Nutrition Counseling Interventions


Box 10.4 Defense Mechanisms Related to Eating Disorders (continued)


• Compensation: Trying to make up for perceived deficien- cies. Example: “They may ignore me at the party, but at least I will be the skinniest person there.”


• Denial: A direct negation or refusal to accept painful or unwanted aspects of reality. (A certain amount of denial allows us to function in the world, but it becomes problem- atic when it distorts reality.) Example: “I could stop my eat- ing disorder any time if I wanted to.”


• Intellectualization: Thinking and talking about feelings and impulses rather than feeling them. Example: “I don’t eat because I just never feel hungry. I watch cooking shows all day but it’s not because I have an eating disorder. I just really like them. ”


• Projection: Attributing unwanted thoughts and feelings to others. Example: “I didn’t follow my meal plan this week. I know you’re so disappointed in me.”


• Regression: The return to an earlier developmental stage or type of behavior to avoid present anxiety. Example: “I know I was eating higher-fat foods last week, but this week I have so much going on, I just can’t deal with all that fat.”


• Repression: Keeping unwanted thoughts or feelings com- pletely out of awareness. Example: “No, I’ve never been unhappy before now. If I didn’t have this eating disorder, I’d be stress-free!”


• Somatization: Converting intolerable conflict into physi- cal symptoms. Example: “I can’t increase my calories. I get immediate migraines if I eat more than this many calories a day.”


• Splitting: Categorizing people, things, and time periods as either “all good” or “all bad” (also known as “black-and- white thinking”). Example: “Once I eat a cookie, I might as well have a binge. I mean it’s already a bad day, so why not go all out.”


Source: Data are from references 10 and 11.


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