Writing Anorexia Nervosa

A person with anorexia nervosa can see themselves as hideously fat even while dangerously underweight

Anorexia nervosa (usually just called anorexia) is an eating disorder characterised by an overpowering fear of being fat or of gaining weight. This fear is so all-consuming that it can lead to illness from self-starvation. This article looks at how to write engaging and believable characters with the condition.

The basis of the psychopathology of anorexia is believed to be valuing of thinness. People with anorexia feel that being thin is extremely important, to the extent of it being an obsession. For this reason, anorexia is much more common among women compared to men, and more common among women exposed to fashion media or who have an interest in sport and fitness compared to other women.

More specifically, thinness is considered important because it’s where a person’s sense of self-worth derives from. Thinness is seen as a virtue by anorexics, which is why the condition is so hard to understand for people who don’t have it.

Some might be surprised to hear that anorexia is one of the most deadly of all psychiatric conditions, up there with schizophrenia and major depressive disorder. An unusually low body weight is linked to a wide range of physical ailments, as many elementary bodily functions cannot operate past a certain level of starvation. Even without intending to, it’s common for anorexics to become sick and die as a consequence of lengthy periods of starvation.

If you are writing about a protagonist that suffers from anorexia, their internal dialogue might have a lot of anxiety based around a need to be in control of their body weight. Sometimes such a person will have a ruthless, almost sadistic approach towards their own body. This explains why there is a high degree of comorbidity with Obsessive-Compulsive Disorder. A person with anorexia often becomes extremely particular and fussy about their food and their calorie intake.

Then again, the approach might be more feminine. Instead of a desire to control, having a meal might conjure feelings of fear, almost panic. The sight or smell of food might trigger a reaction similar to that of a person with a phobia encountering their object of fear. It might be enough to also trigger powerful feelings of self-loathing.

Much like psychosis, anorexia tends to come and go in ’bouts’. An episode of anorexia is often triggered by a traumatic life event. It may be that sudden high levels of stress and anxiety result in a desire to compensate for a perceived loss of control.

Anorexia is not a psychotic disorder. A person with it will generally know that they have something amiss about them – but therein lies the difficulty. This reasonable part of the mind struggles incessantly against the part of the mind that commands that one must be thinner no matter what. It might be that the part of the mind that desires thinness above everything is somehow stronger, or more able to assert itself.

The effect that this might have on a protagonist of your story is therefore similar, in many ways, to that of one with depression. Constant feelings of having undermined oneself lead to guilt, personal recrimination, and a loss of confidence in one’s own intelligence, one’s competence or even one’s will to live. As is true of most of the conditions in this book, anorexics tend to have damaged self-esteem.

Like many of the other conditions in this book, it’s believed that anorexia nervosa frequently has an origin in childhood abuse. It might be that this is the reason for why it goes in bouts: dysregulated stress responsivity arising from the trauma leads to extremes of anxiety, and when one of those extremes is reached, a sudden desire for extreme control appears.

The experience of other characters who have a friend or family member suffering from anorexia is usually a difficult one. In many ways, watching someone waste away through anorexia is similar to watching them waste away through a heroin addiction.

This often brings with it a range of feelings that might profoundly affect that character, in particular frustration at not being able to get through to the anorexic about how dangerous their condition is, and guilt about not being able to “do more” for them. Although it’s true that it’s hard to reason with people who have mental illnesses – by definition – it’s still very common for friends and family of people with them to feel guilt about not being able to do more to get them to live a healthy, normal life.

A more distant character who encountered someone with anorexia might get the feeling that the anorexic is uptight and rigid. Anorexia is often associated with a sensitivity to insults and disrespect, as as perfectionism, and a character that demonstrated any of these traits could plausibly develop anorexia or have a past history of it.

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This article is an excerpt from Writing With The DSM (Writing With Psychology Book 5), edited by Vince McLeod and due for release by VJM Publishing in the summer of 2018/19.

