Restrict, binge, purge & repeat

(So I randomly found my old research paper and thought I would share 🙂

Personal Essay

I still remember the very first time I restricted my food. I was eight years old and I was on a summer swim team in Vegas. I remember just staring at myself in the mirror in my swimsuit and trying to push my hands on my stomach to flatten it and kept grabbing at all the fat I thought I saw. My negative-anxiety driven mind made the decision that night that I would not eat so in the morning at my swim meet I would look thinner. So that night, I didn’t eat, and the next morning my eight-year-old self would swear to you that I did in fact look thinner. When this thought flew across my anxiety driven brain, a surge of fake confidence abounded through. That’s when my battle with anorexia and bulimia began. 

I really didn’t understand how big of an impact my eating disorder or “ED” would have or could do until my eighth grade year. Until that point I used my “ED” to cope with emotional abuse that happened when I was young and some traumatic experiences that happened to me during middle school. Every time I had any negative feelings or when my anxiety was too hard to manage, I would act on eating disorder behaviors. Any time I felt disgusting, worthless, unlovable, I acted on my eating disorder (I didn’t notice this cycle until I went to treatment).  It seemed that because I was never taught on how to deal with any of my negative emotions, if I did know how to regulate my emotions, I would have had the ability to manage my emotions and others (Mayer, 2001). But the only way my little brain learned how to cope was through a form of any self-harm such as an ED, cutting, obsessive thoughts, etc. Throughout middle school, this is how I survived. Then came high school. 

A vicious cycle began all throughout my freshman to junior year. I would restrict my food for days, then binge, purge, and repeat. My eating disorder was literally all I thought about 24/7. My mind became a prison. All I could think or obsess about was negative thoughts, the way I looked and how to self-harm.  I remember getting anxiety the night before the next day because I didn’t know how I was going to eat. I would map out how I would go to the bathroom before each class and how to skip any amount of food that would be thrown my way. I felt like someone was constantly following me and shouting, “you’re disgusting. Shut your mouth. You’re worthless. Please that person. You’re fat. No one will ever love you.” My parents saw how bad it was becoming and in my freshman year put me in therapy. I didn’t like it and kept telling them I had it under control. I became, unwillingly, manipulative. 

The summer before my senior year I gained over fifteen pounds and one of the biggest panic attacks of my life ensued. I was purging 4-5 times a day, running over 4 miles, having rapid obsessive thoughts, etc.  My parents put me into a more intense treatment center in Las Vegas and then later I was sent to another treatment center in Utah. There I was diagnosed with an ED, Obsessive Compulsive disorder (OCD) and a general anxiety disorder. 

When I was given a couple of different diagnoses, I have to admit, I felt relief. I felt relief knowing that I wasn’t “stupid” for dealing with my emotions this way and felt happy that I could finally live a life that could manage these thoughts in a healthy way. My eating disorder became a “friend” who gave me “control” in this life with the bad things that happened to me and the chaos that ensued. It numbed me from the negative emotions I felt 24/7. The world had taught me, at the young age of eight, that if I could control my appearance, I would also be in control of my emotions. But the truth is, my body became riddled with uncontrollable anxiety, obsessive thoughts, shame, hatred and fear. I was not in control, I was a puppet.  I often wonder what would’ve been if I had been taught healthy coping skills to deal with these emotions if I would’ve ever developed an eating disorder in the first place. 

Background

So what is an eating disorder? It is actually something important to know about since in the United States alone, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life, including anorexia nervosa, bulimia nervosa, binge eating disorder, or EDNOS (Wade, Keski-Rahkonen, & Hudson, 2011). The recurrent binge-and-purge cycles of bulimia can affect the entire digestive system and can lead to electrolyte and chemical imbalances in the body that affect the heart and other major organ functions. Eating disorders affect women primarily; the ratio of women to men among those cases of anorexia nervosa and bulimia sufferers is 10:1 and primarily affects adolescents from the ages of 15-25 years (Eating Disorders, 200). By age 6, girls especially start to express concerns about their own weight or shape. 40-60% of elementary school girls (ages 6-12) are concerned about their weight or about becoming too fat. This concern endures through life (Smolak, 2011).  But how and why do these concerns even start?

It seems to be that those who don’t know how to handle or regulate any negative feeling or thought create their own ways of coping. This emotional dysregulation (the inability to cope with emotions in a healthy way) could help in the development of an eating disorder. 

But is it even possible for it to be linked? It has been theorized that disordered eating is used to regulate affect (Cooper, Wells, & Todd, 2004) specifically through the inhibition of emotional experience. In a study done by Catanzaro and Mearns (1990), they used a 30-item self-report scale which measured an individual’s sense of competence in using different coping skills to help regulate their negative mood. In this they found that those with anorexia nervosa were more associated with decreased emotional awareness and those diagnosed with bulimia nervosa were associated with poor emotional regulation. Similar to my experience with my eating disorders, whenever I acted on my anorexic tendencies it’s because I did not want to be aware of the emotions at hand and to cope even more, I acted on my bulimic behaviors to numb out the pain. 

