Where does an eating disorder come from? Countless parents and eating disorder patients ask me this question in person, on the phone, in e-mails from around the United States and different parts of the world. The tone of the question is bewilderment, anguish and deep sincerity. Where do eating disorders come from? Why can t I (or my loved one) stop the behavior and eat normally?

As I listen to the unique stories of individuals and family members plagued by an eating disorder, one common theme I hear relates to boundary invasion. People with eating disorders, at some vulnerable time in their lives, experienced relentless, continuous, thorough and inescapable boundary invasion. The eating disorder developed as a way to escape, protest and, tragically, duplicate that boundary invasion.

Blatant and severe boundary invasions involve extreme behavior such as physical assault, sexual assault and sexual molestation. A body of research now exists that explores the consequences of severe invasions and includes the work in the areas of Post Traumatic Stress Disorder (PTSD) and Dissociation Identity Disorder (DID). You can use your search engines to find some quality web sites that provide excellent information on these conditions.


More subtle invasions can also wreck havoc on the mind and spirit of a developing person. Such a person, if she is creative, bright and determined to survive the assaults on her identity, can develop an eating disorder. The function of the eating disorder is to block out pain and resist invasion. Unfortunately the eating disorder also stops psychological development as it numbs emotions and awareness plus creates a disorder that mimics the hurt the person seeks to escape.

These non-criminal violations are powerful forces that can create an environment in which a young powerless person may need to develop an eating disorder in order to maintain her sanity and, sometimes, her actual survival.

When a young person has no privacy and no right to say, "No," it means she has no boundary between herself and others. No privacy means she can be invaded at any time in any way. When her diary is read, when her possessions are borrowed or taken without permission, when her efforts in school or sports or the arts are overwhelmed by someone else's ideas, goals or personality, when her choices are disregarded or treated with
disdain, when she has little or no choice in terms of clothes, foods, friends her boundaries are being violated.

Lack of boundaries means that no clear and agreed upon understanding exists in the young person or her caretakers about consequences of behavior. Essentials can be ripped away. Luxuries can appear for no reason. Emotions acted out in kindness or cruelty, material objects, abuse and gifts have no understood criteria for coming and going.

Boundaries are invaded when a young person has no responsibilities of her own and no recognized consequences for her actions. If she can have anything she asks for with no effort on her part she learns nothing about personal effort, limits, consequences or what enough means. If someone picks up her clothes, does her laundry, fixes her car, pays her
bills, lets her borrow money or objects without expecting them to be returned, the young person experiences no boundaries and no limits. She lives in a confusing chaotic world that doesn't respect her boundaries or the boundaries of others.

She doesn't have an opportunity to recognize and develop her own identity boundaries.
If she learns that she doesn't have to keep promises, if she doesn't appreciate and reciprocate the generosity of others she doesn't learn how to be in effective and warm relationships. She simply learns that she has no limits in her behavior and desires.
She learns this when her caretakers don't keep their promises, and/or don't have empathy and compassion for her experiences.

Gratifying a child's every whim is not a loving act nor is it spoiling a child through overindulgence. Such treatment is actually neglect. The child's identity, taste, capacity to grow, learn and function, her potential to be competent and responsible are neglected. Worse, this neglect may be based on the caretakers assertion that the child is incompetent and could not now or ever assume responsibility for her self-care. Worse yet, out of their own insecurities and personal weaknesses, caretakers may need to feel powerful and in control. They may feel threatened by a rising competent person in their midst.

When a powerless person is flooded with the agenda of others, even if well meaning, it's as if a steamroller is bearing down on her psyche. She may learn to please, manipulate, compete or control in order to cope and survive, but she is unable to learn to be fully present as her genuine self.

Boundaries are also invaded when a child is given too much responsibility, especially if the tasks require acceptance of deceit and family secrets. If a person with a mental disorder is given authority in a family and the child must defer to that person's illogical and emotional reasoning or outburst as if this were normal, the child either develops a distorted view of the world or develops an eating disorder to block out the assault on her own mind. If she is criticized, insulted, told she is crazy, stupid, clumsy, incompetent or sick for experiencing and expressing her honest response, she will either be severely damaged or develop an eating disorder to help protect herself.

Here are some examples of excessive responsibility that become intolerable
psychic assaults:
*She knows about a sexual affair of one parent and knows the other parent is ignorant of the affair.
*She knows about a crime or act of cruelty or deceit that she must keep secret or be branded disloyal.
*She is expected to witness crimes, acts of cruelty and neglect within her family (against people or animals) without protest or experience the pain of ridicule, punishment or rejection.
*She lives with and must accept the behavior and authority of a caretaker who behaves irrationally, i.e. screams, throws objects; dissembles appliances, computers, cars; takes charge of mail or money and doesn't follow through; must be the driver even though careless or tends toward road rage behavior, hallucinates.

The psyche of young and powerless person in such situations can create an eating disorder to block her from pain and these identity assaults. With the aid of the eating disorder the person places her heart and mind in cold storage until the day she is safe enough or strong enough to come out of hiding.

The tragedy is that she never learned the concept of enough. Furthermore, eating disorders have a tenacious hold on people because the disorder is deeply linked to survival issues. Even if she frees herself of the actual boundary-invading environment or
even if the authority figures change, she still lives the tragedy through the duplication of the invasive experiences in the disorder itself.

From within the structure of the eating disorder she criticizes herself so harshly that she is paralyzed and cannot take independent action in the world. She chooses abusive relationships because they are familiar to her. She is kidnapped for no reason she understands by the compulsive urge to binge or purge or hide through isolation. She cannot express her true feelings out of fear of punishment or abandonment and lives via a
false self. A sense of despair is ever present.

Recovery work involves far more than the end of eating disorder behavior related to food. Through work with trustworthy and responsible treatment professionals the individual undergoes an internal restructuring. She moves through developmental stages she missed while her heart and mind were in cold storage. She learns to cope with what seems to be a new and different world as her psyche matures. She learns how to nourish her body, heart and mind so she can be healthy and strong. From a position of health and strength she learns to recognize danger and make self-caring decisions. She learns that she can take responsibility for choices she makes to build a life for herself that is worth living.

Boundary invasions forced her to go into survival mode. It may be that during the survival mode she unknowingly developed a kind of psychic strength and courage that equips her to journey through the arduous path to recovery. Once she finds her treatment team she can release that courage and move to a life where she can take care of her true self.

Joanna Poppink, L.M.F.T., is a licensed marriage and family therapist. She has a private practice in Los Angeles since 1980 specializing in treating people with eating disorders. She provides psychotherapy to individuals with eating disorders and their family members. 10573 West Pico Blvd. #20. Los Angeles, CA 90064. (310) 474-4165. http://www.poppink.com