Attachment, Trauma, and Eating Disorder - By Mark Schwartz, Sd. D.

The attachment system of the brain is conceived as a biologically and evolutionary-based survival system that evolved to encourage people to connect with other people in times of distress to improve their safety. The rules governing that system are laid down in early childhood through close attunement between the infant and caregiver, and are actively implemented thereafter. Sometimes attachment goes awry or is incomplete, resulting in too much or too little attachment. The avoidant child actively "snubs or ignores" the mother, restricting his attention while exploring his environment in a hyperactive fashion in order to discourage attachment (Wallin, 2000). The preoccupied child seems content but strictly confines his attention to monitoring his mother's whereabouts, ignoring exploration and mastery.

Attachment theory suggests that restrictive anorexia or binge eating could be a dismissive strategy to actively keep the individual from needing food and love, or to substitute the transitional object value of food preoccupation for needing people. A failed attachment system exposes the infant to extreme levels of unmodulated stress, aloneness, and inner emptiness,. This stress can drive the urge to restrict, overeat, or both. Addictions, in general, provide an illusion of control when individuals experience the disequilibrium resulting from the simultaneous activation of their attachment system and fear system. When the person who cares for you is also perceived as dangerous, the result is this type of destabilizing dysphoria. At first glance, eating disorders appear to be about preoccupation with food. On closer observation though, the obsessive regulation of the intake of food is often a frantic attempt to cope with life stressors, particularly intense, dysregulated emotions and confusion regarding identity and self-esteem. Eating obsessions may be used to avoid potential rejection from friends and romantic partners. They can also create the unfortunate, self-fulfilling outcomes that reinforce the original unrecognized, yet enacted, fears around attachment. Unable to establish a stable identity base, the individual states, "I don't know who I am," "I feel like an imposter," or "I'm really bad, but pretend to be good." This confusion and dichotomy is exemplified in the oft-repeated history of the "good girl who earns "A's" and never gives anyone a "moment of trouble," who then compulsively lies, steals, and has promiscuous sexual relations.

At the core of any individual's capacity to bond, lie self-empathy and the related capacity for self-care. Without a caretaker who mirrors and validates the individual's real self, facilitates the expression of attuned affect and who also provides meaning in situations that overwhelm, the individual is often left with feelings of profound shame. They may also display a need to people please, and experience perfectionism that is channeled into the symptom of "feeling fat." They come to believe that only food, or the restriction of food, will reliably quell the internal emptiness.

Disorganized Attachment

Of increased recent interest are individuals with disorganized attachment styles (Main and Hesse, 1992-1998). Researchers originally identified children who, in "strange situation" at 18 months of age, both approached and avoided the returning parent, often appearing dazed, confused, and apprehensive. It is as though an oddity in the structure of the attachment relationship prevents the child from consolidating a coherent strategy for bonding. This occurs in direct