Adolescence is a singular and intense phase in the overall development of a child. By this time, the healthy child has developed trust, autonomy, initiative, and the ability to be productive. Adolescence is the next step. But it is by no means a simple one. It is a battle, the last stand of childhood. A teenager senses that new responsibilities are arriving. This is nothing new. When she was younger, she first developed by experiencing new demands: for example, her parents wanted her to crawl, walk, then ride a bike; her teachers encouraged her to read. The girl experienced her parents' and teachers' wishes as subtle imperatives. She reacted to these and her own internal drive by trying out new behaviors. The ones that worked, she kept. Others, she discarded. In this way, she developed.
And then she hits adolescence. It is as if someone has come along and raised her developmental bar by an order of magnitude. Everything begins changing at once, and the changes do not always move in sync. Her body grows in spurts. Sexual maturation begins. Her mind develops rationality and abstraction. Because of this, the world beyond her family opens up. She begins to recognize the vast culture out there and its often conflicting values. She is measuring herself against these observations and getting frustrated when they contradict what she senses inside herself.
To become a healthy woman, this girl has to complete a mission: she has to develop an identity, a self that abides no matter what form the outer body takes or what circumstances shape its world. There are girls who really struggle with this task. They become extremely vulnerable. A fragile teen can take her struggle with identity out on her body. She is the girl who turns to dieting, exercise, or more extreme behaviors as a stopgap for her developmental shortcomings. Her body dissatisfaction, a common component of adolescence, is evolving into disease.
It is at this psychological crossroads that the eating disorder enters the scene. It offers to rescue this kind of girl by promising to make development easier. But eating disorders function like a crutch for a severely broken leg, one that does not heal. The crutches support for a while, but the leg weakens. When the crutch has to go, the girl is in trouble. She cannot walk unassisted with an atrophied leg. Worse, her whole body has weakened while her leg was casted.
Just as neonatal researchers try to trace the cause of an infant's physical abnormalities back to what might have happened in the womb, so psychologists try to understand the symptoms of a patient with an eating disorder in terms of thwarted tasks in psychological development. But recovery is a painful process because it means, first of all, removing the eating disorder "crutch" to examine the underdeveloped self. Recovery also requires going back and identifying where and when the initial harm was done and then undergoing psychosurgery to repair the injuries incurred, for example, through childhood trauma, incest, or dysfunctional family dynamics.
But the focal points are quite different for every girl with an eating disorder. The behaviors she shows may appear similar enough for categorization: she starves - anorexia; she binges - binge eating disorder; she purges - bulimia. But this is simply the surface. Underneath, every girl is unique in why she chooses her eating disorder. And the places in her development that are stunted, allowing the eating disorder to develop, will also vary. With an embryo, parts mean physical limbs and organs, the stringy spinal cord, for example, or a muscular heart. Each has a proper time when it should develop and begin to function. Each develops on its own and, if all goes according to plan, a whole, healthy baby pushes out into the world, ready to take on life.
Psychological development unfolds in the same way, albeit more invisibly. The parts of identity are more abstract. There is a physical self, made up of skin, bones, and biochemicals; an emotional self that laughs and cries; and a thinking self that analyzes and keeps it all together. There is an ambitious academic self that sometimes becomes a career self. There is a desirous sexual self, as well as a questing spiritual self. Finally, there is a social self, nurtured by family and, later, by the surrounding culture.
Each mini-self has a job that must be completed in order to propel a girl into womanhood. And the selves, while developing on their own, also have to interact in harmony to create a viable, whole self. In fact, it may be helpful to view the self-consciousness that adolescent girls often experience as girls "taking themselves apart," trying, as a puzzle, to reshape the individual pieces. Maturity, then, comes when a girl, in the context of her relationships, can reassemble the pieces into a new self-portrait, herself as a woman. But if a girl allows an eating disorder to enter, it distorts her picture and prevents it from evolving into what it could become. An eating disorder can fit into any part of development and slowly but powerfully disrupt proper development of the whole.
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