Eating Disorders Information (EDI)

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A Quantum Psychopathological Account of Anorexia Nervosa

Posted by a.marlow on May 1, 2013 at 7:25 PM Comments comments (0)

To those regular readers who have noticed a sizeable reduction in output recently, I apologise. However, there is good reason: I have spent the last few months working on a research paper recently published in the academic journal Neuroquantology entitled "A Quantum Pyschopathological Account of Anorexia Nervosa", which is free to read online or download as a pdf if you click on the link.he basic thesis takes recent theoretical work on the potential link between quantum physics and the brain, and applies it to the specific case of anorexia nervosa. I invite you to give it a critical read-through and share your thoughts with me. I hope you find it interesting and helpful.


This last weekend, I was in Palermo, Sicily, delivering a talk based on this article to an assembled multidisciplinary crowd of psychologists, physicists and others who had assembled for a two day conference on the topic of "Quantum Paradigms of Psychopathology". I shan't bore you with details, except to say that current research into the role of neuronal microtubules as a possible site of quantum computation within the brain is flying ahead apace, with particularly interesting evidence submitted regarding the way in which certain microtubular structures closely resemble certain plant structures used in photosynthesis that are now known to exhibit effects best explicable by quantum mechanics. If these developments bear fruit, then the account of the unconscious quantum logic that I present in the Neuroquantology article linked above might represent a valid and crucial step forward in understanding the neuronal basis of anorexia nervosa.

Eating Disorders and Anxiety: Are They Correlated?

Posted by a.marlow on May 1, 2013 at 7:15 PM Comments comments (0)

Below is an article penned by guest contributor Ryan Rivera. He runs calm clinic dot com and has written several articles on the subject of anxiety that have been published on various websites. 


Eating disorders and anxiety often go hand in hand. People who are suffering from a specific eating disorder are also plagued with negative thoughts and mental imbalance, the same symptoms for depression. There have been claims that these two conditions are related; however, no hard evidence has been presented to support this until recently.  Mental health practitioners who have been intensively studying the underlying causes of these two disorders have found an absolute connection.  


The development of an eating disorder, such as anorexia or bulimia, does not stem from the hate or disgust for food or weight but rather on specific emotional issues where food becomes an indirect participant. The person turns to food or away from it as a defense mechanism against emotional stress. This emotional stress is directly related to the things that can cause anxiety. Studies have been conducted and have shown that most people who have an eating disorder are also suffering from an anxiety disorder. 


It is still debatable which of them occurred first and caused the other. The widely accepted theory is that anxiety precedes eating disorder. A good analogy is a person who is suffering from anorexia.  This person is obsessed with the fear of becoming overweight. The fear can be so extreme that food becomes an enemy.  Food is avoided as much as possible, which is both unhealthy and harmful to one’s health.  


The person’s fear can be rooted from the society that sees obesity as an ugly physical aspect. This mentality will cause anxiety. This can push the individual to develop anorexia. But different types of eating disorders are not similar to each other. That is why this conjecture will not hold true for all situations.   


The truth is that most people who are suffering from an eating disorder are also likely suffering from anxiety or depression. 


There are usual anxiety disorders that are often found in people with eating disorders. 


Obsessive Compulsive Disorder (OCD) occurs when people have a strong obsession in following certain rules or rituals. If they are not able to follow this set of rules, they undergo a state of great stress and restlessness. 


Panic Disorder is an intense flood of negative thoughts and emotions that can literally paralyze a person in fear. These attacks are uncontrollable and can come without warning. 


General Anxiety Disorder is a prolonged state of restlessness and worry that lasts far longer than normal. Some of these worries maybe irrational but causes excessive distress to the person. 


Social Anxiety Disorder is characterized by intense fear of social interactions or of the public. A person with social anxiety disorder is very self-conscious and uncomfortable being in public for fear that they will be ridiculed or embarrassed.  

 

OCD and social anxiety are particularly common for people with eating disorders. In cases of bulimia or binge-purge type anorexia, where a person eats a large amount of food then immediately purges it out through vomit or laxatives, they are hounded by a fear of gaining weight that promptly induces them to purge. As the disorder progresses, the ritual becomes habitual and turns into a cycle. Because of these revelations, several treatments for eating disorders are also combined with therapies that are considered help for anxiety.  

