Eating Disorders aren’t only about food, they’re about the CONTROL exercised over food.
The person with anorexia’s search for control is so strong, that it imprisons her.
With this article I’d like to provide a better understanding of the different types of anorexia, in case you know someone who may be going through this.
The idea is for you to understand that the reasons that can lead a person to suffer from something like anorexia can be completely different, so it’s important to adapt the treatment to the person.
In the Strategic Brief Therapy (SBT) (TBE), methodology in which I’m specialized, there are 4 different types of anorexia, with four different ways of treatment.
What is Anorexia?
The SBT works with what is called “operational diagnosis”, based on the analysis of the Perceptive-Reactive System (PRS).
We explore the way in which the person perceives the situation and how they react to it.
For anorexia, the person feels a tremendous fear of losing control over their eating habits.
And how does she react to maintain it?
- She doesn’t eat
- She controls what she eats
- She controls her emotions
- She controls her own femininity
Anorexia makes the person drift away from the emotions that can lead to difficulties, and the everyday things that can make the person lose control (relations, challenges, etc.)
But, do you know what’s the actual problem?
In the end, this large amount of control, will lead them to their worst nightmare: the loss of control.
That’s why it’s quite common for an anorexic person to have bulimic episodes, i.e, the total loss of control over food.
Types of anorexia according to SBT:
1. Abstinent anorexia:
It’s characterized by the tendency to avoid eating.
And these people have extreme sensitivity.
With many fears:
- Towards their own body
- Towards their femininity
- Towards men
- Towards their vulnerability
But her main fear is: TO FEEL any emotion.
Food becomes an emotion.
Because they are afraid of not being able to control that emotion (food), they abstain.
At that time, they feel safe.
But the less they eat, the more afraid they are to lose control over food.
To protect their extreme sensitivity, they put on a sort of shield that protects them from feeling, and they can’t take it off because they can’t manage their emotions.
Direction of treatment
In this case, the solution is aimed at introducing a small risk, both in food and in life.
The shield will have to come down slowly, and gradually, they will have to learn to live without it.
We will have to help her walk through it to be able to relive emotions without fear, and teach her how to manage them.
The treatment ends when the person is able to take the risk to live and cope with her own life, having regained her weight.
2. Youth anorexia
From all the different types of anorexia, this one is becoming increasingly common, and every time at an earlier age.
You can especially find this type of anorexia in hyper-protective families, where children are the princes and queens of the castle.
Children take command and begin to manage the situation.
It’s an anorexia of power.
Anorexia gives them the power to manage everything, even adults.
The girl will do nothing that isn’t for her benefit.
Benefits the child gets:
- Avoiding the responsibility on her own life
- Having power over her parents
Over time, they won’t be able to manage and cope with their life, leading to chronic anorexia.
Direction of treatment
The main work here has to be with the parents, because if they don’t remove the secondary advantages, the therapy won’t work.
The hierarchical family order has to be re-established.
And get cooperation from the child, making them to agree to gradually re-gain weight.
The goal of therapy is for the parents to take the role of parents and for the daughter to take the role of the daughter.
And thus the weight will be recovered by removing all the secondary advantages of the disease.
3. Chronic Anorexia:
These are adult people who’ve had anorexia for at least 5 years.
The disease has ravaged their life and often they come to therapy with several solutions which they tried and failed.
They have also seen many therapists and have great frustration in their lives.
Direction of treatment
First of all, we have to work with the failure that the disease has created in her life, so we create aversion towards remaining the same way.
She has to get in contact with her emotions of frustration, failure, sadness, etc. so she can leave them behind, and start building a new life.
Once the person manages to integrate what happened, then we’ll start working on the subject of weight, body and food.
4. Sacrificial anorexia:
From the types of anorexia mentioned, this is the one which is becoming less common.
In family pathogenic systems, a member of the family, in this case the anorexic, can develop a psychological disorder.
The disorder has a secondary advantage and that is to protect the family from destruction.
For example, a teenager becomes anorexic, to stop her parents from separating.
These are very sensitive and emotional people, and we have to help them a lot with that emotional part.
The direction of treatment:
The treatment will be oriented at changing the illness’s “function” in the family context.
We have to make her understand that her illness will not prevent what is inevitable.
And we’ll offer help to deal with the problems she’s having difficulty accepting.
Note: I want to make clear that this is a minimal approach to all that the anorexia involves.
Anorexia is a mental illness that can kill people, so each case must be carried out with extreme care and, often, with the help of a nearby hospital, where they can provide immediate help.
If you know someone who has a constant need to exercise control over their food, over her emotions and her life, or if this is happening to you, seek professional help before it’s too late.