It was only around 1870 that anorexia nervosa came to be recognized as a specific disorder and was given the name by which it is known today. Yet according to the psychiatrist William N. Davis, who has supplied an epilogue to Holy Anorexia, it has now reached such proportions that throughout the United States and Western Europe there are countless organizations devoted to assisting anorectics and their families. The psychiatric profession struggles with the disorder—by psychoanalysis, by behavior therapy, by group psychotherapy, by family therapy, by various medications, even by forced feeding regimens. The struggle is often in vain: although many anorectics do partially recover, and some recover completely, many others either lapse into a chronic and desperate condition or else simply die. Reported mortality rates range from 10 to 20 percent—which is higher than for any other psychiatric disorder.

The one essential feature of the disorder is of course a persistent, long-term refusal to eat enough to sustain life: the anorectic practices gradual self-starvation. Other common symptoms are vomiting, episodes of binge eating, periods of hyperactivity, and a low pulse rate at rest. Sufferers are much more often female than male (by a ratio of ten or even twenty to one), and more often well-to-do than poor. The most frequent time of onset is adolescence.

In the past Rudolph M. Bell, of Rutgers University, has explored diverse fields of history; his books range from Party and Faction in American Politics to Saints and Society. In the latter work he and Donald Weinstein, of the University of Arizona, examined the lives of hundreds of saints, and used what they found there to illuminate changing patterns of piety and notions of saintliness in Western Christendom between 1000 and 1700. Holy Anorexia continues that enterprise in a more specialized subject. It is concerned with a number of Italian women who are officially recognized by the Roman Catholic Church as saints, blesseds, venerables, or servants of God, and who in their lifetimes demonstrated their holiness by starving themselves to death, or almost. It also tries to explain how these women came to follow so drastic a course.

According to the statistical tables included in the book the women studied by Bell number no fewer than 261, while the time span covered runs from the twelfth to the twentieth century. The text is, fortunately, far less intimidating than this suggests: it outlines the life stories of only a dozen women, and does not carry the story beyond the seventeenth century. That is quite enough to convey the essence of the phenomenon of “holy anorexia.” Quite enough, too, to upset the appetites of all but the toughest readers.

A glance at two of the life stories will give a fair notion of the historical material that Bell has assembled. One of those lives was lived in the late fourteenth century, the other in the late seventeenth; one was lived in a private house, the other in a convent; one ended in premature death from starvation, the other continued into a constructive maturity. Both women have been canonized.

From the age of fifteen Catherine Benincasa, better known as Saint Catherine of Siena, consumed nothing but bread, uncooked vegetables, and water; from the age of twenty-five she simply chewed on bitter herbs, spitting out the substance. On occasion, however, she varied her diet. While dressing the cancerous breast sores of a woman she was tending, Catherine felt repulsed by the horrid odor of the suppuration. Determined to overcome all bodily sensations, she carefully gathered the pus into a ladle and drank it all. That night she envisioned Jesus inviting her to drink the blood flowing from his pierced side, and it was because of this sustenance that her stomach—in the words of her confessor—“no longer had need of food and no longer could digest.”

In offering her his bleeding side to suck, Jesus seemed to Catherine to be behaving like a mother when she offers her breast to her favorite baby. Nevertheless Catherine had to pay for her consolation: from that day onward God made her suffer a sharp and continuous pain in her breast. And she herself added to her torment. She wore an iron chain bound so tightly against her hips that it inflamed her skin, and flagellated herself with an iron chain three times a day. Each beating lasted an hour and a half, and the blood ran from her shoulders to her feet. In the end she refused even to drink water and so, in her early thirties, put an end to her life.

