Emotional Health · Health

Not From Thin Air: The Emergence of Eating Disorders

A clinician today rarely sees patients like the ones Freud saw. Instead, those who consult therapists often report depression, aimlessness and feelings of emptiness, and their symptoms can include (among others) eating disorders, addictions, sexual dysfunction. Kohut named these problems as the products of “the understimulated self:” in the modern world families are smaller and there is less intimate contact between people. The Victorian era, in contrast, produced neuroses that corresponded to the overstimulation caused by large families (and in the middle classes servants as well) living in close quarters. Not surprisingly, when clinicians encounter the rare patient with pathology resembling that of Freud’s women of 100 years ago, she usually comes from a family with this kind of structure.

Eating disorders, as seen from this perspective, represent an attempt to gain control over one’s sense of self. In anorexia in particular, a woman’s entire self-worth is boiled down to a number on a scale. These conditions tend to emerge in adolescence, when a girl is faced with disorienting changes in her body and identity. Suddenly, her body is not just a body, but a commodity, and peers of both sexes react to her differently. Yet the changes she encounters are beyond her power to control. Or are they?

The idea that weight is something you can change, control, and modify is a dominant one, though current research is challenging this view.  A girl goes on a diet thinking she can improve herself, and at first losing weight does often lead to an increase in social capital. What also happens, however, is that she discovers a way to regulate her emotions as well. This explains why eating disorders are also set in motion by separations: a girl goes to camp, college, or has an upsetting breakup. An obsessive focus on food and weight is an attempt to control feelings and events that she is learning are not in her control.

RELATED: Eating Disorders in Women Over 40

A century ago, girls were not judged by their physical attributes and until the 1920s, “reducing” was not popular or even seen as desirable. Joan Jacobs Brumberg, whose fascinating book on this subject, The Body Project, documents the changes in the way girls have seen themselves through the years:

“Before World War I, girls rarely mentioned their bodies in terms of strategies for self-improvement or struggles for personal identity. Becoming a better person meant paying less attention to the self . . .When girls in the nineteenth century thought about ways to improve themselves, they almost always focused on their internal character and how it was reflected in outward behavior.”

Were the girls inherently “better” people back then? One could argue that strong religious ties made a difference, but many people in the United States maintain those today. What has changed is the cultural context, including the way society treats women. The more women have struggled for freedom and gender equality, the more the culture at large has objectified them and made them into commodities. I think it is significant that women’s interest in manipulating their bodies coincides with their struggle for voting rights. Increasingly, women’s physical ideal began to veer away from the soft, rounded shape that is the natural product of female development.

But why did the explosion of this epidemic take place in the 1970s and not sooner? I believe that the introduction of the birth control pill was a monumental landmark for us. It led to many changes in female identity, and it is regarded as seminal to the Women’s Liberation movement. Along with abortion rights, it also heralded the conquest of nature’s most powerful and difficult to master force: reproduction. Before mastering birth control, women’s bodies, fertility, and motherhood were powerful, often mystical symbols. Interfering with these forces was not only difficult, but in many cultures, illegal and even dangerous. Women, and the power their bodies held over societal events, were symbols of respect (if not worship) and motherhood was revered. Though we did not occupy positions of power in the way men did, in this way we were literally life’s most fundamental force.

RELATED: Dr. Pat Consults: Eating Disorders in Midlife

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  • Micki LeCronier June 30, 2016 at 9:37 am

    This reads like a history of eating disorders. Thank you SO MUCH for addressing this crisis.