**2. The body self – a definition and specification of the body self dysfunctions in bulimia nervosa, based on selected elements of the psychoanalytic theory**

In psychology, a variety of terms are used to refer to the phenomenon of experiencing one's own self. They include such notions as the ego, the self, a sense of self, a sense of personal identity, self-awareness, self-knowledge, self-representation, and others. According to the definitions provided in psychological literature, it is possible to distinguish the following domains of the structure of the self: the self-as-agent vs. the self-as-subject, the real self vs. the ideal self, and the body self vs. the mental self. All of them constitute the major components of the so called psychological Self [Pervin].

The correlation between the body self and the individual's mental development has been clearly demonstrated and described in the psychoanalytic and cognitive theories regarding human functioning [Fairburn, Lacey, Thompson, Cash, Pruzinsky, Garner, Józefik, Głebocka, Kulbat, Rabe-Jabłońska, Mikołajczyk, Samochowiec, Schier, Brytek, Pervin, Tyson, Sugarman].

A review of psychoanalytic literature reveals that body image has a considerable impact on the development of an individual's personality. The ego, as conceived by Freud, denotes mainly the "body ego" [Krueger, Tyson, Schier]. Taking into consideration the psychoanalytic approach, an eating disorder is regarded as a pathology that occurs as a result of unsatisfied drives and desires, or as pathological development of the self and a sense of personal identity.

According to the fundamental assumptions of the object relations theory, the early childhood experiences significantly affect the separation-individuation process as well as the development of the self-as-subject and interpersonal relationships [Pervin].

As mentioned in Polish literature, the research results obtained in a group of bulimic females, using the Eating Disorder Inventory (EDI), prove that the women do not accept their psychosexual development, and exhibit incresed maturity fear as well as a tendency towards regression into childhood, which is a form of retreat, going back to a time when they felt safer than in adult life [Józefik]. Moreover, the findings reveal a low level of interoceptive awareness regarding body stimuli among the examined women. The level of difficulties related to psychosocial functioning turned out to be higher in this group, compared with the data received in the population of anorectic females [Józefik].

The findings of Sugarman's research on body image distortions in bulimia nervosa prove that the disturbances have their roots in the failure to carry out the process of **s**eparation of the object from the mother during the early practicing sub-phase of the separationindividuation process [Sugarman]. The author points out that women who suffer from bulimia nervosa find it difficult to differentiate and integrate the body self. Hence, they experience a number of neurotic conflicts and developmental deficits [Sugarman]. The

In an attempt to provide a psychological profile of the body self characteristics, I have referred to cognitive [Fairburn, Thompson, Cash, Pruzinsky, Głebocka, Kulbat, Rabe-Jabłońska, Dunajska, Izydorczyk] as well as psychoanalytic concepts [Schier, Krueger, Lowen, Pervin, Tyson]. I have operationalized the body self variable and conducted statistical and clinical analysis of the research data using psychometric methods and a projective technique. I adopt terminology which is used in the field of cognitive psychology (e.g. body schema, body image, body self-evaluation, the actual self, the ideal self) and psychoanalysis (e.g. the body

self, interoceptive awareness, acceptance of psychosexual development, maturity fear).

components of the so called psychological Self [Pervin].

Tyson, Sugarman].

sense of personal identity.

**2. The body self – a definition and specification of the body self dysfunctions in bulimia nervosa, based on selected elements of the psychoanalytic theory**  In psychology, a variety of terms are used to refer to the phenomenon of experiencing one's own self. They include such notions as the ego, the self, a sense of self, a sense of personal identity, self-awareness, self-knowledge, self-representation, and others. According to the definitions provided in psychological literature, it is possible to distinguish the following domains of the structure of the self: the self-as-agent vs. the self-as-subject, the real self vs. the ideal self, and the body self vs. the mental self. All of them constitute the major

The correlation between the body self and the individual's mental development has been clearly demonstrated and described in the psychoanalytic and cognitive theories regarding human functioning [Fairburn, Lacey, Thompson, Cash, Pruzinsky, Garner, Józefik, Głebocka, Kulbat, Rabe-Jabłońska, Mikołajczyk, Samochowiec, Schier, Brytek, Pervin,

