Wintergirls: Guest Review

Najela from Brave New Adventure is back with another Psychtember post! Today she's reviewing Wintergirls by Laurie Halse Anderson.

Summary:  Lia's best friend, Cassie, died alone in a hotel room after running away and since then Cassie's been trying to make sense of the 33 phone calls she left that night. Lia is racked with guilt from her best friends death, but even then, she can't seem to bring herself out of the throws of her anorexia. She constantly wants to lose weight, deceiving her family into believing that she's healthier than she already is. She's already been to an inpatient care facility, going through the motions of being healthy and being okay. Her therapists are trying to unravel Lia's issues, her parents are blaming each other for Lia's issues. 

Likes: This was a chilling tale.  It was heart wrenching to see Lia trying to solve her own problems and the adults around her not being able to help. All of the characters were flawed and real. The adults were too busy blaming each other to be helpful. They just assume Lia's okay because she says she's okay, but they don't look into the subtle signs such as her cutting up her foods, the laxatives and diuretics hidden in her room, and the fact that they don't talk to her concerning her friends death. Lia was dealing not only with anorexia, but grief as well.  The two of these combine don't make a good mix and it seems that every thing that Lia deals with becomes too much and she goes to drastic measures to deal with her grief.

Psychological Aspect: The psychological aspect of this novel was chillingly real, especially towards the end when reality was blurred. Sometimes when you starve yourself long enough, you'll begin to start to hallucinate as your body starts to shut down. Anorexia is a psychological issue in which a person believes themselves to be overweight and goes to extreme measures to lose the weight they think they have. Cassie's friend suffers from an eating disorder known as bulimia,  in which someone binge eats, then purges (vomits) the food in order to stop themselves from gaining weight.

When I thought of this story, I didn't think the reasons why Lia and Cassie had eating disorders, but when I thought about it a little more to it than that. I'm not a psychologist, but within the confines of the story, the reasons were simple. They usually always are. Certainly there are enormous reasons why a psychological disorder would start, but sometimes there aren't. Cassie started copying all the girls she met at camp and Lia started copying her. They found that these acts soothed something inside of them. It's the same way someone becomes an alcoholic or a drug addict.

Writing Tip:  Psychological disorders typically don't happen overnight, it's a gradual process. The triggers don't always have to be a traumatic experience. For the sake of the story, it could be, but it would depend on where you start.

Another Book to Read: Hunger


Najela is a graduate from UC Riverside with a dual degree in Psychology and Creative Writing and finally making the most of both degrees. She works with kids and is currently pursuing a Master's Degree in Exceptional Student Education. She is also working on several writing projects including a Beauty and the Beast retelling webcomic coming in late October 2012. You can follow her at her website or her tumblr.
   
Thanks very much, Najela, for sharing your reaction to Wintergirls!

Reasons to Be Happy: Interview with Katrina Kittle (Blog Tour)

I'm pleased to welcome Katrina Kittle, author of Reasons to Be Happy, to the blog today for an interview!

  

"Hannah's parents are glamorous Hollywood royalty, and sometimes she feels like the ugly duckling in a family of swans. After her mother's tragic death, Hannah's grief is compounded by her desperate need to live up to her mother's image. She tries to control her weight through Bulimia, and her devastated father is too distracted to notice. The secret of her eating disorder weighs heavily on Hannah, but the new eighth grade Beverly Hills clique she's befriended only reinforces her desire to be beautiful. The only one who seems to notice, or care, that something is wrong is Jasper, the quirky mistfit." (from Goodreads)

Hi Danya, Thanks so much for hosting me on your wonderful blog. I really appreciate the opportunity!

1.) You’ve published several adult novels previously, but this is your first tween book. How has the writing and publishing experience for this one differed?

 In early drafts, I made the mistake of “watering down” and playing it too safe. A wonderful editor encouraged me to “forget your audience.” That sounds crazy, right? But she said, “I picture you picturing this room full of middle school girls. Forget them. Just write the novel you'd always write. The only difference is that all the protagonists happen to be in middle school.” This advice really spoke to me and allowed me stop trying to “filter” for the tween audience. Those attempts to filter will always show and will inevitably be insulting.

    Don't get me wrong. Of course there is a difference in presenting tough subject matter for a tween audience and an adult audience. But for me the key was my protagonist. Especially since Hannah tells the story in first-person, the only “filter” I needed was her. She tells the story with her perspective and understanding of events, not mine. That became important in revision: I would comb through looking for lines or passages that were colored by my own, more experienced viewpoint. When I found them, they had to go. Hannah could only know what she would know as an eighth grader with her own life experience so far.

     That was the biggest difference, and a good exercise for me as a writer: to really capture Hannah's voice I had to stay true to her frame of reference.

2.) On the surface, it seems like Hannah feels the need to purge just to lose weight. But we see her experiencing a kind of physical and emotional relief after her bulimic episodes that suggests there might be more at play here than simply body image. Is this typical among individuals with bulimia, or is something more going on with Hannah?

This is typical among most eating disorders. They may initially begin with a desire to lose weight, but then the need morphs into something else. Lots of people try to lose weight, after all, but the majority don't descend into the hell of an eating disorder. Often the eating disorder provides a feeling of control when the rest of life is chaotic, or it can provide release from painful emotions (Hannah likes the numbness, the “feeling nothing” after a binge) or the rush from the purge. It becomes much like an addiction—the ritual itself becomes somewhat of a comfort, but the person loses the ability to control the behavior. The best treatment of an eating disorder involves delving deep into the need, the void it fills, rather than focusing on weight alone.

3.) How much research did you have to do for Reasons to Be Happy? Did you use anything from your own or a friend’s experience?

