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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Declan on April 17, 2007, at 21:13:06
There's no better place to post this than here.
It seems to me, rightly or not, that eating disorders and self injury (of the modern sort) are relatively recent in the frequency of their occurence.
I know people have always damaged themselves with suicide, alcohol, drugs, guns and fast cars and that has never been a mystery to me.But eating disorders and self injury *are* a mystery to me. It's hard to see what the pay off is.
Please ignore this if you find it offensive.
Posted by Racer on April 17, 2007, at 22:53:23
In reply to Fashions in self destruction? Or what?, posted by Declan on April 17, 2007, at 21:13:06
Eating disorders are weird thigns, Declan. There is evidence of the behavior we now call Anorexia Nervosa going back centuries, although it's hard to tell if it's the same underlying pathology. It does sound like it, in many cases, although there was a religious component to it in many of those cases. ("Fasting saints," and that sort of thing.)
What eating disorders are not, though, is a fashion. They are real, biologically based disordrs, with some pretty significant biochemical abnormalities to them. They're also very hard to treat, even with a fair amount of motivation. A study done in North America a while ago found that Anorexia Nervosa was the most stigmatized mental illness, because many people believed it was as simple to cure as "just eat!" It's not.
So, that's my mini-lecture on the subject. It's a topic which I'm happy to discuss, and I don't want you to think this is meant to censor your post here. It's not, because I want you to have this conversation. It's just something I'm a little sensitive about, and I wanted to point out what looked as though it might be a fallacy...
Hi, Dec! It's always good to see you!
Posted by Declan on April 17, 2007, at 23:08:56
In reply to Re: Fashions in self destruction? Or what? » Declan, posted by Racer on April 17, 2007, at 22:53:23
Hello Racer
Eating disorders are clearly real. Although I was taken by a character somewhere saying to his daughter
'Anorexia is a mental illness. We don't have mental illnesses in this house. Eat your dinner.'I don't recall any people with them when I was growing up though. There were heaps of manic psychoses, some schizophrenia, drugs and stuff, and suicide. But there was no self injury.
Take the current straight-edge fashion. Terrible music, no drugs, and self injury (in wait).....when confronted with this in my children, I have just congratulated them on product differentiation, it being so much harder to alienate the older generation these days.
Posted by Racer on April 18, 2007, at 15:45:03
In reply to Re: Fashions in self destruction? Or what?, posted by Declan on April 17, 2007, at 23:08:56
>
> I don't recall any people with them when I was growing up though. There were heaps of manic psychoses, some schizophrenia, drugs and stuff, and suicide. But there was no self injury.As I recall, you're a couple of years older than I am, and you're kinda right -- we just didn't hear about eating disorders when I was young. But they existed. I knew two girls at the barn who had eating disorders when I was young, although we didn't have a name for it. It was only a few years later that I first started hearing about eating disorders.
There's some debate now about whether there really are more eating disorders now than thirty years ago, or whether the rise in diagnosis is actually based on the eating disorders being more recognized today. From what I've read, though, the incidence of AN, at least, is pretty consistent. Bulimia? I don't know. I know much less about it, but some of the stories I've heard from other women make me think that it may have increased in incidence in the past couple of decades. That's just a guess, though.
>
> Take the current straight-edge fashion. Terrible music, no drugs, and self injury (in wait).....when confronted with this in my children, I have just congratulated them on product differentiation, it being so much harder to alienate the older generation these days.I am so sorry, and I hate to admit this, but I had to laugh a little about this. I've wanted to say something like that to some of the kids I've known -- "C'mon, at least come up with something new! I dyed my hair that shade when I was your age, and I can show you pictures of Mohawk/Mohican haircuts dating from the 1950s!" In fact, wasn't there a Pearl Jam song about that? "Kids of today should defend themselves against the 70s. It's not reality. Just someone else's sentimentality." And even that song has to be a good 10 or 15 years old now...
