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There are some underlying psychological reasons for eating disorders.
By Sandra E. Cohen, PhD — Written on May 13, 2019
Have you caught yourself wondering, "Do I have an eating disorder?"
Whether it's Anorexia, Bulimia, or Binge Eating, the signs of these psychological disorders vary.
And, even more importantly, these disorders have more to do with emotional trauma than food.
Your life may be focused on food. Yet, believe it or not, the cause of eating disorders is not always about food.
Yes, they are about hunger — or the belief that you’re not supposed to be hungry.
But, the problem is with your emotional hunger, not your physical one.
Living a healthy life is not always about your physical health — it's also about your emotional health.
Hunger is a complicated thing. Maybe you feel that you're not supposed to be hungry.
Yet, sometimes, you can’t get enough, even when you're trying to live a healthy lifestyle.
Or, you’ve shut off your desire for food completely and don’t feel hungry at all. Or you won’t let yourself.
Hunger will always exist. The various symptoms of eating disorders are your way of struggling with the emotional hunger that, for particular reasons in your childhood history, weren’t met in the way they needed to be.
Now, you battle with the symptoms. But you might not know exactly what your eating disorder is really about.
But, before you can start figuring out the best eating disorder treatment, you need to pay attention to the obvious symptoms before figuring out what these symptoms are trying to express.
Here are 4 types of eating disorders and their symptoms (you may have several or a combination of them).
1. Anorexia Nervosa
- You’re considerably underweight.
- Have very restricted eating patterns.
- Intense fear of gaining weight.
- Persistent behaviors to avoid gaining weight.
- A distorted body image, including not seeing yourself as underweight.
2. Bulimia
- You have recurrent episodes of binge eating, with a feeling of lack of control.
- Purging behaviors to prevent gaining weight, usually vomiting or laxatives.
- Self-Esteem overly influenced by your body shape and weight.
- Fear gaining weight, despite having what’s considered a normal weight.
3. Binge Eating Disorder
- You eat large amounts of foods rapidly, in secret
- Feel a lack of control during your episodes of binge eating
- Have feelings of shame, disgust or guilt even when you just think of binging
- Don’t purge, even though you feel guilty and uncomfortably full
4. Restrictive Eating
- You avoid or restrict eating and don’t eat sufficient calories
- Have eating habits that interfere with normal social functions or eating out
- You’ve lost a lot of weight or aren’t properly developed for your age
- You have nutrient deficiencies and you might depend on supplements
In every type of eating problem, your image of how you look is never good enough and you struggle with self-esteem.
All of these are serious symptoms but they have nothing to do with what is underlying them. Knowing what’s motivating your symptoms is where you’ll get help and healing.
So, how do you begin to think about what your eating disorder is really about?
It's not so obvious but eating disorders can also happen due to psychological reasons. They are about emotional hunger that you can't allow. And the reasons are complex and individual.
You have your own childhood history, early experiences, and relationships.
Likely, you experienced trauma. Not having anyone to trust or rely on, neglect and deprivation, and/or a belief that what you wanted was too much of a burden.
Eating disorders are about feelings and internal conflicts. These are individual and related specifically to you. Yet, there are some fairly universal truths.
You take care of yourself, never count on anyone, and hate yourself for wanting anything.
You’re certain that if you need someone, that person will go away and leave you. That you are too much. You tell yourself to want nothing — that’s safer.
And you hate the little person still living inside you who is hungry for love.
That’s the key to what eating disorders are really about: emotional hunger that you're trying to get rid of.
This is a hunger that you’ve had since you were a small child. You’ve tried to tell yourself you don’t or can’t have them. And, now you struggle with eating.
You don’t have to live this way. The emotional hunger you’ve had to reject can be worked out — and so will your problems with eating.
But, first, what are emotional hungers? You've probably heard these statements before:
- "Craving love."
- "Feeling starved for affection."
- "Ravenous for attention."
These are some of the forms emotional hunger takes (and you can probably think of others). Now, they’re expressed through how you relate to food.
Yes, food is an essential part of life (even if you don’t want it to be.) But, emotional food is even more important than the literal food you eat.
Emotional food is love, affection, attention, having your needs listened to, respect for your feelings, and being recognized for your talents and the separate person you are.
If your emotional hungers were not fed properly as a child, this affects all future relationships, particularly when it comes to feelings about love and need.
There are 4 ways your emotional hunger manifests itself and turn into an eating disorder.
1. Childhood trauma
Every child needs to be held, greeted with smiles, and the feeling that they are the best gift in the world. Every child needs to feel heard, understood, and accepted.
