Review – The Weighty Body. Fat or thin, vanity or insanity (Lannoo, 2010)

Par Julie De Ganck

Vingt ans après sa première exposition intitulée Saintes de carême, filles miraculeuses et artistes de la faim, en 1991, le musée du Docteur Guislain reprend le thème de l’anorexie pour monter sa nouvelle exposition qui se tient à Gand du 8 décembre 2010 au 8 mai 2011. Pourquoi certaines personnes refusent-elles de s’alimenter ? A travers cette question, le catalogue prend le corps pour objet d’étude et s’interroge sur la gestion de l’apparence physique dans la société occidentale. Intermédiaire entre soi et le monde, le corps et l’apparence sont soumis à diverses pressions et injonctions : religieuses, médicales, sociales ou politiques.

Dans un format pratique et facilement manipulable, ce livre est riche en illustrations de bonne qualité. La mise en page des textes et des illustrations invite les lecteurs et lectrices à voyager entre ces deux types d’expressions qui se répondent et se complètent, témoignant de l’atmosphère de l’exposition. Cette présence visuelle du sujet est un véritable atout pour un livre traitant de l’apparence. Le livre contient un avant-propos, une introduction générale, six articles à proprement parler et une présentation d’œuvres d’art commentées et mises en contexte. Mise à part la présentation des oeuvres d’art dont le texte est en néerlandais, la totalité des articles sont traduits en français et en anglais en fin de volume, mettant ce catalogue à la portée d’un public international.

La mise en perspective historique du traitement du corps et de l’apparence est surtout intéressante pour les historiens travaillant sur les thèmes des « troubles » de l’alimentation et de l’identité. Ils y trouveront matière à réflexions théoriques et à comparaisons historiques. Cependant, le catalogue vise un public plus large que celui des historiens professionnels. L’objectif principal semble bien de donner à la société civile en général les outils philosophiques et historiques nécessaires à la critique de faits de société comme l’anorexie. Cependant le langage n’est pas toujours soutenu et il y a un certain décalage entre des articles scientifiques et de vulgarisation.

Le premier article d’Ignaas Devisch (« Ceci est mon corps ») et le dernier de Pieter Bonte (« Le corps fantastique ») abordent tous les deux la thématique du corps et de la liberté en posant la question de l’auto-détermination de soi et de son expression corporelle. Ils relèvent un paradoxe de notre société qui, en promouvant la libération de chacun vis-à-vis de règles et de systèmes « oppresseurs » afin de nous trouver nous-mêmes, engendre un besoin de réflexivité pour trouver son « vrai » soi en son fort intérieur. Le corps devient alors un enjeu important car il est un donné naturel qu’il nous faut aujourd’hui toujours façonner et améliorer pour le faire correspondre à notre « véritable » nature. Dans ce cadre, la médicalisation des questions identitaires est critiquée dans une perspective d’histoire culturelle et de bioéthique, pour n’abandonner la dignité humaine ni à la nature ni aux biotechnologies.

L’article de l’historien Evert Peeters « Un esprit démocratique dans un corps socialiste » est une belle illustration de cette quête contemporaine de l’intériorité. Durant l’entre-deux guerres, la jeunesse ouvrière du mouvement socialiste belge conceptualisa le corps et l’esprit pour en faire des outils de réformisme et de changement social. La volonté de lutter contre l’embourgeoisement des classes populaires, dû aux transformations du mode de vie grâce aux premières législations sociales, mène les jeunes socialistes à redéfinir le socialisme comme une « réforme intérieure » lors de la rencontre internationale des jeunes socialistes en 1921. A cette réforme psychologique s’ajouta une nouvelle culture physique devant concrétiser cet idéal.

