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Aspects of Health Psychology
Many researchers over the years have been carrying out research to find out why eating disorders occur. An example of this is a journal paper on " Attachment Research On Eating Disorders". The journal paper will be briefly identified and evaluated critically. Then using the journal paper as a starting point the role of psychological processes in health will be reviewed.
The journal paper outlines the fact that insecure attachment is common in the disordered population. The historical perspective was considered, stating the 'broad clinical literature on eating disorders predating the development of attachment theory but replete with references to abnormal familial or mother-daughter interactions' ( Ward & Ramsay & Treasure 000).
It is within the family structure and mainly the mother-daughter relationship, that a girl first learns her outlines of her social role. During adolescence the mother-daughter relationship loses none of its intensity or ambivalence. A mothers feeling about her daughters sexual development are experienced within the relationship. The mother herself has lived through the pressures of having a fashionably attractive body. Then the mother watches over the food her daughter eats (Obarch 186).
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Alternatively many mothers are threatened by their daughters developing sexuality so they are unable to welcome and legitimate the exciting body changes that the young woman is going through. So the daughter seeks confirmation outside the family in magazines, which preach thin is beautiful in society. This is where anorexia originates from the pressures of today's society.
In the journal, Bruch (174) says 'the important aspect is whether the response to the child's need was appropriate, or was the superimposed according to what the mother felt he needed often mistakenly'.
Bruch also went onto discuss the interrelationship between early feeding interactions and attachment, pointing out the interactive nature of the feeding situation.
'At the age of 1 months, the infants in whom feeding interaction had been most appropriate to their needs, permitting them active participation, showed the strongest attachment to their mothers, with the clear cut tendency to seek her proximity and to express distress at her absence. In contrast babies with inappropriate feeding experience, showed little or no tendency to seek proximity, interaction or contact with the mother. The third group included the pseudo-demands of overfeeding (e.g. when the mother is impatient with the child and starves them off with food), in which children were distressed by seperation. They generally showed more maldaptive behaviour in relation to new and strange situations' ( Ainsworth & Bell 16)
The developing attachment theory described above, the mother-child interaction at 1 months was later formalised as strange behavior (Ainsworth 178). These behaviours become internalised as working models of attachment in later life. If seen from a psychoanalyst point of view, one can see how Bruch's developing ideas could be seen fro an attachment perspective.
This is similar to what Melanie Klein described as object relations the 'good' and 'bad' breasts. If the child does not get enough of the breast they become unsociable and withdrawn.
However despite the differences in approach the other the other clinical literature strongly suggests insecure attachment patterns in anorexic patients.
Attachment theories alone cannot account for the attachment disruption. Thus Halmi has proposed a model in which bulimia and anorexia nervosa develop after the stress of dieting. This stress of dieting experience is influenced by antecedent's conditions that included genetic and physiological vulnerability and psychological predispositions that are often affected by the family and societal influences (Halmi 17).
'Addiction, obesity, starvation (anorexia nervosa) are political problems, not psychiatric, each expresses a contest between the individual and some other person in his environment over the control over the individuals body (Szasz 174).
The studies used in the journal fell in to two main categories a clinical group and a non clinical group of female college students in which eating difficulties are categorised by using questionnaires.
Anorexia also affects adolescence men aswell as women. Therefore the paper is bias, as it has selected noral and anorexic, bulimic females. Between 1 in 16 and 1 in 1 anorexic are male. Sufferers are usually in their adolescence but the disorder can appear at any time between 1 to 44 years ( Gilbert 000).
The journal made particular use of questionnaires and interviews. Their were questions on parental attachment, relationships, attachment history, adolescent attachment and adult attachment interview.
The main findings of the research literature are that abnormal attachment patterns exist in eating disordered population.
The preponderance of insecure attachment is also consistant with older clinical literature on the subject, in particular the ideas of Bruch.
The journal uses tables, which fail to give a clear picture of what is being said. Insecurity is rife in individuals with eating disorders, but the more precise associations are lost. The study of non-patients groups has blurred the picture.
Eating disorders are complex conditions that arise from a combination of long standing, behaviour, emotional, psychological, interpersonal and social factors (National Eating Disorders Association).
