Purification,Punishment,and Control: Eating Disorders,Self-Harm,and Child Sexual Abuse

A Feminist Approach to Bakhtin’s Dialogic Theory

As there is a need for new methodological frameworks that gain access to the varied, complex, and socially contextualized experiences of women, we turned, in part, to Russian philosopher Mikhail Bakhtin’s sociological linguistics, for a theoretical and methodological framework. Bakhtin (1981) developed, over a prolific career of some 50 years, a theory known as dialogism, in which he conceived of all discourse as dialogical. Bakhtin argues that there is no one interpretation, no single harmonious worldview and no single truth (Bakhtin, 1981). The spoken word has meaning in particular contexts as it enters “a dialogically agitated and tension-filled environment of alien words, value judgements” (Bakhtin, 1981, p. 276) and all this shapes discourse. What Bakhtin is suggesting here is that we do not learn words from a dictionary, we acquire them from hearing or reading the words of others and, therefore, they are marked with the voices of those prior contexts. Thus, from a Bakhtinian perspective, “discourse is always riddled with and responsive to what has already been and has yet to be spoken” (van Enk, 2009, p, 1267). In this way, words carry histories that go far beyond particular instances of usage and, as such, meaning must be negotiated.

In adopting a Bakhtinian perspective, Hodge conducted up to five individual, qualitative interviews, averaging 90 minutes in duration, with each of the seven women who participated in the study. Thematic analysis was undertaken as a means of eliciting common themes from each of the individual interviews (Braun & Clarke, 2006). Dialogical research does not exclude locating themes; rather such themes are understood not as finalizing descriptions (Frank, 2005), but as tentative beginnings of representing individual struggles and how each voice was the site of struggle, permeated by multiple voices. The women were encouraged to be active agents through reflective processes. This included the use of specific questions that instigated self-reflections (Frank, 2005), and Hodge showing each of the women the analysis of her interview. After each interview, participants were able to email Hodge any other thoughts that they wanted to include, or points they wanted to expand upon. All the participants corresponded with Hodge through email and these reflections became part of the data used in the analysis.

The next level of analysis was to apply Bakhtin’s (1981) theoretical constructs—authoritative discourse and internally persuasive discourse—to the data. As Oliva (2000), interprets, “Bakhtin’s theoretical ideas explicitly resist the assumption of one ‘authoritative’ discourse to allow for the existence of a plurality of voices and perspectives” (p. 37). Considering this point, an authoritative discourse has such binding authority that it seems untouchable, inspires only adoration and respect, and maintains the status quo. An example of such discourse is most notably medical diagnosis (Frank, 2005). In contrast, an internally persuasive discourse is denied all privilege, as is often not acknowledged in society. As meaning is produced (or policed) through discourse, rather than revealed through it (Burr, 2007), these theoretical constructs enabled us to examine how gendered and disciplinary discourses created and sustained the participants’ eating disorders.

There was potential for conflict between our feminist Bakhtinian analysis and the women’s interpretations, as we tried to explain their lives without violating their reality. However, each participant and Hodge did their best to arrive at a compromise regarding their interpretations. This is particularly important for research on child sexual abuse and eating disorders where hegemonic discourses can conceal the potential for other understandings, and thereby the potential for resisting silenced trauma.

Drawings and Poetry as Another Layer

Not everything can be captured in the spoken word. Participants’ own drawings and poetry were important additional research methods. Our aim in using arts-based inquiry was not to obtain an understanding of the participant’s drawings and poetry but to understand the life of the participant through them. For participant drawings, we followed Guillemin’s (2004) adaption of Rose’s (2008) framework, where the data comprised both the visual images and the participant’s verbal descriptions of the image. The events, experiences, and interactions that preceded the drawing all worked to produce the understandings that were embedded in the drawing (Guillemin, 2004). The image itself was used as evidence to develop and support, or to supplement, research findings (Rose, 2008), and to access understandings that are experienced as a “felt sense” in the body (Hodge & Simpson, 2016).

