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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Dear Kathleen,
Thank you for your thoughtful response. I appreciate your sharing your professional experience.
It's agony for a loving parent to see their child ill with any serious illness. To consider that something in the physical or emotional environment may have contributed to that illness may be more than a loving parent can bear.
Yet, to become overprotective could mean that something ignored or about which a person is blind can become even more intensified.
I looked at your website and see that you have a great deal of experience working with people suffering from anxiety, various kinds of abuse and difficult family issues.
Thank you again for adding your voice to this discussion.
best regards,
Joanna
Dear Carol,
I applaud your efforts to continue learning and developing. I appreciate your commitment to be the stopping place in a thread in your family legacy that helps perpetuate eating disorders.
Your own therapy work, your willingness to look at yourself and your family with honesty and love and your dedication in providing your daughter with a healthy emotional environment in which she can develop to be the best she can be is wonderful. And, as I know you appreciate, your effort is necessary and challenging.
When something we know is all we know, we don't know options exist. Plus, those options may be available to us only after we do a certain amount of internal growing. Usually in that growing we have to tolerate pain and experience humility as illusions collapse and more reality becomes clear.
Your efforts to learn, not only to break but change the chain, and use your learning and your love to help your daughter, will help many children and adults beyond the limits of your family.
Thank you for your participation, Carol.
warm regards,
Joanna
"Maybe some day there will be an organization for children of parents with eating disorders"
There is: F.E.A.S.T. (Families Empowered and Supporting Treatment of Eating Disorders) www.FEAST-ED.org.
I am deeply saddened by the assumptions made in this post, and some of the responses. I am grateful to the brave mother who so respectfully outlined the facts. Some day I hope we will all look back and see both the error and the tragic cost in clinicians who assume pathology in families. It is disheartening that practicing clinicians would hold these beliefs, and heartbreaking that parents would absorb them.
Boundaries, it seems to me, apply to clinical assumptions as well.
Laura Collins, Executive Director
F.E.A.S.T.
Dear Laura,
Thank you for contributing to this valuable discussion. I continue to hope for more perspectives so we all can get a more encompassing picture of these issues.
In your post you refer to a population of families I and other clinicians may never see. It's possible and probable that more exists than what comes through our offices for treatment.
I, for example, only work with adults who are affected by an eating disorder. I do not work with children.
The stories I hear from my patients, and I've been in practice for almost 30 years, include unconscious and often unintended boundary invasions by parents. These invasions force the child to develop ways to defend herself. Some children cannot defend themselves. Others find various methods of defense, one of which is an eating disorder.
By the time some of these children are adults and bring themselves to treatment, defense patterns are established and, usually, the difficulty with parents continues.
It is possible that the adults who come for treatment received enough love and developed enough self respect to reach out for freedom from an eating disorder. It's also possible that these adults come from families who may be intrusive, even to an extreme, but at the same time love and want to support their child.
It's not unusual for me to see an adult because she wants treatment and her mother found me and made that first referral. And it's not unusual for that very same mother to create, as she always has in her parenting, difficulties that trigger and even undermine the recovery work.
This is not done intentionally. The mother is unaware and caught in her own psychological patterns. But, she still wants the best for her now adult child.
Families run the gamut from insensitive people who do not care about their children to caring and loving people who want the best for their children. I could never make one category for all families.
It may be that Maudsley and F.E.A.S.T. attract families who are sensitive, caring and willing to grow, learn and develop as they learn ways to help their children move to eating disorder recovery. It may be that families who are incapable of cooperating in such an effort are the families that never enroll in these programs or drop out quickly.
It’s a challenge for all of us to look at these issues because we don’t have information about or experience with the people we do not see. But to address the vast topic of eating disorder recovery, we need to be open to what and who we don’t know about.
We may be talking about different kinds of families.
I’d be very interested in hearing your response to this, Laura.
Thank you again for writing.
Best regards,
Joanna
I understand that you work only with adult women. But, in your article, you refer frequently to the experiences of the child within the family setting. All of us were children once. So, even though you work only with adults, you speak of childhood and families. That's in part what I heard and am reacting to.
When you hear the life version of the adult person sitting in front of you, it is a one sided remembrance of an experience involving a number of people. For that person, it may be their reality. However, to really understand their history, their background, their family, you would need to have the whole family present.
Think of nations. We wouldn't just get the perspective of only one country in a situation. We'd look at all angles before drawing conclusions. We'd talk, listen to each other, negotiate. You can't get a full picture without this. And, yes, you may treat adults, but they were once children. I don't see how this article which refers to families and children within it--this philosophy of cause-- only applies to your specific treatment population. I think there can be real pitfalls in the kind of therapy that looks backwards to causation.