Those of us in the clinical field know that eating disorders are complex, and what causes them and how to treat them is ever evolving. Research, for instance, is looking into genetic links, biological roots (including anxiety and depression) and personality traits, which all may play a role. We are also learning that inherent nature, the disposition we pop out of the womb bearing, may predispose some individuals down the road toward developing an eating disorder.
Most psychological theories today agree that many factors—biological, environmental, cultural, and religious—influence the development of children. At the core of healthy development, however, remains the bonding experience with parents or primary caregivers. This is where the Attachment Theory comes in—a model which I believe is one of the most dynamic for treating eating disorders. Understanding the nature and value of parental / caregiver bonds and learning ways to improve them if they are healthy, or repair them if they are not, is essentially what Attachment Theory is all about.
There are two main precepts that form the core of Attachment Theory:
1. The bond between parent/caregiver and child is extremely important.
2. A child needs a secure and stable environment that supports the understanding that separation and loss are inevitable consequences of attachment (more on the connection between loss and eating disorders in a future blog post.)
As stated in the first precept—without healthy bonds in the developmental stages, a person can often seek a connection, or a relationship of sorts, with some other source. This could translate to an unhealthy obsession with celebrities or mythical beings, it could mean an obsession with body image and working out, or it could mean a fixation on food and diet.
If those primary bonds are not secure or have become weakened due to a variety of interpersonal or environmental factors (i.e. divorce, conflict or faulty patterns of communication, or substance abuse in the family) the need for bonding does not simply disappear. Food and body image obsession can be what the person uses as a substitute, which can easily develop into an eating disorder. And, it is easier, and more "controllable" to feel bad about one's body than to feel sad, disengaged, or angry with the people closest to you.
If you have a family member, or you personally are struggling with an eating disorder, then it might be helpful to identify where and if attachment issues have contributed to its development. Ask yourself a few questions, such as:
If you examine some of these questions, it might give you a sense of how attached you are to the members of your family, and how you feel about your own bonding experiences and family connections.
Recovery and family healing is possible and the roots of eating disorders are unique to every individual. What most people with an eating disorder have in common is that relationships to those they love have been deeply impacted, often in earlier, or key developmental times, and certainly during the course of the disorder.