This is a problem because if people do not know how to cope with negative emotions in a healthy way, they could live a life riddled with anxiety, fear, the inability to actually function and could possibly die from this type of disorder. In a study done by Waller, Corstorphine and Mountford (2007), they presented an analysis of the emotional regulation of people with an ED who have suffered from emotional abuse. They found that those with ED’s that suffered from this type of childhood emotional abuse used impulsive behaviors to regulate affect. In it they saw that the reason why these individuals acted on such impulsive behaviors, such as bulimia, was because they wanted to block the emotion. And they almost always block this emotion before it reaches consciousness.  If one cannot face their emotions or connect to them, they will explode in other harmful ways such as disordered eating.

Research Question

How can the inability to regulate negative emotions help in the development of an eating disorder?

Annotated Bibliography

Harrison, A., Sullivan, S., Tchanturia, K., & Treasure, J. (2009).  Emotion Recognition and Regulation in Anorexia Nervosa. Journal of Clinical Psychology and Psychotherapy, 16, 348-356.

1. Harrison et al., look at the specific aspects of emotional problems that are at the core of eating disorders that often get looked over. They focused their study to investigate how those who suffer from eating disorders lack emotion recognition and emotion regulation. They were able to find by using RME scales and DERS that those who had Anorexia nervosa were more likely to not recognize their own emotions or how to regulate their own. This shows a correlation between emotional dysregulation and eating disorders. This is a credible source (Harrison et.al., because it came from a peer reviewed journal. This fits into my research because it helps show that those who suffer from eating disorders do not know how to regulate their own emotions and in order to cope, they developed an unhealthy way (an ED) to do so.

Harrison, A., Sullivan, S., Tchanturia, K., & Treasure, J. (2010). Emotional functioning in eating disorders: attentional bias, emotion recognition and emotion regulation. Journal of Psychological Medicine, 10, 1887-1897

1. Harrison et.al., look at how difficulties with emotional and social functioning can lead and play an important role in the development and maintenance of eating disorders. They were able to find specific difficulties that people with ED’s have and that also predispose them in developing an ED as well. They look at how attentional biases, emotion recognition and emotion regulation are important for healthy living but those who have ED’s are reported to not being able to do any of those things. They did a study and found that those with ED’s had emotion recognition difficulties, had more attentional bias, and there was a large effect for their inability to regulate emotions. This is a credible source because it was published in a peer reviewed journal and this is an area of expertise for all four ladies who created this study. This research allows me to see emotional dysregulation helps create and maintain eating disorders. 

Avnon, L., Gilboa-Schechtman, E., Jeczmian, P., and Zubery., E. (2006). Emotional Processing in Eating Disorders: Specific Impairment or General Distress Related Deficiency?. Depression and Anxiety, 23, 331-339. 

1. In this study they ask the questions if those with eating disorders show more emotional dysregulation than those who are healthy and if there are unique emotional processes that differentiate between those who face anorexia and those who face bulimia. They did a study on three different groups (Anorexic, Bulimic and Healthy) by conducting interviews by doctorate students. They found a high effect in the fact that emotional dysregulation abounded in those that suffered with ED’s but not with those who were healthy. They also found only partial evidence that those who have anorexia show no more emotional dysregulation than those who have bulimia. This is a credible source because it came from a peer reviewed journal. This fits into my research because it showed me how those who never learn to emotionally regulate are more predisposed to the development of an ED.

Gross, J and Levenson, R. (1997). Hiding Feelings: The Acute Effect of Inhibiting Positive and Negative Emotion. Journal of Abnormal Psychology, 106, 95-103. 

1. In this they wanted to find out the effects of inhibiting one’s emotions, whether positive or negative. They conducted a study in which they showed 180 female participants particular movies (funny, sad or neutral). They were separated into two conditions (no suppression or suppression). They found that those who suppressed their emotions were only able to do it up to a point but later they would explode somehow. They also found that those who inhibited their negative emotions, such as sadness, does not give relief from the experience of that emotion and this could interfere with successful functioning. This is a credible source because it was published in a peer reviewed journal. This is important to my research because it shows that inhibiting negative emotions does not create relief but can create a negative behavior.

Bibliography

Catanzaro, S.J., & Mearns, J. (1990). Measuring generalized expectancies for negative mood regulation: Initial scale development and implications. Journal of Personality Assessment, 54, 546–563.

Cooper, M.J., Wells, A., & Todd, G. (2004). A cognitive theory of bulimia nervosa. British Journal of Clinical Psychology, 43, 1–16.

Mayer, J.D. (Ed.). (2001). A field guide to emotional intelligence. New York: Psychology Press

Shaw, S & Lee, J. (2015). Inscribing Gender on the Body. In Women’s Voices, Feminist Visions: Classic and Contemporary Readings (pp. 199-202). New York, NY: McGraw-Hill Education. 

Smolak, L. (2011). Body image development in childhood. In T. Cash & L. Smolak (Eds.), Body Image: A Handbook of Science, Practice, and Prevention (2nd ed.). New York: Guilford.

Wade, T. D., Keski-Rahkonen A., & Hudson J. (2011). Epidemiology of eating disorders. In M. Tsuang and M. Tohen (Eds.), Textbook in Psychiatric Epidemiology (3rd ed.) (pp. 343-360). New York: Wiley.

Waller, G., Corstorphine, E., & Mountford, V. (2007). The role of emotional abuse in the eating disorders and its implications for treatment. Eating Disorders: The Journal of Treatment and Prevention, 15, 317–331.