Relationships are not easy. And communication—though essential—does not come with a guarantee that a conversation won't start an emotional roller coaster ride. Love, loss, joy, sorrow, disappointments, insecurities, misunderstandings, anger and forgiveness are all natural ingredients in even the best of relationships. It is therefore understandable why having an eating disorder might be the "perfect," less complicated and more "controlled" substitute for a real-life relationship.    

Make no mistake: I don't know anyone with an eating disorder who is truly happy to have one, or, for that matter, anyone who would consider themselves generally happy and satisfied. Most often, the "choice" of an eating disorder is not preferred and most people who have one agree that the desire is for a relationship with a person, not with food or a body image obsession.   

Though eating disorders may feel less complicated and easier than relating to people and dealing with the nuances of relationships, an eating disorder can never provide what is found in relationships—connection, closeness and comfort. We crave attachment to others in life and we cannot simply will the need for it away or seek fulfillment through a symptom like an eating disorder.    

For this reason, I treat disorders from this perspective: Attachment Theory. It is what I have found to be instrumental in helping patients recover and families heal. 

What is Attachment Theory?

Attachment Theory succinctly states that the quality of the early attachment relationship to a parent/primary caregiver is crucial in determining personality, values, and psychological health, including the development of self-worth and self-esteem. Securely attached children use their caregiver as the foundation and "base" to explore their world, and, as a result, over time, develop a high trust in themselves and others. 

The parent facilitates this by carefully and respectfully tending to the needs of the child; in turn, the child feels safe with the parent. Over time, the safety that the child felt in the relationship with the parent is then integrated into the person; self-worth and self-esteem take hold and continue to develop and ripen in the individual throughout life. Strong self-worth and self-esteem enable the individual to pursue others who emulate these qualities. 

Therefore, a person who has this "infrastructure" is more equipped to take on what life throws at them and is more adeptly oriented toward seeking others with a similar solid infrastructure. Healthy people generally choose healthy partners. 

Attachment patterns that are weak or failing in childhood can leave someone vulnerable to a whole host of self-esteem, self-worth and relationship issues later in life. Eating disorders are attempts to fix externally what is internally vulnerable in an individual. An eating disorder falsely provides self-esteem and self-worth through the individual's rigorous adherence to cultural dictates regarding body size and shape. But in reality, it is an imposter that is filling the void in interpersonal relationships that are so badly needed and wanted in that person's life.  

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