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When It Comes to Eating Disorders, "You Have the Bullet, The Culture Shoots the Gun"
Does the typical college student understand the sort of mental health care options available to them? Dr. Judith Brisman of Eating Disorder Resource Center continues our series "Big Thinkers on Mental Health."
Judith Brisman, Ph.D. is one of the pioneers in the field of eating disorders. She opened the first center in the United States dedicated to the treatment of bulimia. Initially called Bulimia Treatment Associates, now the Eating Disorder Resource Center, these centers, based in New York City, were among the first programs in which the original treatment of bulimia developed. Over the last 25 years, the therapeutic programs have expanded to include work with anorexia, bulimia, binge eating disorder and other body image disorders.
Dr. Brisman is well-respected in the eating-disorder community for her ongoing contributions to the field. Her work focuses on the need for direct intervention with disordered eating, while maintaining a sensitive exploration of the psychological factors involved. She is co-author of Surviving an Eating Disorder, which was the first book of its kind to offer effective solutions and support for family and friends of those with eating disorders. Now, years after its publication, Surviving an Eating Disorder continues to be a best-seller in its field.
Dr. Brisman is on the editorial board of Eating Disorders: The Journal of Treatment and Prevention. In addition to being the director of EDRC, she is an associate editor for the journal Contemporary Psychoanalysis, and she is a supervisor of psychotherapy and on the teaching faculty at the William Alanson White Institute. She has published and lectured extensively regarding the interpersonal treatment of eating disorders, and she is well known for her expertise in running training seminars and presentations.
In addition to being the director of the Eating Disorder Resource Center, Dr. Brisman maintains a private practice in Manhattan. Perhaps her most extensive experience comes from raising her twin daughters who teach her more than any training program could possibly allow.
Judith Brisman: The difference between disordered eating and an eating disorder is really an interesting question in our culture because pretty much in our culture most people have disordered eating. It is the rare person who eats when they’re hungry, eats what they’re hungry for. If they are partying and having a good time and enjoying the food and they eat too much. A healthy way of eating would be okay; the next day you don’t feel hungry so you eat a little bit less. But healthy eating would be following your bodily cues. Disordered eating would be when you start to put the "shoulds" in there, you know. I should cut down. I shouldn’t have snacks. I should lose weight. Pretty much all of us know what disordered eating is. You eat a lot and the next day you panic. Oh my god, I’ve gained a couple weights. I can’t have breakfast. I mean, you know, or I better not have any carbs today. That’s sort of disordered eating.
An eating disorder, though, is when the "shoulds" become a psychological way of coping. If I don’t eat carbs, I’m a good person. If I lose 10 pounds, my life will be okay. And what happens is that goal starts to define people. So they feel that if they do indeed stick to these usually unrealistic goals, that they have an idea that their identity would be formed. Everybody knows what it’s like to be upset, to be mad, to just not want to deal with something. And what happens is when someone starts to eat and they realize that they don’t feel anything. Everybody who I work with tells me there’s nothing that feels better. What’s hard about it is it really works. For that moment all they’re focused on is eating and they don’t feel anything. So it’s like a quick Band-Aid to deal with feelings.
And anorexia is the same way. What happens with anorexia is people start focusing so much on their weight or what they’re eating that they disconnect from the outside world. And in a weird way it’s very calming. My patients will tell me that if they’ve hit 95, 94, 93 each day the weight goes down, they know they’ll have a good day. It doesn’t matter what will happen that day. They are in control of their life and it’s a way of coping with their life. It’s a way of coping with interpersonal relationships. You have a fight with your boyfriend; you go home and eat. It doesn’t solve the fight, but it makes someone feel better. So the point to an eating disorder is when repetitively the eating or weight loss or lack of eating is used to cope with life problems.
The way we see eating disorders is sort of a three-point series. We think physiologically, people carry genes that will have certain proclivities. Certain people are just going to be hungrier. Certain people — anorexics we’ve done studies that they’re more perfectionistic. Watch them at five and they get upset if they draw outside the lines of a picture. They line of their shoes. The door has to be open a certain way. We know that anorexics have a very basic physiological drive towards perfectionism, being exacting. So we know there’s a physiological component. We know there’s a psychological component so that if someone is more stressed, if they come from a family where there’s a lot of stress or alcoholism or other eating disorders or feelings that can’t be dealt with or feelings are too out of control, kids are going to need a way to cope. And they’re not going to know how to deal with feelings and the anxieties that they’re brought up with. The third part of it is the culture will tell them what the symptom is. So the culture says well in order to be okay you have to be five foot five and 110 pounds if you’re a girl. And so the physiology that may make someone perfectionistic and the tension that someone’s up against will then be look towards the culture to say okay, well in order to solve this, our culture says be thin. So the way we sort of think about it is people individually have the bullets. The culture shoots the gun.
Big Think and the Mental Health Channel are proud to launch Big Thinkers on Mental Health, a new series dedicated to open discussion of anxiety, depression, and the many other psychological disorders that affect millions worldwide.
There aren't many people on this planet who know more about eating disorders than psychologist Dr. Judith Brisman, founder of the Eating Disorder Resource Center. In this video, she offers a crash course in understanding the difference between someone who eats disorderly and someone with an eating disorder. We also learn that, deep down, people with anorexia use eating (or not eating) as a coping mechanism.