Writing Depersonalisation Disorder

Depersonalisation Disorder is a brutally surreal experience. Also known as Derealisation Disorder, this condition is characterised by feeling like an outside observer of one’s own body despite being in it, and feeling like one isn’t actually in control of that body’s actions. Also common are feelings about reality being vague, dream-like, or less real than usual. This article gives some hints for how writers can handle characters with Depersonalisation Disorder.

This condition is almost always the result of stress, but a distinction needs to be made between a person who is temporarily dissociating in the moment because of an intensely traumatic event that has just happened, a person who has an established pattern of dissociating when exposed to certain stimuli that should not themselves be distressing, and a person who has a tendency to dissociate under small amounts of stress owing to psychological damage from past trauma.

It has to be made clear that Depersonalisation Disorder is not the same thing as psychosis. A person in a dissociated state will be aware that their perceptions are altered (or, at the very least, that something is wrong). In other words, they will not have lost touch with reality, which is a necessary quality of a psychotic experience. They will just have dissociation.

Dissociation is when one starts to feel emotions and sensations that aren’t usually associated with the environment that one is in. For example, one might be in an extremely stressful situation but not actually feel any stress: one simply watches everything from the perspective of consciousness, as if floating outside the body. Things feel unreal, surreal, so that sometimes one feels as if one is watching a film with one’s life on it instead of actually living it.

This lack of connection with the body is the strangest and most difficult thing about the condition. A person with depersonalisation can look at their own hand and not feel like they’re looking at their own body, which is a highly disconcerting experience. It’s also disconcerting to look at yourself in the mirror and not really understand who it is or that it’s you, or to recall a past memory and feel as if it really happened to someone else.

If written from a first person perspective, and written well, the experience of a character with Depersonalisation Disorder might be terrifying to the reader. Dissociation is often terrifying to experience personally, especially for the first time, and may be difficult to distinguish from a panic attack. However, often it is more weird than frightening, especially when the alternative is genuine suffering.

If the dissociation is occurring in a character being observed by the protagonist, that character might seem distant, vacant and “spaced-out”. The protagonist might get emotionless, zombie-like responses from the character undergoing dissociation, which might be a problem if there is something that has to be done quickly. It’s very possible that the protagonist mistakes the person dissociating for being under the influence of a psychoactive substance.

Most readers don’t do a lot of drugs. If they do, they might find the experience amusing to read about. After all, dissociation is a common effect of many recreational drugs. For such an audience, a character’s bout of dissociation might come across as highly comical, and doubly so when paired with another character who is perfectly straight in all regards.

Like most psychiatric conditions, Depersonalisation Disorder is believed to have an origin in psychological trauma. It’s very possible that a character with the condition will have experienced repeated trauma in childhood (usually emotional) that was so relentless it caused the mind to dissociate with reality in order to protect itself. This could be abuse, or a witnessed tragedy, or even simply a realisation about the true nature of things.

The case of Depersonalisation Disorder might then be an ego protection response to extreme trauma so that the person suffering the trauma doesn’t become cruel as a consequence of the suffering. Essentially one goes mad, when under inhumane stresses, in preference to becoming evil. This might be a way of showing the inherent goodness of a character, or their inherent naivety, depending on one’s approach.

Writing about a character who has dissociation might not be very interesting if the story revolves around the dissociation itself. The story might be more interesting if your character is an otherwise mentally healthy person who becomes dissociated as a result of extreme circumstances. This might be a one-time event or it could be part of a pattern.

If it’s a one-time event, it might be a reaction to a grisly sight like a car accident or something seen on a battlefield. This need not, then, be the central role in the story, but might rather be something that befalls the protagonist at a particular juncture, possibly transforming them or causing them to grow.

If part of a pattern, it might play a more central role in the story. It may be that the sight of a certain thing triggers an episode of dissociation on account of being associated with what caused the initial trauma, or it could be that relatively small amounts of stress or uncertainty are enough to tip a character over the edge.