Trois articles sont consacrés à l’anorexie. Dans « la minceur envers et contre tout »,Walter Vandereycken et Ron Van Deth, auteurs du livre Van vastenwonder tot magerzucht. Anorexia nervosa in historisch perspectief (1988), produisent une fresque historique de l’idéal de la minceur et des idées médicales et sociales sur l’obésité. La médecine a en effet théorisé l’obésité comme maladie au XIXème siècle, au moment où l’idéal de minceur et le corps normé de l’homme moyen de Quetelet firent leur apparition. Comme médiateur entre le monde naturel et le monde social, la médecine aurait eu tendance à stigmatiser des comportements individuels perçus comme immoraux sans prendre en compte le système social dans son ensemble pour les expliquer.

L’article d’Yoon Hee Lamot « La sainte faim », tiré du livre des auteurs précédents, revient plus particulièrement sur l’histoire du jeûne dans la société chrétienne européenne du moyen-âge. Le jeûne était un moyen de s’élever spirituellement en se détachant de ses besoins terrestres ressentis corporellement. L’Eglise a rapidement réglementé la pratique du jeûne. Elle combattait ses formes extrêmes, voyant dans cet extrémisme une prétention des fidèles à entrer directement en contact avec le Seigneur sans passer par l’intermédiaire de l’Eglise. Soucieuse de discréditer ces jeûnes extrêmes qui étaient l’objet d’une dévotion populaire importante, l’Eglise voulu dénoncer la supercherie de certains jeûnes. Elle demanda alors à des médecins d’établir des critères de discrimination entre « vrais » et « faux » jeûnes. Il y a ici un parallèle intéressant à faire entre le rôle de médiation de l’Eglise pour l’accès des fidèles à Dieu au moyen-âge et le rôle de médiation de la médecine contemporaine pour l’accès des patients à la santé. Malgré cela, cet article est certainement de talon d’Achille du livre. Espèce d’excroissance de l’article de Walter Vandereycken et Ron Van Deth, sa présence est source de répétitions. De plus, l’auteur rapporte des propos historiques sans distanciation critique, ce qui est particulièrement irritant pour des historiens. Il écrit par exemple en parlant de Saint-Antoine (251-356 après JC), qui aurait quitté ses terres et vendus tout ses biens pour aller vivre seul dans une caverne, qu’il ne mangea presque pas durant vingt ans mais « ne maigrit pas de façon frappante et atteignit l’âge de 105 ans sans avoir perdu une seule dent » (p. 147) ! On aurait aimé que ce fait ne soit pas présenté comme une vérité historique.

L’article écrit par la psychologue et psychothérapeute spécialiste de l’anorexie nerveuse Myriam Vervaet est quant à lui intéressant pour écrire l’histoire de la psychologie et de la psychiatrie en Belgique. L’auteure y décrit son parcours professionnel et personnel depuis le choix de ses études jusqu’à sa carrière dans le traitement psychothérapeutique de l’anorexie. Ce faisant, l’auteure rend compte du contexte d’émergence de la psychologie en Belgique dans les années septante. « Le corps ‘idéal’ comme cuirasse contre le désordre mental » fait aussi un historique et une critique sociopolitique des théories psychologiques expliquant l’anorexie. Elle montre la pression sociale qui s’exerce sur le corps des femmes. Cette pression ferait craindre à certaines femmes de ne jamais pouvoir se conformer aux critères corporels de leur époque. Elles préféreraient alors se réfugier dans un monde où leur volonté propre devient leur unique norme.

Julie De Ganck est historienne contemporaine diplômée de l’Université Libre de Bruxelles. Intéressée à l’histoire des sciences, de la médecine et de la sexualité, elle commence une thèse de doctorat consacrée à l’histoire des traitements médicaux des organes génitaux et de leurs fonctions en Belgique entre 1889 et 1968.