As a middle schooler and high schooler, I studied classical ballet very seriously. Unfortunately, at the time, that world was quite the window into eating disorders! This has happily improved in recent times. The ballet world, combined with being a middle school teacher, gave me quite an education in eating disorders. I had to work with parents and therapists when students were struggling with bulimia and anorexia. I didn't rely on my own observations, though. I read and studied widely, and even worked with a therapist, scheduling an appointment for my fictional character! Dr. Diane Ackerly met with me and talked me through the therapy she'd plan for Hannah, if Hannah actually existed. Because it's fiction, Hannah moves through her recovery fairly smoothly. Hopefully the “jump in time” at the end of  the novel shows how long the recovery can be, and shows that Hannah recognizes she's not entirely out of the woods yet. As with other addictions, the patient must remain very vigilant to avoid falling back into self-destructive behavior at times of stress or sorrow.

4.) As a writer, what do you feel is the greatest challenge to accurately and genuinely conveying a character with bulimia?

I worried a bit that I had a difficult balance to maintain: enough graphic detail to show how horrifying and damaging it is, but not so much that the book reads like a “how to” manual. Again, I focused on using Hannah as my guide, my filter. If I stuck to what she was experiencing—what the disorder did for her, as well as how it betrayed her—then I felt I wouldn't go wrong. I think the greatest challenge was to show how she loses control of it, how she wants to stop but genuinely can't. That's such a misconception for people on the outside of an eating disorder. It can be so frustrating—you just want to say, “Why can't you just eat?” to an girl with anorexia, or “Why can't you just stop?” to a girl with bulimia—but it's not a question of simple willpower, and we do those struggling girls a huge disservice if we refuse to understand that. Eating disorders are just that: disorders. It's very complicated psychology.

5.) Did you have to deal with a “B-Squad” of mean girls when you were in middle school? If so, how did you handle that?

Didn't everyone have to deal with a B-Squad in middle school? I was lucky—while I knew there were girls who didn't like me, no one was overtly cruel to me. I didn't experience any of the awful bullying I became aware of while teaching middle school. I had plenty of strong interests, many of which happened outside of school, to help my life feel balanced. I think that would help a lot of girls who find themselves in Hannah's position—you've got to hang on to the activities that make you happy, give you power, where you excel or feel successful. When Hannah gives up all her activities (running, art), she loses all sense of identity. That makes it easier for her to accept the image the B-Squad presents of her.

6.) What were your top five “reasons to be happy” when you were Hannah’s age?

When I was in eighth grade, I would've listed my top 5 reasons to be happy as: 1) the sweet dusty aroma of horses in the sunshine, 2) putting my pet rabbit Stevie Bunny, (aka Stevie B, the Fun Bun of Fairborn) in my bicycle basket and taking him for a ride (he loved this) 3) mastering a tough combination in ballet class and reveling in the muffled clump sound of pointe shoes on the wooden studio floor, 4) “baking” chocolate chip cookies solely to eat the raw cookie dough, and 5) reading reading reading every chance I got! (I particularly loved mysteries).

www.katrinakittle.com

Twitter:  @katrinakittle

www.facebook.com/KatrinaKittleFanClub

http://katrinakittle.blogspot.com/  (Reasons to Be Happy Blog, lists a reason to be happy everyday)

There's a hash-tag—#reasonstobehappy—for your tweeting purposes. :-)

Thanks very much, Katrina, for taking the time to give these thoughtful answers to my questions!

A bit about Katrina, from her website:

"Katrina was born in Illinois but has lived in the Dayton area since first grade, (except for her Year as a Gypsy). She attended Ohio University and was Outstanding Graduating Senior for both the English and Education departments. She taught high school English and theatre at Centerville High School for five years, and she taught middle school English and theatre at the Miami Valley School for six. She has also worked as a house cleaner, a veterinary assistant, a children’s theatre director, a costumer, and as case management support for the AIDS Resource Center (formerly AIDS Foundation Miami Valley).

Katrina is the author of Traveling Light, Two Truths and a Lie, and The Kindness of Strangers, and The Blessings of the Animals, all with HarperPerennial. The Kindness of Strangers was a BookSense pick and the winner of the 2006 Great Lakes Book Award for Fiction. Early chapters from that novel earned her grants from both the Ohio Arts Council and Culture Works. The Blessings of the Animals was an Indie Next pick (August 2010), a Midwest Connections pick (September 2010), and chosen by the Women’s National Book Association as one of ten Great Group Reads for National Book Group Month (October 2010).

She earned an MFA in Creative Writing from Spalding University in Louisville. Katrina is thrilled to announce that her first tween novel, Reasons to Be Happy, will be published by Sourcebooks Jabberwocky this October (2011)."

I recently reviewed Reasons to Be Happy here.

Reasons to Be Happy: Review (Blog Tour)

Patient: Reasons to Be Happy by Katrina Kittle

Presentation:  

Hannah's parents are glamorous Hollywood royalty, and sometimes she feels like the ugly duckling in a family of swans. After her mother's tragic death, Hannah's grief is compounded by her desperate need to live up to her mother's image. She tries to control her weight through Bulimia, and her devastated father is too distracted to notice. The secret of her eating disorder weighs heavily on Hannah, but the new eighth grade Beverly Hills clique she's befriended only reinforces her desire to be beautiful. The only one who seems to notice, or care, that something is wrong is Jasper, the quirky misfit. (from Goodreads)

Assessment:

Axis 1. Characters

It took me a little while to get used to Hannah's voice. I felt like sometimes it was too mature, a wiser Hannah looking back, but at other times it seemed a bit too young. However, I could definitely sympathize with her, as I remember what it was like to be that age and have to deal with annoying "cool" girls like the B-Squad. It captures the feeling of being in middle school, and all the emotions that come with it, quite well.


