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Academy
for the Study of the
Psychoanalytic Arts


Foucault, embodiment and gendered subjectivities

The case of voluntary self-starvation

  by Liz Eckermann
 Deakin University  

From the idea that the self is not given to us, I think that there is only practical consequence, we have to create ourselves as a work of art. (Foucault 1983: 237)  


THE
SELF AS WORK OF ART

The person who voluntarily starves uses her body to recreate herself.   She recreates herself ‘as a work of art’ whose bodily form is so confronting that it cannot be, and is not, ignored.  The message conveyed by the emaciated self-starver is: ‘Read my body!’ 

Place (1989: 268), an ‘ex-sufferer of anorexia nervosa’, describes experience thus:

she twitched  
and twitched  
longed for some  
understanding  
for the words.

But the words did not come. She recalls:  

the battle to find words to express the world as it is full of paradoxes and not the narrow, simple place some parents describe it to be.
(Place 1989: 268)

The classical and modern traditions of sociology have little to tribute in understanding such messages since they are largely disembodied traditions which rely on evidence from the rational reflexive mind expressed through the spoken and written word.  In the mainstream classical and modern traditions there are no spatial and temporal concepts to allow analysis of such phenomena, much less a sociology of the body. When interviewees say ‘There are no words to describe how I feel’ and they answer questions with poems or bodily gestures where is mainstream sociology’s explanatory power?

     I suggest that phenomenology, post-structuralism and postmodern­ism provide the theoretical means to deconstruct embodied communication. In this chapter I will concentrate on the contributions that a Foucauldian analysis offers to understanding the contradictory discourses of self-starvation. I argue that Foucault’s analysis of the development of disciplinary society helps to explain the conditions for the rise of an epidemic of self-starvation in the late twentieth century and that his later work on power as constitutive and the self as agent aids an understanding of self-starvation as resistance.

     The message conveyed by the emaciated body is contradictory. It acts as a parody of disciplinary society to which the self-starver is the super-compliant servant or the ‘secular saint’ (if we all ate less fat, less sugar and less salt, we too could be ‘thin’). At the same time self-starvation defies both the dictates of science (if you don’t eat you die, yet the self-starver is still alive) and the authority of parents, teachers and the medical profession in a search for independent selfhood.

BEYOND THE CLASSICAL AND MODERN

Foucault challenges all of the underpinnings of what passes for ‘modern', most especially the unitary standpoint in relation to theory and the concept of the ‘self’ and the implications of this unitary theoretical framework in relation to power and possibilities for effective social change.  McNay (1992: 1) summarises the questions that many sociologists raise about the political implications of adopting a Foucauldian theoretical framework to understand social phenomena, thus:

Firstly, where does the post-structuralist deconstruction of unified subjectivity into fragmented subject positions lead in terms of an understanding of individuals as active agents capable of intervening in and transforming their social environment? Secondly, what are the implications of the postmodern suspension of all forms of value judgement, of concepts such as truth, freedom and rationality, for emancipatory political projects?

In answer to the first question, my research interviewing young women who self-starve suggests that political agendas are not compromised by using Foucault to understand voluntary starvation. If anything, post-structuralism sheds light on the extent to which a search for selfhood (and independence) exists alongside a pursuit of secular ‘sainthood’ (‘goodness’ in secular terms) in many self-starvers’ constructions of themselves. The second question raised by Foucault’s critics, when applied to self-starvation, addresses the issue: ‘Is self-starvation a problem?’ and ‘if so, whose problem?’ Are there conditions under which it is rational to starve oneself? What if self-starvation is seen as a solution rather than a problem by the self-starver? I will deal with the first question raised by the critics of post-structuralism and then explore the implications of suspended notions of truth and rationality.

