EATING PRACTICES OF PEOPLE IN PSYCHOLOGICAL DISTRESS: ANALYSIS BASED ON BOURDIEUABSTRACT
Adequate food and nutrition plays an important role in the health of people in psychological distress, as they are instruments to promote quality of life. Therefore, the objective of this study was to understand the constitution of eating practices of users of a Psychosocial Care Center II from the theoretical and methodological framework of Pierre Bourdieu. The selection of participants was carried out through the snowball technique, through key informants who helped in locating people with the necessary profile for the research. Data collection took place between 2018 and 2019 through a semi-structured interview. The analysis was based on the reconstruction of the agents' social trajectory and the factors that influence the practices, namely: habitus, capital and field. Taste and life needs are some of the issues that make up the habitus of users, who have a volume of capital that differs from professionals. Such facts make the dietary practices of users differ from the guidelines of professionals.
Keywords:
Pierre Bourdieu; food; mental health
RESUMO
A alimentação e a nutrição adequadas têm um papel importante na saúde das pessoas em sofrimento psíquico, por se constituírem como instrumentos de promoção de qualidade de vida. Logo, o objetivo deste estudo foi compreender a constituição das práticas alimentares de usuários/as de um Centro de Atenção Psicossocial II a partir do referencial teórico e metodológico de Pierre Bourdieu. A seleção dos participantes foi realizada através da técnica bola de neve, por meio de informantes-chave os/as quais auxiliaram na localização das pessoas com o perfil necessário para a pesquisa. A coleta de dados ocorreu entre 2018 e 2019 utilizando-se de entrevista semiestruturada. A análise deu-se a partir da reconstrução da trajetória social dos agentes e dos fatores que influenciam nas práticas, sendo eles: habitus, capital e campo. O gosto e as necessidades de vida são algumas questões que compõem o habitus dos usuários/as, os quais têm um volume de capital, que difere dos profissionais. Tais fatos fazem com que as práticas alimentares dos usuários/as difiram das orientações dos profissionais.
Palavras-chave:
Pierre Bourdieu; alimentação; saúde mental
RESUMEN
La alimentación y nutrición adecuadas juegan un papel importante en la salud de las personas con sufrimiento psíquico, ya que son instrumentos para promover la calidad de vida. Por lo tanto, el objetivo de este estudio fue comprender la constitución de las prácticas alimentarias de los usuarios de un Centro de Atención Psicosocial II a partir del marco teórico y metodológico de Pierre Bourdieu. La selección de los participantes se realizó mediante la técnica de bola de nieve, a través de informantes clave que ayudaron a localizar personas con el perfil necesario para la investigación. La recolección de datos ocurrió entre 2018 y 2019 a través de una entrevista semiestructurada. El análisis se basó en la reconstrucción de la trayectoria social de los agentes y los factores que influyen en las prácticas, a saber: habitus, capital y campo. El gusto y las necesidades de la vida son algunos de los temas que configuran el habitus de los usuarios, quienes cuentan con un volumen de capital diferente al de los profesionales. Tales hechos hacen que las prácticas dietéticas de los usuarios difieran de las pautas de los profesionales.
Palabras clave:
Pierre Bourdieu; alimentación; salud mental
Introduction
In Brazil, health and food are human rights and fundamental guarantees of citizenship. Therefore, the state must guarantee them through public policies. Food was only enshrined as a social right in the Brazilian Constitution in 2010. In 2006, the Organic Law on Food and Nutritional Security (LOSAN) was approved, and the National System for Food and Nutritional Security (SISAN) was established. The National Food and Nutrition Policy (PNAN) emphasizes the importance of food and nutritional care in the composition of health care (Jaime et al., 2018).
People suffering from psychic distress due to psychotropic drug treatment experience issues that influence their eating and nutritional habits. Based on the principles of Food and Nutritional Security (SAN) and the PNAN, food and nutrition programs must address access to and availability of food, as well as consumption and nutrient utilization by the body. Many medications used to treat mental health conditions interact with nutrients and can consequently cause changes in weight, taste, appetite, tremors, polydipsia, polyuria, a metallic taste, and dyspepsia. These factors can hinder the acquisition, preparation, and consumption of food (Brazil & Menezes, 2013; Branquinho et al., 2014; Bocardi et al., 2015; Ramos et al., 2020).
