The Deconstruction of OCD

“I am such a weirdo. I have strange OCDs.”

“I am so like Sheldon from The Big Bang Theory.”

“Oh, I can’t keep the TV volume on an odd number. I HAVE AN OCD!”

We come from a generation where the word OCD is thrown around with almost little or no thought put into the context surrounding the reference to this term. Part of why this is so can be attributed to the popular yet grossly misinformed portrayal of this and many other mental disorders in media. In fact, the media portrayal of OCD has almost reduced it to a funny illness that is not to be taken seriously. For instance, when you see Sheldon Cooper knock on Penny’s door 3 times in a row with a monotonous “Penny” following each knock, it first makes you laugh and then (maybe) consider this behavior as problematic. But only when we move beyond laughs will we truly understand this psychological disorder and stop trivializing every other quirk of ours as “a full blown OCD.”

OCD—what does it mean?

Obsessive Compulsive Disorder aka OCD is an anxiety disorder characterized by  time consuming and recurring obsessions and compulsions. An obsession is an unwanted thought, word, phrase or image that due to its repeated and persistent presence in a person’s mind causes unease and distress. These unwanted thoughts feel extremely intrusive to the person experiencing them. They drive individuals to engage in some repetitive acts or thoughts which at the first glance may seem quite purposeful but in fact are compulsions that a person performs in order to reduce or neutralize the anxiety generated from the overwhelming fixation on obsessive thoughts. These compulsions are ritualistic or rule based acts and thoughts which have somehow come to be associated with a particular obsession and exclusively hold the power to help regain control over one’s anxiety ridden mind.

Let’s explain the above highlighted keywords with the help of an example. The most commonly heard OCD is related to the need for cleanliness. A person with this OCD may experience an obsession with the idea of that touching any uninspected surface with bare hands poses a serious health hazard. In order to bury the worry that this thought arouses, s/he may wash hands EVERY time they touch a wall or a stool or a window pane. This can be understood as the compulsion that occurs in response to the overwhelming obsession concerned with hygiene needs. In fact, s/he may persist in their behavior even when their skin becomes all raw due to repeated hand washing. Also, we should note here that the distress caused due to the recurring obsession is so huge that it overshadows the distress coming from the physical pain arising due to the irrational, compulsive act of washing. This can be an indicator that the OCD has reached a clinical level of diagnosis wherein it has started interfering with an individual’s everyday functioning and well being.

OCDs—have your pick of the type

The obsession for cleanliness and hygiene coupled with the compulsion for washing is only one type of the many kinds of OCDs that one may suffer from. The need for order and symmetry is another kind which is often followed by the compulsion of putting things in picture-perfect order. Some individuals are overcome by checking compulsions whereby they often fear that they have committed some error that needs to be checked several times. This kind of OCD may not only involve compulsively checking the stove 5 times before you leave the house but may also involve constantly seeking reassurance from someone else about whether the stove was put off before leaving home.

Also, it is not necessary that a compulsion has to be a physical act. Compulsions can also involve mental rituals like counting up to a certain number or reciting a short prayer each time a threatening thought occurs. Although compulsive picking of skin (excoriation), hair pulling (trichotillomania), hoarding compulsions and preoccupation with perceived bodily defects (Body Dysmorphia) are conditions related to OCD and may in fact show similar patterns of expression; they are often diagnosed as separate disorders.

OCD—how does it sustain?

Individuals with OCD are hyper vigilant to danger detection. At the same time, their nervous system is often slow at recognizing that a threat has passed. When combined, this results in extremely high levels of long-lasting anxiety. Since the automatic danger/safety detection system is malfunctional in individuals with OCD, they try to gain control over their paralyzing fears by manually interfering in the form of compulsions. OCDs sustain due to negative reinforcement of the compulsive acts. In simple terms, negative reinforcement refers to an action that is strengthened as it supposedly removes some form of unpleasant stimuli from the said circumstance. For example, if taking a pain killer calms down your terrible headache then the act of ‘popping the pill when in pain’ is strengthened as it removes the unpleasantness experienced due to the said headache.

Thus, the negative reinforcer of hand-washing is strengthened as it illogically gets paired with the idea that it cleans the germs you contact on touching a wall thereby providing relief. However, over time the act of washing almost becomes an addictive behavior that you are dependent on to get rid of your obsessive thoughts and instead of something that helps you deal with the feelings of threat, it becomes something that makes space for you to experience more obsessive images. Instead of serving as a means to an end, the compulsion then becomes an end in itself.

