Anorexia Nervosa and the INTJ Type

Anorexia nervosa has been described as “a dictator who dominates me,” “a ghost who surrounds me,” or “the little man who objects when I eat” (Bruch, 2001, p. 55). Such descriptions highlight the innate complexity of a psychological condition accompanied by extreme suffering and staggering mortality statistics. In fact, anorexia has the highest mortality rate of all psychiatric illnesses (Touyz, Le Grange, Lacey, Hay, 2016, pp. 128-129). By clinical definition, anorexia nervosa is a complex mental health disorder consisting of three essential components: “persistent energy intake restriction; intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain; and a disturbance in self-perceived weight or shape” (APA, 2013, p. 339). In other words, anorexia nervosa is a condition where food is restricted and behavior modified due to an intense fear of weight gain and disturbance in body perception. In its totality, anorexia nervosa encompasses a staunch refusal to eat, subsequent starvation, and often death. According to Bergh and Sodersten (1998), the unique and perplexing homogenous presentation of anorexia nervosa was first named by Sir William Gull in 1874—over a century ago—and the classic presentation has not changed. Though a great deal of research now exists, the disorder remains a therapeutic enigma and psychological mystery due to its unknown causes and origin. However, a Jungian perspective of anorexia nervosa provides insight into the personality of those struggling with the disorder as well as into the nature of the disorder itself. Overall, anorexia nervosa is a very rare disorder affecting only about 1% of the population, according to the National Association of Anorexia Nervosa (2018), and it is not a determinant of any specific set of personality type preferences. Nonetheless, the INTJ personality may have a greater susceptibility towards the condition due to its psychological composition. A typological analysis of anorexia nervosa shows a psychological syndrome based in archetypal possession resulting from the dynamic configuration of INTJ preferences. Therefore, from an archetypal standpoint, anorexia nervosa can be viewed as an unconscious symbolic reenactment of the Persephone myth.

The Greek myth of the goddess Persephone involves what Jung called Kore, a young, innocent maiden of naïve consciousness representing youth, spring, and the renewal of life. There are various versions of the myth; outlined here is a generalized interpretation based on the work of Kerenyi (1998). The story of Persephone began with her abduction. The innocent young maiden, daughter of the goddess Demeter and god Zeus, was kidnapped and stolen from life by Zeus’ brother Hades where she was taken to the underworld. According to Hillman (1979), Hades represents the depths, death, and all that is invisible and therefore unconscious. Once Persephone arrived in the underworld, she was made to marry Hades and crowned Queen of the Underworld. Persephone’s mother Demeter, the goddess of harvest, was made aware of her daughter’s disappearance by the goddess Hekate, known for her connection to the darkness. Demeter confronted and appealed to Father Zeus for their daughter’s return, which was only granted due to Demeter’s refusal to create harvest on Earth until Persephone was returned. Zeus sent the god Hermes, known for his quick thinking and diplomacy, to discuss the matter with Hades, who allowed Persephone to go, but not before tricking her into eating a single pomegranate seed, linking her to the underworld permanently. Kerenyi (1998) noted, “She must spend one-third of the year below the earth, and only for the other two-thirds could she remain with her mother and the rest of the immortals, returning to them with the spring” (pp. 239-240). Thus, Persephone is both a goddess of death and daughter of life.

Persephone’s journey to the underworld details a young woman’s descent into a psychological death-rebirth archetypal cycle in which suffering serves as a catalyst for individuation. Essentially, the myth of Persephone is a journey from unconsciousness to conscious awareness. It is a coming of age story for feminine psychology. Moreover, Persephonean consciousness holds the key to an inner marriage between the existential polarity of life and death.

The individual with anorexia shares a similar initiatory descent into the depths of the unconscious in the psychospiritual journey towards the Self—what Jung described as the whole and unified psyche. Therefore, when understood properly and carefully considered, the experience of anorexia nervosa can propel one along the individuation path into greater self-awareness, psychological development, and ultimately, inner wholeness.

The Living Skeleton

Individuals with anorexia nervosa demonstrate a strict adherence to the specific archetype informing the condition. This is due to the primary/dominant placement of introverted intuition (Ni). Haas and Hunziker (2014) noted that Ni “focuses on the contents of the unconscious” and “involves a psychic awareness of the intangible” (p. 64). These two key characteristics explain the anorexic’s attunement and vulnerability to the unconscious archetypal forces driving the condition. In short, Ni seeks the archetype.

