Saint Rose of Lima: an anorexic saint in Latin America?

Abstracts

A literatura especializada tem nos mostrado que é grande a semelhança entre o comportamento alimentar das santas jejuadoras medievais e o das anoréxicas atuais. No entanto, há poucas referências sobre a existência de santas jejuadoras na América Latina. No presente trabalho, os autores salientam aspectos da vida de Santa Rosa de Lima, Patrona da América e Filipinas, que poderiam ser descritos como comportamentos anoréxicos. Comparando os aspectos psicopatológicos da vida de Santa Rosa com o comportamento das anoréxicas atuais, pareceu confirmar-se um padrão uniforme de comportamento, especialmente quanto ao aspecto imitativo, fator que poderia levar as jovens da atualidade a desenvolverem um transtorno alimentar após terem algum tipo de informação sobre o transtorno.

Anorexia nervosa; anorexia santa; clorose; jejum

ORIGINAL ARTICLE

Saint Rose of Lima: an anorexic saint in Latin America?

Santa Rosa de Lima: ¿una santa anoréxica en Latinoamérica?

Cybelle Weinberg^I; Táki Athanássios Cordás^II; Patricia Albornoz Munoz^III

^IMSc., Universidade de São Paulo (USP) School of Medicine. Collaborator, Interdisciplinary project for care, teaching and research of eating disorders during childhood and adolescence; Center for bulimia and eating disorders (Projeto Interdisciplinar de Atendimento, Ensino e Pesquisa dos Transtornos Alimentares na Infância e Adolescência do Ambulatório de Bulimia e Transtornos Alimentares - (PROTAD-AMBULIM), Psychiatry Institute, Hospital de Clínicas of USP School of Medicine. Coordinator the Clinic for research and studies on anorexia and bulimia psychoanalysis (Clínica de Estudos e Pesquisas em Psicanálise da Anorexia e Bulimia -CEPPAN). São Paulo, Brazil

^IIGeneral coordinator of AMBULIM, Psychiatry Institute, Hospital de Clínicas of USP School of Medicine. Professor and member of the Department of Psychiatry, USP School of Medicine. São Paulo, Brazil

^IIIResident Psychiatrist. Universidad Peruana Cayetano Heredia. Instituto Nacional de Salud Mental Honorio Delgado- Hideyo Noguchi. Lima, Peru

^{Correspondence}

ABSTRACT

The specialized literature has shown us the great similarity between the eating habits of medieval fasting women saints and today's anorexic women. Nonetheless, there are few references to the existence of such fasting women saints in Latin America. The authors of this paper present some aspects of the life of Saint Rose of Lima, the patroness of the Americas and the Philippines, that could be described as anorexic. The comparison between psychopathological aspects of Saint Rose's life and the behavior of today's anorexic women seemed to confirm a uniform behavioral pattern, particularly concerning the imitative aspect, which would lead modern young girls to develop eating disorders after they obtain some information on such disorders.

Keywords: Anorexia nervosa, holly anorexia, chlorosis, starvation.

RESUMEN

La literatura especializada nos muestra gran similitud entre el comportamiento alimentar de las santas de la edad media que ayunaban y el de las anoréxicas de la actualidad. Hay pocas informaciones sobre santas que practicaban ayuno en Latinoamérica. En este artículo, los autores resaltan aspectos de la vida de santa Rosa de Lima, Patrona de América y Filipinas, que pueden ser considerados como comportamientos anoréxicos. Al comparar aspectos psicopatológicos de la vida de santa Rosa con el comportamiento de anoréxicas de la actualidad, parece que se confirma un modelo uniforme de comportamiento, especialmente respecto al aspecto de imitación, hecho que podría llevar a las jóvenes de hoy a desarrollar un trastorno de la alimentación luego de recibir informaciones sobre el tema.

Palabras clave: Anorexia nerviosa, anorexia santa, clorosis, ayuno.

PRESENTATION

Anorexia nervosa is an eating disorder that affects mostly teenage girls and young women. Severe refusal to eat, fear of weight gain, distorted body image and amenorrhea are some characteristics of this disease.

The significant increase in the number of patients with anorexia nervosa in the last decades has lead us to think about a real "epidemics" of the disorder and about the impact that sociocultural factors have on the activation and maintenance of the disease. The improved awareness on the symptoms and diagnostic of eating disorders may have also contributed to this increase.

Although contemporary discussions on the topic comprise biological and genetic factors, and psychological and familial aspects, ideas about the role of fashion and its influence on the determination of body image have been gaining space. Weinberg¹ claims that the importance of fashion role is arguable, as there are records of anorexia nervosa from other times and cultures. The starvation periods that saints and devout women from the Middle Ages were used to imposing themselves aimed at practicing self-discipline and reaching the communion with God; today's anorexic girls' pursuit is to conform to a beauty ideal. Moreover, the saints' refusal to eat was a way of maintaining virginity and refusing arranged marriages.

