Symptoms of illness are an indication that the self's coping abilities are weakened, and conflicts have put the self in a state of strain, proving the need for external intervention. The symptoms that individuals experience vary according to the nature and extent of their unmet psychological needs. Most patients showing symptoms of eating disorders, especially those with bulimia nervosa, exhibit parallels between their eating behaviors and their ways of forming relationships with others. The parallelism between bulimic behavior and obsessive behaviors does not indicate that these patients have obsessive fixations. This is because the mechanism in eating disorders is different.
Many bulimic patients may have hoarding tendencies. Collecting friendships, objects can be thought of as fuel for their psychological mechanisms. When we look at individuals with eating disorders, we see that they have not internalized relationships, just like they vomit after eating without digesting it. Internalizing is related to being able to form close relationships and achieve authenticity in relationships. Individuals exhibiting eating disorder behaviors experience very fast emotional changes and go through many mood swings throughout the day.
This especially shows that they have not sufficiently internalized life experiences. Wanting more in relationships and being in a state of "attention gluttony" can hinder the development of relationships after a certain point. Because this gluttony is directed towards the individual's own "narcissistic" needs, it shows that they cannot invest in relationships. This situation cannot simply be described as these patients displaying "egocentric" behaviors, as the issue here is not the individual trying to be egocentric but the anxiety related to establishing a relationship with another person. Additionally, the failure to meet the narcissistic needs from the past and the unmet needs spilling over into adulthood, causes the individual to try to fulfill them, making it difficult for them to see others and establish healthy relationships, as they are fixated on fulfilling their own needs. And generally, the primary reason for seeking help is to resolve the problems they face in relationships.
Actually, establishing a relationship with someone is both something they desire and something they push away. Both desiring and worrying. In relationships, the "fill and empty" behavior pattern is no different from eating and then vomiting without allowing digestion. In relationships, it is also vomited before being digested and expelled from the body. In other words, just as food doesn't mix with the blood, meaning it doesn't become part of the "body," in relationships, it doesn't become part of the "self." Food is only as much as one can live on. A portion of relationships is only as deep as one is compelled to live and endure. Individuals with eating disorders often have unsatisfied and disturbed relationships with their mothers. These individuals' relationships with their mothers are highly conflictual. Their mothers are generally either obsessive or depressive.
In eating disorders, conflicts are mostly expressed through the body. The body becomes the spokesperson for conflicts. The individual's internal conflicts fluctuate between body weakening and weight gain. And this struggle becomes a lifestyle. Externalizing the conflict makes it easier. Because dealing with the visible is always easier. Many bulimic patients decide to seek help around the end of their twenties or in their second half because the failures in their relationships have started to become noticeable. On the one hand, superficial relationships become both harmless and, at the same time, increasingly unsatisfying. Therefore, seeking help may be an attempt for fulfillment. Help may be sought as a means of fulfillment or in the pursuit of how to provide more fulfillment. However, with good interventions, the source of their dissatisfaction is shown, and the use of the body as a spokesperson is halted. In bulimia, after the mechanism begins to collapse, psychosomatic conditions like migraine attacks may emerge, as the individual is used to somatizing and doesn't know how to deal with the internal struggle in another way. The language of body and psychosomatic reactions has been learned. It has become the language of the self. As verbalization and abstraction abilities increase, the source of the conflict is identified and addressed, thus both the "relational fill and empty" behavior and the eating and vomiting behavior are eliminated.
In Bulimic Patients,
- There is behavior that harms the body, as they deprive themselves of food. (Binge eating is not for pleasure, but is an unconscious ritual.)
- There is no internalization in relationships. The way they relate to others is superficial, and they have difficulty forming deep relationships. They face relationship problems. Relationships are either long-term but uninternalized, or there are frequent separations.
- Conflicts with the mother are very apparent, and these conflicts are processed with a dependency process at one end.
- Bulimic patients' mothers are either obsessive, depressive, anorexic, or their mothers are rule-based, authoritarian, and rigid.
- They do not face issues in academic and professional areas. Where there are no emotions, there are no problems.
- Fear of abandonment, their reactions to separation, and their inability to tolerate these situations are quite weak.
- Dealing with the body is the main preoccupation of their life.
- Rather than thinking, taking action and being in constant motion is a relaxing state for them.
- The hunger for attention in relationships can disrupt their relationships. Because in relationships, they desire to "consume" attention and long for it.
