Manifestation of Anorexia Nervosa in East-Asian Culture

Manifestation of Anorexia Nervosa in East-Asian Culture Tharushi Kaluarachchi Mental illnesses do not exist independent of their social and historical context. Although it is generally accepted that sociocultural factors are key in the development of Anorexia Nervosa (AN), presently, it is bound by Western notions of disease as its criterion is focused on the obsession with thinness for women with the disorder. However with its evolution being mirrored in East-Asia, it has been hypothesised that an increased risk for eating disorders in those countries arises from a greater exposure to Western popular culture, diets and values. However this in itself does not explain the spread of the disorder as a more complex historical view is needed to explain its conception in East-Asia. Being complex in aetiology, there is much debate centred on the motivation behind food refusal in being the most challenging factor to interpret (Keel Klump, 2003). In Western countries, the promotion of thinness as the ideal female form today has forged a template for the diagnosis of AN as eating disorders have become more common among younger females with a period of icons of the American beauty becoming thinner during the late twentieth Century (Keel Klump, 2003). As a result of this campaign, Lee (1995) claims that modern biomedical views of AN have attributed the avoidance of food purely to a fear of fatness while the sufferer becomes emaciated. The essential criteria for Anorexia Nervosa includes an intense fear of weight gain even with a significantly low weight (The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013). Hence it is insisted that the resolution of this fat phobia needs to presuppose recovery. However this explanation is inadequate as East-Asian cultures have a historically unique evolution essentially apart from modern Western culture (Keel and Klump, 2003). Hence in East-Asian countries AN was previously noted to be unknown with the fear of fatness noted to be frequently absent among these rare anorexics. A culturally sensitive study of AN in Hong Kong revealed that although they bore a convincing resemblance to Western Anorectics in terms of physicality, a large portion, 59%, did not exhibit any fat phobia, instead rationalising their food refusal through bloating and oesophageal blockages (Lee, Ho Hsu, 1993) . Hence these East-Asian Anorexics resulted to organic causes for self-starvation, endorsing the body as a social response to illness (Watters, 2010). Thus, an individual’s distress is culturally defined, as these bodily sensations indicate psychological distress carrying as much meaning and impact as a Western complaint of anxiety or depression (Lee, 1995) . Regarding a case study by Lee (1995), a thirty-one year old patient from Hong Kong began complaining of abdominal discomfort and reduced her food intake due to her boyfriend deserting her. Despite seeing doctors, her weight continued to decrease with her attributing it to abdominal problems, denying any fear of fatness or intentionally restricting diet. Clearly this patient did not fit the diagnostic criteria for AN according to the DSM due to the discrepancy between the biomedical explanation of fat phobia and the patient’s personal explanations (Watters, 2010). Aetiological explanations that were sought through Chinese herbalists attributed the self-starvation to imbalances with bodily organs being devoid of normal hunger sensations, yet was found to be ineffective in treatment. As a result, what was needed was a more local understanding of the personal and cultural forces at play instead of relying on a global template driven by the use of Western diagnostic categories as n either Western nor Eastern healing modalities were having an impact. It is imperative to document that cultural forces are often mediated throughout history to mould the contextual factors which result in the mental illnesses of that time. Hence in pursuing an aetiological explanation for atypical Anorexics, hysteria is of particular interest as its symptoms tend to be shaped by the surrounding culture which is constantly changing in accordance with what is deemed to be female by society. (Shorter, 1986:1). Although the patient’s condition cannot be explained through modern conceptualisations of AN, the symptoms exhibited can be traced back to nineteenth century hysteria. This was an extremely popular form of illness manifesting in a variety of symptoms such as convulsive fits, paralysis and muscle contractions, which the patient believed was physical in origin and perceived as being beyond the control of their conscious mind (Shorter, 1986). Lasà ¨gue (1873 as cited in Malson, 1998) presented hysterical anorexia as a form of hysteria caused by the ‘mental perverseness’ of the patient regarded as an illness of female