Anorexia nervosa is one of the most complex and daunting challenges in mental health. Through my clinical experience, I’ve come to see that while anorexia’s complexity cannot be overstated, certain core themes consistently emerge. These insights, drawn from working closely with young people and their families, aim to provide a clearer understanding of what might be happening beneath the surface and offer perspectives that many parents have found supportive.
1. Anorexia as a Way to Feel in Control
For many adolescents, anorexia can feel like a place to hide away—a mental escape where everything feels tightly managed. When the outside world seems overwhelming or chaotic, focusing intensely on food and the body can feel like a way to bring order to that chaos. Rather than being about looks, this control is usually a way to feel safe and stable, as if creating a small world where they can decide what happens, away from the pressures of emotions and relationships.
2. Fear of Needing Others
Teens with anorexia often struggle with feeling dependent or needing others. Eating, in this context, can start to feel like accepting help or care from someone else. By not eating, it’s like they’re saying, “I don’t need anything from anyone,” which can feel safer than risking the potential disappointment or vulnerability that comes with being looked after. Food, then, isn’t just food—it’s a symbol of relying on others, something that might feel too risky or uncomfortable.
3. “Good Self” vs. “Bad Body”
A common pattern is for these adolescents to separate themselves into two parts: an “ideal self,” which feels smart, disciplined, and “pure,” and a “bad body,” which they might see as carrying shameful or unacceptable feelings. This split is often related to early relationships where they felt uncertain about the love or care they’d receive. The body, with its needs and feelings, becomes something to keep in check or even punish, almost like they’re keeping their “good” self safe by controlling the “bad” part.
4. Emptiness as a Way to Avoid Feelings
For some, the drive for thinness in anorexia is a way to avoid feeling anything too deeply. By trying to be “empty,” they may feel like they can be free from the “weight” of difficult emotions like anger, fear, or shame. Thinness becomes a way of being “light” and detached from the messy parts of being human, like needing support or feeling vulnerable. This isn’t about body image; it’s about a desire to feel clear and clean, free of emotions they find hard to manage.
5. Anger Turned Inward
Beneath the surface, many young people with anorexia feel a deep, often hidden, sense of frustration or even anger. This may be directed toward people who couldn’t meet their needs in ways that felt safe or reliable. However, because they feel unable to express this anger directly, it turns inward, taking the form of strict self-control. Refusing to eat can then become a hidden act of rebellion—a way of saying “no” to what others offer, even if it’s just a meal.
6. The Desire for a “Safe Space” in the Mind
Anorexia often creates a mental space that feels private and controlled, almost like a retreat. Adolescents who feel that others can be intrusive or overwhelming may use their control over food and body as a way to create a boundary, a safe, contained area where they can avoid being pulled into others’ expectations or demands. This “claustral” or confined state provides a sense of safety, especially for those who’ve had relationships where boundaries didn’t feel respected.
7. The Ideal of Independence
Lastly, many adolescents with anorexia develop a strong wish to be completely self-sufficient, to need nothing from anyone. They may feel that by controlling their body and emotions, they can avoid the vulnerability of needing others. This desire for complete independence, while it may seem like a strength, often hides a deep fear of being let down or hurt. Anorexia becomes a way to live out this “perfect independence,” where every part of life is managed without needing anything from outside.
I hope these core themes help - everyone is unique of course so we must always hold that in mind.
Comments