Andrea’s Case Analysis of Bulimia and Anorexia

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Andrea’s Case Analysis of Bulimia and Anorexia

This paper herein takes a closer look at the case of Andrea, who despite being perceived as startlingly thin by her friends, is distressed because of her weight. As seen from the case, Andrea got worried about her weight two years ago, when her parents were in a feud to even divorce each other, which indicates the stressful condition in the family as one of the causes of Andrea’s worry. She is also of the opinion that she feels more in control because of her eating habits. She also feels that looking thinner makes others pay more attention to her and that she is fond of having a more athletic figure. This paper would discuss about the Behavioral, Cognitive, Socio-cultural and Psychodynamic perspectives associated with her fulfilling all the criteria of being diagnosed with Anorexia and Bulimia.

Psychodynamic Perspective on Bulimia

Bulimia is characterized by binge eating of high caloric food and then purging out with self-induced vomiting and is also characterized by repetitive attempts of keeping oneself to restrictive diets (Swift and Letven, 1984). The Psychodynamic approach leading to Bulimia, is based on the work of Balint (1955, 1968) and Kohut (1971, 1979), according to which, the Bulimics have “basic fault” in their ego structure, in specific, their ego function that regulate tension. The intolerably high levels of internal tension impair their sense of self. Behaviorally, the symptom manifestation of complex behavior tries to alleviate internal tension by acting as a defensive reparative maneuver to bridge that basic fault (Swift and Letven, 1984). However, instead of dispelling it, the maneuver initiates a biopsychological regression that leads onto serious physical sequelae (Swift and Letven, 1984).

Behavioral and Cognitive Perspectives

Behaviorally, Andrea seems to seek others’ attention by expecting the reinforcement from eating less and looking thinner. Since one tends to engage in behaviors that harness rewards and avoids behaviors that reap punishment (Pearson et al., 2015), Andrea pursues thinness as a reward and thus, has a behavior to binge and purge out. However, it is noteworthy, that such behaviors lead to completely opposite behavioral tendencies (Pearson et al., 2015). An Escape Theory (Heatherton & Baumeister, 1991) is a model that demonstrates that people who binge eat tend to perceive inadequacies in themselves that generates negative emotion. Smyth et al. (2007) suggest that the negative affect leads to episodes of Binge-Purge in women that decreases the negative affect after they purge out or after the episode (Pearson et al., 2015). The cognitive perspective of Binge-Purge Syndrome is that binge tends to shift the cognition towards one’s favorite foods and purging out releases the emotional distress (Pearson et al., 2015). There is usually self-control depletion involved with the Binge-Purge episodes (Pearson et al., 2015). Thus, in Andrea’s case, Negative Affect and stress are the causes of Bulimia and Anorexia. 

Psychosocial Perspective and Thinness

The psychosocial perspective of Bulimia is that women tend to make strong expectations from the rewards of thinness and eating (Pearson et al., 2015). Parental overconcern regarding daughters’ weight and the belief that thinness improves overall life improvement, also pressurizes women to look thinner (Pearson et al., 2015). In Andrea’s case, it is clear that she has expectations of looking thinner and so, she shows such a behavior out of negative affect and in order to keep it at bay, she Binges food and purges out at the same time.

Works Cited

Pearson, Carolyn, M., Wonderlich, Stephen, A. and Smith, Gregory, T. A Risk and Maintenance Model for Bulimia Nervosa: From Impulsive Action to Compulsive Behavior. Psychol Rev. 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486518/

Swift, William, J. and Letven, Ronelle. Bulimia and the Basic Fault: A Psychoanalytic Interpretation of the Binging-Vomiting Syndrome. Journal of the American Academy of Child Psychiatry, 23, 4:489-497, 1984. https://www.jaacap.org/article/S0002-7138(09)60330-7/pdf