Emotions and Eating Disorders: Treatment Implications

Four Pathways to Anorexia Nervosa: Patients' Perspective on the Emergence of AN

“…The Avoidant perceived pathway illustrates the emergence of AN as a way of coping with negative emotions and social insecurity. Avoidance of emotion has been linked to the phenomenology of AN from a theoretical (Fox, Federici, & Power, ), empirical (Brockmeyer et al, ; Corstorphine, Mountford, Tomlinson, Waller, & Meyer, ; Wildes, Ringham, & Marcus, ) and patient perspective (Espeset et al, 2012; Nordbø et al, ). It has been proposed to be a core element of the pathology of AN, and a study by Wildes et al () found that AN patients seem to have higher scores on emotional avoidance than patients with other mental illnesses.…”

Emotion Coupling and Regulation in Anorexia Nervosa

“…It is also worth stating that the cross‐sectional aspect of this study means that the actual eating disorder symptomatology could have led to an increase in negative self‐beliefs and self‐disgust. However, as detailed in Figure , the SPAARS‐ED model also discusses how the actual symptoms of an eating disorder actually feedback in the emotion system, because certain symptoms are more likely to increase negative emotion, such as disgust and negative self‐beliefs (see Fox et al, ).…”

“…It has long been noted that AN is often associated with poor social skills (Treasure et al, ), and these difficulties, it is argued, are pivotal in the genesis of AN (Schmidt & Treasure, ). Research and theory have discussed how losing weight is often seen as a means to be more respected and, hence, likeable and to feel more in control (e.g., Fox, Federici, & Power, ), and the parallel processes of emotion suppression and weight loss become connected over time. Thus, the SPAARS‐ED model argues that the suppression of anger in AN becomes ‘coupled’ with the emotion of disgust.…”

Understanding the ‘Anorexic Voice’ in Anorexia Nervosa

“…How, and why, the anorexic voice emerges in eating disorders is unclear. Possible aetiological factors include the internalization of critical messages during childhood, the disownment of unacceptable thoughts or emotions, the intrusion of dissociated cognitive content upon conscious awareness and/or the effects of prolonged starvation (Fox, Federici, & Power, 2012a; Pugh, ). From an evolutionary standpoint, the anorexic voice could be conceptualized as performing (maladaptive) defensive functions such as facilitating the avoidance of threatening interpersonal events including shaming or rejection.…”