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Who is bulimic ?
B ulimia can afflict very different people: young people who seem to have everything, mature adults, men, women. It often also affects successful people or celebrities who claim to suffer from anorexia. In fact, many celebrities purge or use drugs to stay thin. (Anorexia by itself happens to be very rare after adolescence.) Sometimes people are so overwhelmed by the symptoms that they cannot go to school or work. All, however, are in the same mental prison. Actually, compulsive eating is caused by psychological vulnerabilities, which come from early childhood. Current research (Professor Janet Treasure in England) suggests a genetic predisposition.
They watch their lives fall apart without really being in them. They are trapped, a confinement that pushes them to eat and organize their lives, sometimes the lives of those close to them, around food or control (how they look, weight, etc.)
I have personally observed in these last fifteen years two principal personality types. All are constantly disturbed by obsession, even when they are in control.
To fight the obsession, it is crucial to deal first with a few psychological vulnerabilities (hypersensitivity, relationship difficulties…) that find expression in two very characteristic forms.
The two types of personalities I see most often.
Very dependant personalities who are too afraid of rejection..
They are self-effacing, they don’t dare to express themselves, they’re afraid to be abandoned. Emotionally, they are capable of feeling anger (without hate), but most often without being able to express it directly. When they want something, they deny themselves of it, saying “he (or she) wouldn’t understand”, “this could hurt him (or her)”, “I don’t want to anger him (or her)”. Thus, in their daily lives, they get upset about things that don’t go their way, but keep their feelings bottled up inside. In groups, these people don’t talk much, often keeping at a distance. The objective of therapy for them would be to gain self-esteem and to successfully formulate, authentically, without fear, and with ease, what they want to express. Only once this work is done can bulimia start to go away because they no longer need it as a coping mechanism.
Those who don’t seem to fear anything and express themselves without reserve. Unlike the previous people, these individuals have strong personalities, at least in appearance. In group therapy, some are admired, even feared, for their courage and authenticity. But sometimes, under the appearance of authenticity hides intellectualization, systematic contestation, and anger (sometimes with hate) when things don’t go their way. In their daily lives, they are able to destroy in five minutes long-term personal relationships (marriage, family). They are also capable of becoming fixated by someone instantly, and being self-destructive when it doesn’t work out. Psychiatrists don’t consider such patients to be in a depressed state, but a state of depressiveness. They are often deathly bored, which feels so unbearable to them that they suffocate or manage to feel nothing.
It might seem strange to mix such different people in group therapy. On the one hand are those who, without hate, don’t know how to assert themselves, but have enough love for themselves and for others not to be destructive. And on the other hand are those who are self-affirming, but not always in a constructive way. These people are rigid, full of hatred for themselves and for those who don’t think like them, but are courageous, funny, and creative. In group therapy, though, these two personalities have a lot to offer to each other. Those who talk more make the more reserved members of the group react, and inversely, the kindness and compassion of the quiet ones serves as a model of softness for those who know nothing but the violence and brutality of their emotions.
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