In this article, one participant’s poem as data is intended to evoke embodied responses “and resonate with readers to have them experience the poetry as evocative mediators of, oftentimes, painful societal events and expectations and limitations” (Faulkner, 2018, p. 2). In this way, poetry opened up possibilities for discovering new meanings, as it allowed the women to critically reflect on experience, with at least some of the habitual meanings held in abeyance. Their poetry added additional layers of meaning by resonating with emotions that are difficult to name directly (Furman, 2006), and through an economy of words (Pointdexter, 2003). In essence, participants’ poetry as data could “elicit information that may not have come in a direct formal interview” (Janesick, 2019, p. 497).

Recruitment and Ethical Considerations

This study received approval from the university’s Human Research Ethics Committee. To recruit participants, flyers were placed around the University of South Australia, inviting women to volunteer who were 18 years or older, who self-identified as having an eating disorder, and who were sexually abused as children. The flyers stated participation would require multiple interviews, within a 12-month time frame. An information sheet was provided to participants and they had the opportunity to ask questions prior to the commencement of data collection. Participants signed consent forms before participating in the study: one to participate in the interviews and a second form prior to their artwork, poetry, and journals being collected.

The participants ranged from 20 to 50 years old, with the sexual abuse occurring when they were aged between 2 and 12 years old. Five of the participants had a clinical diagnosis of an eating disorder and two were self-diagnosed. All participants who volunteered for the study were middle class, White, Western women, which excluded an analysis of how classism and racism might contribute to eating distress (Thompson, 1992). Three of the participants were single, three married, and one lived with her same-sex partner.

Self-Harm and Eating Disorders

The women’s narratives, drawings, and poetry presented here offer detailed accounts in which purging or starvation were suggested as particularly punishing forms of self-harm in response to sexual trauma. Eating disorders serve as a way of punishing the body by starving it, stuffing it, or torturing it by vomiting and purging (Gur, 2019). Feelings of anger, vileness, and frustration were expressed not only in the form of eating disorders but also through other self-harming practices as acts of symbolic communication (Evans, 2018). Their bodies served them as an instrument with which to hurt themselves, via the eating disorder and the wounding of the body. In this way, cutting, excoriation, starving, binging, and purging transferred their emotional pain to a place where it became visible and tangible. This speaks to the research done by Le Breton (2018), who noted that, for the person who self-harms, it is a source of power and a temporary relief against emotional pain. Our contention is that visualizing pain was a form of language the participants used to deal with the revulsion and horror of the abuse. It enabled them to manage emotional distress and voice their enduring pain, without speaking.

An interviewee, who was sexually abused by her friend’s two teenage brothers as a child and later raped by her ex-husband, powerfully articulated how her need to hurt herself was part of her eating disorder “ritual”:

This interviewee connected the “physically painful” binging and purging practices of “overstretching” her “jaw” and “pipe” as both reproducing the pain of sexual trauma and as a way to cleanse her body of “hate” and “vileness.” Bakhtin (1984) contends, “no living word relates to its object in a singular way . . . there exists an elastic environment of other, alien words about the same object” (p. 267). Purging was another way of not only coping with the abuse but also constituting the meaning of the rape in more than one way. Her body was represented as a symbol of the self, and her “bodily practices take the form of self-preservation rather than a meaningless set of pathological rituals” (Malecki et al., 2018a, p. 943). Food was constructed as “contaminating body and soul” (Churruca et al., 2017, p. 1494). The act of purging was an attempt to cleanse her body of “feelings” that were attached to her traumatic experience—feelings she found too difficult to name directly.

Another interviewee with an anorexia diagnosis was used in the production of child pornography at a young age until she ran away from home and then worked as a sex worker to survive. Figure 1 is from the interviewee’s art diary. Her drawing portrays a skeletal body with a strong rope and a chair far enough away to indicate a desire for a hanging that will not fail. The featureless face in this image metaphorically articulates unspeakable thoughts, emotions, and the trauma that she has endured. There is nothing life-like in this picture; there is no window and, therefore, no view to the outside world. This strongly emphasizes a total lack of hope.

OPEN IN VIEWER

Figure 1.

Analiese.

