“…whoever knows the human mind knows that hardly anything is harder for a [person] than to give up a pleasure which he has once experienced.”
Freud, “Writers and Day-dreaming,”
SE 9, 1908.
Freud was writing about the pleasure of play, but his words apply as well to binge and binge/purge eating patterns. Within the binge/purge cycle lays a frustrated wish to return to a primal experience with mother—a wish that remains in sensory memory and evokes feelings of safety and pleasure. Perhaps all of us harbor in the deep recesses of our infant souls, a longing for the oceanic oneness, the seamless euphoria that we experienced as an infant in mother’s arms. This yearning for an early feeding situation is a wish to “come home” to a time when there were no words to describe a feeling of being merged with mother, blissfully sated. Both patterns, bingeing and purging, express the wish and the frustration of a need not being met. “Katie,” (a composite example of several people) uses her journal to plumb feelings that existed only as fragmented thoughts and images once too frightening for words:
“What is ‘coming home?’ This should be an easy enough thing to find out, you think? But propelled by fear, I keep hitting walls that keep me from landing in my own life and living there, comfortable in my own skin.
Forget finding my true self, the real me. I have my deceptions and games that keep me from the whole truth—whatever that may be. The naked, raw, godless, helpless, dust-to-dust, come in alone go out alone truth—must we be so dramatic? And yet, maybe, if I can approach that, I can land in myself. Face it. But face what? That I need you? That the better you know me the more disgusting you’ll find me? And even though I love you, I want you to be just as miserable as I am? That I want you to puff me up and make me look good even though I’d hate you and not believe you anyway? That at bottom I’m a green-eyed monster afraid of living and dying alike—afraid of being exposed for what I am and afraid to love because I’ll have no power over you? My worth depends on what I can give you and I must seem to have it all because need is weak and contemptible. I am a weak pathetic loser but I must appear to be desirable and totally together because then you will want me—even though it terrifies me to be seen by you. The mask I wear wears thin but the alternative is unthinkable so I go on pretending, and sometimes I even believe my own act. But down deep there’s always the fear that gnaws—a rat nibbling away at the lie. Someplace inside I pray you will see me and not leave…”
Binge/purge patterns are designed to release anxiety by discharging it through action, either stuffing food down or throwing it up and getting it out of the body. Food is the substance that regulates mood states. It may be used to make one feel good (comforted, soothed) or bad (dirty and impure). Bingeing or purging relieves tension; the action takes the place of words while the symbolic meaning of the action remains unconscious and unavailable for thought. In treating thoughts as concrete entities, one attempts to turn psychic matter into concrete material, resorting to solutions like hiding food, flushing it, and imposing rules. Behavior measures alone usually don’t succeed; failure brings self-hate and blame as one spirals out of control.
“Katie” is 25, but she could as easily represent others: Ali at 32, Chuck at 40 or Ann at 61. They all suffer from binge eating or bulimia. Their histories include experience that left them with psychic injury they could not integrate. Compulsive eating patterns are concrete attempts to relieve anxiety left by psychic trauma and to revive a familiar pleasure—to “come home” again.
In Katie’s family a younger brother was the identified patient while she enjoyed the role of parental confidante, pleaser, student extraordinaire, and all around whiz kid. She was “therapist” to her friends. Even her mother turned to her as a sounding board for her own troubles and struggles with Katie’s brother. Katie felt her problems were insignificant compared to her brother’s, and as subsequent babies arrived she gained more praise for her “independence.” She was loved for being “good.” There was just one visible problem and that was her weight. But there were hidden problems. Katie dreaded social situations and couldn’t feel much toward friends or family she was “supposed to love.” Katie didn’t trust herself to be “real” without a role to play. She was afraid that if people really knew her, they wouldn’t like her. This dynamic was reversed in a romantic relationship where Katie felt comfortable if she could secretly feel superior and in control. But as soon as her partner gained her own emotional confidence, the relationship ended. Katie used food as her anxiety-reducer of choice. In the therapy Katie tried to figure out what might please me and strived to be my best and favorite patient. She thought she needed to lose weight to be “good” but an envious and competitive “bad” side would not cooperate.
Addie, who also struggles with binge eating, identifies her core issue. “Being seen and heard—that is what I didn’t get from my parents. No one was glad to see me when I came home from school. Most of the time no one was home anyway and I got into ‘weird food behaviors’. I was pretty self-sufficient—the good child. ‘Forget it, let it go’ they said, because they didn’t want to hear the arguments between us kids. They didn’t know what made me happy or what scared me. They knew Grandpa touched me but they let him visit anyway. They really didn’t know me.”
Not feeling seen or heard, Katie and Addie turned to food for comfort and to regulate their emotions. Ultimately they found themselves in the grip of compulsive eating. A compulsion is an attempt to make a bad feeling better, and to alleviate anxiety. Bingeing promises a familiar experience of satisfaction, held in preverbal, and therefore pre-symbolic memory. Both Katie and Addie were hooked in the effort to recreate this familiar pleasure, and “hardly any pleasure is harder to give up than this.”
Being “seen and heard” by our parent lets us know ourselves. A child’s self-understanding comes with acknowledgement of reflection in a parent’s eye. A parent puts words to feelings and names the links between feelings, thoughts and external events. “Oh”, mother says, “You thought the coat in the closet was a monster. No wonder you were scared!” Symbols are formed from the meaning we make of these links. If for example, mother says, “Don’t be silly, it’s a coat!” the child is left with fear and shame, cutoff emotionally and not understanding that the coat can represent a monster without actually being a monster. In the absence of linking, symbolic thinking is foreclosed; one is apt to make faulty connections and misunderstandings—to see the world in one-dimensional, concrete terms.
Katie believes her value is in serving others, making them proud of her, and fixing their problems; this became her way to get love and to be special. She plays the role well, hiding envy, pain of being used and her needy “disgusting” self, certain that if known, she would be rejected. A façade of cheery security (false self) covers her aggression and terror. She confuses power and love in a relationship and projects her “inferior” self onto a partner. The partner is then seen as “less than,” allowing Katie to feel like the dominant more desirable one—a replay of the competition with her brother. Katie’s admitted difficulty is weight, a concrete problem. Behind the façade she is depressed and frustrated that she can’t relate to others except through manipulation. Katie learned to manipulate her feelings to fit what she deems socially appropriate. The split between depleted and omnipotent self-representations is repeated in the struggle with food, where the restrictor deprives and the binger demands free reign.
Working in the transference with her assumption that I need her to be a compliant patient allows Katie to question her need to have it all together in order to be accepted. She begins to see her demands on herself as unrealistic and punitive, the result of needing to be the best in order to compensate for feeling inadequate. Our work consists of understanding her “bad” behavior as a means of emotional survival. As our relationship deepens, Katie finds words for feelings once unapproachable and tolerance for integrating conflicting parts of herself.