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Purging To Gain Control

Trying to unravel the web of questions is a difficult task.  Childhood Sexual Abuse is a different experience for each victim.  The age at which the abuse starts, the length of each incident, the actual experience of the abuse; Nothing is the ever the same for the victim and certainly nothing is ever the same between victims.  So, drawing conclusions and suppositions becomes ever so much harder.

In this very short article, I will try to look at a few other studies who have found a relationship between Sexual Abuse with Children and/or Adolescents and how that relates to Bulimic Behavior.  I will also try to explain a bit about how Bulimia becomes a coping Mechanism for the Victim.

Just recently, a study completed at the University of Melbourne, published in Medscape and in Australia’s Archives of Pediatrics & Adolescent Medicine’ set out again to confirm again the incidence of bulimia, but not anorexia nervosa was linked to childhood sexual abuse. "This paper takes a step further in confirming suspicions that clinicians have long had that sexual abuse is common in young women with bulimia," study author George Patton, MBBS, MD, at the University of Melbourne, told ‘Medscape Psychiatry’.  Childhood sexual abuse was reported by 1 in 5 young women in this Australian community; however, it was reported by 1 in 2 young women with bulimia, and the numbers may well be even higher in a clinical setting, he noted.

The study found that the incidence of bulimia in those who had reported childhood sexual abuse was 4.9 times higher than in those who had not reported such a history after adjusting for other environmental factors.  In addition, The association persisted after adjustment for precursors of bulimia — recent depression, anxiety, or dieting behavior.

Other studies have looked at how the psychological effects of abuse influenced the victim’s psychological defenses which are believed to filter perceptions and affects. Defenses were of interest to the authors for two reasons: (1) sexual abuse victims often resort to maladaptive defenses with a self-victimizing quality, in which anger at others is expressed through self-sabotaging acts; and (2)  eating disordered women use primitive defenses, especially as compared to normal and even to psychiatrically disturbed women. The study I used for my research was designed to determine the degree to which traumata like sexual abuse might have effects upon defense-style development.
The authors found a pattern of co-occurrence of sexual experiences and high scores of eating disorder symptomatology after the age of 14. Dieting and bulimia were associated with sexual experience involving force; Once again, they proved that sexual abuse should be considered as one of many possible triggers for the development of an eating disorder, with the context of the abuse likely playing a role in determining whether or not an eating disorder develops.

Consistent with their prediction, the authors found that the Childhood Sexual Abuse subjects reported more bulimic behavior than the control subjects. Furthermore, their prediction that Childhood Sexual Abuse subjects would display more tension-reducing behaviors was also supported.  They found that, the worse the abuse, the worse the behavior.  Incest victims displayed the highest amount of substance use, cigarette smoking, self-mutilation, and suicidal gestures. The authors suggest that these findings, along with the increased level of bulimic behavior, are consistent with the idea that Childhood Sexual Abuse individuals engage in many self-destructive behaviors which potentially reduce emotional distress associated with their abuse.
Interestingly enough, the authors found that the presence of bulimic behavior was also associated with reported symptoms of posttraumatic stress disorder. They suggest that dieting, bingeing, and purging may be efforts to manage emotional states associated with memories of their abuse. The authors further suggest that eating disturbance is linked to the affective reactions, associated with the abuse. Therefore, they conclude that their data provide support for the notion that bulimic behaviors are involved in affective regulation instead of being reactions to thoughts and memories of abuse.

Coping Measures

Children have a wonderful capacity to dissociate.  That is, they think “this is not happening, it isn’t happening to me, it didn’t happen at all.”  They can watch it from afar and that is how many come to survive the experience.  They might let their minds and bodies go numb.  They still have experienced the incident, whether or not they want to allow it through and it has still done it’s damage.  The damage will most likely last for many, many years.

We therefore, must come to the conclusion that the bulimic is not only punishing him or herself.  In their quest to purge themselves of the evil that has happened to them, of the un-pure thoughts, the un-pure acts that they have participated in or been forced to participate in they seek to regulate tension.  The bulimic takes the fact that their bodies may have responded albeit biologically, but that is was a heinous act and disgusting and needs to get rid of the pain of this horror.  The bulimic has lost control of too much, and to regulate his life, turns to bulimia to purge, to control that life. 

Rika B.

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