Cultures Role in the Study of Anorexia Nervosa - Research Paper Example

Mirror Images: Culture’s Role in the Study of Anorexia Nervosa The twin threads of history and culture undoubtedly link civilizations of the past, present, and future. Metaphorically, history serves as an omnipresent canvass on which the story of man and society is continuously painted, while culture evolves as the colorful detail, which makes every frame different. The constant evolution of culture as a set of shared values, attitudes, beliefs, norms, and practices associated with a group of people wheels the continuity of the human story. Undoubtedly, the changes that such group would make to these variables, whether forced or not, would lead the way to the formation of another face of the same culture, another fiber of the same thread. Historical accounts show that drastic changes in culture were marred by bloodshed or wide-spread killings through wars and revolutions. The implicit changes though just flowed and mutated in time. Power struggles were ever-present and wherever the control of power and influence swayed, the other side would always be at the disadvantage. Social problems emerge out of chaos and people were left with the choice to conform or be discriminated as outcasts. The rule is clear, what is acceptable or not in a given culture or period of history depends on who has the power to determine the terms. Although far from its common impression of exactness, the field of medicine is also tainted by a similar kind of social discrimination. There are certain categories of illnesses, mostly in the fields of psychology and psychiatry, which are adjudged as such based on certain social stereotypes. One such example is Anorexia nervosa (AN). According to Lee, Anorexia nervosa is an intriguing condition that is characterized by food refusal, marked weight loss, and amenorrhea in young women. It has been considered as a pattern of behavioral deviance that is generated and sustained by certain cultural values, expectations, and social organizations (1996 129). Recent studies relating to Anorexia nervosa illustrates the evolution of AN to its contemporary form mostly through social changes rather than through scientific development of the medical condition. Conrad states that the meaning attributed to medical problems often reflects the attitudes of a given culture (2008 109). This statement boldly suggests that there is a wider social dimension relating to certain medical problems in contradistinction with the purely biophysiological dimension often associated with the field of medicine. This social aspect of medical problems is not limited to the logical social reactions and interactions of patients, relatives and society itself to a disease or condition but also embraces the condition’s origin, development, treatment, and even the changing perceptions of people, as parts of the whole dynamics involved therein. Conrad’s assertion of a direct link between medical problems and culture implicitly suggests the proposition of a multi-dimensional approach in the study and treatment of medical diseases and conditions. Implied from this multi-faceted approach is the assumption that certain medical conditions are also social conditions, which may bear explanations and solutions that could aid the established medical ones. Finally, Conrad’s thesis is highly dependent on the historical approach because of the time element or context that connects and clarifies medical problems and attitudes of a given culture. A comparative historical approach is also deemed necessary to establish the relationship of these two variables while gauging them on the background of the constantly changing times, settings, and circumstances that surround medical problems and culture. The discussions of both Brumberg and Lee about the etiology of Anorexia nervosa showed its transition from purely but rarely reported biomedical disease relating to extreme weight loss or malnutrition to a predominantly social and psychological illness. Both authors used the historical approach in presenting their theses which supported Conrad’s claim that Anorexia nervosa is indeed a culturally bound syndrome (CBS) with the shared emphasis that the term “culture” should be contextualized. Both Brumberg and Lee noted that AN medical cases were virtually unheard of until the 1960’s although they both accepted the fact that AN’s precursor form already existed centuries before. Brumberg even mentioned that no AN case was reported during the World War II in Italy (2000, 113), which suggests a direct relationship between AN as a medical condition and scarcity, as a social condition. Similarly, the discussions also showed the emergence of a connection between Anorexia nervosa and the condition of plenitude after the war. Verily both relationships clearly support Conrad’s contention that the meaning attributed to medical problems reflects the attitudes of a given culture. It is interesting to note that the contrast in the relationships of AN to scarcity and affluence, respectively, greatly illustrates the transition of AN as a medical condition to a predominantly social