A review of psychoanalytic literature reveals that body image has a considerable impact on the development of an individual's personality. The ego, as conceived by Freud, denotes mainly the "body ego" [Krueger, Tyson, Schier]. Taking into consideration the psychoanalytic approach, an eating disorder is regarded as a pathology that occurs as a result of unsatisfied drives and desires, or as pathological development of the self and a

According to the fundamental assumptions of the object relations theory, the early childhood experiences significantly affect the separation-individuation process as well as

As mentioned in Polish literature, the research results obtained in a group of bulimic females, using the Eating Disorder Inventory (EDI), prove that the women do not accept their psychosexual development, and exhibit incresed maturity fear as well as a tendency towards regression into childhood, which is a form of retreat, going back to a time when they felt safer than in adult life [Józefik]. Moreover, the findings reveal a low level of interoceptive awareness regarding body stimuli among the examined women. The level of difficulties related to psychosocial functioning turned out to be higher in this group,

The findings of Sugarman's research on body image distortions in bulimia nervosa prove that the disturbances have their roots in the failure to carry out the process of **s**eparation of the object from the mother during the early practicing sub-phase of the separationindividuation process [Sugarman]. The author points out that women who suffer from bulimia nervosa find it difficult to differentiate and integrate the body self. Hence, they experience a number of neurotic conflicts and developmental deficits [Sugarman]. The

the development of the self-as-subject and interpersonal relationships [Pervin].

compared with the data received in the population of anorectic females [Józefik].

clinical analysis conducted by Sugarman demonstrates that bulimic females tend to encounter problems in relationships with their mothers. The daughter's ambivalent identification with the mother and her body and femininity, determines the development of pathological behaviours that affect the body such as uncontrolled binge eating and purging.

Sands, who represents the object relations perspective on the concept of the self, refers to Kohut's view and argues that bulimia nervosa "compensates" the deficits in the self-object functions that are initially provided by the mother [Sands]. She claims that a bulimic individual identifies him/herself by his or her symptoms with the false, perfectionist self, created under the influence of the person's narcissistic care-givers. Thus food becomes a substitute for the self-object. It is the bridge between the self and the self-object, and the significant transitional object whose role is to regulate the bulimic individual's affective states. The bulimic self (that is the body self) is expressed through body language and represents the primitive need for dependence and separation. Binge eating symbolically compensates for the need for care and dependence, and self-induced vomiting symbolizes the need for self-identity and for separation from the object [Sands].

Excessive preoccupation with body appearance, which is a natural consequence of developmental changes that occur during adolescence and emerging adulthood, may lead to body-size dissatisfaction among women with low self-esteem, who have experienced some developmental deficits. This in turn triggers the development of eating disorders such as bulimia nervosa.

According to the psychoanalytic approach, body experiences correlate with the development of an individual's sense of identity. Lowen clings to the opinion that "in fact, a person has a double identity – one of them stems from identification with the ego, the other is related to identification with the body and the feeling regarding it" [Lowen]. Meissner established the basic terminology regarding the body and its image. He defined the body as an actual physical organism. He used the term "the body self' to refer to a psychic structure that forms an integral component of the person's self system. Body image is, according to Meissner's definition, a system of images organized into representations of the body [Krueger]. When dealing with the issue of body experience, Bielefeld distinguished between the body schema and body image [Schier]. The body schema comprises the following components: body orientation which refers to the orientation towards the internal structure of the body as well as its surface; body size estimation (i.e. estimation of the volume, mass, length, and surface area of the *body);* body knowledge (i.e. the knowledge of the body structure and body parts) [Schier]. Body image, as described by Bielefeld, comprises such components as body consciousness which refers to a psychic representation of the body or its specified part perceived at a conscious level; body boundaries (i.e. a sense of separation between the body and the external world); body attitude, that is a person's attitude towards his or her body, measured in terms of positive or negative body perception (body image satisfaction and dissatisfaction) [Schier].

