The development of Bulimia Nervosa: A psychological phenomenological analysis

There are many competing etiological theories of Bulimia Nervosa (BN), the majority of which solely address current bulimic behaviors without systematic regard for the life-historical development of the bulimic experience. The literature is fragmented, as various components of the disorder (e.g. sociotropy, dissociation, and anger) have been studied in isolation rather than as interrelated to other pieces of the complex whole. Similarly, there have been no studies on the emergence of BN within its life-historical context or from a developmental perspective. Therefore, a psychological phenomenological analysis was conducted in order to understand the life-historical development of BN, and to examine the similarities and differences in the emergent experience of bulimia among people classified as having BN and those classified as having subclinical bulimia (SCBN; people who exhibit all of the symptoms of BN without enough frequency to meet the criteria for a BN diagnosis). The roles of factors that have been found to be associated with BN (i.e. sociotropy, dissociation, and anger) were also examined. Individual interviews and focus group interviews were conducted with 20 undergraduate students (19 females, 1 male) classified as having BN, SCBN, and no history of an eating disorder. The findings of this study show that the origins of the life-historical development of BN lie in a deep experience of loneliness and isolation, and in a search for seeking refuge within love and comfort. The results suggest that family relationships, body image, comfort, sociotropy, dissociation, and feelings of anger are all significant constituents within the life-historical development of BN. These constituents were also found to be essential to the development of SCBN; however, their organization and structure differed from that of BN. The origins of the life-historical development of SCBN lie in a pervasive fear of being rejected and a persistent movement towards perfection, in an attempt to thwart any potential circumstances of possible rejection. The present study generally offers support for the existing research and theories on BN by elucidating the data of lived experience to which they refer. This study also goes beyond the available research by demonstrating the limits and deficiencies of particular lines of research and theories, supplementing the established findings with original ones, and integrating disparate lines of research