Mentalization and Eating Disorders Essay

are different types of eating disorders. They include bulimia nervosa, anorexia nervosa, and binge eating disorders. Psychoanalytic studies indicate that individuals with impaired mentalizing capacities are more susceptible to the aforementioned eating pathologies. In this regard, it is correct to presume that deficits in mentalization can trigger the development of eating disorders.

Background Literature

Gander, Sevecke, & Buchheim (2015), argue that deficits in mentalization trigger complex attachment issues, which play a central role in the development of eating disorders. There are two types of attachment patterns. They include secure and insecure attachment patterns. Secure attachment patterns are characterized by the provision of emotional availability and support. Secure attachment enables children to internalize external interactions and experiences. These attachment patterns trigger the development of internal working models, which in turn boost children’s abilities to anticipate and make sense of their caregivers’ responsiveness, availability, feelings, needs, and the like. Through secure attachment, children develop a sense of self- awareness and self-identity. As a result, they are able to view themselves as lovable and valuable individuals. Unlike secure attachment patterns, insecure attachment patterns are characterized by the lack of emotional availability and support. Insecure attachment mitigates children’s abilities to make sense of external experiences and interactions (Ward, Ramsay & Treasure, 2000). As a result, they are unable to make sense of other people’s mental states and responsiveness. Further, insecure attachment patterns also hinder the development of self-identity, self-concept, and self-awareness. This in turn impedes children from developing the capacities to understand their own feelings, sensations, beliefs, motives, and desires.

Gander et al. (2015) further argue that insecure attachment patterns impede the development of individual mindfulness, by hindering the development of self-identity,

self-awareness, and self-concept. Mindfulness is perceived as the conscious ability to make sense of present feelings or sensations, without making judgments on basis of past experiences. Lack of individual mindfulness triggers the impaired recognition of satiety and hunger. This in turn results in the adoption of maladaptive weight control and dietary habits, which trigger the gradual development of eating pathologies. Insecure attachment patterns trigger lower acceptance of the self and body image, by hindering the development of self-concept and self-awareness. Typically, body image refers to the manner in which people perceive their bodies. There is a significant correlation between body image and eating disorders. Dissatisfaction in bodily appearance creates the need for bodily augmentation, which is often achieved through restrictive dietary and physical exercise patterns. Overall, distorted body image triggers the adoption of disordered and maladaptive eating patterns, which increase an individual’s susceptibility to bulimia, anorexia, binge, or orthorexia eating disorders.

Gander et al. (2015) conducted a theoretical review, in an effort to ascertain the presumption that there is a correlation between attachment and the development of eating disorders. The review evaluated thirteen studies, which incorporated self report measures and eight studies which incorporated narrative instruments. After exhaustive evaluation, the researchers concluded that a significant majority of patients with eating disorders had insecure attachment patterns. In this regard, they ascertained the presupposition that deficits in mentalization contribute imperatively in the development of eating disorders.

According to Merwin, Zucker, Lacy & Elliot (2010), poor interoceptive awareness is categorized as a resultant feature of deficits in the mentalization process. The authors further argue that poor interoceptive awareness contributes imperatively in the development of severe mental disorders, including eating disorders,

personality disorders, and the like. Merwin et al. (2010), indicate that interoceptive awareness is characterized by an individual’s capacity to accept their affective and somatic experiences, and clarity, with regard to emotional responses. Deficits in mentalization trigger the lack of interoceptive awareness, which in turn triggers the lack of emotional clarity. Individuals that lack emotional clarity are often subject to emotional dysregulation. In this case, they are not able to identify, explain, and separate their bodily sensations, from their emotions. For example, individuals that lack emotional clarity may mistake anxiety for hunger or satiety. These maladaptive interpretations in turn motivate individuals to adopt disorderly eating habits, which ultimately result in the development of eating disorders. In addition to triggering the lack of emotional clarity, the lack of interoceptive awareness also triggers non-acceptance. Merwin et al. (2010), argue that non-acceptance is characterized by the development of negative and distorted body attitudes. Non-acceptance prompts individuals to alter their dietary patterns accordingly, in an attempt to improve body image. Altered dietary patterns in turn induce the adoption of disordered eating habits that ultimately trigger the development of eating disorders.

