Speaking of Anorexia: a brief meditation on the notion of

mediation
Florentino Blanco and Tomás Sánchez-Criado
Departamento de Psicología Básica, Universidad Autónoma de Madrid1
Abstract
The aim of this paper is to discuss on the ‘public’ dimension of identity. The starting point of
our argument is a very simple study of anorexic life stories. Originally the stories were recalled
from an Internet community of ‘people suffering from anorexia’. In brief, the narrative structure
of the stories was analysed in order to find communalities and variations. Our results showed
that stories were virtually interchangeable, its structure and content being almost identical.
They were, so to speak, public artefacts for identification and, perhaps more important, for leading
with and making sense of ‘pain’ and ‘suffering’. On this ground, our work puts forward for
consideration some ideas on (1) identity as a relational enterprise, (2) the socio-technical
regulation of ‘private experience’, (3) the supposed boundaries between subjective and objective
spheres and (4) the genealogy of the experience of ‘pain’ and ‘suffering’ as it is ‘experienced’ in
our Western cultures. Above all, we will try to consider the huge range of mediators (human
and non-human) that are deployed to stabilise a particular notion of the self. In this vein, and
departing from the premise that language cannot be considered the one and only relational
regulator, we will try to take into account the consequences on the concept of mediation that
might arise from our previous study.

Key Words
Anorexia, socio-technical mediation, identity, genealogy of subjectivity
Introduction
Let us start with a brief story:
My name is Violeta and I’m 19. I’m 1,52m tall and I weight 53Kg. Since I’m 12,
anorexia has been a nightmare of which I can’t wake up. Everything started when I was
at school. One day someone said to me ‘hey, how come you look like that?’. I felt
shattered; the hidden meaning was “you’re getting fat”. I started to avoid food and to
try to vomit, but as I couldn’t, I bought laxatives, which only provoked stomach–aches.
I also started to do some exercise. After a long time trying I managed to vomit and
started to do it on a daily basis. So much that it became a routine. I eventually got to the
edge of 30kg. People told me that I seemed to be sick, but I thought that they told me so
because they envied me. I started to go to a psychologist and it was there where they
detected my anorexia. I was interned several times in mental asylums, where I was
given tranquillisers, anti-depressives, serum... But I still didn’t eat. I recovered little by
little, but whenever I exited the clinic and went back to normal life I started to loose

1 Postal Address: Departamento de Psicología Básica. Facultad de Psicología, Universidad Autónoma de

Madrid (28049) Madrid (Spain). Phone: (34) 91 497 32 38. E-mail: [email protected],
[email protected]

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 weight. This illness has made me change a lot, because it has turned me into a liar and a
bastard. I’d like someone helped me and if you are interested e-mail me.
This story is the only result of a very simple study recalled from an Internet
community of ‘people suffering from anorexia’ done in our research group (Maestro,
2003). In fact this story has been literally made out of other stories pieces. Our results
showed that stories were virtually interchangeable, their structure and content being
almost identical: each of the fragments, with different numbers in TABLE 1
corresponds to a narrative structure ceaselessly repeated in every account.
(1) Presentation (1) My name is Violeta and I’m 19.

(2) Current height and (2) I’m 1,52m tall and I weight 53Kg.
weight

(3) Identification (3) Since I’m 12, anorexia has been a nightmare of which I can’t wake up.

(4) Initial Scenery (4) Everything started when I was at school.

(5) Trigger-event (5) One day someone said to me ‘hey, how come you look like that?’. I

felt shattered, the hidden meaning was “you’re getting fat”.

(6) Reactions (6) I started to avoid food and to try to vomit, but as I couldn’t, I bought

laxatives, which only provoked stomach–aches. I also started to do some

exercise. After a long time trying I managed to vomit and started to do it
on a daily basis. So much that it became a routine.
(7) Aftermath: (7) I eventually got to the edge of 30kg.
threshold weight

(8) Social perception (8) People told me that I seemed to be sick, but I thought that they told

me so because they envied me.

(9) Professional (9) I started to go to a psychologist and it was there where they detected
diagnostic
my anorexia.
(10) Relapses (10) I was interned several times in mental asylums, where I was given

tranquillisers, anti-depressives, serum... But I still didn’t eat. I recovered

little by little, but whenever I exited the clinic and went back to normal
life I started to loose weight.
(11) Self-perception: (11) This illness has made me change a lot, because it has turned me into
moral judgement
a liar and a bastard.
(12) Farewell, advices, (12) I’d like someone helped me and if you are interested e-mail me.
seek for help
TABLE 1. Narrative structure of the accounts with its attributed function.
The most surprising fact, even harmful to our Western sense of dignity and self-
regulation, to be derived from our results is that ‘suffering’, something we experience

