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The Origin of Eating Disorders: Out of the Mouths of Babes

» Mental Health Library » Disorders & Conditions » Anorexia Nervosa » Featured Article

By: Florence Rosiello, PhD

Florence Rosiello, PhDHave you ever watched a video of the early relationship between mother and infant? In my profession, there is a lot of research on how mothers and their newborn infants begin what we call the 'first bond.' Some of the behaviors on video are quite beautiful to watch, in that you can see the emotional pairing between the mother and infant as they lock into each other's eyes and attune to each other's reactions. Often, the child smiles in response to the mother's adoration, or becomes agitated when the mother pulls away because of distractions. We study these interactions because it helps us better understand intimacy and emotional development of the child.

It was a surprise to me, when one day a female patient walked into my office and handed me one of these professional infant research videos of herself and her child. The video was a few years old, as her daughter was now two or so years old, but it was a video made by the most esteemed infant researchers in my profession.

My patient was a very depressed woman, who was still controlled by her own mother who treated her quite cruelly. The patient's husband was passive and I think just stayed out of the line of fire between his wife and her mother. All three adults lived in the same house that the mother paid for and kept up.

In therapy, my patient talked about her difficulties growing up under her mother's emotional intrusions and controlling behaviors. Now, as an adult, she had the ability to function fairly well in that she had a career and had gotten married. However, she cried frequently in response to her mother's inability to ever say a kind word to her, or allow her any autonomy in how she thought or felt. My patient experienced her life as always feeling rejecting and isolating because of her mother's verbal aggressions. Still, the sadness of this was continuing because my patient's daughter, at two years old, was clearly suffering far worse under the grandmother's hostilities.

She brought her daughter in to her session and it was shocking to see a two-year-old child who was so thin. The little girl would not eat and instead, mealtimes were hours of screaming and tantrums that left the family exhausted. Meals became shifts where one adult took over for another adult as the day progressed.

I listened as she spoke about their meals and it was clear that the child had complete control, complete attention, and ultimate power over the atmosphere. But that was it. The child had no other control over any part of her day.  All other times, the child was used as a pawn between my patient and her mother, or between the husband and my patient.

This was not the first time I had seen anorexia, but it was certainly the earliest I had experienced it in someone's life. But, is this really an extreme example of an eating disorder? Actually, it's just a very visible example, it's just one that is plainly there in front of you.

How many of us know someone who has an eating disorder? If you think you don't, you're probably wrong. An eating disorder can be overeating, secretly eating, under-eating, not eating as in anorexia, binge eating, eating and purging as in bulimia, or chew and spit which takes in anorexia and bulimia.

Any and all eating disorders develop from childhood, and they all are related to feeling controlled or feeling out of control in reaction to caregivers as we grow up. If you aren't allowed to have a small measure of control as a child, then, you'll try and try to come up with some venue that you can control. Control over what we eat or don't eat, is a failsafe for children who have exhausted all other means of trying to feel a small part of control of their environment.

I told my patient that she had to put food out for her daughter and then let the child go to it when she wanted. No one in the house was to comment, or throw the food out, or interfere in any way. If her daughter didn't eat one day, that was to be allowed. The next day she was to leave food out for her daughter and, again, let her eat when and if she wanted. This was difficult for the family, and while it took a great deal of effort to get the adults to comply, when they eventually did, the daughter ate.

Anorexia doesn't begin in adulthood; it doesn't begin in adolescence. Anorexia begins in early childhood or in infancy even though we don't 'see' it until later in the person's life. The seeds of anorexia are planted in the early infant/mother relationship and grow slowly over the years from repeated attempts of the mother or caregiver to emotionally control the child. The child just waits until it feels strong enough or old enough or desperate enough to eventually show the symptoms of not eating.

It's very important to allow children a small part of control over their environment, and when we do, this helps the child feel as though they matter, as though they are trusted, and as though they have a little responsibility for themselves, both now and in the future, for who they will become as adults.

About the Author...

Florence Rosiello, PhD is author of “Deepening Intimacy in Psychotherapy,” Jason Aronson, Publishers, as well as various published articles on gender and relationships. She has lectured both nationally and internationally. Dr. Rosiello is in private practice in Sedona and Phoenix.

Click here to contact or learn more about Dr. Florence Rosiello

Last Update: 4/26/2011

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