Attachment and separation difficulties in eating disorders: A preliminary investigation

Abstract

Disruptions in normal attachment, signaled by intense separation distress, can be conceptualized as a central risk factor underlying the development of anorexia and bulimia nervosa. In a preliminary study of the hypothesis, Hansburg's Separation Anxiety Test, derived from Bowlby's attachment theory, was administered to eating‐disordered inpatients. These patients evidenced significantly more severe separation and attachment difficulties than is normal in adolescence and in adults undergoing developmentally based relationship crises. They appear to make no cognitive distinction between brief, everyday leavetakings and more permanent breaks. The implications of these findings, and of Bowlby's attachment theory, for the understanding and treatment of eating disorders is discussed.

Eating disorders and attachment: the effects of hidden family processes on eating disorders

“…Previous studies of eating disorders have used only the ABC model, as assessed by several different methods, and had very small samples. The results are contradictory and inconclusive with most, but not all, studies finding (1) few or no secure Type B women with eating disorders and (2) no clarity as to whether most are dismissingly Type A or preoccupyingly Type C (Amstrong & Roth, 1989;Candelori & Ciocca, 1998;Cole-Detke & Kobak, 1996;Fonagy et al, 1996;Heesacker & Neimeyer, 1990;Kenny & Hart, 1992;Lavik, Clausen, & Pedersen, 1991;Ramacciotti et al, 2001;Ward, Ramsay, Turnbull, Benedettini, & Treasure, 2000). Based on these studies, it seems clear that most women with an eating disorder had problems with childhood family relationships, but the nature of the problem and its relation to eating disorders are unclear.…”

Disturbances in identity and self-regulation in bulimia nervosa: Implications for a metaphorical perspective of “body as self”

“…Such an environment would likely interfere with the development of a separate sense of self, at the same time creating a strong motivation to separate from the source of distress. In fact, such difficulties with separation and individuation have been empirically supported (Armstrong & Roth, 1989).…”

Dissociation, Traumatic Attachments, and Self-Harm: Eating Disorders and Self-Mutilation

“…The frequency of self-mutilation in adolescents in residential treatment was found to increase significantly when a staff member announced that he would be leaving his job (Rosen et al 1990). More severe separation and attachment difficulties than are normal were found in eating disordered patients, who seemed to make no cognitive distinction between brief, everyday leave-takings and more permanent breaks, reacting to both as if they were abandonments (Armstrong and Roth 1989). Similarly, Chassler (1997) found that anorexia and bulimia were linked with feeling unwanted.…”