Promoting the health of people in psychic distress must involve adequate nutrition and food, which must be understood as determinants of health. This ensures that actions in this area are integrated with health initiatives, rather than being sporadic and separate (Brasil, 2013). Adopting this stance is paramount to understanding dietary guidelines and practices since individuals' practices are mediated by their economic and social conditions. A distinguishing mark, practices, even the most free and basic ones, such as those related to food, are linked to the positions of agents in social space and the field, habitus, the total volume of capital, and the specific capital of the field, and consequently, to different classes and class fractions (Bourdieu, 2017).
When analyzing the eating habits of service users, it is necessary to overcome the barriers of taste as a choice and of choice as a reality for those from working-class backgrounds. Furthermore, it is necessary to consider the extent to which psychic suffering influences these practices. The objective of this study was to understand the constitution of eating habits among service users at a Psychosocial Care Center II based on the theoretical and methodological framework of Pierre Bourdieu.
Method
This study employed a qualitative approach that focuses on representations, values, beliefs, attitudes, perceptions, and social processes and phenomena (Minayo, 2014).
Participants in the study were users of a Psychosocial Care Center II. Participants were selected through a process called snowball sampling, which began with key informants who helped locate people with the necessary profile for the research. These individuals were selected from an event related to health, food, and nutrition (consultation with a nutritionist, illness related to food or nutrition, happy moment, pleasure with food...), initiating the process called snowball sampling. Thus, from them, the indication of other participants began (Handcock & Gile, 2011; Vinuto, 2014).
The snowball sampling technique ended when the indicated subjects began to repeat themselves and indicate each other, meaning there were no new participants (Handcock & Gile, 2011; Vinuto, 2014). Thus, the study sample totaled 14 users.
Data were collected from June 2018 to June 2019 through semi-structured interviews with questions such as: Tell me about your health. Guiding topics for the researcher: how the user feels about their health; how they would like their health to be; what the user does to maintain or improve their health; tell me about your diet and nutrition. Guiding topics for the researcher: what guidance the user received on food and nutrition at the CAPS (Psychosocial Care Center) and UBS (Basic Health Unit); what is the meaning of food in the user’s life, health, and treatment; and what would change/improve in their diet. The interviews were recorded, with the participants’ consent, transcribed, and analyzed using Pierre Bourdieu’s theoretical and methodological framework, which allowed for the construction of the factors that compose the practices, namely: habitus, capital, and field, based on the reconstruction of the agents’ social trajectory and the sociogenesis of the fields.
This study adopted the concept of habitus as a key category for analysis. Habitus is a structuring and structured structure that generates practices structured by the social context that structures daily and future actions. Habitus is structured because it is not random or without a pattern (Bourdieu, 2017). Food and food practices are considered representations of a habitus, not a habit.
This study was part of a larger research project entitled: A Bourdieusian analysis of food and nutrition practices in a Psychosocial Care Center, approved by the Research Ethics Committee (CEP), under opinion No. 2,919,644. To maintain anonymity, plant and flower names are used.
Results and discussion
Of the 14 participants, 10 were women, and four were men. Their ages ranged from 37 to 64 years. Most were retired due to disability caused by mental illness or received government benefits. The majority had an incomplete primary education (up to the 5th grade). The women generally focused on household chores and self-care while attending the CAPS (Psychosocial Care Center). The participants’ social network revolved around their partner, often also a user of the mental health service, their children, and their mother. The users did not usually frequent the Basic Health Unit.
The eating practices of the user agents involved a series of factors, such as purchasing food items, organizing them, preparing them, and their taste. As observed in this study, Agent Violeta, like most of the other user agents, reported buying food in the form of a rancho: once a month, she purchases enough non-perishable food items to supply her family for that period.
