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The Psychological Basis of Anorexia Nervosa, Part II - Page 2

© Mark Stuart Ellison

In her forties she engaged in strenuous swimming and running workouts. A desire to excel in sports and academics should be encouraged by parents as part of a wholesome lifestyle and work ethic for their children. For anorexics, however, these activities become self-destructive compulsions to avoid dealing with their insecurities.

Though never a team athlete, my mother was physically hyper-competitive. Toward the end of her life, she told me that if her beach-club friends swam two miles, she had to swim three; if they ran four miles, she had to run five. Years later, I was reminded of this comment when Sean Connery's character in the movie "The Untouchables" advised Elliot Ness (Kevin Costner) how to defeat Al Capone: "If he pulls a knife, you pull a gun. If he sends one of your guys to the hospital, you send one of his to the morgue." That kind of escalating warfare might work well in combat situations, but it is an extremely unhealthy way to live one's personal life.

According to a Freudian-based theory, although resentful of her mother, the anorexic simultaneously feels guilty about surpassing her⁸. Here, the disorder is seen as aging the victim, making her resemble her mother⁹. To use the breast metaphor, the daughter is angry at having depleted her mother, and shows "oral aggression and rage"¹⁰. Chernin describes a tooth-grinding patient who said she wanted to bite and tear¹¹. In this regard, another personal example is worth mentioning: my mother ground her teeth in her sleep and had her dentist make her a special plate to prevent this behavior.

The self-starver dwells on the past and fears the future¹². She strives to completely control her environment. At mealtimes, she arranges her food precisely. She places the bathroom scale in a specific spot¹³. Though starving, she is obsessed with nutrition¹⁴. My mother, for example, swore by Dr. Carlton Fredericks.

The illness has cycles of exacerbation and remission¹⁵, making it more difficult to identify. Therefore, it is critical that the starver get treatment as quickly as possible. Otherwise, her life will be short and sad.

Reclusive and asexual¹⁶, the anorexic lacks humor¹⁷. She tends to think rigidly, in "all or none" terms¹⁸. Her desire for control makes her a tyrant at the table, making excuses not to eat while forcing food on others or criticizing their eating habits. Katherine Byrne, whose daughter had anorexia, writes: "the tyranny may even escalate to the point where the family's personal, social, and working lives are virtually destroyed"¹⁹.

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