Hypothesis: Deficits in mentalization cause the development of eating disorders.
Methods: The study relied predominantly on pertinent journals, which were retrieved from pertinent databases that included Pub Med-NCBI (National Center of Biotechnology Information) and Google scholar.
Results: Having performed an in-depth analysis of the primary literature, the study established that deficits in mentalization result in the development of eating disorders.
Conclusions: The study concluded that deficits in mentalization cause eating disorders since they induce, emotional dysregulation, non-acceptance, loss of the self, and poor object relations, interoceptive awareness, and affect regulation capacities.
Key words: Mentalization, Object relations, Affect regulation, Eating disorders, Attachment, The self
Mentalization and Eating disorders
According to Fonagy, Bateman & Bateman (2011), mentalization is a process through which, individuals interpret and make sense of their own mental states and those of others, both implicitly and explicitly. Implicit mentalization is defined as people’s automatic and unconscious abilities to understand, and imagine their own mental states and those of others. On the other hand, explicit mentalization can be defined as people’s conscious and deliberate capacities to understand their own mental states and those of others. These mental states include beliefs, feelings, desires, reasons, and motives among many others. An individual’s ability to mentalize develops during early childhood. Fonagy et al. (2011) argue that deficits in mentalization trigger severe forms of mental disorders, and psychopathologies. These deficits mitigate an individual’s capacity of self-regu...
lation, self-awareness, affective consciousness, mindfulness, and self-mirroring. Psychoanalytic research suggests that there is a significant correlation between the mentalization process and the development of eating pathologies. Eating disorders are characterized by the adoption of weight control and disturbed dietary behaviors, which ultimately interfere with an individual’s psychological, physical, and psychosocial functioning (Robinson et al., 2014). There 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.
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 developmen
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