Dealing with OCD: Exposure Response Prevention Therapy

Although several methods of dealing with OCD exist, the one that has most popular use is the Exposure Response Prevention Therapy. This technique seeks to restructure problematic behaviors and thoughts that drive the OCD. It involves gradual exposure to feared obsessions followed by restrictions on performance of the associated compulsion. A hierarchy of least to most anxiety producing thoughts is created and the person is encouraged to test the waters at a comfortable pace. So, a person excessively concerned about hygiene may start out by purposely touching a glass window and wash hands only after a delay of 10 minutes, then 20 minutes, then 45 minutes then an hour and eventually working up to not washing hands at all in response to such minor anxiety provoking situations. After the touching of this one threatening surface is mastered, one can move on to the next in the hierarchy and so on till a total disconnect is established between the obsession and the compulsion.

This technique and many others are easier said than done. Professional support in diagnosis and treatment is always recommended. OCD is much more than a “funny illness”. It is a very real clinical diagnosis that has the potential to reduce one’s potential drastically. Don’t let the unnecessary obsessions and compulsions take up the mental space that can otherwise be utilized to live a life that is worth it.

From Extra-Large Fries to Extra-Large Size

The “Extra Large” trend can be understood by connecting some dots from the point of view of psychology— apart from obvious biological and genetic reasons, of course. Isn’t it pretty obvious that the lieu of stores offering clothing lines for the “Plus-size” people stems from the availability of “Plus-size” meals at every major fast food joint in the town? The McMaharaja, the Doubly Loaded Pizzas, the Jumbo Pepsi cartons, 50% larger Chips packets and Big Scoop Ice Creams have indeed translated into the need for 3XL sized jeans.

So far, we only looked at how being too thin can be problematic. But at the end of this series on body image, it only seems fair to discuss how being Too Large can be problematic too. When I say ‘Too Large’, I don’t refer to a deviation from what the media has come to portray as the ideal. Too large is a body size where you start experiencing discomfort in your everyday functioning and well-being due to the extra pounds of weight lugging you down.

Did you know: researchers have found that the secret behind thin waist lines of the French is their small portion size? Right in the beginning we drew the connection between serving size and body size and this connection has been indeed upheld by Brian Wansink who found that even nutritionists eat 31% more of ice cream when they are given big instead of small bowls and 14.5% more when they are provided with a large instead of a small scoop. Pretty interesting how your mind fools you into eating more when provided with a larger spoon, eh? Hence, a cool DIY hack to try if you wish to lose some unnecessary body fat is to look around your kitchen and replace all those large serving spoons and plates with smaller ones.

Set point is the weight range in which your body is programmed to function optimally. Biologically, we are bound to return to our set point weight or a number around it because our body is designed as such that when we linger too far away from our set point weight, it either reduces or increases the metabolism rate depending in which direction the weighing scale is tipping. Genes ensure that most of the times you end up having a body shape that your ancestors have had. However, if you believe that hunger happens only in the stomach and not the head, then you’re mistaken. One study conducted with amnesic patients found that if offered 3 meals every 20 minutes after being completely satiated, the amnesic will still eat each with equal appetite. Why? Because they have no memory of having eaten earlier! Thus, your mind has a role to play in weight gain and weight loss too!

Another interesting fact that is widely known is that you eat more when you get more variety. So if you find yourself stuffed and slouched in a corner after hogging on a scrumptious buffet at your BFF’s wedding then you know it is psychology at work! In fact, the phenomenon of social facilitation states that we tend to eat more when we share a meal in other people’s presence. Thus, although savoring meals in isolation doesn’t seem like an appetizing idea, you can try to maybe reduce the number of people who share the table with you at your office canteen to somewhat protect yourself from your brain’s tricks!

Ever reach out for a bar of chocolate when feeling a rush of emotions—good or bad? Ever sit with a box of deep-fried snacks in your lap while you mindlessly watch a chick-flick but reflect on the bad events that happened earlier in the day? Ever use COMFORT FOOD to fight nostalgia, loneliness or anger? Only if these starchy foods ever helped you gain long term relief! All they do is momentarily play with your hormones to give you a “feel-good” factor which fades away soon enough to bring you back to reality with a few extra kilos hugging your waist. So eat when you need, not when you want. Be mindful! One hands-on trick for doing this is to maintain a food journal in which you enter everything that you eat and when. Do keep a record of the self-introspected emotions felt before and after eating to red flag comfort eating. Once the triggering points are recognized, try to consciously replace eating with another, physically involving yet pleasing activity like dancing. This shift will go a long way keeping those love-handles at bay.

Lastly, it is not possible that we talk about food and not mention dieting! Dieting is often considered to be an unpleasant, maybe even fear evoking term for many people. After all it involves putting a check on something that provides an instant mood boost—FOOD! In fact, most of the time people fail to keep up with their diet schedules because of what researchers Herman and Polivy explain to be the “What-The-Hell-Logic”. According to this principle, once you break a small rule of your weight management program, you believe that you don’t have it in you to go through with the rest of it either. This is to say that your thought process in such circumstances goes something like this: “If I am no good at this, what the hell! I might as well chug down that left over cheese pizza with a can of Pepsi and make the most out of my failure.” However, one way in which you can minimize this effect is by harnessing social support and self help. For instance, replace the junk food in your fridge with healthy alternatives. Surround yourself with people who’ll help you achieve this ideal and believe in your efforts. Check whether “out of sight, out of mind!” really works.

