Reconfiguring Relatedness in Anorexia

Abstract

Anthropological concepts of relatedness have not been addressed in any of the writings on anorexia, despite the literature being replete with negative connotations of sociality such as withdrawal, regression, and toxic families (in the form of 'obsessive mothers' or 'absent fathers'). As a departure to the vast literature on this topic, this multi-sited ethnographic project draws on the recent critiques and broadening of the concept of kinship to examine the ways in which a group of people with a diagnosis of anorexia understood and experienced relatedness in their everyday lives, that is, how they continually transformed connections by truncating, creating, sustaining and abandoning them. Those practices that are taken for granted as creating and sustaining relatedness-from the everyday practices of commensality to the capacity to have children-were consistently negated. Negating consensual avenues of relatedness did not leave these people in a void. On the contrary, new and productive meanings and experiences of being related were created and people entered into a relationship with anorexia that, in turn, tempered their relationships with their everyday worlds. In examining the 'relational matrix' of anorexia, new spaces of agency, ambiguity and power are illuminated.

Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria

“…Peer contagion has been shown to be a factor in several aspects of eating disorders. There are examples in the eating disorder and anorexia nervosa literature of how both internalizing symptoms and behaviors have been shared and spread via peer influences [ 37 – 41 ] which may have relevance to considerations of a rapid onset of gender dysphoria occurring in AYAs. Friendship cliques can set the norms for preoccupation with one’s body, one’s body image, and techniques for weight loss, and can predict an individual’s body image concerns and eating behaviors [ 37 – 39 ].…”

“…Friendship cliques can set the norms for preoccupation with one’s body, one’s body image, and techniques for weight loss, and can predict an individual’s body image concerns and eating behaviors [ 37 – 39 ]. Peer influence is intensified in inpatient and outpatient treatment settings for patients with anorexia and counter-therapeutic subcultures that actively promote the beliefs and behaviors of anorexia nervosa have been observed [ 39 – 41 ]. In these settings, there is a group dynamic where the “best” anorexics (those who are thinnest, most resistant to gaining weight, and who have experienced the most medical complications from their disease) are admired, validated, and seen as authentic while the patients who want to recover from anorexia and cooperate with medical treatment are maligned, ridiculed, and marginalized [ 39 – 41 ].…”

“…Peer influence is intensified in inpatient and outpatient treatment settings for patients with anorexia and counter-therapeutic subcultures that actively promote the beliefs and behaviors of anorexia nervosa have been observed [ 39 – 41 ]. In these settings, there is a group dynamic where the “best” anorexics (those who are thinnest, most resistant to gaining weight, and who have experienced the most medical complications from their disease) are admired, validated, and seen as authentic while the patients who want to recover from anorexia and cooperate with medical treatment are maligned, ridiculed, and marginalized [ 39 – 41 ]. Additionally, behaviors associated with deceiving parents and doctors about eating and weight loss, referred to as the “anorexic tricks,” are shared by patients in a manner akin to deviancy training [ 39 – 41 ].…”

“…In these settings, there is a group dynamic where the “best” anorexics (those who are thinnest, most resistant to gaining weight, and who have experienced the most medical complications from their disease) are admired, validated, and seen as authentic while the patients who want to recover from anorexia and cooperate with medical treatment are maligned, ridiculed, and marginalized [ 39 – 41 ]. Additionally, behaviors associated with deceiving parents and doctors about eating and weight loss, referred to as the “anorexic tricks,” are shared by patients in a manner akin to deviancy training [ 39 – 41 ]. Online environments provide ample opportunity for excessive reassurance seeking, co-rumination, positive and negative feedback, and deviancy training from peers who subscribe to unhealthy, self-harming behaviors.…”

Scared but loving it: Children's enjoyment of fear as a diagnostic marker of anxiety?

“…Given the difficulties of identifying and differentially diagnosing anxiety disorders, it would be valuable to have diagnostic markers for screening purposes. Diagnostic markers have been associated with a range of disorders, including Prader-Willi syndrome (Young, Zarcone, & Holsen, 2006), Autism Spectrum Disorder (Peterson, 2005), bipolar disorder (Leibenluft, Charney, Towbin, Bhangoo, & Pine, 2003), apraxia (Shriberg et al, 2003) and anorexia nervosa (Warin, 2006). The presence of one or more key features acts as a "red flag" to indicate the need for comprehensive assessment, or the marker may assist in accurate differential diagnosis by supplementing existing assessment methods.…”