Body-States,Body Image and Dissociation: When Not-Me is ‘Not Body’

The relationship between dissociation, eating disorders and disordered eating is key as it relates to dissociative disruptions to body image. It undermines normal integration of appearance-relevant information and cuts off access to subjective experience and feeling states necessary to form an internal representation of one’s self and body. This vulnerability contributes to body image distortions and the uncritical internalization of society’s notion of the thin ideal—which is an unrealistic standard, that leads, in turn, to body dissatisfaction. Patients with eating disorders live under the assumption that if they feel their sensations and feelings these will overwhelm them ‘forever’. The fear of being consumed by these terrible feelings, leads them to believe that ‘not feeling’-or even not existing-is the only answer. Being able to tolerate one’s subjective, affective experience is part of being able to internally represent one’s states, including body-states and to develop a stable experience of body image.