It takes two to speak the truth. One to speak, and another to hear. – Henry David Thoreau
Eating is a relationship—a relationship that can be either nurturing or abusive, supportive or neglectful, nourishing or punishing. Patterns of emotional eating often develop from the early patterns of loving in our family. If we have been hurt by the people we love, we hurt ourselves with food. Emotional eating becomes protection from pain.
In this way, eating disorders are really about our problems in human relationships. Detouring our need for love, connection, security, and intimacy through food is a way of bypassing our need for human sustenance.
People with eating disorders seek gratification through food rather than connection with people. Food, after all, is completely trustworthy and more compliant than any other relationship can be—it doesn’t abandon, reject, or laugh at us, and it is always available when we say so. We get to say when, how much, and where without having to consult with anyone but ourselves! No other relationship complies with our needs so absolutely.
When we binge, purge, or starve, we become totally self-sufficient and do not have to rely or depend on others.
We try to become invulnerable because “a rock feels no pain. And an island never cries.” Only when we stop this emotional eating do we discover just how needy and vulnerable we really are, and that can be frightening.
Healing an eating problem means learning to turn to people for nurturing rather than to our secret relationship with food. Psychotherapy is a powerful channel for this healing. In therapy, we develop a partnership with another human being who is trained to help us unravel the inner reasons why trusting food feels safer than trusting people.
Fear of therapy
All problem eaters have fears when they enter therapy, especially when their relationship with food has felt like the glue that holds their life together. Joining a diet group or a fasting program does not create the same anxiety as going to a therapist because in therapy we risk sharing our secret selves. “What will the therapist think of me?” “How can I reveal the shameful things I do with food?” “Will the therapist really understand?” “Can I really be helped?” “What if this is just another thing I fail at?” The fear of beginning therapy is exemplified in this letter written to me by a young bulimic woman:
“I am a binge-vomiter and have been bingeing and throwing up for years but have never told anybody. I’m afraid to go for help because I’m really afraid to stop, and I’m afraid the therapist will try to force me to stop. I don’t know how I would cope if I couldn’t throw up. I feel desperate and alone. What should I do?”
And I responded:
“I want to support you for the courage it took to write your letter. I think this is your first step toward healing. Bulimia is not only an illness of bingeing and purging, but a vicious cycle involving shame, isolation, and withdrawal from life and people. Bulimia can be progressive, so you should allow yourself to get help soon.
“Because your problem did not begin overnight, you won’t be able to resolve it overnight, nor would any therapist expect that of you. I think your worrying about how you would cope if you could not throw up means that the bulimia has ‘helped’ you rid yourself of some difficult, inner feelings. You worry that if you did not have that outlet, you would be swamped with those bad feelings. Actually, this is where a therapist can help.
“Therapy is a process that will enable you to better understand your feelings and find other ways to cope with them rather than with food. Therapy will also help you discover tools to undo the habits that have led you to binge and purge. You don’t have to do this alone. You deserve to get help. People with bulimia usually are dealing with lots of feelings of anger and guilt that they need help ‘digesting.’ Of course, you are afraid. Any change—even change for the better—can be threatening.
A therapist is a special kind of friend who can appreciate and respect your fear, and yet gently work together with you to resolve this problem.
“Also, I want to take issue with your statement ‘I am a binge-vomiter.’ You are a human being with fears, hopes, and feelings. I wish you luck as you begin to unfold your unique human self.”
Eating disorders serve to cover up fears. Secrecy, dependency, and abandonment issues underlie many eating problems, to begin with, and the therapy relationship is bound to raise the same anxieties.
It is only after some headway has been made in treatment and the behavior of bingeing, purging, or starving diminishes that a person comes to realize the degree this fear has played in his or her life.
In Wasted, her memoir of anorexia, Marya Hornbacher wrote: “I was reminded again of why I was anorectic: fear. Of my needs, for food, for sleep, for touch, for simple conversation, for human contact, for love. I was anorectic because I was afraid of being human.”
Once these fears are acknowledged, the process of healing is set in motion. The courage to turn to a therapist to unravel one’s problems is a first but crucial step in undoing the bond with food and replacing it with the bond of human nurturing.
In my next column, I will discuss further how to overcome your fears about therapy.
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