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.
Continue “Unbearable Emotions and Feelings”