Regarding her eating habits, Agent Rosa said:
[...] I’ve never been able to strictly follow the diet. Sometimes I manage to do it perfectly, but at other times, [...] when I have financial difficulties, I can’t. I eat whatever is available (Agent Rosa).
Suffering from type 2 diabetes, Agent Rosa stated, “[...] I can’t strictly follow a diabetic diet, I drink soda and eat sweets because I like them.”
Her memories of food took her back to her rural childhood, when she lived in an area far from the city. At that time, At that time, she ate rice and beans, and the meat and eggs were usually from home. The family had a vegetable garden and harvested cabbage and carrots: “[...] We just ate, we just rinsed off with water from the well and ate.” Rosa also mentioned that she was never much of a cook and was more involved in household hygiene.
Agent Papoula reported that she buys the staple food, which she can afford with a minimum wage, as part of her daily routine, such as rice, beans, pasta, vegetables, and fruits.
She said she doesn’t believe her mental disorder interferes with her eating habits, but she has stopped eating and has been hospitalized three times because “[...] she didn’t want to do anything [...] she didn’t do anything [...] she just cried and lay down.”
She lost a lot of weight during this time, and she says her husband told her that:
[...] When I was cooking, I would cry and scream, and he would take me out of the kitchen and finish preparing the food while I lay down. I remember that and tell him that this story must be a lie (Agent Papoula).
Agent Tulipa, in turn, reported experiencing a lot of hunger in her childhood. Regarding food, she says, “She doesn’t eat much,” and you have to “fight for her to eat”. Sometimes she doesn’t have lunch; she doesn’t feel the need to “think about food.” At this point in the interview, she said that this is exactly what she “sees her sisters do when she visits them” (what they will have for lunch, dinner, and breakfast). In her statement, she also said that if she goes to the supermarket, “it’s to buy rice and beans, the staple food.” She explained that she believes she “doesn’t have much interest in food because she didn’t eat much as a child, and as an adult, she sometimes only drinks water for days.”
Like Agent Tulipa, Agent Lírio recounted having experienced food shortages in her life; at the time of the interview, she said:
I’ve been drinking coffee, chimarrão, and eating boiled eggs. I’m eating a lot more since I quit smoking [...] I like salty food with Sazon seasoning. I know it’s unhealthy, but I use it when I’m in a hurry… I have a big appetite. I eat because I have to eat” (Agent Lírio).
She also said that: “She likes all kinds of food and tries what is offered to her.” Regarding her lack of money for food, she said, “Right now [at the time of the interview], I needed to have an ultrasound and buy medicine, but I was ‘strapped for money’.”
The technician (professional agent) responsible for her at the CAPS referred her to the Social Assistance Reference Center (CRAS) so that she could receive a food basket. In her account, she explained that:
[...] The cost of food is high; I pay for the house construction loan, in addition to water, electricity, and medicine. Sometimes there is nothing left, not even for gas; then I have to ask for credit at the bar; I don’t feel good about that (Agent Lírio).
Similar to Agent Lírio’s account, Agent Orquídea that she eats just to satisfy her hunger. She said that her daughter has a room in the city center where she provides massages, and sometimes she trades services for food. She said that some days there is no sugar, and on others, no coffee. She revealed that her life has had “ups and downs.” She went hungry as a child when food was scarce. She had a time of plenty when she was married, and now, at the time of the interview, she was experiencing food scarcity again.
When talking about his memories regarding food, Agent Antúrio also reported experiencing situations ranging from food scarcity to abundance. He said that bananas were counted, one for each family member, and that once, after selling one of his properties, he used part of the money to buy 2 kg of bananas just for himself. “[…] I wanted to eat bananas so badly,” he said. “Before, I could only eat them once a month.”
The experience of food deprivation and hunger has particular and subjective psychological meanings. Maria Carolina de Jesus’s classic book, Quarto de Despejo: Diário de uma Favelada (Room of Discarded Things: Diary of a Slum Dweller), is an autobiographical account that reveals her social perceptions as a poor Black woman in her daily struggle for survival and facing hunger. The symbolic imagery that is constructed becomes incorporated into the lives of those who have experienced scarcity. “A house without a light on the fire is so sad! Pots boiling on the fire also serve as adornment. They decorate a home” (Jesus, 2014, p. 106).
