The Hypothesis That Anorexia Nervosa Is a Passion: Clarifications and Elaborations

We are grateful for these two insightful commentaries, which both see novelty and value in the manner in which we invoke the hypothesis that anorexia nervosa is a passion, to help explain data from the Anorexia Experiences Study, which provides the basis of our inquiry. In this response, we wish to clarify and elaborate on our hypothesis; in particular, the difference between passions and moods, the manner in which our hypothesis touches on issues of authenticity and identity, and the compelling parallel with addiction. We also wish to emphasize that, in proposing the hypothesis that anorexia nervosa is a passion, our primary aim is not so much to exclude or replace alternative theoretical approaches. Our focus, really, is to argue that the hypothesis that anorexia nervosa is a passion adds something rich and unique to our current understanding of that condition, which is not fully or adequately captured by alternative accounts.

Passions and Moods

Hannah Bowden asks whether the descriptive theoretical virtues we attribute to ‘passion’ might also be accomplished by referring to “Heideggerian mood,” or “a form of Heideggerian mood in combination with certain beliefs” (Bowden 2013, 368). She explicitly asks how passions differ from moods. These are important questions.

To begin, note that in her remarks Bowden is inquiring about the descriptive capabilities of the theoretical constructs ‘passion’ and ‘mood.’ Her concern is largely with phenomenological description. Now it is indeed true that we argue that ‘passion’ plays a pivotal role in the description of the clinical course and nature of anorexia nervosa, although admittedly we do not engage in phenomenology per se. However, what must be emphasized is that we also wish to argue that, properly understood, the construct ‘passion’ plays a theoretically irreducible and ineliminable role in the explanation of the clinical course of anorexia nervosa; in particular, the manner in which many of the feelings and emotions in anorexia nervosa succeed one another in apparently rule-governed and even law-like ways. Our contention is that neither the concepts ‘emotion,’ ‘feeling,’ ‘mood,’ ‘belief,’ or any combination of these, can adequately describe or explain the complex progressive syndrome that is anorexia nervosa. Something like the concept of passion we invoke from Ribot is required. Although much work remains to be done, this at least is the essence of our case.

We believe that it is an especially important theoretical virtue of the concept of passion that we employ that it helps to describe and explain, both how and why the anorexic syndrome can sometimes take the tragic, progressive, worsening, course it does. Indeed, at one point Ribot likens passions where there is a loss of control of this sort to an ‘avalanche.’ This compelling metaphor suggests a tightly bound, progressive, worsening, affective–intellectual–motivational syndrome that, in our view, cannot credibly be labeled or identified, described or explained, with moods, or simply moods plus certain beliefs. Furthermore, ‘passion’ in our view cannot be accounted for using other preexisting theoretical concepts, or any combination of these. Our claim is that the concept ‘passion’—and not simply the term—must be added (reinstated, to be precise) to our current existing theoretical framework. None of this is to say that moods might not play an important part in the phenomenological and clinical description of the anorexic syndrome, or its explanation. But that is an independent empirical question that we did not attempt to answer in our article.

To further clarify, there are in fact quite a few important differences between moods and passions on our account. First, passions may initially be voluntarily chosen, whereas moods, normally, are not. Second, passions are tied to an ‘intentional object’ or fixed idea, whereas moods, normally, are not. Third, passions require the intellectual resources of reason and cognition, whereas moods, normally, do not. Fourth, passions are often tied to specific stereotypical action tendencies, whereas moods, normally, are not. Fifth, passions are stable and may endure for years, whereas moods tend to be more fleeting and temporary...