Self injury isn't something I know much about. I do know some people who cut, but I don't know enough about it to tell you if it's truly new -- I certainly never heard about it until maybe a decade ago -- or if it's been out there all along. Dunno. It'll be interesting to see if anyone else joins us in talking about this.
Posted by Declan on April 18, 2007, at 18:18:41
In reply to Re: Fashions in self destruction? Or what? » Declan, posted by Racer on April 18, 2007, at 15:45:03
My mother was so easy to alarm, not that I was up to alarming anyone to their face. All you had to do was grow your hair to your ears and she'd get really upset.
The Straight Edge fashion actually annoyed me. One boy turned up with a bumper sticker saying 'Drugs are for sluts and losers'. So rather than congratulate him on being different, I ripped it off his car.
Maybe the shine has gone off those entertaining methods of self destruction (drugs)?
At any rate kids these days don't read books about "The Death of God" and "LSD and the Search for God".
Posted by notfred on April 19, 2007, at 2:42:21
In reply to Fashions in self destruction? Or what?, posted by Declan on April 17, 2007, at 21:13:06
"It seems to me, rightly or not, that eating disorders and self injury (of the modern sort) are relatively recent in the frequency of their occurence."
People with ED or who SI are often masters at hiding their illness from others, even their partners or close friends. So it may be hard to really know how many did it in the past or the present for that matter; now that these illnesses are talked about more people are seeking treatment.
Posted by Declan on April 19, 2007, at 6:21:39
In reply to Re: Fashions in self destruction? Or what?, posted by notfred on April 19, 2007, at 2:42:21
My best guess, FWIW, is that people who would previously have done it with drugs and alcohol now, because of the evidence of what that has done to their elders, have chosen a different course. A different climate of opinion forms.
Things are so much tighter for young people these days. The price of housing, for example.
Posted by Poet on April 19, 2007, at 8:10:35
In reply to Fashions in self destruction? Or what?, posted by Declan on April 17, 2007, at 21:13:06
Hi Declan,
I was bulimic before the TV movie of the week got ahold of eating disorders. I have an anorexic friend who is in the same situation. All the girls in her dance class were told how to lose weight and keep that weight off in unhealthy ways and this was back in the mid-70s.
I am good at keeping what I do a secret, when I lived at home my family never caught on, I still binge/purge now and my husband has never caught on.
Notfred posted that people keep it a secret and I agree. My anorexic friend can't stand the Mary Kate Olsen's and other young adult women who flaunt their ribs showing through their skin. My friend covers her body because she doesn't want attention drawn to it.
I'm not sure what the payoff with an ED is, it used to be that I was thin, but aging bodies don't take to it well, not at all. I accept that an eating disorder is a form of self injury, but I don't cut or otherwise harm my body and so I can't speak for that.
I didn't find your post offensive at all.
Poet
Posted by Declan on April 19, 2007, at 15:06:13
In reply to Re: Fashions in self destruction? Or what? » Declan, posted by Poet on April 19, 2007, at 8:10:35
I was always quite comfortable about seeing some aspects of drug use as SI. The things you can inject yourself with! I will leave these sordid details for you to imagine.
It interests me as to whether such behaviour has meaning and purpose. Sometimes I think so, sometimes not.
Right now I feel that one gets caught up in a chain of Karma and continues on for no better reason than that one does not step out of the stream.
Posted by Racer on April 20, 2007, at 2:05:33
In reply to Re: Fashions in self destruction? Or what?, posted by Declan on April 19, 2007, at 15:06:13
Well, in terms of ED, specifically Anorexia Nervosa, some research done in the past decade shows that serotonin is way out of whack -- the type 1 receptors are enormously overactive, leading to high anxiety. The theory being looked at is that self-starvation is an attempt to quieten the serotonin system, by reducing serotonin through less dietary tryptophan. Then, the receptors get even more sensitive, so you have to starve more, and it becomes a vicious circle. If that theory turns out to have anything in it, then it's an attempt to self-medicate, not self injure.
