Some Common Myths
"Anorexia is the by-product of a culture that prizes thinness above everything."

Society's emphasis on looks clouds the more important issue that children are dying because they are trying to achieve impossible standards of perfection. This focus on perfection is not so much for personal gratification as it is a misguided attempt to improve the world. Rather than thinking of the supermodel syndrome as a cause of eating disorders, it is best to think of it as a possible trigger. Modeling is an area in which perfection seems attainable, one of the many venues for perfection (such as sports, academics, dance, and so on) that eating disorder victims will fit themselves into. Most teenage girls try to lose a few pounds for the sake of attracting boys in high school. Many women are constantly on a diet, unhappy with their bodies. But a girl with and eating disorder will use the ideal of the model as a way to hone her sense of perfection; boys are not on her mind. A woman with an eating disorder doesn't want to be a size 6; she wants to be a size 0. The difference is knowing how much of what society presents to take seriously.

"Anorexia is more prevalent in females than in males because females are told that appearance is important while males are praised for other qualities."

Women are bombarded with images of unattainable female beauty. Women's magazines are filled with articles and advertisements touting diets, weight loss, exercise machines, and so on. Beautiful women are featured in television ads that sell everything from beer to automobiles to detergent. Perhaps more men are not faced with the anxiety of society's contradictions as often because their stereotypical role is to do rather than to mediate and placate. But given the changing roles in society, men see themselves more often in the position of giving care. Historically, women have been honed to the caregivers of home and therefore of society's needs. For years, they have been the quiet support person, the one to whom the expressions "The power behind the throne" and "Behind every great man is a great woman" applied. So naturally, it would follow that there would be a higher incidence of eating disorder manifestation among females.

"Anorexia is caused by physical, emotional, or sexual abuse."

It may not be the trauma of the abuse per se, but the individual's perception of reality that will cause anorexia. We can change reality only to a certain point (by addressing the trauma and distress that act as triggers), but we can try to change people's attitudes toward and perception of reality. In other words, we can objectify abuse, that is, try to help the abused victim understand that she did not deserve or cause the abuse, in order to preserve the sanity of the victim. Perhaps anger toward ignorance only compounds the problem and prolongs the suffering of the victim. Compassion and understanding for the limitations of human awareness would seem more likely to heal the victim than criticizing her for not condemning her abuse or her abuser.

"Anorexia is caused by distant, uncaring, demanding, or otherwise dysfunctional parents."

There is a widespread perception that anorexia is more common in families in which rigid, exacting, uncompromising parents impose their own personalities on compliant little children. The "best little girl in the world" stereotype conveys that nothing the child does is good enough for insatiable, demanding parents, so the child keeps trying harder and harder to please them.

Parents are primarily responsible for defining the world in which their children find themselves, but the emergence of an eating disorder is not in itself a response to a specific social structure within the family. Moreover, young people with eating disorders work at parenting their parents; they insist on caring for the adults. The stress of parentsí divorce in particular is blamed for children's eating disorders. family traumas such as illness, divorce, or other life crisis may act as triggers that help shift someone with preexisting food issues, into a full-blown eating disorder. If a child is already feeling more negative and subjective about what is going on in her life, she is more vulnerable and susceptible to taking these emergencies personally and feeling helpless about them. The more pervasive the pessimistic thought patterns-that is, if they dominate 60 percent of her thoughts rather than 20 percent-the more effective the trigger will be in setting off the eating disorder. In the long run, placing the blame on parents-even if they are "guilty" of creating triggers for eating disorders-can be detrimental and dangerous to their child. It may prevent them from being available to her when they are most essential as her basic support system. Their energies will be diverted to searching for their error in "causing" their child's condition and possible death. Their guilt will rob them of the strength to stand firm to reverse the Negative Mind, and so they may give in to what they assume are their child's needs when they are actually giving in to the condition's demands.

"Anorexia is the consequence of perfectionistic people failing in their desire to be perfect."

Perfectionism for an individual with an eating disorder is about appeasing society and placating its expectations. Why does a child need to be perfect? Perhaps she does because we, as a society, have told her that she can be, and because she feels she therefore must be. But there is a great difference between seeking to perfect oneself for self-satisfaction or the accolades of family or society-behavior that we would probably label as "normal"-and the victim's attempt at perfection in order to make society, as a whole, a better place for all.

