By Dr. Susan B. Krevoy

Attachment is the bond that develops between a mother and child over time as a result of consistent, appropriate, reliable caretaking. The child grows up feeling secure and protected and is able to acquire the necessary emotional, cognitive and psychological skills that will aid in the development of a strong sense of self. What happens when you don’t develop a sense of a secure base in childhood? When you don’t develop a sense of trust that the important people in your life will be there when you need them?

Although it is not the only problem, most eating disorder patients I have worked with have some sort of attachment difficulty. They have not experienced their early attachment figure as accessible, trustworthy and responsive to their needs. Anxious or avoidant attachment develops from their repeated experiences of inconsistent caretaking and it interferes with feeling safe in relationships with others.

The deprivation of this early attachment relationship is expressed through the disruption in their eating pattern. Eating disorder patients frequently feel they cannot rely on human beings to fulfill their needs. Rather, these patients become attached to food and disordered eating to fulfill these needs. Whether it be not eating, binge eating, or compulsive overeating, the person uses food rather than people to meet their needs in order to avoid the repetition of the earlier shame, disappointment, frustration and or emotional abuse.

For one anorexic, she felt superior because she did not “need” food. That is, she defended against how needy she felt and the low self-esteem that accompanied the neediness. A bulimic patient I worked with felt food was her best friend, the one she could rely on to comfort and soothe herself when she felt badly.

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