Finally, Brisman runs through some typical traits of those with anorexia: perfectionism, genetic disposition, and susceptibility to the pressures of society. Most of all, anorexia offers the illusion of control. When you're unable to control other parts of your life, losing weight by not eating seems like a major accomplishment because it was a (dangerous) decision made of your own volition.
Are we genetically inclined for superstition or just fearful of the truth?
- From secret societies to faked moon landings, one thing that humanity seems to have an endless supply of is conspiracy theories. In this compilation, physicist Michio Kaku, science communicator Bill Nye, psychologist Sarah Rose Cavanagh, skeptic Michael Shermer, and actor and playwright John Cameron Mitchell consider the nature of truth and why some groups believe the things they do.
- "I think there's a gene for superstition, a gene for hearsay, a gene for magic, a gene for magical thinking," argues Kaku. The theoretical physicist says that science goes against "natural thinking," and that the superstition gene persists because, one out of ten times, it actually worked and saved us.
- Other theories shared include the idea of cognitive dissonance, the dangerous power of fear to inhibit critical thinking, and Hollywood's romanticization of conspiracies. Because conspiracy theories are so diverse and multifaceted, combating them has not been an easy task for science.
A growing body of research suggests COVID-19 can cause serious neurological problems.
- The new study seeks to track the health of 50,000 people who have tested positive for COVID-19.
- The study aims to explore whether the disease causes cognitive impairment and other conditions.
- Recent research suggests that COVID-19 can, directly or indirectly, cause brain dysfunction, strokes, nerve damage and other neurological problems.
Brain images of a patient with acute demyelinating encephalomyelitis.
COVID-19 and the brain<p>A growing body of research reveals alarming neurological complications among COVID-19 patients. On Wednesday, for example, researchers from University College London published a <a href="https://academic.oup.com/brain/article/doi/10.1093/brain/awaa240/5868408" target="_blank">study</a> in the journal Brain that describes how some patients have suffered temporary brain dysfunction, strokes, nerve damage, and other neurological problems concurrent with COVID-19.</p><p>Some patients suffered brain inflammation as a result of a rare disease called acute disseminated encephalomyelitis, which can cause numbness, seizures, and confusion. One patient in the study even hallucinated monkeys and lions in her home.</p>
Photo by Mario Tama/Getty Images<p>A separate study published in the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198407/" target="_blank">Journal of Clinical Neuroscience</a> notes that some COVID-19 patients have also suffered neurological complications like impaired consciousness and acute cerebrovascular disease. The study notes that past viruses like MERS and SARS also seemed to cause neurological problems.</p><p>A troubling finding among this growing body of research is that some patients seem to suffer neurological damage even when respiratory symptoms aren't obvious. Additionally, scientists aren't sure whether damage from the disease will be permanent.</p><p style="margin-left: 20px;">"Given that the disease has only been around for a matter of months, we might not yet know what long-term damage COVID-19 can cause," Dr. Ross Paterson, joint first author of the University College London study, said in a <a href="https://www.eurekalert.org/pub_releases/2020-07/ucl-iid070620.php" target="_blank">press release</a>. "Doctors needs to be aware of possible neurological effects, as early diagnosis can improve patient outcomes."</p><p>If you've been diagnosed with COVID-19 and want to enroll in the study, visit <a href="https://www.cambridgebrainsciences.com/studies/covid-brain-study" target="_blank">cambridgebrainsciences.com/studies/covid-brain-study</a>.</p>
Construction of the $500 billion dollar tech city-state of the future is moving ahead.
- The futuristic megacity Neom is being built in Saudi Arabia.
- The city will be fully automated, leading in health, education and quality of life.
- It will feature an artificial moon, cloud seeding, robotic gladiators and flying taxis.
The Red Sea area where Neom will be built:
Saudi Arabia Plans Futuristic City, "Neom" (Full Promotional Video)<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="c646d528d230c1bf66c75422bc4ccf6f"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/N53DzL3_BHA?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Coronavirus layoffs are a glimpse into our automated future. We need to build better education opportunities now so Americans can find work in the economy of tomorrow.
- Outplacement is an underperforming $5 billion dollar industry. A new non-profit coalition by SkillUp intends to disrupt it.
- More and more Americans will be laid off in years to come due to automation. Those people need to reorient their career paths and reskill in a way that protects their long-term livelihood.
- SkillUp brings together technology and service providers, education and training providers, hiring employers, worker outreach, and philanthropies to help people land in-demand jobs in high-growth industries.
Source: McKinsey Global Institute analysis [PDF]<p>Work in understanding the skills at the heart of the new digital economy is leading to novel assessments that allow individuals to prove mastery to faithfully represent their abilities—but also to give weight and stackability to the emerging ecosystem of micro-credentials that make education more seamless across time and education providers. And we are seeing the beginnings of a renewal in the liberal arts, focused on building human skills in affordable ways that are accessible to many more individuals and far more effective.</p><p>Amidst these dark times, there is much opportunity to refresh the nation's education and training solutions to support the success of individuals and society writ large.</p>