From an anthropological perspective, the taste of food is socially constructed, but its perception depends on available material conditions. A specific cultural manifestation may subtly express an adaptation, even if the group experiencing it does not perceive or understand it. This means that behaviors are often defined by the “advantages” that can be generated by the relationships and interests that permeate food choices (Harris, 2016; Rizzolo, 2021).
According to Bourdieu (2017), tastes have distinctive value, revealing different positions in social space and, consequently, in different fields. Tastes of all types unite and separate agents. They unify those who are of the same class and have been subjected to similar conditioning factors (products of the class) and distinguish these agents from all others. Thus, taste is understood
[...] taste is the principle of everything one has, people and things, and of everything one is for others, of that which serves as the basis for classifying oneself and by which one is classified (Bourdieu, 2017, p. 56).
Clearly, practices structure the social and economic organization, as well as the interpersonal relationships of agents or classes of agents. They also shape the symbolic space, which is defined by a set of such practices. These practices are “[...] distinct and distinctive lifestyles that are always objectively — and sometimes subjectively — defined in and by mutual relations” (Bourdieu, 2017, p. 97). Examining the interview excerpts reveals that they all share a class habitus, a unifying and generating principle of practices. The habitus is the embodied form of the conditions and conditioning factors that the class imposes on the agents. Social class influences social organization, practices, and relationships within a set of properties. Consequently, social class determines them. The effect attributed to social class indicates the value of the collective dimension rather than a single property (such as income) or the sum of properties (income, education, gender, etc.).
According to Bourdieu (2017), when shaping practices, one must consider the effect of inculcation exerted by family and social origin, which the author defines as the father’s position in social space, as well as the individual trajectory of the agent. In this context, studying the food practices of the user agents in this research reveals that they have similar volumes and structures of capital, as well as similar past trajectories. These factors constitute a class habitus — a food habitus of this class — in these agents, which is structured by hunger and food scarcity, as well as the acquisition of staple foods. In this context, food and eating are analyzed by the user agents through the lens of need.
This working-class eating habitus, together with the volume of capital these agents possess, has structured what constitutes their eating practices. In relation to the user agents Rosa, Tulipa, Papoula, and Orquídea, these practices entail “eating what is available,” “the basics,” “satisfying hunger”; that is, a “taste of necessity,” or rather, food consumption based on what is permitted by class and, to a large extent, by income, which is determined from childhood and shapes tastes accordingly. In contrast to the “taste of necessity,” expressed by adjustments to the needs of which it is a product, the “taste of luxury (or freedom)” is part of those who possess capital that allows them “conveniences,” “freedoms,” and distances them from what “is necessary,” as in the case of healthcare professionals (Bourdieu, 2017).
Therefore, users do not have a choice about which foods they consume. Similarly, they are not solely conditioned by economic factors. For example, they cannot eat healthier food simply because they cannot afford it. It is important to emphasize that users only “satisfy their needs” because they are inclined to act this way, since their taste for what, in a way, is already predetermined for them (Bourdieu, 2017).
In the expressions of users about their eating practices, one can observe the social world represented or the spaces of lifestyles, which were constructed by habitus, which is, at the same time, a generator and classifier of practices. It is through it, through the relationship of this dual capacity to produce practices and to differentiate and appreciate them, as well as their products (taste), that lifestyles are shaped (Bourdieu, 2017). “Taste is the practical operator of the transmutation of things into distinct and distinctive signs [...] It makes the differences inscribed in the physical order of bodies have access to the symbolic order of significant distinctions” (Bourdieu, 2017, p. 166).
Furthermore, the way people eat and the foods that make up their daily menus also reveal their deepest and oldest dispositions. The taste of food bears the mark of the most primitive aspects that have survived the test of time. These aspects bring to the surface what agents carry from their world of origin, primarily the maternal world, or their first foods and tastes (Bourdieu, 2017).
