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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Joanna,
I am a parent whose daughter developed restrictive-AN beginning at age 9 and who has reached recovery after two years. I understand that you deal with adults, many of whom are not anorexic, but who may have food issues such as bulimia, over-eating, etc. You yourself are a recovered bulimic, to which I say congratulations on the hard work it must have been!
Seeing my young daughter fall into the pit of anorexia after suffering strep throat and then learning of the direct connection between strep and brain diseases such as anorexia, OCD, tics and anxiety, I think I see eating disorders more from the biological side. My daughter is in a loving, very balanced family. Our young son does not suffer from an eating disorder and yet is living in the same family. There are genetic and biological brain changes that are a major part of eating disorders, just as there are for autism and schizophrenia. Do family dynamics trigger an eating disorder? Probably in some cases, yes. But as Bob points out, there really is no one known trigger for eating disorders and how temperament and genetics interact is a key component that needs to be acknowledged. It is complicated, scary, and confounding, but we need to be open to the fact that even the experts do not know the absolute cause of eating disorders. I think having an open mind to all possibilities, without placing blame, is the best place to start helping sufferers recover.
Laura Collins and Erica, thank you for your posts.
....
Just curious - a question for Joanna:
Are you a mother?
I would appreciate an answer.
Thanks!
Yes.
Hi Joanna,
I wanted to clear up a misconception. You write that Maudsley attracts "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."
The research on Maudsley shows good results. The exclusion criteria were not especially strict (abuse, active suicidality or too ill physically for home treatment.) Further, patients were randomized to treatments--the study families did not choose their cohort. So, it's not a select group of "superparents" we're talking about. (Though I think most parents, whether they use the Maudsley approach or not, love their kids!) Interestingly, single parents did just as well as married parents in a recent study of family-based treatment for bulimia nervosa. This page provides links to the available research on family-based treatment.
http://maudsleyparents.org/clinicians.html
Cheers,
Jane Cawley
http://maudsleyparents.org/
Joanna,
There is so much I would like to address here, but I'll stick to the most important points.
There is no evidence whatsoever that parents of eating disorder patients are better or worse parents than the larger population of parents. None.
Eating disorders are a biologically transmitted brain disorder that distorts self-perception and interpersonal relations. It is perfectly logical that an illness that first manifests in childhood and adolescence would, if allowed to fester through to adulthood, would leave a person with very distorted relationships. To take the self-reports of these adults as proof of cause - instead of as symptoms - is a grave misunderstanding and disservice. To the patient, to his or her family, and to all those who read or hear from you about cause.
The parents of F.E.A.S.T. and those whose children have been offered the Family-Based Maudsley approach are no different than the parents of other patients except that our children are not being treated by clinicians who assume we are pathological. And, presumably, that our children will be spared years of illness because we are empowered to act lovingly and assertively during treatment.