We know from previous podcast episodes about eating disorders that family therapy is offered as a treatment option, so family dynamics and relationships are a core part of eating disorders. However, we don’t know until now the role of attachment styles and how our attachment impacts our risk of developing eating disorders. In this great clinical psychology podcast episode is a developmental psychology spin, we focus on attachment styles and how they impact a person’s chance of getting an eating disorder. If you enjoy child psychology, clinical psychology and eating disorders then you definitely don’t want to miss this episode.
Today’s episode has been sponsored by Developmental Psychology: A Guide To Developmental and Child Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also, you can buy the eBook directly from me at https://www.payhip.com/connorwhiteley
And I have to admit here that I am seriously good at being psychic at times, because I won’t go into details here but I have had a very tough week for my own mental health. I am fine now but this was the toughest week I’ve had in years. However, this podcast episode is brilliant because it’s given me a lot of food for thought and a lot of practical tips I can use in my own life and I don’t even have an eating disorder. This going to be a lot of fun.
How Does Attachment Style Impact Eating Disorders?
If you’ve ever done developmental psychology before then you might be aware that our relationships are largely determined by the type of attachment style we have. Then this impact on our relationships can impact our mental health, happiness and the state of our protective factors when it comes to mental health difficulties.
As a result there are four attachment styles and these describe how we maintain and establish our relationships. Firstly, you have secure attachment and this is all about a positive perception of the self and others, so we have the capability to form and maintain close connections with other people and tolerate differences and being separated from them, as well as we can maintain effective emotional coping.
Secondly, you have an anxious attachment. This is an insecure attachment style where a person needs a high need of reassurance, has trouble trusting others and a fear of abandonment.
Thirdly, you have an avoidant attachment, which is another type of insecure attachment style. This is where a person avoids close connections and has a tendency to dismiss feelings and push away from intimacy.
Finally, you have disorganised attachment, and personally I quite like this one because I sort of feel like at this point psychology sort of gave up naming things. Since this is a massive miscellaneous category, so this is a final type of insecure attachment style that characterised by a conflicting or inconsistent response to close connections. Mainly think of this one as a mixture of avoidance and anxious.
Thankfully, there’s a lot of good, high-quality research that links attachment styles and eating disorders. For example, a 2019 meta-review on the topic showed us that people with avoidant or anxious attachment styles are actually more vulnerable to developing eating disorders. This is because these people unfortunately have difficulty in establishing relationships and maintaining these close relationships as well as intimacy, trusting others and exerting self-control over their emotional responses. All of these are traits that might very well help cause
and maintain an eating disorder.
For instance, if we look at Binge-Eating Disorder or even Bulimia, if someone uses their poor relationship with food to cope with their emotional responses. Then they eat a lot and if they have Bulimia they have extreme measures to get rid of the food. This helps them to believe or feel like they’re having control over their life again.
As a result, the authors of the 2019 meta-analysis argued that when it comes to treating eating disorders, we need to focus on addressing the client’s attachment style. Since this might be critical in the recovery process.
Personally, I am really hopeful of any research that helps us to develop eating disorder treatments because we so badly need them. Due to even Cognitive Behavioural Therapy which is our best and most effective treatment for eating disorders still isn’t that grand compared to CBT for other mental health conditions. And over a third of clients still never enter recovery from an eating disorder.
Another study from 2021 looked at the relationship between a person’s attachment style with their friends and parents and the rate of body dissatisfaction in teenagers. As you can imagine, when there were high levels of alienation, trust and communication issues, there was also high levels of body dissatisfaction. Therefore, the researchers argued that we need to maintain our social relationships positively and help a client work towards a secure attachment style with their friends and parents as this might cause a protective effect against body dissatisfaction.
Finally, when it comes to very recent research, another study from 2022 looked at attachment style and how it impacted treatment outcomes for clients undergoing Enhanced Cognitive Behavioural Therapy (CBT-E). The results showed a significant link between treatment outcomes as well as insecure attachment styles because the negative attachment styles caused lower rates of remission and higher rates of eating disorders. Meaning whenever a client comes to us as future or current clinical psychologists, we need to explain to them the role of relationships in their condition and why it is important to create and maintain closeness with others.
How Developing A Secure Attachment Style Can Help With Eating Disorder Recovery?
I mentioned earlier how in psychotherapy, we can help people to adopt and develop a secure attachment style to help them establish and maintain their close relationships. Now we need to look at how this actually helps in a little more detail.
This all comes down to resilience because interdependence is a very helpful way to build someone’s resilience and help them recover from an eating disorder. Since having a network of dependable connections provides a client with a sense of belonging, acceptance and security. Something I know is flat out critical for mental health. This helps the client to increase their self-acceptance and self-worth.
And I will be honest here this is something I am struggling with at the moment and I know this is hard for anyone. But accepting yourself for who you are and what has happened in the past but also what needs to happen in future so you can move on and have a great life. That is critical and the fact that we do have a way to do this in a therapeutic setting is brilliant.