nervousness. Lasà ¨gue (1873 as cited in Malson, 1998) constructs the typical patient to be a young woman who is mentally weak, aged fifteen to twenty years suffering from a personal trauma who is unable to voluntarily resist ascending to the illness. Hence in failing to differentiate between a typical patient and other young girls, he pathologized all young girls, depicting them as being incapable of controlling their symptoms. Hence his report inadvertently enabled a dialogue between the medical society and Victorian middle class females (Brumberg, 1985). Sir William Gull (1873) who shortly succeeded Lasà ¨gue drew the conclusion subsequent to observing similarities across a number of cases, due to the consistent absence of gastric dysfunction which he used as evidence to attribute the loss of appetite to a morbid mental state. Hence Gull defined the loss of appetite as Anorexia Nervosa with the motive for self-starvation being as a result of mental wilfulness differentiated form hysteria which had an organic cause (Gull, 1873). In constructing a weak minded, young nervous girl, Gull (1873) and Lasà ¨gue (1873) presented AN to be viewed as a characteristic or archetype of all young women (Malson, 1998). The ensuing public debate established AN as a distinct disease entity reifying it as a common female disorder which was typified by an aversion to eating food with the patient reporting abdominal pains (Mackenzie, 1888 as cited in Malson, 1998). Yet, as found with the case of atypical East-Asian anorexics, it was repeatedly asserted that careful examinations found no sign of any organic causes that could be attributed to the disorder (Marshall, 1895 as cited in Malson, 1998). Hence a phobia of gaining weight is not the reason for extreme self-starvation, as gastric discomfort was legitimized by physicians, instead attributing anorectic patients’ starvation as the wish not to eat or loss of appetite with the behaviour being as destructive as patients today with anorexia nervosa (Shorter, 1985 as cited in Lee, 1995). Hence non-fat phobia anorexia displays no particular cultural features as it was found in early conceptions of hysteria and atypical anorexics in East-Asia. Oppenheim (1991 as cited in Watters, 2010) documents the influence of hysteria in Victorian culture in the early twentieth century that led to the rise of the disorder as it was mentioned in not only medical literature but also in popular magazines and newspapers that were easily accessible to lay people. Hysteria was encountered everywhere in the public, seen in an ad in Modern Mechanix – Physical Culture that promoted devices such as body braces to remedy â€Å"female weakness, backache, stomach trouble†¦the result of incorrect posture, misplaced organs† (Stop Suffering, 1934). Further an ad in Photoplay generalised woman as having â€Å"no control of herself† with â€Å"constant headache, backache and dizzy spells† prescribing tablets that would give women back their youth, beauty and health (These Hysterical Woman, 1932). Hence this reification of disease by medical professionals and consequently the media can have an unconscious yet powerful effe ct on people as the psychosomatic symptoms of anorexia nervosa were shaped by their beliefs of what constitutes a disease (Shorter, 1986 as cited in Watters, 2010). Shorter (1986) claims that as these expectations change, it targets a specific population and provides patients with a model of how to behave and which symptoms to present. Hence as seen with hysteria, this rapid increase in incidence of a pattern of symptoms coming into vogue through a public interest in medical discourse presents with a problem of incidences of diseases rising (Shorter, 1986). As a result the illness manifested in the population at large and the incidence of the disease drastically rose as self-starvation which was once a rare symptom became common. Shorter (1994:268 as cited in Malt, 1996) postulated that the medical society stimulated the eating disorder behaviour as it influences patients’ ways of communicating their distress to be more recognized and accepted as it offers a person who can no longer cope with their situation to be free of blame through a non-stigmatic label corresponding to medical diagnostics. Hence this rise in hysteria symptoms in early nineteenth century can be matched with atypical anorexics in East-Asian countries in the late twentieth century, with the speculation that the lack of public awareness in East-Asia correlated with the rarity of the disorder, as distressed individuals were less likely to select AN as the illness of choice (Watters, 2010). In the late 1990’s the cultural and individual differences in diagnosis became blurred as the influence of the Western diagnostic manual grew and wouldn’t be confirmed as AN unless the patient fulfilled the DSM criteria which presents a large problem