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Attachment

Self-Beliefs, Perfectionism, and Emotions

How attachment issues can lead to eating disorders.

Miramiska/Shutterstock
Miramiska/Shutterstock

Attachment bonds are the bonds you make when you’re an infant with whoever takes care of you – mother, father, or other caregiver. Babies attach to people who are sensitive and responsive in social interactions with them and who are consistently in their lives between ages six months and two years. As an infant learns to crawl and then walk, he uses his parents and other familiar people in his life as a secure base from which to explore his environment, knowing if he runs into any problems, he can return to that secure base for comfort and safety. Attachment styles have also been linked in research to severity and type of eating disorder diagnoses.

Attachment issues tend to be difficult to understand and often don't seem relevant to day-to-day life. But maybe you have someone in your family who’s a great person, but just can never sustain a relationship for very long. Or you know someone who rages when they get angry or who can’t stop themselves from sobbing over things other people wouldn’t sob over. You may be married to someone who is very needy in relationships but struggles to trust you, which has caused problems in your marriage. Or you grew up with a parent who was emotionally unavailable. Or your partner is a serial cheater or avoids talking about his feelings by being at work all the time. These are all examples of people who may have attachment issues.

Research is now showing that something called “insecure attachment” may also explain why people with a history of toxic stress related to childhood trauma or other specific childhood issues (abandonment, neglect, abrupt separation from a parent, frequent changes in caregivers, lack of caregiver responsiveness, or the death of a loved one or other losses) have difficulty in their relationships.

Secure attachment isn't related to whether your parents or caregivers loved you or whether they fed you properly. It's more related to nonverbal emotional forms of communication between infant/toddler and caregivers. Secure attachment comes from an infant feeling safe around the people in their life who care for them because those adults respond to them and they can "trust" that their needs will be met. Children who have secure attachment styles are more resilient as adults and more able to bounce back from setbacks or disappointments. They will be more able to manage their emotions when they are faced with conflict.

There are many reasons why children are unable to form secure attachments with even loving parents or caregivers:

  1. A mother who is young and has little experience and not much social support.
  2. A parent with depression or substance use disorders.
  3. Separation from parent or caregiver due to adoption, illness, death or divorce.
  4. Inconsistency of caregiver — multiple nannies, daycares, etc.
  5. Frequent moves when child is young, perhaps due to being in foster care.

Insecure attachment styles include:

  • Anxious Attachment (AA). People with AA may be needy, craving intimacy but afraid that they can't trust their partner or friend. AA comes from inconsistent caregiving: Your parent or caregiver was there for you sometimes but at other times, distracted or unavailable. AA can be associated with an emotional hunger that can lead to binging and purging.
  • Avoidant Attachment (AvA). With AvA, you may find it difficult to tolerate intimacy and may use activities like work to avoid being with your partner. You value your freedom and independence over all else. AvA can be due to having a caregiver who was rejecting or unavailable. Because your needs were not met, you learned to take care of yourself. AvA is associated with perfectionism leading to strict dietary habits like restricting or dieting. AvA has been linked in research to anorexia nervosa.
  • Disorganized Attachment (DA). You may find intimate relationships confusing and may alternate between intense love and hate for a partner. You crave intimacy but may be terrified of getting hurt and don't feel you are worthy of love. DA can be either anxious type or avoidant type with corresponding eating behaviors.

A majority of people with food obsessions, binge eating, and emotional eating may have insecure attachment styles. Insecure attachment can be related to adverse childhood experiences (ACEs) — divorce, domestic violence, physical emotional or sexual abuse, or physical or emotional neglect, along with poverty, mental illness or substance abuse in a parent.

If you experienced ACEs, you may also have insecure attachment, both of which are related to emotional dysregulation. This is important because If you have trouble regulating your emotions — for example, if your emotions seem to flood you or if you just can’t cope with strong emotions — you may use food to push down your emotions, even happy ones.

When your needs have not been met as a child, you may have tried to explain this to yourself, leading to the development of core beliefs such as "The reason I'm being abused is I'm not loveable/I'm not worthy." These inaccurate beliefs become what I call core beliefs and serve as the operating system of your life – acting behind the scenes without you even realizing it. It’s like having on purple glasses and everywhere you look things look purple. When you take off the glasses, you suddenly can see the world how others see it — more clearly.

Individuals with insecure attachment are also prone to perfectionism. Their perfectionism may lead to them being willing to take extreme measures to meet the "thin ideal." When they are not able to whip their body into shape, they may turn to more restriction or to binging and other disordered eating behaviors.

Keep in mind that an avoidant attachment style isn’t a character flaw. It’s a self-protective response to difficulty that served a positive purpose early in your life. Because your communication and emotions may have been rejected when you were young, you might have developed a harsh inner critic that still tries to protect you by causing you to deny your emotions and avoid close relationships. Or by causing you to try to fit into a perfectionistic body image or develop negative core beliefs that keep you trapped in binge eating, food compulsions, and dealing with your emotions with food.

When you start to accept and honor your emotions and learn to regulate them without food, when you identify old negative core beliefs and decide whether they fit for you or not, and when you address perfectionism resulting from trauma and attachment insecuity, you will be able to address your deeper hunger, which is not for food but for self-expression and healing.

References

Brewerton TD. (2007). Eating disorders, trauma, and comorbidity: focus on PTSD. Eating Disorders, 15(4), 285-304.

Cortés-García, L., Takkouche, B., Seoane, G., & Senra, C. (2019). Mediators linking insecure attachment to eating symptoms: A systematic review and meta-analysis. PloS one, 14(3), e0213099.

Mitchell KS, Mazzeo SE, Schlesinger MR, Brewerton TD, Smith BN. Comorbidity of partial and subthreshold ptsd among men and women with eating disorders in the national comorbidity survey-replication study. Int J Eat Disord. 2012 Apr;45(3):307-15. doi: 10.1002/eat.20965. Epub 2011 Oct 19. PMID: 22009722; PMCID: PMC3297686.

Budia JM, Alcover CM, Fernández-Muñoz JJ, Blanco-Fernández A, Félix-Alcántara MP. Attachment, Motivational Systems and Anorexia Nervosa: A systematic review and proposed framework for eating disorders. Clin Psychol Psychother. 2023 Mar 2. doi: 10.1002/cpp.2845. Epub ahead of print. PMID: 36861498.

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