If we consider the drawing at another analytical level, it is as if she has metaphorically suffered a double death. The skeleton resembles a faceless corpse, which then hangs, and dies again. In this way, she expresses herself as abject. Kristeva (1982) describes “the utmost of abjection” as founded in the corpse (p. 4). The corpse, according to Kristeva (1982), is “a decaying body, lifeless, completely turned into dejection, blurred between the inanimate and the inorganic” (p. 109). Thus, it unsettles and confronts order and does not respect borders, positions, and rules. From this position, the image is abject because its untidiness violates not only biological but also normative boundaries. Without pride or dignity, it is self-abasing and disturbs the order of things in its representation of dying twice. Moreover, the catastrophe of the abject body cannot be contained by the suffering person because, when others witness abjection, they too become contaminated. Thus, her hanging anorexic body is a sick and damaged body that causes experiences of, as Kristeva (1982) points out, “brutish suffering” (p. 2), in the form of disorder, powerlessness, stigma, and pain, resulting in an ominous seepage of matter of personal, moral, and social significance.

When asked to explain the drawing, the interviewee said she drew her body as “emaciated” because of all “the stuff that was going on” in her head:

It sort of represents the connection between the self-harm and the anorexia stuff just by the mere fact that I was emaciated when I hung myself. And I think it was a representation of the cycle, that whilst I used my food to keep going and survive I knew that at the end of the road there wasn’t much else other than to end up dead, just because of the stuff that’s going on in my head. You end up wanting to die but you’re using it as a thing to keep going. It was that contradiction of starving yourself to death with something that’s keeping you going.

She sought to hurt her body to the point of death. Yet, Bakhtin (1981) contends that when one’s, “ideological discourse is internally persuasive for us and acknowledged by us” (p. 345), other possibilities emerge. “Anorexia” was a way for her to “keep going.” In this sense, she was “starving” herself as part of a “cycle” used to manage the painful emotions that came with being sexually abused. Her emotional state was destabilizing, unsettling, and constantly evading her attempts to govern it. This is an active response rather than a passive reaction to sexual trauma, albeit a very painful one.

The interviewee said Figure 2 was also about suicide being, “intrinsically related to eating disorders,” emotions, the body, and self-harm. Importantly, drawings can facilitate movement from internal to external expression, from silence to voice; they can access experiences that are simply beyond words (Hodge, 2014). This is because visual technologies, and the images they show us, offer views of the world in very particular ways. Thus, a distinction should be made between vision and visuality (Rose, 2008). Rose (2008) suggests, “vision is what the human eye is physiologically capable of seeing” (p. 2), where however, visuality refers to the various ways in which what is seen and how it is seen are socially constructed.

OPEN IN VIEWER

Figure 2.

Angels.

The drawing makes use of color in an image that represents an angel. Here, the angel is colored with a warm pink—a positive color—with blue signifying divine power that pulls her toward heaven, also signified by a rainbow. Angels go back to ancient biblical times, playing important roles in the lives of many humans, and continue to gain distinction through popular movies, books, and spiritual activities. Although these divine illuminating rays of the rainbow appear to guide her on her path, she is being pulled toward it and this indicates her inability to control the situation even if she is going “home.” She has also positioned her body as sitting, and thus resisting, indicating she has some agency in her situation even if home or heaven is represented through the rainbow, which traditionally is seen as a symbol of hope. The halo, in this image, alludes to a desire for purity (Van Leeuwen, 2008). As such, the images within the drawing work together to create a story that impending death is strongly apparent and perhaps the angel is in fact the angel of death as a result of the pointy, darkened, and gothic-like wings. Moreover, the lack of facial features, including no eyes, mouth, or nose, metaphorically illustrates a sense of being silenced and feelings of powerlessness.

When Hodge asked the interviewee to explain Figure 2, she said that harming her body and starving it are “visual” things to get people “to notice” that something is “not right.” She said she was just not “able to get the abuse out” of her “head” and “suicide” was the next step in trying to get someone to take her “seriously.” Therefore, “calling me home” was also a metaphor for death rather than happiness. She explained,

I was obsessed with dying . . . I think a lot of that suicidality came from just not being able to get the abuse out of my head. I think that they are very intrinsically related, the eating disorders and the emotions and the self-harm . . . it’s almost like cutting for me does provide a visual thing that I’m hurting. And even though it’s something that I try desperately to hide from people, it is still something that says that I’m hurting. The eating disorder, it’s the same thing but it’s a bit more open. Once you’ve starved yourself and you’re skinny, people begin to notice . . . that next step of just wanting someone to actually notice and maybe to take me seriously is if I’m dead.