The setting of Catherine’s behavior, including her anorexia, was familial. As a tertiary of the Dominican order she lived at home: all her self-torture was carried out in her parents’ house. This was altogether appropriate, for Catherine was intensely involved with her relatives. She believed that by her sacrifices in this world she would save the souls of her mother and father and sisters in the next. Indeed she believed that she and God had made a deal to that effect. When her mother fell gravely ill she reminded God of his part in the bargain, and in the sharpest terms:


Father, this is not what you promised me: that all my family would be saved. Now my mother is dead without confession, therefore I pray you to return her to me. This I want, and I will not move from here until you have restored her to me.

Catherine’s choice to live at home was an unusual one; youthful virgins who wished to live as ascetic penitents normally did so in a convent. Saint Veronica, born in 1660 as Orsola Giuliani, entered a Capuchin convent at the age of seventeen. As novice and nun she fasted for five years, during which she would eat nothing at all for three days at a time; on Fridays she would only chew on five orange seeds, in memory of the five wounds of Jesus. She finally overcame her anorectic behavior by turning eating itself into an opportunity to triumph over bodily desires: cat vomit, clumps of hair, a leech filled with blood, spiders and their webs—all these she ate with gusto. (Here she could rely on the collaboration of her confessor, who obligingly ordered her to clean various rooms in the convent with her tongue.) In addition she beat herself with chains and sharply studded instruments; carried a heavy wooden yoke on her shoulders; and kept her tongue pressed down under a large stone.

Her reward came when, in her midthirties, she received the stigmata—incessantly bleeding wounds, corresponding to the wounds of Jesus, on hands, feet, and breast. These she bore for the remaining twenty-nine years of her life; at her autopsy they proved to be absolutely genuine. Reception of the stigmata was always perceived as a supreme sign of God’s favor, and it marked a turning point in Veronica’s life: she abandoned her ascetic practices, became a wise and moderate member of the congregation, and ended her days as a respected, efficient, and kindly abbess.

Fascinating stories, and most skillfully presented—but how should they be interpreted? The interpretation offered by Bell turns out on examination to be two interpretations. One of these seems to me wholly convincing, the other not convincing at all.

As portrayed in this book, a holy anorectic feels her whole body to be hopelessly corrupt and an impediment to the salvation of her soul. She sets about destroying her bodily wants and weaknesses—not only hunger but also sexual desire and the desire for rest. But what began as a conscious effort to tame the body engenders hormonal changes, so that the struggle passes out of the anorectic’s conscious control. What happens thereafter depends on what happens in the depths of the psyche.

William N. Davis, in his epilogue, pursues this line of interpretation and points to some instructive parallels between the “holy anorexia” of the Middle Ages and the anorexia nervosa of today. In the former the woman aims at holiness, in the latter, at thinness. But both holiness and thinness represent ideal states of being, as conceived in two very different historical periods. Just as medieval women were presented with a specific, markedly ascetic model of holiness to which they could aspire, so today’s adolescent girls are deluged with cultural messages stressing the high importance of slimness. And just as the medieval anorectic sought a direct relationship with God, so the modern anorectic is involved in an intense relationship with her diet. Finally, an obsessive preoccupation with purity is equally characteristic of medieval and of modern anorectics.

All this is most persuasive. But the book’s main argument leads in a different direction, and it seems to me to go quite astray. In Bell’s view, anorexia in its medieval form represented a female protest against a patriarchal society: the anorectic was struggling to assert her will and to establish her identity in a world dominated by men. Of medieval anorectics he writes that they “did in fact break out of the established boundaries within which a male hierarchy confined female piety, and thereby established newer and wider avenues for religious expression by women generally.” This fits nicely with present-day feminist hypotheses concerning the nature of anorexia nervosa, which Davis summarizes as follows: “Anorexia nervosa is the quintessential symbol of female oppression in a male-dominated culture.” It occurs because women are caught in a trap that is “promoted unconsciously but profoundly by a patriarchal culture that requires female submissiveness and servitude, and is deeply threatened by the prospect of secure, self-confident, and genuinely self-assertive women.”


