Number One Reason for Developing an Eating Disorder
Hundreds of people have asked me why someone develops an eating disorder. Of course many issues are involved, but from my exploration of this field over the years, I have concluded that there is one outstanding theme that runs through every person with an eating disorder whom I have encountered.
Early in their lives, people with eating disorders have experienced, on a sustained basis, relentless boundary invasion on every level.
When their physical, emotional, psychological, intellectual, sexual, and creative boundaries are consistently ignored and penetrated, people experience total boundary invasion. With no control and no way to end, protest, or, often, even acknowledge such invasions, these persons feel helplessness, despair, and a certainty that they are worthless to themselves or anyone else.
The consequences of such total invasion are vast. One consequence is an eating disorder. Having had so many boundaries disregarded, a person has no knowledge or skills in recognizing or honoring boundaries herself. She will eat or starve for emotional relief.
She may eat vast amounts of food for comfort value alone. She may deprive herself of food until her life is in danger.
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Read the Minnesota Starvation Study. It is a real eye opener as to the effects of starvation on a group of normal young men. Sound like an eating disorder? You bet!
anne
http://www.possibility.com/wiki/index.php?title=EffectsOfSemiStarvation
What I find interesting about your comment is that you've addressed young men, a group I think often forgotten or ignored in our rush to judge or treat young women.
As one with years of contact with people with EDs, and a fair measure of experience with their parents as well, I find it difficult and perhaps unwise to stereotype the sufferer’s background. While we all are rightfully looking for answers as to the causality of EDs, at this point in time it seems wisest to look to the broadest range of possibility.
Having said that, I believe that many people with EDs have suffered exactly the same sets of circumstances that Joanna sets forth. Abuse and boundary violations play a huge role in the development of EDs for all too many people.
Yet how are we to explain the fact that given the same set of circumstances, some people will develop an ED while others will not ? The explanation would seem to indicate that temperament plays a larger role than those who seek to narrow things down may currently acknowledge, and may exert such a strong influence that children may develop EDs under "good enough" parenting as well.
Currently there seems to be many different camps when it comes to explaining ED etiology. The recent movement to pooh-pooh and discount the early findings of Hilde Bruch is one example of this, even in the face of some suffers who come from exactly the backgrounds Bruch described.
Expensive private residential treatment programs seem particularly prone to the currently popular “The Parents are never to blame" position. Yet when it is parents who are asked pay the sort of fees such places often demand, such institutional positions can all too easily be seen as self-serving rather than evidence-based. All one has to do is listen to the horror stories from the childhoods of some sufferers to understand that stating this position is professionally irresponsible and without basis in fact.
At the same time, many people with EDs appear to come from authentically loving and conscientious homes. The range of backgrounds for people with EDs seems a wide one.
My sense is that every single one of the various etiological stances will find validity in certain individual cases, and that when it comes to producing an all-encompassing theory of ED development one is wise to remain open-minded, and not cleave too closely to any particular stance.
Oops, double post.
This is exactly why evidenced-based research is essential. Children with a variety of ailments come from a variety of families. Blanket statements are incredibly harmful about any illness, ED's included and perhaps especially. And, more importantly, it flies in the face of current research.
When you are dealing with an illness of denial and distortion, you must-as a therapist-take this into account. I have SO much more to say on this, but am off to work.
My main point this morning is that there are real people and real families out here struggling with this illness. It is disheartening to be pre-judged as 'violators' and 'possible abusers' the minute we walk in the door (and we have been historically and still too often are).
I find it interesting that you say private residential places do not blame parents. That was not my experience at all. That was the place I felt it the most. We were not even allowed to see my 14 year old daughter for 5 weeks--and there was absolutely no good reason for this. It was inhumane. Had I more courage--or not so desperate to get her refed at the time--I would have pulled her out of there in a heartbeat.
anne