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For help with these issues, please contact:

Jane Rachel Kaplan, Ph.D., MPH
jane@optimaleating.com
510.524.6117

902 Curtis St.
Albany CA, 94707


A Glimpse Into Another World
 

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Eating is so simple.
Why can't my partner/daughter/friend use food normally?
This question echoes in the minds of countless people across the country.

People without eating problems are mystified by the sufferer's inability to stop unhealthy behaviors she may no longer even want. To them, her problem may even seem to be exaggerated. But food obsession is not trivial or self-indulgent. Far from being frivolous, the food-obsessed person is often guilt-ridden, driven and unhappy.

If good advice and common sense were as easy to swallow as ice cream, the person you are worried about could be cured of an eating disorder in an instant. A simple instruction would be enough: "If you're too skinny, start eating. If you're too fat, diet and exercise. If you're throwing up to dispose of megasnacks, stop it." Unfortunately, people are not this logical. If we were, not many of us would smoke, gamble, drink or abuse other drugs. The person with the problem has almost certainly tried this logic already and it hasn't worked.

Let us help you try to see the world from the eyes of a person with an eating disorder. She probably does not perceive the world as a comfortable place, and it is especially uncomfortable inside her mind. Her inner conflicts may feel like intruders who mischievously take over and get her into trouble. In one corner is an impulse that may seem like a sort of demon that must be forever chained and guarded or it will take over. In the other corner is a critic who offers no help in controlling the beast, but is always ready to blame when it escapes.

For the person obsessed with food, self-respect depends on how "good" she has been today, or this week, or this month (how successful she has been in restraining her eating). With one little slip, her self-esteem slides into an abyss. There, her despair can only be relieved by the one consolation she knows: food.

Imagine how life would feel if you did not believe the world would accept you unless you were prefect--physically, mentally, and in every way.

Imagine how you would feel about your family and friends if you believed you did not deserve to get anything you really wanted.

Imagine the pressure you would feel if your first law was to control your emotions at all times.

If you can picture these states of mind, you can begin to relate to the internal battle going on inside your loved one, even if you can't see it on the surface.


Masking Inner Conflicts

One can hide many personal conflicts behind food abuse. Anger is a prime example. In some families and cultures, anger is forbidden. A child born into this family or culture learns to suppress anger. Stuffing food down one's throat is a powerful way to stuff down anger, or any other feeling, since you can't speak or cry with your mouth full. Self-hate can result from stuffing one's emotions in this way, but for some people it is safer than feeling anger at others.

Assertiveness is another important issue that may be hidden behind unhealthy eating. Many food-obsessed people feel unworthy to ask directly for what they want. Instead, they use indirect means: being nice, looking hopeful, hinting, and earning it three times over. Sometimes they become care givers, offering to others the very things they need themselves. Since pleasing people is so important to them, they have developed masks of apparent confidence behind which can lie problems hidden for years, from friends, relatives, and even themselves.

When people feel they can never do enough to redeem themselves in the eyes of a critical, hostile world, they become people-pleasers. For example, some people with eating disorders choose careers such as nursing or teaching in which they are rewarded for functioning in a helping or pleasing role.

Body image plays a part in the fasting-overeating cycle. If I feel that the solution to misery lies in thinness, I will orient my life toward achieving thinness, putting off everything else until I am slim enough. Most of the eating disordered clients we have seen feel their bodies are unattractive, ugly, uncontrollable--their enemies. This makes normal eating difficult: why bother to take good care of something you hate?

Like money, food is a currency pressed into service for bad as well as for good. For instance, a person may use eating for not only nutrition, but also to pass the time, to punish oneself or others, to procrastinate, or to keep people away.

Food obsession may involve not only self-hate but also loss of control, loss of body awareness, above-average spending on food or diet-related items, and dread of holidays or other special occasions. Sadly, it also can divert energy and talent. After examining her feelings in therapy for some time, Helen exclaimed one day, "Just think! Now that I'm overcoming this obsession, I can start working toward my bachelor's degree again!" Others have regained energy for sports, classes, relationships and creativity.

