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August 5, 2003. Nathan Szajnberg's review of my book, The Development of Anorexia Nervosa: The Hunger Artists (JAPA 51/2), includes many misunderstandings of the text. I shall cite a few of them.
Several times he refers to my research as having been prospective, which it never was. When I began the work I had no thought of trying to determine the outcome of early experience. I offered no hypothesis about what my future observations might disclose. In view of a previous project concerned with observations of young infants in the presence of their mothers, in which I had participated in Topeka, Kansas, from 1948 to 1950, I wished mainly to enlarge our understanding of psychological events in the oral phase. Mark Twain once said that everybody talks about the weather, but nobody does anything about it; similarly, I had come to realize that “everybody” wrote or spoke about the oral phase but few had studied its complexities—the day-to-day, hour-to-hour, or moment-to-moment events it encompasses, and their possible effects on the infant's and child' s ongoing behavior and development.
In 1963 I started to collect direct observations and running films of the behavior of a sample of mothers (N = 131) engaged in the care of their infants, and so began to learn from those mothers what they were able and willing to tell about their experience with the observed infant. I realized that how a mother fed—in what physical positions, with what affects, with what knowledge—was often more important than what she fed.
Szajnberg accepts a common assumption that anorexia appears in adolescence, so skipping the salient fact—reported in my book— that the eating disorders of the two subjects began to emerge in infancy. One of the two mothers noticed signs of the disorder during her daughter's childhood, but it was never diagnosed as such. More important, Szajnberg omits the main thrust of my account, which reports the slow, silent, and oppressive development of anorexia over the years.
He tell