La gabbia d'oro

by Hilde Bruch

Le vittime dell'anoressia sono, spesso, ragazze adolescenti o preadolescenti, figlie modello di "buona famiglia" che si sentono spesso imprigionate da mete irraggiungibili e aspettative irrealizzabili. Sembrano chiuse in una "gabbia d'oro" di privilegi nella quale sentono di non essere al proprio posto e di non poter sopravvivere. La manifestazione principale della malattia è sconvolgente e comporta perdite di peso catastrofiche; la terapia è difficile e la guarigione incerta; i meccanismi di formazione della patologia non sono ancora definiti. Hilde Bruch, utilizzando numerosi esempi della propria casistica, disegna un quadro delle cause, degli effetti e della possibile terapia che, per essere efficace, necessita di una diagnosi precoce.

Genres: Psychology, Nonfiction, Mental Health, Self Help, Research, Science, Psychoanalysis

162 pages, Paperback

First published January 1, 1978

About the author

Hilde Bruch was a German-born American psychiatrist and psychoanalyst, known foremost for her work on eating disorders and obesity.

Reviews

[Elyse Walters · Rating 5 out of 5]

I read this many years ago............

I thought everyone did. It was a 'go to' book on the subject of anorexia at one time. It might still be. I guess its considered 'The Classic" book on the subject.

Its a valuable book to read --if one feels they need to read about this disorder. Or wants to understand that anorexic is a disease.
Since this book has been published --there have been so many more books published on the topic.
There is no one path to healing ......

Blessings to those who struggle!

[Rachel · Rating 3 out of 5]

the book, of course, is somewhat dated. Not only have we achieved medical and psychological advances in the treatment of anorexia nervosa, but professionals have changed their attitudes about gender roles, patriarchal families, and so on. Also, eating disorders have become even more prevalent since the time this book was first published, and the public is more aware of the disorder. What I admire about this book, though, is its clear, tough, yet compassionate examination of anorexia nervosa as a psychological disorder. There is an awareness often lacking in more recent medicine that such disorders deserve patient treatment and individual attention for the patient.

[Rita · Rating 4 out of 5]

LE ASPETTATIVE DEL MONDO

"Queste bambine personificano in molti modi l'idea della perfezione di ogni genitore e ogni insegnante, ma lo fanno in misura esagerata. È la spinta supplementare, l'essere non buone, ma "migliori", la differenza significativa tra queste infelici che si affamano e altre adolescenti, capaci di godersi la vita. Una vera prevenzione richiede di riconoscere precocemente nella loro gradevole super-perfezione il segno della loro sofferenza interiore."

"La cosa più importante che ho imparato è che la preoccupazione per la dieta, la fissazione di essere magre o grasse, sono soltanto cortine fumogene. Non è questa la vera malattia. La vera malattia sta nei tuoi sentimenti verso te stessa. C'è una strana contraddizione: tutti pensano che fai tanto bene e che sei tanto brava, ma il tuo vero problema è che pensi di non esserlo abbastanza. Temi di non essere pari alle cose che ci si aspetta da te. Tu hai una sola grande paura, quella di essere come tutti, come la media, insomma non abbastanza in gamba. […] C'è un solo problema in questo senso di superiorità: non risolve il tuo problema, perché quello che tu veramente desideri è di essere soddisfatta di te stessa pur sentendoti felice e sana. La cosa paradossale è che ti senti in gamba perché sei malata."