Control is a central theme for people with eating disorders. It is unthinkable to them to relax control over their thoughts, feelings, words or actions. The common fear is that if control is relaxed, even for an instant, disaster will follow. The illusion is that peace of mind can be purchased with eternal vigilance. The cruel trick is that the food-obsessed person gets the vigilance without the peace of mind.

Advertisements, television shows, and movies reveal our imperfections. We are shown in full color how our thighs "should" look. Our own bathing suits leave us exposed for the world to see and (we dread) to judge. Since the media show almost no women with less-than-perfect bodies, the illusion is given that "if you don't like this, you're nobody." To figure-obsessed women, the identity itself is precarious, dependent on success in dieting, forfeited at the least transgression.

But not all eating disordered people are obsessed with their figures. Some people began over- or underrating to cope with a loss, or during an illness, and then found they couldn't break the pattern.

Perfectionism is a characteristic of many bulimics and anorexics. They drive themselves to have excellent grades, the boss's approval, the wittiest conversations and, of course, the perfect figure. If they fall short of their expectations, they judge themselves harshly, shun praise, worry, and work too hard. This perfection is not usually the love of doing a good job, but a driven fear of rejection. Perfect behavior or performance seems to offer a route to some sort of acceptance. Unfortunately, the perfectionist almost never gives herself full marks for a good job, since she is imagining an even more perfect performance. So even success brings no praise or pleasure. It is as if the eating disordered person must be perfect, but cannot be happy.

But what is this perfection for? It may represent a hope that a perfect performance can be a substitute for herself, which she dislikes and distrusts. It's as if she says, "My schoolwork, my house, my mothering, my body are me. This is all of me."

Even if the desired praise results, it doesn't really soothe the anxiety. The hurting, invisible person within who produces the perfect performance remains hidden, feeling unseen and still insufficient. So, seeing no way out of this vicious circle, she tries even harder to be perfect.

Maureen constantly puts herself down. Nothing she did was good enough in her eyes. Kevin, her husband of three years, was amazed and confounded. It was depressing to hear her berate herself day after day. He tried everything to lift her spirits. He praised, cajoled, kidded. But she continued to demand only the best from herself, becoming upset if anything "went wrong." She was also critical of Kevin, who was an easygoing man.

Even though Kevin thought she was beautiful, Maureen hated her body. After a party she would criticize every person there, including herself. Maureen binged and purged since she couldn't keep her weight down to model size any other way. She still felt fat and ugly. She spent a lot of energy hating her weak will.

When she finally realized that she was being too critical, she tried to change her thinking. What's wrong with me? she wondered. I have everything-- a loving husband, a good job, a lovely apartment. Then she berated herself for not being more contented.

Maureen had spent so much of her life criticizing herself that it was a revelation to learn in recovery how much else there is to life. Some people with eating disorders must work hard in recovery to stop blaming themselves and accept life's satisfactions.

Relationships with other people, instead of being restorative and supportive, often feel draining to those with eating disorders. Those we have known are generally hungry for love and respect. They go out to meet the world from a position of high need and low self esteem, convinced, I'm not okay, and I must hide this dreadful secret-- cover it up with perfectionism, or earn love by niceness and taking care of people's every wish.

This is a disadvantageous position from which to meet other people. The eating disordered person, convinced the other person is better, suspects the other person thinks so too. She thinks the other person is busy judging her, and can just imagine what the other is saying. So she tries hard to please. But this hard work creates resentment- which must be hidden. She feels imprisoned and isolated.


The people in her world are cast as potential or actual critics:

  • the person who must be placated
     
  • the person she is angry at (but doesn't dare confront)
     
  • the enviable, successful one
     
  • the authority figure such as the teacher or a beautiful model she is supposed to look like
     
  • the friend who blithely takes up her time
     
  • the person she is supposed to be rescuing
     

There are also men who are to be impressed, and men who are sexually threatening. There are very few people who are seen as nurturing and accepting, or less acceptable than the patient herself.

Her relationships with others are contaminated by her relationship with her body. It accompanies her like an unwelcome guest in every encounter with other people. She may feel that her body is not the one she intends to spend the rest of her life with: this is not her real body-- so this meeting, this friendship, this connection or romance or opportunity, is not wholly real either. At best, it is a dress rehearsal for when she becomes thin and perfect.


