Criticism of Social Constructionism

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CHAPTER 5 EATING DISORDERS (Anthelme Brillat-Savarin)

The purpose of this chapter is to illustrate the perceptions and assumptions held by two women struggling with eating disorders. The case illustrations will be presented in verbatim form and the names changed for purposes of confidentiality. The chapter will consist of four sections namely the women’s biographical information, their experiences of suffering, emerging themes from the conversations and psychotherapeutic implications. These will include a detailed presentation of the women’s assumptions regarding eating disorders. It is hoped that the reader will draw his or her own distinctions about the women’s personal distinctions and assumptions. A brief overview of eating disorders will be presented before the presentation of the case illustrations.

Background to Eating disorders

An eating disorder is a physical and psychological disorder in which an individual uses food to resolve emotional problems (Maloney & Kranz, 1991). Three different eating disorders have been defined by the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) (Robert-McComb, 2001). These are anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified. Eating problems are characterised by symptoms of binge eating, compulsive and addictive eating and attempts to lose weight through dieting, self-induced vomiting, laxatives, diuretics, or excessive exercise (Evans & Wertheim, 1998). These behaviours influence all aspects of the individual’s life including the physical, emotional and social contexts (Garvin, Striegel-Moore & Wells, 1998; Orzolek-Kronner, 2002).
Eating disorders are considered complex compulsive eating behaviours carried out by different people (male and female) and in different contexts (Mickley, 2001). Since the focus of this the sis is on women’s suffering through their bodies, eating disorders will only be discussed in terms of the female perspective.

Anorexia Nervosa

Women suffering from anorexia usually restrict food and literally starve themselves to death (Maloney & Kranz, 1991). They choose different ways of losing weight through dieting, fasting, consumption of food in small quantities, self -induced vomiting, misuse of laxatives, diuretics, enemas and excessive exercising (Robert-McComb, 2001). Although the result is a considerable amount of weight loss, anorexic women continue to see themselves and their weight loss as never thin or sufficient enough (George Hsu, 1999; Maloney & Kranz, 1991; Mickley, 2001).
Many weigh only ¾ of the weight that is normal for their height while others look as thin as ‘prison-camp victims’ (Maloney & Kranz, 1991, p. 48). The biggest problem with anorexia is the consumption of insufficient calories. This leads to the slowing down and destruction of the body’s metabolism and vital body functions (Mickley, 2001).
About 95% of anorexics are female and mostly between the ages of 12 and 24. Most girls come from upper or middle-class families, families with older parents and/or small families. Families with anorexic children generally appear to be perfect on the surface, but troubled relationships between parents and their ‘model’ children usually exist (Clopton, Haas & Kent, 2001; Maloney & Kranz, 1991; Orzolek-Kronner, 2001; Robert -McComb, 2001; Thode, 2001).
Physical problems related to anorexia include the loss of menstrual periods and destruction of crucial stages in puberty, impaired bone formation and osteoporosis, heart failure and irregular heart beat, loss of brain tissue, problems with stomach functioning, low blood pressure, anemia, bruises, a layer of fine body hair (lanugo) which protects the body from the cold due to loss in natural padding, dizziness, insomnia, feelings of numbness in hands and feet, dehydration, kidney failure, lowered body temperature, low tolerance for cold weather, grey or yellow -like skin, dry, patchy hair, fatigue, sunken eyes, loss of concentration and/or irritability (Maloney & Kranz, 1991; Mickley, 2001; Robert-McComb, 2001; Zerbe, 1993).
Anorexics also suffer from a distorted body image. Despite the physically unattractive qualities, weight loss is still considered beautiful, acceptable and necessary. Anorexics are so proud of their new bodies that they are able to ignore the hunger pains and substitute normal food with low-calorie options (Robert-McComb, 2001). These behaviours are usually successfully managed as the anorexic strives for the perfect body.
Eating large amounts of food serves various functions. One function is the ability to be in control of food consumption as a compensatory behaviour for loss of control in other areas of life. Another function is to provide calmness in the face of anxiety. These feelings of control and calmness are, however, only temporary and soon a vicious cycle ensues as seen in the following description: the individual binges in order to escape negative feelings and dissenting experiences, but feels shame, guilt and disgust for her loss of control. She then tries to take control through purging, laxatives or excessive exercise. Doing this makes her feel out of control and incapable of handling her problems. She turns to food once again in order to escape the negative feelings (Arenson, 1989; Maloney & Kranz, 1991). The cycle continues for months and years until help is sought.
Physical symptoms experienced by the bulimic include pressure on the liver due to purging, fatigue, sore throat, sores and tears in the oesophagus due to vomiting, dental problems and tooth decay, heart problems due to nutritional imbalances, infected salivary glands, dry skin from loss of fluids due to diuretics and laxatives, rash or skin eruptions, dehydration, edema or water retention, abdominal cramps, irregular or even absent menstrual periods, bloating, loss of potassium and electrolytes, muscle weakness, inability to have normal bowel movement due to laxatives, gyneacological and obstetrical problems (Maloney & Kranz, 1991; Mickley, 2001; Robert -McComb, 2001; Zerbe, 1993).
Women identified under this category struggle emotionally with food and although they may eat large amounts of food they may do so when not feeling hungry (Romano, 1999). Their behaviour is characterised by the following: eating until feeling uncomfortably full, eating much more quickly than normal, eating alone because of the possible embarrassment of the quantity of food, and feeling depressed, guilty and disgusted with oneself once the bingeing has ended (Katz, 1991; Robert-McComb, 2001). A compulsive eater may also diet compulsively for a while and then binge uncontrollably. Such behaviours may have developed as learned responses to emotional issues and emotional distress during childhood, adolescence or young adulthood (Zraly & Swift, 1990).