 

 

Hysteria: the 19th century's answer to eating disorders?

Posted by a.marlow on November 25, 2012 at 8:00 AM Comments comments (0)

It has been claimed by certain feminist thinkers that the prevalence of Hysteria among women in the late 19th century and the prevalence of eating disorders inour current cultural climate are linked by the idea that both conditions represent an exaggeration of and protest against the prevailing social rolesavailable to women at the time. In the late 19th century, Hysteria represented a response to the view that women should be romantic and frail; in the late 20th and early 21st century, anorexia represents a response to the view thatwomen should, on a literal level, be constantly getting thinner and, on a symbolic level, be denying their own needs and putting those of others first, in the manner of the housewife and mother who makes her husband and children a priority above herself.

 

So goes the theory. But before we can evaluate its validity, we need to have a better understanding of what 'Hysteria' means in the context of psychoanalytic theory.

 

The core of 'Hysteria', according to many psychoanalysts, is a constant search for evidence that one is loved, a search that is rooted in the experience of early trauma in the form of a Mother who was unable to fulfil the needs of her infant child. In this sense, Hysteria comes about as a sort of defence mechanism against the threat of abandonment by the Mother (or, in later life, by a lover). The loss of the loving look and warm regard of the Mother in early life leads to a sensitivity in later life to the threat of being abandoned by a lover, to the loss of his/her loving gaze. This defence operates by means of an auto-eroticism, a sort of self-love that divorces the mind from the body and creates a reluctance to love another, external person. The Hysteric's mode of love is a purely sensual one that leads to a permanent dissatisfaction with all her lovers and a contradiction between her desire to bask in an eternal, absolute mode of love and her reluctance to give such love to the Other. It is common for a Hysteric to complain of being treated as a mere sexual object for use by men, while at the same time treating her lovers in just the same way. She fears abandonment as something that would put her 'ego', her 'self', in danger, while at the same time seeking out lovers who are just the kind of people who would subject her to the very abandonment that she fears. She will often identify with her lover one minute, as if he were the basis of her identity, and then unexpectedly show a cold indifference towards him the next, as if her love, which was so passionate seconds ago, had simply disappeared.

 

According to Jacqueline Lanouzière, Hysteria can be characterised as a sort of addiction to the love of the Other and, more specifically, to his look, to his gaze. The loving gaze of the Other acts as a drug for the Hysteric. Her choice of lover is based on needs that went unmet at a certain point in her life due to the inadequacy of her 'objects' at the time (in psychoanalysis, and particularly in the Object Relations school of psychoanalysis, the term 'object' refers to a significant other who has been unconsciously internalised into one's own mind and plays a decisive role in determining one's mental health). For the Hysteric, only the loving gaze of the Other can bring her to a sense of unity and oneness; otherwise, she feels like a divided person.

 

The irony of Hysteria is that the Hysteric often treats her own body as a sexual object. And it is here that the psychoanalytic account of Hysteria gets... weird. The above description of someone treating their own body as if it were a sexual object is more generally a description of the Freudian conceptof narcissism, which takes on a particularly weird role in the psychoanalytic account of Hysteria. Lanouzière claims that female narcissism comes about later than male narcissism, as the male genital organs are visible from birth while the female genitals are hidden away inside. They only really make an appearance in puberty, when the breasts start to form and periods start to occur. The late beginning of female narcissism gives it a character of uncertainty, and this is at the heart of Lanouzière's account of theHysterical condition. According to her, the fact that an infant girl spends much of her early life aware that, when others look at her, they will notice her lack of penis, leads to this girl overinvesting in her appearance and in ananxiety about how others see her. Her obsession with how others perceive her is almost a fetish for the Hysteric.

