I had been treating Jane, a college junior, for three years. After a long history of anorexia nervosa she had maintained a healthy weight for the past year and a half. Her preoccupation with food and weight had decreased significantly and she was immersed in and enjoying her studies and activities with friends. The end of the school semester, which includes final exams and papers, is a time of increased stress and pressure for college students and frequently leads to abnormal eating behaviors. Yet Jane did not resort back to her previous patterns of overexercise or food restriction.
As the summer began Jane came in and reported that the pull of the anorexia, meaning the desire to restrict her food, had become stronger. “I’m also thinking more about my body. I don’t like how I look in the mirror and I feel fat,” she added. Jane could not understand why she was feeling this way. The school pressure was over and she was enjoying her free time with peers. “Will I ever be over this,” she asked.
As it turned out this was going to be the first summer Jane did not return to her family’s home in MIchigan. Last summer she had been very bored at home. She missed her school friends and the stimulation of New York CIty. As a result, this summer she was determined to stay in the city. She had gotten an internship and rented an apartment with friends.
While Jane was very excited about her summer plans, further exploration revealed it was more complicated than this. She revealed that there were times when she felt like a “bad daughter” for not returning to her family’s home for the summer. “This is the first summer I won’t spend with my family,” she cried. I asked Jane how her family had reacted to her plans. “They are very supportive,” she replied. “They are even coming to visit me.”
In a later session it became apparent that Jane believed that she “should” only feel happy and excited about her summer plans as they were exactly what she hoped for.It was difficult for her to feel and then to verbally express her ambivalence about being away from her family for the summer. Consequently, she was expressing it through her eating disorder behavior. I also wondered if part of Jane hoped that she would lose weight her parents would force her to return home, and she would not have to face her ambivalence.
Identifying Jane’s internal conflict and helping her to put words to her range of emotionswas of great help to her. Able to express her feelings verbally she no longer felt the need to revert back to her self-destructive behavior. It helped her to challenge the pull of the anorexia and enabled us to help her find ways to deal with her feelings in a healthy way. She also felt at liberty to connect with the fact that there were parts of being home with her family that she would miss. Permitting herself to feel all of her emotions and to express them verbally Jane no longer felt the need to revert back to her anorexic ways.
Lisa had been accepted to the college she most wanted to attend. She had spent the past few months telling me that she was ready to graduate high school. “I want to meet new people and I’m definitely over all the boys in my school. I’m not attracted to any of them,” she said. Yet as the school year was ending her bulimia, which included binging and purging, returned. She became very focused on her body, spending hours getting dressed every morning as she believed everything made her look fat.
Similar to Jane, Lisa had achieved her goal and believed that she “should” feel only happy and excited. It was difficult for her to connect to and acknowledge her ambivalence. In a later session and after some exploration Lisa was able to see that there was no one right way to feel and she was able to express her anxiety. “Will I fit in,” she asked. “Will I make friends? How will I learn my way around?”Once Lisa was able to express her many emotions verbally she too was able to deal with her fears in a more constructive way and the binging and purging decreased.
In both of these examples Jane and Lisa thought that they should only feel excited and happy about the new adventures they were embarking on. Yet transitions, even when they are positive and a natural part of the life experience, are stressful. Anxiety and excitement are both part of the change process. When Lisa and Jane allowed themselves to feel and verbally express the full range of their emotions they were able to challenge the pull of the eating disorder.
Life is full of transitions. No matter how old we are, it is vital that we allow ourselves to connect with and express our full range of emotions. There is no one “right” way to feel.