"Anorexia is caused by low self-esteem."

It makes little sense to talk of self-esteem in the same breath as anorexia. Anorexia is a condition based on the lack of a fully defined self. To recover from anorexia, the victim must first develop a self before she can address her self-esteem. Esteem will naturally begin to develop after the self has begun to emerge.

"Anorexia is the result of trauma from the pain of parentsí divorce, adolescence, or other life crises."

Every divorce is unique because every marriage and family is unique, and there are children who feel traumatized by their parentsí breakup. However, it is not the particulars of the divorce itself, but the manner in which the child takes the blame and burdens upon herself that triggers the eating disorder. This can happen even in the most civil divorces. A divorce represents a failed marriage, and the person with food issues will inevitably see herself as responsible for the failure-or as a failure for not being able to prevent it.
Parents are busy trying to accommodate their child's individuality. Given the psychological onus that society places on evaluating the self, parents are perhaps less inclined to make a defined stance on what direction to push their child. Thus the child feels she is sinking in quicksand at the very time she needs direction. She cannot find a platform from which to spring.

Fewer rules, less structure, less black and white. Perhaps parents are loath to appear directive of their child's potential because in contemporary society people are generally less sure of their environment and therefore their role in it. Maybe it is out of a misled "respect" for the child with food issues, given that we are so afraid of harming her integrity as an individual, that we do not create enough structure for her when she needs it early in life.

"Anorexia is a disease of the Ďeconomically advantaged.í "

Eating disorders have often been said to be the province of middle or upper socioeconomic classes. That may generally be true, but it is also understandable. Today there is less physical stress in living in middle- and upper-class households, but more emotional stress and more anxiety that sensitive children are bound to absorb. Perhaps parents in these circumstances are more rushed and anxious in maintaining their lifestyles. This may result in more perceived stress, which children turn translate as anxiety.

Perhaps a child's internal interpretation of her parentsí achievements creates in her the expectation that she must live up to their "standards," even though this does not come from parental edicts. She has constructed these "standards" herself. The middle- and upper-income child may shoulder more responsibility; not because her parents ask her to, but because she takes it upon herself to fulfill what she perceives as their high aspirations.
The existence of boundaries, whether desirable or not, at least provides a form of stability. Perhaps, too, children in lower socioeconomic circumstances enjoy the benefits of a larger extended family. Grandparents, uncles, and aunts may share the chore of nurturing, and as I mentioned earlier, the more adults participate in a child's growth, the more likely the child will grasp objective reality.

"Anorexia is a psychosomatic disorder caused by a child's refusal to grow up into an adult."

A common misinterpretation is that anorexics are struggling to remain childlike. As purported victims of the Peter Pan syndrome, they are thought to fear and loathe adulthood. But our case histories show again and again that the fear of growing up may be a consequence of the eating disorder, but it is not a cause.
Before manifesting the condition, these young people had extraordinary capability for self-direction and social responsibility. Depending on their age, they excelled in every area. Far from reneging on adult responsibility, they shouldered too much of it to adhere to society's extended values. They appeared compliant for fear of offending others. Their primary focus was always for the well-being of others rather than themselves.
Children are also said to become anorexic because they do not want to become sexual beings. Sexuality implies not just maturity but pleasure. Just as the punishing Negative Mind will not allow its victims food, so will it deny them any other form of pleasure as well.
Sexual maturity is also synonymous with graduating to being normal. In their minds, anorexics believe they do not deserve that privilege because they have already "tried" adulthood and failed. Avoiding sexual maturity (or any act of normalcy) is a way of relieving themselves of the guilt they experience for failing to help the world. It is not fear of sex per se, but rather fear of further failure at responsibility and the guilt that new failures would engender. Menstruation, and indication of physiological normalcy, is not a welcome rite of passage for these victims.

"Anorexia is an unconscious attention-getting device, a cry for help."

Anorexics are highly embarrassed at being noticed. They typically wear baggy clothing to disguise their weight loss. Victims of eating disorders yearn for someone to understand them, but their Negative Mind will not allow them to ask for help, and they do not feel they deserve it anyway. If weight loss is the unconscious cry for attention, why donít victims stop losing weight once parents and other loved ones try to intervene, often with valiant efforts? It is because their unconscious motive is to die, not to get attention. If there were a way to die of anorexia without losing weight-a visible sign-they would do it.