Hannah's list of "reasons to be happy" gives us a glimpse into the Hannah that used to be, a girl who is markedly different from the Hannah mid-book. The love for life and trying new things that we see in the old Hannah gives us some idea of the girl she once was. Her pastime of building miniature cities is different, creative and gives her a more distinct character. I would have wanted to be friends with her before she gets in with the B-Squad, becomes bulimic and turns into someone else.


Jasper was sweet but struck me as very unrealistic for a young teenage guy. He was far too mature and understanding to be believable, instead coming off as more of a young girl's fantasy crush. A message about the importance of inner beauty from an adult is one thing, but it stretched my credulity too far to have it come from a guy Hannah's age.


Hannah's dad is a perfect example of how imperfect a parent can be. At one point he's a real jerk who can't see — or chooses to ignore — his daughter's situation and how much she needs help. Once he admits his failings and tries to remedy them, though, he becomes more open with his daughter and willing to listen to her. 

Axis 2. Premise/plot

I enjoyed how her list of "reasons to be happy" was referred to throughout the novel; it gives the story some structure and an angle that makes it a bit more memorable amongst a sea of "eating disorder books." The trip to Africa also adds something different and fresh, giving Hannah perspective and showing her how much she has to be grateful for.

Axis 3. Writing Style

The author's intentions seemed obvious to me at times, and the sentences fairly simple, but it is a "tween" read and I don't read many of those so I'm not that familiar with that level. I also found some of the dialogue (especially exchanges with Jasper) to be inauthentic for their ages.

Axis 4. Psychological Accuracy

The Bulimia Binging-Purging Cycle:

The scenes depicting Hannah's binging and purging were realistic to the point of being somewhat nauseating for me. Her desperate need to devour food — she'd gotten to the point of stealing food from the store — and then vomit it all up made me feel sick. Kittle's ability to evoke Hannah's emotions in me was excellent; I felt guilty and nervous like she did because it seemed like I was binging and purging right along with her. I was fascinated by the relief she felt upon purging, which demonstrated that for Hannah it was not all about her body image. She mentions a few times that she wants to be thin (especially in a misguided effort to please her mother) but I never bought it the same way that I bought her urgent need to feel the physical and emotional relief that the bulimia gave her. It's like an addiction for her, and provides a compelling reason for why Hannah continues to hurt herself this way. Often one might think, "Well, why doesn't she just stop?" but Reasons to Be Happy demonstrates that it isn't that easy.

I think one of the deepest reasons for Hannah's bulimia is that she wishes to maintain control over some aspect of her life. Her mother's got cancer, Hannah's at a new school with a nasty group of girls and she's trying to fit in and not make waves — but the one thing she does have complete control over is what she puts into, and takes out of, her body. And I thought Hannah's name for her bulimia — her "SR," or secret remedy — was a great way to demonstrate how individuals might euphemize their disorder, to make it seem okay to them even though on some level they know it's dangerous. At first, having a secret that's all hers makes Hannah feel special, but as she realizes how deeply she's stuck it begins to scare her. She no longer has control over the mechanism she's been using to exert control.

The physical symptoms Hannah demonstrates are also accurate — the "chipmunk cheeks," marks on her knuckles from induced vomiting, missed menstruation (which, by the way, I did not realize happened with bulimia as well as anorexia before I read this book), and bruising under her eyes from broken blood vessels. I wasn't sure throughout, though, what her weight situation actually was. Is she a healthy weight for her age/height? Is she thin? Overweight?

Validity Score: How psychologically accurate was Reasons to Be Happy?

Axis 5. Miscellaneous

I did think her aunt Izzy should have done more to get Hannah help. Yes, she takes her to a mental health professional, but Hannah doesn't see the therapist for very long before she's shipped off to Africa. While Africa does help Hannah to find herself again, and acts as a distraction, most teens won't be able to just run off to Africa if they have bulimia. Some more emphasis on the importance of getting professional help might have been more constructive.

Patient shares symptoms with: Purge by Sarah Darer Littman, Hunger by Jackie Morse Kessler

Patient's statement:

I’d eaten everything I’d stolen from our kitchen freezer earlier, all those Tupperware containers of peanut chicken, coconut soup, and pasta salads that the cleaning lady had packed up and put away after the funeral. All the boxes of fancy soups, rolls of crackers, and jars of pesto I’d snuck from our pathetic cupboards. The mustard, the maple syrup, the chocolate sauce. I knew I should ration, but I knew I wouldn’t. Once a binge began, I would eat every last scrap. I opened the drawer and devoured a loaf of bread, a pack of pudding cups, a box of oatmeal cream pies.

Finally, it happened.

Like a motor coming on, like a switch. The trance. I closed my eyes. I didn’t need to see. I didn’t taste. I didn’t feel texture.

I didn’t feel anything.

Diagnosis: 3.5 shooting stars. 

For more information about bulimia, see here.

Disclaimer: I received this book for review from the publisher. 


My interview with Katrina Kittle will be up tomorrow, so check back for that!

Forget-Me-Nots: Dare to Be, M.E.!

 

Forget-Me-Nots is a feature on my blog for highlighting books I enjoyed in childhood and the teenage years that I don't see getting much attention nowadays.

This is another Psychtember edition of Forget-Me-Nots!

Dare to Be, M.E.! by Anne LeMieux

From Goodreads: 

"Mary Ellen hardly knows her best friend Justine. After a year in France, Justine has returned to start junior high, convinced that she needs a new image. She has a new haircut, wearing tons of makeup, crazy clothes, and looks much older. She's so out of touch with reality it's almost funny. Except Mary Ellen doesn't realize that her friend's crazy new image is part of a much more serious problem."

