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.