Eating Disorder And Freud’s Psychosexual Development Theory

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One of the most severe and multidimensional mental health issues that includes the aspects of emotional and physical health is eating disorders. The disordered eating behaviours affect emotional connection to food, weight and external appearance. Anorexia, bulimia, and bingeing eat disorders are all types of eating disorder. Diseases with an unknown cause may occur at any age to an individual, it does not matter when in life. They target people from all classes of human beings, irrespective of age, race, and ethnicity. Eating disorders pervade male and female boundaries and it is the misconception that only females are affected by such challenges. Boys and men, too, are vulnerable to the same dangerous consequences and need the same measures to overcome them. This paper evaluates psychodynamic and behavioural models which analyst can sequentially apply to an eating disorder patient.

The German psychiatrist Sigmund Freud (1856-1939) along with his fellow researchers proposed the psychodynamic theory that defines the nature and conduct of human beign (Lacombe et al., 2022). This theory of Sigmond contains all types of psychological views that the process of human functioning is initiated due to the interaction of efforts and forces within the personal context which notably the unconscious (Iscan & Iscan, 2023). This idea also asserts that experiences in an individual's youth have a substantial impact on their later lives, shaping their personality. Sigmond further noted that the end of each stage of sigmund’s 5 stages of development in which he explain the adolescents' pleasure-seeking determinations focus on a new places. This is known as an erogenous zone (Lacombe et al., 2022). Thus, it might be analysed using the theoretical perspective that the personality is shaped as the urges are affected by different conflicts at different times in childhood (during psychosexual development).

Throughout the initial accounts of gastrointestinal disorders (EDs), psychosexual difficulties have been linked to them. Sexual conflicts throughout adolescence have been linked to the development of anorexia nervosa (AN) (Traylor et al., 2022). Starting of the middle age is the literary portrayals of initial Christian saints also termed as starving saints that comes up with the denial of physical necessities, devotion to non-physical undertakings, and spiritual asceticism, creating images of young girls estranged from their sexuality and terrified of normalcy. Thomas (2021) defines anorexia hysterique as the addition of heterosexual concerns in adolescent patients, while the term anorexia nervosa was coined in England at the same time.

The scientific backing of Lacombe et al. (2022) work and statements brought the modern era into focus, emphasising that deficits in the developmental factors of self-regulation, autonomy, identity formation, individuation and separation were major contributors to the development of AN in individuals adolescent age. Vertel (2022) expounded on these developmental aspects, claiming that the development of AN indicates a dread of maturation and a desire to reset the biological clock of puberty to a more peaceful, easy time before adolescence. Currently, numerous researchers and theorists are investigating the impact of physical milestones, 5 stages of development and pubertal experiences in the aetiology and appearance of EDs in adolescence.

Today, the nuclear family at 18-23 years old is seen as an independent person set apart from his family in a wider and more varied society. Separating from parents (the first of the three main adolescent tasks, i.e., developing the independence), seeking one's sexual identity, and planning own adult life in terms of education or career (the second and the third tasks from the list) may be the sources of eating disorders (Learning, 2020). All of these acts of duty, Bearing to one personal perspective, contribute to identity development and the process of self-realization. The early psychiatry discourse characterized EDs as a developmental crisis that impacts young females and capable of being triggered by deeper physical development of breasts characteristic of puberty. Iscan and Iscan (2023) scholars suggest that an anorectic's deterioration of AN would be related to its retraction in the psychosexual development stages as a consequence of maturational pressures in adolescence, which the patient experiences as malignant and dreadful.

A number of studies have recognised teenage development as a potential safety factor for the progress of an eating disorder among the teen agers, as well as sub-syndrome maladaptive eating issues or attitudes and severe weight control behaviours (Thomas, 2021). This type of research typically focuses on nonclinical, non-patient, community populations, often in school settings, and employs self-report measures, questionnaires and individual interviews, surveys and observations follow-up. The majority of the research is cross-sectional; however longitudinal data are now available in recent publications. Exiting studies does not specify which subjects have eating disorders or which young adolescents will develop them, but it does suggest that some factors may place certain adolescents at risk (Ng et al., 2022). If children and adolescents who are at risk are recognised early, preventative methods may be undertaken. However, it is still debated whether preventative programmes achieve their desired outcomes.

A small amount of study has discovered a link between early maturation and eating disorders. A variety of approaches have been employed in the literature to assess pubertal development, including Tanner stages, pubertal maturation, physical measures, maternal report, self-report and body fat assessments (Bachar, 2020). Puberty, which includes normal weight increase and bodily changes as well as other biological and psychological changes, puts some teenagers in direct conflict with the dominant cultural idealisation of a slender body, particularly for girls. Bachar and Verbin (2020) discovered that tardy timing of puberty is linked to sadness, body image difficulties, and eating disorders. Looking at a younger cohort of girls in elementary school of UK concluded that more developmentally advanced (but not older) girls may be more vulnerable to the development of EDs (Adnani, 2020). Brenner (2022) discovered increased dieting and disordered eating in females adjusting to the fat related with menarche and dating's appearance demands.

