Campus Box 1114
One Brookings Dr.
St. Louis MO 63130-4899
My work sits at the intersection of anthropology, psychiatry, religion, and gender studies. I am interested in how individuals experience existential distress, and how this distress manifests as psychiatric symptoms, religious angst, somatic pain, and other culturally informed bodily conditions. Specifically, I consider how bodily practices deemed "deviant," "extreme," or "pathological"-and local responses to such practices-make visible competing cultural logics of acceptable moral personhood. I have been most intrigued by the ways in which subjective experiences of suffering are systematically targeted for change through the cultivation of different forms of body discipline (e.g., in a convent or an eating disorders treatment center) and how institutions shape, but do not entirely dictate, these processes. Through the ethnographic study of extreme bodily experiences and their institutional "scaffolding" I aim to understand cultural processes of meaning making as collaborative, agentic, and morally imbued, and how such meaning assumes motivational force for individuals; that is, how people use their bodies to navigate competing cultural and moral frames in order to make sense of the world and their place in it.
My work to date has taken the form of five major intellectual projects, each of which grapples with different aspects of these core themes and has produced distinct (though inter-referential) sets of publications. Over time, my research has become more collaborative and interdisciplinary.
Eating Disorders, Asceticism, and Ritual Practices
My earliest work examined disciplines of asceticism (fasting, celibacy, deprivation of comfort) as culturally elaborated mechanisms for negotiating gendered conceptions of morality. I am particularly interested in anorexia as a contemporary ascetic practice, the way in which anorexia as an illness is defined and constructed within medical discourse, and how this, in turn, shapes the anorexic woman's subjective experience of her distress. Specifically, I interrogate the cultural dimensions of the illness as one in which particular, moralized forms of body ritual assume center stage (Lester 1995).
Gender and Nationalism in a Mexican Convent
My dissertation research extended my work on gender, asceticism, and moral practice. This project concerned young women in training to become nuns in a Roman Catholic convent in Mexico. I examined the ways in which these Sisters' existential transformation proceeded in direct, practical engagement with larger cultural concerns about Mexican nationalism and cultural identity in the face of an accelerated movement into the "first world" I argue that their bodily experiences were systematically engaged in their religious training in efforts to cultivate a gendered religious subjectivity in the context of a burgeoning nationalist movement in Mexico. This research resulted in the publication of my first book (Lester 2005) as well as two additional articles (Lester 2003 and 2008).
Failed Strategies of Work Reform in a Community Mental Health Agency
This research, conducted on the Lower East Side of New York City was funded by the Rockefeller Foundation as part of a three-year, three-city project evaluating urgent questions of welfare, work, and identity among formerly homeless mentally ill individuals (Rog et al 1997; Lester et al 1997). My particular focus was on questions of the cultural constructions of "mental illness" and "recovery" as projects of spiritual and moral regeneration.
Latina Teen Suicide Attempts and Acculturative Stress
This work was undertaken collaboratively with Dr. Luis Zayas at the George Warren Brown School of Social Work at Washington University. We wanted to better understand the phenomenon of Latina teen suicide attempts (more than three times the rate of other subgroups). We proposed a conceptual model and mixed-methods approach grounded in literature on acculturative stress suffered by immigrant groups and the paucity of adequate mental health care services for immigrant populations in the US. With Dr. Zayas as the Principal Investigator this research was funded by an NIMH R01 grant, and produced two publications on which I was a co-author (Zayas, Lester, and Cabassa 2005; Cabassa, Lester, and Zayas 2007).
Eating Disorder Treatments as Philosophies of Gender and Agency
Over the past 15 years I have been engaged in critical medical anthropological work on eating disorders as biopsychosocial syndromes that both manifest and challenge dominant cultural notions of gender, agency, and moral personhood. I have been particularly interested in how psychiatric models of eating disorders enfold and prescribe certain kinds of gendered subjectivity as healthy, while excluding or pathologizing others. My work in this area has engaged questions of how the body figures into (or disappears from) operating etiological explanations for these illness (Lester 1997), how "healthy" agency is implicitly gendered in dominant models and techniques of recovery (Lester 1999), and how presumptions about the "correct" female sexual body informs understandings of eating disorders and the interventions designed to treat them (Lester 2000). I am currently preparing a solicited manuscript for the Rutgers University Press Series, "Cambridge Studies in Medical Anthropology" (provisionally entitled Treating Eating Disorders: An Anthropological Critique), which synthesizes my work on the critical medical anthropology of eating disorders.