Merwin et al. (2010), further argue that individuals that lack emotional clarity find it difficult to distinguish fantasy and internal distortion, from the accurate and realistic representation of external events, due to emotional dysregualtion. Such individuals are capable of perceiving and understanding reality. However, they often opt to reject its significance and meaning (Shore & Porter, 1990). For example underweight persons may develop a compulsive obsession with obesity. In this case, despite being underweight, such individuals believe that they are over-weight. Thus, they feel compelled to lose more calories. The

inability to distinguish internal distortion from accurate external events is perceived as a deficit of mentalization. This inability may prompt underweight individuals to adopt disorderly eating habits in an attempt to lose weight. This results in the development of eating disorders.

Merwin et al. (2010) conducted an empirical evaluation, to ascertain the presumptions regarding interoceptive awareness and the development of eating disorders. The authors incorporated experimental methods, which were used to deconstruct features of interoceptive awareness, among individuals that embraced restrictive dietary habits. Based on the results, individuals embracing restrictive eating habits were subject to emotional dysregulation. In this case, they lacked the capacity to interpret and understand their emotional responses, feelings, and bodily sensations. This in turn made it difficult for them to discern feelings of hunger from feelings of satiety thus, triggering the adoption of disorderly eating habits. Further, based on the results, individuals that maintained restrictive dietary patterns lacked interoceptive awareness, which in turn prompted them to develop negative bodily attitudes. These attitudes compelled them to maintain restrictive eating habits, in an attempt to augment their body appearance.

According Mauler, Hamm, Weike & Tuschen-Caffier (2006), mentalization is a combination of interpersonal and self-reflective components. These components enable individuals to discern eternal reality from internal reality, and interpersonal relationships from emotional processes. Typically, these components contribute imperatively in the development of the self and individual agency. Mauler et al. (2006) argue that deficits in mentalization hinder affect regulation, which is perceived as the capacity to modulate and understand one’s psycho-physiological constructs (affective states). Affect regulation enables individuals to develop defenses and resistances against emotional experiences, and other factors that might inhibit normal mental functioning. Overall,

affect regulation boosts people’s capacities to regulate their emotions. With regard to the development of eating disorders, Mauler et al. (2006) argue that individuals that lack the capacity to regulate their emotions (affect regulation), are more susceptible to developing negative attitudes towards food cues, hunger and satiety sensations. For example, an individual may develop a negative attitude toward hunger sensations. In this case, the individual will be more likely to adopt unhealthy and disorderly dietary patterns, which ultimately contribute to the development of eating disorders. Likewise, an individual may develop a negative attitude towards food cues. In this case, the individual will embrace dysfunctional strategies, intended to control the overall amount of food consumed.

These dysfunctional strategies in turn result in the development of eating disorders.
Mauler et al. (2006), conducted an empirical evaluation, intended to ascertain the correlation between affect regulation and the development of eating disorders. The evaluation included one hundred and fifty-six female participants. The participants were distinguished into two groups. The first group comprised of women suffering from bulimia. On the other hand, the second group was comprised of healthy and normal participants. The researchers evaluated the participants’ affective regulation capacities. After an in-depth evaluation, the researchers concluded that women suffering from bulimia depicted negative attitudes towards food cues. This attitude was regarded to as the primary causative factor of the women’s eating disorder. Women with bulimia also depicted impaired affect regulation capacities. The researchers concluded that the lack of affect regulation capacities contributed to the development of negative attitudes towards food cues. Conversely, the researchers concluded that the normal women depicted positive attitudes towards food cues. As a result, the women did

not attempt to incorporate dysfunctional dietary management strategies. Thus, they were not susceptible to bulimia. Further, the researchers also concluded that the normal women had normal affect regulation capacities. Therefore, they concluded that these capacities enabled the normal participants to develop positive attitudes towards food cues thus, hindering the development of eating disorders. Overall, individuals that lack affect regulation capacities are susceptible to eating disorders, since they lack the ability to understand, interpret, and regulate their emotional responses. In this case, they are unable to regulate and understand the negative attitudes they develop towards food cues, hunger and satiety sensations. People with impaired affect regulation capacities feel compelled to incorporate restrictive dietary patterns, in an attempt to resolve these negative attitudes.

