CW: disordered eating, anorexia

On March 27, 1942, lying in bed in her childhood home, devout Catholic Alexandrina Maria da Costa stopped eating wordly foods. She would sustain herself on the Eucharist alone, and she would want for nothing else.

At 36 years old, Alexandrina was no stranger to such extreme forms of religious practice. She had slipped into self-mortification in the past, beating herself with small balls of wax tied to the end of a handkerchief, or braiding her hair into her bedframe before sharply pulling her head forward. Tormented from her teens by a spinal cord injury that caused immense pain before ultimately paralyzing her legs, she embraced suffering as an opportunity to emulate her beloved Jesus Christ. 

The decision to give up food could have been a mere addendum to her pious lifestyle, but those in the know would have seen it for what it was: Alexandrina wasn’t just fasting. Rather, she was following a roadmap to sainthood left to her by late medieval greats such as Catherine of Siena—the patron saint of Italy who experienced stigmata, corresponded with popes, and reportedly fasted for seven years without interruption.

“Just like hunger strikes can be effective forms of political protest, periods of fasting could be effective forms of self-expression, in that they allowed women to claim (or reclaim) their agency.”

The Late Medieval Period is rich in narratives of abstinence. Wealth, power, society, sexuality, food—anything could be cast aside in the quest for a more Christian life. Women in particular tended toward rigorous fasting. Historian Caroline Walker Bynum, author of Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women, offers an empathetic explanation for this behavior: women gave up food because they had nothing else. As the daily lives of late medieval women were conditioned by a patriarchal worldview that afforded them precious few avenues for self-expression, so too were their religious and spiritual lives. How could women make a venerable show of abandoning the world and retreating to a cave to be alone with their thoughts when society was primed to value only their competence as wives, mothers, and administrators of the home? How could women renounce political power or material wealth, having so little of either? As Bynum so succinctly puts it, “Human beings can renounce, or deny themselves, only that which they control.” 

Inextricably linked to the preparation of food, women could use their food-related behaviors as a way to control not only their bodies but also their circumstances. Just like hunger strikes can be effective forms of political protest, periods of fasting could be effective forms of self-expression, in that they allowed women to claim (or reclaim) their agency.

This phenomenon has come to be known as anorexia mirabilis, or holy anorexia. The semantic similarity to anorexia nervosa, a rather modern eating disorder, is no coincidence. “The modifier is key,” writes historian Rudolph M. Bell, author of Holy Anorexia. “Whether anorexia is holy or nervous depends on the culture in which a young woman strives to gain control of her life.” The observable behavior may be the same—as a woman voluntarily abstains from food in pursuit of a culturally approved ideal, be it spiritual fulfillment or physical perfection—but its context is not. While present-day anorexia nervosa is evaluated from a clinical standpoint with an eye toward treatment, anorexia mirabilis was seen as a perfectly acceptable form of Christian asceticism.

Anorexia mirabilis proved to be an immensely influential model of female holiness until the 17th century, when it was gradually replaced by a more charitable, less bodily form of sainthood. According to Bell, by the 18th century, compulsive fasting could still be found as a central aspect of the holy reputation of 42 percent of female saints. By the 19th century, however, that figure dropped to 9 percent, and continued to fall to 6 percent by the 20th century. Women exhibiting the same patterns of extreme fasting as late medieval saints were now seen as bizarre “fasting girls,” while medical science and Catholic theology conspired to figure out whether the seemingly supernatural ability to survive without food could ever come about naturally. For women vying for sainthood through self-denial, the path appeared more treacherous than ever. Yet some, like Alexandrina Maria da Costa, chose to take it anyway.

Born illegitimate in 1905, in the small northern Portuguese village of Balasar, Alexandrina led a nondescript childhood until a leap from her house’s second-story window at age 14 changed the course of her life. The episode is described in her autobiography, dictated to a local school teacher in 1940: she was sewing with friends when three men broke in, one of whom was a former employer she had dubbed “the executioner.” Boldly, she jumped out the window, hoping to circle back around the house and attack the intruders from the back. Instead, she fell badly. Months later, she could no longer work the fields to help support her extremely poor family; by 19, she could no longer walk. She took to bed, and her focus turned sharply inward. Alexandrina describes the shift best: “[W]ith the loss of physical strength, I left all the distractions of the world, and with the love I had for prayer—because I only felt good praying—I got used to living in intimate union with Our Lord.” 

She’d always been appropriately religious, but now she held long, deliberate conversations with Jesus. She had visions, as befitted a Christian mystic in the making. She experienced possessions and ecstasies. In these experiences, according to historian Tiago Pires Marques, she followed the lead of many of the female saints who preceded her, in that her religious personality began to take shape as she came to terms with the incurable nature of her illness.

