So I was reading a fascinating book by Ethan Watters, Crazy Like Us, which deals with the issue of how American and Wester views on mental disorders in general have grown to influence instances of mental illness elsewhere. That is to say, that places in other parts of the world are slowly yet surely succumbing to the Western idea of what a mental illness is like – for example, conforming it to the DSM standards and symptoms.
The first chapter of the book deals with anorexia nervosa in particular, speaking of the disease in the context of Hong Kong. The author draws on research done by Dr. Sing Lee on so-called atypical anorexics – those that don’t fit the Western mold. A couple of fascinating cases presented in the chapter prove that anorexia symptoms can and do vary from what we tend to think of as the standard: for example, these atypical anorexics claim they have no fear of being fat and do in fact want to gain wait. They attribute their illness to somatic symptoms – particularly, fullness in their stomachs and food not going down their throat for unknown reasons.
However, the book presents the case that while those instances had happened, since anorexia became a focus of media attention in Hong Kong and more Western scientists had offered commentary on it, the symptoms and perceived reasons for the development of the disorder have shifted as well – shifted closer to the Western standard: girls reported more fear of fat, more dieting, more of the typical behaviors we tend to associate with anorexia.
I won’t summarize the whole book; instead, I want to reflect on my own case.
Before I came to study at an American university, I had heard of anorexia. There’s hardly a teenager in Europe who hasn’t at this point. However, anorexia in Ukraine had always been brushed off as a fad, a diet that one can get over, a thing of caprice and thus, not serious.
I have to note that the first time I studied the illness in depth was during my Abnormal Psychology class during sophomore year – and by that time, I was already deeply anorexic, at 86 pounds and a pulse of 59 BPM. I didn’t know about the whole fear of being fat, the overachiever and perfectionist facets of personality that put me at risk. All of that came later with my extensive studies on the subject. So why did I become standardly anorexic without being explicitly aware?
Though I am not a psychoanalyst in any capacity, and I rarely subscribe to the theory in general, I do believe that internal conflicts and tensions did play a part in the mental and later physical manifestations of my disorder. At the time when I first started exhibiting the behaviors of someone who might be at risk, I was seventeen years old, living away from my family for the first time, had just started my first serious relationship. It was a time of turbulence and change – but I thought I enjoyed the change. Perhaps some part of me did not. Perhaps I was still crying for mommy in a way. Perhaps my struggle with food represented a deeper inner struggle with responsibility. In the psychoanalytic theory, there is a term for this kind of struggle: ego defense mechanisms, wherein the mediator of the human personality, the ego, tries to maintain balance between the selfish impulses of the visceral id and the moral, socially-demanding superego. These defense mechanisms are often immature; and one of them in particular seems to describe what I was going through.
Regression. Perhaps my denial of food was a way for me to struggle against the new maturity role that I had imposed on myself – perhaps I was trying to be a little girl again, waiting to be fed and taught about the benefits of food.
I don’t know. This is just a though. Again, psychoanalysis is not exactly a scientifically sound method; yet it does provide an interesting perspective on what a person could be going through and how it manifests.
Just a little food for thought.
Lol. Get it? Food? Thought? Eh.