A Response to Mitchell, Hinshelwood, and Adshead

Philosophy Psychiatry and Psychology 8 (1):41-44 (2001)
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In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.1 (2001) 41-44 [Access article in PDF] A Response to Mitchell, Hinshelwood, and Adshead Sarah Richmond Iam grateful to Juliet Mitchell for contributing, in her response to my paper, some interesting further ideas about anorexia. Before commenting on these, I would like to reply to her suggestion that a distinction between symptom and phantasy will provide a necessary corrective to my approach. I think that, in relation to my usage of terms, this suggestion is mistaken.If I have understood her correctly, Mitchell maintains that we need to focus on symptoms rather than on phantasy because the former always indicate the influence of something truly unconscious, a meaning that the subject cannot recognize. On the other hand, phantasy, Mitchell says, involves a "slippage between unconscious and preconscious," between the notions of a meaning that remains disguised and inaccessible to consciousness and one that may be recognized by the subject.I meant, in my paper, to use the term phantasy in the Kleinian sense, that is, to denote mental content that is unconscious. On the Kleinian view, symptoms whose cause is psychological are expressions of (and clues to) an unconscious phantasy that underlies them: To understand symptomatic behavior, the analyst needs to understand its basis in unconscious object-relational phantasy. (Many such cases can be found in Klein's writings. In her seminal paper of 1935, for example, she cites a patient suffering from "hypochondriacal complaints" and carefully "nursing these parts of his body"; in her view, "the different organs he was trying to cure were identified with his internalized brothers and sisters, about whom he felt guilty and whom he had to be perpetually keeping alive" (Klein 275). There is not, therefore, any important distinction, as far as the line of thought pursued in my paper goes, between phantasy and symptom.In introducing the distinction, Mitchell seems to want to emphasize the distinctive, conflict-indicating nature of unconscious material and its heterogeneity with respect to conscious thought. On this, I am in agreement; indeed, my complaint against feminist "literalist" accounts of anorexia is precisely that they overlook the opacity of the unconscious, attributing such "reasonable" and straightforward conflicts to women as to render most of the explanatory resources of psychoanalytical theory redundant.In connection with this issue, it is helpful to be reminded by Mitchell of the "delusion" that often accompanies anorexia, that is, the manifestly false belief, on the sufferer's part, that she is fat. This feature of the subject's outlook must be one of the reasons that anorexia is popularly thought of as [End Page 41] a "slimmer's disease"; equally, it may have helped to encourage the view that anorexia is a response to constructions of female beauty in the media.The "delusional" aspect of the belief, however, discredits this view: Anorexic women do not stop "dieting" when they approximate to a conventional ideal of female slimness. (What about the recent use of anorexically thin fashion models? I don't think this provides a real objection to my claim; so far at least, this practice is quite rare, and I think intended more to shock than to provide an aesthetic ideal.)Anorexic women's continued abstinence from food leads them to acquire an appearance that most people find unattractively thin. Often, they become sufficiently malnourished to endanger their health and sometimes to result in their death. This behavior, surely, cannot be attributed to a desire to conform to fashion, even if that is what the woman says she is trying to do. I agree with Mitchell that the anomaly manifested in some anorexic behavior, the mismatch between what is said and done, suggests the need for explanation in terms of unconscious conflict.Nonetheless, it is plausible that the "media message" and the slimming industry play some role. As I suggested in my article, we might see this role as provocative; the message sounds a note that resonates with or encourages an adolescent's distaste for her body. Further, it may also provide her with a convenient rationalization of her behavior: "I need to diet; I look...

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