Psychoanalytic Approach to Eating Disorders

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NHS states that the average GP will have one to two anorexic patients in their practice. However, this is probably more, as eating disorders are such a secret, and many people do not come forth to be treated. Anorexia is a mental eating disorder, characterised by; refusal to maintain normal weight for ones age and height, (more than 15 percent below predicted weight.) intense fear of becoming obese, which doesn’t diminish even with weight loss, body image distortion and absence of at least three consecutive menstrual cycles expected to occur (in women sufferes) For many years psychoanalytic theorists have been interested in the distal influences on anorexia nervosa an extremely common eating disorder. It has been argued that the psychoanalytic approach has made great contribution to understanding mental disorders such as the later, not just through theories, but also through therapies and case studies. This essay will touch upon the aforementioned topics. It became clear that although the psychoanalytic theory has, and forever will make massive contribution in our understanding of mental disorder, there are many fundamental flaws of the theory. There are many theories under the broad umbrella of psychoanalysis, this essay will begin discussing the personality theories such as the ‘object relations theory’; this psychoanalytic theory describes the process of developing the mind as one grows in relation to others in the environment, primarily the family and especially between mother and child. Palazzoli proposed an object relations theory of the mental disorder anorexia nervosa. Palazzoli formulated that the anorexic patient identifies her body with her ‘bad’ internalized mother, who has not been integrated with her psyche. The body is internalised as a maternal object, therefore when changes begin at puberty, the child sees this as a direct attack from the internalised mother. The patient’s response is to fight back against the internalised mother by controlling her body through controlling food intake and exercising. Therefore the psychoanalytic approach proves to have contributed to our understanding mental disorder greatly. However, one weakness of this theory would be that the theory is highly theoretical, therefore all data is based on a concept that cannot be verified objectively. On the other hand, Art therapy has qualities which are integrated with the object relations theory allowing the patient to express unconscious internal material without activating defence mechanisms, proving the psychoanalytic theory to be key in our understanding of mental disorder. Another personality theory that comes under psychoanalysis would be Freud’s theory of psychosexual development. Freud expressed that if there was any problem at any of the stages of development, stressful experiences would arise in adult life through regression. The link from this theory to anorexia nervosa or bulimia nervosa would be fixation in the phallic stage of development (3-6), Males have the capacity to develop the Oedipus complex, while females, the Electra complex. At this stage children begin to differentiate between male and females through genital awareness. Males are intrigued by their mothers and are jealous of their father’s intrusion, resulting in castration anxiety. In the case of the female, she is attracted to her father, and realises that she doesn’t have a penis, this leads to penis envy and the wish to be a boy, she too internalises these feelings. However Freud argued that fixation for both male and female children can occur at this point through displacement of their ‘feelings’ onto their bodies thus resulting in vanity, preoccupation with body shape, and anorexia. Freud (1889/ 1954) likened eating disorders to " a melancholia occurring when sexuality has been underdeveloped…Loss of appetite is in sexual terms loss of libido". Ironically Freud’s daughter suffered from anorexia. While this psychoanalytical...
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