The term “eating disorders,” like so many diagnostic labels, describes a spectrum of experiences and dynamics; while two people might both overeat and purge, the psychological reasons why they do so can be very different. I’d like to discuss one of my clients who suffered from bulimia, along with the emotional factors involved, because her story sheds light on a much larger issue: how we may cope with unbearable emotions and feelings by trying to get rid of them.
When I began working with this client (I’ll call her Sharon), I had little experience with eating disorders. I understood that there might be a connection between childhood sexual abuse and bulimia; I was aware that low self-esteem and perfectionism likely played a role. The first time we met, Sharon told me she’d been sexually molested by her step-father during her early teens; while she didn’t strike me as having particularly low self-esteem, she did seem quite perfectionistic and self-critical. In our early sessions, however, what struck me most was how little she could tolerate her emotions and feelings.
A pattern began to emerge: whenever an experience threatened to stir up emotion (it could be an intensely pleasurable feeling just as well as an anxious or painful one) the powerful urge to overeat would arise. Eventually she would give in, binge eat and force herself to vomit afterward; an enormous sense of relief always followed. We came to understand that what she wanted was to feel empty, void of emotion. Her bulemia, in a very literal sense, was a process of emotional evacuation. By throwing up, Sharon felt she’d gotten rid of the unbearable emotions and feelings along with the food she’d eaten.
The solution wasn’t permanent, of course: the feelings usually came back. Sometimes evacuating her feelings gave her enough time to find an alternative way to remove or avoid the cause of those feelings; on other occasions, emotions would resurface and she’d go through the binge-purge cycle again. In almost every situation, her goal was first to avoid having any feelings if possible, and then to get rid of them whenever she couldn’t.
Sharon’s mother was a very logical, remote woman who also tried to avoid any kind of emotional turbulence. The fact that she somehow managed not to know what must have been obvious, that her husband was molesting her daughter, shows just how far she would go to avoid facing painful and difficult situations that might agitate her. In other words, Sharon grew up in a family with little tolerance for emotions and feelings; she never learned how to cope with them in a mental way and developed bulimia, in large part, as a physical alternative.
There are many other ways to avoid or evacuate unwanted emotions and feelings; the process of projection isn’t usually as literal as it is in this case of bulimia. But I believe it’s something we all do at one time or another.
Finding Your Own Way:
You might have a hard time identifying with Sharon’s methods, but you may use eating in related ways. Many people turn to food as comfort, of course, trying to satisfy an emotional need by physical means. Others use food as a sort of numbing agent. In earlier posts, I’ve discussed different emotional drugs people can use but those tend to function as stimulants; what about food as an anesthetic?
As to the larger issue of avoiding intense emotions and feelings, you may find more common ground with Sharon. Here’s a personal example. When my children were small and the emotional demands of rearing them were high (in addition to the emotional demands of my psychotherapy practice), all I wanted at the end of the day, after everyone was fed, bathed and in bed, was to watch repeats of “Law & Order” with a glass of wine. Nothing stimulating, nothing unexpected … just the comfortable routine of crime and punishment, with characters who never surprised me. Sound familiar? At the end of your day, do you numb out in front of mindless TV shows with alcohol or ice cream? Maybe it’s because, after the stimulation of your day, you can’t take any more intense feelings.
How does your own routine serve to limit the kinds of emotions and feelings you have? Are you a creature of habit? Sometimes repetitive ways of doing things allow us to know (or believe we can know) what we’ll feel in advance. Who of us really likes the shock of unexpected feeling? It might be a wonderful surprise if the Publisher’s Clearing House guy showed up at my door, telling me I’d won the sweepstakes, but I hate late-night phone calls that mean bad news, death or a serious accident.
You’d think, given the shortness of life and the wealth of possible experiences, we humans would constantly be searching for new sources of stimulation and excitement. It’s surprising how many of us prefer the comfort of routine and the set of knowable emotions and feelings that come up in our ordinary day.
I’m not really sure what causes me to binge…it sometimes just seems that I do it out of boredom. I’ve never purged…..never felt the inclination..but I do feel the shame that ultimately follows a good binge…of course I comfort myself with “Oh well, as soon as the weather gets a little better, I’ll get out and start walking again” My concern is more with”body image” than with why I do it ! Seems as though I should be working on trying to figure out the reason for this self destructive behavior..Comfort food, sounds right..Boy I can come up with a dandy ice cream sundae….whipped cream and all….other times though, it’s something like chips, I’ll sit and eat a whole tube of Pringles in a sitting…but mostly it’s sweets..chocolate omgsh, a giant size Hershey Bar can disappear during a movie..I’d like to be able to overcome this behavior….is it necessary for me to understand the reasons why, will that help me change the behavior ? Or is it simply, acknowledge the behavior and then work on self discipline ?
