Bulemia Nervosa

.. owever, this theory is quite controversial. Recently, familial contributions to the etiology and course of bulimia nervosa have been accounted for. Often, women who overeat or undereat have been cited to have had a childhood background of profound deprivation and emotional deficit. Such individuals learned in their families that they were not wanted, worthwhile, or valued. They did not learn to ask for help or to expect their needs to be met.

They did not learn healthy ways to handle conflict, difficult emotions, or disappointments. Neither did they learn that the solution to loneliness is to seek friendship. Such individuals may have been severely abused in their homes and have no knowledge of awareness of the abuse (Katherine, 1991, p. 52). In these families there is a tension between unmet individual needs and equally or more powerful family system needs that require individual self-sacrifice’ (Chassler, 1998, p.400).

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This type of woman may have been screamed at as a child when she expressed a need. She has become accustomed to fear. With such a background, the food addict is a person who expects to only have minimum needs met. She has learned that her needs will probably go unmet, even if she asks, and she adapts. The needs for affection, trust, safety, and honesty do not go away, but they move underground and surface in the adaptive response of food difficulties. Most people who suffer from eating disorders have severe, long-term deprivation in regard to their emotional needs.

As mentioned previously, bulimia began to manifest itself in the 1970’s concurrent with the women’s movement. As the female role began to change, confusion set in and an increasing obsession with thinness began to invade society. Girls who are severely insecure or full of self-doubt take refuge society’s demand of thinness as way of proving themselves to be deserving of respect. Leighton Whitaker (1989) discusses the specific characteristics of the college environment and lifestyle that contribute to the widespread and increasing problem of female students with food. The college environment is similar to a family.

It may bring demands, attitudes, support systems or lack of support. There are constant concerns with finances, transitions, the physical structure and atmosphere, as well as relationships with faculty, staff, and the other students. The academic studies themselves may be unfamiliar and difficult at times. Student support services may not contribute any help to the student who has eating difficulties (Whitaker, 1989, p. 117). Going to college is an important transition for most students, and a sizable number of freshmen experience leaving home for the first college semester as traumatic.

The persistent, unrecognized dependency on parents and their lack of experience in making decisions on their own causes problems of functioning in the less-controlled college environment. Living in a dorm or apartment with other college individuals means getting along with others, withstanding the normal comings and goings as students leave school, and such a situation carries within it all the dynamics that contribute to problem eating. These interpersonal situations impact women more than men because women have greater needs for relationships and have been socialized to be care-givers, always sensitive to the needs of others (Whitaker, 1989, p. 118). For certain vulnerable students who function rather rigidly, the sudden availability of new choices and options may feel unbearable and unmanageable. This type of student may not trust the sorority big sisters or resident hall RA’s and turn their negative feelings upon themselves.

Students from small communities may feel lost on campus. Women who have used and learned to abuse food since the crib and highchair days learn to misread their bodies’ signals and without therapy or education easily reach for food as a substitute for love, rather than making new friends (Whitaker, 1989, p. 119). In a larger sense, the young female student has not observed others handle stress in a mature way, so she experiences loss of self-esteem and automatically seeks a safe emotional outlet which has brought her relief in the past – food. Many college women who seek counseling for assistance with eating disorders have problems in their relationships with their mothers. These students experience dependency conflicts, a diminished sense of individuality, beliefs about personal ineffectiveness, qualities of distrust and immaturity, and an inability to distinguish between emotion and hunger Friedlander & Siegel, 1990, p.

77). The difficulty in determining whether she is hungry or lonely, hungry or tired, hungry or afraid, greatly increases the chance that such a student will eat instead of meeting the emotional need in a healthier way. The young female student with eating problems feels worthless and inadequate. She has a poor sense of personal control. She may be hypersensitive and feel merged with others.

She is unable to regulate herself and may be grandiose, exhibitionistic, even tyrannical. This type of student likely comes from a dysfunctional background, one in which individual differentiation is not valued or promoted. It is unfortunate that the eating disorder serves to further tie her in an unhealthy way to her parents, who in turn, do not wish to let her grow into personal independence. Clearly, there is no one set reason for girls’ and adolescents’ difficulties with eating disorders. They are many and complex. Some of the roots are in society itself – a society that teaches women to acquiesce to pressures and intimidation rather than to fight or change their circumstances and a society that teaches women that they are supposed to look a certain way in order to be acceptable. In addition, the relationship between the family of origin and the resulting eating disordered behavior seems to be great.

Families with addictions, punitive behavior, anger, hostility, blurred identities, and lack of support for growth and individuation create young women who are unable to cope with the stresses of college living without their maladaptive eating. They do not know how to handle the difficulties of relationships, seeking support, and handling the normal changes of life without reverting to the learned childhood behavior of seeking solace in food. The problem is multifaceted and further aggravated by the isolation of young women, who may not understand the nature of their difficulty. Social Issues.

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