RETURN OF THE SUPPRESSED - MENTAL CONTROL AND BULIMIA-NERVOSA

The clinical literature has long acknowledged the paradoxical findings that deliberate attempts to suppress particular thoughts actually inc rease their occurrence. The unwanted, intrusive thoughts that are a ma jor feature of obsessive disorders, depression, sleep disorders, and a range of other disturbances are of particular clinical concern. The e xploration of psychological factors associated with cognitive control is, therefore, clinically relevant. The present paper considers the ro le of mental control and thought suppression in bulimia nervosa in exp laining the occurrence of unwanted thoughts and feelings, specifically in relation to weight, shape, and food. Our fundamental argument is t hat suppression of thoughts of food, weight, and body shape can lead t o the increased frequency of these thoughts. The increase in unwanted thoughts is likely to result in a loss of control over eating, and lea d to the escalation and perpetuation of bulimia. Dietary restriction i s likely to be associated with successful suppression, and binge-eatin g with failed suppression. Indeed, the initial success of suppression paradoxically causes its inevitable failure. We conclude that the supp ression of thoughts of food and weight or shape in bulimia nervosa is maladaptive and counterproductive. In addition, the therapeutic implic ations of thought suppression are considered.