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Understanding My Struggle with Anorexia: Social Identity Theory

Who am I really? What are my values? How do I see myself? These questions address the internal emptiness, human yearning, and quest for belonging so many individuals struggle with. Looking back on my experiences of pain and hunger, I now recognize that ultimately, I was struggling to find answers to these questions. In understanding how my sense of self and identity was originally constructed, the uncertainty and pain that resulted from a loss of identity, and the relief I found when actively constructing an independent identity, I have gained a new perspective on my experience with anorexia and awareness of the roots of my struggle. 

The self does not exist in isolation. Social Identity Theory argues that an individual’s sense of self and self-esteem is largely based on their group memberships (Tajfel, 1978 as cited in Pickett, 2010). Social groups provide a sense of belonging and security, both of which are fundamental human needs, and as Leary explains, people in modern societies regularly change “social groups and must reestablish their social identities each time” (2004). 

In the summer of 2016, alongside my family, I made the significant transition of moving from Hong Kong to Los Angeles. Born and raised in the Sino-British city for over 18 years, I did not realize the importance I placed on my collective identity, and how my self-knowledge was largely tied to the way I thought I was regarded and recognized by others. Hong Kong’s collectivistic culture taught me the value of interdependence and subordination of my personal needs in order to conform. Even in the most implicit ways, I never felt the need to differentiate myself or prioritize independence. From restaurant choices, foods ordered for the table, to job expectations and higher education opportunities, I was never asked to think about what I wanted or who I was. My sense of self-worth and identity was derived from my group membership, and my personal identity was largely based on my academic accomplishments. 

  When beginning my studies at UCLA, I struggled to cope with the multitude of differences in the cultural values, educational environment, and a changing sense of identity. Generally, periods of change create significant uncertainty about the self, identity, relationships, security, and place in the world, and the transition from high school to university represents one especially vulnerable period in adult identities. Transitioning from a culture that promoted mechanical solidarity to one of independence and autonomy was difficult, and I never understood why this period in particular was filled with confusion, lack of sense of self, and low self-esteem. Even questions from friends asking which restaurant we should eat at and what I want to order was new, and triggered a much deeper sense of uncertainty. Uncertainty-identity theory describes the motivational role of uncertainty, particularly about oneself or identity-related uncertainty, in driving self-categorizing with social groups (Hogg, 2011). Self-uncertainty motivates behavior, and the process of identifying with a group effectively reduces uncertainty by providing a consensually validated social identity that can be pursued through conformity (Hogg, 2011). 

Adolescence is a significant developmental period, marked by physical and cognitive change and identity transformation. This, coupled with the fact that belonging, acceptance, and validation are fundamental human needs, explains why adolescents are especially drawn to self-categorize with groups that attract peer approval (Hogg, 2011). The American prototype for beauty tends to be one who is fit and slim, and people understandably think that by working on their weight and physique, they will make a better impression on others (Leary, 2004). The quest for perfection is exemplified in the growing cosmetic surgery, fitness, and wellness industry, not only reflecting the malleable nature of beauty, but also identity (Bordo, 1993). Conforming to beauty standards in an unfamiliar culture of individualism reflected my desire for social approval and validation, while also serving as a tangible means to satiate my hunger for worthiness amidst persistent feelings of self-uncertainty. It was easier to try and fit into the narrow slots of identity American culture offers women than try and create one from scratch, where the volume of choices is new terrain and causes fear and uncertainty that “necessarily attends to the construction of [an independent] self” (Knapp). For me, dieting and exercising was both a symptom and a problem in itself - a way to cope with life, construct an identity, while frantically responding to culturally induced body insecurity. 

