Chapter 16 Eating Disorders: Traumatic Context and Interventions

In: Topography of Trauma: Fissures, Disruptions and Transfigurations
Diedra L. Clay
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Historically, women’s eating disorders have been denominated with such terms as ‘chlorosis’, ‘neurasthenia’ and ‘hysteria’. Since the 1970s an increase in eating disorders have been noticed, possibly correlated with the general phenomenon of cultural gender role change, posited as attributable to the confusion between the terms ‘sex’ and ‘gender’. The biological term ‘sex’ works for both female and male, while the socially given term ‘gender’ is either masculine or feminine. This traumatic bifurcation implicitly involves a cultural dualism. The theoretical consideration of eating disorders has been likened to the crystallisation of culture, with three cultural axes: the dualist axis, control axis, and gender/power axis. Dualism can be thought of as a denied dependency on a subordinated or traumatised other. Within this frame, human existence bifurcates into two territories or substances: that of the body and materiality, as contrasting that of the mental and spiritual. The body must be escaped from a prison and an enemy with which to struggle. In this battle, thinness represents a triumph of the will over the body. The control axis is informed by the experience of one’s hungers as being out of control. One’s ability to ignore hunger and pain evidences one’s control over one’s own body, often the only control one experiences. The gender/power axis is informed by the experience of one’s ‘female’ portions of one’s body, usually at menarche, as a disgusting appropriation of one’s body by fat. These symptoms emerge as an unconscious protest at the limitations of the traditional female role. Successful interventions with eating disorders take these intersecting factors into account. This chapter will expose the range of current treatment interventions in consideration of the traumatic context.

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