December 31, 2015

The Purpose of the Eating Disorder by Ellie Herman, MA, LPC, NCC

Death_to_stock_photography_farm_9 I recently spoke with a dad as he was wrestling with understanding the crippling nature of his daughter’s eating disorder.

He stated, “I know that this is not just about body image, but I just can’t seem to figure ‘it’ out. It’s complicated!”

Agreed, eating disorders are complex!

Rather than seeing an eating disorder merely as a disease that must be eradicated, it behooves us to recognize why the eating disorder came about in the first place.

Eating disorders don’t just appear, they develop, with great purpose—even if unconscious to the sufferer. \

You may ask, “What do you mean? The eating disorder has a purpose!?” Yes, absolutely. This complex illness develops brilliantly over time, beginning as a functional coping mechanism for the individual.

While the illness is debilitating mentally, emotionally and physically in the long run, understanding the function of the eating disorder can help those who struggle with them (and their family!) replace this function with a sustainable, healthier coping mechanism.

I remember a patient of mine feeling surprised when she recognized that her eating disorder’s function was a subtle form of communication. Her dad was verbally harsh towards her, and the daughter would not respond or yell back. Instead, she would restrict her food intake. She discovered later that the purpose of this behavior was to communicate her anger to her father without hurting him as well as exerting her independence from him.  Restricting food meant he had no control over her.

For my patient, refusing to eat communicated: “I don’t need you. I don’t need anything…not even food to survive.  I am totally independent!” Refusing to eat paradoxically communicated a sense of need: “Notice my symptoms. Notice me!”

I suggest the use of the following as a guide to identify possible functions of the eating disorder:
  • A substitute relationship
  • “Good girl” rebellion
  • An inability to express internal states
  • A way to shout “Help!”
  • Fear of being an adult
  • A way of staying connected to or separating from relationships
  • Creating an identity
  • A way to provide control/predictability
  • An attempt towards perfectionism
  • Emotional numbing
  • Punishing self
  • A way of coping
Understanding the function behind the eating disorder can enhance recovery by:
  • Noticing the function of eating disorder behaviors in the aid for survival/coping
  • Increasing self-compassion: No one chooses this illness!
  • Increasing awareness surrounding the triggers for the development of the illness: A helpful tool for relapse prevention!
  • Growing in understanding through increased awareness
  • Connecting the individual with their true values, desires and needs
  • Replacing the function of the eating disorder with healthier coping mechanisms
Choosing to view the eating disorder from a lens of functionality can take great courage! The beneficial outcome may lead the individual and family toward a greater understanding and compassion for the individual as well as the eating disorder itself, aiding in the process of recovery and relapse prevention.

Ellie Herman, MA, LPC, NCC, Alumni Coordinator, shares her perspective on enhancing recovery by understanding the function behind the eating disorder.
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