 DO YOU RATIONALIZE YOUR UNHEALTHY EATING HABITS TOO? This post may seem like the kind of common sense that existed right in front of your eyes but still somehow managed to skip your attention. But sometimes, aren’t simplest of things most required to take a step towards big changes? So, use this "common sense" knowledge from psychology to keep yourself from inching closer to obesity and develop a healthy body image.

Body Dysmorphia: Bodily Complaints That Never End

Like seen in this gif, all of us have a lot of things to complain about when it comes to our appearance. I wish for a flat stomach every time I want to go out wearing a cute crop top. I wish my thighs wouldn’t get all jelly when I sat down in those shorts. Like Rachel from F.R.I.E.N.D.S., I sometimes have insecurities about my nose too. I wish I wasn’t so tall that I looked like a mother to my BFF when we clicked pictures!

But we can’t have all that we want, can we? And most of us make peace with it (trust me, I try).

However, what happens when slight cribbing about your thinning hair turns into a full blown obsession
with trying out all possible hair treatments in the market? What happens when you start believing in the frantic SMS you type out to your friend—“MY LIFE IS OVER”—when you get a pimple on a date night?

Let me tell you what happens: Body Dysmorphic Disorder (BDD).

Body Dysmorphic Disorder is a diagnosis that is related to Obsessive Compulsive Disorders in which a person becomes unhealthily preoccupied with a real or perceived ‘defect’ in their appearance. An important point to note right away is that even if there is a bodily shortcoming present, it is perceived and reacted to in an out of proportion manner i.e. a small scar, barely noticeable, near your eyebrow may be seen as disfiguring your entire face, thereby inviting that much unnecessary stress in response to it. The perceived flaw may seem invisible and imaginary to people around a BDD suffered but it is a firm reality to that person who unrelentingly believes that there is “something wrong” with how s/he looks. So, no: This disorder is not to be confused with one’s vanity with their appearance. It is a very real and distress- causing mental health condition.

BDD is different from Eating Disorders

Undoubtedly, eating disorders and BDD both circle around body image issues. However, eating disorders are solely concerned with one’s dissatisfaction with their body shape and size. On the other hand, in BDD, dissatisfaction with body weight is just one of the many other body areas that can become a target of constant depreciation. This is to say, BDD sufferers may become preoccupied with scars and hair, facial structure and skin irregularities like moles or even the looks of their genitalia.

A surprising fact? In BDD, people (usually men) can be overcome by the thinness of their body i.e. a lack of muscle and sturdy body build. So, BDD is not all about feeling fat and becoming obsessively
worried about it. Instead, BDD may be concerned with the complete opposite of it too! In fact, the clinical term for this particular type of BDD is Muscle Dysmorphia.

Another differentiating point between BDD and eating disorders is that the latter entail erratic food consumption patterns: you eat too much or too less or purge and exercise till you drop. However, BDD involves fairly normal eating patterns and the individuals may or may not be of the normal weight. Instead, BDD patients may seek cosmetic surgeries as a means of dealing with their insecurities.

Lastly, while eating disorders are more common amongst females, the prevalence of BDD is more or less same for both the sexes. Nevertheless, there may be subtle differences in the body parts that become trouble centers for the two. For instance, females with BDD usually perceive ugliness in their hips and weight while men are more likely to see it in their body build and thinning hair.

Sure, there seems like a considerable overlap between the two disorders and it is even quite possible that an individual may be diagnosed with both at the same time. This may be so when a person shows irregular eating along with distress about a bodily area other than their waist length.

Tell tale signs of BDD

A person with BDD constantly checks himself/ herself in the mirror or their selfie camera for ensuring that they look fine. They groom themselves to an excessive degree as if they are trying to make up for some irreparable short coming. They may also be the ones who constantly elbow you to ask if they look fine. They need a lot of reassurance.

Now you may be thinking, “Hey, I do that too!” But in order to understand what makes these signs a clinical diagnosis try multiplying the intense insecurity with which these actions are undertaken by 10 and estimate the number of times these actions are performed to be almost always. Some say that individuals with BDD spend approximately 1 full hour each day wondering and worrying exclusively about their appearance!