Krueger defines the notion of body image, at its early stage of development, as a system of primary bodily sensations. He shares Mahler's view that a sense of touch is the factor behind the emergence of a primitive sense of self. Tactile sensations facilitate the development of the primitive "skin ego" which forms the foundation of a sense of body self [Krueger]. A sense of body boundaries allows to differentiate self from non-self. Empathic resonance between the mother and the child stimulates the process of internalization of reciprocity and affirmation, and consequently determines the development of self-efficacy [Krueger, Schier]. The body boundaries form the foundation for psychological boundaries.

A Psychological Profile of the Body Self Characteristics in Women Suffering from Bulimia Nervosa 151

characteristics which the person believes she or he should display (the ought self) [Higgins]. According to Higgins's theory, an individual aims at minimizing the actual-ideal or actual-

Thompson refers to Higgins's theory of self-discrepancy in order to provide an explanation for body image disturbances. He claims that the constant comparison of an individual's actual body shape and the ideal body image has a negative effect on the development of a cognitive aspect of body image. The ideal-actual body image discrepancy underlies the state of body dissatisfaction, and determines development of an eating disorder [Cash, Pruzinsky,

A cognitive model of eating disorders, developed by Fairburn, Cooper and Safran, points to a variety of interlinked factors which determine development of bulimia nervosa. The theory demonstrates that such factors as social pressure, dietary restriction, the feelings of hunger and inability to control it, trigger the onset of bulimia nervosa. Body image is

 A bulimic individual conducts subjective evaluation of his or her body attributes, which affects the person's cognitive functioning. A bulimia sufferer tends to be excessively concerned about body weight, shape and general physical appearance. This in turn leads to low self-esteem. The compensatory behaviours that a bulimic individual engages in (i.e. the bulimic symptoms) are aimed at improving hi or her self-assessment and reducing the

**4. A psychological profile of the body self characteristics in Polish women suffering from bulimia nervosa – an empirical analysis based on the author's** 

An appropriate diagnosis of psychological mechanisms underlying eating disorders, including a diagnosis of the body self characteristics in adolescent girls and young females suffering from bulimia nervosa, proves to be a significant predictor of successful treatment. Hence, during many years of my scientific research, I focused on the above mentioned

The main aim of this research was to determine the strength level for the characteristics of the body self structure in a group of selected 30 young Polish females suffering from bulimia nervosa, and in the control population of females who were similar in age and social status, and were not revealing any eating disorders or mental disturbances. The main question addressed in this study was: "Do the examined women who suffer from bulimia nervosa significantly differ from the healthy females in terms of the strength level for the

The main independent variable in the research was clinically diagnosed bulimia nervosa in the examined females. Its indicators included bulimic symptomatology as well as a medical diagnosis code (F.50.02, according to the ICD-10 classification).The main variable was the structure of the body self, defined, referring to the subject literature, as a complex construct constituting the following configuration: emotional experience related to body and its functions, as well as mental concept (perception and thoughts) regarding physical

considered to perform a significant regulatory role [Cash, Pruzinsky, Thompson].

consequent emotional tension and frustrations [Cash, Pruzinsky, Thompson].

ought self discrepancies.

Thompson, Garner].

**own research results** 

**4.1 Research objectives and variables** 

characteristics of their body self structure?"

issues.

The body appears to be a "container" for the psychological self which integrates internal and external experiences, thereby stimulating the emergence of a coherent identity [Krueger].

Bulimic episodes of uncontrolled binge eating and destructive compensatory behaviours (e.g. self-induced vomiting, fasting, abuse of laxatives, diuretics or slimming pills, etc.) allow a bulimia sufferer to maintain his or her positive self-portrait and self-assessment which in turn are affected by the person's body experiences as well as the cognitive evaluation of his/her own physical appearance. Engaging in compulsive, self-destructive behaviours, a bulimic individual applies a variety of specific symbols related to the person's sensomotoric experiences, which is aimed at bridging the body and mind [Krueger]. Bulimic symptoms appear to represent the individual's attempt to satisfy his or her needs and compensate for developmental emotional deficits by resorting to substances (e.g. food, alcohol or drugs) or to certain activities (e.g. self-induced vomiting, purging, compulsive spending, impulsive sex, etc.). This can also be regarded as a form of escape from "painful" emotions [Krueger].
