WOMEN &HEALTH

I

DES QUARTERLY

A new publication, the National DES Quarterly, is now available to help the millions of persons who have been exposed to the synthetic the synthetic estrogen diethylstilbestrol (DES) keep in touch with progress in that field. DES is known to cause reproductive tract changes in many daughters and cancer in a few women whose mothers took DES while pregnant with them.

The editor, Phyllis S. Wetherill, M.A., a family therapist, was a member of the Health, Education and Welfare Department's DES Task Force. She states that "Our purpose was to pull together in/one place DES related information from many sources so that exposed persons, and particularly those who live away from large metropolitan areas and major medical centers, would have a way to keep in touch with the growing body of knowledge about this medical issue of personal importance to them."'

DES Registry, Inc. is a non-profit consumer financed organization which, in addition to publishing the Quarterly, will immediately notify registered DES-exposed persons should there be any new findings of critical importance to them. Exposed persons can subscribe to this service for $8.00 annually. The Quarterly is available to institutions for $10.00 a year. Interested persons may write to DES Registry, 5426 27th Street, N. W., Washington, D.C. 20015.

-Amazon Vol. 7, No. 4 Fall-Winter 1978-79

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WOMEN UNDER ATTACK: Abortion, Sterilization Abuse and Reproductive Freedom, a pamphlet published by the Committee for Abortion Rights and Against Sterilization Abuse. $2.50.

The issue of reproductive freedom--not only the right of women to have abortions if they want them, but also the right of all women to bear children free from forced sterilization-is under attack not only from the right wing, but also from the President of the United States, the Supreme Court, and HEW Secretary Joseph Califano.

CARASA, the Committee for Abortion Rights and Against Sterilization Abuse, has just published an invaluable pamphlet for socialists and feminists. The pamphlet gives all the information we need to attack the myths that abortion is murder, or that welfare women do nothing but get pregnant so the state can pay for their abortions.

The pamphlet proves how black, Hispanic and native American women are used by the U.S. government as guinea pigs for "population control" experiments. It places the struggle for reproductive freedom within a social context. It shows that as long as women are defined primarily as child rearers, control over pregnancy and childbirth are necessary conditions for women's participation in all spheres of economic, political and social life.

Finally, it makes the argument for a militant, radical movement, which fights for free abortion, no forced sterilization, and full reproductive freedom; a movement that relies on the potential strength of working class women, and not on the Congress or a U.S. President.

CARASA has given us a useful weapon for our struggle for women's liberation. Limited copies are available from Hera Press, or they can be ordered from CARASA, P. O.Box 124, Cathedral Station, N.Y., N.Y. 10025.

Sunhom

-Barbara Winslow

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4

Anorexia Nervosa Help

The anorexia nervosa/buliniu syndrome occurs in epidemic proportions among the female adolescent population. Both drives are sides of the same coin: self-starvation and food-bingeing occur in cycles. The "medical model" of practice has traditionally viewed this problem from a strictly psychological point of view, diagnosing the "disease" as a rejection of femininity, which stems from pre-Oedipul rivalry or from oral-sadistic Oedipal conflicts. Seen from a feminist perspective, the anorexia nervosa/bulinia syndrome is a symptom created by a combination of factors: 1) a socialization process which reinforces dependency, encourages pleasing male partners, and promises rewards (approval and love) for the development of a passive, accommodating personali ty; 2) a family structure in which the mother overprotects, and thus controls, her daughter and in which the father fails to provide emotional support; and 3) a family value system that emphasizes high achievements defined only in terms of extrinsic rewards to the self and that believes in food as a cure for most problems. Thus, the distortion of body image in this syndrome is a cultural distortion, confronting the adolescent with an impossible struggle to become the "perfect woman" and presenting emaciated bodies as a sign of health and happiness. The seeds of this syndrome are planted in the young girl when she finds that society does not reward her with male attention as she has been socialized to expect. Experiencing either actual or perceived rejection by males, she believes it is due to an excess of body fat. After attempting dieting and other beautification rituals without seeing a change in popularity, the first binge occurs shortly after. Without question, society as it is channeled through the media and advertising accentuates and distorts the girl's perception of her identity.

