Family Dynamics and Eating Disorders in Complex PTSD
When we think about trauma, we often think about events — a car crash, an assault, a tragic loss, a natural disaster. But sometimes, trauma isn’t a singular event. Sometimes, it’s a pattern. A culture. A way of life inside a family.
In complex trauma, we are not talking about an isolated event, rather, about a chronic abusive dynamic that plays out over and over again. In C-PTSD, the most debilitating part is that the voices we internalize come from the people who are supposed to love us most — our family.
Learn more about Complex Trauma on our treatment page.
Our family dynamics have a direct influence on our developing:
Attachment Style: the ways we feel within ourselves and how we relate to others. Often described in terms of how much anxiety and need for connection is experienced within the individual. Learn more about attachment styles on our home page.
secure: people with this attachment style have a low level of anxiety around relationships and a strong desire for connection. They can spend time with others, or themselves, without feeling panicked and are able to be emotionally vulnerable.
anxious-preoccupied: people with this attachment style have a strong need to feel close and connected to others, and have high levels of anxiety around being in relationships. There is often a strong fear of abandonment and they are often misunderstood as “needy” or “clingy.”
dismissive-avoidant: people with this attachment style may be drawn to relationships, but experience intimacy as a threat to their independence. They experience low levels of anxiety, and low drive for connection. They tend to distance from emotional vulnerability and are seen as self-sufficient and independent. They can be misunderstood as “cold” or “rejecting.”
fearful-avoidant/disorganized: people with this attachment style have a push-pull dynamic in relationships. While deep down, they want connection, it also feels threatening and scary. They experience high levels of anxiety and are fearful of others leaving, but also are afraid to get close and emotionally intimate themselves.
Emotional Regulation: how we process and manage our feelings
Ability to Stay Present: if we can remain grounded and present, or need to detach from reality to feel safe
Perception of Self: what we’ve learned about ourselves from others and how we feel when we are alone.
Perception of Perpetrators: whether or not we can hold onto healthy anger and boundaries when others harm us.
There are different types of family systems (ways families function) that contribute to both complex trauma and the development of eating disorders. The intensity of the family dynamic has a direct impact on the severity of C-PTSD symptoms.
1. The “Looking Good” Family
A family where image is everything. Appearances must be flawless. Emotions, messiness, conflict, and needs are hidden to maintain the perfect facade. The severity of the impact depends on how different the family is behind closed doors.
What it feels like:
Growing up here feels like living under a spotlight. Every action, grade, achievement reflects on the family’s reputation. There’s pressure to be perfect, beautiful, accomplished, “together.” You may be praised for success, but emotional needs are ignored or minimized.
“Don’t cry — you’ll ruin your makeup.”
“Let’s not talk about that at the dinner table.”
“Smile for the camera.”
”You need to pull yourself together.”
You learn: visibility is conditional on achievement. Vulnerability is a threat to the image.
Internal beliefs formed:
“My worth is tied to how I appear.”
“If I show struggle, I’ll embarrass the family.”
“I have to earn love by being perfect.”
How eating disorders develop:
Eating disorders become a tool for controlling appearance and maintaining the illusion of perfection.
Restriction feels like discipline and achievement — the thinner I am, the more control I have, the more worthy I am.
Orthorexia develops as a socially acceptable obsession with “clean” eating, reinforcing moral superiority.
Compulsive exercise mirrors the pressure to outperform and excel.
Bingeing and/or purging may happen in secret — a rebellion against perfection, followed by self-punishment for failing.
2. The Chaotic Family
A family marked by instability, unpredictability, conflict, addiction, or mental illness. Rules change daily. Caregivers are unreliable, volatile, explosive, or abusive.
What it feels like:
Growing up here feels like walking on eggshells. You’re constantly scanning for danger. One moment things are fine; the next, an explosion. Love feels conditional and inconsistent. There’s no dependable ground.
You learn:
“I have to be hyperaware to stay safe.”
“My safety is not guaranteed.”
“I can’t count on anyone to meet my needs.”
Internal beliefs formed:
“I’m responsible for keeping the peace.”
“It’s safer to stay invisible.”
“Love is unpredictable and scary.”
How eating disorders develop:
Food and body become the only thing predictable and controllable in an unpredictable world.
Restriction provides rigid rules and certainty when everything else is unstable.
Bingeing may soothe emotional overwhelm or numb chaotic feelings.
Purging acts as a way to punish for meeting needs, or a way to replicate the family dynamic internally - create a false sense of internal safety/soothing (bingeing) and then replicate chaos/explosiveness (purging).
Exercise compulsion serves to discharge anxiety or give structure.
3. The Enmeshed Family
A family with no emotional boundaries. The child becomes the caretaker, therapist, or emotional support for a parent or sibling. Personal needs are sacrificed to care for others.
What it feels like:
Growing up here feels suffocating yet empty. There’s closeness without attunement — physically present caregivers who flood you with their emotions but struggle to see yours. Instead of emotional responsiveness, love is shown through material things, obligations, or guilt-driven gestures.
“You have everything you could want — why aren’t you happy?”
“I give you so much; you should be grateful.”
“I need you to be here for me.”
