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Before adolescence, the life of an anorexic-to-be seems pretty smooth. These people are often described as “model children”: compliant, obedient, and well-behaved. They carry out their duties at home cheerfully and willingly. At school, they are good students who are devoted to their work and usually get good grades.
In short, these people seem happy with their role as children. The demands made on them are easily met. They succeed at a level that fits their position in life, and thus feel good about themselves.
Come adolescence, however, the child is expected to function in new ways. Now an adolescent’s identity derives more from relating to her peer group than from simply meeting the expectations of adults. An adolescent who has trouble with these new demands begins to feel inadequate, although she may not be able to put her feelings into words. Even the rewards for “good behavior” that the adolescent might once have expected from adults are now less tangible and less frequent. A twelve-year-old doesn’t get a gold star for brushing her teeth every night; such behavior is now expected of her.
Feelings of inadequacy sometimes relate to the bodily changes puberty, as the hormonal onslaught triggers a flood of new emotions. The onset of menstruation forces a girl to think about herself as a maturing woman, a sexual being. For some, the sudden awareness of sexuality may be more than they can bear. Many of my patients appear to weather the storm of puberty for some time, accepting menstruation as a natural part of their development. Often, however, it turns out that they have just been putting up a brave front. Deep down, they are terrified of what’s happening to their bodies.
The fragile personalities these girls develop can be shattered by some devastating event. Such events take many forms, but they usually relate to a loss or a sense of failure.
For example, some anorexics have suffered the death of a parent or a particularly beloved grandparent. Sometimes the loss involves the breakup of the first (and most intense) romance. Some patients, about to enter college, are frightened by the thought of leaving the family or by the pressure to succeed. Divorce, relocation, marriage of a sibling, illness-any of these can shake her sense of security, challenge her ability to meet the expectations placed on her, and rob her of self-esteem.
Of course, the same can be said of anyone. The potential anorexic, however, lacks the inner strength necessary to handle loss, rejection, or change. She has aged, but she has not grown up. She has spent so much emotional energy pleasing others that she has none left to invest in understanding her own feelings. She has never learned to recognize the signals coming from her growing body, her brain, and, for want of a more scientific term, her soul.
Even if she does recognize these signals, she can’t respond to them. Instead she has a vague sense that “something is wrong with me.” She begins to mistrust not just herself but everyone around her. In such a state she can’t make new friends or keep old friendships going. She withdraws further into herself.
Soon her insecurity, lack of trust, and inability to recognize feelings affect her perception. She can’t even see what her own body looks like with any degree of accuracy.
Eventually, though, a kind of transformation takes place in her thinking. She gropes for an anchor to keep her from drifting into an emotional whirlpool. The notion that “there is something wrong with me” becomes “there is something wrong with my body-it’s too fat.”
*20/35/5*