 

Indeed, according to Lanouzière, the gaze of the other is the only way that anyone ever becomes a narcissist. In her account, the mother looking at her newborn baby sees it almost as an extension of herself, and thus a mother's love for her child is an extension of her love for herself. This, so it is claimed, forms the basis of the baby's own narcissism that becomes her own self-love and self-esteem as she grows up. But the mother's gaze is different depending on whether the child is a boy or a girl: with a boy, the mother's loving gaze will be centred on the penis, while with a girl, he rgaze will cover the whole body, leading to a sort of exhibitionism seen in Hysterics in particular whereby the whole body becomes a sort of eroticised show for the whole world to see. While such exhibitionism is common during adolescence in most people, the Hysteric maintains it into adult life.

 

The failure of the early maternal gaze to provide a look of unconditional love leaves the Hysteric feeling invisible, a feeling she tries to get rid of through making a show of her body, for example by using bright clothes to attract attention and adoration. In this way the Hysteric engages in a desperate quest for perfection and beauty- because for the Hysteric, she is literally nothing without the loving gaze of the Other.

 

This is basically a summary of the account of Hysteria given by Lanouzière in the work referenced below. You might have noticed that I have constantly used 'she' throughout this blog post, and that is deliberate. Hysteria is and was always seen as a female condition, for some of the logically spurious reasons given above. The psychoanalytic account rests heavily on 'penis envy' to explain why Hysteria occurs in women rather than men, as this (somehow) explains why the Hysteric makes an exhibition of herself when her female narcissism finally comes into bloom in order to compensate for a childhood of lack.

 

But, look, this is psychoanalysis, so don't take it too seriously, okay? It's obsessed with sex and has little evidence to support any of its claims, so don't get thinking this is how the human mind actually works. Most modern psychologists have abandoned it to the coffin of history as an embarrassing relic of the 1950s when psychology wasn't so scientific, and although I do think that sometimes it can come up with some profound insights lacking from the more experimental branches of psychology, this is not one of those times. It really isn't. I have only included it here so that you can understand the concept and see if the feminists are right when they say that the Hysteria of the late 19th century is in some way related to the prevalence of eating disorders in the late 20th/early 21st century. I'll leave you to reach your own conclusions on that one.

 

In other news- I've just yesterday completed my final examination for the Eating Disorders course I've been taking with the British School of Yoga so, assuming I haven't failed, I am now/soon-to-be a qualified Complementary Therapist for Eating Disorders. And when they send me the exams for the other courses I'm taking with them, assuming I pass, I'll also be generally qualified in Psychotherapy and in Vegetarian/Vegan NutritionalTherapy- so if any of you out there feel you would benefit from my services in these areas, get in touch. I'm sure there's a 'contact' section somewhere on this website. I'm currently living in Rennes in France, and plan on moving to Bangor in Wales next year.

 

References:

Lanouzière, J., 2010. "L'hystérique et son 'addiction'", in: Marinov, V., et al., 2010. Anorexie, addictions et fragilités narcissiques. Presses Universitaires de France: Paris. pp. 131-157

 

 

The therapeutic potential of Shamanism

Posted by a.marlow on October 24, 2012 at 6:20 PM Comments comments (0)

Being a shamefully shameless hippy-type, I occasionally frequent Reality Sandwich, a website full of articles on the brilliant, the bizarre and the barmy. It is there that I first came across the ideas and practice of Shamanism which, although interesting, seemed a little far-fetched. How much relevance could the ancient practice of tribal witch-doctors who claim to convene with demons and animal spirits have in the modern world?


So imagine my surprise when I find this passage in (what I assume to be) a reputable medical dictionary, which defined Shamanism as:


"a form of healing that incorporates personal healing, transformation, and regeneration through access to a "higher power." Sickness, disease, and illness are indicators that the individual is out of balance and in disharmony within the essential nature. Success can be achieved if people are, first, willing to take responsibility for the creation of the disease and, second, open to nonphysical realities of life and willing to engage with their inner spirit and their higher selves. This type of healing has been effective for sexual dysfunction, chronic fatigue syndrome, mental health concerns, and obesity and other eating disorders."


I do not know what sources or studies were used by Mosby's Medical Dictionary, but the prospect that Shamanic therapy can be effective is intriguing- and, if you'll permit me to say it, not all that surprising. For, if Jung could examine the psychological meaning behind UFO encounters without offering an opinion on their objective reality, then it is not unfitting to examine the psychological meaning of Shamanic states of consciousness while withholding an opinion on their objective reality.