These dysfunctional dietary patterns in turn trigger the development of eating disorders.
Weinberg (2006) argues that the mentalization process is vital and imperative for the normal development of the self. Through mentalization, children acquire the capacity to internalize responses, which in turn trigger the development of self-awareness and self-identity. Typically, mentalizing enables individuals to develop a sense of self-direction and self-regulation. These factors in turn trigger the development of a sense of continuity, agency, coherence, and responsibility for individual choices and behaviors. Weinberg (2006) noted that deficits in mentalization result in the loss of the self. In this regard, individuals with impaired mentalization capacities are unable to develop a sense of self-agency, self-awareness, self-direction, self-concept, and self-identity. This in turn triggers the loss of the self. Typically, the self is perceived as the inner being, which shapes an individual’s persona and character. The loss of the self is characterized by the prioritization of the external being,

and the trivialization of the inner being. In this case, individuals that are subjected to the loss of the self, tend to prioritize their external appearance, which is gauged on basis of weight, beauty, and the like. The loss of the self induces the development of eating disorders, by prompting individuals to shift their focus from their inner being to their external appearance. People that lose the self develop a compulsive obsession with their weight. In this case, they tend to adopt dysfunctional eating disorders accordingly, in an effort to maintain ideal weight (Weinberg, 2006). For example, over-weight individuals that lose the self may feel obliged to lose weight. Consequently, they opt to embrace unhealthy dietary strategies, which ultimately trigger the development of eating disorders.
Ruangsri (2009) argues that mentalization plays an imperative role in the establishment of human relationships.

Through mentalization, individuals acquire the capacity to understand other people’s mental states thus, making it easier for them to develop human relationships. The object relations theory postulates that human beings are driven primarily by the need to establish human relationships. Ruangsri (2009) notes that deficits in mentalization trigger impaired object relation capacities. Typically, object relations refer to the internalized relationships established between significant others (objects) and the self. Object relations is characterized by the mental representation of the self in relation to the object, the object in relation to the self, and the relationship established between the self and the object. Ruangsri (2009) argues that the development of eating disorders is rooted in impaired object relations. This impairment triggers the disorganization of the self. In this case, individuals with impaired object relation capacities are less likely to self-regulate. They

also lack the capacity to distinguish their desires and wants, from those of other people. Further, they also develop the fear of breakdown. As a result, they opt to attune themselves to the wishes and wants of other individuals, in an attempt to establish relationships. Impaired object relation capacities trigger the development of eating disorders in two ways. First, individuals with poor object relation capacities lack the ability to understand and interpret their feelings, since they focus primarily on the desires and wants of other people (Heesacker & Neimeyer, 1990). As a result, they develop other means of regulating basic affects. More often than not, such individuals use their bodies as a means of regulating their basic affects. They often incorporate disorderly eating habits, in order to perfect their bodily appearances. Disorderly eating tendencies gradually result in the development of eating disorders.

Second, impaired object relations also trigger the development of eating disorders by hindering symbolization. Individuals with impaired object relations often lack the capacity to symbolize. Ruangsri (2009) argues that a child’s mother acts as the primary object. Children that fail to internalize motherly relationships often lack the capacity to symbolize or find a substitute to the primary object (the mother). With regard to eating disorders, individuals with impaired object relation capacities, tend to perceive food as the primary object, as opposed to a substitute. For example, individuals may use starvation as a way of separating themselves from the primary object. Generally, food is equated to the failed mother-child relationship. Therefore, individuals opt to starve themselves, with the intent to control the failed mother-child relations. These tendencies gradually result into the development of eating disorders.
Discussion

Given

an in-depth evaluation of relevant literature, it is evident that there is a significant correlation between deficits in mentalization and the development of eating disorders. Based on the reviewed literature, deficits in mentalization trigger the development of eating disorders in various ways. Firstly, deficits in mentalization trigger eating disorders by hindering the normal development of the self. As highlighted earlier, the mentalization process enables individuals to understand their own mental states and those of others. This understanding aids the development of self-identity, self-concept, and self-awareness. These factors in turn trigger the normal development of the self. Deficits in mentalization trigger the lack of self-identity, concept and awareness thus, hindering the development of the self. Individuals that are subjected to the impaired development of the self, tend to focus primarily on their external appearances, since they trivialize their inner being (the self). In this case, they feel obliged to augment their external appearances. This motivates them to adopt unhealthy and disorderly eating patterns, in an effort to acquire ideal bodily appearances. These eating patterns gradually trigger the development of eating disorders. Secondly, deficits in mentalization induce eating disorders by hindering the development of normal affect regulation capacities. Based on the analysis of literature, affect regulation refers to an individual’s ability to regulate emotions, and other factors that impede normal mental functioning. More often than not, individuals with impaired affect regulation capacities, develop negative attitudes toward food cues, satiety, and hunger. These attitudes motivate such individuals to adopt dysfunctional eating management strategies, which result in the development of eating disorders particularly bulimia.