Anyway, by helping a client to develop trustworthy relationships that give them emotional support so they are able to get through the tough times. In addition, to the practical support when it comes to them planning enjoyable activities, helping to distract them during the hard times and helping them to prepare their meals. This all helps a person to stay motivated for the long term so they can recover.
Therapy isn’t easy but with the right support it is possible.
And the critical aspect of all of this is the simple fact that in psychology, we understand that supportive relationships are the key to start building a life for ourselves and our client that is actually worth living. Therefore, supportive relationships are critical in the recovery aspect of an eating disorder. This is why helping our clients to develop secure and healthy connections by asking for support from our reliable family members, friends and specialists can be immensely powerful on their healing journey.
How Can Someone Practice Secure Attachment As An Adult?
Of course nothing on the podcast is ever any sort of official advice but this is something I am extremely interested in and I know this going to be useful to a lot of psychology students, professionals and people impacted by eating disorders too.
As a result, when it comes to eating disorder treatment we know that clients need to create secure attachment patterns centred about their body image, food, thoughts or even exercise. A given therapist might want their client to choose their relationships over their eating disorder or when they’re emotionally distressed they want to reach for people, not food. This might include helping a client to be there for their friend more by turning up to a work party or something instead of letting their anxious thoughts about the social situation or food possibly harm the relationship.
There are a lot of other examples but in therapy, a therapist might encourage the client to do a lot of these sort of things where they are focusing on their personal relationships instead of their fears.
Furthermore, there are some skills and techniques that people can use to improve their secure attachments. These include establishing clear and helpful boundaries with their friends, developing effective communication skills, showing understanding and kindness towards others and themselves as well as relying on their own internal validation instead of seeking out reassurance from others.
Nonetheless, some personal favourites of mine include tolerating being physically apart and spending time away from someone without feeling abandoned, asking and offering other people support (that is a massive one) and trusting the overall goodness of yourself and the important people you have around you.
Then finally, I really like the idea of having the confidence that we do know what we stand for and that we know ourselves.
Clinical Psychology Conclusion
I flat out love how useful this podcast episode was to me personally because I have a lot of things I need to take away from this episode. I didn’t even know this was going to be helpful to me but relationships are critical for our mental health and we need to have close relationships. And I’m glad that we now not only understand their importance for eating disorders but we understand how we can change our attachment styles for the future so we can better ourselves in the long run.
Of course, talking to a therapist or any other mental health professional will always be critical and it could help a lot. This is beyond critical and outside of therapy, it is important to focus on our close relationships and maintaining them. Not only because this helps us to feel great about ourselves and our lives but also because these can be very important protective factors against body satisfaction in teenagers and helping people with eating disorders overall.
Since even if you have an insecure attachment style as a young person it doesn’t mean you cannot have a secure attachment as an adult.
I really hope you enjoyed today’s clinical psychology podcast episode.
If you want to learn more, please check out:
Developmental Psychology: A Guide To Developmental and Child Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also, you can buy the eBook directly from me at https://www.payhip.com/connorwhiteley
Have a great day.
Clinical Psychology References
Cassioli, E., Rossi, E., Castellini, G., Sensi, C., Mancini, M., Lelli, L., ... & Stanghellini, G. (2020). Sexuality, embodiment and attachment style in anorexia nervosa. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 25, 1671-1680.
Castellini, G., Cassioli, E., Rossi, E., Innocenti, M., Gironi, V., Sanfilippo, G., ... & Ricca, V. (2020). The impact of COVID‐19 epidemic on eating disorders: A longitudinal observation of pre versus post psychopathological features in a sample of patients with eating disorders and a group of healthy controls. International Journal of Eating Disorders, 53(11), 1855-1862.
Gonçalves, S., Vieira, A. I., Rodrigues, T., Machado, P. P., Brandão, I., Timóteo, S., ... & Machado, B. (2021). Adult attachment in eating disorders mediates the association between perceived invalidating childhood environments and eating psychopathology. Current Psychology, 40, 5478-5488.
Laporta-Herrero, I., Jáuregui-Lobera, I., Barajas-Iglesias, B., Serrano-Troncoso, E., Garcia-Argibay, M., & Santed-Germán, M. Á. (2021). Attachment to parents and friends and body dissatisfaction in adolescents with eating disorders. Clinical child psychology and psychiatry, 26(1), 154–166. https://doi.org/10.1177/1359104520962155
Rossi, E., Cassioli, E., Martelli, M., Melani, G., Hazzard, V. M., Crosby, R. D., Wonderlich, S. A., Ricca, V., & Castellini, G. (2022). Attachment insecurity predicts worse outcome in patients with eating disorders treated with enhanced cognitive behavior therapy: A one-year follow-up study. International Journal of Eating Disorders, 55( 8), 1054–1065. https://doi.org/10.1002/eat.23762
Siegal, D. (2020). The Verdict Is In — The case for attachment theory. https://drdansiegel.com/the-verdict-is-in-the-case-for-attachment-theory/
Tasca, G. A. (2019). Attachment and eating disorders: A research update. Current Opinion in Psychology, 25, 59–64.
Tasca, G. A., & Balfour, L. (2014). Attachment and eating disorders: A review of current research. The International Journal of Eating Disorders, 47, 710–717.
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