Often, individuals who develop BDD are said to carry a certain amount of biological vulnerability for the same. However, it is only when biology combines with sensitive social experiences of teasing or rejection related to how one looks during adolescence, is when this disorder manifests. Once the idea of having “not up to the mark” appearance takes roots, their thoughts becoming completely biased—almost as if shining an attentional spotlight—on their negative body image. At the same time, they start engaging in checking rituals mentioned above and slowly begin withdrawing from others out of embarrassment. These behaviors at the crux of the moment may seem like “helping” them to reduce their anxiety levels but carry the potential to emerge into full blown Obsessive Compulsive Disorder (OCD), Social Anxiety Disorder or Major Depression. Obviously, this hampers interpersonal relationships of the individual and in 1/3^rd of the cases the BDD patient may become delusional! For example, if they see two people exchanging a laugh while passing by them, they will be ferociously convinced that the topic of amusement was their bodily shortcoming. Social isolation inevitably cuts off their support networks and this when combined with repeated failures on interpersonal, academic and occupational fronts (arising from interference caused by their mental illness) pushes BDD patients towards suicide ideation and attempts 10 to 25% times more than the general population.

Nevertheless, individuals with BDD may have fairly accurate insight about their disordered thinking but may shy away from opening up about their condition to anyone—not even their therapist—for the fear of being misunderstood or absence of knowledge that BDD is treatable. So take out your keen, observant glasses to look out for these signs so that you can help someone who may be in need for professional help to go ahead and seek that help.

BINGE EATING DISORDER: WHAT UNDERLIES ALL THOSE LAYERS OF FAT?

“Let’s binge eat!” my friend squealed.

 “You mean a ‘who-can-eat-pani puri-till-they-drop’ competition? You’re on, buddy!” I replied.

Fill in any favorite food item of yours in the underlined part above—biryani, ice cream, chips, fries—and there you have it, a fun binge eating day with your BFF by your side or a hearty me-time while you catch up on a rerun of your favorite TV show.

I’m sure that all of us are guilty of “binge eating” on some occasion or the other. So much so, that when I introduce Binge Eating as a disorder, many of you will be surprised, maybe worried? However, let’s not jump to conclusions. In order to qualify for a clinical diagnosis of Binge Eating Disorder (BED), one needs to meet the following criteria:

1. When you say that you are going to binge eat, do you mean that you can eat an amount of food so large within such a short period of time (say, 2 hours) that most others may not be able to consume under similar circumstances? If yes, then you’re binge eating.

2. When you are binge eating, do you feel a sense of lack of control—feel as if you can’t stop eating or how much you’re eating? If yes, then you’re binge eating.

3. Binge eating episodes are often associated with eating rapidly as if under the fear of being caught cheating. You hardly taste the food you are so ravenously hogging on! You may eat until you feel uncomfortably full. You may also eat large amounts of food without physically feeling the need to eat. They feel extremely embarrassed about their seemingly uncontrollable eating behavior. And once the sin of overeating is committed, do you feel disgusted with yourself, guilty or depressed about such “rash” eating behavior? If yes, then probably you’re binge eating.

4. Do you feel distress for gobbling down 10 plates of pani puri? Sure, your body might be protesting for an outlet of all that spice. But do you mentally feel troubled for eating and eating and never stopping?

5. How often do you go on binge eating sprees? In order to receive this diagnosis, one must exhibit a compulsive eating episode at least once per week for a span of 3 months.

6. A person has BED if they don’t repeatedly purge all the food that they eat as in bulimia nervosa and only if they are NOT currently suffering from anorexia during which it is possible to have a few episodes of binge eating while still being significantly underweight and meeting all the other requirements for anorexia nervosa.

It may seem somewhat obvious that individuals with binge eating disorder are often overweight. We don’t binge eat fruits and vegetables. We binge eat fats-laced, carbohydrates-rich guilty pleasures. However, making a reverse assumption that all overweight/ obese people are suffering from BED may not be appropriate. Nevertheless, research has repeatedly shown that BED sufferers are over represented in populations that are obese and seeking help for reducing their body weight.

Binge eating disorder is different from anorexia and bulimia wherein the person starts looking abnormally thin and hence receives a lot of attention and sympathy. Instead, BED simply hides under the layers of fat which somewhat seem normal in our trending move towards widening waistlines but at the same time is despised by most. So if a person is fat, you’re fast to assume that he is lazy and undeserving of your help while if a person looks like a moving skeleton, you may raise your brows to form a crease of worry. Although the process of destigmatizing larger body sizes is a long way to go, would it hurt to ask someone you think is struggling and suffering if they need some love and support?  

How to detect if someone is battling against BED?

Since these individuals are very well aware that there is something wrong with them and that acceptance for their enlarged body shape is scarce, they engage in secretive eating. They may eat in normal quantities at the dinner table but if you were to peep into their room or car, you may discover a secret stash of fatty foods or left over wrappers and tins of such foods. They may eat between their meals to be able to eat “normally” in front of others. There have been cases where binge eaters have reported that they have gone “restaurant-hopping” and feasted on foods while driving their way from one restaurant to the other!

A more extreme step would be to actively isolate themselves while eating their daily meals as far as possible because they fear the judgmental looks that will be directed their way if they eat the way they eat.

