Her Plate was Half Empty: Karen Carpenter's winning voice and her losing battle with Anorexia Nervosa

Welcome to another episode of Psychology Comes Alive.  The game played here is called Blog n Roll.  In the game of blog n roll, I provide the topics and the tunes and you provide the talk.  You do that in the comments section below.  Here's what your "talk" will be centered upon: After doing a little self-guided research, what is your understanding of Anorexia Nervosa and how is it contrasted with Bulimia?  After having seen the movie, The Karen Carpenter Story, and participating in a skit that introduced concepts like proximal and distal causes, contributory causes, significant causes and necessary causes, formulate a sentence or two that addresses Karen Carpenter and her mental health condition in these terms. 

Take a moment to conceptualize Karen Carpenter's experience and the development of a mental health condition in terms of bidirectionality, a concept also introduced in class via a skit. 

Listen to this original song:

Her Plate is Half Empty
words and music by Dr BLT copyright 2004, 2009

Compare and contrast the experience of the fictional character in this song with Karen Carpenter's apparent character as discussed in various sources. 

The Thanksgiving season is upon us, and so it was fitting that, in one of the last scenes in the movie, The Karen Carpenter Story, Karen and her family were sitting around the dining table, waiting to partake in a Thanksgiving feast.   

Mental health, like food, is something we often take for granted, so before I close, so as you sit down to feast upon the Turkey and all that goes with it, I want to ask you to be thankful, not only for your food, but for your mental health (to the degree that you still possess it).  I also want to express thanks for having such wonderful students!  Have a HAPPY THANKSGIVING.  Here's an original, brand new song of mine to get you in the spirit:

Everything 4 Granted 
(Audio Sample) Dr BLT
words and music by Dr BLT copyright 2009

Dr BLT's official website

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  • 11/30/2009 11:14 AM Cathy Lazarus wrote:
    Cathy Lazarus
    According to our text, Anorexia Nervosa is an intense fear of gaining weight or becoming fat, combined with a refusal to maintain even a minimally low body weight. Anorexics typically have a distorted perception of body shape and size. Our case study text notes that ninety to ninety-five percent of anorexics are female. The anorexic typically denies that they are maintaining a dangerously low body weight. Some theories propose that anorexics suffer from low self-esteem, anxiety, and insecure attachments to others. Sociocultural pressures have a huge impact on anorexics by presenting unrealistic body images as the accepted norm. The text presented an astounding statistic that anorexia nervosa has the highest mortality rate of any psychiatric disorder.

    Anorexics either restrict the amount of calories they consume or they binge on huge quantities of food and then purge or remove the food just consumed by vomiting, using laxatives, diuretics, and enemas. They often exercise excessively to eliminate unwanted calories. According to our case studies book, one-half of patients with anorexia also have bulimic symptoms, and roughly one-third of patients with bulimia have a history of anorexia.

    The main difference between anorexics and bulimics is weight. The anorexic is severely underweight whereas the bulimic maintains a normal weight or may be slightly overweight.

    Another interesting statistic from our text regarding anorexics is the fact that one third of anorexics reported that family dysfunction was a factor that contributed to the development of their eating disorder. Therefore, Karen’s family was a contributory factor in her development of anorexia. Karen’s family set very high performance demands on her yet resisted her attempts of gaining independence. Her parents were overprotective and too enmeshed in her life. However, this may have been a bi-directional effect due to Karen’s anorexia and her parents concern for her health and well being. The distal cause of Karen’s anorexia may be her having been over weight as a child. Her weight could have caused her social discomfort and anxiety. Children can be very cruel to other children and they may have teased her for her weight or not included her in their perfect image group. The proximal cause of her anorexia is most probably the cultural attitudes and standards put on successful entertainers that she was exposed to constantly. She would compare herself to the ideal shape of the typical female performer and perceive that she did not “measure up”.

