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3/30/2011

Les Comtesses on Eating Disorder Articles and Commenters

The Comtesses are having a round-table (as we do) about my post yesterday, and the article and comments it covers.  Here are some of the highlights.

Marzie:  It's just astonishing that someone can on the one hand be preaching self-acceptance of physique and aging in a fashion so wholly derisive, dismissive and *offensive* of/to those who struggle with a genuine MH issue, isn't it? Could this person have missed the entire point of the article by a wider margin, I wonder? Simply astonishing!!!

[redacted]:  WTF was with all the motivesplaining?! Is everything on the well like that, or is it common to ED discussions, or what? That is presumptuous, and solipsistic, and unfuckingcalledfor.

CN:  Last time I read any of them, they were pretty heavy on that, yeah.

There's one duo in there where someone tells ED'd b!tches to go volunteer and do something that isn't obsessed with themselves for a change.  The next commenter follows up nicely pointing out that, yeah, there are, like, ED'd doctors and nurses and volunteers and teachers and....  So sometimes you do get the redemptive value thrown in there for good measure.

There's also a fair amount of "THERE ARE STARVING CHILDREN IN AFRICA HOW DARE YOU CARE ABOUT MAGAZINES," which, I cannot even begin.

Personal Failure:  As to motivesplaining: in all honesty, motivesplaining of any kind says volumes about the 'splainer. ED is caused by wanting the perfect, faithful man?  Then this person cannot imagine a man being loving and faithful to anyone who is not physically perfect according to our culture, which is really, really sad for them when you think about it.

Enraging, but saddening.

GlamKitty:  Most people seem to be more the "in one ear/out the other" variety when it comes to anything not directly related to them... That's why so many articles and even posts are written from the simplest perspective... That's who's gonna (if you're lucky) be reading (or at the least, skimming) your article: the huddled masses.

It's easier for people to get an idea about the problems if they focus on the physical issues (such as low weight extremes and all the purgative behaviors resulting in myriad, visually-quantifiable health problems) rather than the psychological ones (like the real "why" behind the behaviors). This also goes to CN's frustration with the triggers so commonly put front and center; but once again, that's kind of my point here: the article isn't written for someone who has struggled with these issues and has given so much thought, time, and effort to learning about the history, significance, reasons, manifestations, treatments, etc., ... it was written for neighbors, co-workers, the checkout girl who sees you three times a week, so that they have a chance of identifying what they see, and possibly even being concerned for the right reasons if someone close to them exhibits any of the more-obvious symptoms.

Marzie:  Which is why the commentary is all the more disturbing, as few people will likely have the sense or skill set to parse the issues raised in some of them. Some people may read the sociobabble of RC or psychobabble of LL and actually take away the idea that they're insightful. In fact some of the other commenters did.

Sometimes the internet can be a crucible of ignorance to a truly disheartening extent. (Was it only a week ago I read Ann Coulter's column on how radiation was really good for us? My eyes!!! My eyes!!! Burned by her idiocy!!!!)  The article: just fine for its particular purpose. The commentary: cost me brain cells, because of exploding white matter.

CN:  These are all true points, I believe.  But I think this is also some of the problem.

Since most people are indeed "in one ear/out the other" when it comes to things not directly relevant to their own lives, then it follows that most people are never going to gain a more thorough understanding of eating disorders and their interplay with everyday life, unless and until an eating disorder directly affects them or their family...  The problem with eating disorders is that yes, sometimes a diet or a new exercise regimen is the trigger that sets them off, but frankly, that's not usually the case.  Talking about eating disorders in terms of "and then she decided to lose weight" is like talking about addictions in terms of "and then he decided to start drinking more."

I can appreciate what the article wants to do, and I'd rather have it written and published than not.  But it doesn't actually do much to address the fact that people in mid-life or later life with eating disorders have always been around, like that older article didn't address the fact that eating disorders and substance abuse have long been bosom buddies.  Maybe that's part of my issue with these two articles: they read to me like just more NY Times "trend pieces."  And in some way they are.