Specialized literature has reported that it is quite difficult to clearly define which aspects of the anorexia nervosa clinical status are culture-derived and which are associated with an invariably morbid feature of the disease. Despite anorexia being considered a contemporary pathology, there are evidences that today's anorexia is a continuum of some kind of behavior that has been remaining unchanged all over the evolution of the Western history. Behar² and Fendrik³ believe the characteristics of this eating disorder have always been the same - systematic refusal to eat dangerously risking health and life - even if socio-cultural contexts have changed, especially in Europe.

It is then possible to draw a parallel between today's anorexic women and the medieval fasting saints, similarly to the studies already developed with the chlorotic girls from the 19th century.⁴ The diagnosis of chlorosis, or green sickness, was characterized by pale skin, weakness, fatigue, irritability, constipation, menstrual disturbances and food refusal, specially of meat, as well as by evident thickening. Johannes Lange, in 1554, described chlorosis as "morbus virgineus", as its probable cause was a "love fever", which could be healed, according to the author, with marriage, sexual intercourse and maternity. After having affected girls from England, France and United States in the 18th century, chlorosis disappeared completely after 1920. Loundon,⁵ among other authors, considers chlorosis and anorexia nervosa as analogous conditions of the same psychopathology.

In an attempt to explain the epidemics of anorexic saints in the Middle Ages, Gamero⁶ says that with the arrival of Christianity there was a drastic replacement of obese and hedonistic gods by the thin Christ. The images of fat ancestral deities, as well as the habits of Roman feasts and self-induced vomits were abandoned. In the early Middle Ages, voracity became a synonym for impurity, gluttony was considered a capital sin, and food denial was elected the best penitence for reaching the maximum level of spirituality. The quest for sainthood and purity demanded privation; moreover, self-imposed starvation had some advantages, as described by Liles & Woods:⁷

"A woman could use the religious starvation to neglect her duties and/or exert some control over the others, bargain for sexual abstinence with her husband, reject an unwanted marriage or as a way of praying for her family members. Fasting saints could overpass the authority of Church men, who followed severe religious practices; they could criticize the religious secular power and authorities and also to undertake the role of professors, counselors or reformers of the Church rules, aiming at their own benefit."

Anorexic saints arouse within this context. Saint Liduina, for example, spent many years eating only a slice of apple a day, and Saint Wilgefortis (from Latin Virgo fortis, "strong virgin"), young daughter of the Portugal king, used to refuse food, fasted and vomited anything she was forced to intake. She got notoriously thinner and almost starved to death. The presence of hirsutism is also significant in her history, even though the legend tells her body was covered with hair and a beard has grown on her face as a result of her prayers for God to have her beauty hidden.

According to the literature, the period of life of Saint Catherine of Siena was the real era of saint anorexia. Fendrik points out that, in the 13th century, the saints' habit of "never eating" makes the records of confessors seem real clinic histories. Another very important work about medieval anorexic saints was developed by Rudolf Bell.⁸ He studied the life of 250 saints and other devout women from the Catholic church, from the 13th century to the present. He studied autobiographic writings, letters, testimonials of confessors and canonical reports. According to Bell, among saints supposed to have eating disorders we find Saint Catherine of Siena, Saint Columba of Rieti, Saint Catherine of Genova, Saint Veronica, Saint Mary Magdalene de Pazzi and Saint Clare of Assis. According to Behar's findings, Saint Columba of Rieti died of severe self-starvation and Saint Veronica used to eat only on Fridays, when she chewed five orange seeds in the name of the five wounds of Jesus.

In an article about Mary Magdalene de Pazzi, Cordás & Weinberg⁹ point that she went through severe fasting and self-induced vomiting when she was forced to eat. She considered food as a devil's temptation and therefore she should avoid it, however, she was frequently caught eating large amounts of food in secret.

Weinberg¹⁰ mentions that Saint Catherine of Siena ate only a single small bunch of herbs a day, forcing vomiting whenever she was forced to eat. Her goal was to became ugly and get rid of an arranged marriage her mother was trying to impose her. She increased her periods of self-starvation, mortifications and had her hair cut very short. Catherine's life has been widely studied by experts on eating disorders because of the interesting clinical features of her disease. Gamero6 transcribed the correspondence exchanged between the saint and her confessor:

"Dear father, I thank you for all the saint dedication and concern you have shown for my soul, because you seem to get really worried when you listen the things I tell you about my life. ( ) you wrote advising me to ask God to make me eat more. I disagree with you, father, and tell you in the name of God that with all my strength I force myself to eat, once or twice a day. ( ) Many times, while I did what you asked me to do, I look at myself to understand my illness and the God's goodness, Who through a very special grace allow me to correct the vice of gluttony".

