Bağlanma kuramı açısından yeme bozuklukları

Amaç: Bu derlemede yeme bozuklukları bağlanma kuramı açısından irdelenmiştir. Yöntem: Bağlanma kuramı, anne ve bebek arasındaki ilişkiyi ve bu ilişkinin özellikle bebek üzerindeki etkisini incelemektedir. Bulgular: Dengesiz ve değişken gelişen ilk iletişimler, yeme davranışında bozukluğa yol açabilirler. Yeme bozukluğunda yiyecek, anne-babanın sevgisinin yerini aldığı zaman hasta onu düzenlemenin, miktarını ve niteliğini ayarlamanın kontrolünü elinde hisseder. Yeme bozukluklarında biyolojik yatkınlık, aile dinamikleri, gelişimsel ve sosyokültürel etkenleri gibi risk etkenleri kimlerde yeme bozukluğu geliştireceğini öngörmeye yardımcı olsa da bu hastalıkların altında yatan gerçek nedeni açıklamaya yetmez. Güvensiz bağlanan bireylerde olduğu gibi yeme bozukluğu hastalarında da düşük kendilik saygısı, yetersizlik ve işe yaramazlık duyguları vardır. Ölümle aşırı zihinsel uğraşının yeme bozukluğu (özellikle anoreksiya nervoza) gelişiminde ve sürmesinde büyük rol oynadığına işaret edilmektedir. Kilo alma korkusu ve gizlenmiş anoreksiya nervoza, bulimiya nervoza belirtileri hastaların ölüm korkusundan korunmalarına hizmet edebilmektedir. Sonuç: Yeme bozukluğu olan kişilerin ‘bağlı’ oldukları kişilerle olumsuz ilişkilerinin olduğu, bu hastaların çocukluklarında güvensiz bağlanmış oldukları kabul edilmektedir.

Eating disorders in the context of attachment theory

Objective: In this review article eating disorders were examined in the context of attachment theory. Methods: Attachment theory focuses on the mother-infant relationship and its effects on child’s behavioral development. Results: Unstability in child’s earliest relationship with caregivers may lead to eating disorders. From this perspective, since food consumption usually replaces parental affection, the patient believes that she/he can control and arrange it both qualitatively and quantitatively. Eating disordered individuals are considered to fail frequently in establishing emotional communication with the persons they ‘attached’ and also to have built insecure attachments during childhood. Although insecure attachment is frequent among eating disordered patients when compared to non-eating disordered individuals, relationship between risk factors which may lead to eating disorders and nature of attachment in pre-adolescence period have not been thoroughly studied. Struggling extensively with fears of death plays a major role in the onset and development of eating disorders, especially anorexia nervosa. Fear from weight gaining and hidden symptoms of anorexia and bulimia nervosa may serve to protect the patient from the fear of death. Conclusion: Both eating disordered and insecurely attached individuals have low self esteem, feeling of insufficiency and incapability.

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