Saturday, June 26, 2010

Dysregulation,eating disorders and other mishaps

Dysregulation, eating disorders and other mishaps

Through the many years I have worked with patients with eating disorders I have come to examine and understand the problem from different perspectives. Like the old and wise story of the blind men and the elephant, I too got a different view of the “animal” depending on what part of its “body” I got to touch at each particular time. So, some times I saw it as the result of an over controlled childhood, sometimes it was a loss of identity, other times it appeared to be the result of over sexualization and objectification of women living in a chauvinistic society or all of the above and more.

Today, in the midst of an avalanche of bad news like the fiasco on Wall Street, the nightmare of the housing market, the catastrophe of the BP spill I am coming around and looking at the elephant from yet another view point: Self regulation. It has become evident that in becoming the land of plenty, America has also lost its ability to self-regulate. The instant gratification of our yearning for the ever elusive bigger house, bigger car, bigger burger, fancier phone, more oil, more energy and so on has become part of our American identity.

From birth on we are training our kids to seek more and more frequent gratification.
The plethora of toys in the nursery which infants do not need and which are over stimulating, the mountain of toys under the Christmas trees that is equally overwhelming, the surfing of the 150 or so TV channels, the ipods, the phones, the computers, should I keep going? In their wish to please parents have become eager contributors to easily bored, restless and demanding kids.

A part of our brain is wired to seek gratification and pleasure. Every time we do something pleasurable Dopamine is excreted in our brain and it makes us feel like a million dollars. So, we seek more of the good staff. Gamblers know this all too well and every time you get excited with the ding sound of a new e mail message you get your dose of the juice too.

It is our job as parents to “train” this part of our kids’ brain that is blindly seeking pleasure. Gratification should be tempered with moderation and balanced with knowledge of consequences. Rewards should be the consequence of work not an entitlement. This culture of self indulgence, from the unearned BMW at 17 years of age to the no-money down mortgages is the path to destruction. Look at history if you do not believe me. It happened to the Roman Empire.

Eating disorders is another example of our inability to self control and self restrain in a world that offers a dizzying variety of foods. I believe the government has recently recognized the need to help people self regulate by mandating better labeling of foods, better education on mortgages and credit cards. But this is just the beginning, a good step but only a step. Restrain, moderation, and responsibility starts in the cradle.