Cultural norms of classification and combination can constitute a true “grammar” because these rules bring foods together in a system, forming the cuisines or culinary systems of a people, just as grammatical rules order words to form sentences specific to each language and, thus, demarcate peoples, subjects, and give them a sense of identity and social belonging (Fischler, 1995). These sociocultural dimensions of food, combined with a subjective dimension, connect social groups with their own history and the dynamics of society in their time, in the same way that this act, which seemed so simple and repetitive to us, must be seen as a complex fact, an event that is neither exclusively biological nor entirely social, uniting the biological and the cultural in such an indissoluble way that it will be difficult to separate them (Aguirre, 2004).
Agent Azaleia revealed much about her childhood when discussing her eating habits. From a very young age, she had dietary restrictions due to nephritis and spent a long time eating almost no salt. She said she could not eat properly and reported her problem to her technician (professional agent) at the CAPS. This user agent takes seven medications in the morning and, according to her, cannot drink coffee or even eat a piece of bread. Speaking about the matter, she stated: “[...] I’m fat, I think it’s from the medication; 12 years ago I weighed 52kg.” She reported having little appetite since childhood and said “[...] I never ate junk food.” She also said she eats fruit, but “not all of it”; bananas, according to her account, “make her feel bad.” She said that if she eats a piece, “it feels like she ate 15kg and vomits.” She said that if she eats one, “it feels like she ate 15 kg and vomited.” She does not know why she lost her sense of taste and smell. She explained that she had spoken to the doctor at the CAPS about this, and the doctor reduced two of her medications.
Even in the face of this situation, she confirmed that she is the one who cooks at home and “doesn’t see herself as being hindered by these issues,” but said she believes that psychological issues interfere with food preparation, as she has burned food before and forgotten to turn off the stove. Today (at the time of the interview), she said she eats very little; she reported making chicken soup or vegetable soup and blending it. At night, she said she doesn’t have dinner and only eats a piece of fruit. She also said that there are foods she has not eaten since childhood; this is the case with rice, which she said is only prepared as whole grain because her husband “had heart surgery.” She also does not eat “red meat,” only “white meat.” Milk was another food she said she does not consume because, according to her, it gives her diarrhea.
Regarding food memories, Agent Lírio recalled her mother, the wood-burning stove, and sweet potatoes with milk. According to her, her mother would bake sweet potatoes on the wood-burning stove, and the children would scoop up the potatoes with a spoon, placing them in the milk, which was delivered in a bottle to their door. She said she also liked the toasted peanut farofa, which they ate while drinking. Antúrio, when talking about food, said that he “ate well” and sometimes he “eats a lot of bread,” but he stated that he “compensates” in “other things.” He also said that “his wife is in charge of food at home, and he just obeys.” Before getting married, he cooked a lot. Afterwards, he said, “it became his wife’s job,” but he added that he “helps with other household chores.”
As elucidated, food preferences recreate primitive bodily experiences. These experiences are intimately linked to the body, which, in turn, is constructed by the social world as a sexualized reality. There has been - and is - a historical and collective work of socialization of the biological and biologization of the social upon the biological appearances of the body, producing, in bodies and minds, a naturalized construction of genders and a division between the sexes, which is seen as normal, natural, and almost inevitable. This division by sex is objectified in things; for example, in the home, where the kitchen is considered “the woman’s place,” becoming incorporated into the bodies and habitus of the agents, structuring their thoughts and practices. Consequently, male domination is grounded and legitimized by the social order. This domination produces symbolic violence that is invisible to its victims since it is exercised through symbolic means of communication and feeling (Bourdieu, 2019).
The symbolic violence imposed by the sexual division of domestic labor is also present in food practices. In general, women are responsible for cooking, while their husbands assist. Men are usually recognized during special occasions, such as Sunday barbecues or preparing a different dish, in which they have a prominent role. This is not by imposition, but by choice and the reproduction of a patriarchal societal structure. A similar scenario can be seen in the image of internationally recognized chefs who head renowned restaurants. Bernardes et al. (2016), in their study on perceptions of health and food among men and women living in a vulnerable region, identified this “naturalization” of women’s work and the clear division of spaces and moments occupied by men and women concerning food.
