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Book Reviews:\nBody Image and Modification: New Problem or Ancient Preoccupation?   |    
The Adonis Complex: The Secret Crisis of Male Body Obsession ? Looking Good: Male Body Image in Modern America ? Making the Body Beautiful: A Cultural History of Aesthetic Surgery ? Body Modification
Stephanie A. Bryson, L.I.S.W.
Psychiatric Services 2003; doi: 10.1176/appi.ps.54.2.255
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by Harrison G. Pope, Jr., M.D., Katherine A. Phillips, M.D., and Roberto Olivardia, Ph.D.; New York, The Free Press, 2000, 286 pages, $25 • by Lynne Luciano; New York, Hill and Wang, 2001, 259 pages, $25 • by Sander L. Gilman; New Jersey, Princeton University Press, 1999, 396 pages, $29.95 • edited by Mike Featherstone; London, Sage Publications, 2000, 347 pages, $27.95

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In 2001, the vast majority (80 percent) of cosmetic surgeries were performed on women. However, approximately 136,000 men reshaped their noses, 48,663 underwent liposuction procedures, 44,726 tightened the skin on their eyelids, 27,817 tried hair transplantations, 18,548 had their breasts reduced, and 106,056 injected botulinim toxin into their foreheads to forestall wrinkling (1). Men who were polled in several recent studies expressed significant dissatisfaction with their bodies. They yearned, almost unanimously, for a more muscular physique.

These data raise several questions. Have men now succumbed to impossible beauty ideals like those long endured by women? Is feminism to blame? Is capitalism complicit? Are men becoming dangerously obsessed with their bodies? Are these preoccupations with how we look and how to change how we look really new, or do they belie ancient desires to gain social acceptance? The four books reviewed here analyze such corporeal concerns from divergent vantage points. Which analyses prove most compelling? We begin with the mental health professionals.

In The Adonis Complex, Harvard psychiatry professor Harrison G. Pope, Jr., Brown professor of psychiatry Katherine A. Philips, and Harvard clinical research fellow Roberto Olivardia document a "health crisis that is striking men of all ages." Named for the Greek god Adonis, whose body represented an exquisite standard of masculinity, the Adonis complex is a collection of male body image problems that can include compulsive weightlifting and exercising, steroid abuse, eating disorders, and full-blown body dysmorphic disorder. This book was written to expose a hidden syndrome that likely afflicts thousands of men and boys.

Interspersed with results from numerous studies—from the gyms of Boston to the alpine slopes of Austria—are stories of men such as Eke Kevin, a fit, 230-pound bodybuilder who won't go outside for fear he looks too small, and Vince, a massive high school senior who is currently on a "cycle" of "juice"—daily injections of steroid formulas including Equipoise, a product intended only for horses. "This problem," the authors explain, "is created by biological and psychological forces that combine with modern society's and the media's powerful and unrealistic messages emphasizing an ever-more muscular, ever-more fit, and often unattainable male body ideal."

Need evidence? Just look, as the authors do, at advertising, action toys, and centerfolds in the past 20 years. G.I. Joe's biceps are now the size of tree trunks, men's torsos are used to sell everything from cell phones to Kahlua, and since 1970, Playgirl centerfolds have lost 12 pounds of fat and gained 27 pounds of muscle. The authors believe that this trend has been spawned chiefly by two things: steroids and feminism.

To their credit, Pope, Phillips, and Olivardia maintain that some features of the Adonis complex are not entirely new. For example, muscle dysmorphia, the incendiary diagnostic category that first drew attention to these researchers, is best understood as a form of obsessive-compulsive disorder. Information about this diagnostic category will surely be useful to mental health professionals, as will accessible facts about steroids, normal muscularity thresholds for most men, and body image symptom questionnaires.

Disappointingly superficial, however, is the authors' analysis of feminism's complicity with male body image problems. For example, although Pope and his colleagues cite "the collapse of the workplace as an arena in which to test and prove masculinity," they simplistically credit "threatened masculinity" to women's greater "penetration" of the labor force, rather than to the transformation of the American economy from an industrial to a postindustrial economy—a shift that eliminated masses of blue collar jobs, threatened many men's ability to provide for their families without retraining in the sedentary occupations of the growing service economy, and emphasized in unprecedented ways the development of personality and image.

Also credibility sapping is a timeline counterposing "milestones of feminism" to examples of the growing "emphasis on the male body over the past forty years." Randomly selected events like the publication of Our Bodies, Ourselves in 1970, for example, are juxtaposed to the introduction of penile lengthening, said to have occurred in the same year. Lacking sufficient analytic or methodologic rigor in its sociocultural and historical analysis, The Adonis Complex falls short in presenting a grand etiological theory. However, mental health professionals will find the book an important, if at times sensationalist, reminder to attend to the hidden dimensions of men's body image concerns.

