Review of Far From the Tree: Parents, Children and the Search for Identity

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Whew! This is one long book! (Although it’s not as bad as it seems–out of 960 pages, the last 259 are acknowledgements, notes, bibliography and the index.) The hardest thing about reading a book this size was trying to get it in a comfortable position. I considered buying the Nook Book but it was $19.99, so I borrowed the print edition from the library. (The hardbound book’s price is $37.50.)

The author, Andrew Solomon, worked on this book for ten years–and it shows. It’s incredibly detailed, almost too much so. I can’t even imagine the amount of thought and effort that went into it.

The best–and worst–part of the book is all the anecdotes from the interviews he conducted. They helped to put a human face on what he was writing about and kept the book from being too scholarly. But at times it was hard to keep track of all the family members and their unique experiences; they sort of blurred together after awhile.

I loved the first chapter, which was basically an introduction. It contained so many thought-provoking comments I just had to copy many of them into my journal. The author states his thesis clearly and gives the reader a perspective that makes sense of the rest of the book. This was helpful because when I saw the chapter headings, I couldn’t help but wonder what made him think that all these disparate topics would have a common thread.

Those chapter headings are: Deaf, Dwarfs, Down Syndrome, Autism, Schizophrenia, Disability, Prodigies, Rape, Crime and Transgender. The first six make sense, since they are all usually seen as disabilities of one kind or another. But the last four seem to be anomalies and it’s to the author’s credit that he’s able to present his premise convincingly in all of them (with varying degrees of success).

I won’t dissect each topic here, but I will make a couple of comments. Some of the chapters were real eye-openers; I hadn’t realized the obstacles that some families face when trying to raise autistic or severely handicapped, for instance. The chapter on prodigies was my least favorite chapter because the author chose to write only about musical prodigies and the examples got to be pretty repetitive.

I was also surprised that he didn’t choose homosexuality as a topic (transgender is not the same thing!). That could be because he writes about his own homosexuality in the first and last chapters, but he doesn’t go into much detail about how various families deal with a child’s homosexuality. I would have liked to have read about that.

For the most part, Solomon presents a good mix of the experiences of fathers and mothers, but even so he seems to imply that the mother has more influence on how well a child transitions into successful adulthood. Although I don’t deny the importance of mother-child relationships, I thought the view that mothers are largely responsible for raising well-adjusted children had been largely discredited. Apparently not.

I also objected to his use of dialect when writing about families that were less educated and poor. He especially did this in the chapter on crime, making it seem like it is only the disadvantaged who have a problem with crime. Plenty of middle-to-upper-class people commit crimes; they just rarely pay the same penalties for their actions as lower class people do.

Far From the Tree is important because of what it says about families. It illustrates how different parents deal with their children’s differences and how those children respond to their treatment. The main thing I took away from this book was a greater sensitivity for what some parents go through in their attempts to love and raise their children. It certainly made me count my blessings.

Don’t let the length of this book deter you. It’s well worth the time and effort.

Obesity and Mental Illness: Are They Linked?

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Depressed Overweight WomanWhen the upcoming 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was being put together, a proposal was received that obesity and overeating be included as mental illnesses. Although this proposal was rejected, it does raise some interesting questions about the mental health of obese individuals.

Weight loss is a complicated process. People who have never had problems with obesity tend to think that losing weight is merely a matter of eating less and moving more. When obese people have trouble losing weight, others think they’re just not trying hard enough. This is the main reason for the hostility that is directed at obese people in our society: they are seen as lazy whiners who cost the health care system billions of dollars a year because of health problems that “they bring on themselves.”

The fact is, it’s not that easy to lose weight. There are myriad factors that play into weight gain. Some people inherit the tendency to gain weight. Others become heavy from poor eating habits, often instilled in childhood. Still others gain weight because of medications they’re on. Certainly lack of exercise plays a role as well. But the main reason obese people have trouble losing weight is that their obesity is all mixed up with mental health issues.

That’s not to say that obese people are mentally ill. But they are often depressed, have low self-esteem and lack confidence because of the way society judges them. If you were constantly being beaten down by “normal” weight individuals who see you as inferior, you’d have trouble mustering the courage and motivation to embark on a weight loss program, too.

That’s why it’s extremely important to have a mental health assessment if you find that you’re constantly trying and failing to lose weight. Clinical or bi-polar depression, anxiety disorders, PTSD, even ADD (Attention Deficit Disorder) can cause overeating. Sometimes medication and/or therapy can bring you up to a healthy level of functioning which in turn can be critical to your success.

This can be a two-edged sword, however. Most psychotropic medications cause weight gain, making it that much harder to accomplish your weight loss goal. Your doctor or therapist needs to be sensitive to the mental anguish this can cause. And you need to be aware that this is not your fault.

Even talk therapy can bring up issues that upset you and make you want to turn to food for comfort or to alleviate anxiety, further complicating your efforts to lose weight. It’s important to not get caught in a cycle of self-recrimination when you have these setbacks. It’s all part of the learning process.

In at least one study, obesity was associated with a 25-50% increased risk of lifetime psychiatric disorders (depression, mania, panic attacks, social phobia, agoraphobia), any lifetime mood or anxiety disorder, suicidal ideation, and suicide attempts. These issues must be dealt with or the obese person will find it nearly impossible to lose weight and maintain that weight loss, let alone be a fully functioning individual.

For more information about the DSM-5 and eating disorders, see this report by the American Psychiatric Association.

See also this article by Dr. Arya Sharma, “Obesity is Not a Mental Illness.”