Anorexia and Bulimia: The Price of Emotional Intransigence

December 12, 2016

Eating disorders such as anorexia and bulimia are a challenge for our society. Although their rate is higher in teenage girls, the truth is that boys do not escape them and women who have passed adolescence are not immune to suffering from them.

The term “good girl” is associated with neatness, warmth, emotional control and a myriad of demands that put bars on the spontaneous and natural development of any human being.

A way to control your weight, control your body, control your image is through food sacrifices. This way of relating to food is, in essence, a tragic way of managing and originating our own suffering. The very longing to be who we are not, the contempt for what we see when we look in the mirror.

Anorexia and bulimia

We usually associate anorexia with food restriction and bulimia with purges, vomiting or compensatory behaviors after eating. These are not standard and rigid patterns, but may vary depending on the person suffering from the disorder.

There are actually two subtypes of anorexia: restrictive and purgative (purging is any compensatory behavior to eliminate ingested food). Non-purgative anorexia is associated with perfectionism, rigidity, hyper-responsibility and feelings of inferiority. The purgative type (in addition to total food restriction becomes purged) is associated with a family history of obesity, premorbid overweight, impulsivity, dysthymic reactions, mood swings, and addictive behaviors.

In bulimia nervosa, purges or compensatory behaviors are common. In prototypical bulimia nervosa, with purges, there is a greater distortion of body image, more abnormal feeding patterns and more associated psychological problems.

The non-purgative (there is a big binge but no compensatory behaviors) could resemble a binge eating disorder, but it is not one because there is the overvalued idea of weight and figure. This subtype is associated with other problems such as suicidal thoughts, addictive behaviors and impulse control disorders.

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What do they have in common?

The basis of these disorders is emotional: patients are unable to regulate their emotions. Emotions that they have sometimes not been able to express satisfactorily in a family environment that is not stimulating, restrictive, highly demanding of their behavior or in an environment that has not been able to respond adequately to their high intellectuality and desire for affection.

When the disease is established clearly, ruling out other organic disorders such as diabetes mellitus, neoplasia, pituitary cathexis or other psychological disorders such as OCD or psychosis, we can say that we have a eating disorder.

Eating disorders typically occur between 10-30 years of age, 95% are women, and they have in common the overvalued idea of thinness. They share an extreme concern about weight and shape, cognitive distortions, depressive and anxiety symptoms, in addition to a social functioning deficit.

Why does it appear at that age?

If we consider that the majority of the victims are teenagers, one of the probable causes is that the girl does not know how to manage the transition from girl to woman. Their communication system “as a girl” is still deficient and pressured. They are in a context of inhibited emotionality and at that age are more aware of what the female gender “apparently” imposes on them: thinness, beauty, and submission.

If it were just an image problem, people with anorexia would restore their caloric intake when they are already thin enough. It is the need for perfection, the fear of relapse, and perceptual distortion that keep their behavioral patterns in place.

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Myths about anorexia and bulimia

The personality of women with these disorders has been associated with a pattern of vital disorganization, of weakness, of low intelligence, of high suggestiveness about the comments of others. But these are not the personal characteristics that we find in these patients when we evaluate them.

They are not delirious people unable to discern reality from their imagination. Anorexic patients are not delirious and hysterical people. According to some studies, it is not a question of perceptual alteration, but of comparison with increasingly demanding norms.

It is their way of relating to the world, of burying what they could never express, not eating is the best way they have found to control what happens to them.

They are not hysterical, they feel alone

Having their attention so focused on a purpose frees them from facing other types of problems, which will always be secondary and able to be postponed until the moment they solve what the real problem is for them.

Most are aware that they are in a destructive process, but once initiated, they have created a system of reinforcements and punishments so powerful that for them it is very difficult to escape. They have programmed their brain to the point where the damaging inertia is really powerful.

Many of the girls and boys who suffer from these disorders are able to restore normalcy in their lives. Doing this is hard, costly work that requires patience and in which relapses are usually suffered. However, in order to overcome it, it is necessary  to have the support of the people who love the person suffering from the disorder. Their support, their faith and their persistence to get out of tunnel are fundamental.

This is because the disorder directly attacks the self-esteem of the person who suffers it; making them feel inferior because they compare themselves with others that they believe to be superior, more perfect, and more desirable. Therefore, the person is always put in a place of inferiority and aspiration, constantly and continuously.

In addition, it is common for people who have suffered some type of eating disorder, such as anorexia or bulimia, to show patterns of excessive dependence, fear of abandonment, hypersensitivity to criticism, alexitima, etc. These types of disorders can be overcome, but they are not cured and will be a constant challenge to maintain their recovery throughout the entire life of the person.

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