This was one of my favourite books when I was younger (probably when I was about 10 or 11, since it's an MG novel). I think it's probably one of the first books I read that dealt with a character who is bulimic, and I really enjoyed seeing how its effect on the girls' friendship is portrayed. The main character Mary Ellen is very relatable, as are her ups and downs with Justine, school, and first love.

Has anyone else read this one?

Psychtember Interview with Jackie Morse Kessler

I'm happy to welcome Jackie Morse Kessler, author of the Riders of the Apocalypse series, to the blog today! She is the author of Hunger, Rage and the upcoming Loss.

Here's the synopsis for her first book, Hunger:  

(from Goodreads): “Thou art the Black Rider. Go thee out unto the world.”

Lisabeth Lewis has a black steed, a set of scales, and a new job: she’s been appointed Famine. How will an anorexic seventeen-year-old girl from the suburbs fare as one of the Four Horsemen of the Apocalypse?

Traveling the world on her steed gives Lisa freedom from her troubles at home: her constant battle with hunger, and her struggle to hide it from the people who care about her. But being Famine forces her to go places where hunger is a painful part of everyday life, and to face the horrifying effects of her phenomenal power. Can Lisa find a way to harness that power — and the courage to battle her own inner demons?

And a bit about Jackie herself (from her website):

Jackie Morse Kessler grew up in Brooklyn, NY, with a cranky cat and overflowing shelves filled with dolls and books. Now she’s in Upstate NY with another cranky cat, a loving husband, two sons, and overflowing shelves filled with dragons and books (except when her sons steal her dragons). She has a bachelor’s degree in English and American Literature, and yet she’s never read any Jane Austen (with or without zombies). She also has a master’s degree in media ecology. (The living study of technology and culture. Which is cool, but she still can’t figure out how to use Tweetdeck.)

Jackie spends a lot of time writing, reading, and getting distracted by bright and shiny new ideas. (She just came up with a new idea right now.) She has a weakness for chocolate and a tendency to let her cat take over her office chair.

You can read my review of Hunger here.

Now on to the questions!

1.) There are many YA novels that involve eating disorders, but yours stands out because of the creative premise of the Four Horsemen of the Apocalypse. Did you set out to write a book about eating disorders using Famine as the main character, and then later expand that to an entire series? Or was it always your intention to write about each of the four Riders, from the beginning?

JMK: It took me 10 years before I finally let myself write HUNGER. (A writing tip: Don’t wait 10 years to write a book!) When I was done, and my agent sold it to Harcourt, she then asked me, “So, which Horseman are you going to write about next?” And I was like, “NEXT???” I really hadn’t planned on a next book at that point; getting HUNGER written and sold was about as much of a goal as I had. But thanks to my agent, I started thinking about the other Horsemen. RAGE is War’s story, and it’s about self-injury. LOSS is Pestilence’s tale, which looks at bullying. And I’m gearing up to write BREATH, which will be Death’s story. **rubs hands gleefully**

2.) From what I understand, Hunger is partly based on your personal experience with bulimia. Was there a reason you centered the story around a girl struggling with anorexia, instead?

JMK: I liked the parallel of a girl who purposely withheld food to become Famine; that felt more poetic than a girl who binges and purges becoming Famine.

3.) How has writing the next books in the series, Rage and Loss, differed from writing Hunger? Have you had to do more research?


JMK: Once I figured out the main character, HUNGER came flooding out. Maybe that’s because it had been percolating for 10 years. :) That book took four weeks. (Granted, it’s a very short book!). But for RAGE, it took me a while to figure out the main character, and that didn’t happen until after I found the opening line. (I’m weird; I need a first line to start writing.) I found that line after my cat died, and from there I started to get to know the main character. Meanwhile, I did lots of research into self-injury. RAGE was a very emotional book, and at times it left me feeling horribly battered and raw. It was exhausting to write. And then came the day I finally heard the voice of War, and that was an epiphany. :)

As for LOSS...oy. Twenty-two drafts. No one should have to take 22 drafts to write a book! But after rereading the entire story (I just finished reviewing the copy edits), I can say that the final product was worth all the trial and error. LOSS fought me a lot — which is ironic, since the main character is so horribly bullied. There’s a subplot about Alzheimer’s disease, and for a while, I couldn’t decide what sort of book I wanted to write. At one point, the entire middle section was going to take an altogether different turn, and I had to set it aside and start it over when I realized it was completely wrong for this particular story. But yay, I figured it out, finally. My editor was extremely helpful, and thanks to her I was able to make LOSS much stronger. I’m looking forward to readers meeting Billy Ballard.

4.) Lisa and Tammy have a very interesting relationship, in which each of them enables the other. You mention in the Author’s Note that you had a close friend who was also bulimic. Did you take aspects of your friendship and use them to shape Lisa and Tammy’s relationship? If so, which ones?

JMK: The character Lisa is very, very loosely based on — inspired, really — my friend. She was the one who taught me about bulimia. We binged and purged together. We absolutely enabled each other in our disorders, and you can see that when Tammy texts Lisa at the diner and again when Tammy binges while Lisa watches. My friend and I were also very close, though; it wasn’t just about the eating disorders. I touched on that a little at the beginning of HUNGER, when Tammy comes over to Lisa’s house and they sit in the kitchen playing cards and chatting.

5.) You invite all four Riders of the Apocalypse over for a dinner party. What happens?

JMK: Famine sits in sullen silence while War tells offensive jokes and takes to the food and drink with a hearty appetite. Pestilence sneezes over the salad. And Death sits in the corner, strumming a guitar and humming a tune. :)

6.) If you could tweet one message to your character Lisa, what would you tell her?

