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Eating Disorders, Ego Deficiencies and Cognitive Disturbances 


Eating disorder theory: 

eating disorderA pioneer in the field of eating disorders named Hilde Bruch developed a theory based upon both psychodynamic and cognitive theories.  She believed that disturbed mother-child interactions lead to serious ego deficiencies in the child (which may include a poor sense of autonomy and control) as well as severe cognitive disturbances, which then combined to produce individuals with eating disorders. 

Brooch concluded that parents of eating disordered children may either respond to their children effectively or ineffectively.  Effective parents are able to accurately attend to their children's biological and emotional needs, giving them food when they cry and comfort when they are in fear.  Ineffective parents, failed to attend to their children's internal needs, and failed to correctly interpret the children's actual needs and circumstances.  They may sometimes feed their children at times of anxiety rather than hunger or comfort them at times of tiredness rather than anxiety.  Children receiving such ineffective parenting may grow up confused and unaware of their own internal needs, not knowing whether they are hungry or full and having difficulty identifying their own emotions. 


When these children are unable to rely upon internal signals they instead turn to an external guide such as their parents. They are frequently “model” children but they fail to develop self-reliance and have difficulty experiencing themselves as being in control of their behavior, needs and impulses, or even owning their own bodies.  This mindset continues on into their adolescence when they have an innate desire to establish autonomy but are unable to do so.  It is believed according to this theory, that in order for them to overcome their sense of helplessness they seek excessive control of their body size, shape and eating habits which eventually develop into eating disorders. 

There has been some research support for Bruch’s theory on eating disorders.  Clinicians have observed that parents of teenagers with eating disorders do tend to define their children's needs rather than allowing the children to have some autonomy in defining their own needs.  Bruch’s interview of the mothers of 51 children with anorexia nervosa found that most had "anticipated" their young child's needs rather than allowing the child to feel the need for food. 

Clinical research has also supported Bruch’s belief that people with eating disorders perceived internal cues inaccurately.  It has been found that when subjects with bulimia  nervosa are anxious or upset they are frequently mistaken by these feelings and respond by eating.  Finally, studies have also supported Bruch’s argument that people with eating disorders rely excessively on the opinions and views of others.  They're much more likely to be concerned about how others view them and to seek their approval.  They tend to be conforming and feel a lack of control over their lives resulting in the development of an eating disorder. 

Some information from Ronald J. Comer’s Abnormal Psychology

Additional information by Paul Susic MA Licensed Psychologist Ph.D Candidate 

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