"People with eating disorders are selfish. They just need to get on with their lives and stop ruining everyone else's!"

Eating disorder victims are the antithesis of selfish. Indeed, they are selfless to the highest degree. Unfortunately, the Negative Mind constantly accuses them of self-indulgence when they want merely to exist in the world, so any allegation of selfishness from external sources such as family or medical professionals simply reinforces and strengthens the Negative Mind's hand.

"Anorexia is a tool for control."

The misconception is that by denying themselves food in the face of the vigorous encouragement to eat, anorexics are trying to control their world against others. Rather than control others, I believe victims are trying to control the remaining bit of their Actual Mind against the Negative Mind. They are losing power because the Negative Mind bullies the Actual Mind into submission.

If we ignore the existence or misunderstand the role of the Negative Mind, it can only follow that we will misconstrue whom the child is trying to control. The Actual Mind always takes the rap for the Negative Mind, since the latter is so carefully hidden from our view. Consequently, the child will understandably be mislabeled as controlling.
As the Negative Mind gains in strength, it creates internal chaos.

"On the outside, I still look like I am in control and so together, but on the inside I have nothing."

"I have been in turmoil. Iím so completely without direction."

"I feel myself completely shattered and I'm so afraid."

"Emotions control my food. The life that I canít control, controls my food."

"There is always that fear of criticism, ridicule, being scolded, losing a job, losing a friend, or failing. Iím always afraid when asked to do a job, or left with the decision of what to make for dinner that Iíll do it wrong and thus be rejected."

Controlling behaviors can be seen as a child's attempt to create a structure for herself.

"Anorexics are to blame for their situation. Theyíre doing it to get back at others."

Given that the dynamics of an eating disorder occur at an unconscious level and are as perplexing and complicating for its victims as they are for their families, the view that anorexics are intentionally guilty of hurting their beloved parents just adds to the nightmare of their existence.

When unwitting practitioners blame parents for their children's anorexia by insisting that anorexia results from favoritism, abuse, or some other symptom of family dysfunction, they often create animosity among parents toward their children, and the victims end up as losers. After such finger-pointing, parents often ask victims, "Why have you done this to us? How could you continue to be so cruel?"

The very word "victim" implies helplessness at the hands of another. In this case, the victimization is neither by the inadvertent ignorance and unawareness of society nor of any given individual. Eating disorders are an exceedingly negative response to a misinterpretation of one's role in the world. The victimization occurs in the negative construct the patient has unwittingly built against herself. She becomes helpless against the onslaught of the Negative Mind within her.

"Sufferers need to hold on to their condition as a crutch."

It has been described that victims of eating disorders are in some perverse way clinging to the crutch of their illness. It is more accurate to say that they are dominated and enslaved by it. They want to let go of it, but they have nothing to replace it withUltimately, victims are terrified to relinquish the condition because they know no other way of being. Therefore to give up the condition is to cease to exist-even worse than death. Anorexia becomes a negative structure- "Who am I if not my illness?"-and an all-pervasive way of being.

"The longer you have anorexia, the harder it is to cure."

On occasion, this may be true because the condition has been confirmed repeatedly, possibly due to so many futile hospitalizations. With each failed program, the Negative Mind reconfirms itself and becomes more pernicious. Similarly, the longer the Actual Mind has learned to exist marginally and the longer it feels the negative comfort of that existence, the more difficult an eating disorder is to cure. Once the Negative Mind has enough control to manifest an eating disorder, healing appears to depend more on the basic personality of the individual than on the duration of the eating disorder manifestation.

"Anorexia can't be cured; it can only be managed. Youíll live with it and die from it."

Eating disorders are a silent epidemic. Anorexics have no constituency. They cannot rise up en masse to say, "We need help." You do not see them banding together to form research societies and associations, although others have formed these organizations on their behalf. Nevertheless, these conditions are completely reversible, though the cure requires a total renurturing of the afflicted individual.

However, to "manage anorexia" is merely to maintain the condition's status. To maintain it is to invite recidivism. In order to correct the eating disorder symptom, the eating disordered person must be addressed and reversed. This reversal requires patience, complete understanding and as much time as each individual needs.

How can we integrate this concept into society as it exists today? How, given the vast tragedy we see before us, can we not.

(With extracts and help from Peggy Claude-Pierre Montreux Counselling Centres)
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