It’s pretty widely known that I do not believe in psychiatric diagnoses and do not believe the people I work with have “disorders” because they might be facing some challenges in their lives. We ALL face challenges and setting up a system where there is a “normal” benchmark and anyone who deviates from it has an unseen and unidentifiable “mental illness” is, in my opinion, not only ridiculous but also very dangerous on a social and political level.
I work with many adolescents and one place this really gets to me is when teenagers are manifesting their lack of control and other issues by refusing to eat or only eating selectively. In a world where teenagers so often feel powerless, it makes perfect sense that they would try to exercise control over one of the very few areas they can – eating. If a teenager manifests their conflicts by staying in their room, they don’t have “staying in their room disorder”. If they manifest their conflict in sleep difficulties, they don’t have a “sleep disorder” and if they manifest their conflict in eating they don’t have a “sleep disorder”.
If a young person were in a train wreck as a small child and struggled with eating because of residual damage to their digestive system, we would not say they have an “eating disorder”. When young people have developmental trauma we can’t see it from outside like we often can with physical injuries, but it is just as real. When a young person manifests their trauma and lack of control around eating, why is that a “disorder”?
As always, the language itself doesn’t matter. What does matter is the message to a young human being, based on nothing, that there is something “wrong” with them – that they have an inherent flaw (their “disorder”). Hopefully we are moving towards a world where we can describe whatever someone is or isn’t doing or feeling without the need to label it as pathology.