Starvation as self-preservation: the paradoxical nature of anorexia nervosa through the lens of schizoid phenomena

Anorexia nervosa is a disorder that affects millions in the United States and has the highest mortality rate of any mental illness, estimated at or above 10%. The majority of sufferers are female, though the number of male cases continues to increase. The current study seeks to explore and interpret the internal experiences of females with anorexia through the lens of British object-relations theories regarding schizoid phenomena. This dissertation offers a review of the current clinical and psychoanalytic literature on female anorexia, as well as current empirical findings. There is also a summary of the theories of Guntrip and Laing on schizoid mechanisms, along with a discussion of psychological aspects of modernity as discussed by Sass and Bordo. This study utilizes published memoirs of women in recovery from anorexia, and through narrative inquiry methodology explores the hypothesis that anorexia is an attempt to alleviate and resolve schizoid concerns. In the analyses, thirteen themes emerge that capture the paradoxical nature of anorexia, in which the sufferer engages in a process of destructive self-preservation. Central to these findings is a self-annihilating narcissism that describes the internal experiences of preoccupation and self-loathing within the sufferer, as well as a desire to become a person without needs and without a body. These are shown to provide a protective boundary between the internal self and the external world. In an attempt to assert a sense of self through starvation, the sufferer exists in a state between being and non-being, which often leads to serious medical complications and sometimes death. Lastly, these paradoxical themes tie into literature on the schizoid condition, which provides insight into the contradictory experiences of anorexia. The splitting that occurs in anorexia between an inner self and a body self appears to parallel the splitting within the schizoid, which protects the person against fears of annihilation, engulfment, implosion, and petrification by the other.Psy. D.Includes bibliographical referencesby Lauren Courtney Dehle