Anorexia nervosa is a mental illness that causes thought distortions including obsessive thinking, black and white thinking and the need for perfectionism and control. Recovery can feel overwhelming and living without your eating disorder may feel impossible, but people can and do overcome mental illness. I have both personal and professional experience with anorexia nervosa. Not only did I recover after a nine year battle, but as a counselor I have seen many others recover as well. See the end of this article for a list of helpful resources.
How an anorexic thinks is dictated by control; it is a major factor in the development and maintenance of eating disorders. Frequently, people with anorexia feel out of control in one or more aspects of their lives. They attempt to control these aspects using food and weight. By controlling these internal factors they achieve a semblance of control over the external, which initially reduces anxiety and feelings of being overwhelmed. In this way, anorexia may feel as if it is giving control to the individual. Unfortunately, this feeling of control quickly dissipates when anorexia begins to take over a person's life.
People with anorexia have a strong tendency to strive towards perfection. Often they were raised in an environment where perfection was idealized and mistakes were not tolerated. They may become addicted to the high that achievement brings, however fleeting this feeling may be. Their self-esteem may also be so eroded that they feel chronically unworthy and compelled towards proving themselves and reaching ultra-high standards that they set for themselves.
This perfection, however, is never attained. People with anorexia may desire to achieve a goal weight but if this goal weight is reached the feeling of achievement quickly dissipates and a new goal weight may be set. People with anorexia may overlook perceived achievements, both weight and non-weight related, and focus instead on aspects where they feel they have failed. These failures may be magnified in the mind of an anorexic, which contributes to the development of anxiety, fear, depression and feelings of worthlessness. When anorexia is severe, the only thing that matters in life is achieving perfection. Although not always suicidal, people with anorexia often will do anything to be 'thin', even though they are aware it may kill them. The alternative to being 'perfect'- maintaining a normal weight and recovering from anorexia- feels like an impossibility.
Competition against self and others is also common in the mind of someone with anorexia. People with anorexia may fixate on the weight of others and compare their weight to their own. As anorexia distorts perception, these judgments can be false. Some people with anorexia literally see themselves as obese, despite being at a normal or below normal weight. People with anorexia may also compete against themselves. They do this by eating less than they did with the previous meal or the previous day, or by increasing their weight loss strategies such as laxative consumption or excessive exercise.
Black and White Thinking
Black and white thinking is a type of cognitive distortion which is also referred to as all-or-nothing-thinking, or dichotomous thinking. People with anorexia often think in absolute terms, such as "always", "never", "good" and "bad". Eating induces thoughts of being a "bad person", whereas missing meals or losing weight makes them a "good person". They feel either weak or strong, in control or out of control, worthy or unworthy. Similarly, food is often categorized into "good" or "bad", and bad foods are forbidden.
Anxiety and Depressive Thoughts
Anorexia and the thoughts, beliefs and behavior it instigates causes a great deal of depression and anxiety for an individual. Often, this can develop into other mental illnesses such as generalized anxiety disorder and severe depression. Certain triggers can make these feelings worse. These triggers can seem relatively minor to others, but to people with anorexia they are huge. Tight clothes, seeing people who weigh less, eating around others and consuming certain foods can feel devastating to someone with anorexia. Often certain situations, such as being around people who may express concern about their weight or situations where they may be required to eat, will be avoided.
Breaking food rules, not losing weight, or putting on weight can make someone with anorexia feel completely out of control and creates extreme anxiety and feelings of worthlessness. Depending on the severity of the anorexia, emotions can be completely tied up with how in control they feel, or how well they adhere to the rules their anorexia stipulates. They may seek to deprive themselves of food as punishment, convinced they are weak and deserve to suffer.
Avoiding eating can often result in obsessive thoughts, which is both a cognitive and a physiological response to starvation. Deprived of nutrients, the starving mind sends signals to the individual to eat. Obsessive thoughts surrounding eating are common. People with anorexia may become obsessed with cooking for other people, reading and stockpiling recipes and purchasing food they have no intention of eating.