in treating them (Watters, 2010). Although increasing industrialisation and fraying of traditional forms of family occurred in the 1990’s, this Westernisation is inadequate in describing the rise in the incidence of eating disorders in Asian countries (Pike Borovy, 2004). This clash between traditional and modernism formed a belief system suspended between East-Asian and Western conceptions at the point where modern attitudes have fragmented families yet not enough to overturn the traditional familism (Chan Lee, 1995). As a result, Cummins, Simmons and Zane (2005) criticise DSM as a diagnostic tool as it requires endorsing specific symptoms, yet it presents as less relevant to East-Asian populations as they may exhibit a different pattern of symptom presentation. However Rogler (1992 as cited in Aderibigbe and Pandurangi, 1995) claim that when translating international instruments such as the DSM, they should be culturally sensitive to ensure an accurate assessment of symptoms as they should be described freely without any Westernised prejudice. Further, Aderibigbe and Pandurangi (1995) call for more flexibly structured diagnostic systems where the diagnostic inclusion and exclusion criteria is applied in the context of the local culture as diagnosis would be improved if there are alternate classifications of disorders that were more suitable to East-Asian countries. Western conceptualisations often neglect the conception of AN in contemporary East-Asia is affected by the dominant cultural expectations for young woman as traditional notions of love, marriage and adulthood create a context which offers financial stability whilst simultaneously limiting their social lives (Pike Borovy, 2004). As a result of this culture, Pike and Borovy (2004) suggest that eating disorders may reflect the individual’s distress in negotiating these constraints which still values women in their traditional roles of domesticity. This is contrasted with Western cultural valuation of women where the tension arises from a result of striving for achievement and autonomy in being required to negotiate the demands of competitive worlds with a devaluation of traditional dependency work (Pike Borovy, 2004). Western societal standards of beauty often overvalue size and weight, expressed through a general distorted body image and fat phobia of the population. Although this pursuit of thinness has been absorbed by East-Asian culture, it is not the central causing factor of East-Asian AN. Instead there is a need to recognise that this fear manifests as a loss of control, which is the more critical factor in developing AN (Lee, 2001 as cited in Pike Borovy, 2004). This is where the culture acts as a guide for the individual by providing a range of symptoms to express distress as it provides a range of physical symptoms for the unconscious mind to physically express the psychological conflict (Shorter, 1986:1). Hence it is important that the aetiological model of AN integrates the local East-Asian culture and the universal need to express distress and global Westernisation. The rise in incidence of fat phobia anorexics can be ascribed to the popularisation of the DSM essential criteria of a fear of fatness in Hong Kong through the media. Instances such as the death of a young anorexic girl, Charlene Hsu Chi-Ying sparked the attention of the media with newspaper headlines from local Chinese-language daily papers such as â€Å"Schoolgirl Falls Dead on Street: Thinner than a yellow Flower† (Watters, 2010). With little local professional knowledge, Western experts were quoted, ascribing her demise to weight loss and dieting (Watters, 2010). Hence this media attention not only generated public interest resulting in the rise of this disorder, but especially a rise in the Westernised form of AN in a different subpopulation, modelling DSM symptoms. A newspaper article in The Nation claimed that eating disorders were estimated to afflict â€Å"one in 100 young Japanese women† (Effron, 1997:14) similar to the incidence rate in the United States. The extent of Western acculturation in Asian countries can be seen as Effron claims that â€Å"a weight-loss craze has swept the developed countries of Asia, sending women†¦scurrying to exercise studios and slimming salons† (Effron, 1997:14 as appearance and figures became very important to young people. Hence raising awareness of AN in Asian culture inadvertently became a double-edged sword as it could draw a susceptible reader in, with Shaw (2006) finding that adolescents tend to respond more to fashion images. Further, vulnerable adolescents who were dissatisfied with their body and perceived the pressure to fit in were adversely affected by exposure to images of thin models (Stice, Spangler and Agras, 2001). Therefore, there is a need to change the perception of AN portrayed in the media as it has become a culturally