Mostly though not always, BED is a response that is triggered by depression or anxiety. So if you find a loved one eating erratically and showing simultaneous unruly mood fluctuations then you may want to talk and find out if everything is okay. All of us find comfort in food. When its exam time, I personally find myself eating more amount and eating at more number of times then I do on a normal basis. That’s basically a response to stress. In our brains, when we eat delicious food, it releases the feel-good hormone of dopamine. Dopamine is the same hormone that is also released when we engage in pleasurable activities or even in addictions like smoking. Thus, speaking of the concept of reinforcement again, we can say that binge eating is somewhat maintained as a disordered habit because the release of dopamine in the brain rewards us to continue this behavior.

Low self esteem and exhibition of a “What-The-Hell” logic can also be considered as indicators of BED. These individuals do not believe in their own ability to regulate eating. Thus, even though they may decide to enter a weight loss regime, the moment they slip (which all of us do, with or without the disorder), they may think, “Of course, I am not capable of doing this healthy eating and exercising stuff. Now that I have already broken a diet rule, what the hell, I might as well break all the other rules!”

We all are foodies in our own right. But when are we pushed across the fine line between normality and abnormality because of a threatened body image is something to ponder on. Keep pondering, keep reading, keep following this series on body image!

ANOREXIA AND BULIMIA: WHEN BEAUTY BONES LOSE THEIR BEAUTY

Demi Lovato, our Disney Star, has confessed, “‘Food is still the biggest challenge in my life and it controls — I don’t want to give it the power to say it controls my every thought, but it’s something that I’m constantly thinking about…Body image, what I’m going to eat next, what I wish I could be eating, what I wish I didn’t eat. It’s just constant…” 

Princess Diana revealed in one of her interviews, “The first time I was measured for my wedding dress, I was 29 inches around the waist. The day I got married, I was 23-and-a-half inches. I had shrunk into nothing from February to July.”

Portia de Rossi, an Australian-American model, actress and spouse of Ellen DeGeneres, has stated in her memoir, “Since I was a 12 year old girl taking pictures in my front yard to submit to modeling agencies, I’d never known a day where my weight wasn’t the determining factor for my self esteem. My weight was my mood, and the more effort I put into starving myself to get it to an acceptable level, the more satisfaction I would feel as restriction and the denial built into an incredible sense of accomplishment.”

These women along with many other celebrity figures have suffered from EATING DISORDERS. An eating disorder is a disturbed pattern of daily food intake (either eating too little or too much) along with high levels of unnecessary distress associated with body shape, size and weight. While Demi Lovato and Portia de Rossi suffered from Anorexia Nervosa (AN), Princess Diana was diagnosed with Bulima Nervosa. At the outset, it is important to note that even though the prevalence of eating disorders is higher in females than in males, we have witnessed several male celebrities to the likes of Eminem, Elton John, Russel Brand and others come forward to be open about their struggles with eating. Another common misconception better corrected at this point is that Eating Disorders are not the “disease of the rich”. Yes, it is through the stories of these high-profile celebrities that we have come to know of maladaptive eating behavior patterns. In fact, Princess Diana was one of the first prominent personalities to disclose her body image related issues which reportedly doubled the rate of women seeking treatment for Bulimia in the Great Britain. This came to be dubbed by the media as the “Diana Effect”. It may also be true that the work industry demands of maintaining a particular “body type” may play a major role in these models, actors, singers or royal family members in developing such disorders. Still, this is no reason why someone you know or love may not suffer from a similar condition.

Anorexia Nervosa

An individual is said to be suffering from Anorexia Nervosa (AN) when s/he shows the following three symptoms:

1.      Severely restricted eating which results in the person being 85% of the expected body weight for people their height, sex, age and physical health.

2.      Fat phobia: Intense and irrational fear of putting on weight.

3.      Disturbed self-perception of body shape and weight such that they view themselves as being fat even when in reality they are actually very thin—at times, dangerously thin.

What do I mean when I say “dangerously thin”?

It means that a person with anorexia may lose so much weight that they may actually be at the risk of dying from being underweight. In fact, research has found that out of all mental illnesses, the mortality rate is the highest for those suffering from eating disorders. This might be so because depriving our body of all vital nutrients to such a drastic extent often results in a number of physiological complications such as weakness and brittleness of bones, muscles, hair and nails; low blood pressure, slow breathing and pulse rate; lethargy and fatigue; heart and brain damage and the possibility of multiple organ failure. Although no longer applicable, earlier the criteria for assignment of this clinical diagnosis to women required that the patient stops menstruating completely. Nevertheless, a majority of women with AN don’t menstruate and experience infertility.

There are two major types of Anorexia Nervosa:

In the restricting type of AN, the individual doesn’t engage in binge eating. They simply refuse to eat or engage in excessively strenuous exercise schedules as a means of preventing weight gain.