The will power thing , or lack thereof, is truly an issue…..HELP SOMEONE…….
I wish I had an answer for you, Betty. I don’t think the self-discipline approach is going to be helpful, because then it’s so easy to come down hard on yourself when you slip up. While it may be self-destructive, the motivation for your binge eating probably isn’t to hurt yourself. It sounds to me as if food is helping you keep other feelings at bay. What they are … well, next time you feel the urge to binge, hold off as long as you can and try to notice what comes up.
This is so good. I believe my daughter has a problem with overwhelming emotions, even though I tried very hard to help her identify what she was feeling when she was growing up. (She had severe abandonment issues with her dad). Although she does not have an eating disorder, she does have a self-image problem and now either levels (sort of insults people to feel better about herself) or just disrespects them, including me. It’s been very difficult. I love your blog.
Thanks, Pat. It’s hard to see your children in pain, know they’re hurting but then have them hurt you because they don’t like themselves. Also hard when there’s so little you can do to help them.
Great piece. The emotional relationship to eating is so profound it sometimes feels like an area that is just too dense to unpack when I do my personal work. I can work with clients all day around their emotional baggage but when I come home at the end of a long day, I feel like I deserve to overeat as it somehow rewards me for working hard. I notice other moments when food feels like a reward in my life. Frustrating process for me. I have great compassion for people who struggle with eating process issues because of my own.
I’m with you on that one. The work we do involves so much emotional giving that it does feel as if we deserve some kind of culinary reward at the end of the day!
I never realised until reading this, that my struggle with new feelings might be due to my abuse. I really find new emotions difficult. I spent many years with a therapist, simply learning to label feelings.
When you think about it, what could be more overwhelming, threatening and unmanageable than childhood abuse? It’s no wonder children can’t process the experience and have to find some other, more radical ways to deal with/get rid of the experience.
I think it is extremely important that people are able to identify and put a lable on the problem of this kind that have been discussed. When the problem has a name it has been identified and therefore recognized. Next step would be accepting it as a part of ourselves and perhaps then would come the substitution of the illbehaviour with more appropriate and mature one. A crusial thing is to discriminate between the symptom and the root of causalic action.
i wanted to make a suggestion but not sure where to put it! i saw the lady comment about last names, which got me thinking. it would b nice as i loved the addition where the ppl can post stuff and anyone can answer. i feel it gives u support and ur not alone. it would b nice if ppl could post what issues they r having, general and no last name as i no u can not answer all the questions but mayb there is someone else out there at that time that could suggest how to cope. sorta a support group on line. then u could review and see what the ppls general problems and it may give u something u may want to cover in ur additional writings. just a thought as i look at this site alot but do not have the time i need to take to really read everything and it may bring ur followers conections to ppl…….just a thought in the middle of a sleepless nite, one of many……..keep up the good work. nice to see there r drs out there that go beyond their call of duty and go overtime like this site to help others….ty
Tracy, the Discussions tab on the Facebook Forum page is designed for just the purpose you describe. Feel free to start a discussion and ask questions whenever you like. I envision that as a place where readers can interact without my moderating or acting as any kind of an authority.
forgot my real comment and i no i may b one of the few that has this issue. but when things r not going well for me i stop eating. i even ask myself (try every day) just to remember did i eat today and what. sometimes in my moments i will go 3 days without eating hence i have had huge struggles maintaining a safe weight. lbs are safer now but lets say u could count my every bone, not healthy at times scary. i still struggle and work to eat and keep wieght up but always wondered is this a combo of eatting disorder w/anxiety/depression.
It certainly sounds like a combination of eating disorder with anxiety/depression, although I’m not sure how much value there is in assigning a label to it. This is very serious, Tracy. I’d like to think you have some professional help on this issue. I realize it’s hard (and often expensive) to find good therapy but when you’re struggling to keep a safe weight, your life is at risk.
Just signed on to follow you back in Twitter. So glad you found me there. This blog is very informative. I had recognized some of the behaviours mentioned, like perfectionism and avoidance of painful emotions have been experiences of which I have sought to overcome. It was a long, arduous undertaking, albiet, commited to a happier lifestyle. Today, life is generally much more emotionally ballanced especially on a day to day living. What has become more apparent is the these lingering affects rear their heads from time to time and once again must be dealt with…but the good news is that when noticed, it are far less impactful and much less lengthy in duration.