manipulated syndrome in East-Asian societies, leading to mimic anorexics as they regard the process of self-starvation with veneration rather than pain (Brumberg, 1985). Hence this proliferation of the promotion of starvation as glamorizing the disease for girls who seek it as an outlet of distress can encourage imitation. As a result, Psychiatry today in East-Asian cultures are treating the subpopulation affected by Western manifestations of AN which is inadequate a s it dismisses the genuine atypical anorexics. In summation, it is important to consider AN as cultural artefact which has been refined over time, as well as integrating a biomedical and personal subjective models. Hence there is no single adequate suggestion that media and advertising or society alone have increased the incidence of AN. It is rather that culture is a layered process of history and social expectations which put modern adolescents at a greater risk for developing the disease such that a deeper historical view, as pursued here, can be sought to explain how expectations of AN have changed. However, the mediation of factors such as media, which help form a dialogue between the disease and the public need to be controlled and take into account the local culture in order to aid in treating and restricting the rise of the incidence of AN in East-Asian countries.

The Birth of Rock N’ Roll – a Case of Racial Conflict

THE BIRTH OF ROCK n’ ROLL – A CASE OF RACIAL CONFLICT The term rock ‘n’ roll has been traced back as far as the 1920s in black music, but it became an accepted when disc jockey Alan Freed began used it to describe the character of the rhythm and blues he played on his radio program in the mid-‘50s. The term â€Å"Rockin' and Rollin† were originally used as slang for sex, in black pop music. However, it went on to become the name for a new, salacious musical genre.Innovation in audio technology, new instruments, fresh talent, business savvy record producers, and a young population of new consumers created by post-war economic prosperity helped turn â€Å"race music† into â€Å"rock and roll†. The roots of Rock & Roll can be traced back to rhythm and blues and country rock. We must note the political context of the rock n' roll movement before delving deeper into the recesses of the genre.Black people were beginning to identify and assert themselves racially supported by a series of Supreme Court judgments in favour of integration and the Black community in general Rock n' roll became a symbol of Black empowerment to the Whites, especially to the segregationists who were accustomed to and valued a separation of the races, but were now legally forced to operate against those segregationist values. The resistance to rock n' roll music, highly enjoyed by young White kids, was a culmination of all the hostility and tension of the Civil Rights movement.There was a certain White resistance to such music in the form of The Ku Klux Klan and other White-supremacist organizations that openly preached the exaggerated consequences of listening to rock n' roll music. The term â€Å"jungle music† was used to describe the rock n' roll beat, declaring it would cause the White youth to lose their sense of humanity and dignity while mixing races. This kind of resistance to the rock n' roll movement often came to physical assaults on Black performers. There have been reports of assaults such as the one on Nat King Cole, arguably one of the most docile African American performers of the time.While performing at a Whites-only venue, a mob rushed the stage and beat him. Nat King Cole not only suffered the bruising from the White audience who ambushed him, but also a tongue lashing from Black activists who reprimanded him for not demanding integrated venues. The conflicts of rock n' roll music are direct reflections of both the institutional resistances of Whites to integration and the widespread exploitations of Blacks across the country in many industries. The post-war economic boom ushered in a new era in radio broadcasting.With greater competition, national radio networks gave way to a horde of new independent, locally based stations hosting a variety of entertainment programs. White radio producers would hide Black performers from White audiences. They would often choose a tune with potential from a Black artist, and have a White singer perform the song without the provocative dancing or emotive moaning of the original version. This proved to be a multiple win for the Whites as the Black artist would be kept away from the spotlight, the White producer was making the money, and White kids were idolizing the White singer.It is widely believed that iconic artists like Pat Boone, Elvis and Georgia Gibbs began by assisting in the exploitation of Black artists who were replaced by more-polished, White impersonators. Many observers suggest that rock n' roll