JMK: If it’s before the events of HUNGER: Find your balance and plant your feet. If it’s after the events of HUNGER: You rock out loud.

7.) Death agrees to play a song of your choice on guitar for you. What song do you pick?

JMK: Hah! Well, he’s in a Nirvana phase at the moment, so I’d have to go with “Jesus Don’t Want Me For A Sunbeam.”

8.) A participating blogger, Laura from All of Everything, recently read Hunger and would like to know how you found your own balance in life, since it was such an important concept to Lisa in the book.

JMK: I wish I could say that there was one piece of advice I received, or one event that happened, that suddenly flipped a switch and let me see the light. It hasn’t been that easy. There’s been a lot of trial and error over the years. :) But lately, I’ve found something that works for me. It’s a combination of things, really.

First, you have to understand that I have a full-time day job, as well as the writing. I also have a husband whom I love dearly, two sons aged 10 and 8 who mean the world to me, and a cranky 18 year old cat who likes to get me up before dawn. I am responsible for my family, but I’m also responsible for myself; if I let myself get too wound up over things — OMG HOW ARE MY NUMBERS??? OMG HOW CAN I FIND TIME TO WRITE??? OMG I STILL HAVE TO DO LAUNDRY FOOD SHOP MAKE DINNER PICK UP THE KIDS CLEAN AHHHHH — then eventually I get sick. And if I really let those things eat at me, I get blue. Sometimes, I get depressed. And then nothing is good — not how I look, how I feel, what I do. Nothing is good enough when I’m like that. So I’ve made it my goal to find my bliss. :)

These are the things that I’ve found that are working for me:

1. Eat right. For some people, that may mean going vegan and eating whole grains; for others, it might mean lots of animal protein and watching the processed carbs. For still others, it’s everything in moderation and watching portion sizes. Finding the right eating style that works can help with everything from energy levels to mood to weight. And note: it’s **not** about being thin. It’s about being healthy. :) (And, in my case, it’s also about having that chocolate once in a while! Yum!!!)

2. Move. I’ve been doing tae kwon do for more than 19 months, and it’s been amazing. It’s built my confidence, increased my flexibility, and hey, I can break boards! With my hands! And not break bones in the process! My husband and sons do it too, so it’s terrific that we do this as a family. I’ve also met wonderful friends through TKD. And, to improve my performance in TKD, I also do moderate cardio 4 – 5 times a week and strength training 3 times a week. When I feel strong, I feel good.

3. Talk. When you’re a writer, it’s easy to just live in your head. That’s why it’s so important to have people to share your life with. I’m so thankful for my husband and my amazing friends. And I’m just as thankful for all my online friends! Sometimes, connecting with people in 140 characters is all it takes. :)

4. Me time. With all that I do for others — as a wife, as a mother, as an employee, as an author, as a daughter, as a friend — it’s become vital that I take some time for me. Maybe that’s just to catch a Doctor Who rerun, or read a book, or take a long walk outside with my iPod playing. But a little downtime, me time, is important — and I’ve stopped feeling guilty for taking it. :)

Thanks so much for taking the time for this interview, Jackie! I'm looking forward to checking out Rage and Loss.

Guest Post: Eating Disorders in YA

Today Laura from All of Everything is stopping by with a guest post on YA books about eating disorders!

Hello everyone! I'm Laura, the girl behind All of Everything. For my Psychtember post I'm going to talk about Eating Disorders in YA fiction, specifically Anorexia Nervosa and Bulimia Nervosa. I'm currently in my third year of university majoring in Psychology, a subject I've been intrigued by for a long time. I've also taken a course about eating disorders and found it especially interesting, hence my topic today! First here are some facts about each:

Anorexia Nervosa

• People with anorexia are obsessed with controlling their eating. Basically, they feel that if they can control what they eat, they can control their lives and any stress or problems they have to deal with.
• They will have a weight that is below what's normal for their age and height and have an intense fear of becoming 'fat', but can't see themselves for what they really are. An anorexic looks in the mirror and sees 'huge' while the reality is they're dangerously thin.
• Anorexics tend to come from families that emphasize looks, or like to keep up appearances. The stress of the pressure at home or at school can be the trigger for the disorder.
• The reality is anorexics starve themselves, which leads to many complications, some dangerous: loss of hair, dry skin, slow heart rate (bradycardia), low blood pressure (hypotension), amenorrhea (periods stop), osteoporosis, anemia, electrolyte imbalance and irregular heart beat (arrhythmia). Organs become starved due to lack of nutrients and can start shutting down. Heart disease is usually the cause of death in anorexics
• Dealing with someone with anorexia can be very frustrating, for doctors and friends/family. They don't see themselves as sick, quite the opposite. They're intensely proud of their weight loss and can become very defensive and reluctant to accept treatment or help. They could deal with the illness their whole lives, and sadly about 10% of anorexics die within 10 years, making it the most deadly psychiatric illness.

