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I HAVE LONG appreciated Hilde Bruch, an intrepid visionary who beat the odds. German and Jewish, she distinguished herself among Europe's largely male, anti-Semitic medical community, and successfully fled Nazi Germany in order to continue her burgeoning career. She landed a position in New York as a pediatric researcher, where her work led her toward psychiatric innovation in the area of eating disorders. In this biography we learn of Bruch's incisive, if sometimes “demanding” or “peppery” (p. 254) tendency to challenge the status quo, preferring that which she herself observed and could usefully replicate. The conventional wisdom that childhood obesity was an endocrine rather than a psychological disorder did not escape Bruch's scrutiny, particularly when she found that her overweight patients progressed to normal puberty. The young pediatrician instead observed mothers of “fat children” giving up their seats to their youngsters during clinic visits, intolerant of their offspring's discomfort and any capacity for more individuated functioning.
When her largely Freudian, male psychiatric colleagues viewed food refusal in terms of accepted metapsychology—perhaps a defense against fantasies of oral impregnation—Bruch was piecing together a new, relational model for eating disorders. Her conclusions highlight not only patient's hidden, conflictual impulses, but youngsters fighting for their lives and personal agency with overpowering, if at times solicitous mothers, primal arbiters of the child's nourishment and vitality.
What better figure to admire, especially since her once fringe views have become all but mainstream? Unlocking the Golden Cage therefore