However, in the binge eating/ purging type, the individual occasionally engages in binge eating of food items followed by means of ridding their bodies of these extra calories by either self-induced vomiting or use of laxatives and extreme exercising. Nevertheless, these individuals continue to remain significantly underweight as they may not necessarily consume a lot of food when they eat, but even such small amounts may make them feel as if they have binged.

An interestingly baffling quality of an individual with AN is that they fail to feel as if there is anything wrong with their eating habits or body image. They show extremely high self control and don’t experience hunger pangs. They often eat the little amount that they do due to force feeding from family and friends. They are less likely to be overweight in the past. Thus, their desire to reduce weight is often driven by an independent and erroneous evaluation of their own “fatness” rather than the need for seeking approval from others.

Bulimia Nervosa

The diagnosis for this disorder is given when an individual meets the following criteria:

1.      Eating excessive amounts of food containing about 3,400 calories within a time period as short as about 2 hours. This might be referred to as binge eating.

2.      Feeling absolute lack of control over eating while engaged in these binge sprees.

3.      Follow up compensatory purging behaviors like self induced vomiting, use of laxatives and diuretics, other medication, fasting or extreme exercising in order to prevent weight gain.

4.      Exhibiting this cycle of binge eating-purging at least once per week for a period of 3 months.

5.      Sole dependence of self esteem on body weight and shape.

6.      Binge eating-purging episodes shouldn’t exclusively occur at the time of meeting all the symptom requirements for anorexia.

An important fact to support the last point is that an individual with bulimia is almost always of the normal weight or slightly overweight which results in failure to make a diagnosis most of the time. In addition, these individuals are very well aware that their eating styles are maladaptive and so their ritualistic binge eating & purging is often kept a secret. Consequently, suicide rates are somewhat higher in this group than those with anorexia as a strong sense of embarrassment is felt by individuals with bulimia. Further, they have a fairly realistic perception of their body shape but are dissatisfied with whatever weight they are at. Their disorder usually is an off-shoot of some critical comments from a significant someone in their life or due to other stressful life situations like marital conflict. For instance, Princess Diana has reported an incident where Prince Charles held her love handles and called her chubby which led her secret journey into the depths of bulimia. Thus, differing from anorexia in important ways, sufferers of bulimia have often been overweight at some point in the past. Also, they are likely to experience strong hunger pangs which when combined with emotional instability may lead them to engage in impulsive eating.

Medical problems undoubtedly follow such erratic feeding patterns. Ipecac syrup used for inducing vomiting have severe toxic effects if taken regularly in large doses. Self induced vomiting also results in dental decay due to the high acidity of thrown up material. This binge-&-purge cycle often causes dehydration which may result in permanent gastrointestinal damage, fluid retention in hands and feet, and heart muscle & valve destruction or collapse.

These disorders compel us to spend a moment of introspection about how body image troubles lead to such severe mental disturbances in something as basic as feeding yourself. Stay tuned for upcoming posts on other related conditions stemming from bodily insecurities.

The Insecurities Underlying Our Love Handles

The Hindu Festival of Lights—Diwali—is just round the corner. And with Diwali come gifts, gatherings and of course, FOOD! From delicious ghee laden laddoos to deep-fried, savory namkeen; one will surely find themselves hogging on all the possible extra but yummy calories in their daily menus during this festive week. This ditto scenario is witnessed be it Diwali, Christmas, Eid, or any other festival.

Quick questions:

1. How many of you would hesitate before giving in to the urging demands of your sweet tooth?
2. How many of you would feel guilty & reprimand yourself after the festivities are over for having lost control over your diet?
3. How many of you wouldn’t even touch the fatty foods for the fear of turning into a fatty you?

My guess: Most of us, to varying degrees of course.

The ideal body type

The “ideal body type” is often a perfect hourglass figure for females and V shaped torso for males. This ideal, however, goes much beyond the idea of “fat is bad” to entail the requirements of fuller lips

and Kardashian hips for females and facial hair that can be flaunted during No-Shave-November for males. It demands fair, waxed-of-all-bodily-hair skin for females and tall, muscular, biceps-endowed frame for males. The list can go on. But two important notes to be made here:

First, the lists are heavily differentiated for the two sexes and any crossover between the two is more or less frowned upon (E.g. a “too tall” female can expect herself to be fired with a slew of mean comments).

Second, the list is so specific in its requirements that it fails to capture the uniqueness of all individuals. Consequently, it labels anyone who doesn’t fit in, as either fat or any other form of ugly. Ipso facto, my waist line of 30 is as imperfect (although a little less unacceptable) as someone else’s waist line of 36. Nevertheless, all of us are lesser creatures in front of that woman who is bestowed with the perfectly tiny waist of 24 inches.

