The Interplay of Psychological, Familial, and Societal Factors in the Development and Continuance of Eating Disorders
by Joseph Scalia III, M.Ed.
A hundred and twenty years ago, in repressive Victorian Vienna, Freud discovered psychoanalysis in his work with conversion hysterics so common in his time. Their psychopathology was an unconscious way for them to disconnect themselves from their feared sexuality. Today, we find a similarly oft-occurring clinical phenomenon in eating disorders, linked to our very different society, an excessive one whose prevalent superego mandate is “Enjoy!” We are inculcated with a value system of the accrual of wealth, pleasure, and media-generated images of “thin” as part and parcel of what is desirable, especially in young women; it is suggested to us that we ought always to be having a good time, and that something is wrong with us if we are not. Substantive considerations of what might generate a meaningful life and meaningful identities are, at best, marginalized. Eating disorders seem to open a path to identifying oneself with thin-ness and attractiveness and desirability. Yet they narrowly expose one’s true self, which is unconsciously displaced and inhibited, cordoned off from the perceived threats of the world outside oneself. The discovery and development of one’s unique capacities becomes constricted, along with one’s ability to register and partake of others’ uniquenesses.
It becomes incumbent upon families, then, to supply sufficient protection from society’s blind exigencies and demands; and that is a formidable task which very few families can fully accomplish. When families cannot both recognize society’s pathogenic effects and also generate a safe-enough familial space of development from which the child can face that society, one outcome is the family’s development of an “identified patient.” That person’s psychological symptom “carries” the family’s unconscious problematics for other family members.
Lastly, a fate which all parents face whether we like it or not, parents’ marital dissatisfactions are “visited upon” the children, each of whom is prone in their unique ways to develop an unconscious response to that dissatisfaction, sometimes leading to psychological symptoms and maladies.
These three factors, arguably always interacting in the cause and maintenance of any eating disorder, constitute a formidable obstacle to recovery, but adequately addressing them constitutes an equally formidable freeing of the vast unconscious resources that have been otherwise bound up for so long.
Joseph Scalia III is a psychoanalyst in Bozeman, Montana. He is a Psya.D. Dissertator, in Psychoanalysis and Culture, at the Boston Graduate School of Psychoanalysis; his dissertation aims to identify instances and causes of Child Protection Services termination of parental rights that could have been preventable. His published writings include Intimate Violence: Attacks Upon Psychic Interiority and The Vitality of Objects: Exploring the Work of Christopher Bollas. He has published a number of articles in Modern Psychoanalysis, The Journal of Interpersonal Violence, Presencing EPIS: A Scientific Journal of Applied Phenomenology and Psychoanalysis, and with Lynne Scalia in Philosophical Studies in Education. Mr. Scalia is the Founding Director of Northern Rockies Psychoanalytic Institute and its Center for Cultural Critique and Intervention. He has been in practice since 1979, having worked as a Staff Psychologist in such institutions as Arkansas State Prison, Warm Springs (Montana) State Hospital Children’s Unit, and Western Montana Community Mental Health Center; and since 1989 in private practice.