Anorexia and issues of control
Issues of control are at the source of the anorexic experience (Farrel & Magagna, 2003; Surgenor, Horn, Plumridge & Hudson, 2002). According to some theories, anorexia is a disorder that develops as a result of an attempt to control one’s body, emotions, thoughts, objects, and life events.
As a result of the rapid physical changes brought about by puberty, girls may have an experience of loss of control over their bodies. Bruch argued that anorexic girls grow up confused about the body and its functions and feel that neither their body nor their actions are self-directed or even their own (Bruch, 1978, 38-39). She argues that in anorexic’s development there has been early failure in the establishment of a cohesive sense of self. In view of the usual developmental tasks precipitated by puberty, the anorexic withdraws to her own body as the only realm where she can exercise control and dominance (Bruch, 1980). The anorexic does not experience her body as something she is, but as something she has. Her body becomes an object of rigid control (Baerveldt & Voestermans, 1996).
According to self-theory, the anorexic’s experience of needing others evokes unbearable feelings, which she attempts to suppress. Orbach argued that the girl’s avoidance of food is due to her need to control her body, symbolizing her emotional needs. Thus, if she can gain control over her body, she may also be able to control her emotional neediness (Orbach, 1993, xii).According to object-relations theory, anorexics’ relationships are based on mechanisms of survival and control, while anorexics maintain a fantasy of controlling significant objects in their lives (Farrell, 1995, 30). It has been suggested that anorexic girls have strong dependency needs in relation to their families, and, at the same time, strive for autonomy, self-containment and separation from their parents. The latter are expressed through self-starvation mechanisms (Fischer, 1989). In controlling their body, eating and weight, the anorexic appears to have exclusive control over satisfying their needs and maintaining an autonomous mechanism of nourishment and satisfaction.
Although anorexics believe that they are in full control of their bodies and their surroundings, this belief may collapse when confronted with real changes. Anorexia can be described as a ‘disease of control’ that develops against the background of uncontrollable life events (Kaplan-Zarchi, 2021, p.215). Accordingly, there may be an increase in concern regarding weight, body shape, and eating when the sense of self-control is impaired by external circumstances (Fairburn, Shafran & Cooper, 1999), as in the current pandemic. It is in such situations that anorexic individuals feel that they cannot control their life and use control of their appetite as a tool to enhance their sense of self-control.
Anorexic prohibitions are central to the anorexic’s sense of control. These prohibitions are usually activated by an internal ‘anorexic voice’ which comments on the individual’s eating, weight and shape and instructs the individual to restrict or compensate (Pugh & Waller, 2016). According to this voice food is forbidden, desires are forbidden etc. When these prohibitions are not followed, the anorexic voice punishes and devalues the individual, leading to behaviors such as starvation and obsessive physical activity. The anorexic believes that compliance with these prohibitions enables her to maintain control over her body. It helps her to feel in control over her internal and external worlds.