Working between interpretive immersion and chapter drafting – not for the faint-hearted?

Apologies for the decidedly chaotic presentation in this post but here’s the latest outpouring of everything I’ve assembled during my work on the stories you’ve sent in. The sheer number of issues I have to write about is what is causing the problem with drafting at the moment. As much as I hate to say it, much of it may not be able to make the final cut…

Men with Eating Disorders

ED Myths and Realities

  • Food and exercise
    • Credit-systems and behaviour-economies
      • Trade-offs
      • No food unless exercise
      • No exercise unless food consumed
    • Eating
      • As a pastime
      • Relegated to last priority
      • Hating what we cook/prepare
      • Wasting food
    • What and why?
      • Sweet
      • Savoury
      • Carbohydrates
      • Fats
      • Fruit
      • Macrobiotic
      • The easy and accessible, not the desirable?
      • Rationing
      • Cost and money
  • Misconceptions as myths – healthy eating messages as distortions of nutritional understanding
    • Government messages
    • Homemade messages
    • Self-help messages
  • Managing emotions not weight, shape and image
    • Mechanisms
      • Undereating
      • Overeating
      • Compulsive exercising
  • Relapse and residual behaviour
  • Not in public
    • food and secrecy
    • criteria for what to eat in front of whom
  • Fasting/bingeing and its long term effects
    • On the body
    • Skin
    • Digestive system
    • metabolism
  • Shopping and the restricter, shopping and the binger
  • Origins
    • Behaviours around food pre-dating/out-of-awareness of ED
    • As the unknown – it could have been anything, not just food.
    • As early negative associations with environment and food – conditioning?
    • As childhood overweight
    • As upheaval and trauma inc bullying
    • As Self-control & Willpower
  • The role of ritual
  • Transdiagnostic theory
    • Links between EDs and other MHIs
      • Depression
      • OCD
      • Self-harm
      • Suicide ideation
      • PTSD
    • Labels and labelling
      • Orthorexia
      • Anorexia
      • Bulimia
      • Binge-eating Disorder
      • Sub-types
      • Names for our behaviours – continuum = eaten too much…super-binge.

Power, Force and Control

  • Work at young age
    • Forced to take an evening job – pressured out of comfort zone
    • Work ethics and class
  • School and confinement
    • Bullying and EDs
    • Victimisation and community shunning
    • Persecution
    • Lack of escape & transgression
    • Becoming small, invisible or hidden within
    • Loss of personal power
  • Emotional and Physical abuse by another
    • Escape – moving away
    • Abandonment
  • Women
    • Matriarch and coercion – strict rules & rebellion
    • Cruelty of teenage girls – words not punches
    • Manipulation and emotional subterfuge
  • Embodiment of power
    • Large and masculine build – unwanted power
    • Lacking a masculine form – yearning for power
  • Dependence and Independence – the effects of ‘being in the system at young age’, dependent on the state
  • The battleground of the self
    • Personal choice and selectivity?
    • Light and dark selves
    • Good and evil
    • Rational and irrational
    • Discounting external strokes
    • Loss of personal power and self-determinism.
  • Control and Restriction
    • Rebellion and transgression as both loss of control and reclamation of self
    • Rationing, planning and obsessing
    • Grief and bereavement when self-control is regained in bingeing
    • A single tipping point into spiralling out of control or a gradual descent?
    • How to judge control and rational decision-making when all previous experience has been of out-of-controlness
    • Addiction – it has control, versus willpower – we control ourselves to manage difficulty
    • Control mechanism versus coping mechanism
    • Routine and ritual
      • To control and restrict
      • To boundary excess and loss of control
    • Public control, private chaos – times to let go or hold on
      • Evenings and excessive urges
      • Special occasions and fear
      • Christmas and excess – holding on to historical social norms
      • Denial of essential functions – denying hunger
    • Redressing a balance – control through credit and debit.
  • Crime and Punishment
    • When does comfort stop being comforting? – Comfort perverted into punishment
    • Alleviation and soothing as confinement and self-surveillance
    • Good health twisted into retribution for transgression.

Masculine and Feminine

  • Masculine and feminine home environments
    • men as homemakers and housewives
    • Gendered behaviour, food attitudes and family conversations
    • need for a quiet life at home
  • Unreadiness for transition from boy to man – puberty and manhood arriving to quickly or unexpectedly
  • Sexuality and perceived sexuality
  • Internalised gender self-stereotyping
    • Being feminised or being de-masculinised
  • Intelligence and image – geek and swot
  • Misogyny and poor relations with the opposite sex
  • Men and the language of emotions – not being able to articulate pain and stress.
  • Destructive feelings’ impact on men versus women
    • Deflection and avoidance or embodying the pain.
  • Sensitivity
  • Self-hatred and masculine appearance
    • links between self-loathing and looks
    • reinvention & makeover culture
    • drawing inspiration for body ideals from the female form
    • acceptance or rejection of attributes perceived to be feminine
    • Fitness and feeling better – social conditioning of the ‘enjoyment’ of weight loss
  • Male anorexia versus female anorexia – experiential and clinical findings
  • Men and mental health stigma – professional and social? Men and women or just men?