Thank you for sharing your insight. Rita
I don’t binge, in fact I hate the feeling of vomiting, but I do use food as comfort. Especially, when I’m bored or stressed. So I do the opposite of wanting to feel empty–I use food to want to feel.
there seems to be a correlation between these disorders and emotionalally muted individuals (people who have difficulty verbally identifying with and expressing themselves emotionally), Not to say they lack in emotion. Rather these individuals seem to have an underlying similarity in that when emotion is felt these individuals seem to not “know” what they are feeling and what to call that/those feeling(s). I recently became aware that indeed my emotions were somewhat muted verbally and that I use a nominclature all to my own the words “fucked-off” for a varying degree of emotions. This insight gave me pause. Upon reflection and an intent to be present or conscious in all that I do, I’ve become aware that the words “fucked-off” are my tidy little basket to carry the emotions and verbally express a feeling/emotion that I do not know what to do with. Am I on the right track here if not insight would be appreciated.
Jeri, what a great observation. I think you must be right about the function of your naming the feelings the way you do. The very process of “naming” or using words makes us feel as if we know something, and most of us feel much better knowing rather than not knowing. I’m reminded of a client who used to do something very similar to what you’re describing; in session, a feeling would begin to arise and he’d label it with some word or another. Over time, I began to feel that the words he used weren’t quite the right ones … maybe in the vicinity but not really accurate and precise. We came to understand that, by naming it, he felt the feeling was understood, that we were done with it and could then move on to something else. He used words and naming as a means to dispose of the feelings he didn’t really want to explore. Our task then was to help him sit with the feelings in silence, internal and external, until their exact nature became clearer. As you can imagine, this put his anxiety level through the roof since he was unaccustomed to bearing intense feeling for any length of time.
I have really enjoyed reading your blogs. I havent been abused the way Sharon has but I understand the need to purge to feel empty. I toohave grown up in a family that dont know how to deal with emotion. My family drink & eat to show emotions – I drink+eat+purge the emotions. It’s so cliche to say that everyone deals with problems in different ways- but it all depends on the way we have been raised. I hope your client has done well and is trying to get better. We should try harder to express ourselves- it would save us all alot of hurt
Ed has been in my life for over a decade. He ensures that I enjoy not even one single bite of food. Instead he fills my mind with percentages, ratios, carbs/protein/fat. He loves to show me the picture of myself 12 years ago when I weighed 265lbs. In 1999, I embarked on a journey with Dr. Atkins leading and teaching me, 10 months later I lost 125lbs. What an amazing accomplishment, I thought to myself. The human body is amazing, you can transform it and reform it, however, the human brain, where Ed lives is less likely to adapt to your transformation or be accepting of it. Your fat, Ed says. I can’t believe you just ate that he mocks. Despite many years of identifying his voice and learning to hide from him, I leave a door open somewhere and in he wanders. While I have mustered the courage to tell him to go F-himself, I always believe him when he tells me that I’m disgusting, dirty or shameful. The feelings echo in my mind, I become erratic and anxious, thoughts begin to spitfire at lighting speed. I reach for Ativan then propanalol, I literally must knock myself out before Ed knocks me out. It’s too late, I reach for the crackers, I chew so quickly, my anxiety grows. Now I’ve entered into sin, shame surrounds me, I scourer the cabinets and fridge. The years have taught me to have no “guilty pleasures” at home. I’m forced to turn any food into a guilty pleasure. My anxiety continues to grow as I realize that I must now get rid of the evidence, I must purge the sin. I have lost control once again, succumbed to Ed and his accusations. He’s right about me ya know, how can I serve as an example to others who struggle with weight loss? I’m still that fat girl in a smaller body, Ed likes it that way. Ed, I hate you, you’re a demon and although we’ve spent many years together enduring career changes, moves, a failed marriage, I pray for your death and my freedom from this bondage.
You can get rid of outside-Ed but you’ll never get rid of the internal-Ed. You need to focus on the place where you agree with him.
You can get rid of outside-Ed but you’ll never get rid of the internal-Ed. You need to focus on the place where you agree with him.
Can you clarify this please? I have a similar issue…
One thing that people often overlook when they talk about being persecuted by a savage part of their minds is that this part is ALSO who they are. People often view the savage superego as if it were a foreign object, or “negative programming” that you need to get rid of. In fact, it’s a highly developed part of you — the “you” who is superior, contemptuous, critical and perfectionistic. Sometimes it also shows up in subtle attitudes toward other people. When I was replying to this reader, I meant that she needed to figure out how to deal with the abusive person who lives inside of her. It’s not going anywhere, whatever happens to the real Ed. After all, why did she get together with Ed in the first place? Because he gave voice to a part of herself.
