“As his (E. Shorter’s) body ofresearch shows, history was full of ever-changing psychosomatic symptoms shaped in large part by the expectations and beliefs of the current medical establishment. ‘As doctors’ own ideas about constitutes “real” disease change from time to time due to theory and practice, the symptoms that patients present will change as well,’ he writes. ‘These medical changes give the story of psychosomatic illness its dynamic: the medical “shaping” of symptoms.’
Shorter believes that is was Lasegue’s famous paper and the public interest in the medical debate surrounding the diagnosis of anorexia that forged a kind of template for self-starvation. As the medical establishment settled on the name, the agreed-upon causes and a specific symptom list for the disease, they were, Shorter argues, ‘disseminating a model of how the patient was to behave and the doctor to respond’. What was once a mishmash of conflicting medical theories surrounding self-starvation had now gained the appearance of a precise disorder with a specific at-risk population. That new conception of this illness took hold not only among women who had already manifested disordered eating but in the population at large. There are no broad epidemiologic studies of eating disorders from the time, but the anecdotal evidence for what happened next is persuasive: soon after the official designation of anorexia nervosa, the incidence of the disease began a dramatic climb. Whereas in the 1850s self-starvation was a rare symptom associated with hysterics, by the end of the century the medical literature was littered with references to full-blown anorexics. As one London doctor reported in 1888, anorexic behavior was ‘a very common occurrence’, of which he had ;abundant opportunities of seeing and treating many interesting cases’. In that same year a young medical student confidently wrote in his doctoral dissertation, ‘among hysterics, nothing is more common than anorexia.’ from “Crazy Like Us: The Globalization Of The Western Mind” by Ethan Watters.
The above quote is not surprising for anyone at all familiar with the nature of modern psychiatry. Dr.s generally see what they already expect, making little or no attempt to understand the patient on his own terms in the tiny slot of peremptory, 15 minute appointments (even your average bootlegging, moonshiner makes more attempt to get to know and empathize with his customers — since in his case, his freedom often depends upon it). On the other hand, the well known psychological ‘labelling theory’, together with related concepts, dictates that ppl will very often play up to expectations, and manifest their ‘diseases’ in socially mandated ways (this is never more the case than with psychiatrists, who are people who one senses get very annoyed when you don’t conform to their exceptionally narrow expectations, so one easily allows oneself to be bullied into doing so) Once again, this demonstrates irrefutably the social nature of ‘mental illness’, with its innate quality being a form of communication, centered around certain semantic forms of distress related to suboptimum factors within one’s environment, rather than being primarily, or even in any way, a physiological brain abnormality.
(from my book, “Gaslit By A Madman: On Philosophy, Madness, & Society”, 2019 — available very economically-priced on Amazon)