Non credo ci sia molto altro da aggiungere. Certo, le riflessioni della Bruch potranno essere datate, e talvolta ci si lascia andare anche a qualche stereotipo. È vero infatti che molti passi avanti sono stati fatti nell'ambito della cura dei DCA, primo fra tutti la necessità di calibrare l'intervento terapeutico sul singolo, senza far di tutta l'erba un fascio.
Che le persone affette da anoressia abbiano qualcosa in comune, d'altra parte, è innegabilmente vero. La scrittrice lo mette in risalto insistendo su quel senso di inadeguatezza permanente che caratterizza il loro stare nel mondo, spesso e volentieri dipendente dalle aspettative dello stesso, incarnate vuoi dai genitori, vuoi dagli insegnanti, vuoi dagli amici. Riflettendo sulla mia esperienza, devo riconoscere che il mio problema si è sviluppato esattamente per questa ragione. Essendomi ritrovata in più di una delle ragazze qui analizzate, non posso che sperare di far mia anche la chiave della loro guarigione.

"Una cosa che tu non sai, ma che io posso dirti è: non sarà questo patimento a portarti a una soluzione. Ti fa sentire speciale, ma non ti dà quello che veramente desideri e di cui hai bisogno […]. Tu hai bisogno di essere convinta di vivere la tua vita, di sentirti meritevole e di sapere che quanto fai è veramente quello che tu stessa desideri fare. Hai il diritto di fare tutto questo senza un senso di colpa, né per la tua ambizione, né perché non vai troppo bene a scuola; ti devi permettere di essere una persona che ama la vita. […] Adesso sei tanto fiera della tua magrezza da avervi sacrificato ogni altra cosa. Per guarire, devi fare un altro e più grande sacrificio - devi rinunciare a questo orgoglio innaturale per una cosa che non serve a nulla."

[Karen · Rating 5 out of 5]

The Golden Cage by Hilde Bruch M.D.
This book was first published in 1978. The copy I read was reprinted in 2001 with an interesting Forward by Catherine Steiner-Adair Ed.D.
I was having a conversation with our pediatrician and he said that this book remains a classic primary source for medical professionals. My youngest son is tall and thin and has always been a very picky eater. I don't think my son has an eating disorder, but his personality trait of trying to please everyone sure fits one of the symptoms that teenagers who do. Most parents who love their children are baffled when they discover that their child has one. It often strikes high achievers who try to live up to high standards in adolescent years.
It often upsets me whole family dynamics. This author states that most families that have a child with an eating disorder are because the child is unable to individuate and separate from pleasing the parents wishes.

This author was extremely harsh towards me parents of girls with anorexia. There are many situations the family is not the primary cause for eating disorders. Catherine Steiner-Adair states that this author's weakest link was her inability to think critically about "the enormous emphasis that fashion places on slimness" and her misguided understanding of the role of the women's movement in the creation of eating disorders.

Since Bruch wrote The Golden Cage eating disorders have become the third chronic illness in the United States. What is so threatening to society-and so repellent to these girls-about women's needs and desires?

I will end with this quote from Catherine Steiner-Adair: "There is a multi-billion dollar industry that feeds off people's feelings that they don't look right. Perhaps the most widely mentioned theme from The Golden Cage is 'the relentless pursuit of excessive thinness' as the hallmark of anorexia-and one doesn't have to look far to see that thinness is still the distguishing characteristic of our definition of beauty. The image is, if anything, more severe than it was twenty-five years ago, because the bodies now being portrayed may not be entirely real. Models and actresses are often reinvented with cosmetic surgery, and then their images are further altered with computer technology."

[Celia · Rating 3 out of 5]

anacrónico en algunas cosas (quizás demasiadas), pero un acercamiento muy humano a la anorexia

[nour · Rating 3 out of 5]

Kind of hard to rate this one bc of its undeniable impact in its assertion of EDs as serious psych conditions and its quite reductive framing of EDs as signifiers of a deficient sense of self. Also hard to get over the fact that her patient population (who provided her data) completely aligns with and reinforces stereotypes ab the “typical ED patient.” A product of its time in many ways I guess.

[Aisling · Rating 4 out of 5]

read for an essay about the female body and food in modern literature

[IBTCV · Rating 3 out of 5]

Desfasado, sin duda, en muchos aspectos, pero creo que ha estado bien volver a lo básico.

