Disturbances in identity and self-regulation in bulimia nervosa: implications for a metaphorical perspective of "body as self".

This study investigates a metaphorical account of bulimia that proposes that bulimics lack a clearly defined sense of self, and subsequently utilize their physical bodies as a means of self-definition and regulation. Three major aspects of this perspective were assessed: identity disturbance; use of the binge and purge as means of emotional regulation; and sensitivity to interpersonal contact. Differences among bulimics, binge eaters, and normal controls were explored. Bulimics reported greater amounts of identity confusion, enmeshment, and overall instability in self-concept than normal controls and binge eaters. The binge led to an escape from self-awareness for bulimics, and the purge served to manage negative affect. Bulimics also showed greater sensitivity to interpersonal contact with positive people, and with their mother than both binge eaters and controls. Implications of the findings are discussed as well as future directions for research.