Lacking no sensationalism of her own, historian Lynne Luciano prefaces her first book, Looking Good: Male Body Image in America, with a tantalizing paragraph that foreshadows the tone and content of her treatise on male body image in the United States. "The book you are about to read is a journey through the world of male vanity. It is a world of steroid abusers and compulsive runners, anorectics and bulimics, men who are losing their hair and potency, and patients getting face-lifts, buttock lifts, and silicone implants—all in pursuit of youth, sex appeal, and success."

Premised on the notion that modern men have fallen into "the beauty trap so long assumed to be the special burden of women," Luciano offers a reading of male preoccupation with hair, physical fitness, cosmetic surgery, and sexual dysfunction since World War II. She begins with the gray-suited organization man of the 1950s whose exercise regimen consisted of lifting his martini glass several times before dinner and whose crew cut signaled conformity with the militaristic hierarchy of the bureaucratic corporation.

Charting the demise of a culture based on character and achievement to one based on personality and image, Luciano ends her analysis with the postmodern parvenu of the millennium. Here is a man who will risk his actual health for the appearance of health, which in this cultural moment is elusively conflated with the appearance of youth. Sparing no gruesome detail, Luciano describes the potential pain a man will endure—steroids, botched implant surgeries, extreme weight lifting—to have a chiseled physique, a commanding penis, or a full head of hair.

At times predictable and formulaic (obvious is the admitted reliance on Christopher Lasch and Naomi Wolf), Luciano's book is nonetheless evocative. It paints America's changing ideals of masculinity in broad, vivid strokes and, to its credit, includes the state and the economy in the portrait. While Luciano's generalist style of documentation left me wondering just how idiosyncratic her historical interpretations might be, I found her book a good read. I recommend it to mental health professionals.

Also idiosyncratic, but impressively erudite and convincingly argued, is Sander L. Gilman's sweeping cultural history of body modification, Making the Body Beautiful. Gilman, a professor of human biology, Germanic studies, comparative literature, and psychiatry at the University of Chicago, puts to rest any facile notion that body modification is a thing of this era, or, in fact, that anxiety about appearance is necessarily gendered at all.

Rather, Gilman reads the history of body modification through the discursive strategy of racialization. He demonstrates how people, throughout history and throughout the world, have modified their bodies to "pass," to signify that they belong to their era's prevailing social group. Using a fascinating array of archival sources—antisemitic tracts from Nazi Germany, diagrams of postsyphilis nose flap surgeries dating to the 15th century, sketches of Irish versus British "character" as revealed by women's noses—Gilman reveals how the body comes to embody transient, socially constructed features of desirability, inferiority, or power.

Wide-ranging in its comparative historical analysis, Making the Body Beautiful is enlivened by Gilman's academic acumen. It is a witty, well-told scholarly tale and a welcome antidote to superficial accounts of body dissatisfaction. Mental health professionals who have an interest in cultural history will enjoy Making the Body Beautiful.

Readers with a penchant for postmodernism are also likely to appreciate British sociologist Mike Featherstone's anthology, Body Modification. In articles on piercing, tattooing, body-altering performance art, and surgery to separate conjoined twins, the book's authors tussle over the cultural and philosophic implications of current trends. For instance, do these practices signify a return to tribalism in the dizzying wake of globalization—an attempt to resolve the "ontological insecurities" of late modernism by "deliberative self-identification?" Or are they merely transitory inscriptions of fickle social allegiance in consumerist societies, strategies for "adding cultural capital to the body's surface?"

If you're up for a provocative gambol in the subcultural world of body modification, written in the highly theoretical tongues of poststructural interpretation and cultural studies, this is the book for you. Attend an interview with French performance artist Orlan, who stages actual cosmetic surgeries, inviting her audiences to witness her gruesome, symbolic transformations. Or read about Stelarc, an Australian performance artist who essentially wired himself to the Internet, allowing hundreds of Web surfers to animate his movements via cyberspace.

Like many anthologies, Body Modification has some uneven writing and editing, but its message, like the messages of all the books reviewed here, is an important one. Culture and history are literally, as the phrase goes, "written on the body." In this technoscientific era, we will continue to see the collapse of all we once considered essentially human, starting—and perhaps ending—with the body.

Ms. Bryson is a doctoral candidate at the Heller School for Policy and Management and the department of sociology at Brandeis University in Waltham, Massachusetts. She is also an adjunct faculty member of the Smith College School for Social Work.

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