It is no secret that a number of women and men struggling with eating disorders have suffered sexual abuse or other tragedies earlier in life. Not everyone with an eating disorder has experienced significant trauma, and traumatic events can contribute to an entire spectrum of problems -- not just eating disorders. But in cases in which a link may exist, how might the trauma contribute to eating disorder development? Here are some possibilities.
Eating Disorders Give Abuse Survivors the Sense of Control
Trauma is an ideal foundation for an eating disorder because trauma survivors have a high need to establish a strong sense of control.
In any trauma, much of the anxiety that arises comes from the survivor's inability to control the situation. Whether it is a car accident, the divorce of parents, or the death of a friend, trauma is a reminder to the survivor that she can be powerless.
A natural reaction is to find new ways to enhance the sense of control. And since our culture has given great attention to body image, and equating thinness with self-control, food and diet represent areas in which the trauma survivor can receive near-instant feedback. A negative comment about her body -- which can be as close as the next commercial -- tells her that she is not in control. Fear of being powerless again is a strong motivator.
Abuse and Eating Disorders Mix Good and Bad
Another powerful and confusing effect in many forms of abuse is the merging of an event that is terrifying with circumstances that would, in other contexts, be physically or emotionally pleasurable.
Sexual abuse survivors, for example, often report great conflict as they think about these events. A young woman may remember her uncle primarily as an abuser, with effects ranging from depression to horrible flashbacks. But if her immediate family rarely gave her affection, her uncle's seduction may represent the most affectionate attention she ever received. She comes to associate what is normally desirable (affection) with what is always horrifying and wrong (sexual abuse).
The phenomenon of merging good and bad shows itself powerfully in eating disorders. The person with anorexia realizes a great deal of satisfaction from harming her body through starvation. She feels pride -- a sense that she has accomplished something others cannot. For the person with bulimia, pleasure and pain occur in a very short span of time. The binge soothes powerful longings before shame and self-hatred raise the desire to purge to unbearable levels.
Treating Eating Disorders After Abuse
Recognizing and dealing with trauma can be a component for some who enter treatment for treatment for eating disorders. Treatment involves increasing the cognitive awareness of what these persons are able to control and what they aren't. It may also involve understanding and reworking connections between pain, pleasure and ambivalent emotional reactions that got associated in childhood and continue to influence the person in his or her current life.
Back to What Causes Eating Disorders
Source:
Allender D. The Wounded Heart: Hope for Adult Victims of Childhood Sexual Abuse. Colorado Springs: NavPress; 1990.