Self-presentation encompasses any behavior intended to “create, modify or maintain an impression of ourselves” in the minds of others (Brown, 2007). Not only can strategic self-presentation facilitate social interaction, but result in the gain of material and social rewards (Brown, 2007). Self-concept refers to the way people characteristically think about themselves, where its consistency and coherence across social contexts influences our inner core of identity (Brown, 2007).The American Sociological Association highlights how “weight-related aspects of appearance are more intertwined with the self-concept in females than males” (Dwyer, 1970). Thus, undertaking corrective efforts with my physical appearance was partly driven by understanding how males and females would regard me because of how appearance is so tightly bound with self-image (Dwyer, 1970). A controlled appetite, the “prerequisite for slenderness, connotes beauty, desirability, worthiness” and I believed that by embodying American beauty, I could influence my social identity and satiate my hunger for meaning and love (Knapp, 2012). 

What started off as self-presentation, in the hopes of assimilating into a foreign culture, quickly turned into a means of escaping the self - my thoughts, anxiety, and physical sensations. Human minds are capable of inflicting unnecessary unhappiness through unremitting self-reflection, a unique ability that stems from having a sense of self (Leary, 2004). Unremitting self-reflection maintains unpleasant emotions, is stressful, and exhausting, so one solution to escape this curse of the self is to quiet it (Leary, 2004). Leary explains how without self-thought, there are “no emotions and no problems” (2004). I found that restricting and overexercising no longer solely fulfilled the purpose of wanting to lose weight, but became a means by which I used to cope with life and ultimately determined my self-concept. 

For so long, I didn’t understand why and how my urge to starve shifted from self-scrutiny to compulsion and fear-driven. In order to avoid the anxiety-fuelled self-criticism, I obeyed my increasingly rigid rules of restraint and permission. These behaviors were a way to punish myself whenever I felt guilty, internalize my anger, avoid pain and sadness, and numb any sensation in my body. Neurological studies have supported this outcome, and Schulte-Rüther found that patients who suffer from acute malnutrition have impaired theory-of-mind and interoceptive awareness, reflected in the reduced activation of the medial prefrontal cortex and frontoparietal-cingulate network respectively (2012). Engaging in these extreme behaviors snuffed out my self-thoughts, and effectively projected my self-uncertainty and anxiety onto one salient and simplified form: my body. Baumeister emphasizes the universality of finding strategies to escape from “the burden of selfhood,” and explains how mindless engaging in simple activities can reduce the “aversiveness of persistent self-reflection” (Leary, 2004) Thinness, sickness, and numbness became tangible representations of the sense of value and belonging, and soon my self-concept became intertwined with my disorder. 

My journey of recovery forced me to cultivate self-awareness and an independent self-identity through practicing meditation, mindfulness, and writing. I never had the vocabulary to describe or understand how cultivating these two things ultimately addressed the void I had attempted to fill with social validation and acceptance. For the first time in my life, I had to identify goals for myself that were independent from others around me, characteristics and traits I possess, and qualities I value to construct a self-identity. One change that notably impacted and positively reinforced my changing sense of self resulted from reestablishing my social environment (Linville as cited in Brown, 2007). When I began surrounding myself with like-minded individuals, girls also pursuing recovery, self-growth and awareness, my “looking glass” or the reflections of myself others offered me shifted to promote further growth (Brown, 2007).

Self-complexity encompasses the number of roles and identities one has and whether these views are confidently defined, internally consistent, and stable (Brown, 2007). Individuals who think of themselves in many different ways are “high in self-complexity,” and those who think of themselves in few ways are “low in self-complexity” (Linville 1985 as cited in Brown, 2007). Prior to entering treatment and pursuing recovery, my self-complexity was low. I saw myself through the lens of my suffering, my ill-health, and my disorder. My response to events that threatened these self-concepts was extreme, and how I saw myself contradicted the goals of recovery. For so long, recovery meant losing aspects of my identity and self-concept, losing the predictable futile safety from the emptiness a lack of identity brought, and I felt stuck in my pain. 

