Integrating two worlds: Virtual and real life experiences of women with eating disorders

This qualitative study explored the experience of women who have an eating disorder and who use Internet communications as a way to express what is difficult to verbalize in real life relationships. The purpose of this study was to gain a deeper understanding of the ways in which these women's attachment and relational styles affected their on-line interactions as compared to real life relationships. The literature review focused on the etiology and the different types of eating disorders, the formation of relationship from the point of view of attachment and psychodynamic theories, the socio-cultural context, and issues related to the psychological aspects of on-line interactions. Participants were fourteen women who have an eating disorder and who use the Internet to communicate about it. The study utilized the combined method of a self-report scale of attachment style and an open-ended questionnaire. Along with negative consequences that may result from the exposure to eating disorder websites, participants' experience showed an interaction between their attachment and relational style and their tendency to use the Internet as a mode of self-expression in which they feel safe and reveal more aspects of themselves. On the Internet, women were more able to gain a sense of mutual impact in relationships, to regain a sense of agency. The Internet provided an added value by assuming certain attributes that are part of a self-object, mainly in its function of mirroring and its availability and responsiveness by others. Results suggest that participants may split between the on-line and the real life worlds; in order to integrate the relational patterns found on-line into one's real life patterns, the two expressional modes should be incorporated in one's psychotherapy.