Psychotherapy Issue Vol. 1: Eating Disorders

…many bulimic clients will be “emotionally eating” which in certain cases will be eating as an effort to dull or avoid negative feelings.

This issue is explored based on my own work with clients and study of the relevant literature. Initially, most people who visit a psychotherapist and face an eating disorder will come to therapy with other issues and not the eating disorder in mind. Some might need help with stress levels, losing weight, medical issues that cause anxiety or others with any issue at all which will be more urgent at the present moment. I am mentioning this in order to make clear that eating disorders tend to start early in life and so they tend to become habitual for the client who sometimes thinks of them as part of their identity and thus as something which is part of their everyday life, all the while they are able to have successful careers, marriages etc.

In clients who experience bulimic episodes, trust needs to be developed with the therapist first before actually admitting to this behaviour, as shame usually accompanies this issue. Trust can take a long time to co-create or develop depending on the client. Work with other professionals in the past might make sharing easier. Bulimia is characterised by episodes of extreme overeating and is followed by extreme fasting or self-induced vomiting.

It is important to discuss what happens with the emotions of the client as many bulimic clients will be “emotionally eating” which in certain cases, this will be manifesting as eating as an effort to dull or avoid negative feelings. An elevated stress in their life might also be causing them to respond by “taking everything in” instead of pausing and deciding what they want.

Working through an eating disorder can be difficult and takes time. It is important for clients to allow negative emotions to be present and to be expressed. Healing can come after difficult realisations through a consistent and committed effort in individual or group therapy.