According to Rampling,¹¹ the most notorious characteristic of Saint Catherine asceticism was her abnormal feeding behavior. Her confessor, Raymone, cited by Rampling reminds us that:

"(...) Eating was a great suffering for her, more than it would be for a starving person to lack food. She used to vomit as a way of reparation; as she could not vomit spontaneously, she used a thin straw or another object she could put in her throat to self-induce vomiting. Her confessor tried to persuade her to abandon this habit, but she insisted that it pleased God".

Other saints and devout women elected Saint Catherine as a model, probably because of her strict asceticism, among other reasons. Saint Magdalene de Pazzi and Saint Rose of Lima are the best examples of Saint Catherine's followers; which on their turn, inspired Saint Veronica Giuliani, another fasting saint.⁸

Saint Rose of Lima is considered the patroness of Latin America and the Philippines. She was the first woman to be canonized in Latin-America (1671) and to have her work known all over Europe. Her history is of great importance, especially for those who are interested in the different aspects of eating disorders.

Ugarte,¹² one of Saint Rose's biographers, tells that she was born on April 20th in 1586, when the city of Lima, in Peru, was reigned by Fernando Torres from Portugal and was celebrating the 50th anniversary of its foundation. Her parents, Don Gaspar Flores and Dona Maria de Oliva, named her Isabel Flores de Oliva, but she was such a beautiful baby that she was called Rose. She did not accept the nickname until she was 25, when her confessor said that her soul was like a rose for Jesus Christ's delight. She made up her mind and accepted the nickname after his comment. When she was a child, she was used to spending many hours praying in the altar, she was extremely obedient and hard-working and was very skilled in handicraft, specially using needles. After reading about Saint Catherine's life, Rose started to fast three times a week and subjected herself to severe punishment, what Bell called a conscious imitative behavior. Besides, she had her gorgeous hair cut (just like did Catherine) and injured her hands with severe hard work, in order to avoid vanity's temptation. For 10 years she fought against her parents' purpose of marrying her, until they consented with her devotion to God. When she was not working, she secluded in a cottage built by her own, where she remained praying.

When she was 20, she went to the Third Order of Saint Domingos, where she redoubled severity with herself and the types of penitence used. She usually wore an iron belt around her waist and a metal thorn crown under a wreath of flowers on her head. She was able to fast for several days, sometimes eating a small amount of food with bitter herbs. When she was almost fainting, she rested on a bed built by her own covered with shards of glass, stones and thorns. She used to say that this continuous martyrdom was rewarded by the frequent Jesus Christ's revelations, which "flooded her soul with peace and joy".

According to Mujica,¹³ Saint Rose's period was convulsed by religious renovation. Since the late Middle Ages, women had been outlining a new stream of lay spirituality. They accepted the vow of poverty, preserved chastity and extreme forms of punitive asceticism, lived in retreat houses, and spent most of their time busy with handicraft work. As they were linked to a sisterhood and, like Rose, did not live in a monastery, they were one of the main targets of Saint Inquisition.

By the time Rose was 13 years-old, her father worked in the administration of a silver mine. Rose knew very well the suffering of the miners, who were mostly Peruvian Indians. That is the reason why some authors believe there may be a probable relation between Saint Rose's way of life and the world of miners. Life at the mine was a real slavery. The miners worked day and night in sub-human conditions, in two shifts. This situation became worst after 1.600, when they were ordered to remain in the subsoil from Monday to Saturday, so that they would not loose time going up and down the mine. Millones¹⁴ thinks "the daily contact with the Peruvian miners made Saint Rose of Lima a person concerned with the cure of diseases and the relief of suffering of those who believed her virtue." He says it would be impossible to understand the ascetic life of Saint Rose of Lima if it is not thought of within a context of oppression, servitude and slavery."

Gray¹⁵ claims that asceticism combined with social concern sometimes hides and apparently validates the anorexic behavior, as it happened many centuries later with the philosopher and activist Simone Weil, a Jewish converted to Catholicism who developed anorexia.

DISCUSSION

The Chilean psychiatrist Rosa Behar describes some important aspects of Saint Rose's life in the article "Santa Rosa de Lima: un análisis psicosocial de la anorexia nerviosa". She claims that there are evidences that the Saint's behavior fits the current diagnosis of anorexia nervosa, although considering her only as an anorexic girl is mere reductionism and a lack of respect for her special qualities and mystic fervor.