But while their aim is to teach, whereas most of the NY Times trend pieces you see aim to divert or socially titillate (Women are deciding en masse to stop wearing perfume because they don't want to impinge upon others' space!  Women are raising chickens in Brooklyn because they are feminists and also environmentalists!), what this piece sometimes does (and what that older piece did to a much larger extent) is to continue to address what are basically ED tropes, and employ rather ham-handed tactics.

For instance, it's hard to see how the writer or editor let the comment "... so [physicians] can recognize and distinguish between menopause-related changes, real health problems and eating disorders..." stand without in-print clarification that when the doctor said "real health problems" she meant, for example, anemia borne of ulcerative colitis, as opposed to the psychiatric problem of an eating disorder that leads to health problems.  Tara Parker-Pope clears that up in the comments, but the fact that it made it to print unadorned suggests an unawareness that is discouraging.  It unwittingly underscores the suggestion that eating disorders are not "real health problems," which you can clearly tell from the comments is a dearly cherished belief by many.  That combined with the weight/height/pounds triggers suggests that while this piece aims to help people "get it," the piece itself doesn't entirely "get it."

So the point and merit of the piece is definitely summed up in the one doctor's quote, "We need to let everybody know that it’s possible to develop these illnesses across the life span."  But in the course of letting everybody know that, the writer and editors missed some pretty easy fixes.

Is there ever going to be a perfect eating disorder education piece that accomplishes consciousness-raising and balanced sensitivity to the special interest group of patients and loved ones?  No.  But that definitely doesn't mean that I have to accept some of the shortcomings in the existing pieces.

3/29/2011

New York Times Blog and Commenters on Eating Disorders. Oh Dear.

I did not study rhetoric.  I was not on the debate club.  I did not study logic.  But I have thoughts.  So let's do this in sections.



The piece:  "An Older Generation Falls Prey to Eating Disorders" on the NY Times blog "Well" written by Tara Parker-Pope.

The piece, on the one hand:  Yup, eating disorders aren't just a rich teeny-bopper trend anymore.  Glad you noticed.  Glad their existence is garnering some kind of coverage.

The piece, on the other hand:  There are so many problems with this well-intentioned piece, not least of which is that it assumes and perpetuates the fallacy that eating disorders are about weight, shape, food, etc.  The symptoms revolve around weight, shape, food, etc.  The disorders are not about those things.

My next issue with the piece is that it seems like it was written/edited without regard to the most basic of trigger knowledge about eating disorders, assuming it was written with eating disordered readers at least partially in mind.  Pieces like this love to, in my opinion unnecessarily, chart the height and low weight/high weight of the interview subjects.

Third, and perhaps most irritating to me:  People of all ages with eating disorders.  They have been around since the invention of eating disorders.  Trufax.  This irritates me on the level of a NY Times piece several years ago about "drunkorexia," that was to say, eating disordered people who abuse alcohol and therefore get most of their calories through booze.  People with eating disorders - especially bulimia - who have substance abuse problems.  They have been around since the invention of eating disorders and also substances.

Fourth and very parenthetically, the piece lists common disordered behaviors, but totally ignores purging, by far and away one of the most common symptoms in clinical-level eating disorders.  Going by the numbers, there are vastly more patients with purgative behaviors, i.e. bulimic behaviors, than with strictly anorexic/restrictive behaviors.  Again, going by the numbers, the most common purgative behavior is vomiting.  It just seems weird that a piece purporting to teach about eating disorders would eliminate the most common eating disorder behavior in anorexia and bulimia.  (Binge eating does not, by definition, include compensatory purging.)

I mostly enjoy "Well," though when it does fat/food/ED pieces like this, it tend to bug me because they tend to be written from this same half-researched, awkwardly-worded place.  But, again, a well meaning place, I think.

Moving on.

The comments:  Why am I even surprised?

I am struggling to cultivate detached compassion about this one, this one (same person) (who is in love with Camille Paglia), and this one.

