Transitions, Eating Disorders, and Changing Selves: Interlocking Psychodynamics of Identity, Self, Life Changes, and Eating Disorders

Abstract Research supports anecdotal evidence that eating disorders often initially develop in conjunction with adolescent transitions, but evidence is growing that other transitions, including menopause, can also trigger these disorders. Over the course of more than three decades of working with and supervising therapists working with individuals with a wide range of eating-related symptoms, including anorexia, bulimia, compulsive overeating, binge eating, avoidant/restrictive eating, and other variations, I have often seen that even small changes can also trigger the behaviors. For example, a number of clients report that they binge on Sunday nights as they start thinking about going back to work the next day. Visits to family (not necessarily a small transition, of course) are also frequent triggers.This article will address some of the possible interplay between unmanageable and/or unformulated affects, on the one hand, and shifts in an individual’s sense of self, on the other, which can occur in the course of a transition. Clinical material from my long-term, two-part work with a client who developed symptoms in adolescence and had a recurrence during COVID will illustrate some of these complex interactions and some of the ways that an integrative, psychodynamically-oriented framework can be used to work with these issues.