In the old-fashioned freudian model, the pathological behavior of a mental illness is in many cases a symptom of, or compensation for, an underlying, causative problem. Once you find the cause, you’ve done the hard part. Examples: a man who is afraid of responsibility and drinks to absolve himself of it. A woman who cannot control her surroundings or her relationships, and starves herself to control her body.
The illness isn’t purely bad: it gives you something. You need it. Like the inflammatory response, or fever, it’s an immune system compensating or repairing. Like vomiting is how your body gets rid of bad food: it’s a helpful thing at first, and you do it again, and again, and then it’s not so helpful. And by then it’s too late to just stop, the nausea perpetuates itself.
You say things like “I feel that I’m fine the way I am. Which is the problem.”
I’ve been sad for longer than I’ve been anything else, I think. It’s always there, even when I’m well, which is most of the time these days. Months and months on end I feel fine. I feel great. I am happy and I know it and sometimes I even clap my hands and sing, seriously off-key, about life and its wonders. But I know it’s there waiting for me to slip. Waiting for an illness or a death in the family or a national disaster, and then it will pounce.
You ever read A Wizard of Earthsea, by Ursula K. LeGuin? That’s what it’s like. It’s always lurking. I may spend years free from it, but it will come back again, and I will have to fight it again. Eventually, I will die. Maybe it will kill me, maybe something else will. But I can never kill it. I can never truly win.
If there’s someone who would know about the relationship between the body and the mind, it’s Eliot “Follow Me Here” Gelwan. I wrote him asking about gastric bypass and mental illness, and his response was this:
In my experience, a responsible gastric bypass surgeon requires his patient to have a psychological evaluation before deciding whether to perform the procedure on a given patient. This is a little simplistic, but essentially the surgery works by reducing the volume of the stomach, producing a feeling of fullness and satiety sooner, and thereby helping the person control their eating. If someone, psychologically, eats compulsively despite feeling full, then not only will the surgery not work but it would be dangerous.
He also sent some abstracts and links to journal articles, which are included below.
Continue reading “In love with your disease”