   
FRAGMENTED SUBJECT POSITIONS  

Much modern sociological theory rests on an acceptance of the concept of the universality of a search for integration in individuals’ beliefs, attitudes, values and actions. This is seen for instance in the work of Festinger (1957) in his theory of ‘cognitive dissonance’.  The theory of dissonance is based on the assumption that the individual ‘strives towards consistency within himself [sic] . . . the existence of dissonance, being psychologically uncomfortable, will motivate the person to try to reduce the dissonance and to achieve consonance’ (Festinger 1957: 1—3).  In sociological theory this concept is generalised to the social system as evidenced in the homeostatic theme of Parsons’s arguments in The Social System (1951).  The pursuit of harmony also underlies Giddens’s (1991) claim that the project of the self involves the production of a ‘coherent ‘and ‘unitary’ self.  In fact, the notion of people being motivated by a search for personal consistency and integrity has inhered in much social theory since the Enlightenment.  

    Foucault denies unitary theoretical constructs and the search for ‘internal consistency’ and argues for the need to adopt a de-centred approach to both individual identity and social formations. Thus any given individual, and any particular society, can contain multiple, shifting and often self-contradictory identities. Added to this is the concept that there is no way of judging the value of one of those identities over the others. There are, as Foucault argues, ‘many ways of being’.  It is this recognition of the many ways of being that renders Foucault more useful than Giddens (1991, 1992) in understanding voluntary self-starvation, since literature on self-starvation over the last decade (Bordo 1988; Probyn 1988; Robertson 1992; Eckermann 1994) has identified contradictory, shifting and multiple identities amongst those who starve themselves.

TWO FOUCAULTS? THE DOCILE VERSUS THE ACTIVE SELF

Foucault’s theorising about power goes through several major transformations over the course of his writing career. His earlier works on institutions, such as his analysis of asylums (1965) and the clinic (1973), the hospital (1973), the prison (1979) and public health (1980), emphasise external constraints on the power of individuals via the disciplines. Both Patton (1989) and McNay (1992) document the transformation which occurred in Foucault’s conception of power in the early l980s. In his later work, from the first volume of History of Sexuality (1981) onward, Foucault offers a framework to theorise the self which allows for the exercise of individual agency. It is this latter emphasis in Foucault’s work which has been ignored by many of his critics (Patton 1989; McNay 1992).  

     Foucault’s early works on the production of docile subjects and his later writing on the active self, as elaborated in volumes two and three of the History of Sexuality (The Use of Pleasure and The Care of the Self), prove singularly fertile in  providing conceptual tools for understanding the body from a sociological perspective and specifically     for gaining insights into the historical forces behind the modern ‘epidemic’ of self-starvation. His ideas have also formed the focus of  new therapeutic techniques for dealing with such ‘disorders’, and these    techniques specifically apply Foucault’s ‘general spectrum of power’ (White and Epston 1989).

     White and Epston note the use of analyses of power in therapy literature as traditionally representing power ‘in individual terms such as a biological phenomenon that affects the individual psyche’ or as ‘individual pathology that is the inevitable outcome of early traumatic experience’ (White and Epston 1989: 25). They identify attempts to apply Marxist class analysis in terms of power in the relations of production and ‘a number of feminist analyses of the operation of power.. . as a gender-specific repressive phenomenon’ which they see as having ‘sensitized many therapists to the gender-related experience of abuse, exploitation and oppression’. However they argue that ‘it is      important to consider the more general spectrum of power as well, not just its repressive aspects, but also its constitutive aspects’; thus the work of Michel Foucault is important (White and Epston 1989: 25).

       Foucault’s work on the disciplined society provides an analysis of the connectedness of the body, self and society, thus combining the macro and micro traditions of sociological analysis (Silverman 1985). Although his earlier work minimises the role of agency and the ‘self’, he refers to the politico-anatomy of the body and the bio-politics of the society as being inseparable parts of the general exercise of power. One of Turner’s (1984, 1987, 1992) unique contributions to a sociology of the body in extending Foucault’s analysis is to draw parallels between regimes of given societies and the regimes people apply to their own bodies. An administered society develops in response to the fact that all societies are confronted by four tasks, namely: the reproduction of population in time, the regulation of bodies in space, restraint of the interior body through disciplines and  representation of the exterior body in social space (Turner 1984: 91).  Self-starvation, and the ascetic practices that accompany it, reflect the overlap between these levels of administration. Self-starvation may represent a personal solution to a broader social problem of lack of order and control. This process is also normalised in the self-starvation that accompanies World Vision’s 40-Hour Famine, whereby ascetic practices of starvation at an individual level are used to appease social guilt about structural inequality globally.  