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This article is an excerpt from Writing With The DSM (Writing With Psychology Book 5), edited by Vince McLeod and due for release by VJM Publishing in the summer of 2018/19.

Blade Runner 2049 Shows That Cyberpunk Will Live Forever

A Blade Runner for a new generation poses a set of moral dilemmas for a new generation – as cyberpunk always will

Film pundits are divided over whether or not Blade Runner 2049 can be counted as a successful film. On the one hand, it lost $80,000,000 at the box office; on the other, it has an 8.4/10 rating on the IMDB. This essay argues that not only is Blade Runner 2049 a great film, but it is evidence that the cyberpunk genre will live forever.

Cyberpunk, like Satanism and Test match cricket, is never going to find mass appeal among a Western population that hates thinking. All of these genres are acquired tastes that only a particular sort of person finds interesting – and then, they usually find it fascinating. So it’s entirely appropriate that Blade Runner 2049 did poorly at the box office but extremely well among cyberpunk fans who have a sophisticated appreciation for the genre.

Cyberpunk will always have a place in popular culture, as long as advancing technology continues to pose us moral dilemmas that bring with them the possibility of horror. New technologies will keep putting people in novel and unique situations without any previous example of how to conduct oneself, and they will continue to provide new methods to control, exploit, dominate and destroy.

Even though most new technological advances will be for peaceful and wholesome purposes, we can predict, to paraphrase William Gibson, that the street will continue to find its own uses for things, and therefore there will always be expression for people using technology to get any edge on each other.

Which means that advancing technology will continue to produce moral dilemmas that make for fascinating fiction.

The moral dilemma at the heart of Blade Runner was whether or not artificial humans could ever be considered real people, and so whether or not there was ever a moral obligation to treat them as equals, in the way that most people feel a moral obligation to treat other people as equals. Roy Batty was outraged that humans might have engineered him to have such an artificially short life span, and viewers were likely to concede that he had a point.

For whatever reason, the collective consciousness appears to have concluded that replicants are not, and can never be, conscious. Fair enough, but the moral dilemma at the heart of Blade Runner 2049 is whether or not the offspring of replicants that can breed are conscious. The characters in the film seem to glibly assume that any creature that is born must have a soul, but the question is never discussed at length by them, leaving such ruminations for the viewer.

Blade Runner 2049 poses this question in a believable and terrifying manner, and forces the reader to consider Philip K Dick’s fundamental question of science fiction: not “What if…”, but “My God, what if…” My God, what if artificial creatures that managed to replicate were actually conscious in the same way that we are conscious? What if acting to reduce the suffering of all sentient beings in the universe meant that we had to consider the offspring of replicants?

Cyberpunk is always going to raise questions like this, because it will always be true that somewhere there is a megacorporation with pockets deep enough to finance bleeding-edge technological research and application away from the watchful eyes of the government or the public, for whatever dark and twisted motives the world can surmise.

Because it did such an excellent job of posing such deep questions in a way that chills the spine of the viewer, it can be argued that Blade Runner 2049 is an excellent piece of cinema for the sort of viewer who appreciates a subtler and more cerebral tale than the usual Hollywood fare, even if it did not find mass market appeal.

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Vince McLeod is the author of the cyberpunk novel The Verity Key, a story of ANZAC mateship in a dystopic future world where it’s possible for devices to control people’s thoughts and actions by satellite.

If Speculative Fiction Genres Were Psychoactive Drugs

Every genre of speculative fiction has its own signature atmosphere: often a combination of fantastic, awesome, terrifying and bizarre. So do psychoactive drugs – and the two match up. This article looks at which drugs give a vibe that best matches the vibe from a genre of speculative fiction.

High fantasy fiction matches up to cannabis. Lord of the Rings contains a couple of sly allusions to cannabis use, most notably when Saruman admonishes Gandalf for his “love of the halfling’s weed” while explaining how Gandalf missed a clue that he should have noticed. The scene in the film Fellowship of the Ring where Gandalf and Frodo sit above the drunken revellers and smoke some magical substance from a pipe is one familiar to most stoners.

