Politics and Recovery

Laurie and Debbie say:

An extremely thoughtful post from Feral Scholar got us thinking about how profoundly the disease metaphor was a very successful 20th century way to depoliticize the oppression of many groups, including women. Stan Goff at Feral Scholar focuses mostly on anorexia and the problems of returning soldiers to make a point which he generalizes some, and we can generalize even further. We especially agree with what he says about control.

Childhood sexual abuse, rape, body-image obssession cultivated for profit, and war all attack real human bodies, and they are all exercises of power. The woman who purges, as well as the veteran who self-medicates with alcohol, are both caught in the paradox that they have experienced a fundamental loss of control over their own lives, that they attempt to re-establish control in these highly circumscribed ways, and that even this “control” is lost as it becomes an obssessive ritual. Suddenly, one day, they discover that the ritual itself has become their prison.

The disease metaphor, starting to replace the religious worldview in the late 19th century, had the initial virtue of saying that “[your problem, whatever it is] is not a sin – you’re not evil,” which could be an enormous help to queers, drinkers, rebellious women, and others. From that good start, it transmuted into an amazingly effective tool of social control.

Women literally had to shake off the bonds of Freud in order to realize that disliking passive submission to their husbands, just to give one example, was not their fault. This growing understanding helped build the second wave of feminism. Pressure from the women’s movement at that time forced the psychiatric establishment to revise some of its basic assumptions about what made women “crazy.” The same phenomenon happened a decade or so later with the first wave of queer liberation, after which psychiatry admitted that homosexuality was not a disease.

Remarkably soon after these silences were broken and the discipline of feminist therapy seriously developed, the backlash began. And the medical establishment (as a reflection of the culture) responded by reconstructing a better-fortified version of individual disease-oriented therapies. When the message of the medical profession to an unhappy person is that they should turn their attention completely in on themselves, they are left isolated and, however “supportive” the therapy may be, in some ways profoundly alone.

If “I have cancer” is a statement about a disease, then “I am deeply unhappy and in pain because of my personal history,” is not. Using the word “disease” to cover both of those statements, and the entire spectrum in between, does great harm.

The fact that 50% of eating disorders are believed to be associated with early sexual abuse, the fact that the most common origin for PTSD is rape, the fact that rape and combat are situations where there are sudden and terrifying losses of control… these connections are always turned inward for resolution, approached with an individual therapeutic orientation, and medicalized with the treatments commodified… this should alert us to something. Beginning with the fact that were women not sexually abused and attacked, and socially subordinated in ways that associate their intrinsic worth with appearance, and stripped of any agency… and begining with the fact that men don’t just take the wrong turn on the way to work one day and end up in combat zones, we might assume that there is a social-power dimension, and therefore a political dimension to all these “disorders.”

Knowing that you need to get help is obviously an important step towards change. The original post is, in our view, too broadly condemnatory of 12-step programs. AA, NA, and the other community-based, free 12-step programs vary widely. As a result, some of them pay major attention to the social change aspects of the problems as well as the individual life changes. And the ones that create real community are doing extremely good work.

To say that our agonies are caused by a society that mistreats and frequently tortures us in childhood (not to mention later in life) is not to say that help is not possible. It is rather to say that help which ignores or denies the context of the larger social issues will frequently tend to be both palliative and limited.

If you’re an incest survivor, saying “My family was abusive as an isolated and detached phenomenon” isn’t nearly as helpful as saying, “My family was abusive as part of a system that encourages and supports the abuse of women and children.” (If you’re interested, read Alice Miller.) Understanding the social system does not make the individual situation less dreadful, but it provides both a sense of community and a relationship to others who share your history. This allows your process to be neither palliative nor limited. Also, it gives you a way to deal with patriarchal society without feeling that this is personally about you. Yet another way in which the personal is truly the political.

Thanks to Marcia for the pointer.

disease, recovery, social control, therapy, Alice Miller, feminism, anorexia, 12-step,psychology,PTSD,post traumatic stress disorder, child abuse, eating disorders, Body Impolitic

2 thoughts on “Politics and Recovery

  1. Sorry I cracked as hard as I did on 12-stepping. I did gain a lot, and experience a lot of valuable new relationships in 12-step programs (AA & NA). But in those two, at least, social power was off the agenda as an “outside issue.”

    Your elaborations here are very helpful.

    “…the medical establishment (as a reflection of the culture) responded by reconstructing a better-fortified version of individual disease-oriented therapies.”

    That’s a very effective turn of phrase, something I appreciate very much.


  2. Today I was reading a paper on how to do psychological screening of a WLS candidate and I was struck by all the different ways there are to be wrong (according to this paper). Since it was about WLS candidates, of course it mentioned inappropriate and unhealthy eating. But then it went on to talk about the ways that WLS candidates with “compulsive” behavior toward food could end up transferring their compulsions to things other than food later on. Along with the usual alcohol and drug abuse, TV watching and shopping were mentioned as inappropriate behaviors.

    I’m not saying there is no such thing as excessive spending, but I was struck by the way the paper on the one hand usefully pointed out that WLS is stressful and a person has to have coping mechanisms for the stress, and on the other hand unhelpfully listed so very many behaviors as problematic. Going through life examining every behavior for possible unhealthy motives strikes me as very time-consuming and soul-draining.

    (For the benefit of folks who don’t know me, since the preceding might not make it clear enough, I’ll mention that I’m passionately anti-WLS.)

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