Starved for Love - Part Three (example)

Example from:  National Eating Disorders Week - Anorexia - Starving for Love

Looking for love in all the wrong places can cause Anorexia. -  Mark Goulston, M.D.

 

"Place your right hand on your stomach, then place your left hand on top of your right hand, close your eyes and start to breathe slowly and deeply through your mouth," I said to the anorexic 19-year-old woman who weighed barely 85 pounds in front of me.

It was 32 years ago. I was a psychiatry resident at UCLA's Neuropsychiatric Institute and I had finished interviewing a young woman I will call Nancy, and her parents in the emergency room and was now waiting for a bed to be opened up in the In Patient unit upstairs. We had sent her parents home and started an IV on this waif of a girl. "Place your right hand on your stomach, then place your left hand on top of your right hand, close your eyes and start to breathe slowly and deeply through your mouth," I said to the anorexic 19-year-old woman who weighed barely 85 pounds in front of me.

It was 32 years ago. I was a psychiatry resident at UCLA's Neuropsychiatric Institute and I had finished interviewing a young woman I will call Nancy, and her parents in the emergency room and was now waiting for a bed to be opened up in the In Patient unit upstairs. We had sent her parents home and started an IV on this waif of a girl.

Nancy had been fighting anorexia for four years and this was her second hospitalization. She spoke a little, but what was clear was the conflict between her and her parents -- and between the parents themselves. When I interviewed the three of them together, the more adamant her mother became and the more her father argued with the mother, the more Nancy withdrew.

When I spoke with Nancy alone, she was a little more verbal, but not much more. She answered my questions politely, but flatly with a vacant, defeated look in her eyes. She had hidden her skeletal condition in loose clothes, but there wasn't a place to hide now that she was in a hospital gown.

It was an unusually quiet evening for me, so I had time to spend with Nancy while we awaited for the transfer orders. I had recently taken some training in Guided Imagery, which is a kind of guided hypnosis and a powerful image came to mind as I sat with her.

I told her that I wanted to try a relaxation exercise with her that I thought might help her relax and all she needed to do was visualize what I told her.

“I would like you to imagine that you are laying on your stomach in a crib as a six-month-old and you are experiencing a deep, crampy, stomach pain (colic) and crying from the pain you feel. As you cry you are staring at the door to your room that is slightly open and you can see light coming in from the hall. Now imagine your mother coming in and tenderly picking you up and holding you against her left upper chest and lovingly patting you on the back. You place your arms around her neck as she holds you.

“Now visualize that your own arms which are on you stomach are your mother's arms holding you. As you visualize that, breathe in from your stomach with deep slow breaths feeling your hands and arms on your stomach as if they are your mother holding you at six months. Take in a deep breath to a count of six: one...two...three...four...five...six. Now hold your breath for a count of three: one...two...three. Now exhale slowly to a count of seven: one...two...three...four...five...six...seven. Now relax.

“I would now like you to visualize and feel that the arms you have on your stomach are your arms as you put them around your mother's neck and pull her close to you, to feel the safety, security and warmth. Take in a deep breath to a count of six: one...two...three...four...five...six. Now hold your breath for a count of three: one...two...three.' Now exhale slowly to a count of seven: one...two...three...four...five...six...seven. Now relax.

“Now I would like you to visualize your father coming into your room when you are six months old going over to your mom and putting his hand and arm on top of your mother's as she holds you and visualize your left hand over your right hand on top of your stomach as his hand on top of hers and both of them tenderly holding you. Take in a deep breath to a count of six: one...two...three...four...five...six. Now hold your breath for a count of 3: one...two...three. Now exhale slowly to a count of seven, one...two...three...four...five...six...seven. Now relax.”

As this was happening I could see her eyes quietly crying as if a lot of the pain she was feeling inside her was being comforted and relieved.

"Now I would like you to visualize your parents and you, being connected and everyone caring about each other and visualize you sealing that caring into you. Take in a deep breath to a count of six, one...two...three...four...five...six. Now hold your breath for a count of 3: one...two...three. Now exhale slowly to a count of seven: one...two...three...four...five...six...seven. Now relax.

"Now I am going to count from one to 10 and when we get up to about seven you will start to flicker open your eyes and come back to where we are. One ... two ... three ... four ... five ... six ... seven ... eight ... nine ... ten ... and back to where we are.'"

Nancy gradually opened her tear filled eyes, which now seemed less dull. There was even a faint smile on her which I think was more about relief than feeling happy. I asked her how she was feeling.

Nancy responded, "I feel a little better and do you think it would be okay if I had a chocolate bar before I go upstairs?"

I smiled back and said, "Sure."

And then Nancy was admitted to our In Patient unit.

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Starved of Love - Part 2

Human Beings are social creatures by nature.  There have been many studies conducted showing that the absence of touch and nurturing can have profound immediate and long term effects on human infants including the ultimate failure to thrive.  It is also well documented scientifically that bonding between a mother and child is strongly 
recommended following birth to begin the healthy developmental emotional attachment process.   Human babies are helpless fragil beings strongly dependent upon environmental and interpersonal relationships from their first breath forward.  While each is born with different personality traits all have the same primary basic needs.

As infants grow into toddlers it can be observed just how important approval, acceptance and validation are to the developing sense of self for the individual child.  Many have observed how often a child seeks support and encouragement from caregivers just through visual recognition for example.  An obvious example would include how often a child looks to it's caregiver for approval for a new behavior or mastery of a skill.

So now to my points...People who develop ED's almost always  have a sense of being unloved, unloveable, not good enough  etc... and yes those are shamed responses.  But underneath of of these horrible feelings of abandonment, rejection and misery these people feel whether (real or imagined) unvalued as a human being.  In order to cope with these feelings they turn to eating disorders to comfort themselves.  Somewhere in childhood their sense of self was bruised or even destroyed from a possible variety of incidents.  (Bullying is just one example). 

All of this results in the individual drowning in a world of thought process distortions, (cognitive distortions) self-criticism, negative self image and even self-hatred.  Often all lies.  The lies become truths to the individual when they attempt to understand and explain to themselves why people have treated them meanly/abusively/cruelly...Some frankly don't even recall what it is that has occurred to make them feel so worthless and disgusting - they just think/feel it.   

So as a therapist my first question to someone who has these beliefs...What if you are wrong?  There is exactly where the recovery begins.  Because beliefs support thoughts and ultimately behavior!  Just think about what I have presented to you...

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