The image of those with anorexia nervosa is represented by the skeletal appearance of the body; hence, the archetype informing the disorder is death. Chevalier and Gheerbrant (1996) stated, “The skeleton is the personification of Death. … The skeleton does not stand for death as an end in itself, something static, but, if one may use the phrase, for a dynamic death which is the herald and the channel of a new form of life” (p. 887).Thus, the archetypal “living skeleton” presentation of anorexics not only derives from an underlying death archetype but is based on a death-rebirth process driving the condition. The concept of death-rebirth is an archetypal pattern best understood by reference to Jung’s theory of archetypes and James Hillman’s archetypal psychology. Essentially, individuals with anorexia unconsciously and fervently seek the archetype by literally becoming—embodying—the psychic image of a death archetype and death-rebirth archetypal process. Shumate (2017) has observed that Ni types in excess can exhibit eating disorders, which may be a consequence of inferior extraverted sensation.

Furthermore, Marie-Louise von Franz (2013) reported, “The inferior sensation of this type also has difficulties in noticing the needs of the body and controlling its appetites” (p. 46). Overall, the Ni dominant individual, especially the INTJ type (see Fig. 1), appears a ripe candidate for anorexia nervosa.

In the depth psychological view, those with anorexia are not trying to “get skinny” as stereotypes portray; rather, they are unconsciously and somatically expressing a psychological death and archetypal death-rebirth process by their presentation as a physical skeleton. Contrary to popular belief, the process is out of the individual’s control as the archetypal influences hijack the ego personality. As in the Persephone myth, the psychic archetypal energy of Hades overpowers and “kidnaps” or captures the individual with anorexia. Therefore, anorexic individuals are not starving the self—they are being starved by the archetypal influences and psychological process. A psychotherapy client once stated of her anorexia, “There is no ‘too skinny,’ only death,” highlighting the extreme psychological dynamic occurring within the condition.

Anorexia’s complex connection to the unconscious realm from the archetypal perspective of introverted intuition highlights the internal drive, motivation, and empowerment commonly seen in the individual. From John Beebe’s function-archetype standpoint, the dominant function channels the hero archetype, and indeed anorexia nervosa is the hero’s journey of a lifetime for any individual who experiences the condition. In accordance with the work of Joseph Campbell (1949) regarding the hero’s journey, and reflecting the Persephone myth, the individual with anorexia undertakes her own heroic psychospiritual journey through the underworld to transform personal and collective consciousness.

As arguably one of the most perplexing psychological conditions known, the clinical presentation of anorexia nervosa corroborates the research on introverted intuitive types reported by Haas and Hunziker (2014), who said these types “often communicate very little specific concrete data and sometimes none at all. The outer world of tangible facts may have little to do with the validity of the message they are trying to convey” (p. 66). Indeed, anorexic individuals have extremely limited attunement towards the biological facts of their extreme condition. To clinicians, this lack of regard towards literal starvation is extremely confusing and obviously disturbing, yet when viewed archetypally and symbolically through the lens of typology, anorexia nervosa is portraying its archetypal message of psychological death-rebirth perfectly.

Furthermore, anorexia is typically accompanied by a condition called alexithymia, meaning an individual has a very hard time describing inner emotional and feeling states. When asked a feelings-based question, individuals with anorexia will commonly draw a blank, which is reminiscent of an INTJ type in excess. Due to a lack of connection with their inner world, they often must think about how they feel as it is rarely ever clear to them. Research conducted by Lule et al. (2014) found patients with anorexia nervosa had significantly higher alexithymia, higher levels of depression, and overall anxiety compared to other populations. From this standpoint, anorexia is an intuitive thinking disorder wherein feelings are often muddled, confusing, and lacking in development and maturity.

Clarity Through Order

Those with anorexia appear to be completely goal-oriented towards the management of the external world, as befitting extraverted thinking (Te) in a secondary or auxiliary position. Haas and Hunziker (2014) noted that “Te wants to evaluate, decide, and complete a task using a system of logical binary judgments” (p. 73). This is due to the unconscious awareness of the strong internal pull of a death-rebirth process; thus, these individuals overcompensate and try to manage their panicked and spiraling lack of internal psychological control by exercising total control over their external environment. As such, individuals with anorexia often have elaborate systems in place for the monitoring and managing of food, exercise, weight, and the body. They devise extreme schedules and complete complex tasks all revolving around their starvation. As an extreme manifestation of extraverted thinking, anorexia “seeks clarity through order” (Haas & Hunziker, p. 74). Most individuals with anorexia obsessively clean and organize because they are seeking clarity and perfection in their surroundings whilst being completely terrified of and dissociated from their chaotic and intense internal world.

According to Beebe (2006), the archetypal pairing for extraverted thinking in the auxiliary position is represented by the good parent, and most anorexic youths are described as “miniature adults” who behave perfectly, follow all the rules, and appear mature well beyond their years. From the outside, anorexics appear to do everything right, just like a good parent would demonstrate, while experiencing invisible internal suffering due to mental and emotional anguish. A client of Bruch’s stated, “My illness represents the ultimate of failure to cope with life” (1973, p. 269). Within the mentality of anorexia nervosa, the mature external presentation covers deep-rooted feelings of inadequacy.