The other thing that's being looked at is the evolutionary advantage in having some portion of the population going into hyperactivity in a state of starvation -- while most of the tribe is trying to find any food at all right here, right now, someone is out there running around, where they might find food. Again, an interesting thought...
Just some other ways to look at EDs, besides self injury...
Posted by Declan on April 20, 2007, at 4:21:59
In reply to Re: Fashions in self destruction? Or what?, posted by Racer on April 20, 2007, at 2:05:33
I am a philosophical ignoramus so....but anyway....
We're back to the mind/body thing. I'm not suggesting that it is irrelevant (how could I?) that such and such mental state corerlates with, or is caused by, such and such biological feedback systems.
But when you do that are you just not changing the focus and arguing by implication for the greater importance of this field (biology) rather than that (psychology).
Some people here are clearly ill. Some people are well enough. There's always going to be something out of whack, and the sicker you are the more that will be true.
The idea that a chemical imbalance explains anything (except the issue of responsibility) puzzles me. I have no trouble with the idea of chemical imblance, indeed there must be multiple chemical imbalances.
Anyway, does the theory that self starvation is an effort at self medicating (via the type 1 seratonin receptors) lead to any promising interventions?
Some people claim that they feel much more calm not eating, and of course there is the tradition of fasting particularly associated with religion and spirituality.
I eat buckets of feed and am astonished by people who don't eat their breakfast.
Posted by Declan on April 20, 2007, at 4:27:06
In reply to Re: Fashions in self destruction? Or what? » Racer, posted by Declan on April 20, 2007, at 4:21:59
I shouldn't have put in 'or caused by'.
It undermines my argument, such as it is.
Posted by karen_kay on April 20, 2007, at 11:24:13
In reply to Re: Fashions in self destruction? Or what? » Racer, posted by Declan on April 20, 2007, at 4:21:59
there can only be one self proclaimed ignoramus and i called that one a long time ago.....
i do not have an eating disorder, never have, never will (though i'm rather ignorant to the subject, can you develope one later in life? maybe i'll develope one later in life? i'm no fortune teller...). i do often say that in a former life i must have been bulimic because i have no qualms with vomiting (i hate that icking feeling in my belly and would just rather have an empty belly than an upset one. when i was at my heaviest, i used to joke 'i wish i could have a tape worm for a month or so and just not know it', but that doesn't constitute an eating disorder, jsut an odd line of thinking...)
but, you said something that i'd like to try to respond to. now, my response may have you thinking 'huh?' and you'll more than likely ignore it (everyone might), hence the ignoramus trigger (sorry for stealing yoru word, but i like to look smart every once in a while)...
back to what you said: *Some people claim that they feel much more calm not eating*
i could see the reasoning behind that, if one has an eating disorder. with me, i'm an extremely anxious person (oh, aren't you jsut in love with me!). adn the more anxious i am, the less i can eat. so, the less i eat, the more i think about 'i'm not eating, i have to eat.' and the more i think about how i need to eat, the more my stomach churns, making it impossible for me to eat (seriously, not even able to drink ensure or slimfast or anything at all). so, when i somehow calm down and am able to eat, i feel even calmer after eating.
basically, from someone without an eating disorder (no, not saying that to disguise an eating disorder (or am i? hmmmm?)) i can understand that logic. i'm proud when i eat after not being able to do so and feel calmer, so i can see how someone with an ed could feel calm when not eating.
Posted by Declan on April 20, 2007, at 15:58:45
In reply to Re: Fashions in self destruction? Or what? » Declan, posted by Declan on April 20, 2007, at 4:27:06
Conciousness may change biology as effeciently as biology changes conciousness.
But biology can change conciousness more easily than conciousness can change conciousness.
Which is another way of saying that the mind/body thing puzzles us because we look at it through the lens of counciousness.
