If I get a cold or the stomach flu, no one is likely to blame my mother or father. We get sick. It happens. If however, I develop anxiety, depression, substance abuse, or especially an eating disorder a parade of people will line up to blame my parents including physicians, therapists, neighbors, friends and other relatives. If we accept as ridiculous the idea that parents can cause diseases like cancer or diabetes in their children why can’t we do the same for mental illnesses? We keep looking for psychic or behavioral/environmental causes for mental health problems while accepting biological causes for other health concerns. An elegant example of the absurdity of separating the behavioral from the biological is the common cold or stomach bug. We confidently and comfortably say “germs” i.e., bacteria or viruses cause these. That seems pretty simple and straightforward. Not so fast. Aren’t we all well trained by the time we are ten years old to cover our coughs and sneezes so as not to spread germs and to wash our hands after using the rest room or before preparing food to prevent transmission of them. Washing hands, covering coughs, getting enough sleep, eating a balanced diet are all BEHAVIORAL factors that can contribute to our vulnerability to germs. As far as ENVIRONMENT, we most certainly don’t say to friends or family “what were you thinking letting your teenager fly for 3 hours in a sealed tin petri dish with re-circulated air”! Therefore, even for the most common of illnesses we can see a role for both biological and behavioral/environmental vulnerability.
This kind of dialectical or both/and reasoning is in short supply when it comes to mental health, particularly eating disorders. Yet neuroscience, genetics and psychology have all evolved sufficiently to provide evidence that eating disorders are biologically based brain disorders that CAN NOT be caused by parents. Can parents, health care professionals and culture contribute to conditions that may maintain, prolong or exacerbate eating disorders? Certainly they can. Just like dismissing a chest cold can allow it to become bronchitis or pneumonia. However, without specific biological vulnerabilities these same factors cannot cause an eating disorder. We actually now know that eating disorders are multi-determined like many other mental and physical illnesses. However, humans like simplified explanations like germs make us sick; carbs make us fat and bad parenting cause mental illness. Unfortunately there are few simple explanations for beings as complex as humans.