Behar considers Saint Rose of Lime's feeding behavior very typical of today's anorexia nervosa. Since she was around 11 years-old, she fasted on Wednesdays, Fridays and Saturdays, eating only some bread and dranking some water. In the remaining days of the week, she ate a small meal made of potatoes and bitter leaves. When she was 15, she promised not to eat meat again, eating water and bread for the rest of her life. Behar also calls the attention for what she suggests was a great hyperactivity, with progressive and volunteer sleeping hours decrease and working hours increase. Rose used to sleep only 2 or 3 hours a day, the remaining time she used to pray, work at home and garden, and take care of poor and sick people. Behar points that Saint Rose had a particular pattern of personality, she had an ambition to improve her spirit, she denied herself through self-punishment, strictness and perseverance in her sanctity ideals, worries and dedication to other people's suffering, besides her lack of interest for social relationships and rejection to the opposite sex. Of her penitence habits, we highlight self-love denial and self-imposed pain. She was constantly afraid of being an object of temptation to someone, so she used to hurt herself, in order to get rid of the remaining of her physical beauty.

Behar says "it is not a case of labeling the today's anorexic girl as a saint, nor the Saint as an anorexic" but in both situations "the girls use food as a symbolic way of expression." They share the same psychopathologic features: refuse to eat (for different reasons: the first for sanctity, the other for thinness), seem to be constantly unsatisfied with their goals achievement (divine consecration and absolute thinness); are very self-critical; lack interest for social relationships and do not accept other people's concerns with them, although they care for the others; they have minimal physical needs and reactions like pain, tiredness, sexual desire and hunger; her mothers are dominating and usually develop contradictory links with their daughters. Yet, we add to Behar's observations another fact that has called our attention: the imitative behavior of Saint Rose, which is frequently seen in today's anorexic young women as well.

Rose took Saint Catherine of Siena as a model and followed her faithfully. She used the same white habit as hers, imitated her eating habits and types of penitence, had the hair cut and prepared the foundation of the Dominican monastery of Saint Catherine of Siena, in Lima, raised soon after Rose's death.

Hilde Bruch¹⁶ associates this kind of behavior to basic deficits in the sense of self, identity and autonomous functioning. Anorexic girls may have faced difficulties during childhood to show their feelings and desires to their parents, which probably only took into consideration their own needs. Thus, individuals with this type of disorder act upon the orders of other people and do not do what they want. In general, their perception of body experiences is disturbed, what makes them feel in doubt about their own sensations and feelings. They have difficulties in identifying their own body, and usually see it as something separated or pertaining to their parents. For Bruch, the anorexic thinness is not an expression of power and independency, but a defense against a feeling of lack of personality, weakness and ineffectiveness.

In The Golden Cage,¹⁷ Bruch compares the anorexic woman to a blank board to be filled with the personality of each new person she gets involved with, with what her friends like and want doing. For Bruch, this type of imitative behavior could be responsible for the rapid increase of anorexia cases in the last years. These girls, whom the author¹⁸ refers to as "me too" developed the disorder after they had access to some information about it. This behavior is different from that of anorexic girls who believed they were making something positive with their disease, and had never had any familiarity with it.

Would it be the case, so, of using the same argument to explain the outbreak of anorexic saints in the Middle Ages, the large number of Saint Rose's followers, who were even chased by Inquisition, and "the roses", founders of the Monasterio de Las Rosas de Lima?

CONCLUSIONS

The occurrence of eating disorders in other cultures and centuries earlier than those reported by Morton (1689), Gull (1868) and Laségue (1874)¹⁹ is of great interest as it draws the attention to issues concerning the pathogenetic and the pathoplastic factors in psychiatry, deviating the focus from the influence of modernity, which is usually elected as the main responsible factor.

Pathographies as the one described in this article do not only prove that the disease existed in other times, but also make possible to draw a parallel between the clinical status of anorexia today and the anorexic saints in the Middle Ages, highlighting the transcultural feature of the disease.

Another point in common is that anorexic women may develop an imitative behavior, influenced and emphasized by society, as we find both in fasting saints' followers and today's teens. The first aimed at the endless communion with God while the last's contentment is the vanishing glory of the catwalk.

The parallel between today's anorexic girls, chlorotic girls and medieval saints allowed us also to realize how surprisingly close different human behavior can be, even if their presentation and motivation vary with time. We agree with Lacey²⁰ that physicians find similar signs and symptoms through different ages, but their interpretations and understanding are shaped by beliefs of different societies. The similar presentation of the disease over the years - food refusal, emaciation, hyperactivity, amenorrhea, quest for an ideal - shows us that the form, the unchangeable, the disease's essence (pathogenetic factors) is not shaped by age, personality or culture (pathoplastic factors), which, on their turn, would have a secondary role in the disease's development.

REFERENCES

Received on September 15, 2004.

Revised on September 21, 2004.

Approved on February 18, 2005.

This study was carried out at AMBULIM, Psychiatry Institute of Hospital de Clínicas, USP School of Medicine, São Paulo, Brazil.

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Publication Dates

• Publication in this collection
  15 Sept 2005
• Date of issue
  Apr 2005

History

• Accepted
  18 Feb 2005
• Reviewed
  21 Sept 2004
• Received
  15 Sept 2004