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Sahana Shanmugam 2012

Bibliography: Kleinman, Arthur, 1988. The illness narratives. United States:Basic Books Singer, Merrill & Hans Baer. 2012. Introducing Medical Anthropology: A Discipline in Action, Second Edition. Lanham (Maryland): AltaMira Press. Warin, Megan. Abject Relations: Everyday Worlds of Anorexia. 2010. New Jersey: Rutgers University Press

Sahana Shanmugam 2012

Thin, starvation and unhealthy are some of the stereotypical view on anorexia. The very term anorexia which literally means lack of desire, loss of appetite or both, is erroneous, for a person with this diagnosis often stands in an ambiguous relationship with food that is obsessed with it...And seen as an object of desire and disgust(Warin 21). Anorexia is diagnosed as an illness by health professionals to individual. In diagnosing inviduals with anorexia, health professionals attempt to look at the disease through a medical approach instead of the experiences of the invidual with anorexia. Health professionals are trained to see an illness as a disease and nothing more. Illness is seen as the consciousness of the individual who is diagnosed with a disease. What health professional see as an illness may not be viewed as an illness by the inviduals who have been diagnosed with the certain illness Despite her cadaverlike appearance, Josies demeanor did not communicate sickness, weakness or fatigue. She sat upright, her head high, her strong voice and direct eye contact reflecting the power of the unease she had created. She held center stage and the other women (including me) were silent, drawn to her presence (Warin 1).Illnesses are shaped culturally. It is through medical anthropology that one is able to understand an illness from an inside perspective. Medical anthropology focuses on understanding what the illness is and how it is experienced by the people diagnosed with the illness as well as their social life as well as how the illness is shape socially as well as culturally. Medical anthropology looks past biology in order to understand health by looking at the individuals experiences due to the illness. Medical anthropologist believe that there is not one specific cause

Sahana Shanmugam 2012


of diseases but illness are created through cultural, biological and physical aspects that affect one another. Medical anthropology focuses on the individuals background such as their relationship with others, family, ethnic background as well as their lived environment. Medical anthropology focuses heavily on ethnographic fieldwork as well as one-on-one observations. Medical anthropology heavily focuses on how people experience their illnesses as well as the social contents involved within the illness, how people go to treatment and when they know its time for heal. In other words medical anthropology is a branch of anthropology that takes into consideration the cultural, political, historical, social aspects of illness and health. In the book, Abject Relations: Everyday Worlds of Anorexia by Megan Warin focuses on the lives of women who live and experience anorexia daily. The book is aimed at understanding anorexia through experiences of the individual instead of a biological approach. The intended audience for the book seems to be aimed at other anoeric individuals in order to them understand a bit more about the different reasons of anorexia as well as let them know there are many other individual dealing with anorexia. The book is also aimed at people who purely think anorexia is to fit an ideal image of being thin. The book allows people with stereotypical thoughts to understand anorexia through the eyes of one who is diagnosed with anorexia. It also allows doctors, nurses and other health professionals to understand anorexia outside the biological field. Through her ethnographic research she unpacks common understandings that have fixed anorexia as the epitome of a Western obsession with individualism, self-control and autonomy and offers an alternative understanding (Warin 19). Warin describes that through her participant observation she was able to see anorexia in a different way which was through the power, desire and disgust (Warin 19). She mentions that anorexia deals with relatedness which is an individual relating themselves to others as well as the world (Warin19). Warins text is a very significant