Posted by LlurpsieNoodle on April 21, 2007, at 10:13:17
In reply to Fashions in self destruction? Or what?, posted by Declan on April 17, 2007, at 21:13:06
> But eating disorders and self injury *are* a mystery to me. It's hard to see what the pay off is.
I have cut myself when I was so dissociated that I didn't feel conscious, didn't feel like I was in my body. it was so horrible, and I thought, kind of that maybe if I make myself feel pain I can stay in my "here-and-now".that's what the pain does.
plus it releases endorphins and can become addictive to some folks.
-Ll
Posted by Declan on April 21, 2007, at 16:49:15
In reply to Re: Fashions in self destruction? Or what? » Declan, posted by LlurpsieNoodle on April 21, 2007, at 10:13:17
I'm very interested in dissociation, having spent way too long there.
It was a carryover of the lack of psychological seperateness of the family life I knew.
So my problems with learning how to live seperately were always going to be there, complicated by drug use (esp. benzos).Fortunately I was disaffected with psychiatry once it was clear they were not in the soul doctor business, and I hacked off to a Winnicottian therapist.
In a different age I might have gone into the Church and found something there suitable for one with fragile ego boundaries.Although, to correct the record a little, once I did some therapy on low dose acid with a shrink, and I came up with this formulation with him, which was 'I'm playing tennis from the wrong end of the court'.
That was *really* interesting.
Posted by Maxime on April 22, 2007, at 20:05:57
In reply to Fashions in self destruction? Or what?, posted by Declan on April 17, 2007, at 21:13:06
Eating disorders are not new. Women used to starve themselves because they believed it made them "pure". Many Saints have starved themselves in the name of religion.
What the pay off of an eating disorder? For me it's control and way to show my pain on the outside. It all started in effort to disappear because I had been molested and I didn't want anyone to EVER notice me again. So I starved myself.
An eating disorder usually starts off as one thing and then over the years the behaviour is the result of many things. Now I need to be thin because it's the only thing I can control in my life. I can make the numbers go down on the scale and NO ONE can take that away from me. I cling to my disorder because it is safe to me.
Hunger. I love hunger. I love resisting hunger. I get a high from hunger. I love feeling empty ... it makes me feel safe and pure. I want to be empty.
I also self-injure. What is the reward? I cut for two reasons:
1. When I can't feel anything at all and I need to know that I am still alive, I will cut and once I see the blood I feel better. It brings me back to "reality" in way.
2. When I am feeling too much. Too much anxiety and stress ... I cut. It's like a release. I imagine that it is similiar to how someone who purges feels after they purge.
Clearly all of these things are screwed up coping mechanism, but they are all I've got. I don't do it for fashion.
Maxime
> There's no better place to post this than here.
>
> It seems to me, rightly or not, that eating disorders and self injury (of the modern sort) are relatively recent in the frequency of their occurence.
> I know people have always damaged themselves with suicide, alcohol, drugs, guns and fast cars and that has never been a mystery to me.
>
> But eating disorders and self injury *are* a mystery to me. It's hard to see what the pay off is.
>
> Please ignore this if you find it offensive.
Posted by Declan on April 23, 2007, at 16:31:57
In reply to Re: Fashions in self destruction? Or what? » Declan, posted by Maxime on April 22, 2007, at 20:05:57
Thankyou Maxie
This was at the end of an article I liked.
"They have figured out how to use the gigantic apparatus of modern medicine to restore our hope: by unburdening us of self-contradiction and uncertainty, by replacing pessimism with 'optimisation', by inventing us as the people who seek Life Enjoyment and Satisfaction, who will buy from the pharmacy what we need to forge ahead with our Well-Being unhindered by Depressive Symptomatology, to pusue antidepression, if not happiness. Who can resist this idea that our unhappiness is a deficiency that is in us but not of us, that it is visited on us by dumb luck, that it can be sent packing with a dab of lubricant applied to a cell membrane."
It hasn't worked with me though (I don't think).
