A growing number of studies are focused on identifying the connection between eating disorders and personality disorders, especially within Cluster C of the DSM-5, which includes avoidant, dependent and obsessive-compulsive personality disorder (OCPD). Many believe that individuals who demonstrated obsessive-compulsive tendencies in childhood also had an increased vulnerability to developing an eating disorder — specifically, in developing anorexia nervosa of the restrictive type (AN-R).
Though I now battle with many other traits of OCPD, these are the most debilitating vulnerability factors from my childhood as they pertain to the eventual development of anorexia.
Cue the eye roll, I know.
Hear me out.
Perfectionism is a complex personality variable which involves the relentless pursuit of unattainable standards and a constant lack of satisfaction, regardless of performance.
I struggle specifically with self-oriented perfectionism (requiring perfection of myself) and socially prescribed perfectionism (the perception that others require perfection of me).
In short, no matter the effort I put in, my self-worth is heavily based on the ability to meet my own unattainable standards, and the unattainable expectations I believe others have of me (irrational and/or untrue included). This belief system has opened the door for other issues in my life, including:
- Psychological problems: chronic depression, suicidal behaviors, anxiety, self-esteem issues and eating disorders.
- Relationship problems: difficulties with intimacy and difficulties with interpersonal closeness, especially when I feel as though I am unable to meet the expectations of others.
- Physical health problems: including migraines, increased stress hormones, sleep problems and more.
As a kid, I exhibited many of these traits. I would beg my mom to redo my hair for the 53rd time because it wasn’t perfect; so often, I would stay up until however late, to redo (again) an assignment that could have been done before dinner. (I messed up that one letter or maybe I found a syntax error, so naturally, I must redo the whole thing.) I felt obligated; nobody made me feel that way, I just did.
This was a serious vulnerability factor in the development of my eating disorder. Even then, if I fell short of the expectation (be it mine, or someone else’s), I felt ashamed, worthless and disgusted with myself.
With anorexia, the standard of “perfection” is ever-changing. It is always just a little further away, always promising you’ll feel better if you go a little longer, fall in a little deeper. The premise is the same: it is unattainable because it is irrational. It is a mental illness; it does not offer love, worth or peace, despite the ever-present voice in the head taunting those very things.
2. Behavioral rigidity and self-imposed rules.
At a very early age, I developed a split sense of self. I simultaneously believed I was loved, worthy of that love and accepted; and unloved, unworthy of love and rejected.
Cue the voice of anorexia, in all of her self-hatred.
Whatever the reason behind this, I felt most accepted by others when I exercised restraint and discipline. When I was the responsible kid, the respectful kid, the well-behaved kid, the “always get your work done on time and look how nice your handwriting is” kid. I made a personal decision that I was only tolerable under these standards; a lapse of my own strict, moral rules would mean rejection and worthlessness.
I was only tolerable in small doses, under specific circumstances, and if that be the case, I’d better be perfect when someone wanted my company.
This belief system fed my cycle of self-destruction: rules about behavior, rules about food, rules about the body and excessive amounts of exercising.
If I sound like you at all, then I’m sure you know where I’m going with this. I had developed a set of rules for everything — there was no tolerance for breaking those rules. The further I fell into my eating disorder, the more I relied on my systems and the promises they made. This is, in my opinion, where people assume eating disorders are a vanity deal; for me, it had nothing to do with compliments, and everything to do with worth.
People would say things like, “You have such willpower!” and I would interpret not eating as an “acceptable” behavior. Or, someone might say “Ugh! I’ve been horrible today, I had leftover pizza for breakfast and now I just feel disgusting.” and I would interpret those things as unacceptable, repulsive; if I participated in stuff like that, people would be disgusted with me — better not.
Eventually, my rules became specific to my disorder. I had too many rules, and I lost control of it all just like that.
Speaking from experience, an individual with OCPD is deeply entrenched in a dysfunctional system of beliefs. It is incredibly challenging to differentiate between reality and systemization, but I believe the more we learn about our struggles and share them with each other, the more power we gain over them.