A biodynamic perspective on conduct emphasises internal conflicts, motivations, and unconscious influences. Many ideas exist within the psychodynamic arena about the development of psychiatric diseases in general, as well as the genesis and origins of eating disorders in particular (Cosenza and Busiol, 2021). This book does not cover each psychodynamic theory and its corresponding therapy strategy, such as object relations or self-psychology.

All mental health theories share the concept that if the underlying cause of disordered behaviours is not addressed and resolved, they may lessen for a period but then resurface (Grose-Fifer et al., 2021). The early pioneers made it known that utilising behaviour modification strategies to encourage people to gain weight may result in short-term improvements but not long-term results. Therapists with a psychodynamic view, like Grynick (2020), think that recognising and addressing the source, adaptive function, or purpose of the eating problem is critical for complete recovery. 

According to Hamlin's (2022) the hypothesis of psychodynamic when wants are not supplied during human development, adaptive functions emerge. These adaptive functions act as substitutes for developmental inadequacies, protecting against the accompanying anger, frustration, or suffering. The issue is that adaptive functions can never be internalised (Lacombe et al., 2022). They have long-term effects that jeopardize health and function, and they can never fully replace what was initially needed. For example, someone who has never learned to self-soothe may turn to food for consolation and thus binge eats when disturbed (Learning, 2020). Consuming excessive amounts of food will never help her internalise the skill to comfort herself, and will almost certainly result in undesirable repercussions such as weight increase or social withdrawal (Iscan & Iscan, 2023). Understanding and addressing the adaptive functions of eating disorder behaviours is critical in assisting patients to internalise the potential to achieve and maintain recovery.

Psychodynamic theory, in its whole, sees eating disorders and weight control as indicators of a troubled inner self that uses these behaviors to communicate or express underlying issues (Lacombe et al., 2022). Direct measures to eliminate the symptoms have been considered unnecessary because they are thought to be helpful to the patient. The idea behind a strict psychodynamic approach is that disordered eating patterns would disappear if the underlying issues could be addressed, resolved, and worked through (Traylor et al., 2022). The psychological attitudes are mostly produced as regular psychotherapy sessions; on one hand, based on the interpretations and the management of the transference relationship or the patient’s view of the therapist (Ukulor, 2024). Whether the psychoanalytic approach or any of other modalities is used, the main objective is to help individual to uncover emotional connections between their past, personalities and interpersonal relations as well as how it is all connected to their eating disorders.

Psychodynamic treatment of those with eating disorders presents two challenges. Emotional eating is a complex issue, and many athletes are in states of hunger, sadness, or compulsivity due to compensatory eating dieting that makes psychological interventions ineffective (Hamlin, 2022). Therefore, starvation, thoughts of suicide, alternating between episodes of binge eating followed by compensatory purging or major physical problems might have to be ruled out before advising sex-therapy for the couple. Aggravatingly, in psychodynamic it takes the patients years to form insights with no diminished symptomatic actions (Grynick, 2020). Maintaining this kind of treatment for a long time without seeing symptom improvement seems inefficient and unfair.

Psychological therapy is a valuable component of treatment for those with eating disorders, but it has not been demonstrated that a rigid psychodynamic approach in isolation, without any discussion of eating and weight-related behaviours, is particularly helpful in producing high percentages of complete recovery (Cosenza and Busiol, 2021). It is eventually necessary to deal directly with the disturbed behaviours. Cognitive behavioural therapy is the most well-known and researched strategy or treatment approach utilised today to transform, manage, and confront certain weight-related and dietary behaviours.

The work of Aaron Beck first created cognitive behavioural therapy (CBT) in the late 1970s as a depression treatment strategy. The core idea of cognitive behavioural therapy is that cognitions (thoughts) cause feelings and behaviours. Albert Ellis's well-known Rational Emotive Therapy (RET) comes to mind. The clinician's role is to assist individuals in recognising cognitive distortions and either choosing not to act on them or, better yet, replacing them with more realistic and good ways of thinking (Bachar, 2020). Common cognitive distortions include all-or-nothing thinking, overgeneralization, presuming, magnifying or minimising, magical thinking, and personalising.

People acquainted with disorders such as eating disorders will recognise the same or comparable cognitive distortions voiced by eating disordered individuals in treatment (Cosenza and Busiol, 2021). Obsessive weighing, laxative use, sugar restriction, and binge eating once one forbidden food item passes the lips are all examples of disordered eating or weight-related behaviours (Thomas, 2021). Regardless of theoretical orientation, most practitioners will eventually need to challenge and address their patients' skewed attitudes and beliefs in order to disrupt the resulting behaviours (Ng et al., 2022). If not addressed, the symptomatic and distortions behaviours are likely to reoccur or persist.

Emergency rooms are ususally not provided easily in this type of disorders. This is the reason that both shows great working relationship between psychosexual development and ED onset is not entirely known, but it is a source of ongoing interest and research. Psychosexual variables are neither required nor sufficient for the development of an ED. The sociocultural setting, which is characterised by a preoccupation with shape and weight, as well as the idealisation of an ultrathin body for girls and a muscular and lean physique for males, serves as the backdrop for all teenagers' development. Human components, such as biological, genetic, and behavioural investments, interact with outside factors and familial difficulties in larger society. Apparently a developing adolescent's timing and combination of psychosexual and other contributing factors is what puts them on the path to developing an eating disorder.

References 

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