    Like Karen, the young lady addressed in the song, Her Plate is Half Empty, is admired and encouraged by her parents for her talents. They don’t seem to be able to see the torment the pressure to succeed is placing on this psychologically immature being. They are comparing her to successful performers making her feel that she must live up to their unrealistic expectations in order to continue to receive their adulation. Oth
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  • 11/30/2009 11:36 AM carlos wrote:
    Anorexia Nervosa Vs Bulimia
    The following information is from the DSM-IV,4th Ed. APA
    Although both are eating disorders they vary in many ways:

    This is the criteria for Anorexia Nervosa:

    • Refusal to maintain body weight at or above a minimally normal weight for age. Body is at less than 85% body weight.
    • Intense fear of gaining weight or becoming fat even though underweight.
    • Disturbance in the way I which one’s body weight or shape is experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight.
    • In post menarcheal females, amenorrhea (the absence of at least three consecutive menstrual cycles, her period only occurs after following administration of hormones and estrogen)

    The criteria for Bulimia

    • Recurrent episodes of binge eating, an episode is considered as follows:
    1. Eating in a discrete period of time, an amount of food that is definitely larger that most people would eat during a similar period under similar circumstances
    2. A sense of lack of control over eating during these episodes( a feeling that one cannot stop eating or control what or how much one is eating
    • Recurrent inappropriate compensatory behavior in order to prevent weight gains, such as self induced vomiting, misuse of laxatives, diuretics, enemas, or other medication; fasting or excessive exercise.
    • The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for three months.
    • Self evaluation in unduly influenced by body shape and weight
    • The disturbance does not occur exclusively during episodes of Anorexia Nervosa

    Overall for Anorexia the individual refuses to maintain body weight and is afraid of gaining weight and exhibits a significant disturbance in the perception of the shape or shape or size of his or her body.

    The bulimic features are binge eating and inappropriate compensatory methods to prevent weight gain. Self-evaluation of individual in influenced by the body shape and size.
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  • 11/30/2009 12:31 PM Vicki Jo Vickers wrote:
    Anorexia nervosa is an eating disorder that is diagnosed with the presence of four factors- 1) the person weighs 15% less than they should to be considered “normal”, 2) they have an intense fear of gaining weight, 3) they have a distorted perception of their body size and shape, and 4) menstruation has stopped for three or more consecutive months. There are two types of anorexia nervosa- 1) restricting type in which the person basically starves himself/herself, and 2) binging/purging type in which the person binges or purges or both. Binging people eat vast amounts of food and then induce vomiting, take laxatives, diuretics, or use enemas in attempts to get rid of the calories. Bulimia nervosa is very similar to the binging/purging type of anorexia nervosa, with the exception of the unhealthy low weight. In fact, people with bulimia nervosa generally have normal weight or are slightly overweight. The three factors involved in diagnosis are 1) recurrent binge eating in which the person feels a total lack of control over eating, 2) recurrent and inappropriate purging or excessive exercise, and 3) they value themselves according to their weight and shape (ie- they give too much importance to their weight.)
    In Karen Carpenter’s situation, distal causes for anorexia nervosa could involve genetics and her mother’s inability to openly say she “loves” her children and the pressure put on the kids to be successful. Another contributory cause and risk factor for the development of the eating disorder is her perfectionism (remember her “practicing that song across the states” as her brother said, and her wanting to record more takes of an already perfect recording session.) These together give her a high diathesis for developing disorders later in life. The proximal causes for her would be reading the review in the paper where she was described as the “chubby little sister,” her mother putting the emphasis on her brother and somewhat ignoring Karen’s accomplishments, and the stress of becoming successful and keeping up a tiresome tour. Bidirectionality can be observed when Karen begins losing weight and is complimented by others, which reinforces that she needs to keep losing weight. She also feels more pressure to look good when she is pushed to come out from behind the drums and get center stage. All of these factors in conjunction make up the causal pattern for her development of anorexia nervosa.
    The character in the song, Her Plate is Half Empty appears to be very similar to Karen as portrayed in the movie. Both girls’ mothers are telling them to “try harder” and look good. The fathers for both seem to be very complimentary towards their daughters, but don’t really see or seem to notice what is going on with the girls. Both get compliments on their looks, which reinforce their distorted thinking and over-importance of body image (bidirectionality.)
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  • 11/30/2009 9:02 PM lindsey koopmann wrote:
    The National Eating Disorders Association defines Anorexia Nervosa and Bulimia Nervosa according to the following:

