Brenda was a beautiful woman with long black hair who came for therapy and recounted her story: “Two months ago I had a double mastectomy. At that time, my husband left me for another woman. My daughter, who saw me through all this, is leaving next month for school in California. Now I have no one. Both my parents died in a car crash when I was 12. I went to live with my grandmother who died when I was 17. That’s when I got married. And now I have no one.” She stared straight ahead, lost in reverie. The image of her parents’ violent death, her mastectomies, and all her other losses were overwhelming.
“Brenda,” I asked, “you’ve been through so much. How would you like me to help you?”
She straightened up suddenly, and said with determination, “I’m here because I’m fat and I need to lose weight!”
The language of pain comes in many dialects. Emotional eating problems and the fear of being fat is one such dialect in which we recruit our bodies to express what we cannot utter in words. Eating problems become a vehicle to communicate matters of the heart that have no other channel. The language of food and fat is a symbolic one, a way to express our inner emotional battles over feelings of emptiness and fullness, vulnerability and protection, urge and restraint, desire and despair. When we cannot express the depth of pain we carry, we trans-form our emotional pain into physical pain. In the case of food problems, we move our focus from our heart to our stomach. We crystallize all our emotional pain into one concrete problem: “I am fat. I hate myself. I need to lose weight.” This is not to minimize the very real upset that people experience when their eating is out of control. Treatment for emotional eating–binge eating, bulimia, anorexia, body image disorder, chronic dieting–needs to incorporate psychotherapy with behavioral/cognitive strategies, and sometimes medication. However, as in the case of Brenda, the obsession with food and fat is all too often a short-hand way of expressing much deeper layers of yearning and pain. Brenda had been assaulted by so many massive losses in her life that she could not bear to face her grief, rage, and abandonment. Her wish to lose weight was a safe, clear way to express her pain– a language that so many people speak. Unexpressed pain and unresolved mourning fuel the anguish of many eating disorder patients.
Even after patients begin the process of relinquishing emotional eating, we clinicians must pay particular attention to help them fully grieve and mourn their losses in order to prevent relapse. Patty was an obese binge eater who was four years old when her father died. Her family told her, “Daddy went to Heaven. He is in a better place.” Daddy was never spoken about again. “Tell me more about him,” I asked. “There’s nothing to tell,” Patty replied. And with that, she began to cry, as the accumulation of 32 years of stifled tears came surging up in a tidal wave of pain. “Oh my God. I have never shed tears for my father before,” Patty sobbed. With each succeeding session, Patty cried deeply over the death of her father. Then, one day she exclaimed, “I wonder if after so many years my fat has been like frozen grief. I think with all these tears, my grief is melting and becoming liquid!”
Grief–frozen by fat, frozen by the numbing of overeating, starving or purging–can be held in the body for years and even decades. Grief has no timetable. Time does not necessarily heal all wounds. Unspoken loss continues to exert its power. There is no expiration date to memories or pain. Death is not the only grief that wounds the heart and soul. The pain of any loss or change or trauma or transition in one’s life can feel like a threat to a sense of stability and self. Divorce, the breakup of a romantic relationship, sexual or physical abuse, personal or family illness can lodge inside without resolution. Unable to dis-lodge the “knot” in one’s throat by crying and grieving, many eating disorder patients turn to the pain-relief “medication” of bingeing, purging, or starving.
Why Do Emotional Eaters Freeze Grief?
Our culture, deeply uncomfortable with death, dying, and grieving, encourages us to stifle our feelings. Mourners are advised: God never gives you more than you can handle. Keep busy! Be strong! Time heals all wounds. But, sometimes, absence makes the heart grow frozen. Emotional eaters, obviously, are not the only people to freeze grief. But emotional eaters are prone to derail, detour, and divert difficult feelings through food. Emotional eaters believe that if they open their hearts to feel their pain, it will never end. “If I ever started to cry, I would never be able to stop,” Yvette, an anorexic woman, declared. Simon, a bulimic man, stated, “My Dad has been dead two months already. Shouldn’t I be over it already and not really feel so sad anymore?”
Yvette and Simon’s beliefs about bereavement reveal common traits of people with eating disorders: impatience with themselves, the conviction that strong feelings are scary and should be avoided, black or white thinking, and critical and perfectionist commandments to the self. Rather than tolerating the process of digesting and metabolizing their feelings, emotional eaters seek the “quick fix.” In their attempt to “just get over it,” they turn to the numbing and anesthetizing behavior of bingeing, purging, or starving. The Process of Thawing Grief Sorrow needs to speak. In order for patients to thaw their grief, therapy will help them to:• Recount fully the story of their loss. As author Isak Dinesen wrote, “All sorrows can be borne if we put them in a story or tell a story about them.” Patients need to mourn for what they have lost, for what they did not have, for what they wished they had, and for what they will never have again. • Express their anger/guilt /self-blame /regrets.• Consider the connection between their loss and their history of bingeing, purging, starving, drinking, taking drugs, or any other addictions.• Experience the deep relief of tears. Crying is our natural healing process of releasing emotions that well up. Tears are a gift from deep inside. “There is a sacredness in tears. They are not the mark of weakness, but of power. They speak more eloquently than ten thousand tongues. They are the messengers of overwhelming grief, of deep contrition, and of unspeakable love,” wrote Washington Irving. Liquid tears can thaw frozen grief.• Integrate a ritual or create a memorial to honor their loss.• Cultivate other secure relationships - a support group or therapy–which will encourage them to nourish themselves without the crutch of emotional eating."
Grieving the Loss of an Eating Disorder
As emotional eaters begin to recover, they also need to grieve the loss of their best friend and enemy (their “fren-emy”) of bingeing, purging, starving, and chronic dieting. People often experience grief when recovering from their eating problems because they lose a tried and true way of soothing themselves, a way of giving meaning and focus to their life, a well-worn way of coping with stress, and the magical belief that weight loss will solve all their problems, repair their self-esteem, and help them feel happier. Grief includes the realization of how much wasted time, energy, money, and obsessing the eating disorder has consumed. Eventually, through the process of healing in therapy, patients need to part from their eating problems, honor the soothing but temporary help the eating disorder did provide at one time, say goodbye, and go their separate ways. Through therapy, patients will learn to sink their teeth into life, not into excess food.
Mary Anne Cohen, LCSW, is Director of The New York Center for Eating Disorders and author of French Toast for Breakfast: Declaring Peace with Emotional Eating, Lasagna for Lunch: Declaring Peace with Emotional Eating, and Treating the Eating Disorder Self. www.EmotionalEating.org