Here, her internally persuasive discourse “awakens new and independent words from within . . . it enters . . . into an intense interaction, a struggle with other internally persuasive discourses” (Bakhtin, 1981, pp. 345–346). Thus, from a Bakhtinian view, the eating disorder, sexual trauma, and self-harm were “intrinsically related,” thereby inscribing and visualizing what was going on alongside her attempts to hide and reveal her struggle. An obsession “with dying,” the “cutting,” and the “eating disorder” were visual ways of giving voice to her unspeakable emotional pain and as such, provided her with an important sense of control and agency (Evans, 2018). Our contention is that visualizing of pain was a form of language she used to deal with the revulsion and horror of the abuse.

Another interviewee who was molested by a babysitter at a very young age, raped by her father from a similarly young age, and raped by a boyfriend as a teenager said she feels shame, that it was her fault, she was disgusting, and that no one is ever going to want her. She said she was diagnosed with anorexia and her eating disorder was her weapon, as it made her feel like she had some power. She could inflict the “pain” that she “deserved” through starvation and “self-harming”:

I started self-harming probably when I was a teenager. I think it was just a way of releasing stuff . . . I certainly believed that I deserved to feel pain on a regular basis and if I wasn’t hurting enough from how I was being treated, then I’d do the job myself. And that was just with cutting . . .

For this interviewee, the body represented the place where the abuse happened and, therefore, it was in need of “regular” punishment. In her saying she “deserved” to feel pain, she was associating harming herself with a very negative construction of the self. Self-harm was a way of achieving order and control in response to feeling so out of control because of the sexual trauma. Her sense of self became a stigmatized other, forcing a body–self separation, which was played out through the self-harming practices of cutting and starvation.

In her poem, Shipwreck Resurrected, she has used phrases such as “lifeless form,” “dashed and broken,” “pummeled about,” and “shattered hands” to metaphorically express her sense of her embodied self. Faulkner (2021) contends poetry is “a way to understand and articulate bodily experiences” (p. 325). As poetry can provide the opportunity to richly and accurately depict stories (Lahman et al., 2010), the interviewee’s poem powerfully engages us as it enables her to show how she understood herself as a failure in all areas of her life as a result of sexual trauma. Through the words “scared” and “broken,” her body is negatively construed as hateful, evil, and uncontrollable and “ruined” because it had been abused. An eating disorder was understood as a form of self-harm and a suicide attempt. It was an extreme act of deliberate self-destruction, because there was “no way back.” Significantly, traumatic memories are not coded like ordinary memories into a clear linear narrative (Pifalo, 2011). In this sense, her poetry has the capacity to capture, “feelings, contradictions, dualities, and paradoxes” that the narrative may not (Cahnmann, 2003, p. 33). Her body represented the place where the abuse happened and, therefore, it was in need of punishment. As such, hatred of the body becomes hatred of oneself. The interviewee’s sense of self, we think, became a stigmatized other, forcing a body–self separation, which was played out through starving and self-harm.

Shipwreck Resurrected

I am a ship

My life is a sojourn of the sea.

All these years I fought

Against those tumultuous waves.

Beacons light my way

As they humbly serve

The Lord of all things light.

A thousand times I faltered,

Overcome by water crashing over me

When the wind was sharp as glass.

Ignoring those beacons,

I reached the rocks,

My lifeless form dashed and broken,

A wreck at the bottom of the ocean.

My shattered hands tore at the light,

The light that penetrates even the darkest,

Deepest waters of mutilated souls.

The light stretched forth,

And I was borne upwards.

Again I am above the sea,

But this time I will follow those beacons

And avoid the rocks.

I am shipwrecked. Resurrected.

Hodge asked the interviewee for her reading of Shipwreck Resurrected in her third interview. She said the poem was about when she first started experiencing flashbacks of child sexual abuse. She went on to say that she considered herself “a write-off now” and had days where she was either going to survive or not:

Poetry is explorative and transformative, as it encourages exploration of inner and outer worlds (Lahman et al., 2010). Her poem was able to evoke feelings of being “broken” and her “whole life” being “ruined” due to “that moment or series of moments.” Like the ship, she sees herself as a broken body, no longer able to regain a sense of wholeness of herself. Specifically, the metaphor “Overcome by water crashing,” together with “There’s no way back up,” indicates an account of the self that is deficient and beyond resurrection. Ollie’s selfhood is in ruins with her body representing a traumascape.