I think it’s important to emphasize that we aren’t to hate those voices in our head that push us forward, that criticize and berate and scold us. This inner critic that we have actually has a very good intention behind his actions: He wants us to be safe. He wants to protect us from pain and disappointment. He might be wrong in the criteria that he uses, but his intention is good. Hating him will only perpetuate the abuse. Trying to understand and embrace him is the way to go. When we aren’t pleased with the way we look, for example, what that voice really wants is for us to look in the way that he believe will make us more likable and less prone to rejection. Isn’t it really a good thing? The rules he operates by are just another matter. To begin with, we might want to see what they are and see whether they are reasonable or not. What important is that hating that part will probably do us more harm than good.
While I agree with the uselessness of hating back, I find that this theory about “keeping us safe” to be true only about half the time. There are many other reasons why that hateful voice can be there. It often has a lot to do with envy. If shame is powerful, the self-critical voice can be an expression of powerful expectations to become an ideal self. Sometimes, when there are psychotic processes at work, there’s a profound hatred of reality (both psychic and external) and “keeping us safe” is true in only a very limited way.
Well, I wasn’t talking about psychotic processes, of which I have no understanding whatsoever. But from what I learned and from my personal experience and observation, I tend to believe that for a normal person the whole structure of his core beliefs, roles, defense mechanisms is still about safety and protection. Perhaps we are not talking about the same thing here, and I am well aware that my knowledge is really limited while you are really the professional here, but isn’t it true that it’s the motive of protection and safety that lies underneath every expression of the image of perfection? “I must be thin,” “I must be beautiful,” “I must be smart”—meeting all these expectations will make us—as our mind thinks—more successful, lovable, likable, less prone to rejection, pain, disappointment. And isn’t it true that these unmet images are the real cause for envying somebody, for being unsatisfied with ourselves, for trying to soothe our pain with comfort food, and so on?
If you take a VERY broad view of things where “protecting yourself” means doing anything to avoid pain, what you say is true. I just find it a little too pat. It also leads to an overly-rational, thought-out approach to one’s emotional experience.
Yes, that sounds so right. And that is exactly what I was curious about; how to deal with the person living inside you. Different people give voices to different parts of yourself.
I really love your words and insights, thank you for the blog.
Brilliant. Yes, focus on that little juncture where you started to agree with Ed. YES. that’s where to start your dialogue. Your description of yourself hashing it out with Ed is something kin to Jung’s method of “active imagination” where you could literally continue on in discussion with Ed and further your process in this “agreement” you’re living.
Did Sharon ever overcome her Bulimia and find another way to cope with feelings/emotions?
Yes. She learned how to tolerate her feelings, rather than evacuate them. It took a while.
I work at a for-profit organization as a floor staff and unit coordinator with young adult females. Most of them have been sexually abused. Im a 25 yr old male who has worked in the same unit 3-11pm mon-fri for 2 yrs straight. I am highly preferred by more difficult individuals with extreme aggression and NSSI. Was wondering if u wud want to answer some questions I have about my clients so I can better help them, as my clinical staff are seemingly either unknowing or uncaring. Dont worry, all wud be anonymous. I only seek answers to be the best floor staff I can be. And I loved your projection post. It made me realize that my ability as an extremely patient 240 pound college wrestler may be a great reason for some of the young ladies to want to work with me. Afterall, I can help them through their toughest times. Even if they have to project all their anger on to me. I can explain a couple of circumstances where i may be the exception to a tendency for a female who has made numerous allegations of false sexual abuse. My other example comes from when a young lady stopped demanding female-only supervision. Why me? What is the ideal role for me to take in these young ladies lives …?
Generally, id like to
You should probably write to me directly at: afterpsy@gmail.com
I can relate to this post as I struggle with all intense emotions whether positive or negative. I don’t relate to food a vice as I’m so disconnected from my physical self as my physical body has failed me throughout my life. I do chose to rid myself of emotions through using drugs which I’ve used on and off since age 12. My biggest issue is that untilI learn to feel intense emotions and be ok with them I’m struggling to not use drugs as everytime I stop the emotions are overwhelming and I fall back into numbing myself again. My therapist has tried to appeal to my physical well being to encourage stopping using as using upto 1500mg of codeine nearly everyday but I honestly do not care about my physical health.