Ego Boundary Disturbance in Anorexia Nervosa: Preliminary Findings

Abstract

Boundary disturbance and the developmental level of the Rorschach human representations of anorectic patients were studied. A group of 12 anorectics was compared with a control group in regard to their degree of boundary disturbance, the developmental level of their human responses, the degree to which they attribute affect to their percepts, and the nature and degree of drive-dominated ideation. The anorectic patients showed significantly more contamination responses, reflective of a breakdown in their self-other boundaries. The affect elaboration, human representations, and drive-dominated ideation measures failed to differentiate the two groups. These findings provide preliminary support for clinical observations from both individual and family perspectives that families of anorectics show greater boundary disturbance which appears to be internalized by these patients. Thus, much of their symptomatology might be understood as an attempt to gain autonomy through an overaccentuation of the boundary between themselves and others. The failure of the drive-dominated ideation measures to differentiate the two groups supports the deemphasis of the role of psychosexual factors.

Denial of illness in anorexia nervosa—a conceptual review: part 2 different forms and meanings

“…In similar terms, anorexia nervosa might be understood as an attempt to gain autonomy through an overaccentuation of the boundary between themselves and others (Sugarman, Quinlan, & Devenis, 1982). In a transactional framework, the anorexic youngster's refusal to eat may be viewed within the family context as a 'negativistic pattern', a form of resistance or rebellion against the parent(s) experienced as overcontrolling: the child will refuse to eat in the presence of the mother, but might binge in secret (Marcus & Wiener, 1989).…”

Autonomy disturbances in subtypes of anorexia nervosa.

“…Very little research has tested object-relational postulations empirically. Only two investigations bear even indirectly on self-and object representations in anorexia nervosa (Strober & Goldenberg, 1981;Sugarman, Quinlan, & Devenis, 1982), and their findings were contradictory and inconclusive. Minuchin, Rosman, and Baker (1978) described the anorexic's autonomy difficulties as emblematic of familywide grappling with boundaries and individuation.…”

The contribution of psychodiagnostic test results toward understanding anorexia nervosa

“…More importantly, there is very little overlap in variables examined. For example, cognitive-perceptual factors (Otte, 1970);Palauoli, 19n;Rowland, 1970;Small et al, 1982;Stroberg & Goldenberg, 1981;Sugarman et al, 1982b), content and dynamic factors (Otte, 1970;Luyckx & de Aguilar, 1972-73;Moron & Bruno, 1972-73), personality traits (Gandiglio, Purpura, & Zerbino, 19n;Moron & Bruno, 1972-73;Palmer, Mensh & Matarauo, 1952;Wagner & Wagner, 1978), symptomatology (Luyckx & de Aguilar, 1972-73), defensive styles (Thielgaard, 1965), and behavioral aspects (Otte, 1970) have been examined. Compounding the difficulty are very small samples and poor research designs.…”

“…Furthermore, they have embarked on developing an integrated theory, the core of which is that anorexics show a fusion of separate ideas or percepts in their thinking and also exhibit a breakdown of self-other boundaries (Sugarman et al, 1982b). These investigators have identified that failures in development can be traced back to the failure to negotiate the transition from the differentiation to the practicing subphase of the separation-individuation continuum.…”