          Foucault uses language as a key variable in explaining how social power is exercised, and how social relations of class, gender and race can be transformed.  Foucault’s place in this tradition is unique in his insistence on the importance of historical processes and specific ‘moments’ as heuristic devices in gaining insight into present social processes.  In arguing that language circumscribes social reality,  Foucault suggests that one should direct one’s attention to the specific details of the discursive field which constitute concepts such as body, illness and madness at a particular historical moment, in the service of gaining understanding of how particular power/knowledge processes are at work (Place 1989; Ussher 1991).

MEDICALISATION AND OBJECTIFICATION OF BODIES       

Foucault’s analyses (1979, 1981) of the medicalisation and objectivisation of the persons of ‘marginal groups’ in the seventeenth century and the subsequent hysterisation of women’s bodies in the eighteenth century (1981) are of particular relevance to understanding self-starvation and binge-purging. The disciplining of the body and the self-denying regime evident in the self-starving individual can be related to the historical process of objectivisation of bodies.

     With the development of the Hôpital Générale in Paris in 1656, the poor, the prostitutes, the vagabonds and the ‘insane’ were rounded up, institutionalised and subjected to a series of experiments, controls and surveillance.  The development of the idea and practices of treating individuals as objects can be observed in this situation. ‘Marginal’    groups were excluded from the population at large, from the mainstream of culture, a process which had started with the exclusion of lepers. Thus these groups were given an identity by the majority group as ‘outcasts’ and the use of the word ‘leper’ as a metaphor for ‘outcasts’ emerged. Such ‘outcasts’ were seen as not meeting the criterion of being persons.  

     The second stage of the objectivisation process was that bodies were treated as objects.  Foucault argued that ‘the study of human beings took a decisive turn’ at the end of the eighteenth century. ‘Human beings came to be interpreted as knowing subjects and at the same time as objects of their own knowledge’ (Foucault 1981). With the development of epidemiology, statistical techniques for aggregating social data, clinical medicine and the application of science to the social sphere, bodies could be transformed into objects. Women were especially vulnerable to this process because the traditional areas of female medical knowledge and therapeutic techniques did not fit the requirements and specifications of scientific medicine. Women were ascribed a specific identity by men and relegated to the spheres of nature, emotion, desire and the household. Women’s knowledge in the area of birthing and healing was undermined by the application of clinical medicine with its instrumental-rational base. The objectivisation of the body in self-starvation is reflected in the development of the thin body as a project to be worked upon. Similarly, the binge-purging body becomes an object to be ‘filled up’ and ‘emptied’. Thus it could be argued that the stage was set long ago for the development of contemporary self-starvation and binge-purging (White 1988).  

     ‘Rational’ developments in other fields such as architecture came with the emergence of modern medicine. Foucault (1979) notes the application within institutionalised settings (especially the prison and the hospital) of an architectural design which reflected the developments in science of techniques of control and surveillance — this covered control and surveillance of whole populations (census data, epidemiology, registers of demographic data) and surveillance of bodies (with developments in clinical medicine and anatomy). The design emanated from Jeremy Bentham’s notion of the Panopticon which involved maximum supervision with minimum effort (Foucault 1980;  Armstrong 1983).  The Panopticon’s ‘potential’ for surveillance nurtures self-discipline (causing individuals to ‘gaze upon themselves’) and self-discipline replaces torture as the ‘paradigmatic’ method of social control.  Thus where persons themselves and their bodies are turned into ‘objects’, self-surveillance emerges as a practice of control.  This practice is reflected in language (‘Watch yourself’), architecture and power relations.  When people are treated as objects they see themselves as objects and tend to torture their bodies and desires to fit instructions and specifications.  They evaluate their own behaviour and tend to become either docile subjects or rebellious subjects. The self-starvers whom I interviewed as part a major study on self-starvation and binge purging (Eckermann 1994) displayed both of these extremes.  Sandy talked of the: 

 power I felt when asked by Dr K. to register on the body size metre how large I thought I was. As I moved the lever a ridiculous distance out I watched his reaction from the corner of my eye. His expression was ‘Boy this kid is wacko!’ and all the time I knew what I was doing manipulating him and it gave me enormous pleasure.

