Bulimia Triggers Can Lead to Food, Isolation, Sex and Danger
This article is my attempt to bring understanding to this painful, desperate and all too common experience in the life of a bulimic woman. Please share your comments as we develop more understanding together. I also wrote this because articulating a burdensome secret can help the secret holder know she can be understood and accepted. She just might experience a new sense of validated hope.
Bulimia before recovery work
Trigger: Your roommate goes out of town for a week.
Action: Bulimic episode
Why? You don’t know. You don’t seem to have a choice.
Day One: You are on your own. You like the freedom. The apartment is all yours at last. You also feel the apartment is less familiar. You feel you are somewhat of an intruder and are getting away with something. You eat dinner in the living room in front of the TV. You don't clean up. You binge and throw up your roommate's ice cream.
Day Two: You continue to eat in the living room while watching TV. You leave your dishes on the coffee table and food wrappers on the floor. You drop your clothes and papers where they fall. You leave food and open food packages scattered on the kitchen counter.
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You raise important and sensitive issues. The experience of being touched is varied, even among people who are not struggling with any kind of disorder at all. We use some form of the expression, "That was touching," to mean that we have emotions about something, that we feel vulnerable and moved by something.
The woman with bulimia or other eating disorders struggles with body image, body shape and size, weight gain and loss, bloating and cramps. Her body is a battle ground, and the feeling of battle is familiar.
Feeling soothed by physical touch requires a sense of safety and trust. The woman must be capable of allowing herself to be vulnerable. A woman with little or no recovery from bulimia is frightened of her own vulnerability. She is already being courageous and as vulnerable as she can manage by working with her psychotherapist.
At some point in her recovery work, however, body work is very helpful, as long as it occurs with sensitivity and at the right time for her. For example, I sometimes will recommend that a patient take a yoga class. If she takes a class and can tolerate the experience, I will suggest that she wear something that leaves some part of her body exposed. Usually she has been wearing sweat pants and a sweat shirt or loose t shirt. She will looked startled and worried when I make this suggestion.
I explain: I want you to have an experience of skin on skin. Yoga offers you many poses where you are holding yourself. Find a way to wear something you can bear so that in some of the poses you are holding your own body and feel your own skin.
This is a beginning, incorporating breathing and a body accepting environment with touch at the most non threatening level and where she is in complete control.
Baths, jacuzzis, showers, warm sun, breezes on bare skin are other physical activities that help bring her to her body experience in a soothing and pleasurable way, again with no threat. She will know when she is ready for a massage or body work of some kind. These experiences can be wonderfully therapeutic because they introduce a kind of body awareness and emotional connection with body that is strange and unknown to her.
It's not unusual for women to cry during yoga classes or during a massage without knowing why.
I love it when a woman gets comfortable enough in her body to dance. But we have to be careful about movement in treatment. Dance can take the form of exercise. Yoga can too. And exercise, before recovery work, is often a weapon against the body.
Achieving the ability to experience soothing without a heavy price is a sign of progress in recovery.
Thank you for your participation. I appreciate hearing from you.
warm regards,
Joanna
How is the woman not present? If she is trying to consume him - and give to him what she thinks needs to be given - how is she behaving in a non present way? And doesn't intense stimulation create feeling? Or do you see this intense stimulation as a blocker or a sedative?
Yes, I can see where the language is confusing. She is physically present. She knows where she is and what she is doing. She has a plan and is following it. So, in that way she is present.
Awareness and feelings about what she needs, how she feels, what she cares about are missing. She is in the midst of a binge.
During a bulimic binge on food, a person will devour massive quantities of food and purge them out. She can have the experience of looking for the bag of cookies or chips to binge on following a purge only to discover she already ate them and vomited them up. She loses track of time and may continue her episode until she is exhausted or in pain or both. The pain itself can be a relief because it floods her with sensation that distracts her or blocks her from her desperate anxiety
While she binges on food we can say that she is not present. She's in the room. She's eating. She knows who she is and she feels a desperate need to devour her binge foods until her bingeing and purging bring her the relief she craves.
She can do that with a man too.
Intense stimulation can create body sensations and raise emotions. But the circumstances I'm describing in this episode are an attempt to flood the person, body, mind and emotion so that she doesn't feel who she is or who he is, for that matter. The goal is to get relief from a kind of existential agony by flooding her system with sensation. And sometimes it works. It certainly works enough for her to seek out this remedy again and again.
So, going back to your last question, the intense stimulation is a blocker when it works. It's a sedative if she's exhausted from the effort and can maintain fantasies about her experience. If she doesn't get relief she will feel disapointed, unloved, unlovable, terribly flawed as a woman and may be disgusted and frightened about the situation she's in.
But that won't stop her from attempting this again. She believes it didn't work because of her mistakes in not behaving the way she should have or being enough of a woman. Once in a while she will think she chose the wrong man, but usually she will blame herself for being unworthy.
Thank you for your questions. I appreciate the opportunity to attempt to clarify this complex experience.
warm regards,
Joanna
Joanna,
I just wanted to thank you for the time that you have taken with your answers here. Have you written a book? And so, what is it? I would be interested in reading it.
Best,
Pamela
Dear Pamela,
Thank you so much for asking. You are more supportive than you may know.
I'm writing a book right now, under contract with Conari Press. It's a self help book on eating disorder recovery with an emphasis on mature women.
warm regards,
Joanna