Psychological explanations of anorexia: Psychodynamic

Question 1

Refusal of adult sexuality

Answer 1

• Freud claimed that AN seems to be a melancholia occurrence where sexuality is underdeveloped
• For Freed, eating can be a substitute for sexual expression, so eating disorders could be a way of repressing sexual impulses, it could also express a fear of becoming pregnant

Question 2

Crisp in refusal of adult sexuality

Answer 2

-Crisp developed ideas that AN leads to amenorrhoea, he proposed that this was an attempt by girls to remain prepubertal and so postpone the onset of adulthood, something that Crisp believed they were unable to cope with.

Question 3

Starvation in refusal of adult sexuality

Answer 3

-Starvation in adolescence is also a means of avoiding the development of an adult body. Restricted food intake also stops the development of secondary sexual characteristics (e.g. breasts, enlarged hips) By preventing adulthood, an adolescent can avoid anxieties associated with adulthood and mature sexuality.

Question 4

Asserting control

Answer 4

• Hilde Bruch (1973) claimed that the origins of anorexia are in early childhood. She distinguished between effective parents who respond to their child’s internal needs
• If a child cries because they are anxious, an ineffective parent may feed them, or may comfort them when they are hungry.
• Children of ineffective parents may grow up confused about their internal needs becoming overly reliant of their parents

Question 5

Asserting control through starving in adolescents

Answer 5

• Adolescence increases a desire to establish autonomy, but adolescents often feel they do not own their own body
• To overcome their sense of helplessness they can take excessive control over their bodily shape and size by developing abnormal eating habits

Question 6

Button & Warren

Answer 6

-Found that anoretics often report feeling a lack of control over their lives

Question 7

Steiner et al. (1991)

Answer 7

-Notes that parents of adolescents with anorexia have a tendency to define their child’s physical needs rather than allowing children to define their own.
Bruch (1973) for example found that many of these parents claimed to anticipate their children’s needs rather than ever letting them feel hungry

Question 8

Carter et al. (2006)

Answer 8

• Found that 48% of the 77 female anorectics they studied reported childhood sexual abuse.
• Similarly Feldman & Meyer (2007) found that those who reported childhood sexual abuse were significantly more likely to be anorexic than those who had not suffered abuse.

Question 9

Polivy and Herman (2002)

Answer 9

• Psychodynamic explanations are difficult to test scientifically and are largely based on case studies
• P&H point out that such studies investigating family influences are correlational and carried out after diagnosis
• Therefore is difficult to determine whether dysfunctional fam leads to anorexia or anorexia leads to dysfunctional fam. (causality issue)

Question 10

Psychodynamic evaluation for: Refusal of adult sexuality

Answer 10

Psychodynamic: because eating is a substitute for sexual expression, a denial of adulthood and a denial of maternity
Supported by:
-Carter et al.
-Could be because they want to remain as a child, avoiding adult sexuality and therefore avoiding abuse

Question 11

Psychodynamic evaluation for: Asserting control

Answer 11

Psychodynamic: Ineffective parenting will mean they feed them when they actually need comforting and so will lead to a fixation in the oral/ anal stage.
Supported by:
-Button & Warren; lack of control of their lives
-Steiner; parents defined their physical child’s needs - Bruch found this anticipated children’s hunger

Question 12

Psychodynamic evaluation generally

Answer 12

• Polivy & herman; correlational issues into dysfunctional family relationships and AN
• Difficult to test scientifically; fails to explain increase in anorexia/ cultural differences
• Leads to parent blaming
• Ignores bio factor
• Control explanation- practical application in parenting strategies

Question 13

Minuchin et al. (1978)

Answer 13

• M et al. sees anorexia as a symptoms of dysfunctional family relationships
• Enmeshment: parents are intrusive and over-involved but dismissive of their emotional needs and place constraints on children, preventing them from developing their own identity
• According to Erikson’s psychodynamic theory, establishing identity is a crucial milestone in adolescence
• Conflict with the family: which is avoided or remains unresolved
• Minuchin argues that if adolescents are prevented from asserting themselves in the family, one way of gaining control is through AN
• It can also divert family issues; if parents are splitting up the attention is diverted away from their relationship and onto the child’s well being.

Question 14

However… (Minuchin et al. )

Answer 14

• The evidence for this theory is largely based on observations of clinicians who support it (Bennett)
• Polivy and Herman’s criticism also applies here