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Eating Disorders and Personality Disorders (narcissism) |
Current Info on Eating Disorders |
Eating Disorders
Eating Disorders and Personality Disorders (narcissism) uestion: Do narcissists also suffer from eating disorders such as bulimia nervosa or anorexia nervosa?Answer: Patients suffering from eating disorders either binge on food or refrain from eating and sometimes are both anorectic and bulimic. This is an impulsive behaviour as defined by the DSM and is sometimes comorbid with Cluster B personality disorder, particularly with the Borderline Personality Disorder. Some patients develop eating disorders as the convergence and confluence of two pathological behaviours: self-mutilation and an impulsive (rather, obsessive-compulsive or ritualistic) behaviour. The key to improving the mental state of patients who have been diagnosed with both a personality disorder and an eating disorder lies in focusing at first upon their eating and sleeping disorders. By controlling his eating disorder, the patient reasserts control over his life. This newfound power is bound to reduce depression, or even eliminate it altogether as a constant feature of his mental life. It is also likely to ameliorate other facets of his personality disorder. It is a chain reaction: controlling one's eating disorders leads to a better regulation of one's sense of self-worth, self-confidence, and self-esteem. Successfully coping with one challenge - the eating disorder - generates a feeling of inner strength and results in better social functioning and an enhanced sense of well-being. When a patient has a personality disorder and an eating disorder, the therapist would do well to first tackle the eating disorder. Personality disorders are intricate and intractable. They are rarely curable (though certain aspects, like obsessive-compulsive behaviours, or depression can be ameliorated with medication or modified). The treatment of personality disorders requires enormous, persistent and continuous investment of resources of every kind by everyone involved. From the patient's point of view, the treatment of her personality disorder is not an efficient allocation of scarce mental resources. Neither are personality disorders the real threat. If one's personality disorder is cured but one's eating disorders are left untouched, one might die (though mentally healthy)… An eating disorder is both a signal of distress ("I wish to die, I feel so bad, somebody help me") and a message: "I think I lost control. I am very afraid of losing control. I will control my food intake and discharge. This way I can control at least ONE aspect of my life." This is where we can and should begin to help the patient - by letting her regain control of her life. The family or other supporting figures must think what they can do to make the patient feel that she is in control, that she is managing things her own way, that she is contributing, has her own schedules, her own agenda, and that she, her needs, preferences, and choices matter. Eating disorders indicate the strong combined activity of an underlying sense of lack of personal autonomy and an underlying sense of lack of self-control. The patient feels inordinately, paralyzingly helpless and ineffective. His eating disorders are an effort to exert and reassert mastery over his own life. The patient does not trust himself in the slightest. He rightly considers himself to be his worst enemy, a mortal adversary. Therefore, any effort to collaborate with the patient against his own disorder is perceived by the patient as self-destructive. The patient is emotionally invested in his disorder - his vestigial mode of self-control. The patient views the world in terms of black and white, of absolutes ("splitting"). Thus, he cannot let go even to a very small degree. He is constantly anxious. This is why he finds it impossible to form relationships: he mistrusts (himself and by extension others), he does not want to become an adult, he does not enjoy sex or love (which both entail a modicum of loss of control). All this leads to a chronic absence of self-esteem. These patients like their disorder. Their eating disorder is their only achievement. Otherwise they are ashamed of themselves and disgusted by their shortcomings (expressed through the distaste with which they hold their body). Eating disorders are amenable to treatment, though comorbidity with a personality disorder presages a poorer prognosis. The patient should be referred to talk therapy, medication, and enrol in online and offline support groups (such as Overeaters Anonymous). Recovery prognosis is good after 2 years of treatment and support. The family must be heavily involved in the therapeutic process. Family dynamics usually contribute to the development of such disorders. In short: medication, cognitive or behavioural therapy, psychodynamic therapy and family therapy ought to do it. The change in the patient following a successful course of treatment is VERY MARKED. His major depression disappears together with his sleeping disorders. He becomes socially active again and gets a life. His personality disorder might make it difficult for him – but, in isolation, without the exacerbating circumstances of his other disorders, he finds it much easier to cope with. Patients with eating disorders may be in mortal danger. Their behaviour is ruining their bodies relentlessly and inexorably. They might attempt suicide. They might do drugs. It is only a question of time. The therapist's goal is to buy them that time. The older they get, the more experienced they become, the more their body chemistry changes with age – the better their chances to survive and thrive. About the Author Sam Vaknin is the author of Malignant Self Love - Narcissism Revisited and After the Rain - How the West Lost the East. He is a columnist for Central Europe Review, PopMatters, and eBookWeb , a United Press International (UPI) Senior Business Correspondent, and the editor of mental health and Central East Europe categories in The Open Directory Bellaonline, and Suite101 . Visit Sam's Web site at http://samvak.tripod.com Written by: Sam Vaknin ### While the articles on this Website were written with great care, errors or omissions may occur. The information is provided "as-is", without any warranty whether expressed or implied. All readers agree to use the information provided on this site entirely at their own risk. The information provided here is for educational purposes only and should not be used as a basis for any form of diagnosis or treatment for any medical condition whatsoever - including eating disorders. If you suspect you or someone you know has an eating disorder, always seek the advice of a professional medical doctor. Eating Disorder Symptoms in the News07/30/2010Flu Vaccines Are Approved and Urged for Most The Food and Drug Administration approved vaccines for the next flu season, and health officials recommend vaccination for everyone 6 months old and older. Flu Vaccines Are Approved and Urged for Most 07/31/2010 Swine Flu Pandemic Hit Children the Hardest Title: Swine Flu Pandemic Hit Children the Hardest Category: Health News Created: 7/30/2010 10:51:00 AM Last Editorial Review: 7/30/2010 10:51:31 AM Swine Flu Pandemic Hit Children the Hardest 07/30/2010 Your New Flu Vaccine Is On The Way, A Little Early Flu season is in full swing in the Southern Hemisphere, with H1N1 the predominant strain in Australia and New Zealand. No one's predicting what our season will look like just yet. Your New Flu Vaccine Is On The Way, A Little Early 07/30/2010 Flu vaccine for under-5s given OK THE suspension of flu vaccine for children under five has been lifted by the after a series of adverse reactions earlier in the year. Flu vaccine for under-5s given OK 07/30/2010 Flu vaccine for under-fives given OK THE suspension of flu vaccine for children under five has been lifted by the Commonwealth's Chief Medical Officer. Flu vaccine for under-fives given OK Eating Disorders (Home) | Eating Disorders Sitemap
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ating disorders include complusive overeating (eating excessively) or eating far too little (overly restrictive eating) or any other compulsion to eat in a manner that upsets or threatens physical health. Eating disorders that are continued over time may have severe consequences on a person's health, including death.