Perfectionism and Shame in Anorexia in Middle-Aged Women

When I was anorexic and continued to be readmitted to eating disorder units, there was one phrase that ran through the community of patients. I’m not sure if the staff was aware, although I wouldn’t be surprised if they’d heard it as well: “The perfect anorexic is a dead anorexic.”

There were several traits we all had in common. We were all perfectionists who felt we could never live up to an idealized version of ourselves. The perfectionism almost always started in school (some patients recalled traits even earlier) as we strove for perfect grades and chastised ourselves if we fell short. We often had one or more parents who were demanding and even abusive in some way — verbally, emotionally, physically, or sexually.

One study found that “participants spoke about striving for perfectionism in all areas of life. They inevitably found that this always led to failure and shame as they were not able to be perfect.”

My father was verbally and emotionally abusive, especially when he was intoxicated. He was extremely intelligent and knew just what to say that would sting the most. Words hurt. So did words never uttered. Until he died, I never heard you are good enough.

Since I developed anorexia later in life as an adult, I was always on eating disorder (ED) units with adults and when we talked, I heard a lot of women verbalizing their feelings of not being good enough at their jobs and a constant fear of…