This one just needs to learn more about nutrition.

But this one is just so out-of-left-field-awful that it's actually hilarious.


Shorter CN:  I'm not so good at arguing.  I sputter a lot.  I use this emoticon when in doubt:  o_O

Shorter, shorter CN:     o_O        >_<    

3/15/2011

The Guilt of Bingeing


And now, I will talk about something that produces feelings of intense shame, and which I therefore don't talk about here a lot, outright.  Bingeing.

Bingeing, purging and restricting is a self-perpetuating cycle, and most eating disorders feature it in some way.  The bingeing isn't always an objective binge, the purging isn't always vomiting, and the restricting isn't always the restricting of calories, but the cycle is pretty universally applicable.  

Now that I've explained that in so many words, I could be about to tell you about a subjective binge I had involving an objectively appropriate amount of food, and a purgative episode that only entailed fasting or exercise, and a restrictive behavior that was the restriction of social interaction.

But I'm not.  I'm talking about bingeing on an objectively unnecessary amount of food.  I'm talking about purging by vomiting.  And I'm talking about restricting by limiting food variety and amount to an objectively inappropriate level.  And primarily, I'm talking about the bingeing.

Generally, the farther you get into an eating disorder that involves restricting, the more and more limited your "safe" foods get.  And if you have an eating disorder that also involves bingeing *waves*, the farther you get into that restricting, the more kinds of foods become potential binge foods.  Luna bars are a recent example of mine.  I actually binged on Luna bars.  Because that's what was around that wasn't a "safe" food.  That's what was on hand.

I keep getting tripped up over in Hell lately.  PF mentioned in a recent post that mentioning or displaying pain is verboten in polite society.  So are bingeing eating behaviors.  Anorexia is at once less and more secretive, at least its popularly known features are, than bingeing that takes place in bulimia and in binge eating disorder.  (And that also takes place in anorexia, but that doesn't count if you can't see it, right?  Right.  Anorexics are holy.  Bulimics are gross.)

Today the discussion is about* access to food, and all I can think - maybe rightly so - is what a fucking little shit I feel like that I recently binged.  On Luna bars.  Which are expensive.  Addictions are expensive:  alcohol is expensive, cigarettes are expensive, gambling is expensive. An eating disorder, binges or not, isn't an addiction - not chemically, not behaviorally.  But a bingeing eating disorder is a privileged expense; there's no denying that.  So on top of the guilt about having an eating disorder at all, add the guilt of, well, being a disordered, privileged little shit.  

There is guilt in the restricting, and of course in the purging, too.  But for me the guilt has always been primarily about the bingeing, which is why I usually pussyfoot around it here.  The guilt is about the money, even though I can afford what I'm doing.  (The guilt is that I can afford it, partly.)  

The guilt is about the waste, regardless of money.  The guilt is basically that I'm taking too much.  The purging is because there will be too much of me if I don't.  The restricting is because there is just enough of me right now.  And the bingeing is, biologically, a physiological response to there not being enough.  And the bingeing is, subconsciously, a revolt, a demand for more.  Rinse and repeat, ad nauseam.  (Ha.  "nauseam."  Get it?  Do u see wut I did thar?)

And this post is after my second week of therapy.  Mehhhhhhhhhhhhhhhh.  I have a lot of work to do.



*or was supposed to be about, before everyone missed the point in a round of really peerless privilege display, which the redacted Comtesse has named "carsplaining"

3/03/2011

Reentering Treatment


I had my first therapy session since (I think?) 2008 yesterday.  It was kind of the opposite of the above picture, but look at that picture.  I had to.

The meeting was with a LCSW who led the group I went to for a couple years at Renfrew (from around 2004 - 2006).

I left feeling incredibly energized and hopeful for the first time in a long time.

I still didn't do so hot in terms of food when I got home, and I'm still not all about, you know, "eating" this morning.

But it's a start.  Letting myself be the center of my own universe again for 45 minutes a week is a start.