Some of the experiences that Elric has in the Stormbringer series of novels by Michael Moorcock were also very likely to have been cannabis-inspired. There’s something about Elric’s experience of having an extremely powerful ally that couldn’t really be trusted that speaks to the paranoia that sometimes comes with the cannabis experience.

The sword and sorcery style of low fantasy matches up with psilocybin mushrooms. It’s unlikely that Robert E Howard took any magic mushrooms before writing any of the Conan the Cimmerian stories, but the protagonist’s many adventures in dark, subterranean caves and inside fantastic towers and castles are reminiscent of the depth and range of sometimes terrifying personal insight that often comes with mushrooms.

The Forgotten Realms universe of Dungeons and Dragons adventures, with their massive, dark forests full of elves and goblins also relates closely to the vibe of the psilocybin mushrooms experience. The reason why magic mushrooms enthusiasts are encouraged to try taking five grams in silent darkness is because it leads to exploration of a fantastical inner world, and going down into the subterranean to arise wealthier at some later point is a regular theme.

Most of what sells as science fiction could have been inspired by LSD. Stories like The Demolished Man, with a very strong psychological content, harken to the disintegrative effect that psychedelics can have on the personality. The main character of The Demolished Man, somehow between protagonist and antagonist, ends up having his personality completely demolished (and then rebuilt) as punishment for his crimes, reminiscent of how the psychedelic experience can destroy a person and then build them back as something stronger than before.

This sense of twisted psychology comes through also in the writings of Philip K Dick, who had himself tried LSD. Psychedelics might have inspired the plot of Ubik, in which the character Glen Runciter experiences a believable but bizarre reality while his physical body is “on ice” in a cryogenic chamber. Wondering if you’re really dead or alive is the kind of thing that LSD can make happen to you.

The almost schizophrenic belief in a hidden real world outside of this merely simulated one is a mainstay of cyberpunk literature, and is similar to the impressions one gets on DMT or salvia divinorum. For thousands of years, human shamans have been having experiences of dying to the physical world and being reborn to the real one, like Neo did in The Matrix. In that regard, The Matrix is really a retelling of the ancient mystery school teaching of death and resurrection, reclothed in 21st-century technology.

A description of what might be the spirit of the DMT experience is given in the ANZAC cyberpunk novel The Verity Key. In the chapter Mindknife, the protagonist Jonty Gillespie has his perception altered by ingestion of a drug called Cinque Nuevo, which briefly blasts his consciousness out of his physical body and into an entirely external dimension that is occupied by beings that take the form of balls of light, while mechanical constructs that might be metaphors churn around him.

The datura experience is pretty similar to what befell many of the unfortunate researchers in the Cthulhu mythos of H. P. Lovecraft. A disquieting sense of things not being quite as they should be grows into an intense paranoia that leaps at every shadow and from there to total psychological collapse at the raw horror of reality itself. Alien beings that seem to have come to Earth just to torment you is the kind of thing you’re dealing with in either case.

Datura is also the kind of drug that fits the background of weird horror stories such as those in His Master’s Wretched Organ. Talking to grotesquely deformed entities like Mr. Creamfeather and eating tobacco cakes are the sort of horror that, once experienced, leaves a person never quite the same again. The concept of ordeal rituals that leave you wiser for having suffered come to mind here.

Others are arguable. The steampunk of The Rocketeer might suit opium, the boo-yah aggression of Starship Troopers might suit mescaline, and the gritty military noir of the Altered Carbon series might be the old classics of caffeine, nicotine and alcohol.

It might be hard to read any speculative fiction on most of these drugs, because a person on them is more likely to be occupied with the inner theatre of the thoughts in their head than a book in the external world. However, it might be possible to have a richer experience of reading speculative fiction after having tried some of them, because they could open your awareness to realms of thought previously unimagined.