Overview

Since the advent of the women's movement, women have made unprecedented gains in almost every field, from politics to the professions. Paradoxically, doctors and mental health professionals have also seen a staggering increase in the numbers of young women suffering from an epidemic of depression, eating disorders, and other physical and psychological problems. In The Cost of Competence, authors Brett Silverstein and Deborah Perlick argue that rather than simply labeling individual women as, say, anorexic or depressed, it is time to look harder at the widespread prejudices within our society and child-rearing practices that lead thousands of young women to equate thinness with competence and success, and femininity with failure. They argue that continuing to treat depression, anxiety, anorexia and bulimia as separate disorders in young women can, in many cases, be a misguided approach since they are really part of a single syndrome. Furthermore, their fascinating research into the lives of forty prominent women from Elizabeth I to Eleanor Roosevelt show that these symptoms have been disrupting the lives of bright, ambitious women not for decades, but for centuries. Drawing on all the latest findings, rare historical research, cross-cultural comparisons, and their own study of over 2,000 contemporary women attending high schools and colleges, the authors present powerful new evidence to support the existence of a syndrome they call anxious somatic depression. Their investigation shows that the first symptoms usually surface in adolescence, most often in young women who aspire to excel academically and professionally. Many of the affected women grew up feeling that their parents valued sons over daughters. They identified intellectually with their successful fathers, not with their traditional homemaker mothers. Disordered eating is one way of rejecting the feminine bodies they perceive as barriers to achievement and recognition. Silverstein and Perlick uncover medical descriptions matching their diagnosis in Hippocratic texts from the fourth century B.C., in anthropological studies of Africa, Asia, and Latin America, and in case studies of many noted psychologists and psychiatrists, including the ""hysteric"" patients Freud used to develop his theories on psychoanalysis. They have also discovered that statistics on disordered eating, depression, and a host of other symptoms soared in eras in which women's opportunities grew--particularly the 1920s, when record numbers of women entered college and the workforce, the boyish silhouette of the flapper became the feminine ideal, and anorexia became epidemic, and again from the 1970s to the present day. The authors show that identifying this devastating syndrome is a first step toward its prevention and cure. The Cost of Competence presents an urgent message to parents, educators, policymakers, and the medical community on the crucial importance of providing young women with equal opportunity, and equal respect.

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9780195069860

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Reviews

The use of historical figures--actresses, scientists, authors, activists, and world leaders--lends an interesting aura to this reevaluation of the reasons behind anxious somatic depression, anorexia, and overeating. --Booklist By explicitly linking a pattern of symptoms to the social position of young women, they argue powerfully for a cure at the level of society rather than at the individual or family levels --Women's Review of Books

A dull examination of the idea that a certain set of symptoms commonly afflicts ambitious, talented young women growing up in societies that value males over females. Authors Silverstein (Psychology/CCNY; Fed Up, not reviewed) and Perlick (Psychology/Cornell Medical College) assert that they find evidence of this syndrome - which they dub anxious somatic depression - in medical writings going back to the fourth century B.C.; in recent writings of anthropologists, psychologists, and psychiatrists; and in the biographies, correspondence, and diaries of some 40 prominent women (e.g., Queen Elizabeth I, Charlotte Bronte, Indira Gandhi). In addition, they distributed questionnaires and psychological tests to some 2,000 young women whose responses confirmed their findings. They cite evidence that women seeking to achieve in areas traditionally reserved for men pay a heavy price: depression, anxiety, disordered eating, headaches, and other somatic and psychological symptoms. These first appear in adolescent girls who chafe under the societal limits placed on them as females and who are ambivalent toward their femininity, especially those growing up in a period of great change in women's roles and those with traditional mothers. In other times, the disorder was recognized as hysteria or neurasthenia, but today, the authors assert, it frequently goes undetected by physicians and therapists. Silverstein and Perlick's aim is to make the syndrome known so that it will be recognized and treated. Preventing it, they note, would require changing society so that women's ambitions are given equal opportunity and their roles equal respect. Although the authors have consigned some of their research data and discussions of methodology to appendixes in an attempt to make their writing accessible to the general reader, the effort largely fails. Professional colleagues may persevere, but the stilted, redundant prose may well discourage those less dedicated. (Kirkus Reviews)

The use of historical figures--actresses, scientists, authors, activists, and world leaders--lends an interesting aura to this reevaluation of the reasons behind anxious somatic depression, anorexia, and overeating. --Booklist By explicitly linking a pattern of symptoms to the social position of young women, they argue powerfully for a cure at the level of society rather than at the individual or family levels --Women's Review of Books The use of historical figures--actresses, scientists, authors, activists, and world leaders--lends an interesting aura to this reevaluation of the reasons behind anxious somatic depression, anorexia, and overeating. --Booklist By explicitly linking a pattern of symptoms to the social position of young women, they argue powerfully for a cure at the level of society rather than at the individual or family levels --Women's Review of Books The use of historical figures--actresses, scientists, authors, activists, and world leaders--lends an interesting aura to this reevaluation of the reasons behind anxious somatic depression, anorexia, and overeating. --Booklist By explicitly linking a pattern of symptoms to the social position of young women, they argue powerfully for a cure at the level of society rather than at the individual or family levels --Women's Review of Books The use of historical figures--actresses, scientists, authors, activists, and world leaders--lends an interesting aura to this reevaluation of the reasons behind anxious somatic depression, anorexia, and overeating. --Booklist By explicitly linking a pattern of symptoms to the social position of young women, they argue powerfully for a cure at the level of society rather than at the individual or family levels --Women's Review of Books The use of historical figures--actresses, scientists, authors, activists, and world leaders--lends an interesting aura to this reevaluation of the reasons behind anxious somatic depression, anorexia, and overeating. --Booklist By explicitly linking a pattern of symptoms to the social position of young women, they argue powerfully for a cure at the level of society rather than at the individual or family levels --Women's Review of Books

The use of historical figures--actresses, scientists, authors, activists, and world leaders--lends an interesting aura to this reevaluation of the reasons behind anxious somatic depression, anorexia, and overeating. --Booklist<br> By explicitly linking a pattern of symptoms to the social position of young women, they argue powerfully for a cure at the level of society rather than at the individual or family levels --Women's Review of Books<br>

<br> The use of historical figures--actresses, scientists, authors, activists, and world leaders--lends an interesting aura to this reevaluation of the reasons behind anxious somatic depression, anorexia, and overeating. --Booklist<p><br> By explicitly linking a pattern of symptoms to the social position of young women, they argue powerfully for a cure at the level of society rather than at the individual or family levels --Women's Review of Books<p><br>

Author Information

Brett Silverstein is Associate Professor, Department of Psychology, City College of New York, and the author of Fed Up. Deborah Perlick is Associate Professor of Clinical Psychology, Department of Psychiatry, Cornell University Medical College.

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