New Issue of PSN

A new issue of PSN (Psychiatrie Sciences Humaines Neurosciences) has just been released online. Included in this issue are two pieces that may be of interest to h-madness readers. Titles, authors and abstracts listed below:

Les états anxieux dans l’histoire de la médecine Première partie: d’Hippocrate au « nervosisme », by T. Haustgen

The description of anxiety disorders, in their somatic and emotional components, depends on successive pathogenic theories since the antiquity. Evoked by Hippocrates and Galen among digestive illnesses, they are included into hypochondriasis in the 16th and 17th centuries. Sydenham compares this last entity with hysteria. In the 18th century, Blackmore and Cheyne at London, then Raulin and Pomme at Paris, describe the “vapours”, in the continuity of humoral theories. In 1765, Lorry in France and Whytt in Scotland (“nervous disorder”) describe on the contrary an injury of the nerve fibers, clearly differentiated for the first time from hysteria and from hypochondriasis by Whytt. Cullen introduces the term neurosis (1769), propagated by Pinel’s “Philosophical Nosography” (1798). At the beginning of the 19th century, appears the word neuropathy (Pougens, 1825; Cerise, 1841). The term anxiety is used by Cheyne (1733), Boissier de Sauvages, “the Panckoucke’s Dictionary” (1812), J.-P. Falret (1822), and occasionally by the first alienists in their manuscript observations, but as a symptom and not as a clinical entity. In 1822, E. Georget, a pupil of Esquirol working in the Salpêtrière hospital, isolates most symptoms of the later “panic attack,” in his picture of “cerebropathy” (i.e., hypochondriasis). During the 2nd half of the 19th century, several remarkable and synthetic descriptions of anxiety disorders are published separately in France by alienists (délires émotifs: Morel, 1866; “hypocondrie morale”: J. Falret, 1866; “vertige mental”: Lasègue, 1876) and by general practitioners (“état nerveux”: Sandras, 1851; “nervosisme”: Bouchut,1860; “cerebrocardiac neuropathy”: Krishaber, 1873).

L’introduction faussement simple du cognitivisme dans la thérapie comportementale, by D. Ravon

The conflicts within behavior therapy caused by the public advent of cognitive behavior therapy in America are examined. The origins of the latter are sought out within the behavioristic heritage itself (classical conditioning, operant conditioning, and social learning theory), as well as in the rest of the psychological and psychotherapeutical environment of the 1960s and 1970s. Two findings go against a simplificatory speech commonly heard in France. Firstly, the acceptance of cognitive frames of reference in the behavior therapy movement wasn’t and isn’t unanimous, since the Skinnerian radical behaviorists, still active today, dissociated themselves from it. Secondly, the therapy’s cognitive-behavioral integration didn’t happen with reference to the information processing model, but rather through a disparate process of internal and external borrowings in answer to anthropological questionings on the cognitive control of behavior.

Book Announcement – Freud’s Mexico. Into the Wilds of Psychoanalysis

Rubén GALLO, Freud’s Mexico. Into the Wilds of Psychoanalysis (Cambridge, MIT Press, 2010)

Freud’s Mexico is a completely unexpected contribution to Freud studies.  Here, Rubén Gallo reveals Freud’s previously undisclosed connections to a culture and a psychoanalytic tradition not often associated with him. Freud found a receptive audience among Mexican intellectuals, read Mexican books, collected Mexican antiquities, and dreamed Mexican dreams; his writings bear the traces of a longstanding fascination with the country.
In the Mexico of the 1920s and 1930s, Freud made an impact not only among psychiatrists but also in literary, artistic, and political circles. Gallo writes about a “motley crew” of Freud’s readers who devised some of the most original, elaborate, and influential applications of psychoanalytic theory anywhere in the world: the poet Salvador Novo, a gay dandy who used Freud to vindicate marginal sexual identities; the conservative philosopher Samuel Ramos, who diagnosed the collective neuroses afflicting his country; the cosmopolitan poet Octavio Paz, who launched a psychoanalytic inquiry into the origins of Mexican history; and Gregorio Lemercier, a Benedictine monk who put his entire monastery into psychoanalysis.
After describing Mexico’s Freud, Gallo offers an imaginative reconstruction of Freud’s Mexico. Although Freud himself never visited Mexico, he owned a treatise on criminal law by a Mexican judge who put defendants—including Trotsky’s assassin—on the psychoanalyst’s couch; he acquired Mexican pieces as part of his celebrated collection of antiquities; and he recorded dreams of a Mexico that was fraught with danger. Freud’s Mexico features a varied cast of characters that includes Maximilian von Hapsburg, Leon Trotsky and his assassin Ramón Mercader, Frida Kahlo, Diego Rivera—and even David Rockefeller. Gallo offers bold and vivid rereadings of both Freudian texts and Mexican cultural history.
Rubén Gallo is Director of the Program in Latin American Studies and Professor in the Department of Spanish and Portuguese Languages and Cultures at Princeton University. He is the author of Mexican Modernity: The Avant-Garde and the Technological Revolution (MIT Press, 2005).