At the other extreme Tammy desperately wanted to please. She wanted to be ‘super-good, not to cause anyone any fuss’ and argued that over time she ‘felt anything anyone thought [she] should feel and became everything [she perceived] her parents, her teachers and her friends thought she should become’.  She believes her self-starving started when she could ‘no longer read the messages of how [she] ought to be’.  Both of these examples suggest that self-starvation represents defiance of prescriptions of ‘normality’ but in Tammy’s case such a response followed years of absolute conformity as a docile subject.

    Ironically a modification of the Panopticon architectural design is adopted in the large hospitals where self-starvers are treated.  The concept of surveillance and the production of docile subjects are central to the treatment process in treatment regimes based on behaviour modification. The point of the exercise is to break the self-starver’s will.  In my study, the rooms chosen for those undergoing behaviour modification were within sight of the nurses’ station, with glass panels internally and large windows to the outside to allow uninterrupted vision. All meals, showers and toileting were carefully supervised.  Despite this level of surveillance, many of my interviewees, who had been institutionalised under such a regime, boasted of their ability to dispose of food or to exercise undetected. In one instance the ‘patient’was able to deposit much of the food presented to her into the hollow steel tubular bed head, even while under the eagle eye of the nurse who supervised her eating.  The hiding place was only detected weeks later when foul smells emanated from her room.  Thus the tension between striving for ‘sainthood’ by keeping the body need-free and thus morally unsullied and the drive for selfhood in defying the dictates of authorities comes to a head in the therapeutic setting. Turner (1992: 221) succinctly encapsulates this dilemma in suggesting that: 

The anorexic avoids the shameful world of eating, while simultaneously achieving personal power and a sense of moral superiority through the emaciated body. Their attempt at disembodiment through negation becomes the symbol of their moral empowerment.

Over time the specification of ‘normality’ has become narrower and more stringent — it is easier to fall outside of the specifications where the penalties are harsh (institutionalisation). Self-maximisation, self-actualisation, self-discovery in psychology and in community services are emphasised.  Thus to qualify as a ‘normal’ person one must torture oneself in relation to strict and constricting criteria (in both mind and body). Language is an important part of this process of self-evaluation and self-monitoring. Concepts like ‘insight’, ‘guilt’, ‘hang-ups’, ‘obsessions’ are used as people operate on themselves to test their existence against ‘normality’.  

    The implications for women are enormous, given their continuing marginal social status. In the narrowing specifications of how women should be, women operate within the language of patriarchy and consumerism which forms the dominant discourse of twentieth-century society. The self-starving and binge-purging individuals who emerge in such a society understand themselves in terms of these dominant discourses.  Clara, whom I interviewed, claimed: ‘I wear tent dresses to hide a multitude of sins!’ These actions were designed to disguise the fact that she is not a secular ‘saint’. However, as the examples cited above indicate, self-starvation can be seen as either super-conformity to or super-defiance of such dominant discourses.

    Asceticism represents an aspect of objectivisation of bodies and self-surveillance of bodies. At the same time consumerism promotes the commoditisation of the body. Thus, it could be argued that the dominant discourse surrounding these processes determines, or at least circumscribes, the very consciousness of those who develop problems with eating. However, Celermajer (1987) argues that these processes only determine in a negative way the form of rebellion chosen by young women. 

    The argument that women tend to conform is put forward by Spitzack (1987), who employs Foucault’s concepts of confession and surveillance to analyse the ‘discourse of weight loss’. She argues that:

weight-reducing techniques weave the language of science, deviance and theology to find the perpetuation of a wholly transparent female subject. The weight-conscious woman is divided within herself (mind versus body) and must ironically become and remain body-conscious to alleviate body consciousness.  (1987:357).