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to be in the most private angle of our intimacy can be a collective affair. Even our way
of experimenting suffering of such a kind can be thought as a mediated activity.
We can say ‘not even what I thought to be so intimately o privately mine is
mine at all’. Even if this seems absurd in the eyes of a bio-psycho-social model of
psychopathology, anorexics learn to be, learn to perceive themselves as or become
anorexics participating and sharing unstable devices that allow them to form a group, to
create and constantly enact and perform a particular identity. As an example of this
strange behaviour to our eyes, we can cite this: in some of the web pages we found
messages of girls who asked what they had to do to be anorexics. Implicit in this is that
they were probably asking, what they had to say, too (even to ‘themselves’!).
Our purpose in this brief speech is to meditate, using these stories as a pretext,
on our heterogeneous features, our hybrid existence: the question is, to what extent,
and exaggerating the metaphor, are we beings made out of other not-so-human beings
pieces, heteropoietic entities? To what extent are we Frankenstein monsters, designed to
fit in the delicate and variable theories of action by which our lives are given meaning?
To what extent are we mediated or re-mediated? To what extent are we mediators of
other beings?.
Given the fact that artefact mediation has been considered by some the
touchstone of the process of evolution of the Great Apes; considering that language, in
particular, as an artefact has been thought to be by many the threshold of humanity we
would like to meditate on what makes us human and the diverse functions of language
in the stabilization of subjectivity and identity in so-called Modern World.
Mediation in the bull’s eye
We are going to talk about mediation but it is possible that the concept of
mediation needs to be changed, for the common sense cannot describe what is taking
place in our example.
In the Vygotskian socio-historical theory (Kozulin, 1990; Vygotsky, 1995)
language is seen as a ‘tool’ that mediates activity, internalised after having been
established ‘inter-psychologically’. Soviet and American revisionisms of his
conceptions have maintained a very similar ontology, portraying man as agent and the
object as patient, and tools as extensions of human functions, related to culture (see
FIGURE 1).

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 FIGURE 1. The structure of a human activity system (Engeström, 1987: 78)2
Nevertheless, in our opinion and as we will try to explain, the very problem of
this approach is to situate Nature, Objects, Societies (and their rules, division of labour
and so on), Subjects or Instruments (such as Discourse) as the touchstones of any kind
of explanation. Even the use of all of them as in Engeström’s model is perverse, given
the fact that not only these concepts have multiple meanings for many different groups
but, overall, we are taking their genesis for granted!
Our modest suggestion is that, first of all, we should reconsider the relations
between all those terms and how these stances have been segregated from a huge work
of entanglement through a non-reductionist empirical type of study of all the practices,
heterogeneous associations and dissociations of the materials that are forming and
reforming, in a recursive dynamics, the groups we live by (Latour, 1993; 2001). And
secondly we should try to overcome the micro/macro, intra/inter dualisms in social
sciences and to understand its genesis following the different kinds of actors, spaces
and times.
Technology and Subjectivity
But now we would like to give an example that might illustrate the genesis of
one of those supposedly stable dualisms. Later on we will come back to the general
considerations. In particular we are going to focus on the very nature of the particular
mediation that gives meaning to the story we read before and its relationship with the
development of subjectivity.
Going back to our example, the main literary genre that mediates our stories of
anorexia is a hybrid narrative device placed in between the classic clinical history’s
contents and the genre of self-revelation. Clinical history’s mediation is clear in both
form and content. Anorexics are precise measurers of their height and weight. They are

2 Image taken from the Center for Activity Theory and Developmental Work Research (University of

Helsinki) Web Page: http://www.edu.helsinki.fi/activity/pages/chatanddwr/chat/ Accessed 25

November 2004.

