Thursday, April 16, 2009

The Anorexia Gene

Here's an opening paragraph that caught my attention.

In today's Daily Beast Rachel Shukert wrote: "Just the other morning my therapist and I agreed that pretty much everything wrong with me can be traced, in one way or another, back to my parents. The revelation, which has cost my insurance company thousands of dollars, is hardly groundbreaking." Link here.

It may not be groundbreaking, but as Shukert describes in her article, "Was I Born Anorexic?" it isn't true either.

Recent research suggests that some people are genetically vulnerable to a condition that Shukert suffered from: anorexia. Link here.

Shukert concludes that her anorexia was not caused by inadequate parenting or slim fashion models. Apparently, she inherited her genetic predisposition from her father.

Her opening paragraph also alerts us to a curious fact about talk therapy. What really matters is getting patient and therapist to agree. It does not matter whether the points they agree on are true or not. What matters is the meeting of minds.

Therapy teaches you how to construct a coherent narrative-- usually involving a family romance-- that appears to explain your problem. It does not matter whether knowing it solves the problem. It does not even matter whether it corresponds to the facts.

The narrative must make sense and it has to elicit wholehearted mutual agreement.

Shukert is quite right to emphasize that her "groundbreaking" insight is worth what she paid for it. Which is: next to nothing. Her insurance was footing the bill.

As long as insurance companies are willing to pay for these extended explorations into these fictive causes of illnesses, patients will happily go along for the ride.

The European research that discovered the genetic predisposition declared that it afflicted 70% of hospitalized anorexics. But then, what about the other 30%?

I will follow Aristotle here and say that some people are anorexic by nature and some by habit.

If anorexia can be a bad habit, then the correct treatment issue would be: how can you break a bad habit. Or better, again from Aristotle, how can you replace a bad habit with a good one?

Hopefully, there will soon be a medical treatment for the genetic predisposition to anorexia. While we are waiting, we should be working on correcting a bad habit, not making the habit make sense.

At the least, we know better than to imagine that the cause of anorexia lies in inadequate parenting or excessively thin fashion models.

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