Posted by Cecilia on August 20, 2007, at 6:44:24
In reply to Fashions in self destruction? Or what?, posted by Declan on April 17, 2007, at 21:13:06
The pay off for bulimia seems obvious to me. Not being fat. Of course it's dangerous and can turn you into a Terry Schiavo, but it's certainly not some new fashion, people were doing it, or trying unsuccessfully to do it, long before there was ever a word for it or an official diagnosis. They just didn't tell anyone about it, like childhood sexual abuse, they thought they were the only one. Maybe Princess Dianna brought it out of the closet. It's certainly the most socially acceptable ED, because it doesn't show, I doubt very much that Dianna would have been so beloved by the public if she were fat. Anorexia is socially acceptable to a degree, to the movie star fashion model degree, not to the concentration camp surviver look alike degree. Being overweight is never socially acceptable, except maybe for Japanese Sumo wrestlers. Which is why people who can't make themselves vomit often pay huge sums of money for surgically induced bulimia (aka gastric bypass surgery), even though it often leads to dangerous and sometimes fatal complications.. Cecilia
Posted by LlurpsieNoodle on August 20, 2007, at 7:06:58
In reply to Re: Fashions in self destruction? May trigger » Declan, posted by Cecilia on August 20, 2007, at 6:44:24
Before Diana there was Elisabeth (Sissy) of Bavaria, married to Austrian Emp. Franz Josef. She still arouses the curiousity and devotion of many, who revere her as a great beauty and tragic figure (murdered at the fin de siecle).
Portraits reveal her to have supermodel-like proportions.
A tour of the Imperial Palace Schönbrunn in Vienna will reveal a rather fascinating aspect of her personality. Whereas all of the other bathrooms and dressing rooms are very utilitarian, hers has a uniquely medical feel about it. Several large devices for measuring weight and large soaking tubs (in addition to one of the fanciest vanity sets) reflect Sissy's obsession to maintaining her reed-like figure. Our tourguide says that she was in the habit of not eating her dinner and riding horses obsessively to keep her waist the smallest in the court.
Did it pay off? Many Austrians and Germans have heard about Sissy but know very little about Maria Theresa (1717-1780), archduchess of Austria, Holy Roman Empress, and queen of Hungary and Bohemia. She was the only woman ruler in the 650 history of the Habsburg dynasty. She was also one of the most successful Habsburg rulers, male or female, bearing sixteen children between 1738 and 1756. Her figure was not so reed-like...
Style over substance? Certainly in Sissy's case. I suppose the jury's still out on Diana's contribution to humanity.
-Ll
Posted by Cecilia on August 20, 2007, at 8:04:19
In reply to Empress Sissy** May trigger » Cecilia, posted by LlurpsieNoodle on August 20, 2007, at 7:06:58
I've also read about how women in times past used to have their bottom rib removed, if they could no longer achieve a 17 inch waist the famous Scarlett O'Hara way, holding on to the bedpoint while their corset was tightened to a point just short of turning totally blue. Extreme measures in pursuit of the ideal body are definitely nothing new. Cecilia
Posted by zazenducke on August 20, 2007, at 12:15:04
In reply to Re: Fashions in self destruction? May trigger » Declan, posted by Cecilia on August 20, 2007, at 6:44:24
I was posting about this below. A lot of bulimics aren't able to stay slim so I wonder if there isn't more to it than social pressure tho of course that's probably the starting point for most. The vomiting thing is still hard for me to imagine tho vomiting frequently brings relief to some migraine sufferers who sometimes also experience mild exhiliration when it ends.
Why is it so easy to become a bulimic? One reason is that both binging and vomiting can trigger waves of the potent brain chemicals - the endorphins. The release of these natural heroin-like brain chemicals helps establish the powerful compulsions that bulimics are helpless to fight. When we develop false ideas about what we "should" weigh and begin dieting, we open ourselves up to the possibility of developing an eating disorder, .....Alternative Mental Health-no link because dieting is mentioned on the site
This is the end of the thread.
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