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proficient users of diagnostic categories; they expose their symptoms with a kind of
emotional distance proper of a doctor and so on and so forth. The genealogy of the
other genre or self-revelation technology and of some of the cultural practices to which it
was linked was analysed by Foucault (1988).
In short, the development of subjectivity in the wake of Christianism depended
on the re-elaboration of the Greek technology of askesis or remembering, developed by
the Stoics. The master-disciple relationship is, to the eyes of Stoics such as Marcus
Aurelius, deeply asymmetric. The ancient Socratic pedagogy based in dialogue is
substituted by a pedagogy of active listening, repetition and remembering. In fact, the
beloved retirement of the Stoics was a strategy to remember properly, with the aid of
peace, silence and solitude, the master’s words. The disciple listened and the master
spoke. No questions, only rules to learn. ‘I retire so that nothing can disturb my askesis
[remembering]’. We will exemplify it with bits of Marcus Aurelius letters:
‘Hail, my sweetest of masters:
We are well. I slept somewhat late owing to my slight cold, which seems now to have
subsided. So from five A.M. till nine, I spent the time partly in reading some of Cato’s
Agriculture, partly in writing not quite such wretched stuff, by heavens, as yesterday …
After easing my throat I went off to my father and attended him at a sacrifice. Then we
went to the luncheon. What do you think I ate? A wee bit of bread, though I saw others
devouring beans, onions, and herrings full of roe. We then worked hard at grape-
gathering, and had a good sweat, and were merry … After six o’clock we came home.
… Then I had a long chat with my mother … My talk was this: “What do you think my
Fronto is now doing?” Then she: “And what do you think my Gratia is doing?” …
Whilst we were chattering in this way and disputing which of us loved the one or other
of you two the better, the gong sounded, an intimation of my father had gone to his
bath. So we had supper after we had bathed in the oil-press room … After coming back,
before I turn over and snore, I get my task done and give my dearest of masters an
account of the day’s doings, and if I could miss him more, I would not grudge wasting
away a little more. Farewell, my Fronto, wherever you are, most honey-sweet, my love,
my delight. How is it between you and me? I love you and you are away’ (In Foucault,
1988: 28-29).
As can be seen Fronto was not only his master, but also his lover.
In order to treat with more precision what Professor J.D. Ramírez (2004)
pointed out in the symposium, private reading is not privative of a civilized bourgeois
history of manners. History of technology needs to be analysed much more carefully.
One of the problems is to suppose that all of these practices are necessarily progressive.

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 For instance, the conditions of possibility for the development of epistolary
communication in the Roman Imperium had to do with the construction of Roman
communication networks. Written messages had as primary function the transmission
of military and economic orders, related to the building of secured boundaries. A
network construed for one purpose could serve as grounding for other uses and this
network fell to pieces with the Imperium. Some of the pieces were re-used, of course.
Anyway, Foucault (1988) used to say that in the primitive Christianism, a
religion not only confessional but also of self-salvation, two basic forms of self-
revelation, of self-presentation, of self-discovery were invented: 1) exomologesis; and 2)
exagoreusis, whose common characteristic was that they assumed the renunciation of
one’s autonomy.
First of all, exomologesis was the public acknowledgement of the truth of one’s
faith or of one’s condition of Christian. It implied the dramatic, not verbal, expression of
the penitent’s condition as sinner, a practice situated in between the extreme
expression of mortification and martyrdom. The penitent followed strict rules of
dressing and sexual behaviour for four or five years imposed by the bishop (to whom
the person had to apply for the condition of such, presenting a convincing case). This
technique evolved with that name until the Middle Ages.
Secondly, exagoreusis was the continuous, detailed and systematic revelation of
one’s thoughts to an external and non-contestable authority (such as the abbot, the
bishop…). Of the two, exagoreusis has been the one that has survived and evolved,
embodied in other practices. Exagoreusis was verbal whereas exomologesis was of
another kind and was much more related to the Stoic technologies previously
commented: ranging from soliciting master’s counsel in love and friendship affairs to
the use of letters, diaries and writings of an autobiographic kind. The “innovative”
feature of exagoreusis was the imperative to “tell the truth” as the one and only way to
be at peace with oneself.
In any case, we would like to sketch a historical argument (Blanco, 2002): these
forms of self-revelation have progressed and some of them have suffered a great
degree of sophistication at the same time and as a consequence of the extension of
literature (and the disciplined act of reading) and the multiple institutionalisations of
counselling in mesmerism, spiritual counselling, phrenology, psychotherapy, aid
groups, sects, and so on.

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 In brief, what these historical considerations may depict is what has been called
genealogy of subjectivity: in them it can be read the chronicle of the process of the
cultural genesis of the Western individual, understood as the locus of what we now
know as psychological conflict, always a normative conflict of power or of ‘autonomy’
(Blanco, 2002). This is why we can say that the historical genesis of the idea of a
psychological subject is symmetric to, and is originated at the same time as, the genesis of
the idea of a political subject.
Anyway, the form of self-revelation that takes place in that Internet community
of shared suffering can be considered as a hybrid genre of: 1) the public “honesty”
required in exagoreusis; and 2) the acknowledgement of the sin, compulsory in
examologesis. This genre can only be understood at the heart of a ‘saturated of
subjectivity’ conception of the self and is very similar to the one used in Alcoholics
Anonymous groups.
Reconsidering the concept of mediation
This example exposes the very difficulty of a mediated activity theory. We
would like to propose another turn of the screw: to take Actor-Network Theory (ANT) as
grounding for a new mediational philosophy (Latour, 2001; Law, 1994). We will sketch
some of the relevant ANT features for this aim.
First, these theorists argue that every so-called ‘social’ or ‘natural’ patterns are
formed by the work of association and substitution of humans and non-humans. In saying
this they point to the fact that we must follow the practices, the associations and
dissociations of all the materials needed in the building of a collective: the name they
give to our groups, in which humans and non-humans or hybrids, as they call them, are
intertwined, forming networks that could be metaphorically described as a rhizome
(Deleuze and Guattari, 2003). The rhizome metaphor opposes to classical taxonomies
based on the root or tree metaphor.
As the Actor-Network theorists say (Latour, 2001), a way of life, an stabilized
type of relationship can only exist thanks to a relational system of translations: all the
redefinitions and changes of materials that are needed to act in a particular way
(Callon, 1986); and mediators that are implied in this work of translation. Mediators are
agents or more strictly ‘actants’ (for an agent, for them, does not necessarily have to be
human), which are able to translate.
In employing these concepts their aim is to substitute Subject/Object
reductionism by what they call a material relationism (Latour, 1993; Law, 1994). The

