On Amy, the Development of Eating Disorders and the Influence of Societal Ideals of Beauty

In response to the recent press cycle around the promotion of the current movie biopic / documentary Amy about Amy Winehouse, both acclaimed and notorious music magazine Pitchfork and feminist-theory orientated film critics blog Btchflcks recently have published pieces on Winehouses life, her mental problems and the influence of the society on this. While especially the article on Pitchfork is pretty well researched concerning the general facts on eating disorders and while I really support its general criticism and questioning of societal beauty ideals, I still feel that it still stays a bit superficial on a.) what the problem is in eating disorders and b.) where they come from. Of course the rationale of saying that Amy Winehouse died of exhaustion means that she died from drug overuse and reduced calory intake means that she died from an eating disorder is true. But it doesn’t help to really understand the dynamic of a mental disorder and its roots.

Symptoms are not the roots of an illness (even if the standard definitions of disorders by symptoms, as practiced by the WHO’s International Classification of Diseases (ICD) and the APAs Diagnostic-Statistical Manual of Mental Disorders (DSM), might suggest this idea). Symptoms represent a coping style for resolving an inner conflict, and usually they are the best possible way of coping that was availiable to the individual in the moment of crisis. That doesn’t mean that this is the best (or sanest, or most functional) way of coping. Just the best possible way availiable to the individual in the moment it needed a solution.

It’s like rain pouring down on a soil. The stress, the internal object relations, the negative ideas about other people and the self – all this is the rain. The most exciting question is: in which direction is the rain going to pave its way through the soil when it hits the ground? How is the structure of the soil – how will it give way to the rain forming a stream? In other words – in which external form will these internal conflicts find an expression, an outlet on the outside of the individual?

This evokes the question: How does it appear to a person (rationally or emotionally) to be a valid and helpful solution to stop eating? And how do societal ideals and values influence this idea? Why not become depressed? Why not an anxiety disorder? Why not other ways of expression?

As always, the possible answers to this questions are numerous again. Some ideas:

  • a genetical, epigenetic or neurophysiological disposition.
  • the significance of eating and food in the family (e.g. in conflicts of autonomy: „i won’t it what you serve me, because if I eat that, I’ll have to take in all the other stuff you’re giving me, too! And I’m not doing that any more!“).
  • the symbolic idea of wishing to disappear (shame!) and therefore reducing your physical appearance („I don’t want to be here any more!“).
  • the magical idea that not eating will serve you feeling a sense of autonomy, success, self-efficacy in a way you can’t feel these things in other contexts (which it actually does – but only in the short run).
  • AND – last but not least – societal ideals.

Societal ideals implicitly suggest and explicitly propose, that
being thin means being happy.
being thin means being disciplined, attractive, having a high social status, having a partner, receiving attention, being successful.
Sounds like a perfect remedy, doesn’t it?ED-3

There are a lot of routes in which societal norms and believes influence us: Via our upbringing and the beliefs of our parents (Route a), via social learning and feedback on our behaviour (Route d), etc. I want to especially highlight two other routes that might have an effect on developing an eating disorder. Route b.) directly influences the development of a low self image by comparison to others – do i fulfil the demands of the ideal? Am i good enough, is my body good enough? Is it my fault, if my body is good enough? Is this the reason why I am not happy?– and therefore constitutes a risk factor.

The second route (Route c.) is at the very point of trying to solve the internal conflicts. As the subconscious is looking for a form of expression, an outlet, as the dealing with the actual conflict appears overwhelming, it is influenced by all the factors mentioned above: genetical heritage, strengths and weaknesses, symbols in the family, but it also is influenced by the suggestion that society makes:
Maybe I can’t control certain interpersonal dynamics and fights and discussions in my family.
Maybe I can’t control symptoms of depression.
Certainly I can’t control what society thinks about the ideal female body.
But what I can control is – my body!

As a conclusion: Can societal norms be the reason for the development of an eating disorder? I would say no.
Can societal norms influence and contribute to the development, perpetuation and deterioration of an eating disorder? Absolutely, yes. Should these norms therefore not only be questioned, but criticised? Absolutely, yes.