Bulimia Nervosa

• People with bulimia go through cycles of bingeing and purging. The out of control bingeing can be a way to numb feelings of anger or sadness, but afterwards it creates feelings of anxiety about weight gain so the person purges to get rid of the food, usually by vomiting, or with laxatives or diet pills.
• Whereas anorexics are proud of their control over food, bulimics tend to be ashamed and embarrassed by their relationship with food, and keep it a secret, making it difficult for them to seek treatment.
• Purging isn't actually an effective way of losing the calories in the food, and bulimics usually can be seen as having a normal weight, so it's harder to diagnose just by looking at someone.
• Purging, and especially vomiting, can cause a number of physical symptoms that could worsen and be fatal if continued: tooth erosion, gum problems, electrolyte imbalance (could lead to kidney failure), or rupturing of the esophagus.
• Bulimia also tends to coexist with other disorders, like mood or anxiety disorders. Treating these problems can be the start of uncovering why bulimics feel the need to binge and purge and eventually get them to stop these destructive behaviours.

 ~~~~~~~~~

Now onto the books! I've read three books that I thought really captured these eating disorders in a way that realistically portrayed their seriousness. If you'd like to get a better picture of anorexia or bulimia I'd recommend reading any or all of these.

Wintergirls by Laurie Halse Anderson
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This is probably a very well known book and for excellent reason. Reading this after I'd learned about eating disorders, I was hit hard by how realistic this book is.
It portrays a character with anorexia, but not struggling with it. Like most anorexics, Lia wasn't ashamed of her illness, she was proud. She didnt even think she was sick.

Who wants to recover? It took me years to get that tiny. I wasn't sick; I was strong.

To read this book is to go inside the mind of an anorexic, someone who doesn't want to be treated. Absent parents in the midst of divorce let Lia keep her illness hidden until she blacked out while driving, and she was found out. She's sent to a treatment centre, not once, but twice, and becomes what she's expected to be until she can be let out and start all over.

I knew how much it hurt to be the daughter of people who can't see you, not even if you are standing in front of them stomping your feet.

At one point Lia is ecstatic about reaching a specific weight. Except...now she wants to go lower. Such becomes the problem, which Lia admits. No number will ever be low enough. She wants to keep losing weight until she disappears into nothingness and is finally able to escape her life and all she has to deal with.

If I got down to 070.00, I'd want to be 065.00. If I weight 010.00, I wouldn't be happy until I got down to 005.00. The only number that would ever be enough is 0. Zero pounds, zero life, size zero, double-zero, zero point. Zero in tennis is love. I finally get it.

Lia also had a friend, Cassie, with bulimia and they each shared a deep desire to be thin, actually competing over it. Cassie eventually died from complications due to bulimia, sending Lia into a dark spiral of self destruction, while her loved ones struggle to help her.

The light beyond my eyes flashflashflashes with a hundred futures for me. Doctor. Ship's captain. Forest ranger. Librarian. Beloved of that man or that women or those children or those people who voted for me or who painted my picture. Poet. Acrobat. Engineer. Friend. Guardian. Avenging whirlwind. A million futures--not all pretty, not all long, but all of them mine. I do have a choice.

Hunger by Jackie Morse Kessler
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If you want to ease into learning about anorexia, Hunger is the book for you. Lisa is anorexic and has been chosen as the Hoseman of Famine, bringer of starvation. The paranormal elements somewhat soften the harshness of the disorder but the basic issues still remain.

Lisa's absent mother and loving but clueless father lets her keep her anorexia secret from all but her worried now-ex-best friend. The 'Thin Voice' is always in her head, telling her how fat she is, or does she really want that french fry? you're disgusting, you're weak, over and over on replay.

Along with starving herself, Lisa also suffered from what's called 'anorexia athletica', a compulsive desire to exercise. Most nights she'd sneak downstairs and jump on the exercise bike for hours, anxious to burn off any calories she may have consumed, which was usually very few to begin with! Because of this, she was almost always very weak to the point of collapsing.

Similar to Wintergirls, Lisa also had a friend with bulimia, with whom she shared a desire to be thin. Obviously not the best person to associate with, she praised Lisa for her control, all while she binged on junk food and excused herself to the bathroom to throw it up, suffering the entire time.

When Lisa becomes Famine, she becomes witness to real starvation around the world and hates what she sees. Her compassion is what drives her to use her new powers for good and find the strength courage and, most importantly, the balance within herself to overcome her struggles with food and seek help.

Living means constantly growing closer to death. Satisfaction only temporarily relieves hunger. Find the balance, and plant your feet.

Purge by Sarah Darer Littman
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I recently finished Purge and it's the first book I've read that focuses on a MC with bulimia. It was able to portray bulimia, as well as anorexia, in a less harsh way than Wintergirls, and with a bit more humor too.

Janie is admitted to Golden Slopes after she broke down and purged at her step sister's wedding. She's a great character to follow, as she really wants to recover, but getting there involves opening up to the psychiatrist about the darkness she feels inside her, and how purging is able to, temporarily, make her feel light and beautiful.

As soon as I finish eating, itís like this tape starts playing in my head: ìYou are SO FAT! What the hell did you eat that for?îÖDid I used to be able to eat a bar of chocolate without hearing that critical voice in my head?

Golden Slopes, along with the 'Barfers', is home to the 'Starvers', the anorexics, and they are constantly at odds with each other. It was entertaining to witness meal times with the two groups, as they were completely different. The bulimics would eat quickly, savouring every bite before they were monitored to prevent purging,  while the anorexics would be at the table for far longer, struggling with every mouthful.

There is a dynamic group of people in recovery, guys and girls, and it gives a good idea of how eating disorders can affect wide ranges of people, not just teenage girls as many assume. It was wonderful to then see all these different people come together and share their fears and feelings, giving each other strength and support to commit to recovery.

Iím afraid that without [bulimia], Iíll crumple into a heap of nothingness on the floor. But on the other hand, what if letting go is like being unshackled from leg irons that have been weighing you down? What if doing it makes you so light and free that you can fly?

~~~~~~~~~

All three of these books deal with a serious mental disorder, but they also all give the reader a resounding feeling of hope. I'd recommend them all to you, and I sincerely hope you take that message and maybe pass it on to someone who could use it. Make someone's day; tell them you love them, they're beautiful, you care. And if you think someone might be dealing with an eating disorder, don't hesitate to ask for help. It could get worse before it gets better, but you could be saving a life.

