The mother of three children wrote, saying she's had an eating disorder for two years since the birth of her last child. When the child was born, this woman stopped eating, felt depressed, lost weight and still sees herself as fat when she sees her reflection.
She feels elated when she loses weight and works out in the gym for three hours a day or more. She doesn't eat all day; she just drinks water and diet drinks. If she does eat, she purges as much as she can get out of her body.
The dominant feeling she describes is guilt. She feels guilty about keeping food in her body, puts off purging as long as she can, but always winds up in the bathroom. She knows something is wrong but doesn't know what or why. She thinks she's crazy (her word).
Her condition has deteriorated to the point where she now gets leg and back pain that is so severe she falls to the ground. She faints. She sleeps 13 hours a day and is still tired when she wakes up. But she insists that she can't stop her behaviors because she feels like she is "giving up something" and feels guilty.
What I say to her and what I say to you is not the same. To her, I say,
It seems that your symptoms began as a form of postpartum depression that evolved into a form of anorexia. Your symptoms are emotional and psychological and move quickly into physical conditions brought about by over-exercising and starvation. Your great challenge is to admit this and get yourself into psychotherapy with a clinician who understands eating disorders in adult women.
This is a challenge because the obsessive-compulsive aspects of your illness, the aspects that seem to force you into behaviors you don't want to act out and the thinking distortions that come with starving your body and your brain cells create blocks to your seeking real help. You may think that you can force yourself to "be good" when actually you need treatment to be well.
What I say to you:
This woman is ill and needs to be in treatment. Treatment will, of necessity, focus on her thoughts, feelings, perceptions, needs and challenges. In speaking with you we can look and see the wider view that is unavailable to this woman. She talks of her pain. We know she has three children.
She sleeps 13 hours. She works out for three hours. She faints. She falls to the floor. She spends time purging in the bathroom. That doesn't leave much time for being with her children or her husband. And the quality of the time she spends with them is questionable because she is so ill.
When I speak to her, I align myself with her and her emotional and mental state. That is crucial for recovery work. We develop a genuine bond based on her reality and mutual respect and appreciation for the courage required to expand her perceptions.
In speaking with you, we can look at the toll an eating disorder takes on the people in her environment. She is not the only person suffering. She doesn't know this because her eating disorder limits her perceptions. And that adds more suffering to the people around her, especially the children.
It's frightening to a child to see a parent ill, fainting, immobile on the couch or completely absent. A mother can be absent by being physically gone. She can also be absent by being in a dulled condition.
A child needs to see himself reflected with love in his mother's eyes. When a child looks at the face of a mother who is deep in her eating disorder, he sees a face with the features of his mother but who is not his mother. He sees the absence. The face is there, but nobody is home. This is terrifying to a child and can have long-lasting effects.
The mother can’t know this while she is in the grip of her condition. As her recovery progresses, she does become aware of the effect her eating disorder has had on her children.
This becomes a painful part of the recovery work as we face this reality together. Part of her healing and recovery process then begins learning how to mature, gain emotional strength and not only take on more parenting responsibility but enjoy being a better mom.
Please share your thoughts in the comment section below.
Written by Joanna Poppink, MFT. Joanna is a psychotherapist in private practice specializing in eating disorder recovery, stress, PTSD, and adult development.
She is licensed in CA, AZ, OR and FL. Author of the Book: Healing Your Hungry Heart: Recovering from Your Eating Disorder
Appointments are virtual.
For a free telephone consultation, e-mail her at
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