rachelmanija: (Books: old)
rachelmanija ([personal profile] rachelmanija) wrote2017-08-03 05:41 pm

Brave Girl Eating: A Family's Struggle With Anorexia, by Harriet Brown

A memoir by the mother of a teenage girl with anorexia, written with her daughter's consent. (Her daughter is given the pseudonym "Kitty.")

There are a number of memoirs by people with anorexia (by far the best-written is Wasted by Marya Hornbacher, which is worth reading for the prose quality alone), but fewer by their loved ones. But a child with an eating disorder affects and is affected by the whole family.

This book attracted some really angry negative reviews, many of which took very vehement exception to Brown's refusal to take the blame for her daughter's illness, and for her saying that her family became temporarily dysfunctional due to the stress of it, but was doing basically okay before and after. I have no idea whether that's true or not, since all I can go by is the book itself. But I was struck by how pissed off a subsection of readers were at a mother saying, "This wasn't my fault" and "I think my family has good relationships," and how sure they were that this couldn't possibly be the case--that if a child has a mental illness, the mother and her family must be to blame.

Brown thinks the culprit is a combination of genetic predisposition and social pressure. She leans more heavily on the former as a factor in anorexia in general than I personally would, and if her account is correct, it does sound like that played more of a part in her daughter's case than it usually does. From her perspective, anorexia descended on her daughter like the demon in The Exorcist; while Brown herself had some mild issues with eating and weight that could have also affected her daughter, they're the sort of issues that probably 90% of white American moms have, and 90% of all daughters aren't anorexic. She might be in total denial about terrible problems within the family... but she might not be. Being a "good enough" family isn't a magic shield against mental illness.

As a memoir, it's gripping and well-written, and makes a convincing case for the family-based (Maudsley) approach to treating anorexia. (That approach also has very convincing evidence behind it.) But it's the response to it that fascinates me. Like I said, maybe the reviewers are right that she's lying or in denial. Brown does sound a little defensive. But who wouldn't sound defensive if she's constantly getting blamed for the illness that nearly killed her daughter? Could any mother have told her story without being blamed?

Americans are very apt to blame the victim. In every respect. And that goes one million if they're female. Were you raped? It's your fault for going on a date/wearing that dress/trusting your uncle/not buying a state of the art home security system. Do you have anorexia? You're vain/weak-willed/selfish/not really sick. Does your child have anorexia? You're a bad mother.

Brown's unknowable truthfulness or accuracy aside, there is nothing more infuriating to a big section of America than a woman who says, "It wasn't my fault."

Brave Girl Eating: A Family's Struggle with Anorexia
naomikritzer: (Default)

[personal profile] naomikritzer 2017-08-04 04:07 am (UTC)(link)
A friend of mine recently mentioned a friend of hers who struggled with anorexia for years ... and it vanished when this friend came out as trans. I sort of wonder just how many anorexics were dealing with unspoken dysphoria, and that was a piece of what was going on.

The thing that struck me after I read this book a few years ago: for decades, the belief about autism was that it was caused by "refrigerator mothers," and it was treated by trying to keep the mother out of the picture. And yet, I know so many parents of autistic kids where the mother is the kid's best advocate. Anorexia was similar: blamed on the mom, treated with "parent-ectomy," but in fact, family-based treatment works vastly better than inpatient programs.

I don't know. I mean, I definitely know friends with eating disorders who had parents who certainly set the stage for disordered eating in every possible way. But that's certainly not always it. I like the comparison to alcoholism; like, there are families that set the stage for it in various ways but there's also clearly a genetic predisposition factor and when a teen has a drinking problem, it's not treated in the context of, "obviously your Mom made you into an alcoholic, so let's try to fix what she screwed up."
kore: (Prozac nation)

[personal profile] kore 2017-08-04 05:25 am (UTC)(link)
Anorexia may also (sometimes) be a form or manifestation of OCD.

Mmmm no. Hornbacher talks about this -- she didn't have OCD when the anorexia was treated, but when she did, she sure as hell seemed to, what with the obsessing over steps in exercise and counting calories and so on. But that typically lessens as the person gets less dependent on stuff like weighing every scrap of food and figuring out if gum burns calories. What you're saying is kind of dangerous because people who actually have OCD can get misdiagnosed and mistreated for other conditions, and the OCD goes untreated. OCD can share symptoms with eating disorders, and disordered eating can be a symptom of OCD, but anorexia does not "manifest" as OCD. OCD can be comorbid with eating disorders, but people with eating disorders are, as mentioned elsewhere, a lot more concerned with gaining control over and reshaping their bodies. But there's a difference between disordered eating being a consequence of OCD, or disordered eating being a precursor to OCD-like behaviour. Ritualism and rigid behaviours are common to both but just because there are similar symptoms doesn't mean it's the same thing.
rydra_wong: Lee Miller photo showing two women wearing metal fire masks in England during WWII. (Default)

[personal profile] rydra_wong 2017-08-04 07:30 am (UTC)(link)
I've seen some interesting mentions that people with anorexia are disproportionately likely to be on the autistic spectrum or have autistic traits:

https://spectrumnews.org/features/deep-dive/the-invisible-link-between-autism-and-anorexia/
https://www.sciencedaily.com/releases/2017/02/170202085719.htm

shehasathree: (Default)

[personal profile] shehasathree 2017-08-04 11:04 am (UTC)(link)
I've definitely come across this association between transness and anorexia before, and I think there's a bit more literature on it now than there was when I originally looked into it (maybe 8 years ago?). Anecdotally, it seems like there's a strong overlap, too, but obviously anecdotes != population data.

Wrt OCD potentially manifesting as anorexia, I remember reading some theoretical stuff about the construct of compulsivity as a link between OCD, OCPD and EDs (and also Jennifer Traig's memoir, in which (iirc), she linked her experiences of OCD and anorexia via scrupulosity).

Also: orthorexia.