ABSTRACT
Children raised in neglectful or abusive households are unconsciously assigned one of three roles by their parents. Alcohol and drug abuse become parts of the codependents’ lives, who themselves may self-medicate with other addictions: work, gambling, sex, excessive spending, food, or obsessions with personal appearance and plastic surgery. The unifying experience of childhood abuse or neglect is toxic shame: inadequacy, insufficiency, vulnerability, and damage. Nearly all physicians have obese patients. Childhood emotional abuse is associated with both alexithymia and disordered eating and mediated by “general distress” or depression. Abusive and demeaning behavior, threatened abandonment, or an intrusive, overprotective, chaotic, or emotionally cold environment create boundary violations and a sense of betrayal, distrust, and vulnerability in the child.