Issues in Mental Health Nursing

The October issue of Issues in Mental Health Nursing is available online and includes an article by Philipa Martyr entitled A Lesson in Vigilance? Mental Health Nursing Training in Western Australia, 1903-1958. The abstract reads:

Researching examples of historical hospital-based training can provide some measure of the improvements in mental health nursing education which have taken place over time. Claremont Hospital for the Insane was the only major stand-alone psychiatric institution in Western Australia, and recent research into its mental health nursing training program between 1903 and 1958 provides an example of how nursing training could suffer in the hospital setting. There is much to learn from Claremont’s experience: Not just to measure how far mental health nursing has progressed since that time, but also as a reminder of why and how accountability, supervision, and independent auditing all help to ensure quality delivery of training.

Book Annoucement – Madness in Medieval Law and Custom

TURNER Wendy J. (ed.), Madness in Medieval Law and Custom (Brill, Leiden-Boston, 2010).

This collection of essays opens a new discussion about the mind, body, and spirit of the mad in medieval Europe. The authors examine a broad spectrum of mental and emotional issues, which medieval authors point out as ‘unusual’ behavior. With the emerging field of medieval disability studies in mind, the authors have carefully considered legal and cultural descriptions for insight into the perception and understanding of mental impairment. These essays on madness in the Middle Ages elucidate how medieval society conceptualized mental afflictions. Individually, the essays cover aspects of mental impairment from a variety of angles to unearth collectively medieval perspectives on mental affliction.
Contributors are James R. King, Kate McGrath, Irina Metzler, Aleksandra Pfau, Cory James Rushton, Margaret Trenchard-Smith, and Wendy J. Turner.

Book Annoucement – Madness in Buenos Aires: Patients, Psychiatrists, and the Argentine State 1880-1983

Jonathan ABLARD, Madness in Buenos Aires: Patients, Psychiatrists, and the Argentine State 1880-1983 (Latin American and Caribbean series, Ohio University Press, Athens, 2008)

Madness in Buenos Aires examines the interactions between psychiatrists, patients and their families, and the national state in modern Argentina. This book offers a fresh interpretation of the Argentine state’s relationship to modernity and social change during the twentieth century, while also examining the often contentious place of psychiatry in modern Argentina.

Drawing on a number of previously unused archival sources, author Jonathan Ablard demonstrates how the experience of psychiatric patients serves as a useful case study of how the Argentine state developed and functioned over the last century and of how Argentines interacted with it. Ablard argues that the capacity of the Argentine state to provide social services and professional opportunities and to control the populace was often constrained to an extent not previously recognized in the scholarly literature. These limitations, including a shortage of hospitals, insufficient budgets, and political and economic instability, shaped the experiences of patients, their families, and doctors and also influenced medical and lay ideas about the nature and significance of mental illness. Furthermore, these experiences, and the institutional framework in which they were imbedded, had a profound impact on how Argentine psychiatrists discussed not only mental illness, but also a host of related themes including immigration, poverty, and the role of the state in mitigating social problems.

Jonathan D. Ablard is an assistant professor at Ithaca College in Ithaca, New York, where he has taught Latin American history since 2005. He received his doctorate from the University of New Mexico in 2000. Ablard was previously an assistant professor at the University of West Georgia.

