Until I saw The Empath magazine, I’d never heard of Highly Sensitive People. I had, however, met many. Sensitive to change, a complex tangle of emotions, highly conscientious, easily overwhelmed, feeling a need to withdraw, needing to avoid upsetting or overwhelming situations, highly attuned to other people’s feelings, often emotional, shy and self critical; all of these are characteristics familiar to anyone with an eating disorder.
Disordered eating, far from being a desire to be thin, often develops as a negative coping skill to deal with overwhelming feelings. An undernourished body is numb to emotions due to the brain
directing resources to deal with the crucial physical functions.
These big emotions can be overwhelming. The fear related regions are particularly stirred by threats; a world that feels overwhelming and unsafe to an individual with big emotions which they don’t know how to articulate or process, will seek some kind of coping mechanism. By offering a set of rules, eating disorders also suggest a false sense of control that soothes the anxiety. Uncertainty is dangerous and eating disorders, at least at first, make that world a bit more certain (i). They also create a barrier to others, dealing with the sense of being apart, at feeling different.
Studies show that eating disorders seem to be more common among those on the autism spectrum than in the general population, and there’s also a correlation between the disorder and identification as a Highly Sensitive Person. In 2007, Asperger’s syndrome expert Tony Attwood (ii) reported that between 18% and 23% of teenage girls diagnosed with anorexia meet some, or all, of the diagnostic criteria for Asperger’s syndrome. This is echoed by eating disorder specialist Dr. Janet Treasure, who, with a team of researchers, ‘discovered that this distorted pattern of processing information has a strong similarity to autistic spectrums.’
Brain imaging studies suggest that both eating disorders and HSP could have their roots in genetics. One thing that they both have common is a hyper-responsive amygdala - an area of the brain involved in processing of emotions and responses to stress (iii). For those with anorexia nervosa, amygdala hyperreactivity (iv) decreases as weight does - making it an attractive outcome for the brain, and one being constantly reinforced (v).
Assessment of the cortical areas linked to attention, perception and processing, show higher activation in response to all kinds of stimuli for both groups. When it comes to eating disorders, the possibility of reward sparks an immense response in the reward circuit, and it’s this short-term high that restriction, bingeing or purging results in that becomes addictive. Over aroused and easily triggered, subtle stimuli becomes too much, and emotional regulation difficulties are found in both anorexia and bulimia. Intolerance of uncertainty and anxiety are traits suggested to be a key factor in the vulnerability for eating disorders.
Robyn Chutervi is a Naturopath and EFT Therapist who treats a large number of HSP with eating disorders. She is also an HSP who has recovered from an eating disorder. Many of the characteristics of HSP, such as a high degree of conscientiousness, intense experiencing of emotions and a difficulty in expressing them, are also found amongst those with eating disorders.
She uses energy psychology techniques with her clients, and believes that ‘HSP with eating disorders as they respond far better to these than to conventional cognitive behavioural strategies...which don't address the underlying emotional drivers of the disordered behaviour.’
According to Amber Rochelle (vi)i a lot of Highly Sensitive People grow up feeling like there is something deeply wrong with them. That they are somehow flawed. A message that comes to them from being told that they are too sensitive, dramatic, emotional or ‘too much.’ This leads to feeling misunderstood, and a sense of distrust of their own feelings and intuition. An attempt to make up for this ‘flaw’ can result in perfectionism, and a structure to follow. Just like eating disorders: ‘Eating disorders are a way of stuffing feelings. Of eating over them, or throwing them up, or starving them away.’
There’s a misconception that eating disorders are a choice; a diet taken to extremes by vain girls wanting to be skinny. Not only is this damaging, it’s wrong. Georgia Foster (vii)i is a hypnotherapist, and sums it up; ‘People don’t just create an eating disorder. Their mind does, often to make that person feel safe. High levels of stress and trauma create anxiety and negative thinking. The mind demands a way to calm down, even if the habit is unhealthy or illogical and food is a good, quick easy fix.’
Those who have a tendency to be highly sensitive may find that their inner and critical voice takes over. Georgia helps people tune into what she calls their Healthy Logical self, which we all have. ‘When someone has logic, they don’t feel the world is against them and takes life in their stride so much better. The key is to train the deepest part of the mind how to do this.’
This doesn’t mean that they won’t develop an eating disorder, or be at risk of it. It’s just another tool in their arsenal. It also doesn’t mean that eating disorders are the result of highly-strung individuals being pushed too hard by families or society. It’s just that, like all aspects of health and wellbeing, things happen on a spectrum.
Amy tells me how she had an eating disorder as a teenager. A therapist explained that she had probably always had a higher likelihood of developing one due to being more sensitive than her peers, as well as something of a high achiever, perfectionist and introvert. But having a predisposition to an illness does not mean that its onset is inevitable. Environment, neurological make up, personality, circumstance and experience all play into the mix. For Amy, the awareness that she is a highly sensitive person, that this isn’t a flaw, and knowing how to structure her personal and professional lives to maximise her strengths and minimise exposure to triggering situations has helped her enormously.
There’s nothing wrong with being emotional, sensitive, or attuned to feelings. What causes harm is when those characteristics take over and used to control a life, limiting the individual, and damaging their emotional, social and physical wellbeing. Recognising the qualities that come with being an HSP, and using those as strengths, seems to be the key. The only thing wrong with empathy is believing that it’s wrong. You can’t starve or stuff empathy away. You can live and flourish with it.
i. Frank GK, Roblek T, Shott ME, Jappe LM, Rollin MD, Hagman JO, et al. Heightened fear of uncertainty in anorexia and bulimia nervosa. Int J Eating Disord. 2012;45(2):227–232. [PMC free article][PubMed]
iii. Harrison A, Sullivan S, Tchanturia K, Treasure J. Emotional functioning in eating disorders: attentional bias, emotion recognition and emotion regulation. Psychol Med. 2010:1–11. [PubMed]
iv Joos AA, Saum B, van Elst LT, Perlov E, Glauche V, Hartmann A, et al. Amygdala hyperreactivity in restrictive anorexia nervosa. Psychiatry Res. 2011;191(3):189–195. [PubMed]
Francesca Baker is a a word lover, book geek and literary enthusiast.