This article details the making of community and bodies in online environments, specifically the online pro-anorexia community. Building community among members of these groups is particularly fraught because tensions over claims to authenticity permeate these groups. Because these are embodied practices and online spaces are presumably disembodied, participants constantly grapple with authenticity, largely through the threat of the ‘wannarexic’. Participants manage these tensions through engaging in group rituals and deploying individual tools that attempt to make the body evident online. This (...) article documents the way in which tensions around authenticity and embodied practices are managed through treatment of the wannarexic. (shrink)

In this paper, I discuss empirical evidence regarding anorexic patients’ distorted body representations. I fit this evidence into a broader framework for understanding how the spatial content of the body is tracked and represented. This framework is motivated by O’Shaughnessy’s (1980) long-term body image hypothesis. This hypothesis posits a representation that tracks changes in the spatial content of the body and supplies this content to other body representations. I argue that a similar kind of body representation might exist and, in (...) the case of anorexia, be distorted. Finally, I suggest that this body representation might become distorted through influence by affect. -/- . (shrink)

Understanding Eating Disorders is an original contribution to the field of healthcare ethics. It develops a new theory concerning the moral basis of eating disorders, and places such disorders for the first time at the centre of philosophical discourse. The book explores the relationship that people have with food and their own body by looking at genetics and neuro-physiology, sociology and family studies, clinical psychology and psychiatry, and frames abnormal eating at the extreme of a spectrum of normal behaviours, directed (...) by moral values. Giordano argues that abnormal eating is not a psycho-pathological phenomenon, but the coherent implementation of ordinary moral values with a long tradition in Western culture. The book also contains a detailed analysis of UK legislation, accompanied by a timely critique of the law on treatment of mental disorders in general and of eating disorders in particular. (shrink)

The general definition of mental disorder stated in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders seems to identify a mental disorder with a harmful dysfunction. However, the presence of distress or disability, which may be bracketed as the presence of harm, is taken to be merely usual, and thus not a necessary requirement: a mental disorder can be diagnosed as such even if there is no harm at all. In this paper, we focus on the (...) harm requirement. First, we clarify what it means to say that the harm requirement is not necessary for defining the general concept of mental disorder. In this respect, we briefly examine the two components of harm, distress and disability, and then trace a distinction between mental disorder tokens and mental disorder types. Second, we argue that the decision not to regard the harm requirement as a necessary criterion for mental disorder is tenable for a number of practical and theoretical reasons, some pertaining to conceptual issues surrounding the two components of harm and others pertaining to the problem of false negatives and the status of psychiatry vis-à-vis somatic medicine. However, we believe that the harm requirement can be maintained among the specific diagnostic criteria of certain individual mental disorders. More precisely, we argue that insofar as the harm requirement is needed among the specific diagnostic criteria of certain individual mental disorders, it should be unpacked and clarified. (shrink)

The general concept of mental disorder specified in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders is definitional in character: a mental disorder might be identified with a harmful dysfunction. The manual also contains the explicit claim that each individual mental disorder should meet the requirements posed by the definition. The aim of this article is two-fold. First, we shall analyze the definition of the superordinate concept of mental disorder to better understand what necessary criteria actually (...) characterize such a concept. Second, we shall consider the concepts of some individual mental disorders and show that they are in tension with the definition of the superordinate concept, taking pyromania and narcissistic personality disorder as case studies. Our main point is that an unexplained and not-operationalized dysfunction requirement that is included in the general definition, while being systematically violated by the diagnostic criteria of specific mental disorders, is a logical error. Then, either we unpack and operationalize the dysfunction requirement, and include explicit diagnostic criteria that can actually meet it, or we simply drop it. (shrink)

In this surprising book, Allan V. Horwitz argues that our current conceptions of mental illness as a disease fit only a small number of serious psychological conditions and that most conditions currently regarded as mental illness are cultural constructions, normal reactions to stressful social circumstances, or simply forms of deviant behavior.

Traditionally, philosophers of mind have been guided by a brainbound approach: the mind, whatever it turns out to be, will be related to or identical with the brain. The body, under this approach, plays a merely instrumental role — it is what keeps the brain alive and healthy. Over the past few decades there has been increasing resistance to the brainbound approach, and a strongly supported push for taking a non-brainbound approach: the body is not merely instrumental, but in many (...) ways constitutive of the mind — the mind, whatever it turns out to be, is bodily in many fundamental respects. Thus, in explaining the mind, we must consider not only brain states, but also wider bodily processes. What those wider bodily processes are, and how they constitute certain mental states, are the key questions that we now face as non-brainbound philosophers of mind. -/- One avenue of investigation that many have taken in view to answering these two questions has been to look at bodily awareness and its relation to our sense of self. How does our body, and our awareness of our body more specifically, constitute our sense of self and our subjective experience of the world. A clear way of investigating this last question is to turn to pathological cases of body awareness, e.g. body dysmorphic disorder and anorexia nervosa. Anorexia nervosa is an interesting case. The DSM-5 distinguishes anorexia nervosa from body dysmorphic disorder — the former is classified as an eating disorder, while the latter is classified as a mental disorder. As I will explore in this chapter, this very manner of distinguishing among such pathologies admits of a traditional brainbound approach to separating the mind/brain from the body. Here I shall consider how a non-brainbound approach might give us different, and perhaps even better insight into cases such as anorexia nervosa, and I shall, conversely, consider how such body awareness disorders might serve to further strengthen the view that the right approach to understanding the mind is the non-brainbound approach. (shrink)

The processing, representation, and perception of bodily signals (interoception) plays an important role for human behavior. Theories of embodied cognition hold that higher cognitive processes operate on perceptual symbols and that concept use involves reactivations of the sensory-motor states that occur during experience with the world. Similarly, activation of interoceptive representations and meta-representations of bodily signals supporting interoceptive awareness are profoundly associated with emotional experience and cognitive functions. This article gives an overview over present findings and models on interoception and (...) mechanisms of embodiment and highlights its relevance for disorders that are suggested to represent a translation deficit of bodily states into subjective feelings and self-awareness. (shrink)