How did this “hunger for the ideal body” manage to creep into our psyche?

The perfectness quotient enshrined by this ideal that as often showcased and praised in media is next to impossible yet aspirational. “Someone on the big screen was able to achieve it. So why can’t I?”—this is the logic that is often invoked by our minds when acceptance for what we are is already available scarcely in the society that we live in.

Most of the movies we watch portray stereotypically fat characters as having a stereotypically tragic story—one of low self confidence, gullibility and failure in matters of school, love and career (E.g. Think of Sweetu aka Delnaaz from Kal Ho Na Ho). In real life too, the “fat guys and gals” are reduced to nothing but a point of joke, criticism and rejection—no one wants to date or befriend a “fatty”, the “sit-on-you-and-kill-you” joke is a classic and a million other ways have been discovered to label them not good enough.

Time to rethink if this is really funny

It might be “just a joke” to you. Others along with your “fat or dark skinned friend” may even laugh with you, irrespective of really being comfortable with it. But a deeper consequence results at a psychological level when body shaming becomes a part of our everyday conversation. In psychology, reinforcer is a term used to denote positive and negative environmental responses that strengthen a particular behavior. Thus, unquestioned transmission of body shaming in everyday communication reinforces us to laugh at the next “fatty/ blackie” we see, reducing that person to nothing— embodying no talents or positives—beyond their undesirable body type.

 

Barbie (Left) v/s Emme Doll (Right)

Next, the availability of innumerable cosmetic surgery    procedures and beauty products essentially perpetuate the    idea that we are NOT OKAY the way we are and that there is always “something better” in store for us. Who would imagine that this all-time-optimistic-phrase could be twisted to play with our psyche and make us consumers (or aspiring consumers) of these so called enhancers?

In one study by Dittmar and colleagues (2006), it was  found that exposure to images of Barbie dolls (reflecting the 36-24-36 ideal) increased bodily dissatisfaction than exposure to Emme dolls (a doll with realistic bodily proportions) or neutral images, in girls as young as 5 and 6 years old! Imagine how seemingly harmless toys are so shaped to slyly corrupt our body image i.e. our own view about our own bodies!

Thus, these are some ideas that help explain the hesitance, guilt, self- deprecation, self- hatred and self- constriction that exists within most of us in varying degrees and very well reflect in the answers that you provided to yourself for the 3 questions I asked you at the beginning.

How to respect your body type?

1. Mirror, Mirror, on the Wall: All of us are aware or even guilty of using the many camera filters that are available. What makes you think that movie stars or even your friends at work may not be using these filters to look “better” than they already do? And even if a picture is #unfiltered, always remember that only the best of your moments find their way onto social media. So your bedroom mirror is where you want to find your true beauty—looking only at yourself, drawing no comparisons, especially with the Photo shopped media pages.
2. Care for a little history? : Among our ancestors, roundness of body was indeed a sign of wealth and attractiveness as indicated by various stone age figurines and paintings found all across the world. This is so because those times were marked by food shortages and so voluptuousness was indeed a beautiful feature. Thus, embrace your curves for they were not always a bad thing and who know, you may eventually be able to bring them back in vogue for time-appropriate reasons!
3. Body beyond beauty: Appreciate your body for the tool it has provided you to achieve your many aspirations than being simply wound up in figuring out how beautiful an instrument it is. For instance, value how your body helps you achieve little things like cycling to school or dancing in the rain or hug a loved one.
4. Is the “ideal” really beautiful? : What the ideal body type tends to bring along with it in terms of wealth, suitable romantic partners, self confidence, societal acceptance, and prestige may have more to do with it wrongfully being perceived as beautiful than it actually being beautiful. Maybe we care more about these by-products than about achieving the ideal itself. But since they all tend to more or less CO-OCCUR with the ideal body type that is described, we tend to wrongfully assume that the ideal body type CAUSES these by-products to occur. If causation was true, how do you explain the success of personalities like Barack Obama, Oprah Winfrey, Bhumi Pednekar and many others who don’t meet the “ideal” in certain obvious ways? Thus, breaking this incorrect linkage will go a long way in questioning the beauty stereotypes.

The above described methods can be handy in dealing with the milder body-related insecurities that most of us have. But, do you know that some individuals suffer from full-blown psychological illness categorized as EATING DISORDERS due to ill-formed body image? What are these and how they can be dealt with will be covered by a series of upcoming blog posts. Stay tuned!

Change is the Rule, Adaptability is a Choice

Would you dip your hand in a completely opaque box without knowing what’s in it?

Would you try some outlandish food item without attempting to find out what its ingredients are?

Would you mind taking your evening stroll around an unknown part of the city?