Foucault’s analysis of the extent to which bodies are ‘inscribed in discursive practice’ provides a framework to understand how the dogma of weight-reducing discourse (which is legitimated in public health campaigns) problematises the body, especially the female body, which is seen as in need of alteration both by the ‘owner’ of the body and by medical and public health institutions through the medical gaze (Spitzack 1987: 357).  Spitzack’s analysis suggests that the use of Foucault’s framework of discursive power can turn a self-induced ‘disease’ category into a political issue. ‘Surveillance of the self plays a central role in domination strategies’ (Spitzack 1987: 362) which       constitute weight-reducing discourse. The individual views her body as ‘ultimately untrustworthy’ and its desires as ‘capable of taking her over’.  As Foucault explains, the separation of mind and body:

permit[s] individuals to effect, by their own means, a certain number of operations on their bodies, their own souls, their own thoughts, their own conduct, and this in a manner so as to transform themselves, modify themselves, and to attain a certain state of perfection, happiness, purity, supernatural power.   (1981: 367)

Spitzack (1987: 357—8) concludes that will-power (mind over matter) ‘in the discourse of weight reduction, is a central component in the perpetuation of an obese population’ and points to the paradox that despite the fact that ‘American consumers spend an estimated ten billion dollars annually on reducing formulas’ the ‘failure rate among dieters is 98%’.

    The decision to diet entails dissatisfaction with bodily appearance, which is so widespread amongst women as to be viewed as endemic (Cleo 1988; Ben Tovim and Morton 1989).  Similarly ‘the struggle between body and consumption’ appears ‘endemic to contemporary culture’ and the ‘metaphors of discipline and theology intertwine to establish a context of [social] disease centred on the Body’ (Spitzack 1987: 359). Foucault’s contributions to an understanding of these phenomena are considerable since his theoretical understanding of the self allows for multiple constitution of the self. 


THE HYSTERICAL BODY

One of the ways in which women’s bodies were given meaning and their selves made ‘nervous’ from the turn of the eighteenth century onwards was by the process of hysterisation, which involved:  

 a three-fold process whereby the feminine body was analysed —qualified and disqualified — as being thoroughly saturated with sexuality; whereby it was integrated into the sphere of medical practices, by reason of a pathology intrinsic to it; whereby, finally, it was placed in organic communication with the social body (whose regulated fecundity it was supposed to ensure), the family space (of which it had to be a substantial and functional element), and the life       of children (which it produced and had to guarantee, by virtue of a biologico-moral responsibility lasting through the entire period of the children’s education): the Mother, with her negative image of ‘nervous woman’ constituted the most visible form of hysterisation.  (Foucault 1981: 104)

Turner (1984: 183) claims that the ‘historical specificity of the eruption of anorexia in the late nineteenth century’ suggests a correlation between Foucault’s idea of the ‘hysterisation of women’s bodies ...and the peculiar conjunction of social structures which produced a crisis in middle-class urban family life. This conjunction of circumstances was combined with a specific interest in family organisation by the medical profession.'

TRUTH CONSTRUCTION AROUND THE STARVING BODY

Foucault saw the development of psychoanalysis as a further repression of the self rather than as ‘a liberating step beyond the human sciences’.  To Foucault (1981: 67), psychoanalysis was the ‘culmination of a normalising confessional technology’ first used by the early Catholic Church and which ensured that ‘sex’ as well as the ‘body’ became medicalised, psychiatrised, psychologised and hygienised.  One could enter the ‘illness’ world and ‘disordered’ world via a variety of ‘new personages':

the nervous woman, the frigid wife, the indifferent mother — or worse the mother beset by murderous obsessions.. . the hysterical or neurasthenic girl, the precocious and already exhausted child ...
(Foucault 1981: 110)

Surveillance of the family under the gaze of the new professionals of psychiatry and psychology could turn up a variety of ways of ‘disturbed being’. Foucault (1981: 111) argues that the family from the mid-nineteenth century was compliant in this process:

the family broadcast the long complaint of its sexual sufferings to doctors, educators, psychiatrists, priests and pastors, to all the experts who would listen . . . [it] engaged in searching out the slightest forces of sexuality in its midst, wrenching from itself the most difficult confession, soliciting an audience with everyone who might know something about the matter and opening itself unreservedly to endless examination.

