Psychological Explanations of Eating Disorders

Psychodynamic

These explanations revolve around the idea of conflict, for example the young girl’s denial of her emerging sexuality. While it is true that anorexia can indeed limit the development of secondary sexual characteristics, reduce sexual urges and suppress menstruation, such explanations have little direct in their favour.

Another account sees the disorder as resulting from an attempt to passively rebel against a domineering parent (especially the mother). Hilde Bruch (1973) has argued that disturbed mother-child interactions lead to severe ego-deficiencies in the child and to serious cognitive disturbances which jointly produce disordered eating patterns. Parents who are ‘ineffective’ fail to attend to their children’s internal needs and arbitrarily decide when their children are cold, hungry etc. Children reach adolescence with a need to develop autonomy but an inability to do so. To overcome their helplessness, they strive to achieve extreme self-control. There is some evidence for this theory but the main problem is that it doesn’t explain the massive gender difference in the incidence of eating disorders — surely as many boys suffer from domineering parents as girls.

Perhaps more realistically, psychoanalytic practitioners have suggested that eating disorders, especially bulimia, can be seen as reactions to personal stress. Support for this is to be found in experiments have shown that when given electric shocks, women eat more than men, especially if they are trying to control their weight through dieting at the time (Cools et al., 1992).

Cognitive theories

From this perspective, it is suggested that individuals with an eating disorder have ‘incorrect beliefs’ about their weight. What starts of as a relatively mild concern with being ‘overweight’ is soon exaggerated, as evidence to the contrary is ignored and only confirming evidence attended to. In a study by Zotter & Crowther (1991), bulimic women kept a detailed diary of their thoughts for two days. Not only did these women have more thoughts about dieting than controls, they also had more distorted thoughts (for example about being overweight). However, because the study is correlational, we cannot be sure whether the thoughts were the cause of the disorder or its consequence. It may be that the distorted beliefs are one of the ways that the disorder influences behaviour. Its cause may be something else, for instance biological.

Behaviourist theories

The behaviourist account of eating disorders emphasis learning (i.e. conditioning). Western society’s preoccupation with and cultural idealisation of thinness, has contributed to the increase in eating disorders, because of the real or imagined rewards of being thin. Research has shown that the most desired female image has progressively become thinner since the 1950s. An increased emphasis on dieting has also been found over the same period. In cultures where these trends have not occurred, the incidence of eating disorders is much less (although they are not absent altogether). It is interesting to note that an increased emphasis on male thinness and dieting in recent years has been accompanied by an increase in the number of eating disorders among males.

Another source of reinforcement is family environment. Research suggests that as many as half of the families with eating disorders have a long history of emphasising thinness, physical appearance and dieting.

However the role played by families is more complex than this. It has been argued by systems theorists that families of people who develop eating disorders are often disturbed to begin with, and the eating disorder is simply a reflection of the larger family pathology. Minuchin (1978) referred to an ‘enmeshed family pattern’ where family members are over-involved with each others’ affairs and there is little room for individual autonomy.

Families of bulimic sufferers seem to have higher than average levels of stress and conflict and poorer problem-solving skills. They tend to support each other less and tend to criticise, reject and compete with each other more. In such families, children often feel isolated emotionally but are, at the same time, deeply enmeshed in the lives of other family members. The influence of peers and media in BN has been investigated in the study by Field et al (1999).

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