The Interconnection between Eating Disorders and Narcissistic Trauma

This theoretical review proposes a conceptual model of the links between narcissistic trauma and eating disorders, focusing especially on how young adults with such trauma use defensive communication in relationships. Building on the psychoanalytic views of Kohut (1971) and Kernberg (1975), this paper argues on psychoanalytic and empirical grounds, that narcissistic vulnerability develops from early failures in empathic mirroring and is later organised around chronic shame. Social pressures, intensified by social media and socially prescribed perfectionism (Hewitt & Flett, 1991; Twenge et al., 2014), often push this trauma into the body through strict control of weight and shape. Eating disorders are understood here as psychosomatic defences that give a temporary sense of control while hiding deeper feelings of emptiness and vulnerability (Fairburn, 2008; Garner, 2004). This formulation is conceptual; the review synthesises associations reported in empirical work rather than claiming a single proven causal pathway. Paradoxical communication helps maintain distance from others and protects against expected criticism or rejection. The paper suggests that an integrated approach combining enhanced cognitive behavioural therapy for eating disorders (CBT-E), strategic paradoxical techniques, and compassion-focused therapy (CFT) can address both the behavioural symptoms and the underlying shame. Clinical implications are considered. The model is illustrated with four anonymous individual cases, who are included as illustrations rather than as evidence of narcissistic trauma.