would never have been so controversial had it not been for the sexual revolutions and conflicts going on throughout the mid 1900s. The rock n' roll revolution coincided with the institutional revolution of acknowledging youth sex. Rock n’ roll music often ended up portraying sex as a new, fun activity, something that normally happens when young people fall in love.The older generations were quite averse to such music and u sed many tactics to resist the trend. Magazine campaigning became very popular among the older generations; parental guides and â€Å"girl talks† were printed to show that people still valued pre-marital abstinence. The situation eventually escalated into full censorship, until disc jockeys and music hall owners refused to play Black records in general. There were petitions and requests for radio stations to not play sexually-explicit lyrics, but the response was relatively weak. The truth is that the White artists, who impersonated the Blacks, saved the movement.They cleaned up the sound and look of rock n' roll, until White parents would accept it. Parents did not want their sons and daughters listening to wild rocker Little Richard Penniman, but would let them listen to Pat Boone. Soon, White faces like Elvis Presley and Jerry Lewis were reintroducing the sexuality of rock n' roll music and launched it into mainstream legend. Black popular music—everything from jazz and blues to boogie-woogie and rhythm and blues—stood at odds to the white pop songs and artists that epitomized post-world war conservatism. By comparison, rock n’ roll was raunchy, unrestrained, rowdy, and even evolutionary. That which was categorized by the record industry as â€Å"race music† stood as a powerful cultural alternative to the tight-lipped, conformist values. Black Rock n' Roll music also reflected major social and cultural changes brought on by post war urbanization, including youthful rebellion. By contrast, white pop music had ignored or watered down these transformations. American youth, inspired by nonconformist icons like James Dean, Marlon Brando, and Natalie Wood, naturally gravitated toward the more edgy black tunes which they felt spoke of their frustrations.These young whites made black music their own by learning the dances, memorizing the slang, and copying the cool swagger of African-American boogie-woogie and rhythm and blues art ists. They claimed as their own a genre scorned by most whites born before World War II. Thus, Rock n' Roll was indeed reflective of the Civil Rights movement. It stirred up a whole generation and shows that a culture conflict usually always has a deeper context to be found.

The Untold Story About Admission College Essay Samples You Must Read or Be Left Out

The Untold Story About Admission College Essay Samples You Must Read or Be Left Out Top Choices of Admission College Essay Samples This section comprises two examples of fantastic college essays. Please note there is an essay at the close of the application. Before you commence writing your college essay, you may choose to see the essay examplesA that we've listed for you, so that you can have more idea on what things to put in the college essay which you will create. Possessing good essay examples provides the reader an in-depth and on-the-court idea about what a well structured and coherent essay appears like. The duration of your essay is not what universities start looking for. Before you even begin writing the content of your college essay, there are a number of essay writing basic guide that you need to always bear in mind. The Most Popular Admission College Essay Samples Your college essay should contain information that are related to the instruction provided to you. 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Multicultural Counseling Is The Hour Of The Need - 1204 Words

Multicultural counseling has been on the rise since the 20th century and so far plenty of literature highlighting the need of it has been published. The practice is getting more and more popular because the idea is fully in line with the dynamics of the modern world. In diverse regions like US, where the population is composed of culturally different people, multicultural counseling becomes more of a necessity. Thus, the emergence of programs based on multicultural counseling is the hour of the need. A recent research showed that 89% of programs (of counseling psychology) today focus on multicultural-centric courses (Sue et al, 1992). There are several approaches to multicultural counseling. This paper would focus on the Three Factor Model for multicultural counseling and would delve into the model discussing its various aspects, also examining it critically. The three factors that the model takes into account are cultural identity, development stage and adjustment to disability. 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