Institute of Social and Cultural Anthropology, University of Oxford, 51-53 Banbury Road, Oxford, OX2 6PE, UK.
Cult Med Psychiatry. 2018 Mar;42(1):159-179. doi: 10.1007/s11013-017-9545-8.
Bulimia nervosa and anorexia nervosa are inextricably linked, with substantial clinical and epidemiological overlaps. Yet, while anorexia has been analyzed extensively in medical anthropology, bulimia remains under-theorized. This is, perhaps, because, compared to self-starvation, binge eating presents a logic of practice that is difficult to reconcile with culturally reified notions of self-control, transcendence, and hard work. Thus, although anthropologists have analyzed anorexic subjectivities as imbued with a sense of cleanliness and purity, moral superiority, and heroics, similar analyses have not been extended to bulimic subjectivities; instead, bulimia has been subsumed, as a tangential disorder, into analyses of anorexia. In this paper, I aim to move bulimic identities from the margins to the centre of anthropological analysis. Based on participant narratives, I analyze bulimic identity as articulated by six Israeli women who identified as bulimic and received treatment for bulimia. The women's narratives show that bulimic identity is aligned with concepts of distinct selfhood. For these women, to be bulimic was to be framed as 'abnormal'; but this 'abnormality', albeit a source of social stigma and shame, held meanings that went beyond pathology. Through the claiming of bulimic identity, the women positioned themselves as untamed, non-conforming subjects, who acted against gendered and classed expectations-and even against the limitations of the body. Their constructions of bulimic distinction highlight the need for anthropological work that situates bulimia not as a footnote to anorexia, but as a structurally and culturally meaningful condition in its own right.
神经性贪食症和神经性厌食症紧密相关,在临床和流行病学方面有大量重叠。然而,尽管厌食症在医学人类学中得到了广泛分析,贪食症仍然缺乏理论。这也许是因为,与饥饿禁食相比,暴食呈现出一种难以与文化上僵化的自我控制、超越和努力工作观念相协调的实践逻辑。因此,尽管人类学家分析了厌食症患者的主体身份,认为其具有清洁和纯洁感、道德优越感和英雄主义,但类似的分析并没有扩展到暴食症患者的主体身份;相反,暴食症作为一种次要障碍,被归入到对厌食症的分析中。在本文中,我旨在将暴食症患者的身份从边缘地带推向人类学分析的中心。基于参与者的叙述,我分析了六位以色列女性的暴食症患者身份,她们认同自己患有暴食症,并接受了暴食症的治疗。这些女性的叙述表明,暴食症患者的身份与独特的自我概念相一致。对这些女性来说,暴食症意味着被框定为“异常”;但这种“异常”,尽管是社会耻辱和羞耻的根源,但具有超越病理学的意义。通过声称自己是暴食症患者,这些女性将自己定位为未驯服、不遵守常规的主体,她们违背了性别和阶级的期望——甚至违背了身体的限制。她们对暴食症患者身份的构建强调了人类学工作的必要性,这种工作不是将暴食症作为厌食症的脚注,而是将其作为一种具有结构性和文化意义的自身疾病。