Boys and Their Muscles: The Paternal Object in Muscle Dysmorphia

ABSTRACT

This article elaborates the psychodynamics of the paternal object for a subset of patients with muscle dysmorphia. In many cases, there is father-child object relation in which the father maintains his own narcissistic equilibrium by keeping his son small, vulnerable, and weak. Whereas in optimal development the paternal function facilitates the young boy’s separation and individuation, it instead threatens the child with the possibility of remaining forever lost in the archaic mother-child matrix of helplessness and dependency. Faced with this, the child discovers the possibility of idealizing a particular form of masculinity characterized by “bigness” and impermeability that the paternal function comes to represent. The developing boy, his mind’s ability to represent and symbolize the affects evoked by this traumatic theme compromised, takes muscularity as a symbolic equation for masculinity and engages in a frantic drive for muscularity to keep experiences of weakness, vulnerability, and shame, associated with femininity, at bay. These dynamics are illustrated with a clinical case.

KEYWORDS:

• Muscle dysmorphia
• eating disorders
• male development
• body image
• paternal function

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. In contrast to other eating disorders, relatively little is known about those afflicted with muscle dysmorphia. In a review of the literature, those afflicted were largely male (87.5%), ranging in age from 15 years to 32 years and with an average onset of 18.67 years. Where sexual orientation was noted, 80% were heterosexual and 20% were homosexual (Tod, Edwards, and Cranswick 2016). This is more-or-less consistent with the demographics encountered in the author’s clinical practice.

2. Mahler’s original formulation of a normal symbiotic phase has been subjected to important critique and elaborated in ways that respond to that critique (Pine 2004). Given this, I wish to emphasize that the term symbiosis anxiety in my usage points to a fear of returning to a relative symbiosis/merger, not an absolute loss of experience of self-other differentiation (ibid). I have decided to retain the term because I feel that it points toward a special experience of self-with-other that the infant has in this early developmental period that has resonances throughout later development and that plays an important role in organizing the struggles of patients with muscle dysmorphia, as described in this paper.

3. Research suggests a positive correlation between prior experience of homophobic bullying and muscle dysmorphia (Fabris et al. 2020a). Although further research is needed, emerging evidence suggests that muscle dysmorphia may be prevalent among men who have sex with men (Fabris et al. 2020b). These men may attempt to present themselves as “masculine” – and to develop their musculature – in an effort to mitigate the discrimination they have suffered from belonging to a marginalized group (Badenes-Ribera, Fabris, and Longobardi 2018) and from being subjected to homophobic bullying in their school years (Varjas et al. 2008).

4. I understand masculinity to be a construction involving constellations of object relations and sociocultural forces, with hegemonic masculinity (Connell 1995/2005) representing one end of this continuum constituted by highly constricted gender norms that rely upon rigid dichotomies between male and female, strong and weak, reason and feeling as mechanisms to gain and maintain power. My thesis is that a particular form of masculinity, shaped by a father-child object relation in which the father maintains his own narcissistic equilibrium by keeping his son small, vulnerable, and weak, may be implicated in some instances of muscle dysmorphia.

5. Here, I understand Manninen (1996) to be referring to castration in its broadest sense, encompassing early, bodily-based anxieties about genital injury as well as experiences of diminution – of not “measuring up” – more generally.

6. Debate about muscle dysmorphia’s nosology is ongoing. Some suggest muscle dysmorphia's strong conceptual similarity to anorexia nervosa, highlighting its obsessive compulsive features, and argue for reanalysis through the lens of an eating disorder spectrum to more fully encompasses the male experience of disturbances in eating, shape, and weight (Murray et al. 2010). In this vein, people with muscle dysmorphia share more disturbances in eating and compulsive exercise features with people who have eating disorders than with asymptomatic gym users.

7. Empirical research suggests that gender role endorsement may be a central factor in determining whether males with body image concerns strive toward excessive thinness, as in anorexia nervosa, or toward muscular development, as in muscle dysmorphia (Murray and Touyz 2012). In fact, gender role endorsement appears to be more important than sexual orientation (Lakkis, Ricciardelli, and Williams 1999; Meyer, Blissett, and Oldfield 2001) and may be more important in boys than in girls (Thomas, Ricciardelli, and Williams 2000). Both heterosexual and gay men who report lower masculine and higher feminine gender identification are more prone to seeking excessive thinness (Hospers and Jansen 2005; Meyer, Blissett, and Oldfield 2001).

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Tom Wooldridge

Tom Wooldridge, PsyD, ABPP, FIPA, CEDS-S is a psychoanalyst and board-certified psychologist, an Associate Professor at Golden Gate University, and Faculty at the Psychoanalytic Institute of Northern California. He has published numerous articles on eating disorders, masculinity, technology, and psychoanalytic treatment as well as three books, also on these topics. He is in private practice in Berkeley, CA.