Eating Disorders: The Body Speaks
18th February, 2010
Eating Disorders at any age are the outward expression of deep psychological and emotional turmoil. Sufferers turn to food and eating as a means of expressing their difficulties.
Whilst on the surface the issues appears to be about food, at a deeper level eating disorders express a fundamental unhappiness which may originate from a number of different sources. An eating disorder can therefore be seen as:
An avoidance mechanism — in that the sufferer by concentrating all her/his energies round food and eating, can avoid facing other more painful issues in her/his life.
A way of coping with life which otherwise appears to be fraught with insoluble problems.
A way of exerting control over her/his body, and life in general, in a situation where the sufferer feels other people are controlling her/him.
A reaction to unresolved stress which may go back many years.
Eating disorders are fundamentally not disorders of eating; they indicate and express a disturbed perception of self.
In private Psychoanalytic psychotherapy practice it is most common to see people who have struggled with food issues for many years. Some will have had previous intervention that helped them with symptom relief, but the underlying issues have been unresolved. Others out of shame and fear have never sought treatment and it is only when they can go on no longer or when their bodies break down, and relationships start to fail, do they reach out for help.
It is interesting to note that all those suffering from stress, anxiety and depression use food in an inappropriate way. It is not surprising given that food, our very first source of comfort and care and closely related to our mother's early care, is what people turn to when they are stressed. Take Sally (not a real person but typical of someone suffering from an eating disorder) would come regularly to her sessions, she was alwasy keen to do the right thing and seemed to feel that she had to please me. She felt that I would not like her or care about her unless she was my perfect patient. She couldn't imagine that I would value her just as she was; sad, depressed, lonely and empty. It was impossible for Sally to fully articulate these feelings. Instead we came to understand the way her body would express how she felt. When she starved herself, she felt clean inside (no messy feelings). She felt good about herself and in control of things. This never lasted and soon the old cycle of bingeing started all over again. She would tell me with great shame how she would rush home from work, stopping at the supermarket to get her supply of goodies. She planned her binges reporting great excitement at the prospect of all that was on offer when she got home. It was like christmas every day, she could have what she wanted and didn't need anyone else in order to get it. We understood this as a 'do it yourself mothering' Sally's mother who had become very depressed when she lost her own mother shortly after Sally was born, could not engage with her in the lively way a baby needs to fully develop emotionally. It was as much as Sally's mother could do to feed and change her. She could not play or laugh or fully engage with her This meant that instead of being with a mother emotionally engage with her baby, Sally was with a Mum who was sad and depressed. The baby's coping strategy is to put on a false face, to show a happy face and to try to cheer her mother up. The cost to Sally was that she could never discover her own individuality. The roles became reversed and Sally grew up to be the carer of her depressed Mum. Her solution was to find a source of comfort that she could control and rely on. When she rejected the food it was as if she was angrily rejecting and chastising her Mother.
In a research project that I carried out on early feeding experiences in women with eating disorders, I discovered that nine out of ten women in the study all had mothers who had suffered a bereavement, or past bereavements that came to the surface, just before or shortly after the birth of the person taking part in the research.
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- Working therapeutically with obesity
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