The self and eating disorders

In our review, we focus on self-related constructs in the context of eating disorders with four aims. First, we examine a variety of self-related constructs that have been theoretically and empirically linked to the development and course of eating disorders. In addition to the more well-researched constructs of self-esteem and self-efficacy, we also report on findings related to selflessness, contingent self-worth, self-objectification, ego-syntonicity, self-concept clarity, self-compassion, social comparison, self-oriented perfectionism/self-criticism, and narcissism. Second, we discuss self-related constructs that may be especially relevant to comorbidities common among those with eating disorders. Third, we review intervention and prevention programs where self-related constructs play a prominent role. Lastly, we share future research directions regarding self-related constructs and eating disorders that we believe will advance a deeper understanding of the role of the self in the eating disorders.     

Working with Italian patients in Munich – The case of Penelope1

Abstract

With their book Psychoanalytic perspectives on migration and exile (1989), L. Grinberg and R. Grinberg (1984) opened up a new clinical field, which had been neglected for a long time in the psychoanalytic community, although Freud’s multilinguistic competence had greatly contributed to the creation of psychoanalysis. With their book The Babel of the unconscious, Jacqueline Amati Mehler, Simona Argentieri, and Jorge Canestri were able to confirm the hypothesis that it is possible to help multilingual patients to integrate the different aspects of their self which are bound to their mother tongue and to their foreign tongue(s), and thus to allow them to develop a new identity. The author, who has been a psychoanalyst in Munich since 1999, works every day with his Italian patients in this new clinical field, that is in their common mother tongue and at the two levels of their old Italian and their new German identity. Through the detailed presentation of a clinical case, he furthermore shows how, on the one hand, the migration creates a new space in which therapy actually becomes possible, and on the other hand, not only therapy, but also the kind of relationship developed by the patients to their “new country” plays a decisive role in the whole process. Such a frame proved to be particularly good for the emergence, revisitation, and reelaboration of the transgenerational trauma around which the case of Penelope is centered. The author further assumes that the theme of “migration and identity” is becoming more and more important in our globalized world, with clinical consequences whose elaboration requires a specific cultural and technical preparation.     

Perversion and infancy and adolescence

Abstract

Studying the works of Freud and Lacan, the authors carried out research on perversion in childhood. Their work covered the perverse polymorphism of infantile sexuality and the perception of the anatomic difference between the sexes that leads the child to create sexual theories and fantasies. The phallic mother and the fetish are viewed as imaginary solutions directly related to the Oedipus and castration complexes. In perversion, a particular position is taken in relation to the Oedipus complex: a serious flaw occurs in the symbolization of the law, and the mechanisms of denial and disavowal take form. Sexuality requires a second “logical time,” separated from infancy by the latency period, in order to confirm (in action) that a fixed position of jouissance (enjoyment) has actually been established. This can only happen in a period after adolescent enhancement. The distinction between perverse traces and a perverse structure is made, taking into account the fact that, in the case of child analysis, the analyst should free the child from the family fantasy and help him/her to build his/her own fantasy.

Campos Santoro V. et al. Perversion und Kindheit und Adoleszenz.

Im Studium der Arbeiten von Freud und Lacan haben die Autoren Forschung über Perversion in der Kindheit gemacht. Die Studien behandeln den perversen Polymorphismus der infantilen Sexualität und die Wahrnehmung des anatomischen Unterschiedes zwischen den Geschlechtern, welche das Kind dazu führt, Sexual-Theorien und Phatasien zu schaffen.

Die phallische Mutter und der Fetisch werden als imaginäre Lösungen angesehen, die sich direkt auf den Ödipus- und Kastrations-Komplex beziehen. Bei der Perversion wird eine besondere Position in Bezug auf den Ödipus angenommen; ein ernsthafter Mangel tritt bei der Symbolisierung des Rechts auf; die Mechanismen der Verneinung und der Verleugnung bilden sich. Sexualität erfordert eine zweite “logische Zeit”, von der Kindheit durch die Latenz Periode getrennt, um (in der Handlung) zu bestätigen, daß eine fixierte Position der jouissance (Vergnügung) sich tatsächlich etabliert hat. Das kann sich nur in einer Periode nach der adoleszenten Verstärkung ereignen.

Es wird die Unterscheidung zwischen perversen Spuren und einer perversen Struktur gemacht, in Rechnung stellend, daß im Fall der Kinder-Analyse der Analytiker das Kind von der Familien-Phantasie befreien sollte und ihm/ihr helfen sollte, seine/ihre Phantasie auszubilden.