Sahana Shanmugam 2012


read to individual within medical anthropology as it grasps the fundamental aspects of what medical anthropology focuses on. Medical anthropology focuses on looking beyond the medical diagnosis of an illness. Without just looking at what treatment and medication will help the individual medical anthropologist focus on how individuals cope with the illness and how they view the illness. Warins text does exactly this. Without viewing anorexia as just a medical illness, she focuses on how people relate to anorexia on a daily basis. For the individuals diagnosed with anorexia, anorexia is just not an illness but practising anorexia they are empowering themselves by having their body cleansed. Anorexia becomes a friend or a comfort place for them. It allows them to form new relationships. New forms of reledness includes concealment of anorexic practices (from family, medical staff and friends).. secrecy and competitiveness with other in-patients, friendships forged through sharing a common diagnosis and the personification of anorexia as a friend, an abusive lover, a parent, a child, the devil in disguse or an enemy (Warin 21) Some practices of medical anthropology are participant obersevation,one-on-one interview and illness narrative. Warin uses these concepts throughout her book making it more clear of what anorexia is in the view of medical anthropology. Illness narratives as defined by Arthur Kleinman edifiys us about how life problems are created, controlled, made meaningful. They also tell us about the way cultural values and social relations shape how we perceive and monitor our bodies, label and categorize bodily symptoms, interpret complaints in the particular context of our life situation we express our distress through bodily idioms that are both peculiar to distinctive cultural worlds and constrained by our shared human conditions. We can vision in chronic illness and its therapy a symbolic bridge that connects body, self and society. This network interconnects physiological process, meanings and relationships so that our social world is linked recursively to our inner experience. Here we are

Sahana Shanmugam 2012


privileged to discover powers within and between us that can either amplify suffering and disability or dampen synptoms and therefore contribute to care(Kleinman 1988 xiii).As Kleinman explains, our bodies are shaped socially. Warin mentions that thinness is linked to anorexia and it holds a fascination(Warin 26). She also mentions that media portrays thinness shaping the view of the female body to be thin. She mentions that by only focusing on the visual aspect of anorexia it allows the female body to be examined as an object(Warin 26). But the stereotypical assumption of being anorexia to be skinny is seen incorrect through medical anthropology. As Warin learns from her one-one research individual diagnosed with anorexia did not starve themselves to be skinny. The women in this project wanted to cut the flesh off their bodies and be left with the clean, hard truth of bones. For Sonya, flesh was feminized and associated with excess sin and guilt(Warin 154). Sonya did not want to have flesh because she believed it was the flesh she had on her body before that lead to her sexual abuse. There are reasons why people diagnosed with anorexia wanted to stay thin and it was not just purely to fit an image. There were family problems, abuses, economic, culturally and political aspects that made anorexia part of ones life. Anorexia was not only just a disease but a community. There was a community of anorexic people helping each other to stay skinny, tips on how avoid foods when given by health professionals as well as competing with each other to be the most anorexic. Anorexic was like an elite group and to feel powerful you must be the thinnest (Warin 19). Individual helped each other to stay thin and if you were seen as coping with the health professionals in treating yourself to become better you were seen as an outcast. As a medical anthropologist you are able to understand the illness better and have a better connection to the individual because you are not trying to asses their illness through biology or medication. Warin mentions that one of the

Sahana Shanmugam 2012


participants of her study, Natalie, mentioned she felt more comfortable with Warin then the community nurse as Warin was not wanting her to eat(Warin 71). Abstract Relations is a great read to understand medical anthropology as it implies all te aspects of medical anthropology. It questions what causes individual to take upon anorexia. Warin for example mentions that the participants in her study range from low income families to high income families, individual who have faced some sort of abuse especially sexual abuse since childhood, economic issue as well as gender issues weigh in the reasons people turn to anorexia. Through one-on-one interviews as well as participant observation and focus groups, Warin was able to understand anorexia on a whole different level which is beyond biological which is what medical anthropologist do. Her study on anorexia allows her readers, to understand that anorexia is not just wanting to be thin to fit some ideal image but a sort of comfort certain individuals turn to in order to cope with their problems. The way Megan Warin writes her ethnography engages her readers. She starts of by explaining anorexia as well how relatedness relates to anorexia. She then goes onto looking at food and anorexia and slowly engages her readers into the understanding anorexia at greater lengths. The book was a great way to look at anorexia outside the biological view. Anorexia can be their best friend or their worst enemy leading them to death.