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Bulimia: A Tool for Relief From Self-rejection & Criticism
Emotional regulation develops over time, and our early experiences and interactions with parents, caregivers, and adults significantly influences how we learn to identify, manage, and express our emotions.
Emotional dysregulation is when a person experiences vulnerability and invalidating interactions from their peers and family.
This dysregulation means that when a person is seen as being emotional, they are met with experiences of being overlooked, misunderstood, or criticised by peers or family [1].
These experiences lead to an inability to express emotion and turn to negative coping tools to try to release what they are feeling.
In eating disorders, emotional dysregulation is common. Typically those with bulimia nervosa are more likely to use dysfunctional tools such as excessive worry, obsessive thoughts and emotion suppression to situations.
When an individual engages in binging and purging behaviors, it serves as a way to distract or ameliorate from painful internal emotions, and therefore may reinforce the eating disorder behaviors [1].
Other factors, such as interpersonal difficulties, inability to express emotions to others, a distrust of others, and insecure attachment can affect emotional regulation. This lack of regulation can be both an external reaction and an internal response to self-rejection and self-criticism.
Self-image can be described as a self-directed behavior. It is how a person treats, thinks, and feels about themselves.
The way a person carries and interacts with others is a guide of how others perceive and interact with them as well. Self-criticism, therefore, is how one talks to him/herself about their image, strengths, weaknesses, and others perceptions.
Bulimia: A Definition
Bulimia is when an individual has recurrent episodes of binge eating with compensating behaviors, such as vomiting, laxative or diuretic abuse to prevent or control weight gain [2].
Bulimic episodes are typically done in secret, and there are three or more occurrences a week.
With bulimia, it first is about being ‘safe’ with foods, trying to manage weight, but then eventually progress into a coping tool to manage feelings.
One in two people who develop anorexia, will in time, develop bulimic symptoms, and are considered to have anorexia, but with the bulimic subtype [2].
Low self-esteem is a risk factor of bulimia and can be seen in attitudes or fears of inadequacy, rejection, and the need to gain approval from others.
There is also a high correlation of those with bulimia and insecure attachments. Individuals also sign of depression, anxiety, feelings of guilt and shame, impulsive behaviors and obsessional thoughts.
Managing the Inside Out
Food and bulimic behaviors are often used to help cope with past history of abuse or trauma. Those who are bulimic tend to come from families that are significantly hostile, argumentative, maladaptive relationships, often divorce among parents and abandonment issues. Also, addiction is high among relatives of those with bulimia [2].
Many times in those who struggle with bulimia, body dissatisfaction, weight issues, dieting behaviors, and teasing or bullying around weight/shape is common. In these families, parents or caregivers may be overly concerned with their child’s weight, shape, and reward for weight loss efforts.
Bulimia and perfectionism are also common, and often the person will strive for perfect grades, being the perfect daughter or the perfect employee. When they are unable to meet their own expectations, it translates into behaviors and increased symptomatology.
With the purpose of bulimia to help regulate and manage emotions, often the sensation of feelings can be a trigger for a binge-purge episode.
Emotions are seen as overwhelming and undeserved by the person, and the purging can act as a disconnect from the awareness of negative self-beliefs.
Feelings of inadequacy around others who the person perceives as ‘thinner’ than they are or more attractive, can also trigger bulimic behaviors.
When these types of interactions and/or perceptions occur, the sufferer will put all of those emotions into self-rejection and self-critical thoughts about their body [2].
When childhood experiences or rejection occur, a bulimic is not able to identify and gain their basic needs of validation and acceptance. The behaviors are a way for people to be able to feel in control. Control of emotions. Control over life situations.
The binge-purge cycle is seen as a way to get rid of or punish oneself for engaging in the purge. It is a way to rectify their overeating and reinforces the idea of self-punishment for the behavior, or trigger of thoughts and feelings.
Once the cycle is complete, often individuals feel a sense of relief. Some people may feel energetic, depressed, guilty, or sleepiness. Different reactions give clues as to how the person finds the behavior useful and why.
It can be a way to self-regulate negative or unwanted emotions. It can be a way for the person to become motivated to finish tasks or stay on ‘track’ with school, work, etc.
Binging can change one’s mood and shift their internal sensations from that of being tense, stressed or overwhelmed, to a state of feeling calm and peace after an episode.
Self-Regulation
Bulimia is a way to express self, emotions, and unresolved personal challenges. It can be the coping tool to represent the chaotic emotional state that they feel internally. Bulimic behaviors can help create a sense of control when they feel out of control externally.
Control over personal feelings of rejection and criticism for not being ‘perfect.’ They will use binging and compensating behaviors as a way to manage feelings of low self-worth, self-neglect and self-esteem. They control, abuse, and punish themselves with the behaviors.
Bulimia is a treatable disorder. By engaging in therapy, one can learn to identify, manage, and healthily express emotions.
Through the use of cognitive behavioral therapy, acceptance commitment therapy, somatic and body movement therapy, and other forms of treatment, a person can recover from this disorder and go on to live successful lives.
About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.
Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.
References:
[1] Monell, E., Högdahl, L., Mantilla, E. F., & Birgegård, A. (2015). Emotion dysregulation, self-image and eating disorder symptoms in University Women. Retrieved September 06, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666164/[2] Bulimia Nervosa. A Contemporary Analysis. (n.d.). Retrieved September 06, 2017, from http://eating-disorders.org.uk/information/bulimia-nervosa-a-contemporary-analysis/
The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.
Published on October 12, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on October 12, 2017.
Published on EatingDisorderHope.com
The EatingDisorderHope.com editorial team comprises experienced writers, editors, and medical reviewers specializing in eating disorders, treatment, and mental and behavioral health.