This situation culminated in the late twentieth century in the rise of family therapy as the procedure for tapping the dark recesses of neurosis and psychosis, and from Freud onwards the tendency was to blame the development of ‘disorders’ on inadequate parenting when no biological cause for the ‘illness process’ could be discerned.  The body, and its sexuality, were problems at the middle level of analysis — the family. With the ‘long campaign of inoculation and vaccination went a new emphasis on the family as the most constant agent of medicalisation’ (Foucault 1980: 172—3) and in explanations of anorexia nervosa, from the nineteenth century onwards, the family emerges as a key culprit (Turner 1990).  

    However, hygiene on the middle level in the family (and on the micro-level of the individual) was supplemented with a grander programme as the development of ‘homo hygienicus’ involved ‘a regime of health for [whole] populations [that entailed a certain number of authoritarian medical interventions and controls] . . . the city with its spatial variables [came to appear] as a medicalisable object’ (Foucault 1980: 175). Foucault suggests that a ‘different project was also involved, that of the indefinite extension of strength, vigour, health and life’ at a more macro-level in the service of the economy, especially the dominance of the bourgeoisie.

The emphasis on the body should undoubtedly be linked to the process of growth and establishment of bourgeois hegemony: not, however, because of the market value assumed by labour capacity, but because of what the ‘cultivation’ of its own body could represent politically, economically and historically for the present and the future of the bourgeoisie. 

(Foucault 1981: 125)

However, Foucault goes on to suggest that it was ‘a physical matter as well’.  

        The works published in great numbers at the end of the eighteenth century, on body hygiene, the art of longevity, ways of having healthy children and of keeping them alive as long as possible, and methods for improving the human lineage, bear witness to the fact:  they thus attest to the correlation of this concern with the body and sex to a type of ‘racism’. (1981: 125)

One could speculate about the reasons for the interest in hygiene and healthy living inherent in the late twentieth-century world’s obsession with health promotion (the second wave of emphasis on ‘homo hygienicus’). The self-starving and/or binge-purging individual may represent a victim of such campaigns, given the dominant discourse which emerges surrounding the concept of healthy eating, healthy living, exercise and ascetic attention to lifestyle (Turner 1984; Kalucy 1987; Colquhoun 1989). If ‘anorexia’ represents slavish observance to      the specifications of medical and public health discourse (whether such discourse is in the service of narrow professional interests or cost—benefit analysis for the state), its entrance into the realm of the ‘abnormal’ in relation to psychiatric categories is somewhat ironic. The normalising ‘truth’ that is constructed in the operation of power in relation to nutrition and ‘lifestyle’ has unintended consequences, such as obsessive concerns about weight, shape and eating.

    Medical and psychiatric discourses act as definers of truth around the self-starving body. The almost universal use of the American Psychiatric Association’s Diagnostic and Statistical Manual (currently DSM-IV), as an administrative process, attests to this. Laing (1988: 62) argued that DSM-III (APA 1985) functioned only as ‘a billings list for third party payments. You have got to have an entry in DSM-III for the insurance company to pay up.’ To be diagnosed as suffering from ‘anorexia nervosa’ or from ‘bulimia’, a person needs to fulfill the criteria set out in DSM-IV (APA 1994). There is an arbitrary cut-off point which decides whether you ‘are in or not’. Psychiatrists emerge as Foucault, self-starvation and gendered subjectivities key figures in an administered society, because they are in a position to define madness and disorders and their discourse pervades the rest of society.

    Psychiatry has the power to influence discourse by being ‘entrusted’to set the diagnostic criteria for ‘madness’ for the whole of society. By its arbitrary classifications, psychiatry is involved not only in imposing norms on people but also in providing the discourse through which people think; there appears a significant use of understanding of psychiatric concepts in the community generally. It has an influence on the way people ‘can be’. Place (1989: 97) describes her experiences of the discourses around self-starving thus:        

The medical profession, under the guise of uniforming language for the purpose of clarity, adopts a language of clinical description.... The clinical discourse. . . . But language is never innocent.  [Psychiatrists and the medical profession] use a language which denies sub-texts [and which] 

refuses to flirt 
to admit 
to the hidden

And it would seem to me that any language that denies sub-texts must be diminished in its capacity to effectively treat illness.  Especially anorexia nervosa, which I believe is first and foremost a language problem.