Indeed, it is worth looking at how these altered states of consciousness work, especially seeing as they are the lifeblood of Shamanic healing. Whether we consider drum-induced trances or ayahuasca-induced trips (ayahuasca being a type of tea drunk by Shamans that contains DMT, the most powerful hallucinogen/psychedelic/entheogenic drug known to man), it appears that these can bring certain therapeutic benefits to those suffering from mental illnesses.


From a psychoanalytic perspective, for example, it has been suggested that the 'temporary psychosis' of Shamanic integration could be viewed as a restructuring of the ego, which could be beneficial for those suffering from conditions like anorexia nervosa that have been linked with a failure to build a sufficiently strong ego due to problems in early relationships. And from the perspective of neuroscience, one of the effects of altered states of consciousness found in Shamanic rituals is a blocking of the inhibitory effects of serotonin in the frontal lobes of the brain. Again, seeing as neurological research has repeatedly found links between altered (often increased) serotonin function and eating disorders, a reduction in serotonin activity caused by Shamanic intervention could be beneficial for someone suffering from anorexia or bulimia.


However, all of this is speculation. I have nothing to go on but an entry in a dictionary and one article I happen to have read in the Journal of Consciousness Studies, so you should take my words with a pinch of salt. The moment I find some kind of scientific study on the use of Shamanism in psychotherapy, I'll post it here- and, in the meantime, if you know anything about shamanism that could add to our shared understanding, whether it supports or contradicts the ideas espoused here, I'd love to read it in the comments section below.


References:

Krippner, S., & Combs, A., 2002. "The Neurophenomenology of Shamanism: an Essay Review", Journal of Consciousness Studies, 9(3), 77-82

Anorexia nervosa as an "addiction to the outside world"

Posted by a.marlow on October 20, 2012 at 11:15 AM Comments comments (0)

In a second blog entry on the psychoanalytical ideas of Monsieur Marinov, we come to one of his more intriguing and sensible propositions: namely, that anorexia nervosa should be conceived of as an "addiction to the outside world [1]".


His approach, unsurprisingly for a book whose title is "Anorexia, addictions and narcissistic fagilities [2]", is to examine anorexia through the prism of narcissism and addictions. (Here, we need to understand what is meant by the psychoanalytic use of the word 'narcissism': it does not refer to the personal vice of excessive self-love and self-importance as it does in ordinary speech, but rather refers to the ordinary and healthy process in early life where we learn to love and accept ourselves, where we invest our "libido" in ourselves). His view is that, due to having been "injured" by the hostile look of another in early life, the person who is now anorexic never learnt to love herself and instead saw the outside world as her source of self-love or self-acceptance. A child who followed a healthy course of development would have learnt to love herself in a process Freud called 'primary narcissism'; a child who might later become anorexic never learnt to love herself and derives her self-acceptance from "loaned narcissism [3]", which is, evidently, loaned from others. She can therefore never take her social worth for granted- for it ends as soon as the other pierces her with a hostile or indifferent look. She must constantly try to better herself or keep herself in line with what is socially expected of her- for otherwise, deprived of the love of the Other, and lacking the love of her self, she will feel totally worthless, having no libido invested in her from  any source at all.


It is based on this logic that Marinov sees anorexia as a "submission and... addiction to the outside world [4]". The anorexic develops a "false self" by which she can negotiate it, seeming to meet others' expectations, while inside her true self is undeveloped and seeking desperately to be free, to be released from her slavery to the approval of others. She is thus confronted by a confusing conflict of emotions between, on the one hand, her need for approval from the other and, on the other hand, her need for emancipation from that very first need. The ideal of her true self is, thus, an "ideal of emancipation from body needs [5]"- an ideal that is conveniently fulfilled by her most prominent symptom: the denial of hunger and denial of food.


