When Medicine Got it Wrong

I have often compared the way parents of schizophrenics were treated decades ago to the way parents of eating disorder patients are often STILL treated: harmful, unnecessary, ignorant.

This film tells the story of how that changed with schizophrenia, and it is wonderfully done:
When Medicine Got it Wrong

And I once got the chance to tell the filmmakers that!

Comments

  1. Hi Laura

    I agree that EDs have a biological basis, with that biological basis being linked to the brain's response to malnutrition as well as to the sufferer's inherent temperament/character traits. Furthermore, I don't blame my parents' treatment of me whatsoever for my history of AN and co-morbid difficulties. Most people I know with EDs come from very loving and supporting families.

    Having said that, EDs are triggered by environmental/social/interpersonal factors. Their biological basis is not the trigger in itself, and people who are born with the genetic susceptibility to developing EDs don't just automatically develop these illnesses at a certain age. Thus, the biological pre-disposition underpinning EDs doesn't mean that the vulnerable individual will definitely develop an ED. They'll only do so if exposed to potent triggers.

    When a person has an ED their eating and other behaviours take on personal meanings. Nowadays, that meaning often relates to 'body image' or being thin, perhaps because of our society's obsession with 'body image', obesity avoidance, 'healthy' eating etc. In different cultures, the personal meaning of ED behaviours are very different. In people who have been subjected to the trauma of physical or sexual abuse, ED behaviours are interpreted by the sufferer in accordance with traumatic memories.

    I know a number of individuals who started to restrict food when they were traumatised by abuse within the family. These individuals needed trauma therapy to recover from their ED, as well as separation from the family, because the personal meaning of their ED behaviours was so integrally linked to traumatic memories of abuse. Perhaps it is true that these survivors of abuse also had a genetic vulnerability to developing an ED, but it could equally be argued that trauma triggered anxiety and other psychological disturbances.

    It would be unhelpful and unproductive to the ED sufferer who has experienced parental abuse to be told that this was all their problem and to ignore salient traumatic triggers.

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  2. Cathy,

    I do not want anyone to ignore trauma or ANYTHING that is important to the patient. I only want us to make it specific to the patient and not leave a pall over all families affected by eating disorders.

    Trauma, parental abuse, bullying, societal pressures, thin models - all these things DO have an effect on recovery and MAY have an effect on severity and onset, but it is important to distinguish between things that influence initial disordered eating and the grave mental illness that ensues.

    If it helped treatment, I'd be all for talking about triggers but I have yet to see that evidence. In fact`I see the opposite.

    Mental health requires insight and self-knowledge - and psychotherapy can be so helpful with this. But mental ILLNESS is far more than a lack of insight.

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  3. Thanks for the feedback Laura...

    You write: "it is important to distinguish between things that influence initial disordered eating and the grave mental illness that ensues..."

    I definitely support the concept that first and foremost, ED patients need to rectify their disordered eating and achieve a healthy weight. For some people normalisation of eating and weight + CBT go a long way to resolving the problem. The person may not have underlying issues to resolve.

    However, some ED patients do have underlying issues, including trauma, and their ED behaviours and trauma are integrally linked. This can occur quite frequently in patients with BPD. Even though this may not be talked about much, or widely documented in the ED literature, I know of a number of ED patients (albeit mainly with BN rather than AN) who have benefitted (in terms of their ED behaviours) from trauma therapy in conjunction with DBT. These patients often have multiple self-harming behaviours and addictions, which include bingeing and purging.

    I also agree that mental illness is far from a lack of insight...

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  4. You and I are in complete agreement. Trauma therapy, DBT, CBT - these are all important tools to have in the toolbox when needed.

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