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networks that derive from such collective (human and non-human) work are growing
or shrinking associations of heterogeneous materials that act recursively. Why
recursively? Because the act of definition can have performative effects, defining and
redefining constantly the elements that are held together. See FIGURE 2 for a visual
depiction: the main problem of this image is that temporality has been neglected for
the sake of the exposition of our argument.
Heterogeneous associations

Growing

Work -Net

Recursivity of the patterns Shrinking

FIGURE 2. Formation and recursivity of Work-Nets.

Going back to our example: if we observed the case of an ‘Internet-community-
of-people-suffering-from-anorexia’ to use this new ontology as a basis would mean to
study the actants (discourses of and about anorexia as the one showed, applied
technologies of the self, doctors and psychologists, computers, wires, definitions of
‘pain’ and ‘suffering’, ‘vomit’ and ‘fashion’, the World Wide Web…) that are needed to
extend multiple networks and to eventually stabilise a new actor called “anorexia” and
how they are related.
The arranged discourse showed above is a long-running artefact, whose nature
is apparently discursive and that allows the formation and disciplining of some people
and the categories they use to ‘lead with pain and suffering’ and to share it. In sum, the
previous genealogy of the technologies of the self could be inserted in a broader
description that focuses on two mediated process, crucial to the understanding of the
most widely spread theory of action in our Western thought (Latour, 1993):
1. The development of the Subject-Object distinction in the West or work of
purification, by which the arrangement of collectives and hybridization has
been rendered unseen and unheard.
2. The formation of networks of hybrids or work of translation, by which
collectives are formed.

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 The only way to establish a cultural comparison would be to look at the
processes of purification (understood as a mediational process) and translation: so-called
natures and societies have only been ‘segregated’ in our civilization (our collective)
through these mediational processes. Nevertheless, the work of translation has been
also constant in other collectives, forming ‘rhizomes’ as well (see FIGURE 3).

FIGURE 3. Natures-Societies or Rhizomes? 3

This change of ontology or philosophy has recursive implications for our work
as psychologists observing the discourse of anorexics sharing their suffering. In brief,
there is no ‘suffering’ without this narrative mediation, among many other elements.
Conclusions
The first step is to reconsider the function of the mediators, or relational
regulators, we live by, of which language is not but one among many. Secondly, we
should start to take into consideration that language is a relational mediator. In this
line of thought neither Piaget nor Vygotsky were strictly right in their depictions (see
Cole and Wertsch, 1996), for if our argument makes sense:
“Language also […] becomes a mediating artefact like the ruler, the chart […] even
when we talk to ourselves, memorize a routine, or invent shortcuts and rules of thumb
to overcome a difficulty of calculating” (Latour, 1996: 58)
“It is tempting to think that the words and the world are coordinated by language in
order to produce the meanings. It is more accurate to say that the meanings, the world,

3 Image taken from Latour (1993: 152).

9
 and the words are put into coordination with one another via the mediating structure of
language” (Hutchins, 1995: 299-300).
In Actor-Network Theory wording language or cognition cannot be the
property of an individual, nor of a society, but of a collective of humans and non-
humans working together. In this vein, to close we would like to quote a brief piece of
Latour’s article On technical mediation (1998):
“Objectivity and subjectivity are not opposite; they grow together in an irrevocable
way. The challenge for our philosophy, social theory and morality is to invent political
institutions that might absorb so much history, this enormous spiral movement, this
destiny, this fate… At least I hope I have persuaded you that if our challenge were to be
attended it wouldn’t be considering artefacts as things. They deserve something better.
They deserve to be located in our intellectual culture as social actors in their own right.
Do they mediate our actions? No, they are us” (Latour, 1998: 299-300; our translation)

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