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A Psychologist's Thoughts on Clinical Practice, Behavior, and Life

The Childhood Origin of Anorexia Nervosa

Though the psychodynamics of Anorexia Nervosa are well understood, it remains the deadliest of mental health disorders with the highest death rate. Its origin lies in parental failure to encourage their child's independence with the child's only possible autonomous behavior being to control what they eat.

Symptoms begin at a time of expected independence for this child who is socially immature and has little awareness of their feelings, the family power struggle around eating being a substitute for the normal developmental struggle of separating from parents and entering adult relationships. Thus symptoms arise when personal autonomy is required: beginning school, entering puberty, or leaving for college.

The initial treatment goal must be to restore and maintain the patient's healthy nutrition. Starvation affects the central nervous system causing increased irritability, hyperactivity, and an obsession with food. Individual psychotherapy can then help the patient resolve their dependency issues and rage toward parental figures, with their low self-esteem naturally rising as normal developmental goals are achieved.

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