Relational Origins of Eating Disorders

Holidays often trigger an increase in eating disorder symptoms. In addition, family members often report feeling more vulnerable to their loved one's behavior, including anger outbursts and changes in control over food and eating. As a result, they often feel like they are walking on eggshells, resulting in a less-than-merry family celebration.

Hopefully, this post can remind family members about negative emotions, particularly anger, for the person with an eating disorder. Anger acts as a defensive and default emotion; it is safer than feeling more vulnerable feelings, like sadness and loss. It also keeps others away as a path of assertion, defiance, and independence. As a result, family members often feel baited and react negatively; they take the proverbial bait, which often escalates the unrest, and creates isolation and disengagement, adding tension to family members already on guard.

Perhaps by understanding the underbelly of emotions for their loved one, greater compassion, or at least not engaging in the battle, can be possible.

It is no mystery that people with eating disorders have difficulty experiencing negative emotions. The anxiety and disgust associated with fullness is a metaphor for not being able to tolerate the "full" range of emotions, the "full" experience of being human. The need to binge is a way to feel comfort from food when human comfort is unavailable, or intimacy in relationships feels threatening.

Most psychological theorists agree that anger is a normal and powerful component of the human psyche. How is it, then, that many patients with eating disorders rarely recall having felt anger their whole lives, and suddenly, anger and volatility appear around food and eating? Or, conversely, that anger is the only emotion they can recall in life, often covering up more vulnerable feelings like sadness, guilt, fear, and hurt. Emotions are part of what it is to be human. Feelings are omnipresent, although they may not be conscious. They do not disappear; eating disorders are physical proof of psychological and emotional truths. Unfortunately, individuals with eating disorders often avoid emotions, find justifications for them, or sometimes have difficulty accepting that they exist.

Emotions do not go away because a person has consciously or unconsciously decided not to feel them. Eating disorders become a way to channel physical manifestations of these complex emotions. They become a container for feelings, a place to put them, and a way to express them. As a result, the eating disorder often begins to feel like it is an entity separate from or a buffer against the internal experience of the person who has it.

Disconnecting the eating disorder from the person's internal experiences often allows her to rationalize it and believe it is solely about wanting to be thin, or, with bingeing, that it is a way to feel comfortable when there are negative emotions. But the symptoms of an eating disorder represent the individual's states of being, thinking, feeling, and relating—they are metaphors. They are a way for the person to subconsciously deal with an internal emotional experience about aspects of her life that are troubling or conflicted.

In this way, eating disorders become a double bind. On the one hand, the person makes himself think that "there is nothing wrong" and wants to be thin or feel comforted. On the other hand, the disorder functions as the only way he has to deal with his emotions. This double bind is one of the reasons eating disorders are so difficult to treat.

Of course, the complete causes of any eating disorder are complex, and no single explanation is likely to be uncovered. For example, we know that the desire to be thin or the love of food for those who compulsively or binge eat are not at the root of causing eating disorders, even though that is what the person with the disorder starts out believing. We also know that predispositions toward anxiety and depression and personality play a role and that some individuals may be more predisposed than others to develop an eating disorder. But, focussing only on those factors limits our ability to examine the relational underpinnings contributing to causation. In short, the push toward an overly simplistic view of how these difficulties evolve is seductive.

Family gatherings and celebrations, particularly festive ones, are stressful, at best, for eating disorder sufferers; relational conflicts abound and are often palpable. Some argue that conflicts come as a result of the disorder. Indeed, relational issues are exacerbated by the eating disorder. Chances are, however, that the relationship issues preceded the development of the illness and become compounded throughout the "life" of it.
During this holiday season, keep in mind that, first and foremost, eating disorders are disorders of relationships with others and with oneself. We see long-term healing for the person with the illness and their family by healing these critical relationships.

Eating Disorders Essential Reads

When an Eating Disorder Isn't Just About Body Image

The Quiet Radicalism of Looking After Your Body

Aside from our physical health, the strength of our relationships sustains us throughout our lives. When our ability to relate to others and ourselves is damaged, it casts a vast shadow that may eventually become an eating disorder or an assortment of other psychological problems.

Your family member with an eating disorder is a relational being; holidays are incredibly triggering. While there is generally an excess of food available, the food is not the real threat to the sufferer; instead, the relational stressors and feelings of shame, guilt, hurt, and competitiveness are a source. Keeping this perspective can offset or soften any possible battle or conflict that might otherwise emerge; not taking the bait, although difficult sometimes, can limit reactivity. Compassion and empathy all around are, indeed, what constitutes the holiday spirit. Keep in mind that if everything were ok for the sufferer, there would likely be no eating disorder.

When in doubt, it is ok to walk away; you cannot control the symptoms. Also, for a short time, disengagement allows the sufferer to reflect upon feelings and the consequences of their symptoms and behavior.