Campos Santoro V. Perversión e infancia y adolescencia.

Estudiando los trabajos de Freud y Lacan, los autores han investigado la perversión en la niñez. Los estudios cubren la sexualidad infantil perversa polimorfa y la percepción de la diferencia anatómica entre los sexos, que llevan al niño a crear teorías sexuales y fantasías.

La madre fálica y el fetiche son vistos como soluciones imaginarias relacionadas directamente con el complejo de Edipo y de castración. La perversión, toma una posición particular en relación al Edipo; un fallo importante tiene lugar en la simbolización de la ley; los mecanismos de negación y repudio toman forma. La sexualidad requiere un segundo “tiempo lógico” separado de la infancia por el periodo de latencia, para confirmar (en acto) que una posición fija de jouissance (goce) se ha establecido. Esto solo puede ocurrir en un periodo posterior a la intensificación adolescente.

La distinción entre las huellas perversas y la estructura perversa se ha hecho, teniendo en cuenta que, en el caso del análisis de niños, el analista debe librar al niño de la fantasía familiar y ayudar a el/ella a construir su propia fantasía.     

Narcissism,sex roles,and self-functioning

This study examined the relationship between gender, sex role, and narcissism. Two hundred and three students completed the Bem Sex Role Inventory, the Narcissistic Personality Inventory, and the Narcissistic Personality Disorder Scale, along with several measures of self-esteem and depression. Overall, the data indicated that males and masculine individuals were not higher in their levels of maladaptive narcissism, that an adjusted narcissism was more obvious in males and in masculine subjects, and that femininity appeared to inhibit the display of an unhealthy exploitive self-concern. Androgyny failed to appear as the healthiest sex role, although multiple regression analyses suggested that future research may need to further explore this possibility.     

Love, sex roles, and psychological health

College students were administered a series of questionnaires designed to determine the association between psychological health, involvement in a romantic relationship, and the quality of love in a relationship. As predicted, subjects who had been involved in at least one love relationship scored significantly higher on a measure of self-actualization than individuals who had never been in love. In addition, it was found that level of self-actualization directly correlated with the degree of healthy love (Maslow's B-love) among individuals who had been involved in a romantic relationship. Among individuals who had terminated their relationship, those who demonstrated higher levels of self-actualization felt less resentment toward their ex-lover. Furthermore it was discovered that females show a higher level of B-love than males, but contrary to predictions the length of a romantic relationship did not influence B-love. It is concluded that the results of this study are essentially consistent with Maslow's theories about self-actualization, hierarchy of needs, and healthy love.     

Loneliness, social interaction, and sex roles

Forty-three male and 53 female college seniors maintained the Rochester Interaction Record for 2 weeks, providing information about every social interaction of 10 minutes or more. Subjects then completed the revised UCLA (University of California, Los Angeles) Loneliness Scale and the Personal Attributes Questionnaire, measuring sex-role orientation. For both sexes, loneliness was negatively related to the amount of time spent with females and to the meaningfulness of interaction with males and females. However, meaningfulness with males was more important than meaningfulness with females. Femininity was negatively related to loneliness for both sexes and partially mediated the above relationships. There were sex differences, however, in the extent to which variables overlapped in predicting loneliness. For example, a large group of nonlonely males was characterized both by having meaningful relationships with males and by spending time with females, whereas a second group of nonlonely males was characterized simply by having meaningful relationships with males. The largest group of nonlonely females was characterized simply by having meaningful relationships with males, but another sizable group was characterized simply by spending time with females. Females doing both accounted for very little of the variance.     

Race,sex, and juvenile inmate roles

Mate selection researchers have long assumed that surveyed listings of ''ideal traits'' indicate strong preferences by women for virtuous males. This assumption is contradicted, however, by increasing evidence of sexual abuse in dating relationships and suggests the possibility that the hero-centric Western culture of romance greatly complicates the mating process. A review of literary heroism revealed extraordinary individualism. Notably, George Gordon Byron's protagonists ('Byronic Heroes') are men of stupendous assertiveness and uncertain morality; derivatives abound in contemporary American popular culture. A comparison was made of three typologies; the third, domestic batterers being ''stand-ins'' for abusive dates. Byronic traits were found to much more closely resemble those of batterers than of hypothetical ideal mates. Thus, the development of intense admiration of fictional Byronic Heroes during socialization could lead to an admiration of same traits in encountered males with or even tragic results.     

