Scale 4 reveals anger that compliant anorexics cannot openly express. Her parents failed to meet her childhood dependency needs, or they infantalized her so she never developed competency to meet her own needs. Strong dependency needs therefore persist, but are combined with anger at those who failed her. She elicits and demands caretaking, but she is angry at the caretaker whom she perceives as incompetent or controlling. She experiences an unresolvable dilemma.
Bulimics often have emotion regulation problems.
They often display impulsive or self-harming behaviors. They cannot cognitively self-soothe or regulate their intense feelings. The ED accomplishes emotion regulation. Bingeing and purging discharge emotional tension, being negatively reinforced. Purging releases innate opiates, further reinforcing this behavior as calming, regulatory, and pleasure-seeking.