Anorexia nervosa is a psychological disorder known as a fixation with the control of shape and weight. It is a fear as well as a desire. A fear to gain weight and a desire to be thin.
Anorexia can’t be considered a typical phobia, since avoiding the subject of the phobia doesn’t generate the arousal anorexic people experience when they manage to lose weight. For an arachnophobe, staying away from spiders isn’t in any way ecstatic. Anorexic persons experience feelings of satisfaction, and even happiness, when the scale tells them they’ve lost weight.
Anorexia falls under the avoidance paradigm. It is considered to be a coping mechanism meant to keep the individual away from the actual fear. It’s a disorder developed to help the patient avoid confronting that fear. Most commonly the fear is of psychosexual development, high-performance standards, separation from family, or family conflicts.
Childhood sexual abuse, dysfunctional families, low self-esteem, lack of control, depression, anxiety, and loneliness are the main psychological causes of anorexia. They can become the hidden aversive stimulus that triggers the disordered behavior of the anorexic. All of them induce the feeling of guilt that makes the anorexic need to punish himself by not eating. Not gaining weight helps the individual maintain the appearance of a child.
One of the most important aspects to be understood about anorexia nervosa is its core psychopathology. Managing the control of shape and weight induces a positive cognitive reinforcement in patients suffering from anorexia nervosa and other eating disorders. The obsessive self-judgment over shape, weight, and the way to control them is the epicenter towards which psychological treatments should focus their means.
Since the phobia side of the disorder is observable and measurable – a scale of shape and weight – than the treatment can be directed to developing changes in that scale. The control over them can be loosened by helping the patient to develop new schemes of self-evaluation that are not centered on shape and weight.