The Psychological Basis of Anorexia Nervosa, Part II

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Jul 13, 1999

An earlier version of this article contained incorrect attributions. On September 3, 1999 the relevant endnotes and text were revised accordingly.

This article attempts to explain some of the family dynamics of anorexia nervosa. It is not a diagnostic tool or recommendation of any particular treatment modality. If you suspect that you or a loved one is suffering from this disorder, seek advice from a physician or other qualfied health-care practitioner.

Family Dynamics

Palazzoli believes that anorexia is more than an illness affecting an individual: it is a symptom of a sick family¹. She notes that "the conspicuous figure in the home of anorexic girls is the mother; the father is usually an emotional absentee, generally overshadowed, and secretly or openly belittled by his wife"². Similarly, a study by Dr. Margo Maine found that mothers of anorexics tend to be overbearing and overprotective, while fathers are physically and emotionally absent³.

Intra-familial communication is usually poor. Dr. Hilde Bruch notes that "there is a tendency in anorexic families for each member to speak, not for him or herself, but in the name of another member, always modifying, correcting, or invalidating what the other person has said"⁴.

My mother's parents were perfect examples of these theories. My grandmother was physically strong and had a personality to match. She was always slaving away in the kitchen. My grandfather, who immigrated to this country from Poland around 1920, worked 15-hour days at his jewelry business in lower Manhattan and had little time for his family. I remember him as a sweet old man who enjoyed telling fascinating World War I stories. He was constantly interrupted or cut short by my grandmother who bitterly complained that she was tired of hearing them and that he should stop acting like a "greenhorn."

Parents of anorexics either do not listen much to their daughters or smother them with attention⁵. In either case, independent thought is stifled⁶.

This atmosphere leads to a lack of self-confidence. According to Bruch, the anorexic, in her quest for perfection, fueled by a desire to please her parents, will often excel in studies and athletics⁷. My mother once confided to me that she would often try to show my grandmother her high school honor cards, but grandma never found time to look at them. In cleaning out some drawers, I recently found three, carefully preserved from the World War II era. Mom had a 95 average in English, Spanish 2, and Commercial Law.