A genealogical exploration of the conditions of possibility for re-feeding to emerge as a treatment regimen

Following the genealogical work of Foucault, Rose and others, this thesis aimed to trace the conditions of possibility for re-feeding to emerge and continue as a primary treatment regimen for self-starving individuals. This focus was in relation to the known poor long-term outcomes – an approximately fifty per cent recovery rate - for people who come into contact with services and are diagnosed with anorexia nervosa. Historical and present case narratives, which captured re-feeding practices in 1960s and 2000s, were presented and analysed using the genealogical research strategies of ‘surface of emergence’ and ‘descent’ in relation to five perspectival dimensions, namely strategies, authorities, technologies, subjectivities and problematizations. Re-feeding emerged in relation to neo-hygienic strategies for public health for preventative and individualised medicine, and the reconfigured authority of psychiatry as a ‘mental medicine’, which had new physical technologies such as modified insulin therapy and psychopharmacological treatments, to shape the conduct and bodies of self-starving individuals in accordance with the ‘norms’ of health. Increasingly, re-feeding practices have become imbricated within strategies for the ‘administration of risk’ as self-starving individuals have become problematized in terms of the degree of AN or level of risk they pose. Overtime re-feeding as a life-saving measure, and self-starvation as a ‘mental disorder’, has become ‘black boxed’ in relation to bio-political strategies for administering risk within the context of rights, choice and empowerment, and a culture of blame and sanctions. Implications for research and clinical practice are discussed.