Huge thanks to Danya for letting me be a part of Psychtember! Psychology and books, my two huge interests, together. I really hope you're all enjoying it and get a clearer picture of the complexities of the mind.

The information I've provided and more can be found from the sites below:

National Eating Disorder Information Centre: definitions, stats, research, treatment, how to help, tons of articles
National Institute of Mental Health:  A detailed booklet that describes the symptoms, causes, and treatments of eating disorders.
The Something Fishy Website on Eating Disorders: Contains information and resources pertaining to anorexia, bulimia and compulsive overeating. Definitions, signs and symptoms, physical dangers, treatment finder, online support and much more.
Eating Disorder on Wikipedia: Might not be the most credible site but there is lots of information here to get you started, and seems to be accurate.

Thanks, Laura, for a very informative post! 

Thoughts on the books Laura mentioned, or generally, YA books about eating disorders?
 

Hunger: A Psychtember Review

Most of my Psychtember reviews will be formatted a little differently than usual, to reflect the mental health theme. I've structured things as though the book is the patient and I'm giving them an assessment. Each axis is an aspect of the book that I'll give my thoughts on (characters, plot, etc.), and the validity score refers to how psychologically accurate I think the book is. Then I may list some other books that this one "shares symptoms with" (i.e. novels dealing with similar topics) and provide the patient's "statement" (quote) before giving the "diagnosis" (my shooting star rating). The rating still reflects my overall view of the book, using my standard rating system.

Patient: Hunger by Jackie Morse Kessler

Presentation: (From Goodreads)“Thou art the Black Rider. Go thee out unto the world.”

Lisabeth Lewis has a black steed, a set of scales, and a new job: she’s been appointed Famine. How will an anorexic seventeen-year-old girl from the suburbs fare as one of the Four Horsemen of the Apocalypse?

Traveling the world on her steed gives Lisa freedom from her troubles at home: her constant battle with hunger, and her struggle to hide it from the people who care about her. But being Famine forces her to go places where hunger is a painful part of everyday life, and to face the horrifying effects of her phenomenal power. Can Lisa find a way to harness that power — and the courage to battle her own inner demons?

Assessment:

Axis 1. Characters

We are introduced to Lisa when she is already experiencing a full-blown case of anorexia. While we are privy to a few of her memories, I wish we had been given more glimpses of how Lisa reached the state she's now in. I wanted to see more of her journey to this point — what had motivated her to begin, how it had progressed, etc. Her mother is hinted at having a role in Lisa's obsession with body image, but I wanted to better understand their relationship and history. Perhaps because I didn't know much about Lisa before this point, I didn't fully connect with her mindset. And I felt like the voice suited a younger teen, perhaps somewhere around age 14 rather than 17.

Lisa seemed so rational in other ways that I had a hard time seeing how she could be so illogical when it came to her anorexia. However, I think this illustrates really well how anorexia can kind of "hijack" the brain, sending its victim into a vicious cycle that is difficult to escape. Furthermore, my incomprehension of Lisa's behaviour likely mirrors a frequent response of outside observers to someone with anorexia; they just don't understand it until they've actually experienced it.

I found the relationship between Lisa and Tammy (a friend with bulimia) to be one of the most fascinating aspects of the novel. Their disorders "feed" off each other (pun intended, sorry), enabling each girl to continue along her path of self-destruction. Lisa barely eats anything, but she bakes all the time. And who does she bake for? Tammy, of course, who binges on the cookies and then later purges herself. Tammy's apparent self-control in her bulimic lifestyle inspires Lisa, in turn, to keep on refusing her body nutrients. I do wish, though, that we'd had more resolution to Tammy's story; after a certain scene she just isn't mentioned again.

I enjoyed the side characters of Death, Pestilence, and the horse Midnight, although they admittedly weren't that multi-dimensional. Death was fun, Pestilence was kind of disturbing (which he should be, although I liked his hopeful attitude) and Midnight was cute... War was the least fleshed-out of the Riders, and I didn't really care for her — but I don't think we were supposed to.

Axis 2. Premise/plot

I really liked the freshness of this premise — Lisa's struggle with anorexia is seen through a more fantastical lens than most "issue books." Her role of Famine, one of the four Riders of the Apocalypse, is used to give Lisa perspective as she sees first-hand how people in some parts of the world are starving and have no choice in the matter. I think the unique premise provides a hook that many other YA novels about eating disorders do not, and might reach readers who ordinarily would not pick up that kind of book, but are intrigued by the fantasy aspect of it.

In terms of the magic of the Riders of the Apocalypse, I would have appreciated a clearer explanation as to how everything worked, particularly Famine's powers. There's one scene where she starves another character (through her powers) almost to the point of death, but after being healed, oddly enough that character does not comment on what just happened.

Plot-wise, there could have been more action. I think I was expecting a plot encompassing more than just Lisa's own development. Despite the fantastical premise, this is really the story of her personal journey, as she recognizes that she has a problem she doesn't have control over and she needs help. We aren't ever given a solid explanation for why she in particular is chosen to be Famine — although her relationship with food definitely plays a part, I'm sure — but it is quite obvious that the role is intended to bring Lisa to some realizations about her life. But I did enjoy how Lisa realizes that as Famine, she has the power to help as well as hurt, and how helping others eventually leads to Lisa helping herself.

Axis 3. Writing Style

There's a very clear message within the pages of Hunger, and at times it feels too obvious, even heavy-handed. I hesitate to label it 'preachy' simply because eating disorders are dangerous, and so anything demonstrating this is really just well-intentioned. However, I think the manner of delivering the message could have been a bit more subtle.