Furthermore, the foods chosen for consumption are generally those preferred by the men in the household. This can be seen in the account of Agent Violeta, who said she enjoys cooking chicken pie, lasagna, and cake when she feels well; however, when she feels unwell (which she reported happens frequently), her husband is responsible for preparing the food. Regarding food preferences, she said she “doesn’t like vegetables” and “is selective about fruits”; on the other hand, she said she likes sweets, juices, and soda. She stated that she uses natural seasonings but also processed ones because “her husband likes them.”
Like the latter, agent Papoula brought up the topic of food preferences in the interview, stating that she “likes to eat and has fond memories of French fries, rice, and fried eggs because of their flavor.”
When analyzing the eating habits of these two user agents (Violeta and Papoula), some points are important to highlight. The foods they “like” to eat are associated with pleasure, flavor, and childhood memories. In light of this, it is necessary to understand that: “[...] taste, as the ‘faculty of judging aesthetic values in an immediate and intuitive way,’ is inseparable from taste in the sense of the ability to discern the specific flavors of foods, which implies a preference for some of them” (Bourdieu, 2017, p. 95, author’s emphasis).
Food taste is also influenced by the idea of “body” and the “consequences of food on the body” that each class holds. The working classes pay more attention to the physical strength (especially the male body) for work than to its shape; therefore, they tend to seek cheaper foods that meet this expectation. The bourgeois classes, on the other hand, will seek tasty foods that are “good for health” and “non-fattening”. Thus, it can be said that taste contributes to shaping the “class body”. This is because the body transforms something abstract or subjective into something objective or concrete, thus bringing class taste into reality. Beyond the issues and points raised so far about food practices, it is necessary to problematize the social uses of food and eating. That is, the way food is used and the purpose for which it is consumed, in other words, how it is perceived, appreciated, and used, transforming action into practice and objective utility into practical use (Bourdieu, 2017).
For women, the body is signified and perceived only when it is uncomfortable, or when, compared to the “standard,” it seems different; when it hurts; when the mirror points out an imperfection; and when society imposes and/or “demands” something. Pleasure is found in eating, but it is rarely recognized in the body. Eating and experiencing pleasure, as well as discovering sexuality in adolescence, can be taboo experiences or forms of internalizing affections, especially for women. The social control of the female body generates overlapping normative discourses. Diet books, recipe books, clinical nutrition manuals, and gastronomic guides disseminate prohibitions and prescriptions in the form of rules, supplements, consumption models, and warnings.
The working classes allow themselves to eat types of food - without formalities - that the bourgeois class does not admit in its social world. These users eat foods that health professionals consider fatty, unhealthy, and harmful. They engage in this dietary practice simply because they feel they cannot deprive themselves of the freedom food provides. For the rest of their lives, they will be subject to their needs. It is also possible to identify two distinct approaches to food, from the type of food to its consumption. Users prioritize substance (what is real in food) and nutrients, which provide energy and sustain the body; thus, favoring fattier and more substantial foods. Health professionals, on the other hand, prioritize form (such as body shape), which leads them to place substance in second place (Bourdieu, 2017).
The first group, the user agents that occupy popular classes, are linked to matter, substance, and reality. However, when referring to health professionals, who are a dominated fraction of the bourgeois class, with the symbolic, it is observed that some are concerned with “being” and others with “appearing”. The relationship that classes have with the body, therefore, is expressed in all practices in which the body is the object, such as in food practices. Thus, different dimensions of the social world/lifestyles can be perceived in food, commensality, and the body (Bourdieu, 2017).
Commensality is a concept that reveals, among other things, the social function of food, considering that the preparation and sharing of food can promote social interaction, strengthen bonds, express affections, and awaken sensations. However, it can also awaken tensions, ruptures, and conflicts, allowing the expression of symbolic aspects that mark subjectivities and cultural identities. It is in daily sharing that conflicts and emotions emerge and permeate social relations. Eating together is not always positive, and it can become a moment of tension or conflict, provoking or causing situations of violence, harassment, or disintegration (Carneiro, 2003; Poulain, 2004; Moreira, 2010).
