believe their problems are internal--problems of the psyche or an unruly body--and they feel a strong need to control their bodies in several ways that are replicated in the treatment program, especially through tracking patients' body weight and caloric intake," said Gremillion. "These measurements become highly ritualized and heavily controlled in the clinic, just as they were for the patient at home.
"As a result, patients and clinicians struggle over issues of bodily control, because patients feel that they need to be in charge of monitoring their bodies in order to be competent, successful individuals."
So, how can therapists interact with patients without re-creating the conditions that encouraged anorexia in the first place?
"In the course of my research," said Gremillion, "I met several 'narrative therapists' who draw on cultural anthropology and gender studies in their work. Anorexia is one of the many problems they confront, and they analyze the problem as a set of stories people tell one another about who they are, and how they got to be this way. These stories include ideas such as, 'if I just had a stronger sense of self, or worked harder, or had a positive attitude, I could overcome anorexia.'
"A major goal of narrative therapy is to see these stories as reflections of powerful, cultural beliefs that can become internalized. These therapists believe that their clients are caught up in the ideals of dieting and fitness with particular intensity. But they do not believe that the cause of anorexia can be found in their client's psyches, bodies or family dynamics.
"This approach allows people to fight anorexia without self-deprecation and without guilt."
Related Link: 
Return to Table of Contents