With greater self-complexity, a person's "eggs are not all in one basket," and when one identity is threatened, the visceral response to negative events is mediated by “having other identities to fall back onto”  (Brown, 2007). As I began to develop interoceptive awareness and identify what my independent desires and passions were, I was able to build a more diverse self-concept. When I let go of my identity as “helpless” and “struggling,” the prospect of recovery was less daunting because of how recovery no longer threatened how I saw myself. Identifying myself through an integrated set of intrinsic qualities, talents, and passions - including a creative artist, empathetic friend, respectful daughter, and resilient survivor - allowed me to cultivate a consistent and certain view of myself. However, developing an independent identity contradicted my deeply entrenched and learned rules about what a “good” self was in an interdependent culture (Picket, 2010). I had to recognize how some of the beliefs and expectations I grew up with, such as constantly putting others’ needs above mine and never speaking up, prevented me from ever having to identify my own needs, preferences, and self-concept. “The self does not exist in isolation,” and my sense of self developed through my participation in a collectivistic, interdependent culture (Baumeiter, 2011). But in recovery, for the first time, I had to get to know who I was “psychologically, [and] know my nature, preferences and tendencies” independently and without social and cultural influence (Smurda, Slide 20). When I started seeing myself as an individual agent, the beliefs I held about my abilities to perform began to strengthen, and fueled my persistence to recover. Self efficacy refers to the beliefs one has about their ability to perform a behavior or attain a goal, and developing an independent sense of self fueled my belief that I could achieve a full recovery. As my self-concept became more diverse and my self-efficacy grew, so did my willingness to take on harder challenges, persistence when acting, and ability to try and implement new healthy coping mechanisms (Smurda, Slide 22).

Looking back on my experience with anorexia, my tumultuous and confusing journey of recovery, and how much my sense of self has grown is a daunting task. Countless factors interacted to produce the outcome of recovery and place me where I ultimately am today. Though I am still unable to explain where some of my pain originated from, applying a social psychological perspective of the self to explain my experiences has offered me insight and understanding into my past actions. By understanding how the collectivistic culture I grew up in influenced the development of my sense of self, how self-presentation and escapism fueled my disordered actions, and how developing my degree of self-complexity allowed me to cultivate a resilient and diverse self-identity, I am aware of how my struggles were tied to concepts of the “self” and “identity.” Knowing this, and seeing the importance of developing an independent sense of self in my recovery and healing, I am passionate to continue exploring who I am, and how I see myself. 

Works Cited

Baumeister, R. F. (2011). Perspectives on the Self: Conversations on Identity and Consciousness. Boston, MA: Published by Blackwell Pub. on behalf of the New York Academy of Sciences. doi: 10.1111/j.1749-6632.2011.06224.x

Bordo, Susan (1993). Unbearable weight: Feminism, western culture, and the body.  Berkeley, CA: University of California Press. 

Brown, J.D. (2007). The Self. New York, NY: Psychology Press.

Dwyer, J. T., Feldman, J. J., & Mayer, J. (1970). The Social Psychology of Dieting. Journal of Health and Social Behavior, 11(4), 269–285. doi: 10.2307/2948575

Hogg, M. A., Siegel, J. T., & Hohman, Z. P. (2011). Groups can jeopardize your health: Identifying with unhealthy groups to reduce self-uncertainty. Self and Identity, 10(3), 326–335. doi: 10.1080/15298868.2011.558762

Knapp, C. (2012). Appetites. Berkeley, CA: Counterpoint.

Leary, M. R. (2004). The curse of the self: self-awareness, egotism, and the quality of human life. Oxford: Oxford Univ. Press. doi: 10.1093/acprof:oso/9780195172423.001.0001

Schulte-Rüther, M., Mainz, V., Fink, G. R., Herpertz-Dahlmann, B., & Konrad, K. (2012). Theory of Mind and the Brain in Anorexia Nervosa: Relation to Treatment Outcome. Journal of the American Academy of Child & Adolescent Psychiatry, 51(8). doi: 10.1016/j.jaac.2012.06.007

Smurda, J. (2020) Lecture 5: Conscious Self Awareness in “Self and Identity,”Psychology 137J. [Powerpoint Slides]. University of California, Los Angeles

Smurda, J. (2020) Lecture 11: Self-Regulation in “Self and Identity,”Psychology 137J. [Powerpoint Slides]. University of California, Los Angeles

Pickett, C. L., Chen, S., & Gardner, W. L. (2010). The Self. New York, NY: Guilford Press.