Posted by: drrozkaplan | November 24, 2010

Nobody’s Perfect

I just finished reading Courtney Martin’s book, ‘Perfect Girls, Starving Daughters’, and I am fired up.  If you haven’t read this book, and you are a young woman under 30, or you have a daughter, or you are a person concerned about eating disorders or just about the well-being of young women in this country, I strongly recommend this book.  I won’t say it’s the best-written piece of non-fiction I’ve read lately, nor do I buy into everything that Ms. Martin, a young journalist, has to say.  But having treated eating disordered patients for most of my career, a lot of what she writes rings true, and feels right, and seems particularly to apply to some of the young women I happen to be seeing right now.

One of the important messages of this book is that eating disorders are quite multifactorial, but that societally we have an incredile set-up for young women to be body-obsessed and to have a complicated, dichotomous relationship with food and eating, so that it is the rare high school girl, college girl, or post-college young woman who simply eats to fuel her body’s needs and sometimes to enjoy food, exercises for health and enjoyment, and expends the rest of her energy on other pursuits.  Instead, almost every one of the many urban, suburban, white, black, Latina, girls and women and women from every part of the country and every socioeconomic sector recounted struggling with food, exercise, and body image.  I know that Ms. Martin’s sample was not random, and yet it was broad and deep.  I feel terribly disheartened when I realize that I have heard almost every woman I can think of in my life, too, across the board- friends, relatives,  colleagues, patients, women I write with, exercise with, walk dogs with and chit-chat with in the line to get coffee, say negative things about their bodies or comment that they shouldn’t be eating something they are about to eat.

I can’t give a synopsis of everything Ms. Martin had to say in ‘Perfect Girls, Starving Daughters.’  What I can share is the basic premise that young women are in an especially precarious position in society.  They have been told in the ‘post feminist’ era -(I say this loosely- I have much to say about feminism that could comprise another post, and it pains me that most of the young women I know do not clearly identify themselves as ‘feminists’- I see this as a terrible lack of dialogue between younger and older women, dialogue that could benefit both age groups, and I hardly see that we are ‘done’ with the whole issue of gender equality- there are still old problems to solve, there is backlash, and there are new problems that need to be tackled as well)- anyway, young women have been told that ‘they can be anything they want to be’, but for various reasons have interpreted this as they ‘have to be everything.’  By ‘everything’, I am saying successful, brilliant, driven, athletic, efficient, and powerful, as well as beautiful, sexy, glamorous- and of course THIN and IN CONTROL.

As parents and as a society, we have given our girls the message that they can, and should, reach for the stars.  And they should.  But somehow this has come to mean ‘being the best.’  At everything.  The ‘Perfect Girl’.  Not just being good at some things.  Not just doing their best each day and calling it a day.  It means the A’s, the trophies, the road to ‘the best’ colleges.  And since not everyone can be the winner, and there are only so many spots at those elite schools, it pits girls against each other, making each other girl competition instead of potential ally.  And girls don’t just leave it at that.  It’s also who is prettiest, most popular, and gets the most attention from boys as well as from other girls.  But if you’re at the top, nobody really likes you-they just fear you. Plus you’re always at risk for a fall from grace.  And if you’re closer to the bottom, you’re a loser and to be avoided.  The only thing this seems to add up to is isolation.  And a feeling of emptiness.  The ‘Starving Daughter.’  Nothing is ever good enough or perfect enough, because no matter how you slice it, this is a bad deal.

Okay, step back.  It’s not all dire.  Despite this culture, plenty of our girls seem to be doing fine.  But a good question to ask about any given girl is, ‘Is she doing fine, or does she SEEM to be doing fine?’   Because the real catch-22 in this is that most of these girls will not develop full-blown eating disorders.  They will soldier on and look happy most of the time. Many of them may BE happy much of the time.  But is that happiness true, internal contentment, or is it happiness that is contingent on what accomplishments they have achieved that day or that week, whether their grades are high enough, their athletic performance good enough?  Will they still believe in themselves when the rejection letter comes from the school they had their heart set on?  Is it a real sense of self-worth, or is it dictated by whether they have a boyfriend, or the right set of girlfriends, or what they weigh, or whether they were able to resist eating the donut and get in 45 minutes on the elliptical machine today?  If they start to slip, and get a B on a big test, or gain 5 pounds, or get injured and become unable to play on the team or even exercise for 2 months, are they going to have the resilience to still believe it will all be okay?