Reversing Natural Processes

INTJs have introverted feeling (Fi) in the tertiary position in their psyche, a position Beebe associated with the puella aeterna archetype that symbolizes eternal youth. Significantly, the typical clinical presentation of anorexia nervosa occurs most frequently during adolescence and quite commonly during the onset of puberty. Mehler and Andersen (2010) noted that the initial presentation of illness peaks at ages 13-14 and 17-18. Persephone as Kore represents a version of the puella aeterna archetype corresponding well with the underdeveloped feeling aspect of INTJs. The same archetypal pattern is also shown by the common Peter Pan syndrome of the typical individual with anorexia, who often expresses fears of reaching maturity and adulthood. According to Haas and Hunziker (2014), introverted feeling “wants to make choices and act in ways that create and maintain inner harmony” (p. 103), and in the eternal child position, introverted feeling can distance the individual from life, just as Persephone was removed from the upper world. Lenore Thomson (1998) stated, “When extraverted thinking isn’t working well enough, INTJs draw directly from their tertiary function, Fi, which merely rationalizes and supports their worst tendencies. It encourages them to idealize their abstract ideas about life and to avoid real relationships as unworthy of their investment” (p. 245). In alignment with Thomson, the Fi positioning in anorexia causes individuals to rationalize their condition by unconsciously seeking death in lieu of having to experience the vast and difficult contradictions inherent within living. As Marion Woodman (1980) wrote, “Life may be rejected, consciously or unconsciously, through the rejection of food. A despairing woman may silently decide to make her slow escape through starvation” (p. 36). In other words, within the interior of anorexia, life is shunned.

It would seem, too, that the transition from childhood to adolescence and adulthood activates the trickster energy of extraverted feeling (Fe). As the archetype of the child gives way to the new archetypes, psychic images, and somatic responses of adulthood, a negative trickster attempts to interfere and even reverse the natural process. Thus, the starved body itself is not allowed to reach adult maturity, instead taking on the appearance of a child, and eventually a skeleton. In this way, the underdeveloped individual with anorexia distinctly embodies Kore and the puella aeterna. A key component of these young feminine archetypes is what Jung (1950/1980) described as “the girl’s notorious helplessness,” which “is a special attraction” (¶ 311) making the anorexic individual particularly helpless to the archetypal forces driving the condition, especially that of the negative trickster.

Haas and Hunziker (2014) noted that individuals using extraverted feeling in the dominant or auxiliary positions “often have a very hard time focusing on taking care of themselves” (p. 95), instead becoming caretakers of everyone around them. Moreover, “it is common for their own physical needs to be neglected until a personal health crisis demands their attention” (p. 95). When Fe is in the trickster position, such self neglect can be taken to extremes. Demonstrably, those with anorexia are known to cook and clean for their entire household yet refuse to eat any of the food they make, behavior which seems representative of the trickster position of Fe. They also attempt to ignore their own basic survival needs until the point of crisis when most are on the verge of death. In this way, anorexia essentially “tricks” an underdeveloped feeling function into believing the psychological demands of maturity are too overwhelming to live with and the overall experience of life simply too difficult to bear.

The Key to Understanding

The positioning of the sensation functions in the INTJ psyche holds the key to understanding anorexia nervosa at its core archetypal level. Jung (1921/1971) stated that introverted intuitive types repress most of all the “sensation of the object and this gives rise to a compensatory extraverted sensation function of an archaic character” (¶ 663). In anorexia nervosa, the body as a “sensing object” is repressed to the point of near or absolute death. The condition elicits an extreme unconscious repression of the body’s natural sensations as extensions of the external world. This repression leads to subsequent starvation and can eventually cause death. Due to alexithymia, anorexics cannot feel their internal states, but because of the physiological effects of starvation, their externalized sensing becomes extremely sensitive and heightened in response to the environment. Von Franz noted the inferior position has “difficulties in noticing the needs of the body and controlling appetites” (p. 46). Those with anorexia have vast difficulty in identifying basic bodily cues such as hunger, fullness, satiety, and even pain. Additionally, Shumate has observed that it appears relatively easy to slide from an egosyntonic function to its opposite-attitude shadow function. For example, “The act of eating can take one from the extraverted sensation (Se) experience of tasting the food to an introverted sensation (Si) experience of monitoring the internal operations of the body” (personal communication, February 13, 2018). An overall internal and external dissociation from the body that encompasses the anorexic’s experience can easily blur the boundaries between extraverted and introverted sensation. Furthermore regarding the inferior function, von Franz (2013) stated “the symbolic meaning of an unconscious fact appears outside, as the quality of the outer object” (p. 16). In those terms, the “unconscious fact,” or key to understanding anorexia nervosa, is portrayed by the skeletal appearance of the body. Again, the body portrays the internal psychological death and archetypal death-rebirth process occurring within the psyche.

