REVIEWS

Elizabeth A. Wilson
Gut Feminism
Durham, N.C.: Duke University Press, 2015 (ISBN 978-0822359708)
Reviewed by Suze G. Berkhout and Ada Jaarsma, 2016
Narrated by Zoe Belinsky

Elizabeth A. Wilson's latest monograph, Gut Feminism, is a captivating study that crosses numerous disciplines in order to press the boundaries of both feminist theory and biology. Gut Feminism brings together feminist politics, mood disorders, pharmacology, psychoanalysis, and a deep understanding of biochemical and physiological data. Split into two parts, titled "Feminist Theory" and "Antidepressants," the book builds a case for utilizing biological data for feminist theoretical gain. This case is especially productive because it is framed by Wilson's own diagnosis of the treatment of biology in feminist theory, in which she points to a certain Foucauldian "repressive hypothesis" at the heart of antibiological tendencies in feminist theory. Antibiologism, she argues, is predicated on a juridical notion of biology, precisely as Foucault's account of the repressive hypothesis suggests; it upholds a conventional view of the organic as controlling, domineering, authoritative, magisterial. According to this feminist repressive hypothesis, one is either for or against biology; biology is either taken up with credulity or is seen as being in need of overthrowing (34-35). In contrast to such prevailing tendencies within feminist theory, Wilson wants her reader to appreciate how one might rigorously engage with biological data in order to attend to the entanglement of mind, body, and world.

Issues of method are close at hand from the first pages of the introduction, which cues readers to the ways in which Wilson will engage with biological data in the rest of the book. Citing "abdominal migraine" as an example, she reorients us to the dynamism of the peripheral body (the gut, in particular) by mobilizing biochemical, pharmacological, and clinical data. This sets up the subsequent chapters, which utilize the periphery to explore depressive symptomatology and treatment, along with hostility and aggression.

In chapter 1, "Underbelly," Wilson combines deft readings of canonical feminist texts with an incisive critique of current trends in feminist theory. She advances her call to resist and undo the commitment of feminist theory to hold biology at a distance, critically as well as politically (23), by tracing the antibiological gestures in Gayle Rubin's "The Traffic in Women" and "Thinking Sex," among other influential texts. Arguing that the repressive hypothesis of feminist theory and its concomitant juridical view of biology is one side of a problematic coin, Wilson demonstrates that the flip side is an equally vexed entrancement with biology--an overly interested, noncritical appropriation of neuroscience in particular. (Wilson points to Catherine Malabou as one example of this investment by feminists in the promise and prowess of neuroscience.) Regardless of whether the value of biology is discounted or inflated, there is a polarization between feminism and biological matter, and Wilson offers a different way forward: "perhaps we can move away from a politics primarily informed by the rhetoric of domination (biology!) and rebellion (culture!) and look for theories that exploit the logic of imbrication" (37-38).

Chapter 2, "The Biological Unconscious," takes up the notion embedded in the juridical understanding of biology: namely, that biology--and anatomy in particular--is immutable and determined. Engaging the work of Sandor Ferenczi as well as contemporary views of bulimia, Wilson argues for a view of anatomy that is malleable, heterogeneous, and unpredictable in ways that are theoretically resonant with the commitments of feminist thinkers. In doing so, she breaks down ontological distinctions between psyche and soma, traditionally employed in what she calls a "flat" biological economy (64). This is useful work for those interested in engaging with a nonreductive understanding of the organic, one that is more dynamic than determined, and moves away from a conventional mechanistic, causal narrative of biology.

Chapter 3, "Bitter Melancholy," opens up the role of hostility and aggression in feminist politics. Interesting as it is, Wilson's analysis in this chapter reads as a somewhat provisional line of inquiry, in contrast to the careful positioning and attention she pays in other chapters to both theory and data. As a result, the attempt to relate aggression in melancholic states with biological processes and with feminist theory feels disconnected from the earlier groundwork she lays down. That said, there is a compelling parallel between the claim that feminism ought to engage more fully with its own hostilities and Wilson's methodological resolve to remain anticonsilient with the material she engages with. In both instances, reconciliation or amelioration is not the goal. Likewise, the broader point that fantasy and physiology are "coeval" (77) is key for Wilson's study and for broader feminist reflections on the biosocial nature of life itself. This chapter offers the beginnings of an account of feminist politics that affirms, perhaps even solicits, relations to hostility; we wonder, however, what such an account ultimately translates into, pragmatically as well as philosophically.

In contrast, "Chemical Transference" (chapter 4), offers fully realized and novel insights for both biology and feminist theory. Here, Wilson dives into the pharmacokinetics of SSRIs in order to undermine conventional understandings of depressive symptomatology and the relief thereof. Her analysis complicates the material geography of symptom and treatment, demonstrating the relationality of "pill and gut and synapse" (112). On this reading, SSRIs are subject to transference; it is through this transference that inside/outside, central/peripheral, organism/environment are entangled. Such entanglement produces the very distinctions themselves. Wilson offers a compelling explication of entanglement through the concept of transference. This formulation provides crucial insights to feminist work on embodiment, subjectivity, and relationality, as well as work that engages with the organic realm. It moves beyond pro/anti-drug debates and rote claims about Big Pharma to give a biosocial foundation and intersubjective framing to depression and its treatment.