Review – Alfred Tauber. Freud, the Reluctant Philosopher (Princeton University Press 2010)

By Simon Taylor

Is psychoanalysis a science? London’s Science Museum appears to think so: last month it opened an exhibition entitled “Psychoanalysis: The Unconscious in Everyday Life.” Some have interpreted the exhibition, nestled comfortably between Tesla’s induction motor and an atomic clock, as a conferral of popular acceptance upon the scientific status of this still-ambiguous profession. Alfred I. Tauber is having none of this. In his new book, Freud, The Reluctant Philosopher, Tauber argues against the scientific validity of psychoanalysis, seeing it rather as a humanistic voyage of self-discovery. Moreover, he claims, by the latter half of Freud’s career – a period heralded by Totem and Taboo (1913) and the metapsychological papers that followed – Freud had himself, albeit reluctantly, come to recognize the fundamentally “speculative” (i.e. philosophical) character of the psychoanalytic endeavour (2). Psychoanalysis cloaks classical myths of self-mastery in the language of modern science, but, on Tauber’s reading, Freud declared this language itself to be little more than a myth. In abandoning positivism for myth and subjectivism, then, Freud had opened the door to a fully humanistic understanding of psychoanalysis.

This is the barest adumbration of Tauber’s dense, ambitious, and hugely impressive new book. Freud, the Reluctant Philosopher takes the form of an imagined dialogue between Freud and a variety of philosophical sources that either did shape the development of psychoanalysis but were left unacknowledged by Freud; or could have influenced its development had Freud not been so resistant to philosophy (Tauber often conflates the two categories, resulting in some unfortunate conceptual muddles). The philosophical breadth of Tauber’s book, as well as the author’s skill in elucidating the salient aspects of such demanding material, is perhaps its greatest virtue. Scholars owe Tauber a debt of gratitude for his impressive coverage of not only the mainstays of post-Kantian thought – Hegel, Schopenhauer, Nietzsche – but also those movements less well-served by today’s literature such as historicism, positivism, and neo-Kantianism. Indeed, if nothing else, his book serves as a comprehensive introduction to the main currents of nineteenth-century German philosophy; happily, however, it is much more than that.

Crucially, Tauber resists the tendency, so common in prior treatments of Freud’s relationship with philosophy, to merely hunt for philosophical precursors to psychoanalysis – finding, for example, the unconscious in Schopenhauer’s concept of Will, or drive theory in Nietzsche’s biologicism. Although he does outline these (potential) antecedents, his analysis goes much further: by situating philosophy and science within a post-Kantian struggle for epistemological dominance, Tauber highlights the tensions and contradictions that shaped the development of psychoanalysis. This approach is especially helpful in trying to make sense of Freud’s ongoing attempt to reconcile a series of apparently mutually exclusive concepts – determinism and freedom; positivism and subjectivism; empiricism and speculation; science and humanism – into a single viable framework. Throughout, the spectre of Kant looms large; indeed, the Sage of Königsberg is the book’s fulcrum.

Chapter 1 details Freud’s “tutelage” (16) under the great Austrian philosopher Franz Brentano. Tauber argues that Freud’s effort to establish a positivistic basis for psychoanalysis was an attempt to meet Brentano’s criteria for a truly scientific psychology. In particular, Freud was haunted – and remained so throughout his career – by Brentano’s rejection of the unconscious. Chapter 2 tells the story of psychoanalysis’ fall, under pressure from Brentano, Wittgenstein, and the logical positivists, from an empirically-verifiable science to a speculative idea based upon an assumption (that the unconscious is a natural object rather than a mere descriptive). By the end of the chapter Freud emerges as a somewhat forlorn figure, taking refuge in psychoanalysis’ sociological success where once he had aimed for science. What Freud saw as defeat, however, Tauber sees as an opportunity for a more productive understanding of Freud as a humanist.

Chapter 3 expands the historical background, focusing on the challenge faced by nineteenth-century German thought as a whole: on what grounds ought we to establish knowledge of the human sciences? Tauber contrasts Freud’s positivism to a number of competing epistemologies, particularly neo-Kantianism. Although the central role neo-Kantians accorded to consciousness was an anathema to Freud, Tauber argues that there was much in their approach that could have benefitted him. Indeed, Tauber concludes by noting – rather startlingly, if plausibly – that Freud might himself be considered a neo-Kantian (115).