So what can be done to help someone suffering from anorexia? It must be remembered that, from a psychoanalytic perspective at least, the reason she never developed any self-love or "narcissism" in the first place was because she lacked the experience of an unconditional loving gaze early on in life, which would then have gone on to be the first stage of her developing a stong sense of self-respect and self-control. Having lacked such unconditional acceptance, she might have grown up to experience herself as living in a world where she must put on a False Self and conform to external expecations to earn that loving look. If you are the friend, relative, or family member of someone suffering from anorexia, one of the most important things you can do is continue to provide that loving gaze. Let the person close to you know that she is accepted for who she is without needing to meet any particular expectations and hopefully, with time, this will go on to form the basis of her developing a strong sense of herself without needing to rely on the gaze of the other to find such self-acceptance.


[1] original: "addiction au monde extérieur"

[2] original: "Anorexie, addictions et fragilités narcissiques"

[3] original: "narcissisme d'emprunte"

[4] original: "soumission et... addiction au monde extérieur"

[5] original: "idéal d'emancipation des besoins corporels"


References:

Marinov, V., et al., 2010. Anorexia, addictions et fragilités narcissiques, Presses Universitaires de France: Paris

- Marinov, V., "Le narcissisme dans les troubles de conduites alimentaires", pp. 37-66

 

Psychoanalysis and feminism in the case of anorexia and hysteria

Posted by a.marlow on October 18, 2012 at 8:00 AM Comments comments (0)

At its best, psychoanalysis can give us profound insights about the unconscious causes of mental illnesses. At its worst, it can come across as sexist nonsense.


I first realised this while reading a book on the psychoanalytic account of anorexia nervosa and other conditions related to addiction. In the chapter on anorexia nervosa, I read:


"But this lilliputian perspective in the fantasies of women in general, and in anorexics in particular, is also linked in all probability to the comparison made at a certain age between the small size of the clitoris and the 'grandeur' of the boy's penis[1]"


Just before this point, the author had been making a generally insightful argument about how the failure of anorexics to realise just how thin they are relates not simply to a cognitive deficit, but is mainly due to a complex relationship between the physical sensation of space and size of the body and the emotional sensation of closeness to, or distance from, the mother, as well as the fear of being made to feel insignifant by her gaze (of course, to those unacquainted with psychoanalyic thought, the 'mother' in this case would be an unconscious image [or "object"] of her that was internalised at an early age: a distracted, empty or hateful gaze from mother towards infant might have been internalised as a constant unconscious presence to breed body self-loathing in the infant girl).  This idea has some merit, and is more convincingly developed by feminist thought, which goes on to posit a "psychology of femininity" (see Orbach) where women are raised to believe their value in society is primarily based on looks and service and to judge other women, including newborn baby girls, accordingly (even if they are unaware of it). In the logic of psychoanalysis, however, this is not even considered, and the default position is to return to a consideration of the infant's erogenous zones- which seems to me to be patently absurd.


Worse, another chapter in the same book offers this startling analysis of the related condition of 'hysteria':


"It is well known that love, as Molière said, is chiefly the business of women. This is also true of hysterics. It is here that we find the affinity between femininity and hysteria, perceived everywhere and known since time immemorial. [2]"


This isn't sexist in the sense that it's showing any kind of hatred towards women, I'll give it that. But the reasoning here seems shoddy at best. It seems to be playing on old stereotypes of how women behave without piercing through them and asking if they are true. Personally, I find the feminist account more convincing- or, at least, more intellectually rigourous- in that it views a close link between hysteria, a condition common among women in the late 19th century, and anorexia nervosa, common in contemporary culture, taking the view that both of them represent exaggerations of and unconscious protests against the social exclusion of women in their time: in the late 19th century, hysteria was a protest against/exaggeration of the romantic, frail female social role of late Victorian England, while now, anorexia can be seen as the protest against/exaggeration of the stick-thin model and all-providing mother archetypes that have defined women since the middle part of the 20th century.