    Anorexia Nervosa is a serious, potentially life-threatening eating disorder characterized by self-starvation and excessive weight loss.
    Anorexia Nervosa has four primary symptoms:
    • Resistance to maintaining body weight at or above a minimally normal weight for age and height
    • Intense fear of weight gain or being “fat” even though underweight.
    • Disturbance in the experience of body weight or shape, undue influence of weight or shape on self-evaluation, or denial of the seriousness of low body weight.
    • Loss of menstrual periods in girls and women post-puberty.
    Bulimia Nervosa is a serious, potentially life-threatening eating disorder characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting designed to undo or compensate for the effects of binge eating. Bulimia Nervosa has three primary symptoms:
    • Regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior.
    • Regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting, and/or obsessive or compulsive exercise.
    • Extreme concern with body weight and shape.
    The diagnosis differ in that Anorexia is when a person deliberately starves themselves by refusing to eat adequate amounts of food, whereas Bulimic individuals tend to over indulge in foods and cause themselves to vomit afterwards.
    1. A distal cause in Karen Carpenters eating disorder could be the social pressure she felt to be thin as a celebrity, while a more proximal cause could be the need to make her mother love her and feel proud of her.
    2. Karen’s need to have her mother recognize her accomplishments throughout her childhood could be considered a contributory cause.
    3. Karen’s family becoming aware of her condition and the severity of her circumstances was a necessary factor in her healing.
    Dr. BLT’s song “Her Plate is Half Empty” seems to describe perfectly Karen Carpenters life and struggle with Anorexia Nervosa. The character in the song has parents who both either don’t notice or appear to never be satisfied with their daughters achievements. The character also is noticed not eating and the character is also a successful singer. I wonder by the title of the song title if it is hopeless for this character, as the title reminds me of the saying regarding one’s viewpoint on life or issues being, “The glass is half empty/full.”
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  • 11/30/2009 11:59 PM carlos Santander wrote:
    Proximal causes: A proximal cause for Karen was the parents never giving her any attention. It seemed mother was not there for her and her emotional needs thus causing her to desire perfection from herself.

    Distal causes: I believe some the distal causes were started at a young age with her. With a lack of guidance and lack of knowledge on nutrition and the constant pressure fro the media, it is easy for kids to feel left out. In Karen’s case she was a big kid so it could have affected the way she ended up.

    Contributory causes: Her family and the environment were the main causes to falter Karen. Her desire to please her fans and family was too much for her to handle.

    It seems the song fit well with the movie. First of all the plate is always half full not half empty. The latter is so negative just like the attitude in the song. In the song, the father support the kid but does not seem to care as for the mother, she tell her to try harder and may be be prettier (wear a flower). This can really hurt a kid mentally and cause them to turn to eating disorders if they are over weight.
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  • 12/1/2009 3:41 AM sean wrote:
    People who suffer from anorexia nervosa (a psychological eating disorder) believe that they are overweight, even though, they are severely underweight. When a person suffering from anorexia looks at his or herself in the mirror, they see an overweight person despite being underweight. They also have an irrational dread of gaining weight mixed with a relentless pursuit of thinness. The key features of anorexia nervosa are: (1) Refusal to sustain a minimally normal body weight. (2) Intense fear of gaining weight, despite being underweight. (3) Distorted view of one’s body or weight, or denial of the dangers of one’s low weight. There are two types of anorexia. In the restricting type, weight loss is achieved by restricting calories. Restricting anorexics follow drastic diets, go on fasts, and exercise to excess. In the purging type, people get rid of calories they’ve consumed by vomiting or using laxatives and diuretics. Anorexia is most common in adolescent girls and young women, with a typical age of onset between the ages of 13 and 20. But people of all ages¬—including men and children—can suffer from anorexia.