Loneliness and Stress

  • Compensatory behaviour for absent parents/other
  • Abandonment and self-sufficiency
  • Instability and insecurity
    • Moving home
    • Swapping homes in custody arrangements
  • Virtual friendship and online attachments
  • Dealing with suicide of significant other
  • Anxiety and the link to coping mechanisms
  • Depression and the link to coping mechanisms
  • Dealing with (unwanted) change
  • Tolerance, resilience and dam-breaking trauma
    • Overload and thresholds
    • Concentrated periods of distress and trauma
    • Psychosomatic responses – emotional pain & physical ailment
  • Grieving the loss of the ED
  • Addiction and habits – self-preservation and living in fear
  • Stress, appetite and weight-loss
  • Attraction and intimacy versus isolation and solitude
    • Comfortable with our own company or craving company
    • Sex and closeness
    • Belonging and desirability
    • Withdrawal.

Relationships, Secrets and Lies

  • Not being able to access treatment as trying to disguise need for it from others
  • Becoming secret-keeper and confidante to establish one-sided conversations
  • Friendships, loyalty and instability
    • ability to maintain friends when the ED has replaced them
    • discounting positive feedback
  • Seeking out pseudo-relationships to safeguard against emotional investment
    • Attachment theories and men
    • Virtuality – real or synthetic?
  • Distance and absence in key relationships
    • Parents who cannot manage their own emotions
    • Parents who invalidate or negate the existence of feelings in their children
    • Parents who dismiss MHI in their children
    • Transactional analysis theories
    • Where’s Dad?
  • Loss, grief and distress in key relationships
    • Infidelity, separation, divorce and family fragmentation
    • Suicide and bereavement
    • Abuse by trusted other
  • Lying to others promulgates a need for ‘punishment’
    • Does it feel good because of control? Does it undermine because it causes guilt?
  • Professional façade and personal failure
  • Inheriting relationships with food or learning relationships with food from others
  • Attracting sexual partners
    • Conforming to an ideal
    • Projecting what others want – skinny women wanting skinny men
    • Small versus Large in sexual images
    • Hot and cold – the pendulum effect
    • Indifference without guilt?
  • Letting others down versus letting ourselves down.

Introspection and Self

  • Emotionally impenetrable
    • Where are the feelings?
    • Feelings = cognitive processes not cognitive processes = feelings
    • Emotion embargoes
    • Opening up and becoming available – risks and pay-offs
  • Looking to the self for the reasons people treat us badly
    • Introspection as a search for answers
    • Blaming ourselves for a lack of unconditional love
    • Attempting to self-soothe hurts
  • Exercising alone
    • The rise of solitary exercise versus social sports
    • Escaping from the self through physical activity
  • The role of shyness
  • The role of sensitivity
  • The role of denial – suppression and avoidance
  • Fragile sense of self and self-worth
    • External events – single trauma or collection of unfortunate events?
    • External gauges but internal judgement
    • Wrecking the self and wreaking havoc
    • ED eroding sense of self
    • So how do we then judge ‘normal’?
    • Mattering
  • Self-protection & non-confrontation – consumed by fear and anxiety
  • Dis-integrating the ED – it is not part of the real me?

Recovery and Recovering

  • New and robust sense of self emerges
  • The help or hindrance of diagnosis
  • Courage and bravery in accessing help, personal or professional support
    • The theory of asking for help
    • Self-help versus professional support
    • Going it alone
    • Going more than once
  • Stories of hope or stories of truth – where are the nadirs and ongoing struggles?
  • Virtual support – online peer websites
  • Helping ourselves by helping others – altruism or social selfishness
  • Eureka moments and epiphanies – positive tipping points
  • Measuring success in recovery
    • Steps backwards as well as forward – spiral of change not linear progression
    • Others as a gauge
    • Giving up old habits – addiction to denial and lying
    • Finding a new relationship with previously compulsive behaviours
  • Confession, coming out – the catharsis of telling someone else.

Clinical ‘Influences’

  • Public health messages and their pervasiveness
  • Walking the line – seeing danger in eschewing professional help
  • It does not exist and cannot be real if an expert does not know it (see screenshot above and force & power)
  • Reliance of self-reporting and the inherent dangers of diagnostic criteria
  • Non-clinical or health-based support and its application
  • Self-perception versus clinical diagnosis – unhappy bedmates?
  • Treatment and the time-lag
  • Compartmentalisation and connections EDs within the broader context of an MHI
  • Does clinical evidence have ANY bearing on lived experience?