I think the real issue here is exactly that:  resilience.  We have done a great job getting our girls motivated to achieve, to enter the intellectual and athletic and social arenas.  We have taught them to compete and to win.  But in our zeal to propel them to the top,  we haven’t really taught them much about the benefits of losing, of failing, of making mistakes, of screwing up and regrouping and moving on.  We’ve just given them the message that they mustn’t do those things, that the stakes are too high to screw up.  I don’t just mean ‘us’ as parents.  I mean ‘us’ as a society.  Let’s face it:  it really is set up that way.  It’s really too bad.

Think about this:  in a lot of schools, there is ‘tracking.’  So poor academic performance, even early on, even a few bad test grades, a midterm that a kid doesn’t study for appropriately, can have far-reaching academic effects.  So they better not make mistakes in school.  Any behavior errors:  one suspension, a few detentions, go on a ‘permanent record’- so kids better behave from the get-go.  Experimentation with drugs or sexuality get kids ‘reputations’-  throwbacks to decades ago-  for example, girls get called ‘sluts’ fairly easily if they ‘hook up’ with the wrong boy.  So better not make any behavior mistakes, even when you’re 14.  Oh, and don’t hang out with the ‘wrong people’, or wear the wrong clothes.  That can mean ‘social death.’  And since colleges are oh-so-competetive these days, you better start participating and committing to your sport and some other extra-curriculars.  If you find you’re not interested, well, really, too bad, stick with it, or it might look like you’re not ‘committed’.  These are just a few of the messages high school kids get.  I remember my son, now a sophomore at an elite liberal arts college, being told by his teachers and college counselor that it was a big mistake for him not to take the extra science class and the 5th year of Latin, in order to pursue Studio Art in his last two years of high school, though he’d burnt out on Latin and visual arts was a strong passion.  He didn’t listen, and his father and I supported that.  It turned out not to be a mistake.   But again, these are the messages.  So where is the opportunity to take a chance, take a wrong turn, discover something about oneself, make a mistake, take a fall?  How does anyone learn to say, “well, that didn’t work, guess I should try the other direction.”?  How do kids learn to pick themselves up, dust themselves off, and keep going, without feeling that there are dire consequences when the stakes seem so high all the time?

When I was in high school, I was perfectionistic about my schoolwork, and I tended to over-study for tests.  I remember my mother, a clinical psychologist,  telling me, “It would be good for you to fail a test.”  I thought she was crazy.  Fail?  An F?  I wouldn’t even accept a B, back in those days.  But the day came when I did fail a test.  Calculus, in my senior year of high school, after a break-up with my boyfriend, who’d gone off to college and left me behind, and a few days of feeling sorry for myself.  I didn’t have time to study for the calculus test once I finished my pity party and the two papers that were due that week.  Guess what?  The world didn’t end.  I didn’t turn into stone.  My calc teacher looked at me a little funny when he handed the test back. My ego was slightly bruised.  But I picked myself up, brushed myself off, and studied for the next test.

That was 1977.  A different world.  But not really.  It honestly is good to get lessons in resilience, and without them, many girls go out into the world with the feeling that they must maintain that ‘perfect girl’ record, or something terrible will happen.  Problem is, there’s only so many things a girl has control over.  Sickness, injury, interpersonal crises, family issues- it can’t all be controlled.  It’s no wonder that she’s going to make absolutely certain that she controls the things she can- including weight and food and exercise.