How You Can Provide Support

As mentioned earlier, the way you think may not seem logical to the person with an eating disorder. In fact, it can intensify her feelings of being different and helpless to break the vicious circle of eating, guilt and self -hate. The well-meant cries, "Eat!" or "Stop eating!" can drive her deeper into her problem.

Gillian, a recovered bulimic, explained the "rules" she had lived by during her teens and early twenties, when her problem was at its peak:

I'm not good enough, but I'm supposed to be perfect. So I must take care of others first. It helps if I get good grades, so I study very hard. If I let go of my tight control I'm convinced I'll melt or explode or maybe disappear; I especially can't show anger or aggression. I should be the best because, if not, I must be the worst.

To many people with eating disorders, this is how the world works, and it isn't an easy world to love in! Give your loved one credit for doing for doing as well as she does with work or school while coping with all this. Your understanding can provide support while she explores and tries to resolve hidden problems. In later sections, we will suggest ways to express your understanding and concern.

For many eating disordered people, inner conflicts are constantly raging:

  • They feel worthless but have high expectations for themselves.
     
  • They try to fulfill the social roles of both female and male.
     
  • Their hunger for affection battles the habit of appeasing and taking care of others.
     
  • They treat the body as an ugly, disobedient servant, robbing themselves of a source of the pleasure and consolation they sorely need.
     
  • They desire to be attractive but fear the vulnerability that mature sexuality requires.

To bulimics, life is a series of nightmarish transitions from relative calm to revulsion and loathing; how tenuous and fragile is their capacity for control; how much effort they expend to maintain control for even a few hours; and how purging, for all its horrible effects, is all that stands between them and an anticipated loss of all self-worth. They accept the pain of purging rituals as the only remaining test of endurance they know they can pass.

To succeed in a world now requiring male toughness, their ability to starve and purge becomes the only remaining vestige of toughness to which they can point. Emotionally, physically and socially enfeebled, they dread a future of dependence and mediocrity, but doubt their capacity for anything else. If they fear growing up and facing the demands of adult life, it is not only because they do not know what to be, but also because they no longer have the energy reserves to "be" anything.

We have many sayings in English that connect eating with anger, frustration, or other unpleasant emotions or events: eating crow, eating your heart out, ramming something down someone's throat, swallowing your pride--even cramming for an examination. An eating disorder is a sort of powerful and dangerous saying in action.

Little did Joy know that Kate's inner life was drastically different from what she presented to the world. Behind Kate's friendly, competent facade lay a scared, obsessed person who was convinced people would not really like her if they knew the real Kate. She had learned many ways to hide this true self. She was so good at it, in fact, that people even turned to her for advice, thinking that she "had it all together."

But sometimes Kate was so tired and lonely, tired of pleasing everyone and doing everything perfectly, that she would lock herself in her room with a bag of cookies and a gallon of ice cream. She would eat until she couldn't hold any more. It felt awful afterwards, but while she was chewing and swallowing, all her troubles seemed to disappear.

But they reappeared, with a vengeance, as soon as Kate stopped eating. Agonies of self-hate would well up. I can't believe it! She would cry to herself. I broke my promise again! I'm such a wimp. I can't do one simple thing, how do I expect to ever amount to anything? At this point she would go to bed and cry herself to sleep, usually swearing to herself, tomorrow for sure I'll be good.

Copyright 2011 by Jane Rachel Kaplan. Published at www.optimaleating.com.


* Author's note, February, 1997: Please keep in mind that every eating disordered person's world is different. This chapter was designed to give you a sense of some of the struggles people face in living with an eating disorder.

Jane Rachel Kaplan


© Copyright 1997-2012 Jane Rachel Kaplan, Ph.D. All rights reserved.

 

Dr. Jane Kaplan Ph.D., Psychologist Provides Eating Disorders Therapy in the SF East Bay area, near Berkeley, Albany. Weight Management Coaching, Psychology of Nutrition and Healthy Eating Counseling, Individual, Group and Family Therapy for Anxiety and Depression.