Loneliness and eating disorders

This article examines the link between loneliness and eating disorders. This concept is evaluated through a systematic review of the literature that links loneliness and eating disorders and through a survey of themes connecting the 2 conditions. Eating disorders-including anorexia nervosa, bulimia nervosa, and eating disorders that are not otherwise specified, which include binge eating disorder-are challenging health issues. Each of these diagnoses specifically relates to loneliness. This negative emotion contributes to and fuels eating disorder symptoms. Negative interpersonal relationships, both real experiences and individuals' skewed perceptions, exacerbate eating disorders and feelings of loneliness. Characteristics that have been associated with loneliness clearly relate to eating disorders. Understanding this relationship is vital, so that we can appreciate our patients' struggles and work to target these intense emotions within the treatment setting. We need to be aware of the power of loneliness as it applies to individuals in general and specifically to those struggling with disordered eating.     

Guilt, guilt-evoking events, depression, and eating disorders

A long theoretical tradition has linked guilt with internalizing disorders. We find no evidence, however, that a greater personality proclivity for guilt is related to depression or eating disturbances as reported by 85 female undergraduates. Females also described guilt-producing incidents involving school versus eating and exercise. We examined reactions to the events including guilt feelings and perceived effectiveness in alleviating these feelings, intropunitive responses, action tendencies, and rationalizations. Both depression and eating disturbances were unrelated to guilt feelings over school, but were related to guilt feelings over eating and exercise. Ineffective alleviation of guilt feelings in both domains was correlated with depression and greater eating disturbances. Women who reacted to guilt-producing events with fewer intropunitive responses such as rumination and self-hatred, and by confiding in others, distancing, and rationalizing their actions through justifications and excuses were less likely to have eating disturbances.     

Perfectionism in depression, obsessive-compulsive disorder and eating disorders

High levels of perfectionism have been observed in major depression, anxiety disorders and eating disorders. Though few studies have compared levels of perfectionism across these disorders, there is reason to believe that different dimensions of perfectionism may be involved in eating disorders than in depression or anxiety [Bardone-Cone, A. M. et al. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 84-405]. The present study compared patients with major depression, obsessive-compulsive disorder, and eating disorders on dimensions of perfectionism. Concern over Mistakes was elevated in each of the patient groups while Pure Personal Standards was only elevated in the eating disorder sample. Doubts about Actions was elevated in both patients with obsessive-compulsive disorder and eating disorders, but not in depressed patients. Analyses of covariance indicated that Concern over Mistakes accounted for most of the variance in the relationship of perfectionism to these forms of psychopathology.     

Healers,Leaders and Entrepreneurs: Shamanic Revival in Southern Siberia

While it is generally agreed that in the postmodern world all tradition is invented, in many post-colonial contexts the emerging identities are spelled out in the idiom of ‘traditional heritage’. This article considers the social field of ‘shamanism’ as it has been shaped in the post-Soviet years in Tuva, an autonomous republic within the Russian Federation in Southern Siberia, and analyses Tuvan shamanism as a product of local historical and social forces, and global processes. Based on both the ethnography of the organisational structure of contemporary Tuvan shamanism, and portraits of different categories of practitioners, the article analyses continuity and change in various aspects of what is locally seen as ‘traditional knowledge’, and discusses different skills, orientations, and divisions of labour among the practitioners. Shamanism in post-Soviet Siberia is seen as a postmodern religious movement enmeshed in global structures and processes, and it is only in this context that a local tradition can become alive and meaningful again.     

Cooperative and Conflictual Policy Preferences: The Effect of Identity, Security, and Image of the Other

What is the connection between identity and conflict behavior? This article begins by exploring some of the theoretical currents in this area, notably social identity theory, Erikson's work on identity development, Burton's ontological needs, and image theory. The theories differ somewhat in their expectations of the effect of identity development. Two studies were conducted to investigate these differences. The first, a priming experiment, partitioned identity and its effects. The second, a group-based simulation study, measured actual development of ingroup identity and assessed its effect on conflict behavior. Results from the first study show that identity does affect conflict behavior, but only as it is mediated by levels of insecurity. Increased feelings of security correspond to more cooperative behavior. Positive and negative images of the opponent, on the other hand, did not influence conflict behavior. In the second study, higher levels of ingroup identity resulted in more conflictual behavior. As with the first study, image of the other was not significantly related to conflict behavior.     