Place (1989: 137) suggests that language and text are the appropriate sites for understanding self-starvation:

The person with anorexia nervosa has, for various reasons, often failed to pick up the sub-texts of language that her/his peers use to decode the double meanings and messages given to them by parents, teachers and media. (Place 1989: 137)                                 

Laing argues that DSM-JII is ‘very useful for controlling the population because you can bring [the criteria] to bear on practically anyone if the occasion seems to demand it.. . a mandate to strip anyone of their civil liberties’ (Laing 1988: 61). Classifying and objectifying criteria in psychiatric medicine provide insurance companies with defined ‘illnesses’ on which to base their business. This presents a case of the extended medical gaze which may have a benign intent but some detrimental ‘administering’ and ‘normalising’ effects. 

IMPLICATIONS FOR TRUTH CONTESTATION

Foucault’s analysis emphasises that no power/knowledge is entirely dominant or ascendant over other discursive fields. The potential for the exercise of agency from within different discursive fields is always there, and this has significant repercussions for the development of alternative subjectivities and for countering the ‘truth’ generation which emanates from psychiatry.

Let us not therefore ask why certain people want to dominate what they seek, what is their overall strategy. Let us ask, instead, how things work at the level of on-going subjugation, at the level of those continuous and uninterrupted processes which subject our bodies, govern our gestures, dictate our behaviours, etc. In other words we should try to discover how it is that subjects are gradually, progressively, really and materially constituted through a multiplicity of organisms, forces, energies, materials, desires, thoughts etc. ... We should try to grasp subjection in its material instance as constitution of subjects.  
(Foucault 1980: 97)

Foucault suggests that the process of constituting subjectivity occurs not ‘top-down’ but in circulatory ways whereby local power/knowledge processes are constitutive also. The individual, in this case the self-starver, can exercise agency not only in starting to eat again, but also by rewriting her problem of self-starvation (as defined by psychiatry and other institutions), as a solution to broader problems in her life.  

    Many critics of Foucault’s arguments about power and language claim that while theoretically Foucault provides insight, the implications for political practice are sterile. If language constitutes all knowledge, how is deviance developed and sustained (Connell 1987; Turner 1987)?  Similarly, given the nature of power and surveillance, how can one explain opposition, criticism and resistance to prevailing or dominant discourses? Foucault’s epistemology makes it difficult to provide grounds for alternatives and a hiatus is evident between his theoretical accounts of society and their political implications. Furthermore, he is seen as ignoring subjective experience (Turner 1984, 1987).

    Turner argues that Foucault, alone, provides us with a comprehensive framework for examining ‘bodies in plural, that. . . is populations’ (Turner 1992: 58). Against the charge of critics like Rorty (1986) and Taylor (1986) that Foucault’s project is ‘apolitical’, it would seem that conceiving of bodies en masse is an inherently political exercise.

 FOUCAULT AND POLITICAL PRACTICE

    Weedon (1987) and McNay (1992) argue that Foucault’s analysis is invaluable in developing a feminist political practice. Weedon suggests that what Foucault’s work contributes to feminism is ‘a contextualization of experience and an analysis of its constitution and ideological power’:

Although the subject in post-structuralism is socially constructed in discursive practices, she none the less exists as a thinking, feeling, subject and social agent capable of resistance and innovations produced out of the clash between contradictory subject positions and practices. She is also a subject able to reflect upon the discursive relations which constitute her and the society in which she lives and able to choose from the options available.  (Weedon 1987: 125)

White and Epston’s ‘orientation in therapy.., is considerably informed by Foucault’s thought’ (1989: 32). They suggest that Foucault’s ideas provide them with tools with which to critique their ‘own practices that are formed in the domain of power and knowledge’:

We would work to identify the context of ideas in which our practices are situated and would explore the history of those ideas.  This would enable us to more readily identify the effects, dangers and limitations of these ideas and of our own practices. . . we would work to identify and critique those aspects of our work that might relate to the techniques of social control.  (White and Epston 1989: 32—3)

These therapists see Foucault’s concepts as being directly used in the service of clients.

