Dr Mel Siff Discussing DYSMORPHIA & CLASSIFICATIONS
Author: Dr Mel Siff Blog // Category: Dr Siff on Injuries/DiseaseIf we examine the concept of ‘muscle dysmorphia’ (the apparently
pathological perception that one has not enough muscle bulk), then we will
note that it is one of many such syndromes which reflect some sort of
dissatifaction that afflicts the human being.
Its inverse, anorexia nervosa, has already been commented upon, but if we
scan through the learned literature, the popular media articles and the
records of various medical professionals such as cosmetic surgeons, we
discover that the human may exhibit dissatisfaction (pathological or
otherwise) with some perceived structural or functional *ugliness* or
undesirability of the human condition, including:
Structural Characteristics
Body Size (too large or too small)
Body Proportions
Skin colour (hence the tanning ‘psychosis’)
Breast size and shape
Hips
Waist
Thighs
Calves
Ankles
Feet (size, shape and appearance)
Face (nose, lips, eyes, ears etc)
Height (too short or too tall)
Hair (baldness, texture or colour)
Penis
Butt size and shape
Skin appearance and texture (basis of the cosmetics industry)
Nudity (a central focus of many laws, religions and rituals)
Functional Characteristics
In sport and health, individuals may perceive imperfection, deficit or
*ugliness* in various functional indicators of human ability:
Coordination and motor skills (‘clumsiness’ deters many children from taking
part in sport)
Sports competition (Winning, losing and belonging to a team)
Posture (high heeled shoes are one of many ’solutions’)
Cardio fitness (massive focus of sports medicine and the sports industry)
Ageing
Vocal features
Social or group acceptability (’social anxiety’ is selling a new class of
drugs)
Work performance (job output, publications, earnings etc)
Status (ranking relative to one’s peers)
This list may be extended, but it suffices to illustrate that we humans
display an inordinate degree of dissatisfaction with some structural or
functional aspect of being alive among a group of fellow humans who are
feared to be judging your worth in terms of such characteristics.
Psychologists and scientists such as Abraham Maslow, Alderfer, Olds, and
McLelland have examined human behaviour and produced models to identify and
understand the role of needs in life, with Maslow’s ‘Hierarchy of Needs’
becoming well known in many circles. These models have stressed that we are
driven or motivated by any perceived need, be it physiological, safety,
social, self-esteem or self actualisation.
What all the models have in common is that we have to experience stress
created by need or the perception of need (*want*) if we wish to be motivated
to do anything in life. This raises some interesting implications for the
entire concept of *dysmorphia* or other aspects of perceived ‘ugliness’
relative to a given situation or group.
Suppose that we all felt totally satisfied with all structural and functional
aspects of our being – would there be any motivation to achieve anything in
life, other than be driven by sheer physiological need to eat, drink, have
sex, move and sleep?
Probably many will answer something like this: “Yes, we do need some needs,
be they real or imagined, otherwise the human would be no better than the
lowest form of life, but it is when the need or want becomes exaggerated that
the problems arise. And, as we all should know, an exaggerated want or
preoccupation with something in life becomes an obsession or psychosis. It
is just that one must maintain the right balance to stay sane and happy.”
If we apply this to sport, then we immediately sense a contradiction. If a
top level athlete does not show exceptional motivation and dedicate a large
part of daily life to preparing for sport, then progress will halt and
winning surely will become a memory. So, at what stage does passionate
dedication and devotion to achieve a goal become an obsession, a dysfunction,
a pathological condition? Ah, we might say, that is easy to recognise,
because these disorders become apparent when they dominate above most other
interests in life and often cause physiological signs of dysfunction.
The critic might retort:”But that is just a sign of imbalance in one’s
life, not necessarily a psychosis or a disease. Regarding the accuracy of
physiological indicators, there are many distance athletes who frequently are
very weak, thin and almost chronically fatigued.”
If we return to the above list, we will note that it is probably very
difficult to find anyone who is entirely satisfied with her/his body and its
function. It would appear that we all perceive some deficit in what we look
like and what we do, largely because we are inordinately concerned with what
others think of us.
That raises the age-old question of what exactly is normal and who decides
what is not normal or acceptable. If we lie at either extremes at both sides
of some Gaussian distribution, we are deemed to be *abnormal*; if we show
characteristics which fit into the *majority* interval, then we are *normal*,
with no need to be treated, exterminated, legislated against, medicated or
incarcerated. Obviously, there is a lot of great area on either side of
what is deemed to be “normal”.
In the medical world those who fit into one of the extreme categories may be
deemed to be suffering from a psychosis or pathology, the reference framework
being the society in which we live, replete with many subjective laws,
perceptions, religious undertones, biases and operational models.
Yesterday’s psychosis and obsession may become today’s norms (and vice
versa), such as the Western preoccupation with sport and fitness, earning a
large salary, owning a large home, using cosmetics to *look more attractive*,
wearing fashionable clothes, listening to *canned* music, relying on
psychologists to resolve personal problems, eating “health foods” and going
on vacation. The entire fashion industry is founded upon the perceived need
by humans to look attractive according to some totally arbitrary standards.
The acceptability of the naked body in public has been legislated against so
vigorously by State and religious organisations that it has almost become
the ultimate symbol of depravity and ugliness (unless indulged in the privacy
of one’s bedroom). To some, this fear of public nakedness is a sign of severe
national and religious psychosis, to others quite the norm. The symbolism
here is that we often fear physical nakedness because we are terrified of our
minds being exposed naked for all to see.
In short, how accurate and universally applicable is it to categorically
identify a psychosis which is based upon one’s perception of the human body
and its functions, when those who decide upon the definitions are part of the
system itself? How do we assess whether the problem is a long lasting
“trait” or a more transient “state” in a person’s life? The more glaring
aberrations may indeed reflect medical psychoses, but the less obvious cases
may simply reflect idiosyncracy, eccentricity or a passing phase in one’s
life.
If we liberally apply an analogy of Godel’s Incompleteness Theorems to
society, we might humbly caution one another to state that we cannot truly
explain a system if we have to rely on constructs that are part of that
system. On the other hand, as some wag once said: “It takes one who has a
problem to recognise that problem!”
This is what Hofstadter (in his fascinating book, “Gödel, Escher, Bach”) had
to say about the implications of Gödel’s work (which is often ranked
alongside Einstein’s Theory of Relativity and Heisenberg’s Uncertainty
Principle in terms of fundamental scientific importance.)
“How can you figure out if you are sane? … Once you begin to question
your own sanity, you get trapped in an ever-tighter vortex of self-fulfilling
prophecies, though the process is by no means inevitable. Everyone knows that
the insane interpret the world via their own peculiarly consistent logic; how
can you tell if your own logic is ‘peculiar’ or not, given that you have only
your own logic to judge itself? I don’t see any answer. I am reminded of
Godel’s second theorem, which implies that the only versions of formal number
theory which assert their own consistency are inconsistent.
The other metaphorical analogue to Godel’s Theorem which I find provocative
suggests that ultimately, we cannot understand our own mind/brains … Just
as we cannot see our faces with our own eyes, is it not inconceivable to
expect that we cannot mirror our complete mental structures in the symbols
which carry them out? All the limitative theorems of mathematics and the
theory of computation suggest that once the ability to represent your own
structure has reached a certain critical point, that is the kiss of death:
it guarantees that you can never represent yourself totally.”
Dr Mel C Siff
