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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It's also possible that the very pathology that you assume CAUSES the eating disorder actually RESULTS FROM the eating disorder.
I have a son that developed anorexia at age 11. There are no boundary issues in our family (and our therapist would back me up on that statement). We have a healthy, loving home. The anorexia came from a brain disorder, an illness. And it isn't anyone's fault.
We have used Maudsley methods to successfully refeed my son. There are indeed lingering issues that have resulted FROM the anorexia, but they do not predate his illness.
I am heartbroken that fault continues to be perpetuated.
Wendy
Dear Wendy,
You and your family have been through agonizing times. I'm glad to know your son is out of harm's way.
Please tell me, is your comment based solely on my article or are you following the discussion in the comment section?
I ask because the various sharings on this theme have, in my opinion, been expanding perspectives. Eating disorders are painful and disruptive enough.
We don't need or want more heartbreak in patients, parents or, for that matter, treatment providers.
best regards to you,
Joanna
I am just appalled at this information provided. Some of these boundary issues may be evident in some cases and maybe reach the attention of professionals because of a range of problems. There were no boundary issues in my now recovered two young adult children. My s had been successfully living away from home for 3 years when he became AN following glandular fever.
Our children were much loved, encouraged, bright and very independant children prior to their illnesses. If you believe what they said WHILST ILL you would think they were emotionally abused. Surely professionals can not trust what this ill malnourished brain is telling them even if the individual seems to believe it at the time. My D received 5 years of wasted traditional treatment whilst we backed off as advised and we watched her decline and attempt suicide.
Thank goodness for Mandometer and Maudsley who work together will loving families towards recovery. When oh when will professionals start working with families rather than adding to everyones trauma by blaming them.
I'd like to see you working with that mother who probably picked up her approach to her D whilst frightened and playing safe for fear of causing further harm. Have you sat there beside your child in intensive care? She needs guidance to provide the support she desperatly wants to give her D not being told she is the problem so go away. It is also often the case that those same behaviours do not trigger ED in children in other families.
It is heathier for everyone to have a loving supportive family whatever their age. Please move past the blaming (inappropiately) and everyone work together to refeed and renourish the individual. Then listen to what their well brain tells you and work with that.
Linda
I would add that maybe, just maybe the adult patients that you see are so enmeshed with their illness, that they themselves are looking to place blame. Their brains are so twisted by chronic malnutrition, and their clinicians are so willing to accept without question what these patients are telling them. "My mother controlled me. My father molested me." Maybe it is the ed talking, and not the real patient. The real patient is in there, being tortured by ed. The patient who could be helped -- not by being told to "choose" to get better, or to follow 12 steps -- but by being fed, lots of food, consistently, week after week, and supported until his or her brain heals. Who can do this best -- a clinician who sees the patient once a week? Or someone who lives with the patient and truly loves them...
Erica
Dear Erica,
Thank you for contributing.
Please know that the patients I see in a private practice are required to have a medical check before we work together. If anyone is at physical risk because of low weight or suffers from any kind of malfuction because of nutritional deprivation I refer them to in-patient treatment. Private practice is not equipped to work with people at medical risk. Such persons need to receive medical care, ongoing psychological treatment and, as you say, food. They need to be healthy enough to be able to work through the considerable cognitive and emotional challenges they would face in psychotherapy.
Eating disorders cover a broad range of physical experience. Not all eating disorder patients are deprived nutritionally. Not all eating disorder patients are underweight. And certainly, not all eating disorder patients are children. My patients, for example are adults ranging in ages from 26 - 76.
Also, patients rarely, in my clinical experience, accuse their parents of being responsible for their eating disorder. Often parents, spouses, boy friends or girlfriends are afraid that they will be the focus of criticism in private therapy sessions. The fact that the work is confidential allows fantasies to develop in the people who are excluded from the details of the work itself.
Yes, Erica, I agree with you on this point. The symptoms of an eating disorder are not the person. The true identity of the person unfolds and blossoms when she or he is free of the eating disorder and learns to function in the world as a competent and substantial adult.
I appreciate hearing your views. You bring up more of the topic that needs to be included in this discussion.
What is your position in this field, Erica? Are you parent or family member of someone with an eating disorder? Have you suffered from an eating disorder yourself? Is your connection something else?
Please feel free to write again and share some of your story.
best regards,
Joanna