It is in chapter 4 that Tauber first explicitly turns to Kant, arguing that although Freud ostensibly rejected the transcendental basis of Kant’s philosophy, his picture of the mind – divided between a somatically-grounded unconscious and a rational conscious existing independently of natural cause – is an essentially Kantian construction. He notes that the “striking character of Freud’s epistemology is the persistence of applying his notion of a Kantian noumenon to the problems of deciphering unconsciousness,” going so far as to term Freud’s “Kantian debt” a “philosophical parapraxis.” (120-1) More important, however, is the common role both figures assign to rationality as the basis for morality.

Having reformulated Freud’s theory from a Kantian perspective, however, Tauber draws back. He notes that in rejecting Kant’s deontological conception of the right in favour of an ethics grounded in biology and culture, Freud more closely resembles Nietzsche. This is the subject of chapter 5, which situates Freud as a philosophical midpoint between Kant and Nietzsche. Although Freud agrees with Nietzsche’s characterization of human beings as biological creatures subject to drives and instincts, they differ in the role they ascribe to those instincts. Where Freud wishes to tame the instincts through the application of autonomous reason, Nietzsche seeks to liberate them from what he takes to be the strictures of that selfsame reason. Tauber concludes by outlining Freud’s “ethical turn,” arguing that here Freud is most indebted to Spinoza.

Despite the book’s many qualities, there are a number of problems to which it is worth drawing attention. To begin with, Husserl is conspicuous by his absence, an especially surprising omission given his post-Brentanean critique of psychology; indeed, one could also draw fruitful parallels between Freud’s attempt to establish psychoanalysis as a legitimate science and Husserl’s similar endeavour on behalf of phenomenology. This points toward the deeper and more troubling concern that Tauber’s claims for the philosophical character of Freud’s thought are exaggerated. To take one example, Tauber notes that Askay and Farquhar’s Apprehending the Inaccessible: Freudian Psychoanalysis and Existential Phenomenology (2006) “complements my own portrayal of Freud as a moral philosopher.” (231-2, fn. 2) But one could draw just the opposite conclusion: the fact that Freud entirely ignored existentialism and phenomenology suggests the limitations of such a characterization. Rather, for a genuinely philosophical psychoanalytic one must turn, as Tauber occasionally does, to Freud’s contemporary Ludwig Binswanger, who marshaled numerous philosophical resources – from Leibniz and Kant to Kierkegaard, Husserl, and Heidegger – in his so-called Daseinsanalyse. This contrast between Freud and Binswanger puts the former’s philosophical commitments into sharp relief.

Finally, no matter what Tauber himself might think of psychoanalysis’ status as a science, it cannot be denied that Freud did conceive of it as such, and for a very significant portion of his career – at least 18 years between 1895-1913 by Tauber’s own estimate. Where this becomes significant is in Tauber’s normative agenda: he is very hard on Freud, ruthlessly subjecting the latter’s epistemology and metaphysics to his “postulated dialogue” (xii) with philosophy. Yet rarely does Tauber postulate Freud’s side of the dialogue: rather than offering responses on Freud’s behalf (which, methodologically-speaking, would be no more or less sound than the critiques he launches in the name of Windelband, Dilthey, Lange et al), he adduces the later Freud’s turn away from positivism as evidence of his acquiescence to the philosophical critiques arrayed against him. Tauber makes this move in order to clear a path for his preferred vision of Freud – humanist, moralist, Enlightened Spinozist – to emerge. This notwithstanding, Tauber has produced an original, arresting and, on the whole, convincing treatment of Freud’s intellectual development, one from which philosophers, psychologists, and historians alike can learn much.

Simon Taylor is a graduate student in the Department of History at Columbia University. He specializes in modern European intellectual history, in particular the history of philosophy and the psy-ences. He is writing his dissertation on the intellectual origins of the existential-phenomenological approach to psychoanalysis.

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