So what am I proposing?  To be honest, I know a lot more about the problem than about the solution.  Should we tell our children to fail tests and make mistakes?  Clearly that is not a sensible answer.  But beginning a dialogue about the pitfalls of perfection is a start.  And allowing our daughters to make their own mistakes and learn from both the natural consequences and the imposed consequences of those mistakes is another piece of the puzzle.  But a larger part lies not just within the family, but between girls and women, and in the schools, and on sports teams, and in our culture as a whole.   It can’t change unless we as a culture buy into a new ideal- one not of ‘perfection’, or attaining the unattainable, which drains women of their physical, intellectual, and emotional resources, fosters competition between women, leads to self-hate, and is ultimately unhealthy; but one of ‘resilience’ and ‘resourcefulness’- which leads to collaboration, increases energy, and fosters self-esteem and wellness.

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Responses

  1. This post is interesting, Dr. Kaplan. As one of the 30 and under female set, I still acutely feel the pressure to be successful, pretty, well-liked- and in that vein– sometimes “play nice” where I suspect a man of my age and profession might not have to. I’ve had the experience of being thin, and of being overweight, and can safely say that despite all of the eating disordered behavior it took for me to be thin– life was still easier as a thin person.

    Your suggestion about having an open dialogue with young women in multiple aspects of their lives from family to schools to their doctors. My question is what you envision this looking like? What do you tell your own daughter? Your patients? And how do we go about convincing young women that it’s ok to make mistakes in the context of a world where a mistake can make the difference between her getting into Yale (or other school of her choice) And the girl who didn’t make the mistake getting in instead?

    How do doctors, teachers and mothers who themselves have issues with food become credible in this dialogue… Unless they deal with their own issues first? From experience I can say that it is very difficult to take seriously the advice of a professional that herself is concerned with her appearance, and has issues with food and exercise? To a person who isn’t eating disordered, the subtle signs displayed by such a professional may be missed… But to a young woman struggling with identity and self-image, those signs are anything but subtle.

    Maybe the questions I’ve asked are too numerous and complicated to answer, but any thoughts you have would be interesting.

    • Honestly, your questions are the same questions I have- I am not sure what the dialogue looks like in a general way. I know what I say to my own daughter, and to individual patients but that is because I know each one of these people. A larger dialogue would take a huge cultural effort- which sometimes I feel hints of and other times I feel hopeless about. It might be encouraging each and every one of us to find our strengths and capitalize on those, and recognize that we ALL have weaknesses and that these are what make us human and link us together- and that being linked together is so much more powerful than being a ‘powerful’ island. But it would have to start when kids are little… And that’s not how we’ve generally been raised.

  2. Your thoughts are interesting, 2 in particular. The first was about teaching kids when they are young. My senior thesis in college examined the social influences on eating disorders– and I specifically looked at media and athletics and the influence (if any) they have on the development of eating disorders. One of the things that came out of the sports literature was a poignant reminder that eating disorders inflict damage on both genders- something that in my opinion is not discussed often enough. A reminder that in addition to the “Little Girls in Pretty Boxes”
    (another good book)– there are the male skaters

  3. (sorry accidentally hit submit), male gymnasts, jockeys and please don’t get me started on the fact that wrestling basically condones bulimia during the on season. One of my best friends in high school was a very talented wrestler who placed at states. During wrestling season, it was awful to watch him lose 20 pounds, starve and dehydrate before a match… And the further into the season, the more his healthy tan turned ashen.

    The 2nd point about teaching kids young is even more critical– it was disheartening to read multiple studies showing that kids who are only 5 years old chose to play with dolls of different races, and missing limbs, and several other differences before they will play with an overweight doll. Not that I think that kids playing with missing limbs or of different races is a bad thing- just the uniformity with which the overweight dolls were rejected by kids so young shows that this attitude is developed at a very young age- probably even earlier than the age of 5.

    Finally, the concept that we are stronger and healthier when we utilize or similarities instead of trying to exist alone is key. It is one of the reasons that 12 step programs… As different as the individuals are that attend the 12 step meeting with me are– we find strength and comfort in knowing that we all have the same disease and people who otherwise never speak or interact become friends, confidants and cheerleaders for each other, a bond that helps people stay sober, clean, quit gambling etc– all because we share a common affliction. You are so right about your observation that we are stronger as a group.

    Do you ever speak at schools, or to athletic teams where young athletes might be at higher risk of developing an eating disorder? If so, how do you address a group, as opposed to your daughter and patients that you know individually?


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