[Peggy Sharp · Rating 3 out of 5]

This is a hard one for me. It’s a “classic” on anorexia, but because it was written 40+ years ago, it felt so outdated that I had a hard time with it. It focused solely on white, middle-upper and upper class, adolescent girls. The focus for treatment was involvement of parents and the “cause” was focused on childhood experiences.

Anorexia is so much more than this, and of course does not discriminate. If you are prepared to read it in the context of when it was written and understand its narrow scope, you can appreciate what it provides.

[Becky · Rating 1 out of 5]

If you want to blame your mother for your eating disorder, read unscientific, outdated theories about eating disorders, then this is the book for you. If you want information backed up by science that is up to date in 2013 this will not give you that. The damage done by these theories about mothers is criminal. Correlation does not equal causation. This book is a great example of how unsubstantiated theories spread and linger and do harm to society.
Becky Henry

[Lanxin Li · Rating 4 out of 5]

It's always tricky to read non-fiction that is dated. But I wanted to give it a go while keeping the caveats in mind, as I wanted to explore this topic that is less known to me, and where better than with a seemingly reprinted classic from the 70s...

Now having read it, I think this book still can hold some use and relevance. It offers insight for a limited demographic of anorexia nervosa patients: the white, upper-middle class, teenage/young adult, female (probably because those were the people that could afford/have time for therapy in those days). Within the narrow boundaries of this topic, the book felt quite adeptly informed, it was written in an approachable writing-style, the tone was sensitive and open.

The modern pervasiveness of eating disorders has meant that this book is not going to satisfy everyone, but then again, it's hard to expect a common, ubiquitous experience in mental health. So for what it was, I found this book very interesting and eye-opening.

[Gabriella Leigh · Rating 4 out of 5]

Didn't love this book ... BUT it is an absolute must read for anyone who is affected with an eating disorder--be it a recovering survivor of the disease, a parent with a child who has a disorder ... or anyone in between. It sheds light on the horrors--although I do think it focuses more on anorexia than anything else--without over complicating the issues or making anything seem too far fetched an idea. With outtakes from varying perspectives, it is a short read, but one worth investing time in just to gain insight to eating disorders.

[Moriah Conant · Rating 4 out of 5]

The book was published 1978 and because of that, the research is not entirely up to date. However, the book provides great explanations to some of the thoughts, causes, and motivation of anorexia. I would recommend this book to counselors, people who have contact with those who struggle with eating disorders, and to anyone who is genuinely curious about the subject.

[Victoria Ferrari · Rating 4 out of 5]

L’ho trovato ottimo sebbene scritto nel 1978, dunque più di quarant’anni fa! Di conseguenza non tutto risulta valido e totalmente condivisibile oggi, ma mi è tornato utile. Detto ciò, sicuramente esistono testi più aggiornati e può essere interessante stendere una storia ed evoluzione della terapia

[Melissa Pollick · Rating 5 out of 5]

Good for anyone wanting to learn more about anorexia - either for themselves or a loved one.

[Vicki Gooding · Rating 4 out of 5]

A frustrating glimpse at some of the underlying factors, mental and physical damage that can happen to good girls trying to claim who they are

[Diana · Rating 5 out of 5]

A complete reflection on anorexia nervosa.

[Patricia · Rating 4 out of 5]

I read this book back in the early 80s when dealing with at least two cases of anorexia nervosa while an RA in college. A college guidance counselor gave it to me to read. It was very informative.

[Wenjing Fan · Rating 3 out of 5]

很意外我居然也有一些related的片段，也许女性的生命体验就是如此相似吧。不过我也在想，把“原生家庭”作为主要的病因是否是合理的？毕竟整个父权制对女性外貌的苛求已经渗透到方方面面，可不止是家庭

[Camila · Rating 4 out of 5]

Outdated, but so, so interesting.

[Sam · Rating 4 out of 5]

Me ha fascinado la mirada profundamente humana y llena de testimonios sobre un tema que a veces parece tan irreal y lejano.

