RECOVERY FROM ANOREXIA-NERVOSA - A DURKHEIMIAN INTERPRETATION

Attempts to explain ''eating disorders'' in contemporary western socie ty have concentrated on aetiology at the expense of resolution. Most ' 'recovered'' anorectics, however, question medical definitions of ''an orexia nervosa'' and clinical criteria for recovery. This article refe rs to a study of 32 people at different stages of the recovery process , to reconceptualize the problem in sociological terms. Durkheim's acc ount of asceticism offers a fresh interpretive framework in which anor exia and recovery are understood as the negative and positive phases r espectively of a ritual of self-transformation. In western culture, wh ere appropriate myths and rituals of re-incorporation are not readily available following a period of symbolic fasting, it is not surprising that recovery from anorexia is not automatic. Participants in this st udy referred to anorexia as a spiritual quest and for them recovery in volved a re-discovery (or creation) of a threefold connection: inner, with others and with ''nature''. These connections are, for them, the defining features of spirituality. The negative phase of the ritualist ic quest (anorexia) involves a confrontation with the inevitability of death as a condition of the positive phase (recovery) in which people actively choose life. This new theoretical approach provides a non-me dicalized understanding of anorexia and simultaneously enables a re-in terpretation of the fasting of medieval women saints. Recent scholarsh ip in this area is re-evaluated to demonstrate that the continuity bet ween asceticism and anorexia lies in the use of food as a metaphorical attempt to confront the universal problem of one's own mortality. In certain historical situations, asceticism served a socially valuable s ymbolic purpose. In contemporary society, however, this meaning is no longer available. Instead, it is recovery which constitutes the active and metaphorical ''rebellion'' against forces of social control. Fina lly, the work of Van Gennep is used to explore some of the specific ri tual processes through which people effect the self-transformation fro m suffering to recovery, providing further insights into how recovery takes place from a wide range of other sufferings as well. Copyright ( C) 1996 Elsevier Science Ltd