An eating disorder is a psychological illness where the subject has an abnormal relationship with food, and has a distorted view himself or herself. Particularly in those who suffer from anorexia and bulimia, there is an obsession with weight loss and food intake. They are also unable to see how self-destructive their behaviour is, and view themselves as too fat even when underweight. (Tighe, 2011)This essay will examine the causes of eating disorders and the psychological explanations that go along with them. Three psychological models will be looked at the cognitive approach, the behavioural approach and finally, the psychodynamic approach.
The basis of the Cognitive approach is the theory that the human brain works like a computer. Processed outside information becomes our thoughts and our output is our behaviour. Cognitive psychologists would explain that the causes of eating disorders are due to faulty cognition (thoughts) and having distorted perceptions of self. A. Beck was the pioneer of Cognitive Behavioural Therapy (CBT), which can help eating disorder sufferers challenge their faulty thinking and change their perceptions. (DK, 2011)It is easy to see then, how CBT could be very useful in treating those with an eating disorder, as many symptoms of eating disorders are to do with faulty perception of the self.
Fallon and Rozin (1985) also did research based on the cognitive model. They gave a chart of nine images of body types to both men and women. On the chart the silhouettes were either very slim to those of a higher weight. On the chart they placed how they perceived their own weight, how they perceived what weight was attractive to those of the opposite sex and their own, ideal weight. Women tended to place both their ideal weight and the weight they thought men would be attracted to on the lower side of the scale. Their perceived current weight placed at a significantly higher point on the scale. The men however, placed both their ideal weight and current weight close together but the weight that they perceived women to find attractive was higher on the chart*.
This research is useful at seeing the difference between how male and female perception of self and ideal weight differs. However, there are some problems with it. For example, all the people asked were American and between the ages of 18-19 and all went to a private college, which suggests that they were, upper to middle class. This means that this piece of research is highly ethno- centric; it is not applicable to those who are exempt from that background and culture. The research in itself also lacks a certain amount of objective, as even though it shows people’s perceptions of their body it does not mean they are all suffering or will suffer from an eating disorder. The research also now lacks historical validity as it was carried out in 1985. Ideal body image was different to how it is now. (Adler, 1992)
The cognitive approach can have positive appraisal as it backed up scientifically. Its face validity reflects in the success rate for CBT, which is often very high. The downside is that is seems to de-humanise people. It does not place any bearings on the patient’s emotions or their individual circumstances. A patient also seems to face large amount of blame and responsibility.
In contrast with the Cognitive, approach is the psychodynamic approach; Sigmund Freud was the main trailblazer and the first person to study the mind. He believed that Mental Illness and mal -adaptive behaviour was due to repressed memories and emotions held in our ‘unconscious mind’ and that, ’causes of emotional pain can be bought out through psychoanalysis’ (DK, 2011). This quote also links into another part of what Freud’s theory was on how the human mind worked. He believed that the human psyche had three main parts: the id, ego and the superego. Freud believed the id is responsible, for our basic animal instincts, such as wanting food, or sex. There was also the ego was the part of the mind that was connected with the reality of the situation you are in. Finally, the superego is the moral part of the psyche. It is the voice that tells us was is good and right to do regardless of what the id wants. Freud’s belief is that if the id, ego and superego are unbalanced then it is one of the pre- cursors to mental illness, such as an eating disorder.
Freud also put a strong emphasis on early childhood experiences. He concluded that poor parenting or difficulty bonding with parents as a child could lead to mental illness and abnormal behaviour as an adult. A psychodynamic view of the cause of someone having an eating disorder if a younger women for example, would be that in her unconscious mind she fears becoming an adult. Due to this fear, she tries to revert to being a child by losing weight, causing her to lose her feminine figure and to stop herself menstruating. H. Bruch also believed that this aspiration of wanting to become a child might also be to do with having a poor relationship with parents who did not help her to develop any sort of identity. *
There are some definite criticisms about the psychodynamic approach. One of the biggest problems with it is its very difficult to test as it is based on case studies, not scientific testing.
In fact, the only way you could test it is by using identical twins by putting one through a trauma and the other one not; this of course, is greatly unethical. You also cannot duplicate the exact result on any other patient. What more, the approach has a huge bias against parenting and the role it could play in mental illness. However, numerous case studies back up the psychodynamic approach and the use of psychoanalysis; so it could work for some people.
The last and final approach analysed is the Behavioural approach. The theory of it is that all behaviours learned are due to experience. In addition, those behaviours can then be unlearned. Ivan Pavlov, research the theory of classical conditioning by using dogs. He used a stimulus such as a bell ringing and giving the dog food at the same time to condition the dog to expect food whenever it heard the bell ring. The dog would even start to salivate before it saw the food but still heard the ringing of the bell. (Youtube, 2008) B.F Skinner expanded on Pavlov’s research and called his theory ‘Radical Behaviourism.’ He started by using mice. He would place the mice in a box; whenever the mouse pressed a lever or bar, it food was given. Skinner explained that this wasn’t operant conditioning like Pavlov’s as there was no preceding stimulus; the behaviour of the mouse was continued by the positive reinforcement of getting food. He continued his research by then wiring up the floor of the box to an electric source. The mouse would then get a shock when performing certain behaviour. The mouse then learned the behaviour and shock were linked .This is negative reinforcement. (DK, 2011)
The behavioural approaches’ explanation of the causes of an eating disorder in an individual would be due to either positive or negative reinforcement. An example of operant conditioning, that led to someone developing an eating disorder would be, that if a teenage girl kept losing weight and got continuous praise from friends, but then also receiving negative criticism from her parents for saying she was greedy whenever she ate. She would learn that if she lost weight and did not eat much her friends would complement her and her parents in turn, would accept her.
Criticisms of the behavioural approach are that scientific testing is possible. It also gives quick results when it comes to treatment. Unfortunately, it does not focus on the patient’s emotions or their current personal circumstances. Neither, is it suitable to treat all illnesses, with eating disorders in particular a downside of it would be, that it changes the behaviour but has not influence of the cause, of that behaviour.
In conclusion, it is widely acknowledged that eating disorders do not have one overruling cause but have a complex mixture of disordered thinking and negative perceptions of self. Poor interpersonal relationships and past trauma may also play a part. Eating disorders may also run in social groups and behaviours associated with eating disorders may be picked up/learned through peer pressure. (National Eating Disorders Association, 2004)It is safe to say then that all of the psychological approaches: cognitive, behavioural and psychodynamic are all perfectly valid in explaining why someone may suffer from an eating disorder and it is wise to keep an open minded approach to treating an eating disorder, as all of the approaches work in a highly interwoven and harmonious way.
*Allen. C (2012) Lecture notes: Studies on eating disorders. [Access to HE, 24th October]
Adler, L. D. (1992). Female and Male Perceptions of I deal Body Shapes. Retrieved October Wednesday 24th, 2012, from Lillianmcmaster.com: http://www.lillianmcmaster.com/resources/ideal%20body%20image%20study%20on%20caucasians.pdf
DK. (2011). The Psycholgy Book. London: Dorling Kindersley.
National Eating Disorders Association. (2004). What Causes Eating Disorders. Retrieved October Thursday 25th, 2012, from National Eating Disorders.org: http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/WhatCaus.pdf
Tighe, J. (2011, May). Eating Disorders. Retrieved October Wednesday 24th, 2012, from BBC Health: http://www.bbc.co.uk/health/emotional_health/mental_health/mind_eatingdisorders.shtml