Chances are that you won’t spontaneously show an excited head nodding agreement to engage in these activities. This is because most of us Fear the Unknown. In the mildest of its forms, fear of the unknown is our hesitance to try something new, something different, or something that has CHANGED. Evolutionarily, fearing the unknown helped our ancestors survive the rough realities sprinkled in their way by Mother Nature. By being apprehensively skeptical about attractive yet untried fruits/ roots or by treading extremely carefully and in groups in untouched habitats, they saved themselves from falling into traps or getting poisoned. Thus, this fear is somewhat passed as a part of our genetic heritage and becomes activated in varying forms and degrees even today, given particular circumstances. The most common way in which this hesitance manifests itself is in the face of an impending change or transition.

Change is the only constant— everyone seems to be bringing up this philosophical axiom all the time, right? But, does portraying this idea as a “normal aspect of daily living” make it any less discomforting? Sadly, no. Sometimes, change may seem to be appealing and worth trying. Nevertheless, it requires us to step outside our comfort zone which essentially fluctuates our motivation and frustration levels while pursuing this new path. For instance, most of us as children were super excited to switch from using pencils to pens. However, changing the way we grip the pen, the amount of pressure we need to apply for smooth flowing ink and, of course, the obvious change in handwriting was a nightmare that most of us must have had to endure.

Thus, we are all surrounded by changing realities in all spheres and at all ages—whether for good or for the worst. How can we adapt to change so as to ease our way through this process?

1.  Expect discomfort but don’t lose sight of the exhilaration waiting at the end: Knowing and imagining what one is likely to encounter given our past experience with change can prevent us from painting an unrealistically rosy picture of this process. Plus, expecting that there will be a difficult period even though not knowing exactly what it will entail, helps to reduce the uncertainty levels and allows us to exercise some control over our situation, thereby, directly influencing our perceived fear of the unknown. It is important to place ourselves in the centre of this whole dynamic and realize a position of active power than passive helplessness. Although “expecting discomfort” might inculcate a slightly pessimistic outlook; this can be counterbalanced by a positive belief that once the change (irrespective of it being good or bad) has occurred and dealt with it will bring an exhilarating moment of peace.  Why? Just because the process is over and done with!

2. Refrain from cementing the change into a “new old”: What makes change overwhelming is our tendency to settle so comfortably in previously occurred changes that make them seem like they have always existed as it is. For instance, when we move from school to college, we form a new circle of friends and acquaintances. This requires quite a lot of effort, investment and adjustment. Still, when we are to move from college to work, the same anxiety of meeting and making new acquaintances seems burdening once more because we have too easily cemented our college friendships into a “new old of our social circles”. Rather, being aware that a tweaked routine is in fact tweaked will serve as a reminder that other lifestyle changes will occur and we’ll have to accept and adapt to them as well. Thus, always carry the nostalgia of that rigorous reshaping process you had to undergo before landing up with a great bunch of people who helped you survive college! Key Takeaway: Openness to experience helps facing changes head strong.

3. Don’t just think, do: You’re going to be a first time parent? Read a book on parenting. Moving to a new city? Look up the internet for various amenities available in the vicinity of your new home. Have the college prom to go to while your dancing skills suck? Take a few classes. Sometimes when changes come well announced, the best way to prevent ourselves from bouncing off the wrong foot is to prepare for them in small yet concrete, action-oriented ways than simply building castles in the air.

4. I choose future: What to do when changes are impromptu in nature? Well, for starters, don’t think about “What you’d done to deserve such unpleasantness?” Bad things happen to good people and that’s a reality check we must all maintain. Instead, a study has found that individuals who cope well with change are those who think about what can be done now and in future given that the change has already occurred than expending all their energy only in tracing “meaningful causes” from the past that help explain their dire circumstances. This is called showing existential courage. 

5. Slowing down doesn’t equate to failure: At the heart of our fear of the unknown is our fear of failing at this new thing that life has thrown at us. And when does this sinking feeling of failure start setting in? When we are seemingly stagnant, getting nowhere, just watching things as they go haywire. Yes, your performance charts may show dipped ratings. Yes, you may not meet your self- expectations. But guess what? IT’S OKAY. Reiterating a recent and relevant example from my life itself, I’ve been unable to put up blog post for the last month or so because of the transformation that my schedule went through as I moved from graduation to post graduation. This was a personal failure to me at some level. Weekly submission deadlines, power packed lecture schedules with bulks of information to consume, group projects, 3 hour daily commute, earlier than expected semester-end examinations and many other changes had pushed me over the edge in the days I took a hiatus from blogging. It was overwhelming. It was new. I may even venture to say that, “It was CRAZY.” Every week I wanted to pick up my laptop and start penning down some ideas for a new post. But somewhere deep within I knew that it wasn’t going to happen. And once I had this acceptance at a conscious level, it was easier for me to settle down to face the challenges one at a time—slow at pace, strong willed at heart.

Hence, concluding with a beautiful quote by Fred Emery, “Instead of constantly adapting to change, why not change to be adaptive?”