An interviewee, who said she had experienced anorexia, was sexually abused by a male friend of her mother. She said she felt terrified and trapped and really “dirty” and self-harmed by peeling her fingernails off, which was also a form of “cleaning”:

I just wanted to be clean . . . as a teenager I used to peel my fingernails off . . . I used to peel the layers off . . . I used to peel them, actually peel them, oh gross . . . so that would have been self-harming . . . I’d just be picking, picking, cleaning, picking and cleaning.

All the participants experienced shame and the desire to “clean” their “gross” bodies, as they somehow felt responsible for the abuse. This “shame” was further compounded by the stigma associated with living with an eating disorder (Firkins et al., 2019; McCallum & Alaggia, 2021). This participant, in particular, wanted to remove the shame, layer by layer. Shame allows for another way of thinking even though its effects may be destructive, because, as Probyn (2005) argues, “shame speaks of the intricacy with which our bodies operate in the world” (pp. 72–73). In this way, self-harm was “transformative, bringing into sharp relief the precarity of an individual’s sense of self, their relation to others” (MacDonald et al., 2020, p. 479). Her body became a battleground where she acted out this struggle with the self, a self who is unique and a self who is a social subject, molded and constrained by beliefs and practices, which have been embedded by society (McAllister, 2003). This, however, is not without tension because, as the women’s accounts show, a tug-of-war took place between the public and private self, with the body as a site on which this tugging is inscribed.

Significantly, a vast amount of research supports the notion that many survivors of child sexual abuse never disclose the abuse (McElvaney, 2015). This is because survivors often blame themselves for the assault and fear negative reactions from others (Ullman et al., 2007). Delaying disclosure can indicate feelings of responsibility in terms of the impact of disclosing on those around them (Alaggia et al., 2019). However, the longer disclosures are delayed, the longer individuals potentially live with serious negative effects and mental health problems without receiving necessary treatment (McElvaney, 2015). Moreover, holding back their pain for the sake of others undoubtedly has a profound impact on their sense of self (Alaggia et al., 2019). As such, through the act of harming the body, participants were creating a voice in the sense that, no matter whether the self-harm occurred through cutting, purging, starving, or otherwise, the wound was a mouth that could speak when the actual mouth had been forbidden to (McLane, 1996). Thus, when the participants harmed their bodies and attempted to rid themselves of emotions, inside and outside, pain and voice became one in the act of creating a voice. Yet, when experiences are narrated through self-harm, they are dismissed and pathologized. In this way, dominant discourses suppress their lived experience.

Cleanliness and Control

For all participants, the closeness of bodily disgust that came from being sexually abused, and the sense that it never leaves the body, was a common experience. Central to the participants’ understandings of their sexual trauma was the need for purification, where the body was cleansed of unwanted emotions and memories. We demonstrate, in this discursive theme, the multiple ways the women attempted to clean their bodies through purification rituals of bathing and eating disorder practices. This argument parallels the theoretical work of Warin (2010), who has argued for an alternative understanding of purging based on the relationship between disgust, dirt, and cleanliness. Warin (2010) suggests that purging is a purifying practice to maintain a clean and proper body. In Bakhtin’s (1981) terms, “no living word relates to its object in a singular way” (p. 276, original emphasis), and as such, purification for the women was not a straightforward process. In this sense, scrubbing the skin, starving, or purging were also attempts to articulate a strong sense of grief over what they understood as a loss of innocence after child sexual abuse had occurred. Yet, no matter how hard they tried, their innocence could never be recuperated, or reinstated.

Although the women negatively construed purging as self-destructive, it was simultaneously construed positively as a process for purifying an unclean, unruly body. Borrowing from Mary Douglas (2003), “our idea of dirt is compounded of two things, care for hygiene and respect for conventions” (p. 8). As such, dirt is never a unique isolated event; where there is dirt, there is a system (Douglas, 2003). The participants’ accounts presented here powerfully articulate their need to clean as an expression of dealing with child sexual abuse.

