Anorexia

Anorexia can be a complex condition which seems to have elements of obsessive compulsive disorder (OCD); phobic type behaviour; addictive behaviour; and also be bound up with self-esteem issues; self-preservation and attempts at self-autonomy and control.

The more straightforward cases of anorexia involve a young person developing a fear of being fat while simultaneously often having their weight loss positively reinforced ('you look great, have you lost weight'). The individual then takes this behaviour to the extreme in a rigid way, adopting a 'black or white' thinking style.  Essentially, such individuals are caught in a loop that they need help to break out of. May express shame, guilt and embarrassment at their behaviour, which they often keep secret and lie about. In these cases, therapy can often reach desired outcomes in just a handful of sessions.

More complex cases of anorexia involve the presence of secondary gains (the inadvertant desired spin-offs to having a problematic behaviour). This could be the feeling of power and control some people experience; the attention gained from otherwise uninterested others or even as a form of punishment to others towards self or others. Some people gain immense satisfaction from thwarting the attempts of others to change them, whereas others sincerely want to change but still need to be reassured that it will be on their own terms.

Some anorexics idealise the anorexic values and mind set and are proud of their behaviour. They feel superior to others whom they feel lack the necessary will-power and discipline to stop themselves being fat, and as such have no desire to change, as change is seen as threatening the values they live by.

Therapy can assist with working with boosting necessary self-esteem; clarifying and aligning conflicting values; and working with anorexic part to lead it to adopt more constructive behaviours. The amount of sessions needed will depend on the individual and the type of anorexia presented.

© 2011 – Felix Economakis, Heath Mind Body Therapies