The slide from Se to Si takes the anorexic directly to the eighth function with its demonic/daimonic archetypal defense complex, which for anorexia highlights a death complex. According to Jung (1948/1972), “An active complex puts us momentarily under a state of duress, of compulsive thinking and acting, for which under certain conditions the only appropriate term would be the concept of diminished responsibility” (¶ 200). In those terms, anorexia becomes a prolonged constellated complex wherein individuals lose control of their autonomy, specifically their control over their body and subsequently their lives. Bruch (2001) reported that “when anorexia develops, patients feel the illness is caused by some mysterious force that invades them or directs their behavior” (p. 55). Such beliefs reiterate the death complex and the Hades possession at the condition’s core.

In archetypal terms, anorexia’s portrayal as a Persephone myth envisions the condition as an initiatory journey which can facilitate a transformation from Kore consciousness to a queen archetype wherein the individual’s psyche can be brought into balance as existential opposites are married within. As the myth told, Persephone maintained a connection in both the upper world and underworld, acting as a powerful intermediary between life and death. In summary, it is within Persephonean consciousness where the archetypal and psychological meaning and outcome of anorexia nervosa can be found. With proper therapeutic support, many individuals move through the process and completely recover from the experience.

Case Study

A seventeen-year-old female presented with anorexia nervosa of the restricting type. The client had never been to therapy and did not yet have a formal diagnosis. The client appeared very mature and well-spoken for her age; she held two jobs and had graduated early from homeschooling. The client stated she had struggled with eating, weight gain, anxiety, and depression since around age eleven, at which time she began menstruation. She reported not knowing what was “wrong” with her until being exposed to a documentary on eating disorders around age fifteen. The client had recently lost ten pounds without much effort, putting her at around 75% of ideal body weight with a body mass index of ~15 [normal BMI is 18.5 to 24.9]. The client stated she now felt the condition “taking over,” which deeply frightened her, and thus she was seeking treatment to recover. She acknowledged her skeletal appearance and stated that feeling and seeing her bones brought her comfort because “it was what she was supposed to be doing.”

The client’s reported type was INTJ via the MBTI®. She struggled to connect to her feelings and had difficulty describing her inner emotional states besides feeling incredibly anxious and, at times, struggling with suicidal ideation. She lived with her religious parents, did much of the family’s cooking and cleaning, and reported feeling pressure to be a “perfect person” in terms of the family’s religious beliefs. The client had only a few friends and spent most of her free time by herself.

Significantly, the client reported that her first romantic relationship was with a “scary and dangerous” boyfriend. Although she had never been outwardly harmed, the client discussed many violent dreams of the now ex-boyfriend attacking her, which caused her to fear and avoid him in waking life. After initially denying inpatient treatment, the client expressed high suicidality and was subsequently hospitalized where she was stabilized, after which outpatient treatment resumed with good success.

Analysis

In this brief case study, many aspects of INTJ preferences are showcased within the client’s anorexia, including a strict adherence to the archetypal image; extreme introversion accompanied by alexithymia; acting as an adult in terms of work and household duty; high levels of anxiety, depression, and perfectionism; and expressed suicidality. The client’s sense that starving herself down to the bone was what she was “supposed to be doing” highlights the Ni type’s deep resonance with an archetypal image and vulnerability to the archetypal possession of the condition. Also, the client’s first romantic relationship, both in waking life and the dream world, seemed to aptly represent the mythological motif of a Persephone myth as represented by the “underworld” character of the boyfriend.

Psychotherapeutic treatment focused on the development of healthy ego strength utilizing strength-based approaches, including Dialectical Behavior Therapy as well as working towards resolution of severe existential crisis themes with the exploration and cultivation of spirituality and mindfulness-based practices. As the client recovered and thereby transformed, she was able to balance anorexia’s “living skeleton” archetypal image of death with an image representing life, demonstrating the ability to hold and embody the tension of opposites as the myth of Persephone illustrates.

Hope for the Future

Jungian typology sheds new light upon the condition of anorexia nervosa by providing a unique and enlightened depth perspective based on personality type. From a depth psychological perspective, anorexia nervosa can be understood as an archetypal death-rebirth process wherein the body becomes the archetypal symbol. Many of those who suffer from the disorder appear to fit a profile of INTJ preferences in excess. Recognizing this connection has proven valuable in terms of client conceptualization and psychotherapeutic treatments as it provides deeper insight and greater awareness into a disorder that is notoriously difficult to treat and understand. Understanding the nuances of personality within anorexia is vital for clinicians and family members who desperately struggle to help individuals suffering from the condition. Lastly, it bears repeating that anorexia nervosa is a very rare disorder affecting only 1% of the population; therefore, anorexia is not caused by INTJ preferences, though these individuals may have a greater propensity towards the condition due to their psychological makeup.

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