Internal beliefs formed:
“I shouldn’t need more than I’m given.”
“If I prioritize myself, I’m selfish and ungrateful.”
“My worth is tied to taking care of others and showing gratitude.”
“Big feelings need to be stopped.”
How eating disorders develop:
The eating disorder becomes a private, secret form of control and identity in a family where personal emotions and autonomy were never allowed.
Restriction becomes a way to create boundaries where none existed — “this is the one part of me you can’t invade.”
Binge eating may occur after feeling emotionally drained from caretaking others while being unseen.
Purging serves as a ritual to “expel” guilt, enmeshment, or feelings of being overwhelmed by others’ emotional demands.
Orthorexia mirrors the family’s over control or perfectionism disguised as care — “if I just do everything right, I’ll finally feel safe or seen.”
Exercise compulsion functions as an approved outlet for autonomy while still appearing “good” in the family’s eyes.
4. The Neglectful Family
A family where emotional (or physical) needs are ignored. Caregivers are absent, distracted, or disengaged. The child feels invisible.
What it feels like:
Growing up here feels empty, lonely, overlooked. You learned early that your feelings, needs, and desires didn’t matter enough to be noticed.
“No one asked if I was okay.”
“No one cared if I ate or slept.”
“They didn’t even see me.”
You learn:
“If I need something, I’m on my own.”
“It’s pointless to ask for help.”
“My feelings are irrelevant.”
Internal beliefs formed:
“I’m invisible.”
“I don’t matter.”
“Needing makes me weak.”
How eating disorders develop:
Food becomes a way to self-soothe, self-punish, or fill the void of unmet needs.
Binge eating fills emotional emptiness or loneliness.
Restriction acts as self-denial or punishment for “being too much” or needing anything.
Binge-purge cycles reflect the inner war between craving care and rejecting vulnerability.
Exercise compulsion numbs feelings of inadequacy or creates a sense of earning value.
The eating disorder becomes a surrogate caregiver — both punishing and comforting, both withholding and providing.
5. The Authoritarian Family
A family where control, obedience, and strict rules dominate. Emotional expression is punished or dismissed. Love is conditional on compliance.
What it feels like:
Growing up here feels rigid, restrictive, and full of pressure. There’s little room for mistakes, softness, or individual choice. Complying replaces nurturing and emotions are forced underground.
“Because I said so.”
“Stop crying or I’ll give you something to cry about.”
“Good kids don’t talk back.”
”You’re being disrespectful. Change your tone.”
You learn:
“It’s dangerous to express, or even feel feelings.”
“I must earn love by following the rules.”
“Perfection keeps me safe.”
Internal beliefs formed:
“I must be perfect or I’ll be rejected.”
“My worth is tied to obedience.”
“Feelings make me weak.”
How eating disorders develop:
Eating disorders mirror the rigid control, punishment, and achievement focus of the family.
Restriction reflects compliance, self-discipline, and the ability to “master” needs.
Orthorexia channels the desire to follow rigid “rules” of being “good” and “healthy.”
Bingeing may emerge in secret as rebellion or relief from repression.
Purging acts as self-punishment for perceived failure or “wrongness.”
Exercise compulsion mirrors pressure to perform and earn approval.
Food and body control become an extension of the family’s control — and sometimes, the only domain where control feels achievable.
6. The Golden Child / Scapegoat Family
A family where one child is idealized (golden child) and another is blamed (scapegoat). Love is conditional; roles are rigid and inescapable.
What it feels like:
Growing up here feels divisive, comparative, and isolating. One child feels pressure to stay perfect; the other carries blame for everything wrong. Both roles are traps.
Golden child: “I have to stay perfect or I’ll lose their love.”
Scapegoat: “I’m the problem; I’ll never be good enough.”
You learn:
“Love is conditional and competitive.”
“My value depends on staying in my role.”
“If I slip up, I’ll lose everything.”
Internal beliefs formed:
Golden child: “I’m valuable only if I succeed.”
Scapegoat: “I’m unworthy; I ruin everything.”
How eating disorders develop:
Golden child: Restriction, orthorexia, overexercise reflect attempts to stay idealized, “good,” and superior.
Scapegoat: Bingeing, purging, chaotic eating mirror internalized shame, self-blame, and rebellion against unfairness.
Both: Eating disorder serves as a way to cope with conditional love, unmet emotional needs, and a lack of authentic identity outside family roles.
Eating Disorders as Protectors
Each eating disorder behavior is a brilliant survival mechanism in an emotional environment that didn’t meet core needs. Whether control, perfection, rebellion, or comfort — food and body became the battleground for unspoken pain.
Understanding these dynamics opens the door to healing — not by blaming, but by recognizing: what once kept you safe may now be keeping you stuck.
If you’re tired of feeling alone, misunderstood, or invalidated, it’s time to start online therapy for your complex trauma and complex PTSD.
Maybe you’re a college student struggling with bulimia, or a teen battling anorexia. Maybe you’ve had enough. Get help today - start virtual counseling for eating disorders. Book your complimentary consultation here.
Healing is possible. And you don’t have to keep fighting this battle alone.
Visit Bloom Psychological Services to learn more or schedule a consultation.
