Ethan Watters contributed a fascinating piece to the New York Times Magazine last week (I know, komrades, I know, I’ve sworn off the Grey Lady about 200 times, but she’s hard to quit.) It was framed, rather predictably, as another American-influence-as-cultural-imperialism story. And more and more, these days, the story of Western hegemony feels a bit as though we doth protest too much – after all, being the epicenter of evil is just as powerful as being the epicenter of good, so isn’t white liberal guilt just a renewed form of occi-centric egotism?
But I digress. The article, “The Americanization of Mental Illness” (linked above) references the work of Sing Lee, a scientist who examines the effects of context on manifestations of anorexia and other eating disorders. Specifically, he looks at the cultural transmission of symptoms. Apparently, there was an upsurge in anorexia immediately following the well-publicized starvation death of an anorexic schoolgirl. Her demise was described in the particular terms outlined by the DSM. Sing Lee noticed, as well. that an increased number of anorectic patients in Hong Kong began describing their disordered eating in terms of ‘fat phobia.’ Prior to the media attention to the schoolgirl case, anorexia had usually manifested as a feeling of ‘stomach bloating.’ Actual disease profiles were transformed by exposure to information – they began to comply more and more precisely with the ‘authorized,’ DSM-validated description of anorexia.
Lee’s work in the intervening years makes a good case for the direct cultural transmission of mental illness – or, more precisely, the transmission of symptoms. The NYT article posits that mental illness has a culturally-determined ‘vocabulary’ of symptoms with which to express itself, and that exposure to the symptom-language of another culture can cause the illness to express itself in new, non-native ways.
But wouldn’t it be interesting, instead, to envision a sort of imaginative identification? That you can read an account in the paper of a schoolgirl who collapses in the street, and then read more and more about her, studying her methods, studying the ways she is described, post-mortem, by experts and authorities and baffled parents – and that the act of investigating this girl, and imagining her life, might transmute, somehow, into a haunting? A form of possession, a curse? So that your understanding of her deepens into identification – not just identification with her, but identification AS her? An identification so deep that your flesh begins to mimic hers, you starve as she did, you diminish as she did….?
Here are a few links to scholarly-type journal pieces exploring the cultural transmission of eating disorders. If you have an institutional subscription access, they’re probably free to download, and if you don’t, well, comment here, and maybe I can do a little somethin’ for ya.
Lee’s article on rationales for disordered eating (how patients describe their desire to starve)
Journal of Transcultural Psychiatry:
Springer book on cultural aspects of eating disorders, with a nice intro by Lee: