Medialization catch-22s
I’ve recently been inspired by Dr. Walter Vandereycken and his research on eating disorders. In his article “Media Hype, Diagnostic Fad or Genuine Disorder? Professionals’ Opinions About Night Eating Syndrome, Orthorexia, Muscle Dysmorphia, and Emetophobia,” he presents a great point:
“By regarding a phenomenon as a psychiatric diagnosis–treating it, reifying it in psychiatric diagnostic manuals, developing instruments to measure it, inventing scales to rate its severity, establishing ways to reimburse the costs of its treatment, encouraging pharmaceutical companies to search for effective drugs, directing patients to support groups, writing about possible causes in journals–psychiatrists may be unwittingly colluding with broader cultural forces to contribute to the spread of a mental disorder.”
“These reflections force us to think about the question whether, by publishing this study, we are part of the social construction of “new” disorders? Perhaps that is unavoidable. With this study we are exploring the borderlands and cross-overs between scientific and popular discourses about health and illness. We are facing an increasing media attention for scientific issues on the one hand and an increasing orientation of science towards the mass media on the other hand. The medialization of science, when applied to medicine, can get intertwined with another powerful process of a two-way relationship between medicine and mass media: the medicalization of our society, of which the dissemination of diagnostic labels is a classic symptoms. The two sociocultural processes, medialization and medicalization, actually culminate in cyberspace. With this study we are, so to speak, participant observers at the crossroad of these processes. By publishing about it in a scientific journal we not only are becoming part of this medi(c)alization but also, unwittingly, we may shape and fuel it!”
I think about that last statement all the time whenever I see media attention on eating disorders. While I don’t really want to promote ignorance, sometimes I think that any attention is negative attention — this blog included! It’s a kind of catch-22: the public needs more information to decrease the stigma of mental illness, but at the same time you are “unwittingly colluding with broader cultural forces to contribute to the spread of a mental disorder.”
How many times have you heard about the influence of culture in the development of eating disorders? Fashion, society’s obsession with thinness, celebrity-whatever, etc. You hear about it all the time. Heck, you have groups about it in treatment! However, given this idea that just “regarding a phenomenon as a psychiatric diagnosis” is enough to influence society in an unhealthy way, then essentially even treatment could be viewed as a perpetuating factor of mental illness. Maybe that seems a little extreme, but it’s something to think about.
In a conversation with my friend Emily, she countered by explaining the following:
“While mental illnesses are to some extent social constructions, the thing about research is that you are creating new knowledge by observing and writing about it. While new diagnoses may be fads, they also are probably worthy of additional study and analysis. It’s only through additional study that scientists can determine if they are worthy of being called an official diagnosable disorder. Since psychology is a social science there is far more grey and societal norms influence what is deemed as being pathological…. and since social media is a growing part of our society, it seems understandable that it would have an influence on pathology and symptomology. It also begs the question as to whether or not the DSM is only reliable as a diagnostic resource in western countries.”
Wow, lots of good points and things to toss around. The social media factor is something that I’m going to blog about tomorrow, so stay tuned….
A catch-22 indeed!! In order for potential disorders to receive funding to figure out if they are actual separate disorders worthy of inclusion in the DSM, you first you need publicity and speculation about them – which in turn is going to create a group of people, whether scientists or the general public, who believe wholeheartedly that the disorder should be included. In medical school we actually had a whole lecture on night eating syndrome because one of its biggest proponents is an emeritus professor. From his perspective, obviously it should be listed separately in the DSM, but I thought it fit in well with BED.
But, I think the bigger point, as you so nicely pointed out, is this nexus between medicalization and medialization. This, in my opinion, is a continual problem with eating disorders in particular. Although more media coverage of eating disorders can help reduce stigma, that is very contingent on what the coverage says. Do more celebrities saying that they have an eating disorder actually help reduce stigma, or do perpetuate the idea that eating disorders are mostly caused by societal pressures, and easily fixed with a quick trip to “rehab”? It’s all about the way it is presented. I wish there were more blogs like yours that help show that eating disorders are not so simple!
On a different note, the idea of treatment perpetuating illness is something to think about. I know you have blogged about it before (I am specifically thinking of this post: http://www.greythinking.com/2009/01/05/dark-side-of-inpatient/).
They used to say: “It’s good to talk!”; but is that always the case? It’s certainly worthwhile to research the intricacies of your condition and maybe bounce a few ideas off both fellow-sufferers and friends. But if you want to keep the latter, do it sparingly! I suspect that overexposure of any given condition can award it cult status: e.g. bipolar, my own condition, became fashionable overnight, when celebrities like Spethen Fry admitted to having it, and Anorexia acquired its followers with its size zero image.
To “recover” from a condition, you need to first embrace it as part of you before learning to accept it by giving it a less significant role in your life. I framed my condition, placed it in an imaginary art gallery and closed the door on it. It’s still there, and I can visit it at any time, but only as an observer: I am not the exhibit itself.
The battle against pre-digested interpretations is immense. None of us can experience an unmediated reality.
Everything can be manipulated to fit what you want to see/hear/read, this is fact.
Its not whats written, spoken about or reported on that needs to change, its the way people react to such news that needs to change. Just how to do this is not going to come easy, what needs to happen is for people to stop taking such a negative view on everything, everyone and every situation which is diferent from the norm. Learn to accept who they see not what they see and stopping the knee jerk reaction to blame and point fingers.
We live in a culture which seems to like to bully others and make them feel secure, normally to big-up their own ego or to attempt to rebuild and already fagile ego. I’m sorry if this sounds global but most of the time with people finger pointing and avoiding like this, its a case of the blind leading the blind. These people are wrong, not the people suffering on the other end who are in many cases further ahead and dealing with those exact issues within themselves. You could say those that are finger pointing, do so because it threatens their own sense of self: that maybe they infact need to change, that infact they also have a problem which they cannot find the courage to deal with, maybe someone who has stopped to aknowlegde a problem puts their own failure to do so in the spotlight to their own eyes.
I think maybe in this case the best way around the problem would be to arm yourself with your own strength and conviction (which itself can be a dangerous thing!) and basicly: stop worrying about what other people think!
I really like what you said about the blind leading the blind. I think that’s extremely true. The only problem is, where does this stop? Everybody says society influences people.. that’s fine, but how do we change it? I know I can say that I will react different to EVERY situation (I truly believe I react right to EDs because I’ve had one, but what about other issues I haven’t dealt with?) but will I really do it without noticing? It’s such a hard concept. Much easier to say than do.
[...] I blogged about medialization and medicalization in regards to “the spread of a mental disorder.” In continuation with that theme, I [...]
This post is completely true!! I love that BL included that post of the dark-side of inpatient responding. That post was actually how I found your blog, because I “wanted to be in treatment” I know for me, it’s hard hearing about eating disorders, because I’m so interested in them, I get distracted from recovery and actually focus more on the issues that people struggle with. But also, people need to know they are real issues, that people aren’t alone!, and how people can recover. I think the line comes when someone is obsessed with the studies, articles, letters, etc about recovery/eating disorders. Then it’s not helping. So I think being aware is very important to each individual!