    In contrast: People who suffer from Bulimia go through periods of extreme overeating, followed by purging, fasting, or intense exercising in order to get rid of the un-wanted calories. Another key difference is, the person suffering from Bulimia maintains a normal weight range. This vicious cycle of bingeing and purging takes a toll on the body. During a period of bingeing, a person will typically consume from 3,000 to 5,000 calories in a short time period.

    I believe there were several (possible) distal and contributory factors in Karen Carpenters Anorexia. She was slightly overweight as a child, and this, coupled with being raised in a competitive environment (where perfection was expected), and having a mother whom never verbally affirmed her love for Karen, could have been the impetus of Karen’s Anorexia. Later in life, the proximal factors were, reading about herself as the “chubby sister” in the paper, and the pressure of looking perfect, as was expected of entertainers.

    We can see several bidirectional effects in Karen’s life. First, she has overly controlling and protective parents, who become even more controlling and protective when they become aware of their daughters poor health. Second, when Karen looses weight, people tell her how great she looks, and this only reinforces her beliefs, so she continues to loose more weight.

    The character in the song, Her Plate is Half Empty, is similar to Karen Carpenter with regards to the pressure(s) that are placed upon her. She’s even compared to the late great Karen Carpenter. Undue pressure and stress, placed upon a child can have long term devastating consequences. We can see this with the multitudes of child stars that have drug and alcohol dependencies.
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  • 12/1/2009 1:15 PM Paul Kenney wrote:
    The main difference between Anorexia and Bulimia is body weight. The anorexic will be underweight and still think they are fat. Bulimics overeat and are concerned about body weight and shape therefore finding unnatural ways to compensate for the overeating, such as vomiting.
    According to the text there are two types of anorexics the restricting and the eating/purging. Karen as potrayed in the movie would fit the restricting type. Karen in the movie wore baggy clothes, refused to eat and exercised. To think of a distal cause to her mental condition I would say that the newspaper article that described her as the chubby sister was a factor. In terms of bidirectionality I would say that her family complimenting her about how good she looked after she lost weight contributed to her mental condition.
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  • 12/1/2009 4:20 PM Aimee Le wrote:
    Her Plate was Half Empty: Karen Carpenter Blog Questions

    *Anorexia vs. Bulimia
    Anorexia Nervosa is a psycho physiological disorder characterized by an abnormal fear of becoming obese and a distorted self-image, which results in an unwillingness to eat leading to severe weight loss. It can also be accompanied by vomiting, excessive exercise and other physiological changes. On the other hand, Bulimia is an eating disorder characterized by episodes of secretive, excessive eating (binge-eating) followed by inappropriate methods of weight control, such as self-induced vomiting (purging), abuse of laxatives and diuretics, or excessive exercise. The insatiable appetite of Bulimia is often interrupted by periods of Anorexia. Additionally, in one of my past health classes, I learned that with Bulimia, an individual could be either 10-15 pounds underweight or overweight, but someone who is Anorexic is severely underweight.
    *Using the terms: proximal, distal, contributory, sufficient, and necessary causes
    The emotional trauma Karen Carpenter felt from a news article calling her Richard’s talented chubby sister could encompass necessary, contributory, and proximal causes to her development of Anorexia Nervosa, while some distal causes might have involved childhood teasing or the effects of excess baby fat that she retained until an older age. Furthermore, some sufficient causes of Karen’s disorder would include her distorted self-image and fear of becoming overweight.
    *Using the term: bidirectionality
    In terms of bidirectional influences on her development of Anorexia, Karen Carpenter felt somewhat emotionally disconnected from her parents, especially her mother, in addition to the psychological damage done to her from the harsh review calling her chubby.
    *Compare & contrast character in the song to Karen Carpenter
    The young woman’s lifestyle in the song seems extremely similar to the life that Karen Carpenter led. These similarities include: a beautiful singing voice, emotionally neglectful parents, dreams of being thin and loved, and a penchant for not eating.
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  • 12/1/2009 5:01 PM Patricia Mikel wrote:
    It's not surprising to know that Anorexia Nervosa, is one of the most common abnormal behavior conditions in the world today, with so much pressure to be thin, not healthy just thin. We are sending the wrong message to people. The text makes mention that this disorder affects women more so than men, I'm sure it's because more pressure is applied to look perfect. When are we going to realize that beauty is in the eye of the beholder. Society has a hardtime accepting the fact that NO BODY IS PERFECT !