Thirdly, deficits in mentalization also trigger the development of eating disorders by hindering the normal development

of object relations capacities. Ruangsri (2009) notes that object relations refer to people’s capacities to foster human relationships. Deficits in mentalization hinder people from understanding their own mental states and those of others. This in turn makes it difficult for them to foster human relationships. Individuals with impaired object relations capacities are more likely to prioritize the needs and wants of other individuals, in an effort to foster human relations. As a result, they end up neglecting their wants and desires. People that lack object relations capacities may feel obliged to lose or gain weight, in order to fit in with other people and feel accepted. The obligation to lose or gain weight motivates them to adopt dysfunctional and disorderly eating habits that ultimately trigger the development of eating disorders.
Further, impaired object relations capacities also trigger eating disorders by impeding normal symbolization abilities. Object relations capacities develop during early childhood stages. The mother acts as the primary object. Individuals that are subjected to poor mother-child relationships often lack the ability to symbolize. They also develop negative attitudes toward the primary object (the mother). Such individuals tend to equate food to the primary object. In this case, they develop negative attitudes towards food, since they equate it to the primary object. The development of these negative attitudes is linked to the lack of proper symbolization capacities. As opposed to viewing food as a substitute to the primary object, individuals view it as the primary object. These attitudes motivate them to adopt dysfunctional eating habits, which induce eating pathologies.

Fourthly, deficits in mentalization also trigger the development of eating pathologies by impeding the normal development of interoceptive awareness

capacities. These capacities make it easier for individuals to understand and interpret their emotional responses, feelings, desires, and wants accurately. Poor interoceptive awareness triggers emotional dysregulation, which is characterized by the lack of emotional clarity. People that lack emotional clarity are more susceptible to developing eating disorders. They are often unable to discern hunger and satiety, from other emotions such as anxiety or fear. In this case, they may mistake satiety for fear. Thus, they may feel obliged to alter their dietary patterns accordingly. These alterations result in the incorporation of disordered dietary patterns, which in turn induce the development of eating disorders. Fifthly, deficits in mentalization also trigger the development of eating disorders by hindering the development of individual mindfulness. Typically, mindfulness is perceived as the ability to interpret and understand one’s feelings accurately, without making judgments on basis of previous encounters. Individuals that lack mindfulness are more susceptible to developing eating disorders, since they find it difficult to understand hunger and satiety sensations. These maladaptive interpretations of emotional feelings and bodily sensations trigger the adoption of disorderly eating habits, which in turn induce the development of eating disorders.

A significant majority of the primary literature indicate that affect regulation, loss of the self, insecure attachment, non-acceptance, emotional dysregulation, and lack of interoceptive awareness, object relations, and symbolization capacities, are among the primary causes of eating disorders. However, factors such as genetic makeup have also been classified among primary triggers of eating disorders. Skårderud (2013) argues that eating disorders are also rooted in people’s genetic make-up. People born with certain genotypes such as the FTO genes are more susceptible to developing eating disorders. The FTO

gene encodes the alpha-ketoglutarate protein also known as the obesity and fat mass protein. Individuals that have the FTO gene have the GG and GA genotypes (Helder & Collier, 2010). These genotypes increase their susceptibility to eating disorders.

Conclusion

Based on the evaluation, it is apparent that deficits in mentalization cause eating disorders. Mentalization aids the development of the self. It also makes it easier for individuals to understand their mental states and those of others. Deficits in mentalization hinder the development of the self. They also hinder the accurate understanding and interpretation of mental states. In this case, these deficits induce the lack of object relations capacities, interoceptive awareness abilities, emotional clarity, affect regulation, mindfulness, self-identity, concept, and direction. Individuals that lack the aforementioned factors are more susceptible to developing eating disorders, since they are unable to discern sensations of hunger and satiety, from other emotions. They are also susceptible to eating disorders since they trivialize the self and prioritize external appearance. Further, they also lack the capacity to symbolize and regulate their emotions. This also makes them susceptible to eating disorders. Further research should be conducted to evaluate the correlation between mentalization and the development of eating disorders. The research will not only provide an extensive understanding of the relationship between mentalization and eating disorders, it will also inform treatment strategies for eating disorders.

References

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3. Heesacker, R. S., & Neimeyer, G. J.
   

(1990). Assessing object relations and social cognitive correlates of eating disorder. Journal of Counseling Psychology, 37(4), 419.