Forced migration, adolescence, and identity formation

Adolescence is a complex biopsychosocial phenomenon. All the inner-subjective changes in adolescents take place within the context of a specific social environment, which offers the necessary ideological setting that adolescents must confront in the course of their identity formation. Forced migration creates conditions under which the adolescent Ego may be traumatized more easily, resulting in the development of defensive mechanisms, which may interfere with the natural process of identity formation. The aim of this paper is to investigate how a traumatic situation such as forced migration may affect the mechanisms of identity formation in adolescence. For this purpose, clinical material, consisting of two cases of psychoanalytical psychotherapy of adolescents who were forced to immigrate to Greece, is presented and discussed in a psychoanalytical theoretical framework, along with the historical-sociological background.Dimitris C. Anagnostopoulos, M.D., is a child psychiatrist and psychoanalyst, Child and Adolescent Psychiatric Unit, Community Mental Health Center, Psychiatric Department, Medical School, University of Athens, Athens, Greece.Maria Vlassopoulos, Ph.D., is at the Child and Adolescent Psychiatric Unit, Community Mental Health Center, Psychiatric Department, Medical School, University of Athens, Athens, Greece.Helen Lazaratou, M.D., is at the Child and Adolescent Psychiatric Unit, Community Mental Health Center, Psychiatric Department, Medical School, University of Athens, Athens, Greece.     

Rumination, experiential avoidance, and dysfunctional thinking in eating disorders

The majority of research in eating disorders (ED) has investigated the content of disorder-specific thoughts, while few studies have addressed underlying cognitive-affective processes. A better understanding of processes underpinning ED may have important implications for treatment development. Two studies were conducted that investigated levels of rumination, beliefs about rumination, experiential avoidance, and aspects of schematic thinking in individuals with eating pathology. The latter was assessed with a newly designed ED-Sentence Completion Task (ED-SCT). Study 1 (N = 177) examined relations between ED psychopathology and these variables in a student population. Extending this, Study 2 (N = 26) assessed differences between patients with anorexia nervosa and healthy control participants. The results showed that ED psychopathology was related to disorder-specific cognitions, experiential avoidance as well as ruminative brooding but not reflection. A follow-up of anorexia nervosa patients indicated that changes in ED psychopathology were associated with changes in dysfunctional attitudes and maladaptive cognitive-affective processes. These findings highlight cognitive processes that may play an important role in the maintenance of eating pathology.     

Reflections on athletes and eating disorders

ObjectivesThe purposes of this paper were to offer reflections, thoughts, and observations on the burgeoning research regarding eating disorders in athletes over the past 25 years, to comment on the findings and clinical implications of the studies contained in this special issue, and to provide suggestions for future research.ResultsDisordered eating and eating disorders are complex, multidimensional, and multiply determined, and can affect the health and performance of athletes in both genders and most sports. Although coaches and teammates can be significant sources of weight and body image pressure, they can also play a positive role in identification and prevention.ConclusionsFurther research is needed in several areas. These include a broader focus that includes athletes believed to be at less risk, most notably males and non-lean sport athletes, and ironically younger athletes, who may be at greatest risk. We also need more research related to treatment of athletes with eating disorders and especially how we might better motivate them for recovery.     

The roles of ethnic identity,anti-white attitudes,and academic self-concept in African American student achievement

Conventional wisdom in much of the educational and psychological literatures states that the ethnic and racial identity of African American students is related to their academic achievement. The purpose of this study was to determine whether ethnic identity and anti-white attitudes predicted the academic achievement of African American students at a historically Black university. A hypothesized path model was proposed that included ethnic identity, attitudes toward other ethnic groups, anti-white attitudes, perceptions of caring faculty, academic self-concept, and devaluing academic success. The path analysis model explained 27% of the variance in grade point average and revealed three direct effects on grade point average: (a) academic self-concept (positive), (b) devaluing academic success (negative), and (c) anti-white attitudes (negative). Ethnic identity was indirectly linked with grade point average (GPA) through academic self-concept and devaluing academic success. Tests of two alternative nested models suggest that even in an indirect role, ethnic identity may be more important than anti-white attitudes in a model of African American academic achievement.

The thin ideal, depression and eating disorders in women

It is proposed that a cultural ideal of thinness for women causes depression at a higher rate among women than among men. This model accounts for five currently unintegrated trends in the epidemiology of depression. It explains why: (1) twice as many women as men are likely to be depressed; (2) this sex difference emerges at puberty; (3) this sex difference is only found in western countries; (4) there is more depression today; (5) the average age of onset for depression is younger now than in the past. Four parallel trends in eating disorders can also be accounted for by the same factor.