If this interpretation were correct one would find little or no anorexia nervosa in the upper strata of society in the United States and Western Europe, where women generally enjoy a high degree of independence and self-determination; rather more in the lower social strata in those societies; and very much more in, for instance, the Soviet Union, where women are still grossly exploited both by their menfolk and by the social system. In fact, one finds the opposite. Indeed, I am informed by a woman psychiatrist who worked for many years in the Soviet Union that she never met with a single case of anorexia nervosa until she emigrated to the West.

To return to the Middle Ages: Was female piety really so confined by a male hierarchy, until the first anorectics set it free? There is evidence to the contrary. The first anorectics known to Bell died early in the thirteenth century—but there were holy women who enjoyed prestige and exercised influence well before that. The mystic, visionary, and abbess, Hildegard of Bingen, for instance, corresponded on terms of equality with two popes and two emperors, as well as with the leading theologians of her time. She died in 1179.

And when anorectics did make their appearance, how different were they from male aspirants to sanctity? It would seem, very little. “Holy anorexia” cannot be divorced from the other ascetic practices that invariably accompanied it. The women who starved themselves into an anorectic condition also deprived themselves of sleep, wore hair shirts, carried spiked chains wrapped around their bodies, and beat themselves bloody. But male aspirants to sanctity did these things also, and in just as extreme a fashion. What is more, they existed on amazingly little food. Their aim, too, was the same as the women’s: by taming the flesh, to come closer to God. And a man’s reward, when one was granted, was also the same: mystical ecstasy, sometimes the stigmata.

In almost every respect, medieval men and women in pursuit of holiness followed identical courses. The one difference seems to be that some women actually died of undernourishment, whereas men apparently did not. But is it at all plausible that these deaths, such tiny events in the vast panorama of medieval self-torture, represented a female protest against patriarchy? It is not difficult to think of other possible explanations—ranging from the physiological differences between the sexes to the role of fashion in shaping the behavior of both women and men.

The title and subtitle of Immodest Acts: The Life of a Lesbian Nun in Renaissance Italy give a very inadequate indication of the book. Judith C. Brown, of Stanford University, has discovered, in the State Archives of Florence, the record of ecclesiastical investigations that took place between 1619 and 1623 into the visions and miraculous claims of Benedetta Carlini, abbess of the Convent of the Mother of God at Pescia. The biographical study she has constructed out of these and related materials is a serious work of scholarship—and the questions it leaves in one’s mind are not primarily about lesbianism.

Benedetta Carlini was born in 1590 and at the age of nine joined a community of religious women known as Theatines. When, some twenty years later, the community received papal permission to become a fully enclosed convent, the nuns elected Benedetta as their first abbess. She was young for the job—but then for some years she had been singled out by a series of visionary experiences. When she was twenty-three she saw herself surrounded by a pack of wild animals set on harming her. At the last possible moment she was saved by a splendidly dressed Jesus, who dispersed the animals and explained that they were demons. He also told her that she would have to fight them again and again, but that he would always come to her aid. Other similar visions followed, to the delight of Benedetta’s superiors: what better way for these nuns to earn the status of an enclosed congregation than to point to this holy woman in their midst?

Benedetta lived up to her promise. When the day came for the solemn procession to the newly built convent she walked in an ecstatic trance, seeing angels paying her homage and scattering flowers in her path. At the convent gates the Virgin Mary herself greeted her and presented her with a guardian angel. A couple of months later Jesus reappeared, this time nailed to a crucifix but alive. He asked whether Benedetta was willing to face lifelong suffering for love of him. When she assented a flash burst from the five wounds on the crucifix and imprinted them on her hands, feet, and side.

This seeming miracle secured Benedetta’s election as abbess. Again she rose to the occasion: during the Lenten season she delivered sermons while the other nuns purified themselves with their whips. And these were no ordinary sermons. As a woman, Benedetta would never have been permitted to preach at all—but she persuaded her confessor that an angel was speaking through her mouth. The angel concluded each sermon by praising Benedetta, chosen above all others to receive marks of divine favor.