An interviewee who was sexually abused by the son of her mother’s best friend said this left her feeling there was something intrinsically wrong with her. When explaining her experience of “anorexia and bulimia,” she said the eating disorder was a method of keeping everything in “order” and under “control.” She could turn over a “new leaf” through flushing out the “accumulated filth”:

Here, the self is constructed as impure and dirtied. The interviewee felt she needed to “start over” and saw herself as contaminated after sexual abuse had occurred. For her, being healthy was the same as “purification.” This was because having a healthy body and being healthy is portrayed in the media as needing to be thin (Lupton, 2013). Thus, she continually needed to “start over,” as a way of gaining back her sense of self.

She went on to say she was “in love with the idea of being a nun” because it symbolized purity:

Her retreat into the sanctuary of “a convent” not only represented a haven but also offered a new powerful feminine identity. Malecki et al. (2018a) suggests ascetic practices are “discursively constructed as a movement toward a divine union with Christ, rather than as the ‘mindless pursuit’ of a ‘thin ideal’” (p. 943).

Another interviewee who was sexually abused by her grandfather for a period of 18 months described her eating problem, which began during the abuse, as needing to “overeat and then try and compensate for it.” She said she felt “dirty” and associated this with feelings of “guilt” about the abuse:

The whole feeling dirty thing, I think just having that feeling of guilt it felt like a physical thing that I had in me . . . it’s kind of a strange description but it was usually when he’d been drinking that it happened . . . so he’d usually smell like beer. I mean he was never drunk but he had had alcohol and he always smelt like soap as well. Whenever I smell either of those two things, beer or soap, it makes me feel kind of dirty and I just want to go have a shower and wash myself off and get rid of the smell, clean it all away.

She needed to “shower and wash” to remove what reminded her of her grandfather’s “smell,” which triggered painful abuse-related memories and emotions such as shame, guilt, or disgust. She also strove for “purity”:

I used to have a purity ring that I wanted to save for when I was married. And then after my grandpa started doing these things . . . I thought, “oh gosh I can’t wear this” . . . I suddenly felt guilty for wearing it, like I was lying if I told anyone I was innocent of anything. And so I got rid of it after that.

No longer being “innocent” left her feeling her body was no longer pure. During the dialogical interviews, she said that she began to think the abuse and the eating disorder were linked. She said binging and purging was “a coping mechanism” as the binging was a way to “stop the feelings” that were associated with the abuse, and purging was a way to make her “feel a bit cleaner”:

I said last time something about the fact that when I am feeling dirty it gets worse if I’m binging and then I’ll feel guilty. So I’ll go and throw up and then it kind of makes me feel a bit cleaner again. Then I’ll sometimes go clean myself up, clean my teeth and wash my face as well . . . looking at it now it’s easier for me to link the two, to recognize that the two are linked. Back then, I wasn’t so much aware of it. I just would eat because I was feeling bad . . . I always felt better when I was eating but then afterwards I’d feel worse and then it was kind of a vicious cycle. Food made me feel better, so I guess I’d turn to that to kind of distract me . . . I suppose it was like a coping mechanism, as much as it made me feel bad about myself it kind of made me feel better about the situation. I was at least a little in control of something.

She felt “dirty” and then binged to cope but then felt “guilty” and needed to “clean” and “wash.” In this way, her eating disorder had less to do with weight and everything to do with social relations involving power and control (Norman & Moola, 2019). Her loss of “control” over her eating mirrored her experience of being disempowered by her grandfather. Her state of powerlessness made her feel “dirtier.” In this sense, she used her body “to negotiate the complexity of social relatedness . . . [and] wider issues of belonging, connection and disconnection” (Warin, 2010, p. 190). Feelings of dirtiness were a point of connection and disconnection between her and the context of her abuse. “Cleaning” was used as a way of alleviating emotions of guilt, shame, and disgust that she felt after being abused.

One of the participants said she “bathed in Dettol,” a strong smelling disinfectant antiseptic liquid, typically used to kill germs on household surfaces:

Scrubbing, lots of scrubbing . . . really scrubbing even to the point where I bathed in Dettol . . . I can remember going out to my friend’s house and her mum said “what is that smell” and I said “I was just getting rid of germs.” I’d put four capfuls of Dettol in the bath; it was pretty foul . . . It was bad between in my early teenage years but it was also pretty bad as a young adult because you get over it but then it keeps popping back into your head . . . I had to be totally scrubbed, yeah, very clean. It’s what people used to say about me, “you’re very clean.”