one through the background of cultural change. The years of affluence after the war showed a change in the values, norms and practices of the people as their priorities changed. The trend became not solely about survival but ideas about social status, luxury, and even aesthetics came into the picture. The significant change in behavior introduced a more relaxed but alarming categorization of Anorexia nervosa. The historical approach of Brumberg and Lee showed the upsurge of Anorexia nervosa vis-à-vis the rise of social stratification and stereotypes. Western societies became continuously patriarchal, which contributed to the subjection of women to positions of subordination and powerlessness. The traditional role as support-system to powerful men presents not only an issue of discrimination but also a stereotyped image attributed to women. The quest to fit in to the role as a perfect good-looking woman in a masculine-controlled society pushed women to resort steps that would not only jeopardize their health but also their state of mind. This desire to become the perennially slim, well-groomed, almost “Steford wife” illustration of a perfect woman launched a wave of obsession to thinness that served as foreground to the contemporary form of Anorexia nervosa especially in the west. Cases of Anorexia nervosa became common to upper-class white women who, through their affluence, showed the psychological dimension of the medical condition by the consistent refusal of food in order to lose or maintain weight. The existence of Anorexia nervosa, in its pure biomedical form, necessitates the existence of weight loss through involuntary refusal of food as a main criterion for diagnosis. Initial diagnostic standards even capped the weight loss to 25 percent of the body mass index but later standards saw a trend toward a more lenient threshold of less than 17.5 kg/m2 (Lee, 1996 141). The growth of AN over the years can be characterized as a departure from the old emphasis on extreme weight loss due to the involuntary nature eating disorder toward a more relaxed diagnostic characterization of uncontrolled and obsessive dieting motivated by the fat phobia. Lee specifically suggests that the AN’s contemporary form reflects the culture of modernity more than specific geographical sites (1996 133). Lee’s discussion show that the CBS concept relating to AN did not change despite the illness’ growth outside the west. Rather Lee posits that this culture-boundedness should be seen as an evolutionary concept, which exemplifies relativism in a background of constant cultural change. To see Anorexia nervosa through the lens of a socio-cultural perspective made readers realize that there is indeed more to medical condition than its biological components. This realization undoubtedly stressed the fact that a constantly evolving world produces constantly evolving conditions and thus necessitates a constantly open and relative approach thereto. Victor Turner’s dialectical approach poses an interesting attempt to solve an assumed social problem with a social solution. This approach of evoking negative societal reactions toward Anorexia nervosa was intended to delegitimize the thirst for thinness and to endorse dieting as a normative part of the cultural setting (qd in Lee, 1996 140). Ultimately, it relies on the premise that a change of perception may lead to a subsequent change in behavior. While the socio-cultural approach provided more depth and context in the study of Anorexia nervosa, Brumberg concludes that culture alone does not cause the condition. She saw AN in its current form as an addiction or dependency to starvation. Her dependency-addiction model shows the two-pronged stage of AN, which involves a socio-cultural context and a medical one (2000 121). The strings that connect AN’s biological, psychological, and cultural components indicate how complex AN has evolved over the years. History showed that cases of contemporary AN cannot be categorized as homogenous because of the wide-array of factors that come into play in each case. What these papers have established with clarity was the fact that the unitary approach of causality and treatment would not suffice against the threats of modern Anorexia nervosa. Both Brumberg and Lee concludes that while the dynamics of culture are largely involved in the genesis of pathologies and even the medicalization of social ills, the sole reliance thereof is misplaced and futile. In the end, the interdependence of anthropology, biopsysiology, psychopathology, and psychiatry in the life and story of Anorexia nervosa unequivocally points to the direction of a multi-dimensional approach relating to any cultural problems, medical or otherwise. Works Cited Brumberg, Joan Jacobs. “Anorexia Nervosa in Context”. The Sociology of Health & Illness: Critical Perspectives. Ed. Peter Conrad. Eighth edition. 2008. Print. Conrad, Peter. The Sociology of Health & Illness: Critical Perspectives. Eighth edition. 2008. Print. Lee, Sing. Reconsidering the Status Of Anorexia Nervosa As A Western Culture-Bound Syndrome. Social Science & Medicine, vol. 42, no. 1 (1996), pp. 21-34. Read More