CHAPTER 1 INTRODUCTION
Suffering
Motivation for the Study
CHAPTER 2 METHOD
Qualitative versus Quantitative Research
Aims of the Study
Descriptive Research
Natural Setting
Case Studies
Purposive Sampling
Inductive Data Analysis and Emergent Design
The Influence of Social Constructionist Principles on
Qualitative Research
Description of Social Constructionist Thinking
Criticism of Social Constructionism
The Research Design for this Study
Research Process
Focus of the Study
Inductive Data Analysis
Emergent Design
Conclusion
CHAPTER 3 CONTEXTUALISING THE FEMALE BODY
Women and their Bodies
A Historical Understanding of the Body
Plato and Descartes
Freud, de Beauvoir and Merleau-Ponty
A Twentieth Century View of the Body
The Feminist Perspective
The Social Constructionist Perspective
Conclusion
CHAPTER 4 FAMILIAL BREAST CANCER
Background to Familial Breast Cancer
Case Illustrations
Laura’s Story:The Generational Curse
Biographical Information
Facing the Suffering
Nature of the Interaction
Emerging Themes
Loss of Identity
Fear and Anxiety
Anger
Sadness
Loneliness and Lack of Support
Psychotherapeutic Implications
Finding Meaning in the Suffering
Significant Shifts
Reality Check
Into the Future
Christel’s Story: The Unexpected Twist
Biographical Information
Facing the Suffering
Nature of the Interaction
Emerging Themes
Shock
Fear
Sadness and Depression
Psychotherapeutic Implications
Finding Meaning in the Suffering
Significant Changes
Into the Future
Conclusion
CHAPTER 5 EATING DISORDERS
Background to Eating Disorders
Anorexia Nervosa
Bulimia Nervosa
Eating Disorder Not Otherwise Specified
Case Illustrations
Lisa’s Story: Facing the Truth
Biographical Information
Facing the Suffering
Nature of the Interaction
Emerging Themes
Loss of Control
Feeling of Emptiness
Depression
Low Self-Esteem
Perfectionism
Psychotherapeutic Implications
Conclusion
CHAPTER 6 INFERTILITY
Background to Infertility
Case Illustrations
Psychotherapeutic Implications
Biographical Information
Facing the Suffering
Nature of the Interaction
Emerging Themes
Psychotherapeutic Implications
Conclusion
CHAPTER 7 MEANING AND SUFFERING
The Social Construction of Shared Meanings
Suffering
Conclusion
CHAPTER 8 CONCLUSION
General Discussion of the Study
Objectives of the Study
Main Findings
Recommendations
Limitations of the Study
Conclusion
GET THE COMPLETE PROJECT
A THERAPEUTIC UNDERSTANDING OF WOMEN SUFFERING THROUGH THEIR BODIES