Sexual Abuse and Eating Disorders

Article excerpt

MARK E SCHWARTZ AND LEIGH COHN, EDS.: Sexual Abuse and Eating Disorders. New York, Brunner/Mazel, 1996, 228 pp., $27.95, ISBN 0-87630-7942

Eating disorders are essentially psychological in etiology. This interesting book examines the relation between eating disorders and the psychologically traumatic experience of childhood sexual abuse. It contains an Introduction (Overview) by the editors and sections dealing with prevalence, prevention, clinical perspectives, and treatment strategies authored by a variety of contributors.

In the Introduction it is suggested that intrafamilial sexual abuse is part of a syndrome including chronic abuse and neglect. This syndrome may produce posttraumatic dissociative symptoms, compulsive reenactments, and a tendency to revictimization. Sexual abuse is an extreme example of boundary violation and disruption of attachment and bonding and may induce symptoms of self-injury, including eating disorders. The relation between eating disorders and childhood sexual abuse is complex and difficult to predict. Some eating-disordered individuals have not been sexually abused and many sexually abused individuals do not have eating disorders.

Sexually abused individuals frequently have a resistance to "knowing" the fact of their sexual abuse, and rehabilitation requires the retrieval of repressed memories. Early trauma may be associated with eating disorders since eating occurs in the setting of family meals that should, but often do not, represent nurturing and proof that the parents care for the child. When sexual abuse has also occurred, the child finds the integration of the image of the caring parent into his developing personality doubly difficult.

In the survival strategy of children who have been sexually abused they try desperately to retain the belief that adults are "good" and may come to believe that they themselves (their bodies) are bad and deserve to be punished. …