If we accept Foucault’s proposal that the techniques of power that incite’ persons to constitute their lives through ‘truth’ are developed and perfected at the local level and are taken up at the broader levels, then in joining with persons to challenge these practices, we would also accept that we are inevitably engaged in a political activity. This  is not a political activity that involves the proposal of an alternative ideology, but one that challenges the techniques that subjugate persons to a dominant ideology.  (White and Epston 1989: 33)

The specific techniques used to achieve this include ‘externalisation’ of the problem (that is, separating from the unitary knowledges), challenging techniques of power, such that ‘docile bodies become enlivened spirits’, resurrecting the subjugated knowledges, the generation of alternative stories and rewriting personal narratives (White and Epston 1989: 17—39). The above techniques White and Epston see as having particular relevance to treatment for self-starvation and binge-purging, which they believe ‘reflect the pinnacle of achievement of [self-subjugating] power’. They suggest that there are many ways to ‘know’, that the dominant ways are historically specific and challengeable. They suggest that self-erasing stories can be rewritten as self-embracing stories.

    Silverman (1985) is another writer who defends Foucault’s project as a basis for practice. Silverman counters all three of the major critical charges against Foucault’s work: Foucault’s tendency to ‘displace man’, his relativism and his pessimism. Silverman argues that these criticisms represent a selective reading of Foucault’s work. He suggests that Foucault offers a significant solution to the ongoing methodological problem of ‘integrating macro and micro levels of analysis’ (Silverman 1985: 91). Foucault provides both content and method for generating research and suggestions for therapeutic intervention.  

    In proposing ‘existential ontological therapy’ Foucault argues for the enabling role of language, alongside its restricting role in relation to its inadequacy in reflecting thought processes and feelings. He suggests that we can learn other ways of thinking and perceiving. However, they must occur on a broad basis, otherwise therapy can produce ‘only isolated and temporary “areas” in which an individual’s narrowing of reality may open up, while the contradictions and normalizing closure of our everyday social practices continue to produce individual problems and a general malaise’ (Dreyfus 1987: 330). For Foucault, the effective agenda is to counteract the situation where:

the individual, through a series of accidental historical interpretations focused on a series of paradigms, comes to have a one-dimensional, normalising understanding of reality in which every anomaly must finally be made to yield its truth and confirm (the individual’s) systematic interpretation.  (Dreyfus 1987: 330)

The implication is that all individuals are ‘pathological’ since they live in one dimension. The problems of the lack of language and lack of other dimensions of subjectivity to give expression to existence are taken up by the new feminist postmodernists and have particular relevance to self-starvers and binge-purgers. Foucault’s analysis offers concrete treatment implications. Witness White and Epston’s (1989) and Robertson’s (1992) applications of Foucault to self-therapy.

CONCLUSION

Foucault also offers solutions to the other problems associated with traditional sociological understandings of self-starvation. His theories move beyond the media and the family, as institutions responsible for causing self-starvation, to look at discursive and non-discursive practices in all institutions of modern Western societies which regulate and control individuals. However, Foucault acknowledges, especially in his later work on the self (1986), the role of individual agency in determining outcomes. I agree with McNay’s assessment that although Foucault’s earlier work reduced social agents to docile and passive subjects, unable to act in an autonomous fashion, in the last two volumes of The History of Sexuality he does provide an ‘elaboration of a notion of self’ (McNay 1992: 3). Foucault also offers a theory of the body in social relations as the site of both negative and constitutive power and provides the most comprehensive account of the role of language in constructing illness and the body, both of which he conceives of as cultural rather than natural entities.  

    The self-starver is recreating a sense of self, but a self which is not based on a stylised notion of beauty. It is a self which is distant enough from our current culturally constructed notions of aesthetic beauty, ‘outside the dictates of style’, to not be merely a reflection of fashion. It appeals almost to the timeless image of the thirteenth-century Catholic  saint or the Eastern ascetic rather than the twentieth-century fashion model. The self-starver challenges our sense of rationality and our twentieth-century Western sensibilities. Foucault’s notions of the relativity of truth and the possibilities of multiple constitution of the self allow us to engage with these apparent anomalies rather than dismiss them as signs of irrational deviance.

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