Chapter 5, "The Bastard Placebo," continues the enlivening analytical work of the preceding chapter and again demonstrates Wilson's deft handling of a range of data and theory. This chapter speaks to feminist-materialist and science studies as it follows the traffic of placebo and drug effects, ultimately arguing for the adulterated ("bastard") nature of pharmaceutical treatments. Although she does not explicitly engage with disability or crip studies, Wilson's work here resonates with those who would critique a metaphysics of purity, as well as the "curative imaginary" of biomedicine (Kafer 2013). This holds especially true as we move to chapter 6, "The Pharmakology of Depression." Here, Wilson develops the insight that what harms cannot be separated so cleanly from what heals. Mobilizing data surrounding SSRI black-box warnings of suicidal ideation in pediatric populations, she understands this phenomenon as a demonstration of the traffic between self, others, and world (156). This insight is a launching point for her argument that the data reveal how drugs, mood, and rating scales interact with one another in a nonlinear, causal fashion (159). This final chapter is also able to make inroads into theorizing hostility and harms in feminism that earlier chapters don't quite achieve. "Remedies," Wilson explains, "are always breached by their capacity to injure" (146). These harms are physiological, social, and importantly, political.

Gut Feminism is a timely and inventive project that extends the traditional scope and methods of feminist theorizing. We are especially compelled by the conceptualization of antidepressant pills working through biochemical relationality (113) and dispersed across a network of "psycho-genetic-institutional-pharmacological action" (138); these are valuable conceptual insights for feminist theorists working with biological data. Moreover, these claims, along with the work Wilson does to "muddle" distinctions between poison and cure (161), have particular resonances with disability studies and crip theory. However, as we note above, we're struck by the lack of references in the monograph to disability studies, an absence that limits the political terrain Wilson is able to engage with. Readers who are interested in extending this aspect of Wilson's work might find productive tensions reading Gut Feminism against works by Alison Kafer, Kim Q. Hall, Rosemarie Garland-Thomson, or the anthology Against Health, edited by Jonathan Metzl and Anna Kirkland (Metzl and Kirkland 2010; Garland-Thomson 2011; Kafer 2013; Hall 2014).

Despite Wilson's enlistment of placebo in her theorizing, we did not find any engagement with the concept of nocebo, the adverse effects that arise from supposedly "inert" substances. This is puzzling, given that Wilson's analysis of placebo is systematic and thorough, and her emphasis on psyche-soma mutuality (140) and the adulterated nature of medication responses lead directly into a discussion of the interrelatedness of remedy, harm/poison, and cure. Grappling with the relationship between placebo and nocebo would be a welcome addition to Wilson's theorizing in the final two chapters of the work and would further the burgeoning field of placebo/nocebo studies, which tend to lack critical or theoretical underpinnings. Our own research interests in placebo/nocebo lead us to wonder whether attention to nocebo studies in particular could provide further traction for Wilson's linking of hostility and feminist theory.

As Wilson describes at the outset, the questions and issues that motivated Gut Feminism have circulated (albeit in somewhat different forms) through some of her earlier works. What she offers here is a robust exploration of three notable themes: the role of the peripheral body in minded states; the relationship between feminism and biological data; and the mobilization of depressive phenomena in conceptualizing the place of aggression in feminist theory. Overall, Wilson's project is fast-paced and far-reaching, engaging with an impressive breadth of data, theory, and argumentation, not, as Wilson identifies, as an attempt to bring consilience to the issues she touches on, but as a way to trace entanglements and ruptures within neuroscience and critical inquiry.

References

Garland-Thomson, Rosemarie. 2011. Misfits: A feminist materialist disability concept. Hypatia 26 (3): 591-609.

Hall, Kim Q. 2014. Toward a queer crip feminist politics of food. philoSOPHIA 4 (2): 177-96.

Kafer, Alison. 2013. Feminist queer crip. Bloomington: Indiana University Press.

Metzl, Jonathan, and Anna Kirkland, eds. 2010. Against health: How health became the new morality. New York: New York University Press.

Suze G. Berkhout is a psychiatry resident at the University of Toronto, where she is a member of the Clinician Scientist Program. She completed a combined MD/PhD at the University of British Columbia, and works in the areas of feminist methodologies, contemporary feminist philosophy, and philosophy of science/STS. Her current projects include a feminist interrogation of placebo effects and placebo studies (with Ada Jaarsma, www.feministplacebos.com) as well as a critical ontology of first episode psychosis.

Ada S. Jaarsma is an associate professor of philosophy at Mount Royal University in Calgary, Alberta, where she works in continental philosophy, feminist philosophy, and critical theory.  Her current research reflects on the existential significance of recent evolutionary theory, particularly epigenetics, mobilizing Kierkegaard's existential texts (and interpretations of Kierkegaard by Habermas, Arendt, and Derrida) in order to explore the critical, queer, disability, and post-secular implications of evolutionary thought and science studies.

"Arguing that the repressive hypothesis of feminist theory and its concomitant juridical view of biology is one side of a problematic coin, Wilson demonstrates that the flip side is an equally vexed entrancement with biology—an overly interested, noncritical appropriation of neuroscience in particular."