False Neutrality and Anorexia Mirabilis

False Neutrality and Anorexia Mirabilis June 27, 2011

In the wake of New York’s legalization of gay marriage (Excelsior!) and the Pride marches happening around the country, I thought it might be a good time to take a look at the article in last week’s New York Times Magazine about therapists who help gay Christians stay in the closet. Here’s how one therapist approached the problem:

“Throckmorton’s approach was, first of all, not to argue. “If we try to subtly or directly advocate for our personal loyalties, then we’ve stopped doing the kind of therapy that we advocate,” he said. Rather than challenge Rob’s desire to marry a woman, as other therapists might have done, Throckmorton felt the important thing was to help him accept that his thoughts were his own. Rob’s language was, to Throckmorton, “a kind of religious imagery,” and he noted that religious clients with eating disorders use the same words. Throckmorton didn’t engage in a discourse about good and evil but simply said “this sounds like something that feels really out of control to you, something you haven’t been able to manage.”

I thought it was interesting that Throckmorton mentioned the eating disorders parallel. In an epidemics seminar in college, one of our course books was Fasting Girls: The History of Anorexia Nervosa, which is where I learned about the popularity of extreme fasting among some female saints and devout nuns during the Middle Ages. The phenomenon is known as anorexia mirabilis which translates as miraculous lack of appetite.

Despite the name, there was nothing miraculous about the prognosis of these girls. One model was St. Catherine of Siena, who ate only the Eucharist and a small portion of herbs each day and pushed a stick down her throat to induce vomiting if she ate anything else. The consecrated sisters who imitated her starved to death.

Religiously-tinged anorexia inverts the problem of suppression of homosexuality due to religious convictions. Homosexuality is now accepted by the medical community as a ordinary part of human experience; it is a cause for concern only insofar as the patient sees it as disordered through his religious framework. In contrast, anorexia is widely accepted as a serious pathology, but religious convictions may cause a patient to see it as a special vocation, an essential part of her identity.

Ultimately, I don’t buy the therapist’s contention that he can or should keep his personal loyalties out of his work. I doubt that when religious patients come to him content with their anorexia he only focuses on making sure they feel like they are in charge of their fasting. The value judgment Throckmorton has made is that repressing homosexuality is below some tolerable level of harm or risk. He can defend that judgment but he can’t divorce himself from the fact that he has made it. There’s no magical objective assessment of harm and distress in the DSM.

That’s my problem with Throckmorton, but this article also left me wanting to ask a question of some Christian commenters: How do you think the medical profession and/or the family and friends of patients should respond to anorexia mirabilis?

It has a place in the historic tradition of the Catholic Church and it was used as evidence for the holiness of some saints, so when, if ever, would you let a daughter or sister’s private revelation trump your own experience of anorexia as disease? Did Christians acquire a duty to try to quash this kind of devotion once they learned more about anorexia nervosa? Is there a frightening Pascal’s Wager for Christians that implies you shouldn’t interfere with someone’s chosen martyrhood because a life is a small thing to weigh against salvation?


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