Overcoming Eating Eating Disorders

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By Cynthia Griggins

In a previous article on eating disorders, I discussed the problems of anorexia nervosa and bulimia in a social context. I showed how they are in a way a logical outgrowth of a society obsessed with slenderness and which still values physical beauty above all else in women. With this incredible pressure, women are doing everything they can to get and stay thin.

If eating disorders are a logical result of our culture's sickness, then why isn't every woman anorexic or bulimic? Actually, sometimes on my

...for most of us [adolescence] was a difficult time....At times I wonder how any of us made it.'

rougher days at the Clinic I think they are, but I know it's my warped perspective. Still, consider statistics such as this: "Of 114 women (with no history of psychiatric illness or eating disorders) 109 reported an unnatural relationship to food and eating. Of those selected as subjects-whose weights all fell within the normal range-only one woman was not actively waging a war against fat” (Marcia Germaine Hutchinson). What seems to be true, I think, is that we're all on a continuum, facing the same pressures, battling the same issues, but some women succumb more than others. In some, the 70-pound anorexic or the successful business woman who's vomiting four times a day, the struggle seems to take over their lives. In this article I'll discuss the inner psychological experience of these women and how they can be helped.

Think for a moment about what it was like to be an adolescent (I'm sorry-painful, isn't it?). But that's the point; for most of us it was a difficult time. A time of fumbling with first relationships, male and female. A time of bodily changes that produced incredible anxiety. A time of fear-will I be competent? Will I make the right decisions? Will someone love me? A time of change and separation from family and childhood. And a time of incredible pressures that some of us responded to more than others, depending on how secure we were. Pressure to look and act a certain way. Pressure to achieve. Pressure to compete.

At times I wonder how any of us made it. And it's true, some of us don't make the transition from childhood to adulthood so smoothly. So much of it depends on our families. Do they hang on or let us fly? Do they encourage individuation or want us to be carbon copies of them? Do they teach us to handle conflict and ambiguity or fail us there? Probably most important, do they teach us to love and believe in ourselves or not? The answers determine to a great extent how we'll do as we struggle to become adults.

This is the time when anorexia nervosa develops, and most experts agree that it's the outward manifestation of a young girl's battle to become an adult. If she feels especially unprepared for all the responsibilities and demands of adulthood, if her family is not helping, and if she feels out of control and incompetent, she may want to avoid or retreat. As my clients, tell me, "When you feel like you haven't got anything going for you, the one thing you can do is be thin and beautiful." So, feeling helpless and incompetent in other ways, the girl focuses in totally on her body and dieting. It also becomes a

4Rage:6/What She Wants/June, 1983

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convenient way to avoid thinking about any other more serious problems.

Bulimia (anorexia's "twin sister," as one author put it) develops in much the same way. However, these women are a little older, and seem to have managed a little better with separation and individuation. They've made it to adulthood with education, careers and sometimes an intimate relationship. But the nagging doubts about inadequacy remain and so they too worry a great deal about being attractive enough to be acceptable (translation: "thin enough to be acceptable). They diet constantly (one client laughed when she described her 10-year “diet”) which, as I'll explain below, produces the binge/purge cycle of bulimia.

These basic doubts about adequacy, competence and independence are certainly not confined to women with eating disorders. Colette Dowling discussed them thoroughly in The Cinderella Complex, and showed they are widespread among women today and are a result of our socialization to be "good little (dependent) girls". But women who start to focus on manipulating their bodies out of inadequacy then commence a vicious cycle which adds a myriad of additional problems.

As researchers are now showing, keeping oneself constantly on a diet produces the same effects as starvation from any other cause. Metabolic changes occur in the restricted states which are manifest in a number of symptoms: irritability, decreased activity, total focus on one's self, preoccupation with food, and a constant urge to eat. Anyone who's been on a diet can recognize the symptoms, as can women with eating disorders. The last two are especially important, because they are the essential and most agonizing symptoms of anorexia and bulimia. The anorexic will constantly deny her urge to eat and with incredible tenacity stick to her "diet". The bulimic (possibly because she's psychologically healthier) eventually gives in to it and eats-a lot. But then the overwhelming hatred and guilt cannot allow her just to "forgive" herself and carry on. She must undo the effects of the binge, and drastically purges herself by vomiting, taking laxatives or diuretics, or launching an even more intense fast. The cycle then repeats

On July 28-29, the Free Clinic will sponsor a conference at Baker Hall, CWRU, devoted to the examination of eating disorders in women. The conference will be one of the first in the country aimed at training professionals while keeping a solid feminist orientation.

Among the invited speakers are Marlene Boskind-White, Ph.D., author of Bulimarexia. Her article, "Cinderella's Stepsisters: A Feminist Perspective on Anorexia and Bulimia," perhaps the first feminist examination of eating disorders, appeared in 1976 in Signs: Journal of Women in Culture & Society. She is a psychotherapist who treats bulimarexics in group therapy in Ithaca, New York.

Susan Wooley, Ph.D.., head of the Eating Disorders Clinic at the University of Cincinnati Medical Center, will discuss anorexia and

itself, over and over, until the woman is hopelessly trapped.

Another important feature of eating disorders is related to the intrinsic nurturant and rewarding prop-

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erties of food. As the behaviorists would say, it's a "highly powerful reinforcer." Who hasn't rewarded oneself with a fancy pastry or picked oneself up with a hot fudge sundae? Much like alcohol or drugs, eating becomes a way to deal with anxiety, remedy depression, or avoid something aversive, and like any

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"coping mechanism” it can become habitual-addictive, if you will— and extremely difficult to change.

Some women may realize soon enough what they are doing to themselves to be able to change on their own. Actually no one knows how many anorexics

bulimia in the context of a society obsessed with dieting and prejudiced against anyone overweight. She has been quite critical of the medical community for emphasizing the need to diet without offering people successful methods by which to accomplish this.

Other speakers will discuss anorexia and bulimia as political diseases, hospitalization, family therapy, group therapy, and self-help groups. While the 2-day conference will concentrate heavily on treatment techniques, not only professionals are invited. Anyone with a concern about eating disorders and women's health issues is welcome.

Cost for the conference is $60, $35 for students. Scholarships are available. For further information, contact Cynthia Griggins at the Free Clinic, 721-4010.

and bulimics there are who recover in this way. Also, many women who think they have an eating disorder in reality do not. Overeating does not constitute bulimia, and being concerned about your weight does