My theoretical work on eating disorders has evolved in tandem with the following field projects as grounded ethnographic engagements with these themes:
Comparing Eating Disorder Treatments in Mexico and the US
Continuing my interest in how psychiatric models encode and deploy cultural values regarding gender, morality, and health, this project entailed comparative work in two eating disorder clinics; one in Mexico City and one in the American Midwest. I was prompted to this project by reports that eating disorders are rising in Mexico and that this seems to correspond with Mexico's push to modernization. Yet the available evidence for this claim is often problematic. I reframed this as an ethnographic question by examining how specific clinical practices at each site enable global diagnostic categories to become entangled with local social realities in ways that problematize existing epistemologies about culture and illness (Lester 2004, Lester 2007)
Managed Care and Clinical Decision Making: Eating Disorders and Everyday Ethics
I am currently in the writing phase of my most recent long-term ethnographic project in an American eating disorder clinic. This book, tentatively entitled Bargaining Lives: Eating Disorder Clinicians in the Era of Managed Care is about how front-line clinicians experience their therapeutic work in the face of what seem to be insurmountable odds: clients who often don't want to get better, families who are in crisis yet resist change, an illness that kills more people than any other psychiatric condition, and a healthcare system that devalues the very sorts of clinical expertise that seem to help. The kinds of everyday ethical negotiations in which these clinicians engage percolate throughout the American healthcare system and are key mechanisms through which notions of economic expediency become entangled with concepts of the healthy subject. As clinicians struggle out a course of action between competing ethical imperatives, they also struggle out the workability-and failures--of various articulations of the subject within contemporary American cultural ideologies of health and pathology. In addition to the book manuscript in preparation, this research has produced two articles (Lester 2008, Lester 2009).
In all of my work, my aim is not to exoticize certain behaviors (of the people who engage in them) as "bizarre"; rather, I want to understand what draws individuals to extreme bodily practices, what such practices communicate psychologically and socially, what kinds of cultural values and meanings comprise or are challenged by them, and how real people navigate among competing moral systems in trying to make sense them. I believe people do things for discernable reasons, and that those reasons, conflicted and convoluted though they may be, do make sense if one understands the moral and practical frames within which they take shape. I am dissatisfied with explanations that locate motivations solely in the realm of the psychological or in the realm of the social or cultural. People are enormously complex, and often use their bodies-sometimes in violent ways-to try to make sense of their own experiences and to communicate those experiences to others. In considering cutting I will continue my exploration of the body as polysemic as well as mortal; as symbolic resource as well as fleshy home; as inhabited by, as well as constitutive of, "self," and as what makes us both truly alone in the world as well as utterly connected to those around us.
In Press Treating Eating Disorders: An Anthropological Critique (working title).
Cambridge Studies in Medical Anthropology. Rutgers University Press.
This book is a critical intellectual history of Western views of eating disorders
and their treatment from the Middle Ages to the 21st century. I propose that
clinical, theoretical and popular thinking about eating disorders-what they are,
what causes them, how to treat them, and what recovery looks like-crystallize
historically specific concerns, anxieties, and fantasies about what makes us human
and what makes that humanity meaningful.
2005 Jesus in our Wombs: Embodying Modernity in a Mexican Convent.
University of California Press.
Peer-Reviewed Articles and Book Chapters
In Press How do I Code for Black Fingernail Polish?: Finding the Disappearing
Adolescent in Managed Mental Health Care. In Policy-Relevant Research on
Adolescents: New Directions from Anthropology (Anderson-Fye and Korbin,
eds.). Being considered by Rutgers series on Childhood and Springer series
on Child Well-being.
2009 Brokering Authenticity: Borderline Personality Disorder and the Ethics of Care
at an American Eating Disorder Clinic. Current Anthropology 50(3).
2008 Anxious Bliss: A Case Study of Dissociation in a Mexican Nun. Transcultural
Psychiatry 45(1): 56-78.
2007 Critical Therapeutics in Two Eating Disorders Treatment Centers. Medical
Anthropology Quarterly 21(4): 369-387.
2007 It's Like Being in a Labyrinth: Hispanic Immigrants' Perceptions of Depression
and Attitudes Towards Treatment, (second author with Leo Cabassa and Luis
Zayas), Journal of Immigrant & Minority Health 9 (1): 1-16.
2005 Why Do So Many Latina Teens Attempt Suicide?: A Conceptual Model for
Research (second author, with Luis Zayas and Leo Cabassa), American Journal of
Orthopsychiatry 75 (2): 275-287.
2004 Eating Disorders and the Problem of 'Culture' in Acculturation. Culture, Medicine
and Psychiatry 28 (4): 607-615.
2003 The Immediacy of Eternity: Time and Transformation in a Roman Catholic Convent.
Religion 33 (3): 201-219.
2000 Like a Natural Woman: Celibacy and the Embodied Self in Anorexia Nervosa.
In Celibacy, Culture, and Society: The Anthropology of Sexual Abstinence. E.J.
Sobo and S. Bell, eds. Pp. 197-213. Madison: University of Wisconsin Press.
1999 Let Go and Let God: Religion and the Politics of Surrender in Overeaters
Anonymous. In Interpreting Weight: The Social Management of Fatness and
Thinness. Jeffery Sobal and Donna Maurer, eds. Pp.139-164. Hawthorne, NY:
Aldine de Gruyter.
1997 The (Dis)Embodied Self in Anorexia Nervosa. Social Science & Medicine 44(4):
1995 Embodied Voices: Women's Food Asceticism and the Negotiation of Identity.
Ethos 23(2): 187-222.
Medical Anthropology (L48 142)
Psychological Anthropology (L48 3882)
Gender, Culture and Madness (L48 3201)
Pharmaceutical Personhood (L48 3875)
Advanced Seminar in Psychological Anthropology (L48 4113)
Theorizing the Body (L48 4112)
Argumentation Through Ethnography (L48 4123)