Beware tagging Anorexia nervosa

Your advisory on what you term a “bewildering mental illness” is both helpful and partial, (editorial, February 12).

Anorexia nervosa is indeed a debilitating, distressing scenario for all concerned — families and &children alike and all are effected and implicated. The option/ choice to hyper-control one’s body-weight typically arises from an inner sense of loss of control, and severe internalised low self-esteem.

Compounded by relentless promotional advertising of an almost impossible ideal, the vulnerable are at risk of being overwhelmed. Body-image obsession becomes inordinately distorted, appearing to offer the only conduit of control available.

It must, however, be clearly established that the person at the centre of the maelstrom, cannot merely be deemed as having an individualised physiological or mental “disease”.

The chaos and challenges they experience may have overt and direct physical consequences, but the core origin of the relational dysfunction lies within an inner experience of self-to-others. The familial/ communal dynamic is prime and key.

It can often afford a measure of comforting convenience to presume the ‘sufferer’ has their own innate and isolated problems which need to be addressed and processed for ‘cure’.

A much wider trawl of causative dynamics must be tackled, and that can be uncomfortably challenging for many others in the ‘close-quarter’ round. Identifying and processing such inter-relational nuances is a tricky, and sometimes painful business, with reluctance and reticence operating as regular obstacles to clarification and awareness. Far past, near past and current experiential realities may be at play, deep down.

You suggest, and with certain validity, that “the disease can frustrate and challenge parents who can feel powerless to counteract a malaise threatening the very future of a loved one”. This is undoubtedly true. But the sooner one can distance the “disease” and “mental illness” labelling from the frame, endeavouring cautiously and respectfully to survey the in-depth cycle of shared emotional dynamics at play, the sooner might clarity be achieved. It can perhaps be most fruitfully addressed via a genuinely open commitment to honest appraisal of self, and& group dynamics.

Painful yes, protracted probably, but possible indeed.

Jim Cosgrove

Chapel Street

Lismore

Co Waterford