Clinginess of the non-static variety

I love it when a seemingly little insight can yield so much understanding. In this case, the insight isn't from therapy or thinking, but instead from research (and a cleverly worded press release).

Why Anorexic Patients Cling to Their Eating Disorder

This has been a topic of much conversation and consternation in therapy for me. My one therapist, Dr. G, would always ask me what I was getting out of the eating disorder because "there had to be something since I kept on starving myself." It's true that my eating disorder had an adaptive function, but in those moments when I could recognize how ill I was, I usually wanted to rid myself of the eating disorder, not cling to it. But Dr. G and I discussed things like control and mothers and feelings and some of it was useful and some of it was simply a time suck.

Many times, I didn't really have an explanation for my behaviors. I didn't necessarily understand them myself, and when an understanding did dawn on me it rarely resulted in real, lasting behavioral change. A lot of times, the ED behaviors were just a part of my routine. I woke up, I did X. At "lunchtime", I did Y. After work/school, I did Z. I ate the same breakfast every day for almost two years because choosing a different cereal was overwhelming and I had planned my meals around this one particular type of cereal so I kept on eating it.

The recent paper from the American Journal of Psychiatry titled Neural Correlates of Impaired Cognitive-Behavioral Flexibility in Anorexia Nervosa, found that my experience with a need for routine and inflexibility was common to many AN patients. In fact, the researchers hypothesized that anorexics "clung" to their disorder because they had difficulties in developing new behavioral patterns.

“In this study, we confirmed that anorexic patients cling to familiar behavioral responses more frequently than healthy subjects, thus suppressing alternative behavior," explained Dr. Hans-Christoph Friederich, head of the working group for eating disorders. The analysis of the MRI images also showed that in patients with anorexia compared with healthy subjects, a certain network pathway between the cortex and the diencephalon is less activated. This network pathway plays a decisive role in initiating and controlling actions under rapidly changing environmental demands.

The results of the study contribute decisively to a better understanding of anorexia. In particular, they make it clear that neurobiological factors are involved and sustain the clinical symptoms. Since psychological and neurobiological factors can influence each other, this may lead to new therapy approaches for anorexia.

"We have developed a treatment program for anorexia patients that specifically targets the flexible modification of behavioral responses,“ says Dr. Friederich. In this way, the researchers hope to improve the success of psychotherapeutic treatment. The MRI examination of the brain could contribute to measure the success of treatment.

(I inserted the links in the above quotes)


Anonymous said...

i like this ... and i can relate. i have a hard time with change, and i get into my little routines and am comfortable - i definitely can say that sometimes i fall back into my unhealthy eating patterns just because it is what i do - it is what i know - and no choice is involved.
some of my friends tell me that when i am faced with too many options, i freeze - i just don't choose anything because it is easier to have to make the choice. i think that falls into this same frame of thinking.

thanks for this

CeCe said...

I'm in agreement with Sarah. It's funny just today my fiance was asking me how I can eat the same thing every day for months on end because right now it's PBJ in the morning. EVERY day. I told him it's comfortable for me to eat that PBJ. I don't think most would understand that-he didn't. I know the world doesn't end when I eat it, the calories and nutrients are such that is comfortable for me to eat and that makes me feel safe so to speak and so I keep doing it.

Carrie Arnold said...

For me, I can listen to the same CDs over and over and over again, in a continuous loop that would drive my brother bonkers. He'd always ask me "Do you HAVE to do that?" And I would say "Why, yes. Yes I do." And there are some books I can keep re-reading, too. So this trait extends far beyond EDs.

Eating With Others said...

Total agree. Forget the whole CD, I listen to the same track over and over for hours at a time. This seemed perfectly normal to me until now. Great more stuff to think about. When I first showed my T what I was eat, not just the exchanges she freaked. Said it was not ok to eat the same thing every day - ok 2 or 3 times a day. Lunch and dinner, a chicken breast, canned spinich, a slice of whole wheat bread- the only variety came from subing mixed vegies sometimes. That was life since Jan. Now there are choices - I hate choices.

Carrie Arnold said...

For me, the sameness is quite soothing and reassuring. The food hasn't changed, the song hasn't changed, the book hasn't changed, and it makes me feel just a little okay.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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