    My interpretation of of the causes and risk factors for abnormal behavior in reference to "Anorexia Nervosa" and Karen Carpenter is as follows:

    Necassary cause - The condition itself the "eating disorder".In the beginning it was mild, but it yet still existed.

    Sufficient cause - Fame and stardom these factors guaranteed the condition to surface

    Contributory cause - The stress and pressure to look socially acceptable for her parents and her fans

    Distal Causal Factors - In Karen's childhood her parents I think unknowingly instilled constant pressure with words about how she looked especially her dad, and mom was always pushing her to perform so she could work with her brother.

    Proximal Causal Factors - When Karen received a negative review in the newspaper after a performance, this truly started the onset of the disorder. This was a crushing disappointment to her.

    Signicant Causes - When success was overwhelimg to her the stress levels increased causing her life to spiral out of her ability to control the disorder or keep it hidden any longer.

    Karen Carpenter had a predisposition, a "diathesis" to develop Anorexia Nervosa from a very early childhood due to her parents contantly applying pressure to her concerning her looks and talent. Because of her inner fear of being fat, weight was always the center of her attention. Karen had a high level of diathesis so the smallest amount of stress increasingly reinforced the disorder.

    The bidirectionality of feedback in Karen's life made it pretty easy to see the onset of her eating disorder. Her need to please parents, her social circle, her fans, the media always focused on her weight, combined with the pressure of her great gifts and talents and wanting companionship and a family, just overall wanting to be accepted by all proved to be too much for Karen.

    The Song: HerPlateshelfEmpty
    The bitter sweet truth about how people sometimes have difficulty seeing what is right in front of there face. We see what we want to see. Her parents were so focused on her becoming this great talent they pushed a little to hard. Sometimes we just can't see the forest for the trees. Always comparing her to other gifted people and Karen not ever wanting to diaappoint the people she loved and cared for the most. Feeling the pressure to perform and be accepted by everyone can develop into unhealthy life threatening circumstances. In which case things ended sadly for Karen and all those who loved
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  • 12/1/2009 5:55 PM Garrett Wampler wrote:
    Anorexia Nervosa is the intense fear of gaining weight or becoming “fat,” coupled with refusal to maintain adequate nutrition and with severe loss of body weight. The term anorexia nervosa means, “lack of appetite induced by nervousness.” Many patients woth anorexia nervosa deny having any problem at all. Instead they feel fulfilled by their weight loss. There is two types of anorexia nervosa one being bingeing/purging type and the other being the restricting type. The core difference between the types is in which the patient maintains their low body weight. In the restricting type, the patient limit’s the quantity of food consumed. In binge eating and purging the patient consumes excess amount of food followed by purging by induced vomiting.

    Bulimia nervosa is characterized by uncontrollable binge eating and efforts to prevent resulting weight gain by using inappropriate behaviors such as self-induced vomiting and excessive exercise. The difference between a person with bulimia nervosa and a person with the binge-eating/purging type of anorexia nervosa is weight. The patient with anorexia nervosa is severely underweight. This may not be true of the patient with bulimia.