(Marlene Boskind-Lodahl, excerpted from Ithaca Women's Anthology, originally published in its entirety in Signs: Journal of Women in Culture and Society, Vol. II, No. 2 (Winter, 1976))

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"We are all entitled to a good measure of selfesteem, and we cannot function without it." The words belong to Vivian Hanson Meehan, R.N., founder and director of Anorexia Nervosa and Associated Disorders (ANAD),

Through ANAD, Vivian Meehan is putting her words into the kinds of action—counseling, information and referral, self-help groups, educational programs, and encouragement of research-that can bring hope and help to the thousands of anorexia nervosa victims and their families suffering the effects of this most "secretive," as she calls it, illness, "I started ANAD because I believed the disease process of anorexia nervosa was almost identical to that of alcoholism," Ms. Meehan explained. "If the Alcoholics Anonymous program could be so successful, a similar kind of program might also work for anorexics.”

Although there were groups working in the field when Ms. Meehan began placing small personal ads

seeking out anorexics in local newspapers in late 1975, the nature of the disease is such that many anorexics are more confused by the contradictory treatments offered than by the illness itself. "I thought anorexies needed a place to get help getting help," Ms. Mechan said. "Some do get some profes sional attention because they are starving, but there is no consensus on what should be done. One therapy or one therapist may not have all the answers.. Anorexics need to know that they may need more than one kind of therapy and that more than one kind is available”.

Because anorexia nervosa is most frequently associated with girls ranging from 13 to 19 years of age, many doctors misdiagnose the condition as "Tad" dieting inspired by our society's admiration of thin women, Ms. Mechan explained. Often a doctor will tell the anorexic patient to return in six months. for another checkup. By that time, Ms. Meehan said, the anorexic will have lost another 20 pounds.

Ms. Mechan noted that as well as the starvers, "There are the stuffers." The anorexic who is constantly reprimanded about weight loss will feel guilty and try to accommodate the concern of others by going on cating binges, Ms. Meehan explained. Those who do binge then become obsessed with the fear of gaining weight and will induce vomiting. These bilumic anorexics live on an emotional seesaw. "It becomes a very circular thing and through it all, they are filled with guilt and anxiety," Ms. Mechan said. Anorexics will also sometimes enter into a laxative and enema regimen to insure continued weight loss. One anorexic Ms. Mcchan knew would take as many as 30 laxatives a day.

There is a definite profile of an anorexia nervosa victim. Feelings of low self-esteem and lack of control or helplessness are almost always present. These characteristics may be overlooked because the anorexic is also almost always an overachiever with high intelligence and a strong drive for perfection. The classic anorexic is the "good" child who, before the onset of anorexia nervosa, "never gave the parents a moment's worry."

Treatment for anorexia nervosa varies widely. Behavior modification, family therapy, hypnosis, psychoanalysis, and hospitalization varying from a few weeks to several months have been used. In England, there are claims of success for trance therapy, Ms. Mechan says, while the Cornell Medical Center's approach is group work based on Gestalt therapy.

When an anorexic contacts Vivian Meehan at ANAD, the first step is a discussion of the problem and its manifestations. She sees anorexia nervosa as a family-oriented problem, and is very supportive of family therapy as an approach whenever possible.

An important step is stabilization of the patient's weight. "The average anorexic weighs between 45 and 64 pounds and ranges in height from 4 feet 11 inches to 5 feet 9 inches," Ms. Mechan said, “At that point, the patient cannot really think, I believe we have to get her weight up before we can really begin to talk about the problem."

Ms. Meehan has also inaugurated a pilot early detection program at ANAD. Through this program, literature about anorexia nervosa and its signs and symptoms were sent to school nurses in the Chicago area. Posters describing early signs and symptoms were also included. Ms. Meehan also hopes to involve teachers and parents in the program, "We have had some response, but we haven't evaluated it yet to decide if it is worthwhile," Ms. Meehan said. "I suppose, however, that if we can reach even one-anorexic, it is worth doing.”

Excerpted from American Journal of Nursing, February 1979