I’m not trying to minimize or whitewash the influence there is – I still am convinced that as a man I can’t even fully grasp the excruciating effect the images of women, the concepts of beauty and the daily comparison to these societal rules and ideals have on girls an women. I am sure that this effect is very powerful and very dangerous and influences people on a daily basis. I’m just saying that in the context of Eating Disorders, it’s even more complicated. The problems people with depression, a low self-esteem, bad experiences in growing up or bonding have, are probably as old as humanity. The forms of expression of these conflicts are an appalling and alarming sign of our modern times.

2015-08-14 amy btbReturning to the case of Amy Winehouse, one can not only find the routes of influences of a society found above. The fact of her being a person of public interest, a star, in some ways depending in her job on the attention of the press make her (apart from her personal conditions) even more vulnerable to influences from society and/or press or public opinion. The Btchflck article points out very clearly in how far the greedy press (and public!) interest in the deterioration of Amy Winehouses condition had a devastating effect: Mainstream media loves to watch when a famous woman–Courtney Love, Britney Spears, Lindsay Lohan–breaks down in public. Btchflcks, who always have been mindblowing at identifying and analyzing cultural stereotypes and tropes (e.g. the Manic Pixie Dream Girl) also mention the myth of the depressed and mentally destroyed artist who actually needs the suffering in order to make great art, and if he/she succeeds in that, it’s even therapeutic. What kind of lesson does this idea teach to a young, confused, uprising musician, with an already conflicted background?

If one really wants to get to the root of societal influence on the development of mental disorders and the role of the media, one has to ask oneself, in how far the public interest in Amy Winehouse was responding to individual needs and desires. Society is not an isolated object. In how far did we create, maintain and reconstruct these societal ideas?

It’s not the press. The media. The society. It’s us! Who bought the records of Amy Winehouse? How did it happen that a song like Rehab, that celebrates the resistance of seeking professional treatment, became something like an anthem of independence? Who reads, even still now, the articles on the documentary, or comments on them in blog posts? How did we, the audience, and still do, repeat and corroborate the medial attention, the desire for information on an individual tragically suffering and dying from it? Aren’t Eating Disorders always associated with a certain sense of innocence, of innocent suffering, of the victim under the pressure of the society, images we all want to identify with?

We probably want to see people suffer, because we either identify with their suffering or we’re glad that even though we feel our inadequacies so strongly in our daily life, there are still people who are worse off than us – so hey! As Conor Oberst (Bright Eyes) once put it in his song Road to Joy (sic!): Well I could have been a famous singer // If I had someone else’s voice // But failure’s always sounded better // Lets fuck it up boys, make some noise! And it raises the pretty awful question: Would we really would have been as interested in seeing a clean, mentally stable, self-empowered Amy Winehouse? And what does that say about ourselves?

Pitchfork: We Need to Talk About Amy Winehouse’s Eating Disorder and Its Role In Her Death

Btchflcks: ‘Amy’: Our Love Didn’t Do Her Any Favors

Tl, dnr: The post aims at distinguishing various ways in which societal beauty norms influence the development, perpetuation and deterioration of Eating Disoders. Pathways include model learning from parents, subtle suggestions from society about the effects of being thin and adapting to an ideal of beauty and social feedback on trying to stay thin.


Aprox. 40% of war zone-escaping asylum-seekers suffer from PTSD

According to data from the German Federal Chamber of Psychotherapists, about 40% of the asylum-seekers entering Germany suffer from post-traumatic stress disorder (PTSD). The prevalence of this condition stems from the experience of a huge number of stressful and traumatic events they experienced a.) in their homeland, under the conditions of war, violence, poverty and various kinds of deprivation and b.) during their flight to a safer country, including harassment, stigmatization and persecution.

Commemorating the World Refugees Day on June 20th, that was installed by the United Nations General Assembly in 2001, the Federal Chamber of Psychotherapists released a press statement demanding amends in the treatment of refugees seeking asylum in Germany.

Post-traumatic stress disorder is one of the few mental disorders where the influence of an external life event by definition is a causal (or etiological) factor for developing the disorder. Symptoms include hyperarousal, hyper-vigilance, impaired memories of the traumatic event while at the same time experiencing intrusive memories of certain aspects, to the point of full-blown flashbacks.

