Emotional Health · Health

Not From Thin Air: The Emergence of Eating Disorders

fordCecilia Ford, who has been a psychologist in private practice in New York City since 1987, has addressed emotional issues for Women’s Voices in many articles over the years.

 

UntitledPhoto by Flickr user. (Creative Commons License)

I was born in the mid-1950s, and I experienced the explosion of the eating disorders epidemic as it unfolded 20 years later.  I remember when I was still in middle school hearing about a senior, rumored to be a model, who had a secret formula for staying thin: she threw up. When I was in high school, a classmate started dieting and couldn’t stop. No one, including the expensive expert in adolescent psychiatry her parents consulted, recognized what was happening. Soon magazine articles appeared about the “mysterious dieting disease” that was cropping up.

When I began my dissertation research on this subject in 1978, it was the first thesis ever written about this in the department of clinical psychology. Research on the subject was so hard to come by that I used the approach of focusing on a single case history. The scant literature available mostly explained anorexia as an expression of a girl’s wish to deny her sexuality by trying to look like a young boy. At the same time, though, psychodynamic psychology was undergoing a shift from the Freudian emphasis on sexuality and the Oedipus complex to looking at disorders of narcissism and the self, led by Chicago analyst Heinz Kohut’s “self psychology.” As I thought about patients with these issues, whose attention was narrowed to a single-minded obsession with their bodies and their diets, it seemed to me that this was more a problem in the realm of self-regulation and self-esteem.

Kohut’s work was largely theoretical and he had not presented a case like this, but I wrote to him and asked him if he thought eating disorders were due to “self-psychological” pathology. He wrote back with an emphatic yes, and though he died in 1981, just as his work was gaining widespread acceptance, it is now recognized that narcissism, identity, and the vicissitudes of one’s sense of self are the key issues of our time. Freud’s patients, mostly women who suffered from “hysterical disorders” that he traced to sexual repression and its attendant conflicts, were products of the Victorian era. One hundred years later, at the end of the 20th century, cultural conditions in the West, at least, had changed drastically, and so had mental health symptoms.

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  • Micki LeCronier June 30, 2016 at 9:37 am

    This reads like a history of eating disorders. Thank you SO MUCH for addressing this crisis.

    Reply