She aspired to be “clean” through “scrubbing” when her emotions came “popping back.” These emotions threatened to embarrass or humiliate her by their entry into the social world as they threatened to break down her sense of autonomy and challenge her self-control and interdependence (Lupton, 1998). When Hodge asked her to talk more about the cleanliness and purification theme through the dialogical process, she came to the realization that she understood herself to be “tainted”:

Tainted, I was tainted. I wasn’t pure, I was tainted . . . the experience had tainted me. I wasn’t clean. It wasn’t right. If I’d met a 12-year-old boy from school and he had been kissing me at the back of the shed, but it wasn’t like that. It was a dirty middle-aged disgusting man who’d done what he’d done.

After being sexually abused, she no longer felt “clean.” When Hodge asked another interviewee whether she needed to clean herself, her account portrayed extreme grief and loss. She also did not see herself as “pure,” yet for her, cleaning seemed “irrelevant.” She explained,

I don’t see a point in it. I mean I don’t see myself as pure. I do see myself as broken, damaged goods, but cleaning myself . . . it seems irrelevant to me because it’s not on my skin, it’s in my insides and it’s in my head and it’s in my soul. I’ve been broken on just about every level . . . it would be pointless. The only real way of cleaning the whole thing would be to put a gun in my mouth pretty much. I mean when I first started having flashbacks I used to scrub, but there’s no point, it doesn’t make you feel any cleaner.

She never felt any “cleaner.” Her “embodiment of disgust . . . signalled something that was both out of place and too close” (Warin, 2010, p. 150). She had “been broken” on “every level” by her abuse experience. She also spoke about purification and needing to start “over again” through being “thin”:

I need to start all over again and the first step of starting again is to be thin. Good things happen to thin people, they don’t happen to fat people. Nobody likes fat people . . . Thin people get everything. That’s what you want. So that’s first on the list and once I’m thin, which of course I’m never going to be, then I’ll get good marks . . . it’s double sided too. You can only have control when you’re thin. Thin comes before everything else. Once you’re thin good things will come to you. And it’s also about punishment because it hurts. All you can think about all day is food, until the point where you’re so hungry when you look at it you feel physically ill . . . you’re not good enough at this, you’re not good enough at that, and if you were then you wouldn’t have to starve but you do because you’re not good enough, so get starving.

Her explanation suggests she was “not good enough” after the abuse. This highlights how the combination of “profound betrayal, sexual dehumanization, and self-blame” affected her deeply in personal ways, causing destruction to her sense of self-worth (Tarzia, 2021, p. 293). Although it has been suggested that “fat people” are universally considered out of shape, dirty, serving as visual shortcuts for gluttony, and deemed unworthy of public accommodation (Owen, 2015), when she said, “good things happen to thin people,” her preoccupation with “fat” and “thin” functioned as a powerful “normalizing” strategy. Getting thin was not about getting “thin,” per se, but rather, staying in control of her body, emotions, memories, and thoughts about the abuse. Put differently, not eating was an assertion of individual control where food and body weight featured as the only arenas in which control was possible. In this sense, the controlled body quite explicitly signifies total control and “the positive subjectivity signified by the thin body here is accompanied by a subtextual subjectivity of ‘failure’ in all other aspects of life” (Malson, 1998, p. 123). As such, a “thin” body was an attempt to gain social acceptance and eventually to improve her relations with others. Thus, the distress she experienced with her body was associated more with living in a culture that subjugates and violates women’s bodies than it was with the idealization of thinness (Piran, 2016). “Starving” signified having a sense of voice about something she could not talk about openly or freely.

The participants’ accounts illustrate not only the extreme anguish and distress associated with child sexual abuse and eating disorders but also the damage done by the many discourses that converge to constitute and regulate women’s experiences of themselves, of gender and subjectivity. The discursive construction of “fat people” as bad is a cultural discursive construction rather than an individual aberration. It can be found in culturally sanctioned authoritative discourses, including constructions of obesity in medical discourse (Lupton, 2013). The act of purging was simultaneously construed negatively and positively as a cleansing and purifying process, bringing comfort and relief for some, yet also as disgusting, shameful, and shrouded in secrecy.