In this sense, “[...] it becomes clear that taste in food matters cannot be completely separated from other dimensions of the relationship with the world, with others, and with one’s own body, in which the practical philosophy characteristic of each class is realized” (Bourdieu, 2017, p. 184). It is therefore necessary to grasp and understand all parts of the equation that Bourdieu proposes, which comprise the practices [(habitus + capital) field], to understand the food practices of the user agents. Understanding the dynamics of the fields in which food practices are shaped is essential to this study because it is at the intersection of food and health fields that user agents construct and develop their food practices.
From this theoretical perspective, it is necessary to state that, in the field of health, there is health capital, and, in the field of food, food capital. Both are objectified (e.g., medicine and health supplies/food that are commercialized), or incorporated (e.g., scientific knowledge about health/illness and nutrition/marketing), in the agents, and only exist, from a material and symbolic point of view, due to class struggle, in which, according to Bourdieu, the agents who possess this capital obtain advantages over other agents; thus, defining the legitimation of what is health/healthy and establishing a mark of distinction. It is the volume of specific capital that tends to organize the field. On one side, the wealthiest in capital, and, on the other, the less wealthy (dominant and dominated), further subdivided, within the field of the dominant class, between the dominant and dominated fractions (Bourdieu, 2017).
It is important to note that these fields share similar production and consumption structures that define “taste” and adjust products (medicine/food) to the expectations of the agents. Furthermore, there is an identification of what is produced and what will be consumed by the agent, according to its suitability to their position in the field, thus maintaining the distinction and differentiation between classes. The pursuit of distinction does not always intend to distinguish oneself; most of the time, it is a symbolic struggle motivated by the imposition of the (legitimate) lifestyle of the bourgeois/dominant class on the popular/dominated class. It is, therefore, a symbolic struggle over being and appearing (Bourdieu, 2017).
The idea that eating practices of the user agents are constituted at the intersection of health and food fields, and that user agents circulate through these fields rather than being fixed to one, increases the complexity of dietary guidelines. As previously mentioned, the eating practices of CAPS users were studied in the context of the health and food fields. However, it is evident that these practices are significantly influenced by other fields, including economic, bureaucratic, scientific, power, and state.
In the health field, the health habitus (previously structured) and health capital (biomedical knowledge, knowledge about the physical body, and about the mind), along with other capitals, influence the structuring of user agents’ practices according to the guidance of health professionals regarding how to maintain good health. Similarly, the structured dietary habitus in the field of food, in which food is the specific capital (with its symbolic role in distinction), structures dietary practices.
Finally, it becomes evident that health and nutrition guidelines and protocols are conceived and developed by agents from the scientific, political, and state fields, with a high total volume of capital. These guidelines must be incorporated into the habitus of the agents who receive them in order to transform their practices.
Final considerations
Because this is a qualitative study that used a theoretical framework focused on social issues, it is not a generalizable study, but it does generate clues and questions that broaden the perspective on studies about food, especially for people in psychic distress.
In order to understand the constitution of the eating practices of people in psychological distress, it is necessary to know the constitution of their habitus. Memories and tastes make up these practices; they are and exist in the bodies. Thus, the eating practices of user agents end up not aligning with the recommendations of professional agents, which are in line with health and nutrition guidelines and protocols (e.g., consuming fruits, vegetables, little salt and sugar, and lean meats). Despite sharing the same habitus in the fields of health and nutrition, their formation occurred differently because agents occupy different positions in the field and have different amounts of capital, social origins, and individual trajectories. These factors determine the placement of agents in opposing classes, just as habitus is structured.
Therefore, more than guides and protocols are needed to guide the diet of CAPS users. People’s life trajectories, stories, preferences, and needs influence what they eat and how they eat.
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After publication, the data will be available to the authors upon request.
