Kathleen M. Pike, PhD


Okay. I admit it. I am one of those Americans who is irrationally beguiled by British royalty. So what better way to indulge my fascination than to watch The Crown this past year? I finished Season Four just before last week’s Golden Globes. This Netflix TV drama took home multiple awards, including Best Performance by an Actress going to Emma Corrin, who played Diana.

Season 4 could have been called, Even Princesses have Problems. In her lifetime and her legacy, Diana taught us some painful truths about mental health and illness. Hers was a story of an eating disorder, the quintessential mental health condition that disproportionately burdens women. March is Women’s History Month and this coming Monday is International Women’s Day. What might Diana say about The Crown’s depiction of her story? What might the “People’s Princess” say about women and mental health, particularly eating disorders, today?

1. Not just princesses. One cultural myth is that princesses enjoy fairytale lives. Diana’s story clearly busts that myth. Another myth that still needs busting is that eating disorders only afflict people who fall in the category of the 3W’s: women, white, and wealthy. It is correct that anorexia nervosa and bulimia nervosa are more common among women, and anorexia nervosa is less common among women of color, but people of all cultures, colors, and gender can and do suffer from the whole range of eating disorders.

2. Don’t dismiss my struggles. The Crown depicts those around Diana as responding in ways that convey a clear lack of understanding. Disgusted by Diana’s eating disorder, members of the royal family disparage her mental health problems as silliness. They want her eating disorder to disappear. In a 1995 BBC Panorama interview, Diana described her struggles with depression, postpartum depression, self-injury, and bulimia, “I was crying out for help, but giving the wrong signals, and people were using my bulimia as a coat on a hanger: they decided that was the problem – Diana was unstable.” Fortunately, she eventually got the help she needed.

3. Don’t be afraid to ask for help. Because mental disorders are so widely misunderstood, many people are afraid to seek help when they are hurting. We don’t hesitate when we have a toothache, backache, or headache, so why do we wait when our mental health aches? Long before mental health became a celebrity cause, Diana found her voice and used her platform to bring mental health out of the shadows. Her legacy lives on in her sons, who are champions for increasing understanding about mental health. In 2017, William spoke of his mother’s bulimia, praising her for speaking out about her experience and asserting that “we need to normalize the conversation about mental health.”

4. Would Diana say that The Crown depicted her experience accurately? I can only speculate, but in her own words at the 1993 London International Conference on Eating Disorders, she shared with us (photo above), “I have it on very good authority that the quest for perfection our society demands can leave the individual gasping for breath.” Eating disorders “have at their core a far deeper problem than mere vanity” and reflect “painful issues” that can lead to a “spiral of secret despair.” The Crown clearly portrayed these profound psychological struggles and conveyed the pain and suffering that Diana, herself, described with dramatic effect.

5. Was it really necessary for The Crown to show repeated episodes of binge eating and purging? I don’t know. Emma Corrin was committed to rendering the full story as she felt that it would honor Diana’s honesty. Others contend that it was gratuitous and perhaps even risky. Would these graphic episodes distract from the underlying pain? Would they traumatize or trigger some viewers? Would The Crown create a copycat risk similar to what has been described in the case of suicide? These are very legitimate concerns, but they should not keep us from speaking the truth. The Crown consulted with experts, provided a warning at the start of relevant episodes and treatment resources at the end. When Diana spoke out about her eating disorder, we saw a surge in treatment-seeking among individuals who had been suffering in silence. It was dubbed the “Diana Effect.” My hope is that The Crown does the same.

As Emma Corrin accepted her award, she thanked many people (as one does). She ended by thanking Diana, “You have taught me compassion and empathy beyond any measure that I could ever imagine…” Very fitting as we celebrate Women’s History Month and International Women’s Day.

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University.

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