[Alexa · Rating 5 out of 5]

Outdated psychiatric information with some strange concepts (anorexia being caused by the need to feel special and unique???) but still interesting to read with some parts that still hold up in 2025

[Linny · Rating 3 out of 5]

The language and science of this book are certainly outdated by now. However, this was an exploratory depiction of how eating disorders can present psychologically. Bruch demonstrated the common threads that seem to appear and reappear in cases of anorexia nervosa.

[sfr · Rating 4 out of 5]

«Los desórdenes alimenticios son la encarnación tanto literal como simbólica de la resistencia profunda al poder de la mujer. Si una chica no tiene necesidades, alberga una sensación de poder inmensa; ha conseguido un control sobre su cuerpo. Como es diferente, es especial. Al mismo tiempo, sin embargo, pierde sus ambiciones, aspiraciones y expectativas respecto a los otros. Cree que pierde el derecho a ocupar un lugar en el mundo.»


La tolerancia al dolor del hambre. La sensación paralizante. La perfección como expresión de tristeza interior. La evitación de cualquier mirada. La incapacidad de abordar cualquier situación. El miedo a la vida.

Las pequeñas que ponen voz a este libro ayudan a visibilizar la complejidad, gravedad y el inmenso dolor que lleva inherente los trastornos de la conducta alimentaria.

Hilde Bruch destaca la importancia del abordaje multidisciplinar de la anorexia nerviosa. Esta enfermedad, como cualquier otra enfermedad mental no se elige, se sufre. No es una realidad escogida. No hay un culpable y no se curan solas. Se trata de una forma de autocompasión como única opción para la supervivencia.

[Vicky · Rating 5 out of 5]

Muy vivencial, sirve para ver la patología desde distintas perspectivas , recomendando para cualquier persona que se dedique al ámbito de la salud, y especialmente para aquellas que trabajen en Salud mental.

[Charlotte Bevan · Rating 1 out of 5]

Some 30 years out of date and a very destructive book. Science has moved on and most of Bruch's clinical observation about the role of the family, control and other clinical observations have been disproved. Sadly, too many clinicians treating eating disorders have yet to let go of this as a clinical text book.

Whilst Bruch did much to raise the profile of eating disorders, her theories and observations were just that. Evidence based research and advances in genetics and biology have moved us on from this psychobabble.

I would advise this be read in much the same way as one would read a book about humours and how to cure them from the 16th century!

[Ayla · Rating 3 out of 5]

A glimpse into the underlying causes of the disease. How it is not the food but issues of control and pychological well being, the need to be accepted or in some cases an outlet for the pressures of being perfect what the family or parents desire the child to be rather than what the child wants to be. Most of those inflicted by this disorder come from affluent families that have high motivations and hopes for the children, in this study the doctor looks at how these pressures affect these children and the approrpriate treatments for well being.

[stephanie · Rating 5 out of 5]

maybe the first book to really examine anorexia as a psychological disorder that wasn't comorbid with "hysteria" or whatnot (though note, the dsm diagnosis is still "anorexia nervousa), hilde birch uses case studies to prove her points in a very forward-thinking way. amazing when you think about how long ago this book was published. a serious must-read for anyone with any interest in EDs.

[Jordan · Rating 3 out of 5]

This book is supposedly a "must-read" for anorexics, their families, and therapists. Bruch uses case histories of former patients to describe the disease, its consequences, and difficulty in treatment. The stories are compelling and make this book seem accessible to people who are not psychologists or therapists. The book helps to demystify anorexia for the general public.

[soulAdmitted · Rating 3 out of 5]

I sintomi delle giovani e giovanissime pazienti anoressiche come retorica muta o come codice unico e variegato di una lingua, soggettiva e comune, caparbiamente proclamata. L'autrice-psicoterapeuta è altrettanto caparbia nell'accoglierla e nell'esplorarla.
L'operazione mi risulta, oggi, più utile dei contenuti.