On Anger....

I have heard a few times recently, "I don't really feel anger very much." Sometimes, of course, this is followed by statements about how and why anger is invalid, unnecessary, unacceptable. Now, ask the parents of a teenager with an eating disorder, and sometimes you will find there is plenty of anger being expressed. But the problem is that the vast majority, if not all, of the anger being expressed is about food, rather than about what really angers him/her.

However, I have noticed that, a lot of the time, those with eating disorders, especially anorexia, are seen as fragile, breakable, in need of being treated with kid gloves. I see it very differently. In my experience, behind a lot of eating disorders is a good amount of anger, but the individual does not feel anger is okay, so the anger leaks out in ED symptoms. In many ways, eating disorders are even somewhat aggressive disorders. Now, the actual person is not aggressive, but the disorder creates a level of aggressiveness.

Now, some would say that someone with an eating disorder is not in control of their behaviors and their actions, and sometimes that is true, but in my experience, it is not true as often as maybe providers assume. Certainly eating disorders dramatically impact brain functioning, but I'm not sure it is in such a way that the patient no longer has control over his/her actions. 


So, back to the aggressiveness. Again, I want to be clear that I am NOT stating that those with eating disorders are intentionally aggressive. But, if you think of the behaviors, I think the anger behind them becomes more evident. Eating disorders require a lot of defiance; defiance of of bodily needs, others' expectations, treatment recommendations. They are not passive disorders, and thus, in my opinion, to treat them passively, rather than more directly confronting the disorder, may do a disservice to the person suffering with the disorder.

But, more importantly, in order for one to recover, he/she must deal with the underlying anger. It must be safe for him/her to express anger and that emotion must be accepted. I often encourage patients to get angry with me, which sounds kind of strange I am sure, but my goal is to make it clear it is okay to show anger, even anger at me. And I'm sure if you could ask the patients I work with, they will likely all confirm that I REALLY annoy them at some point, if not frequently. The key is, you must get past the anger at food, at treatment, at feeling controlled, and get to the "real" anger, the anger that comes from your experiences.


So, find a relationship where it's okay to be angry, and express away! For many patients I have worked with, as they have learned to express anger, they have found they have less need for their ED symptoms.