Eptsd beitragsbild2tiological models of PTSD state that the intensified neurobiological stress reaction during the traumatic situation impairs the encoding of episodic memory aspects, which later on leads to an impaired memory recall. As a result, in certain situations affected people aren’t able to distinguish between the memory of the past traumatic event and the perception of a present situation. When triggered, they repeatedly feel caught in the perception of an immediately impending thread, just as it was during their traumatic experience, again and again during their everyday life. This means that even when these people escaped the lifethreatening situations they experienced, the terror of fearing for their life stays in their minds, not just as a memory, but as actually present.

As the research of Neuner and colleagues shows, there is a strong connection between the number of experienced traumatic event types and the development of PTSD symptoms. In a sample of West Nile Refugees, they found that while 23% people reporting three or less traumatic events types developed an PTSD, it was 100% of the people who reported 28 or more traumatic event types showed the symptoms of the disorder. Therefore they conclude: (…) if the cumulative exposure to traumatic events is high enough, these results indicate that anybody will develop chronic PTSD. We conclude that there is no ultimate resilience to traumatic stress (…). In other words: The development of this mental illness for these people does not depend on any individual factors as their growing up or mental state. At some point, experiencing too many of these kind of situations WILL lead to the onset of this illness.

These findings are of high relevance especially in the context of refugees escaping from war zones, as they are most probable to have been exposed to a variety of different types of traumatic events (violence, persecution, witnessing of killed or dying people, assaults, rape, and others).

Sources & further literature:

Gäbel, U., Ruf., M., Schauer, M., Odenwald, M. & Neuner, F. (2006). Prävalenz der Posttraumatischen Belastungsstörung (PTSD) und Möglichkeiten der Ermittlung in der Asylverfahrenspraxis (Prevalence of Posttraumatic Stress Disorder among asylum seekers in Germany and its detection in the application process for asylum). Zeitschrift für Klinische Psychologie und Psychotherapie, 35 (1), 12-20.

Neuner, F., Schauer, M., Karunakara, U., Klaschik, C., Robert, C. & Elbert, T. (2006). Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC Psychiatry, 4 (34), full text availiable online

Spiegel: Gewalt in Flüchtlingsheimen: Traumatisiert und eingepfercht (German article describing the tensions in asylum-seeker camps due to their mental strass and acommodation conditions)

Spiegel: Therapie für traumatisierte Asylbewerber: „Ich kann leider nichts für Sie tun“ (German article dealing with the extremely limited possibilites to treat traumaticed asylum-seekers)

Is the Ugly German Back? Flames of Hate Haunt a Nation (English article on the violence attacks on asylum-seeker camps and shelters.

Tl, dnr:
Refugees and asylum-seekers are an incredibly vulnerable population, escaping from circumstances that not only threatened their physical but also their mental health. This has to be considered in the procedures and treatments they receive when looking for a safe place to stay.

Darren Hayes on Depression

As the people who know me will know, I always have a very soft spot for Darren Hayes, the former singer of 90’s Australian Pop (yes, with a capital P) Group Savage Garden.

Is it because one of his songs was the soundtrack to me falling in love for the first time, at the beginning of high school? (You know – this will always stay with you, deeply engraved in your DNA.)

Or was it the heartbreakingly devastating song he co-wrote about growing up in a family with an alcoholic father in an environment of domestic violence?

Or (as I’m still convinced today) his incredible way of putting emotional issues into words? Probably all of it.

Anyway, the man just posted an in-depth and honest essay on the effect of Major Depressive Disorder on the perceptions of your everyday affects and emotions, and also touches an the pro’s and con’s of antidepressant medication.

He delivers an authentic recount of the constant battle of dealing with a psychological condition on a daily basis, in both the short and the long term.

In addition, it also portrays the confusion and disorientation it causes when somebody realizes the disconnection of his self from his emotions – i.e. that his emotional reactions not only don’t work the way they usually do, but stopped responding to his will completely.

It’s definitely worth a read. You can find the whole essay here:

Former Savage Garden-frontman and now solo artist Darren Hayes wrote a candid Facebook Post about his experiences with depressive episodes, dealing with disconnection and the use of antidepressant medication.