    The character in the song, “Her Plate is Half Empty” is definitely struggling with the same eating disorder as Karen Carpenter. Feeling many pressures of success and image this person has felt the need to put her looks before her health.
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  • 12/5/2009 12:55 PM Michelle Wagner wrote:
    Anorexia Nervosa is characterized by an intense fear of gaining weight or becoming fat; combined w/ the refusal to maintain an even minimally low body weight. Those suffering from the disease have a distorted perception of themselves and are painfully thin. Although it is possible for males to suffer from this disease, Anorexia Nervousa is most prevalent in young women today. In addition, to meet criteria for this diagnosis accoding to the DSM-IV-TR, the absence of at least three consecutive menstrual periods is required, however, many are concerned with this last requirement since meeting all other criteria in the DSM-IV-TR should already constitute the diagnosis of Anorexia Nervosa (Buther, Mikeka & Hooley 307).

    In contrast to Bulimia, those suffering with this disease are typically of average weight or sometimes even slightly overweight (Buther, Mikeka & Hooley 308). Rather than having a distorted perception of themselves as those with Anorexia do, the person suffering from Bulimia is more overconcerned with their weight. Bulimia is mainly characterized by binges, which is an out of control consumption of an amount of food that is greater than what most people would eat in any sitting. Purging, another main characteristic of Bulimia, would then most likely occur afterwards, ridding the body of the food they just ate by self induced vomiting.

    The overwhelming attention by the media is probably the biggest contributory causal factor to Karen's disease. In addition, Karen's view of her mother having control over her, her dad and others around her informing Karen of how good she looks and her brother's drug use also act as contributory causes to her disease. These causes are both distal and proximal and act bi-directionally to Karen's disease.

    Karen & the fictional character in the song, "Her Plate is Half Empty" by Dr. BLT, have a lot in common. The character in the song seems to also suffer from the same eating disorder, Anorexia Nervosa, since she does not eat. They also seem to have similarities in their parents, being that the character's mother in the song tells her that she can make it if she just tried harder and maybe if she wore a pretty flower in her hair. Her dad also encourages her in regards to her singing but does not really care and assumes it is just one of her dreams when she does in fact take it seriously. Both their parent's put expectations on them that far exceed normality.
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  • 12/7/2009 6:07 PM sandra Seufert wrote:
    Anorexia is a psychological disorder that can lead a person to a death if it is not treated it. Anorexia is a condition that goes beyond out of control diet. This is what happened with Karen. She had psychological problems from her childhood unsolved and as a result her obsession of dieting lead into anorexia .
    Who is at risk for anorexia?
    Approximately 95% of those affected by anorexia are female, but males can develop the disorder as well. While anorexia typically begins to manifest itself during early adolescence, it is also seen in young children and adults. In the U.S. and other countries with high economic status, it is estimated that about one out of every 100 adolescent girls has the disorder. Caucasians are more often affected than people of other racial backgrounds, and anorexia is more common in middle and upper socioeconomic groups. According to the U.S. National Institute of Mental Heath (NIMH), an estimated 0.5%-3.7% of women will suffer from this disorder at some point in their lives.
    Many experts consider people for whom thinness is especially desirable, or a professional requirement (such as athletes, models, dancers, and actors), to be at risk for eating disorders such as anorexia .
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  • 12/8/2009 5:30 PM sandra seufert wrote:
    Anorexia nervosa is a psychological disorder that can lead a person to a death if it is not treated it. Anorexia is a condition that goes beyond out of control diet. This is what happened with Karen. She had psychological problems from her childhood unsolved and as a result her obsession of dieting lead into anorexia nervosa.
    Who is at risk for anorexia?
    Approximately 95% of those affected by anorexia are female, but males can develop the disorder as well. While anorexia typically begins to manifest itself during early adolescence, it is also seen in young children and adults. In the U.S. and other countries with high economic status, it is estimated that about one out of every 100 adolescent girls has the disorder. Caucasians are more often affected than people of other racial backgrounds, and anorexia is more common in middle and upper socioeconomic groups. According to the U.S. National Institute of Mental Heath (NIMH), an estimated 0.5%-3.7% of women will suffer from this disorder at some point in their lives.
    Many experts consider people for whom thinness is especially desirable, or a professional requirement (such as athletes, models, dancers, and actors), to be at risk for eating disorders such as anorexia nervosa.
    Reply to this
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