Working with Sufferers of Bulimia, part III

Some of the common traits amongst bulimia patients are age, history of battling with their weight and a perception of the ideal woman that is or may be contrary to their own personal development.
This lack of drive to self-actualise, and instead to try to define themselves in accord with this false image of the ideal woman is suggest to have come from early childhood influences (Bruch 1977). That is to say that a lack of encouragement to identify and to express herself may have stemmed from her parents.


And once again although there is no such thing as a typical Bulimic (Quinlan, 2013) research has shown a common theme of emotionally distant father and overly controlling mother to be the case (Bruch, 1977). “Within these family dynamics, the child gained approval by performing a role in conformity with her parents’ values. Failure to develop an adequate sense of personal power and self-worth has led to these women to depend on others to validate their sense of worth” (Bruch, 1977)
This notion is reinforced by the frequent cases where these women who outwardly would be seen as highly successful are plagues by self-doubt, seeking affirmation from others, often the men in their lives, for validation.


Oft described by others as competitive, driven, perfectionistic, this drive is actually rooted in a desire of approval. Success, outwardly is not for success’ sake, rather it is a means to feel loved and approved of, once again especially by the men in her life, and she lives in constant fear of disapproval or of otherwise “failing”.


The impulsivity expressed that is common to the bulimic woman as discussed in Working with Sufferers of Bulimia, part II then serves as a means of releasing all this pressure that she has brought to bear on herself though this drive for perfectionism, stretch goals and accomplishment. However as is intrinsic in the binge purge cycle, shame, guilt and self-criticism quickly follow this momentary relief and so depression follows as a typical bed fellow. (Pyle et al 1981)
This is why cognitive therapeutic interventions can prove to be so successful, as the role of CBT in the treatment of depression has been proven time and again to be so successful.


( Royal College of Psychiatrists, 2013) “CBT can help you to change how you think ('Cognitive') and what you do ('Behaviour'). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.”

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Working with Sufferers of Bulimia, part II

 

As mentioned in Working with Sufferers of Bulimia, part I the need for counsellors who work with sufferers of Anorexia, Bulimia, to enhance their understanding of these disorders in order to improve the quality of the therapy they provide is becoming more and more apparent as each new piece of research emerges. Furthermore, “Delineated treatment specifically tailored to the needs of each disorder” (Quinlan, 2013)as required for the treatment of eating disorders may be best accomplished by a full understanding of the differences in characteristics of these disorders.


Though there is no such thing as a typical patient or client, commonalities do emerge between sufferers of bulimia. It is often found that women who are engaged with the binge purge cycle, have been engaged with weight loss or have concerned with their weight and or a fear of being fat since their early teens (Beaumont, George and Smart, 1976). Additionally, further commonalities in personality traits have emerged among bulimic sufferers. Research into the personality traits of bulimic sufferers has show that they will often display more impulsive behaviours than those with Anorexia, (Garfinkel, Moldofsky and Gerner, 1980).


These findings are confirmed by research carried out that showed a higher that average impulsivity often expressed by substance abuse (Pyle, Mitchell and Eckert 1981). In marked contrast to this, those sufferers of Anorexia are often “markedly obsessional, socially withdrawn” ( Bruch 1973). The rigid control of the anorexia patient is at variance with the more outgoing and extroverted style of behaviour of the bulimic patients. Bulimic patients however may alter their naturally outgoing social style as the binge purge cycle takes over their time and efforts, and they may become withdrawn and isolated.


Add to this the on-going shame associated with bulimia and the sheer volume of time many bulimics give to their binge purge cycles and even though they may actually crave interaction, friendships and social encounters, they may find they withdraw and retreat into the comfort and familiarity of their food obsession rather than actively seek out and engage with others.

Once again given the propensity for sufferers of bulimia to maintain a fairly even weight, then identifying their eating disorder can be very difficult among their friends and family and so this eventual withdrawal can seem all the more difficult to explain and leave residual feelings of hurt or anger by those who cannot understand her behaviour.

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