Eating disorders become the way that people cope with difficulties in their life. Eating or not eating is used to block out painful feeling. For some dieting, binging and purging may begin as a way to cope with painful emotions and to feel in control of their own life, but ultimately, these behaviours will damage a person's physical and emotional, self-esteem and sense of competence and control.
Dieting can lead to a condition called anorexia. Anorexia is characterised by self starvation and excessive weight loss (National Eating Disorders Association).
An individual with anorexia restricts the amount of food they eat and drink, sometimes to dangerous levels. They focus on their food in an attempt to cope with life rather than starve to death. It is a way of demonstrating they are in control of their body weight and shape. Ultimately however the illness itself takes control and the chemical changes in the body affect the distort thinking, making it impossible for the person to make rational decisions about food (Eating Disorder Association).
Bulimia nervosa is another eating disorder. The term bulimia nervosa means literally 'the hunger of an ox'. The hunger is however a emotional need that cannot be satisfied by food alone. After binge eating a large quantity of food to fill the hunger gap the person will immediately get rid of the food they have consumed, they will do this by vomiting or by taking laxatives (or by both), or they will work off the calories by exercise. This is an attempt to prevent gaining weight.
Eating disorders are associated with early attachment theories but they can also be related to environmental pressures. When a child is young he/she is not consciously aware of the surrounding they are in, but as they grow older they develop their conscious. This is when they become aware of the social surroundings (environment) they are in and they then act upon the environment.
'Many experiences will shape our lives and indeed 'social learning theory' suggest that our social environment is responsible for shaping our behavior, where there is a continuos and recipicol interaaction between a behavior and its controlling condition' (Jenner 1).
Our modern society idolises slimness and denigrates fatness (Gilbert 000). The changing cultural trends in the female body shape are an obvious explanation of why women strive to be and remain thin (Hepworth 1). Thinness became the feminine new look of the 1th century. During the 160's and 170's the media created an impression that the ideal female body was thin (Hepwort 1).
These cultural developments were the fundamental to the social-cultural explanation of the onset of anorexia nervosa (Wooley & Wooley 18).
There have been many studies stating the increase in slimness of cultural, stereotype of feminine beauty as evidenced in the ever decreasing size of models in women's magazines ( Silverstein et al 186).
Women are surrounded by images of beautiful women, which are mostly thin women. Whose body represents a contemporary idea of femininity have 10 to 15 per cent fat compared to to 6 per cent healthy, normal rate women (Brownell 11).
Being overweight or some would say being fat is seen as unpretty. But people forget beauty is only skin deep.
There has to be a link between the media and cultural factors portraying a certain female body size as beautiful, with eating disorders. When we switch on our televisions we are bombarded with images of thin people and advertisements such as weight watchers including individuals who have lost some weight claiming they feel much better and more confident now they are thinner. Why didn't these people feel good about the size they were before?
'It is surely more than a coincidence that societal changes in attitudes to female body shape and dieting have occurred at the same time that diagnosis of anorexia appear to have multiplied (Malson 1). A fear of fatness and preoccupation with body weight are relatively recent phenomena in anorexia (Russell 186).
The ideal of a thin female body increased its presence in the western culture. 'Anorexia appears to be a largely western phenomena (Edwards 1).
Anorexia is also associated with low self esteem, with lack of sense of self, of independences autonomy and control as well as the fear of fat or relentless pursuits of thinness (Bruch 17).
Anorexia can be expressive of societal concerns with the consumption, personal display, the fashion for dieting, slimness and the individualistic competitiveness of late capitilism therefore it can be culturally bound (Brumberg 188).
Anorexia can also be related to stress, anxiety and depression. When an individual has had enough, anorexia can take its toll. When you are feeling vulnerable, lonely, insecure, lacking confidence or have a low self esteem, eating or not eating might be the only way of handling things, therfore these conditions can cause eating disorders.
As well as attachment theories there are other causes of anorexia. From a personal point of view, I feel the media is very much to blame for eating disorders. As being a young woman myself, I have realised that where ever I seem to look or whom I ever I speak to, being thin is definitely associated with beauty.
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