Further marks of that favor were immediately forthcoming. Benedetta was again visited at night by Jesus, and this time he tore her heart from her body. For three days she lived without a heart, until Jesus reappeared, carrying a heart that was larger than the one he had taken. “Oh, my bridegroom,” exclaimed Benedetta, “did you come to give me back my heart?” But it was Jesus’ own heart that he inserted into her body. Henceforth Jesus and Benedetta were united body and soul. “I have given you my love,” said Jesus, “now return my love.” As for Benedetta, she felt, in her own words, “in love with Jesus.”

A few weeks later the relationship became closer still: Jesus announced that he wished to be married to Benedetta in a solemn ceremony. The ceremony was duly performed before the congregation of nuns, all kneeling, and with their abbess in a trance. To Benedetta Jesus was gloriously visible and so was his retinue of angels and saints, headed by the Virgin, and so was the ring he placed on her finger; but none of this was visible to anybody else. The nuns did however hear Jesus speaking through Benedetta, in a voice more beautiful than her usual voice. What he told them was the entire story of Benedetta’s life—so that, as he put it, they might see that his bride was also the greatest servant he had on earth. Jesus concluded: “I want the grand duke [of Tuscany] to know all these things about my bride…. And he who does not believe in my bride, shall not be saved.”

The ceremony over, Benedetta came out of her trance and behaved almost as though nothing unusual had happened. Others were less nonchalant. The provost of Pescia, who was the leading ecclesiastical official in the town, relieved Benedetta of her duties as abbess until further notice, and began an investigation.

This first investigation ended well for Benedetta. The investigators found her visions to be genuine and even accepted that Jesus had spoken through her mouth; and she was reinstated as abbess. But some three years later, for reasons that remain obscure, a second investigation was opened, this time on the initiative of the papal nuncio in Florence. Its findings were damning. The investigators decided that all Benedetta’s visionary experiences, and the stigmata too, came not from God but from the Devil. But the most damaging evidence came from a nun, Bartolomea Crivelli, who had been appointed, years before, to share Benedetta’s cell and to assist her in her battles with the Devil. She revealed that for two years, at least three times a week, she and Benedetta had engaged in mutual masturbation. Moreover, said Bartolomea, “Benedetta would tell her that neither she nor Benedetta were sinning because it was the angel Splenditello and not she who did these things. And she spoke always with the voice with which Splenditello spoke through Benedetta.” This Splenditello was a guardian angel whom Jesus had long since assigned to Benedetta. Originally he had appeared to her as a beautiful boy with long curly hair, and dressed in a white robe with gold embroidered sleeves. Now he had become part of Benedetta herself—so much so that when he was present in her the woman looked, not only to Bartolomea but to the nuns in general, like a beautiful boy.

The second investigation left Benedetta herself convinced that she had been deceived by the Devil throughout. Her visions ceased, Splenditello vanished, she herself became an obedient nun under the care of a new abbess. The investigators inclined toward leniency, stressing in their final report that the acts in which she had participated were done “without her consent and will.” But the papal nuncio took a sterner view. Influenced no doubt by her notoriety, he sentenced her to perpetual imprisonment within the convent—which meant solitary confinement, with a diet of bread and water several times a week. This punishment lasted until Benedetta’s death thirty-five years later.

What is one to make of this extraordinary story? During the first investigation Benedetta claimed to have no recollection of the praises Jesus had bestowed on her through her own mouth. During the second investigation she disclaimed all knowledge of the acts she had performed as Splenditello. Of course, if she was to avoid or lessen the punishment that hung over her she had to give those answers. But then again, those answers may have been truthful. So: Was the woman simply a fraud, or was this a case of what at the time would have been called possession, and what present-day psychiatrists would call multiple personality? Professor Brown favors the latter view. Her argument is impressive—even though, inexplicably and unfortunately, an essential part of it is tucked away in the notes at the end of the book. She is probably right.

This Issue

January 30, 1986