No child can tolerate criticism, being made to feel "bad", ashamed, obligated, or unheard. Every child needs someone they can turn to. Every child needs love.
When you don’t get those very basic needs met, you turn away from needing them. You tell yourself you can’t expect it.
"Who cares? I don’t need anything anyway."
Not infrequently, these struggles with emotional need are played out with food.
You go on very little and tell yourself that’s all you really need. You’re not even hungry for more. And you tightly control what you take in. That’s a big part of anorexia.
Or, in bulimia or binging, you’re starving, lonely, yet don’t feel you have any option but to feed yourself.
Then the shame takes over because you "shouldn’t need so much".
When there’s been no one in childhood to count on to give you the love or emotional understanding you need, you don’t trust there’s anyone to really count on now.
So, what else can you do, but try to have no needs? Or to hide them?
2. Rejecting your emotional needs
Needing anything from anyone wasn’t a good option as a child. And, it certainly doesn’t feel like a good option now. Why need something when you’re certain of rejection, disappointment or hurt?
It seems like it’s always been that way. So, you’ve had to reject your emotional needs. At least when it comes to other people.
You may even pride yourself on being quite tough. You’ve learned to take care of yourself.
People might rely on you, but you keep your own needs well buried, and you’ve learned not to expect much from anyone.
Maybe you don’t even let yourself know you want anything. You might believe it’s a sign of independence to push your emotional needs aside.
Or, you think it’s a terrible weakness to have needs. It’s not. Needs are normal.
But you’ve lived with trauma, abuse, unreliable people who’ve hurt you. Or people that needed you more than you could ever consider needing them.
Maybe a harsh voice inside calls you “a baby” if you feel a need at all.
3. Hating the child living inside you
There’s a little child living inside you — the child you once were. And, that child self carries all the feelings and memories of early trauma you’ve tried to put aside.
If you feel it’s a weakness to need something or anything from anybody or that it makes you a "baby", you probably hate that child self.
That self-hate carries over from the ways you took in the neglect or abuse from your childhood and what you thought it meant.
You felt hated. Bad. All wrong. Or that something was wrong with you. You blamed yourself for your needs. And you shut them down.
That’s a big part of what eating disorders are really about. Not needing and not feeling.
And it leaves you in a terrible dilemma, which you express in your struggles with food.
You hate yourself (that little child self) for having emotional needs or wanting to be loved at all. So, you try not to feel.
4. You’ve tried your best not to feel
You have a lot of feelings you’ve had to bury. Anger, loneliness, hunger, sadness, longing. But, you’ve numbed them.
And, these are the feelings that live inside your eating problems, along with symptoms of depression and anxiety.
Trying not to feel may have been your only option.
When you have to control your child self so they don't want anything, controlling any feelings you have goes right along with it.
If you feel or need, what do you do if you’ve never had anywhere to turn? You’re in a vicious cycle and you probably don’t see a way out.
There is a way out. You don’t have to continue this cycle of rejecting your emotional needs, hating your child self, or numbing your feelings with food or controlling food.
The best option is psychotherapy, one that takes seriously your traumatic history of deprivation and distrust.
How do you work it all out?
Don’t give up hope. You can work out what your eating disorder is really about in all the ways it has to personally do with you.
You can learn how be healthy, both physically and emotionally.
And, the best way to do that is in psychotherapy with a therapist you can grow to trust and rely on. That isn’t easy when you’ve felt it was best to rely on no one.
Choose a therapist that understands how hard it is for you to trust and need. A therapist that specializes in eating problems.
And, most importantly, understands how they relate to trauma, deprivation, numbed feelings, and unmet emotional hungers.
A therapist who talks to you about your worries in a sensitive and non-judgmental way is essential.
You already hate your child self. You and that child self need encouragement to find and see that there’s a safe place to talk, feel, and need.
The right kind of psychotherapy will get to the root of what your eating disorder is really about.
How does therapy do this? By focusing on your feelings and your history. Not on food, diet, or the "realities" of eating.
Good therapy is a place to talk and work out what is going on under the surface.
How your early trauma plays out with food. Hating your child self, why this is so, and all the ways and reasons that you’ve had no choice but reject your emotional needs.
This can all be figured out. You don’t have to live this way. There is a place for understanding. Things can change.
Dr. Sandra Cohen is a Los Angeles -ased psychologist and psychoanalyst. She works with people of all ages struggling with eating disorders. Psychotherapy can help you get to what your eating disorder is really about. You don’t have to live this way.
This article was originally published at Sandra E. Cohen, Ph.D's Moving Forward Blog. Reprinted with permission from the author.