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Biting the Hand that Starves You: Inspiring Resistance to Anorexia/Bulimia
by Richard Maisel, David Epston, and Ali Borden
W. W. Norton & Co., 2004
(314 pages, $35.00, hardcover)
reviewed by Nun Katherine (Weston)
We all ‘have’ anorexia to some extent,” says the father of an afflicted teen. “So I think of the person ‘with’ anorexia as just ‘having’ more of it than the rest of us.” The siren voice of anorexia lures vulnerable people through shared cultural ideals, using every possible medium.
Freedom from it comes from learning and embracing the truth, and how much easier this will be when thinness is not deified by society at large or universally recognized as a hallmark of success. For many with anorexia, which predominantly afflicts women and girls, it is the only attainable mark of success. Therein may lie its seductive appeal.
Using narrative therapy, the three authors of Biting the Hand That Starves You have developed an insightful approach to dealing with life-threatening anorexia/bulimia (a/b). The authors, not interested in diagnostic categories so much as an experiential description of a/b, use the terms interchangeably. Their therapy presents a unified approach to a continuum of conditions.
Narrative therapy helps clients look critically at their thought processes by creating distance between the person and the thoughts, “the person and the problem.” This is done metaphorically by externalizing the voice of a/b. Sufferers dialogue with it, discovering it to be a traitor rather than best friend.
Typically, sufferers come to the authors’ practices completely identified with a/b’s agenda for them, saying that they themselves want to get thinner, they themselves want to burn off calories with hours of daily exercises. By using “externalizing conversations,” the authors have been able to “flush the presence and operations of a/b into the open” and to “reverse the vocabulary of self-blame . . . that a/b employs to represent people, thereby constructing a/b linguistically and conceptually, as a force or influence separate from the person.”
Only in this way do sufferers come to recognize the right to reject a/b and thus the possibility for taking personal responsibility. Their therapy is also advanced by deconstructing the societal definitions of success and beauty, the a/b in all of us, balanced by the reconstructing of their sense of meaning and fulfillment.
In the authors’ practices there are no “anorexic clients”; instead there are “insiders.” Downplaying the therapist-client relationship, they style themselves and the insiders as “co-researchers” into a/b. This position helps lift the stigma of mental illness and helps sufferers discover their personal resourses for engaging in an arduous but winnable fight for their lives.
A/b entails much more than just weight loss from not eating. It proposes to rescue its victims from engulfing feelings of worthlessness, grief, and guilt that prod them to strive for impossible perfections as a source of “moral worth.” This “moral worth” comes from a distortion of the Christian virtues of temperance, self-control, and self-discipline.
The search for quantifiable perfection often makes a/b sufferers competitive. Some insiders, once they are labeled as “anorexics,” find that a/b defines a new contest for them to be the best, thinnest of all anorexics. By elevating their clients to the level of co-researchers, the authors have been able to help them discover their wholesome desires. They join them in an “anti-anorexia” stance, teaching them to evaluate their thoughts, impulses, and actions as pro- and anti-anorexia.
I was especially surprised to discover that an aspect of their work is the recording and publishing of therapy sessions with insiders. The authors have found that many have been socialized to care only for the needs of others. They may also feel so worthless that they cannot muster the motivation to strive on their own behalf.
The idea that recording their progress will help other sufferers gain their freedom often gives them the boost they need. They are asked if there’s anything they’d like to say “to someone who’s just beginning to see and oppose anorexia?” The insiders may have the chance to review the transcript later and make comments.
The entire book is woven around such transcripts taken from different stages of anti-a/b therapy. These stages define the themes of the first three parts of the book: recognizing that one has been seduced and imprisoned, learning how to resist, and reclaiming one’s life. They also include insiders’ journal entries and some inspired and inspiring poetry.
The fourth and final section is called “Becoming an Anti-Anorexic/-Bulimic Ally,” beginning with a practical chapter on how parents can join the fight. It also introduces readers to the Anti-Anorexia Anti-Bulimia League, a “community of insiders and their allies” who share their anti-a/b struggles, tactics, and victories.
My only concern is with the book’s postmodern, deconstructionist stance. Clearly the demands of a/b must be deconstructed. The authors, however, in taking a stand against “heterosexist supremacy,” covertly attack the authoritative voice of Scripture on the issue of human sexuality. They assert that “the beliefs associated with [‘heterosexist’] discourses are readymade to instill self-hatred and shame” through a/b’s power to distort meanings.
They further claim that any dominant worldview “that establishes a hierarchy of moral worth is inherently empowering to a/b.” That is, a/b either instills shame in those who do not conform to the prevailing ideals or instills the need for outward compliance.
The Devil A/B
This raises two questions for me. First, is deconstruction inherently the foe of Christianity? I do not believe so, as the Lord Jesus often deconstructed the contemporary understanding of Mosaic Law in order to make room for his higher moral code.
Second, is it possible for conscious Christians to practice or avail themselves of this form of therapy while still upholding the moral demands of the Church? I believe so: The key is the right understanding of her laws and practices. Church tradition, for example, has always encouraged fasting in moderation as a virtuous practice.
To their credit, the authors do not blame the Church for contributing to a/b in this regard so much as they show how a/b can twist Christian precepts. Also to their credit, they acknowledge that a/b can twist any well-meant discourse to fit its agenda—even the words of their book.
Although they might be very surprised, I found promising parallels between the ancient Church’s approach to therapy for the soul and the authors’ work with insiders. They direct the constant battle for life-enhancing choices in the face of “a/b’s rhetoric [which] is like a many-tentacled octopus.”
This mental battle, entailing great vigilance and discernment, is what ancient Christians termed “unseen warfare” against hostile spiritual powers. In attributing to a/b its own voice and purposes (“I knew I had to prepare for mortal combat as anorexia intended to murder me”), it becomes what insiders see as a “devil,” an “evil” force telling, propelling them to harm themselves.
Compare this with the “narrative approach” of the sixth-century writer St. John of the Ladder. He questions one of the passions thus: “Tell me, you nerveless, shuffling fellow, who viciously spawned you? Who are your offspring? Who are your foes?” Under compulsion, anorexia might be thought to answer, “My foes are truth and openness, perseverance, and dedicated friends.”
Congratulations to the team of therapist-authors who have discovered and shared such a hope-giving approach to fighting anorexia/bulimia. May Biting the Hand That Starves You help many to discard their pro-anorexic thinking, whether they see themselves as insiders, outsiders, or mere Christians.
Information on the Anti-Anorexia Anti-Bulimia League can be found at www.narrativeapproaches.com.
Nun Katherine Weston of the St. Xenia Monastic Community (Serbian Orthodox Church) is a Pastoral Care and Counseling student at Christian Theological Seminary, Indianapolis, Indiana.