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Question
Posted by: D | 2010/09/26

Binge and starve

Hi Dr Alexander.

I''ll try and be brief. I am 40 year old female, married with 2 children and successful career. I have suffered 3 severe cases of suicidal depression (now in remission) and am on Efexor for life. Was repetitively raped as a child but therapy has helped me deal with that. I was emotionally neglected by a narcissistic mother - again therapy has helped me get beyond this. However most recently I was in therapy with a psychiatrist who" apparently fell in love with me"  - to cut a long story short he violated many boundaries - I got angry - he denied everything and I took him on peer review via SASOP who appointed a senior therapist who he will be doing his own " depth therapy"  with. I had feelings for him so did not have the heart to take him to the HPCSA despite being advised to do so. Guess we are all human - huh?

So in short I have been left feeling abandoned and abused all over again. I have been binging and starving myself on and off - apparently the binging part is " literally filling up the hole" . I am slightly overweight. How else do I fill up the hole? (I am in therapy " for therapy gone wrong)"  . How do I get myself into a balanced eating cycle whilst dealing with so much emotional pain?

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Our expert says:
Expert ImageEating Disorders Expert

Hi D,
You have certainly faced a lifetime of challenges and you have survived them all. Without sounding patronizing, well done! Your upbringing was punctuated by repeated sexually violent and emotionally damaging experiences. This must have, undoubtedly, clouded your judgment and made it difficult to form trusting relationships. Although I do not know the details of what unfolded in your therapeutic relationship with your psychiatrist, it must be very difficult once again facing those familiar feelings of “abandonment” and “abuse”. This is especially the case where a therapeutic relationship is one in which qualities like trust, safety, honesty, and clearly defined boundaries are the hallmarks by which the relationship is defined. So, you ask why you are bingeing. Yes, it is likely you are metaphorically attempting to fill an empty emotional space with food that food will never replenish or fulfill. You must understand that food is a source of physical nourishment and should consciously fulfill that role and not be used to meet unmet emotional needs. If you understand the basics of good nutrition, keep to a well-balanced and moderated diet through the day. If you are not sure, visit a registered dietician for some guidelines. In your current therapy, try to explore the ways in which you are using food to camouflage you from your emotional distress. You have experienced much distress recently and this has, no doubt, reflected the relationship and emotional distress that you experienced for many years in your youth. As such, you are facing an accumulation of pain right now, so you need to try and face this in an as healthy and honest way as possible. You might want to consider remaining in regular contact with a dietician while seeing your current therapist, just so that you have someone assisting you in assuring that you are eating well while you are facing all your emotional demons. I hope that helps.
Regards,
Graham

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2
Our users say:
Posted by: Eating Disorders and Obesity Expert | 2010/09/27

Hi D,
You have certainly faced a lifetime of challenges and you have survived them all. Without sounding patronizing, well done! Your upbringing was punctuated by repeated sexually violent and emotionally damaging experiences. This must have, undoubtedly, clouded your judgment and made it difficult to form trusting relationships. Although I do not know the details of what unfolded in your therapeutic relationship with your psychiatrist, it must be very difficult once again facing those familiar feelings of “abandonment” and “abuse”. This is especially the case where a therapeutic relationship is one in which qualities like trust, safety, honesty, and clearly defined boundaries are the hallmarks by which the relationship is defined. So, you ask why you are bingeing. Yes, it is likely you are metaphorically attempting to fill an empty emotional space with food that food will never replenish or fulfill. You must understand that food is a source of physical nourishment and should consciously fulfill that role and not be used to meet unmet emotional needs. If you understand the basics of good nutrition, keep to a well-balanced and moderated diet through the day. If you are not sure, visit a registered dietician for some guidelines. In your current therapy, try to explore the ways in which you are using food to camouflage you from your emotional distress. You have experienced much distress recently and this has, no doubt, reflected the relationship and emotional distress that you experienced for many years in your youth. As such, you are facing an accumulation of pain right now, so you need to try and face this in an as healthy and honest way as possible. You might want to consider remaining in regular contact with a dietician while seeing your current therapist, just so that you have someone assisting you in assuring that you are eating well while you are facing all your emotional demons. I hope that helps.
Regards,
Graham

Reply to Eating Disorders and Obesity Expert
Posted by: D | 2010/09/26

PS Just to contextualise the " hole"  - I was in depth therapy with him for 4 years so it was a significant attachment.

Reply to D

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