Anxiety.
The most common reason patients come to see me is because of consequences of lifestyle (such as diabetes and high blood pressure from being overweight and sedentary). Most people intend to be healthier, they say they want to exercise regularly, they want to eat better, they don't want to be on medication, but they find themselves too busy with managing family and work and the chores of life, and feel too tired to go for a jog and have no time to prepare a meal from scratch. In truth, every aspect in a day is a choice, everything we do or don't do is a decision, and these decisions demonstrate our priorities. In our North American culture, we are encouraged to strive, to be over-worked, to be over-committed; many of us have to live like this for financial reasons, but our culture encourages this over-subscribed lifestyle to keep us consuming and to keep us distracted from paying attention to our best interests.
Not taking care of our basic needs for good health can cause or exacerbate anxiety.
Anxiety arises out of difference, out of comparing ourselves or being compared, from fearing or being judged 'less than.' These differences are based on aspects such as class, race, ethnicity, biology - generally traits that we have no choice about, and thereby easy targets - and they are used to gate-keep us, to determine who has access to what sorts of education and employment and housing. These differences determine your opportunities in your life. These differences are used to determine who has access to 'the good life.'
In my experience, women are far more likely to see a doctor for help with anxiety, whether they recognize their struggles as such or not. Often women present to a doctor because they are tired and can't keep up with the demands they feel, and rather than examine the demands (work, family and extended family, house maintenance, friends, exercise classes - and the right kind of exercise classes, appearance, etc), they believe there is something wrong with them. They would rather have a vitamin deficiency or physical malady than question the cultural expectations and say it is too much. When I asked one exhausted woman when she had last had a vacation, she burst into tears; still, she was determined that she was missing a nutrient rather than missing rest.
Men rarely come to a doctor because they are exhausted. This is likely partly because they are less medicalized (women are trained from youth to go to doctors, for reproductive health primarily), but men also have fewer expectations placed upon them (they can gain a few pounds, they don't have to scrub the toilet before guests arrive, they don't have to be the one responsible for buying a birthday present for an in-law), and they also have more cultural permission to take a time-out (beer with the guys watching a game). I am painting in broad strokes, but this is the illustration many individuals follow as though a map.
We try to manage anxiety in many ways, some with over-commitment, some with exercise, some with substances. In our culture, not often are we endorsed for admitting we are anxious and are taking quiet time to regroup - unless that quiet time is of the right kind: the right meditation class, the right holistic supplements, attendance at the right retreats - and, of course, having to do anything a proscribed 'right' way increases anxiety.
The most common reason patients come to see me is because of consequences of lifestyle (such as diabetes and high blood pressure from being overweight and sedentary). Most people intend to be healthier, they say they want to exercise regularly, they want to eat better, they don't want to be on medication, but they find themselves too busy with managing family and work and the chores of life, and feel too tired to go for a jog and have no time to prepare a meal from scratch. In truth, every aspect in a day is a choice, everything we do or don't do is a decision, and these decisions demonstrate our priorities. In our North American culture, we are encouraged to strive, to be over-worked, to be over-committed; many of us have to live like this for financial reasons, but our culture encourages this over-subscribed lifestyle to keep us consuming and to keep us distracted from paying attention to our best interests.
Not taking care of our basic needs for good health can cause or exacerbate anxiety.
Anxiety arises out of difference, out of comparing ourselves or being compared, from fearing or being judged 'less than.' These differences are based on aspects such as class, race, ethnicity, biology - generally traits that we have no choice about, and thereby easy targets - and they are used to gate-keep us, to determine who has access to what sorts of education and employment and housing. These differences determine your opportunities in your life. These differences are used to determine who has access to 'the good life.'
In my experience, women are far more likely to see a doctor for help with anxiety, whether they recognize their struggles as such or not. Often women present to a doctor because they are tired and can't keep up with the demands they feel, and rather than examine the demands (work, family and extended family, house maintenance, friends, exercise classes - and the right kind of exercise classes, appearance, etc), they believe there is something wrong with them. They would rather have a vitamin deficiency or physical malady than question the cultural expectations and say it is too much. When I asked one exhausted woman when she had last had a vacation, she burst into tears; still, she was determined that she was missing a nutrient rather than missing rest.
Men rarely come to a doctor because they are exhausted. This is likely partly because they are less medicalized (women are trained from youth to go to doctors, for reproductive health primarily), but men also have fewer expectations placed upon them (they can gain a few pounds, they don't have to scrub the toilet before guests arrive, they don't have to be the one responsible for buying a birthday present for an in-law), and they also have more cultural permission to take a time-out (beer with the guys watching a game). I am painting in broad strokes, but this is the illustration many individuals follow as though a map.
We try to manage anxiety in many ways, some with over-commitment, some with exercise, some with substances. In our culture, not often are we endorsed for admitting we are anxious and are taking quiet time to regroup - unless that quiet time is of the right kind: the right meditation class, the right holistic supplements, attendance at the right retreats - and, of course, having to do anything a proscribed 'right' way increases anxiety.
Sometimes we manage anxiety not through over-functioning, as above, but by under-functioning, such as binge-watching shows. This isn't relaxation; it is collapse and avoidance.
Anxiety manifests in many ways, from a unsettled, worrying mindset to fatigue to depression. It is expressed culturally. For example, eating disorders were rarely seen in Hong Kong, until Princess Diana's eating disorder was made public.
The language of gender and transgenderism is an expression of anxiety, specifically in response to biologic discrimination and oppression of women, no less than eating disorders are primarily a language about oppression of women. When an anorexic woman who weighs ninety pounds says her best self weighs seventy pounds, the response ought not to be, "You are right, let me remove that second leg that is in the way of you being your best self." The response ought to be, "Your body is not the problem; it is the messages about your body and who you are that are the problem. Let's look at that."
Anxiety manifests in many ways, from a unsettled, worrying mindset to fatigue to depression. It is expressed culturally. For example, eating disorders were rarely seen in Hong Kong, until Princess Diana's eating disorder was made public.
The language of gender and transgenderism is an expression of anxiety, specifically in response to biologic discrimination and oppression of women, no less than eating disorders are primarily a language about oppression of women. When an anorexic woman who weighs ninety pounds says her best self weighs seventy pounds, the response ought not to be, "You are right, let me remove that second leg that is in the way of you being your best self." The response ought to be, "Your body is not the problem; it is the messages about your body and who you are that are the problem. Let's look at that."
And so how would wanting to change gender and attempting to do that by trying to change biology help anxiety? Well, it wouldn't, it doesn't, but it keeps people busy, and distracted from their true discomfort. As for why transgenderism exists, I will save that for a next post.
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