Lianne* came to see me for help with her compulsive binge-eating. "I can't stand myself," she said. "I've tried every diet I can think of. I lose weight...and then I gain it all back...and more." Lianne was smart and very funny. She had a successful job and many women friends. But she didn't date and she didn't think any men could possibly be interested her because of her weight.
Like many of my clients with eating disorders, Lianne knew that she was unhappy, but she could not talk much about what that meant. "I'm just...not happy," she said. She attributed all of her bad feelings to her weight. "I would be fine if I could just lose thirty pounds."
Yet within a few months of our work together, I discovered that Lianne had another compulsive binge habit: shopping. She bought kitchen equipment, Italian pottery, exquisite dishes, elegant glasses and other things for her apartment. She could afford her purchases, but she was ashamed that she bought all of these things, most of which stayed in their boxes in her closet or piled in a corner of her apartment.
I asked Lianne to try to make a mental note of what she was doing, thinking or feeling everytime she began to think about making a purchase or starting to eat something that she did not want to eat. The task turned out to be surprisingly difficult. Not only did Lianne have trouble seeing a connection between her feelings, thoughts and actions; she also could not tell me anything about what she was feeling at anytime. I guessed she felt empty, sad, and sometimes frustrated during her sessions. I could see at times that she actually felt happy. But for her, the feelings were interchangeable and unknowable.
It is pretty well-established these days that many people with eating disorders also have difficulties managing their feelings. The odd thing is that it is not just bad feelings that they have troubles with. As Lianne put it one day after she had been in therapy for awhile, "When I feel happy, I feel frightened. It's too much. I feel like there's electricity running through my veins and like I might...explode. Or worse, I might start to enjoy feeling good, and then it'll go away...and I'll feel even worse." So she ate or shopped away the scary good feelings.
Researchers have found that this is in fact one of the links between eating and shopping disorders: that the behaviors are ways of trying to cope with feelings that seem to be overwhelming or somehow potentially out of control.
Talk therapy helps make these feelings more manageable; but not in the ways we are accustomed to thinking. The most important task is not to uncover terrible (forgotten) past events or painful childhood experiences, but to find new ways to manage feelings that seem so uncontrollable that they have to be binged out of existence.
The first step is to begin to put the experience itself into words. Lianne, like many men and women with these "companion" disorders, often felt only a physical emptiness, which she filled up as quickly as she could with food and purchases. She could not separate out any other feelings, and the only thoughts she could tell me about were that she really needed to stop, that she was going to make herself fatter with the food and mad at herself over the purchases, and that she must be really weak and despicable because she could not get a handle on this behavior.
The key to the ability to manage these feelings and stop this behavior is not willpower, however, but the ability to use language in a very specific way. No matter how smart or verbal we are, if we suffer from one of these binge behaviors, we are very likely going to have difficulties "using our words" to make ourselves feel better.
The path to developing this capacity is often surprising in its simplicity. It really has to do with talking about the tiny details of everyday experience to another person who is interested in and curious about what it is like to be inside your body and living your life. Although it may feel embarrassing to share some of the boring details of your day-to-day experience with someone else, it can lead to an ability to pay attention to those details yourself. And it is often amazing to find that what has seemed boring and unimportant is actually where your feelings sit.
This connection does not happen quickly or easily. For Lianne, for example, it took almost two years before she actually felt the connection we were working towards. But one day she walked into my office with a huge smile on her face. "I got a raise this week. I was excited. But I didn't shop," she said. "And I didn't eat. I would have a year ago. Maybe even a couple of months ago."
Making the connection is not the end, however. Once the feelings begin to be sorted out, and actually felt, it becomes necessary to find ways to tolerate and manage them. How do we do that? I'll talk about this process in my next post.
*Names and identifying information changed to protect privacy
(This post is drawn from my chapter "When Eating and Shopping are Companion Disorders" in the book I Shop Therefore I Am, edited by April Lane Benson)