By 1930, she’d committed her new direction to paper: “May the blessings come upon me and I will have nothing to fear. I will be a saint: these are my most ardent desires.” Soon after, she accepted Father Mariano Pinho as her spiritual director, and her resemblance to the holy women of old, who had so greatly relied on the political prowess of their confessors and biographers, continued to grow. It was Father Pinho who urged her to dictate her memories, and it was through his influence that she was able to write to Pope Pius XII on the subject of the Consecration of the world to the Immaculate Heart of Mary.

When the Vatican sent a priest to speak to Alexandrina about her bold request, which essentially involved formally entrusting the world to the care of the Virgin Mary, she claimed to be a mere messenger of Jesus, unworthy of such attention. Yet it’s easy to imagine how she may have felt triumphant: the girl who could no longer go to church now received the Holy See at her bedside. The quintessential female saint is full of contradictions, according to the profile drawn by Bell: “[S]he is an utterly worthless and debased servant of God. Nonetheless, possessed of supernatural grace, she is perfectly willing to tell popes and kings what to do and how to do it.” What else was there for Alexandrina to take on?

Anorexia mirabilis, of course.

On March 27, 1942, Alexandrina stopped eating anything but the Eucharist, which she took every morning. Her second spiritual director, Father Humberto Pasquale, wrote that from that Friday onwards, “if Alexandrina tried to ingest anything [...] she would vomit with horrible pain.” Doctors soon pounced on her case, asking why she didn’t eat. “I don't eat because I can't,” she replied. “I feel full, I don't need to eat, but I miss the food.” Like Catherine of Siena had done in the 14th century, Alexandrina ascribed her inability to eat to a physical and therefore immutable inability, rather than a choice.

Thirteen months into her fast, Alexandrina experienced the full brunt of the medical scrutiny the 20th century had in store for “fasting girls”: she was committed to a hospital for 40 days of round-the-clock observation. Terrified, but confident that her piety would see her through, she mentally re-framed the clinical trial as a spiritual one. Her autobiography describes unsympathetic doctors, downright malicious nurses, and endless examinations where her body was handled, poked, and prodded, much as Christ’s had been prior to the crucifixion. “They undressed Jesus, too,” she writes, leaning into the comparison because, like Christ, she would emerge victorious—or at the very least, vindicated.

Here was a fasting woman whose mystical experiences were supported by the Church and not explicitly contradicted by the medical establishment: what else could she be, if not a saint?

Physicians and psychiatrists penned multiple multiple reports about her stay, all of which agree on one point: the 36-year-old patient from Balasar known as Alexandrina Costa did not eat for 30 days. Medicine, which could so easily have halted Alexandrina on her path to sainthood, unwittingly contributed to validate her reputation. The consequences were nearly instantaneous. Northwestern Portugal, with its wide range of “death cults” that juxtapose physical and spiritual death, was fertile ground for the adoration of people like Alexandrina. Here was a fasting woman whose mystical experiences were supported by the Church and not explicitly contradicted by the medical establishment: what else could she be, if not a saint?

When Alexandrina left the hospital, she was met by hundreds of believers. Judging by her autobiography, the internment feels like a culmination of a quest for public recognition. She never returned to her extreme old habits, but she reportedly maintained her fast until her dying day in 1955. Father Pinho, Alexandrina’s first spiritual director who would soon become the main champion for her beatification and canonization, rushed to compare her feat to those achieved by Saints Angela of Foligno and Catherine of Siena. His protegée, he thought, could very well join the sisterhood.

Alexandrina led a life so far removed from the world of medieval holiness that it would be irresponsible to directly juxtapose her path with those of late medieval greats, who not only practiced anorexia mirabilis, but defined it as a recognizable, emulatable pattern of behavior. A holy hopeful living in 20th century Portugal, Alexandrina’s remarkability lies not in the strenuity of her self-denial, but in the diligent way she adapted the path, and adapted to the path of female sainthood. Even wholly out of context, she was able to practice her faith in a way that gave her greater agency over not only her body but also her circumstances. She couldn’t overcome her illegitimate birth, but she could find social status in her spiritual authority. She couldn’t cure her illness, but she could reframe it as an enviable opportunity to live, in her words, “in intimate union with Our Lord.” She couldn’t go to church, but she could make the Holy See come to her.

In the end, it seems her efforts paid off: Alexandrina was declared blessed by Pope John Paul II on April 25, 2004. 

Further Reading

 Rudolph M. Bell, Holy Anorexia (Chicago: University of Chicago Press, 1987).

 Caroline Walker Bynum, Holy Feast and Holy Fast: The Religious Significance of Food to Medieval Women (Berkeley: University of California Press, 1987).

Image credit: Painting of The Ecstacy of Saint Catherine of Siena, ca 1530-1535 (Wikimedia Commons | Public Domain)