My sister is bulimic and has been in therapy for several months now. She seems to be making progress, but this eating disorder seems to rule her life nevertheless. Overwhelmed with conflicting desires, she is obsessed with food and her appearance. I see her suffer and wonder what has caused her to develop such behaviors. I know that there are several factors that can play a role in the inception of an eating disorder. Because of my sister’s problems, I have become interested in the interplay between familial relationships and bulimia. Is there a relationship between family interactions and bulimia?
There have been numerous studies about the characteristics of a bulimic's family. One of the earliest by Laurence Igoin-Apfelbaum (1985), studied 21 women who were diagnosed by the DSM-III as bulimics. In the group of patients, two patterns of family background could be found. Thirteen patients were from broken homes, and a common characteristic of these families was that the father virtually disappeared from the life of the daughter. The twelve other patients came from close knit families, in which the sacred union of these families against the outside world was a defensive organization hiding major tensions within the family unit.
The relationship between the bulimics and their mother is one of polarity. They feel that because their eating disturbances seem to worry their mother, she is the only one who cared, and as a result they do such things as calling their moms daily to make sure she is not worrying. At the same time they avoid their mother because they feel she can guess everything or demand so much from them that they would have no personal life left.
All the patients had harsh words for their fathers. They see him as an incompetent irresponsible man who, in 50% of the subjects, was a violent tyrant who flies into wild rages, beats his wife, lies, or is a seducer. The patients who were the most self-reproachful and depressed after binges were those who drew the worst images of their father.
According to this study, the patient is overcome by her desire for a loving family. The patients realize that their families are beyond any patching up, and to escape the reality, they become bulimics. They cannot give up the idea that their families are forever lost, and to have a sense of their own existence, they make up a fantasy. Bulimia then, is a secret behavior, that is a celebration. The patients regress to a time when the family was together, and this psychological state is accompanied by bingeing. The occurrence of bulimia may be related to the combination of a history of violent separations in the family, and the endless denial of these separations (Igoin-Apfelbaum, 1985).
I have several problems with this study. The first and foremost is that I have trouble understanding how the author was able to conclude from the evidence that bulimic patients binge because they are going through a regression. The evidence that led to that...