Hunger did a really excellent job of evoking sensations as I was reading. Along the way, it had me feeling both fat and thin, both nauseous and hungry — in a book about an eating disorder, that's a sign of good writing.

Axis 4. Psychological Accuracy

I thought Hunger was quite accurate in the symptoms Lisa exhibits. She obsesses over calories and cuts her food into tiny pieces, she's missed a couple periods, she over-exercises, and she displays symptoms related to extreme weight loss and malnutrition (she often feels cold, she's sometimes dizzy, her memory can be fuzzy) — these are all classic red flags for anorexia. The dad's lack of awareness of Lisa's problems also indicates how well individuals with anorexia can hide their disorder for a long time. The one aspect I wasn't fully on board with was the "Thin Voice" Lisa often hears, counting calories and reminding her about her goal of becoming thinner. I felt like she was quite separate from this voice, rather than it being a part of her, so I didn't entirely buy it when she would so easily give in to its demands. Again, though, I can't claim any knowledge of what it's actually like to have an eating disorder, so I'm merely speaking from my own perspective as a reader.

The bulimia is also portrayed genuinely, with the typical bingeing-then-purging pattern Tammy demonstrates. One of the scenes that made me most uncomfortable — a graphic description of one of Tammy's purging sessions — is also the one that felt the most real. When I later read in the Author's Note that Jackie Morse Kessler actually was bulimic at one point, this helped to explain how she'd written such a visceral, true-to-life depiction.

If you'd like to learn more about the symptoms of anorexia nervosa or bulimia nervosa, go here and here.

Validity Score: How psychologically accurate was Hunger?

Axis 5. Miscellaneous

I really liked how the ending was handled. It demonstrates that there is no "quick fix" to an eating disorder — that it isn't something that happens overnight, even once the person realizes they need help. However, it highlights the importance of that recognition and the strength needed to ask for help.

Patient shares symptoms with: This list of books

Patient's statement:



"Feeling a hint of elation—a tenth of a pound thinner than yesterday morning!—Lisa set the scale back to its proper resting spot. But as she slipped on her panties, she caught her reflection again, and her happiness shriveled as she understood just how much further she had to go. She couldn't tell you how she'd know when she'd finally achieved her goal; in truth, she didn't know. But what she felt with all of her soul was that until she was thin, she would never be happy. 

When she was thin, everything would be perfect."

Diagnosis: 3.5 shooting stars

Note: There is some content in here that might make some readers uncomfortable, in particular a scene involving purging.

Check back tomorrow for my interview with Jackie Morse Kessler!

Guest Post: Reading YA books with the Psych Lens On (Part 1)

I'm happy to welcome Len from Musings of a Reader Happy to the blog for Psychtember! Here's Part 1 of her guest post:

To begin with, I really read YA books for leisure and love.  I love reading YA books and I have no intentions of being so critical about them.  But then sometimes, I couldn't help but read the books with my psychology lens on:  see some subjects that are psychology-related - analyze issues, characters, etc., even if the book is indirectly tackling one.  

There are a number of psychology-related topics that are touched on or dealt in some of the young adult books I know.

Here are some I would like to share:

Bullying

This has been an age-long subject of concern, not only in the field of Psychology but has stemmed into other social aspects as well.  Studies have shown that there can be an age-long effect of bullying in their victims and some, if not, most of them are negative effects that can have long-term effects (e.g. self-esteem, relationships).  The worst effect it could have can even drive the bullying victim to death.  And my ongoing research is actually includes its modern counterpart, which is Cyberbullying.

Bauman (2011) in her book on Cyberbullying, includes a statistic that, estimates that “20% and 30% if students in US schools are involved in school bullying in some way.”  She also stressed the negative consequences associated with bullying.  

In a way, YA books give readers insight to the experience of bullying.  There were bullying instances in books like The Mephisto Covenant, Beautiful Creatures, (I would also include the upcoming JMK’s Loss), where there are bullying experiences in school.  Though I must note that although there are bullies, there are also those who are now brave to take a stand against it and empower the bullying targets to strength. Reading it in books can help readers vicariously experience it, gain insights in how the experience can seriously make or break a person.

Eating Disorders

Consumerism and media now portrays the image beautiful in girls as being skinny.  This distorts the self-image of some young girls, especially teenagers into thinking they are not beautiful if they are not skinny.  And to be beautiful you can belong, you will be liked, or loved.  

This distorted thinking is hard and complicated to break, especially to young girls because it is not rooted in their want, but in their need to have an approval of others who thinks highly of physical appearance.  

Laurie Halse Anderson's Wintergirls wrote a moving and wonderful story about a character who has Anorexia Nervosa.  Hunger by Jackie Morse Kessler have her character with Anorexia becomes the horseman of Famine.  Both are good reads about the eating disorder, the latter with a paranormal setting and Wintergirls’ a more haunting feel.  

I think it is wonderful that these issues are raised in books that are intended for both young and adults.  These are issues that are real and are need to be understood and addressed.  

 

Next on Part 2:  Sexual/Physical/Verbal Abuse, and Suicide 

[Len Delgado (maidenveil) graduated with a Bachelor of Science degree in Psychology, and MA in Counseling Psychology. She currently focused with research and recent studies on social, young adolescent, gender, and personality, and exploration on Forensic Psychology.]

Thanks for sharing your perspective, Len! Tune in tomorrow for Part 2 of Len's guest post. 

In the meantime...what are your thoughts on portrayals of bullying and eating disorders in YA novels? Have you read any of the books Len mentioned? What did you think? 

Also, if you haven't yet checked out my "Beliefs About Psychology" survey, hop on over here!