What's worse, the description of hysteria given in this book verges on making a pathology out of ordinary female alienation. We read, for example, that one feature of hysteria are:


"the fears, the complaints, the accusations of women suffering from hysteria that they are not loved for who they are and are only 'sexual objects' for men [3]"


This is a key part of the feminist approach to anorexia nervosa: that women, faced with a world where they are sexually objectified by the culture around them, retreat into a child-like androgynous state where they are safe from the dangers of sexuality (as the denial of one's desire for food is taken to be a denial of desire in general, including the desire for sex; the result of this denial is that one's body loses the sexualised form of a teenage/adult woman and comes to resemble once more that of a child, free from the objectifying look of the other and the constant inconvenience of period pain). To make this an individual symptom of a mental illness, rather than a genuine complaint about a harmful culture, is to blame those suffering from eating disorders or hysteria for not managing to fit in well enough, rather than recognising the social pathology at the heart of our culture in the way that it relates to women- a pathology that must be cured on a collective level, rather than/as well as focusing treatment on individual sufferers in therapy. 


To sum up, we should not forget that psychanalysis has given us a lot of profound insight into the nature of mental illness. It is from psychoanalytic thought that we realise that the issue at the heart of anorexia nervosa is not food per se, but rather the search for self-control through the medium of food. And yet we cannot just ignore the deficits at the heart of psychoanalysis. Many of its ideas remain deeply offensive to many, and unless it wants to remain the embarrassing elderly relative of modern experimental psychology that few still take seriously, it needs to address some of its problems and adapt its ideas to the modern world and the insights of feminist thought.


[1] Marinov., V., p. 62 [translated from French].

[2] Lanouzière, L., p. 131 [translated from French].

[3] Lanouzière, L., p. 134 [translated from French]


References:

Marinov, V., et al., 2010. Anorexia, addictions et fragilités narcissiques, Presses Universitaires de France: Paris

- Marinov, V., "Le narcissisme dans les troubles de conduites alimentaires", pp. 37-66

- Lanouzière, J., "L'hystérique et son "addiction"", pp. 131-156

"Compulsory promiscuousness" and the sexual revolution

Posted by a.marlow on October 14, 2012 at 12:25 AM Comments comments (0)

It is a common train of feminist thought that anorexia and related disorders represent a flight from the sexual objectification of the female body. However, it might be that this analysis misses the wood for the trees and ignores a far wider phenomenon.


That, at least, is the suggestion of Young-Bruehl who, writing in the 1993 edition of the International Journal of Psychoanalysis, accuses feminism of being blind to a wider culture of over-sexualisation, where children grow up under the "tyranny of youthful sexual experimentation". The accusation is that, as an ideology that grew up in the heady days of the 1960s sexual revolution, it is loathe to criticise it in its totality, instead taking the specific effects of this revolution on women and ignoring its effects on young people in general.


If feminism identifies a cultural imperative on women and girls to conform to the thinness of the model and the generosity of the mother, then Young-Bruehl suggests we might need to also consider the equally pervasive cultural imperative on young people in general to have sex. It may seem strange to some people that this would be experienced as an imperative- after all, doesn't everyone want sex? How is this an imperative rather than liberation?


Yet such thinking ignores the fact that being sexually active is experienced as something obligatory by many teenagers. The worst thing in the world is to be a virgin. Sex has become a rite of passage, a route into adulthood- and some people just aren't ready for that when they hit puberty. For some people, the idea of sex itself is terrifying, and this might, suggests Young-Bruehl, manifest itself in an eating disorder: for when one is anorexic, one almost becomes desexualised. Below a certain weight, teenage girls stop having periods. Losing weight means a flattening of the chest and, perhaps, a loss of sexual interest from others. In the end, her body might resemble that of a child more than it does that of a woman- and to someone frightened by the very thought of sex, or by growing up in general, that is a comfort.


This kind of idea had already been identified by feminism- in Orbach's book "Fat is a Feminist Issue", she describes becoming obese and becoming anorexic as two different responses to the same fear of becoming sexually objectified. Yet Young-Bruehl's insight is that this kind of fear can come not just through the tyranny of feminism's Female Beauty Ideal, but also through the general experience of being a child in a sexualised world.


References:

Young-Bruehl, E., 1993. "On feminism and psychoanalysis - in the case of anorexia nervosa", International Journal of Psychoanalysis, 10(3), 317-330