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Posted 05/18/2022 in Category 1

Understanding shame and bodily shame in eating disorders in athletes

Understanding shame and bodily shame in eating disorders in athletes

Eating disorders are prevalent in society. Sport is part of society. Eating disorders are prevalent in sport. This logic seems reasonable, but as psychologists and people in sport – coaches, administrators, health professionals, doctors and so forth – we need to help where we can to support those at risk. Gillian Rathbone, a consultant psychiatrist and group analyst working in the NHS as lead clinician, wrote “Shame is everywhere but nowhere”. What she meant here is that experience of shame is so painful, we organise our lives to avoid it. We all feel shame; it’s a normal response, a pro-social response to help us in our social settings. But when shame is excessive, it joins with rage and violence. It draws people to a world of pain much greater than the shame itself. 


But what is shame? And what does it mean in sport? Shame emerges from self-reflection or self-perception. We fear or expect (that we or our actions) will disgust others. When you think about it, you would not feel shame if you did not reflect on what happened or consider how people might experience you or your actions. Power, rank and status play their part and we feel we judged or flawed (real or imagined) by someone (higher in power, perhaps). We often feel shame because we have not lived up to our personal moral standards too. Now we can imagine how shame is everywhere and nowhere in sport.


These two parts – internalised shame (e.g., judging ourselves as worthless or flawed) and external shame (e.g., feeling others judge us as objects of ridicule) help us understand shame and eating disorders which are common in sport, especially weigh-categorised sports like horse racing, boxing and weight-lifting and aesthetically judged sports (e.g., forms of gymnastics). Troop and colleagues used a longitudinal panel design to study shame and bodily shame among fifty-five women with past or current eating disorders. Over two-and-a-half years, the participants completed measures of eating pathology, depression, general shame (internal and external) and bodily shame. Bodily shame is this study captures current feelings of shame and bodily shame one expects if one were to gain weight. 


Bodily shame predicted an increase in anorexic symptoms. One’s current bodily shame predicted an increase in the degree of underweight and the misunderstanding of body size. Worry about bodily shame (if one were to gain weight) predicted an increase in fear of gaining weight. Our current bodily shame, it appears, predicts different anorexic symptoms compared with expected bodily shame. 


In sport, where weigh-categorised athletes are training now and preparing for events in the future, we can see how such effects manifest. Understanding shame, internal and external shame, considering the role of status and power of selection by others, coalesces to create highly demanding circumstances for athletes to negotiate. Knowing more about our internal and external shame can help athletes to get to grips with the world in which they train and compete. Athletes can see the role they play and the healthy ways forward in their sport knowing the demands of a weight-category or bodily aesthetics. Managing in a seemingly unmanageable world is work best done with a close colleague, understanding coach, or trained health professional like a sport psychologist. 


References

Troop, R. (2012). General shame and bodily shame in eating disorders: A 2.5‐year longitudinal study. European Eating Disorders Review, 20(5), 373–378. https://doi.org/10.1002/erv.2160

Rathbone, G. (2011). Shame. British Journal of Psychiatry, 199(3), 224–224. https://doi.org/10.1192/bjp.bp.111.095828


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