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On the last track, we discussed three binge trigger categories. These three binge trigger categories included: food and eating; body weight and shape; and negative emotions.
On this track, we will examine three concepts of interpersonal relationships with regards to the binging and purging client. These three concepts of interpersonal relationships include: early childhood development; as a means to please; and secrecy.
3 Concepts of Interpersonal Relationships
Concept #1 - Early Childhood Development
Nina, age 15, was sent off to boarding school at the age of nine. Prior to her high school years, Nina had never had a close relationship with her parents. Her mother and father were constantly at activities, so Nina and her younger brother were raised by the nanny.
Nina stated, "I always thought that there was something wrong with me! That I had done something to disgust my parents and make them not love me! I didn’t want to make the same mistake again and chase off any potential friends at school. So I watched them and I noticed the thin girls were much more popular. I wanted to be like them! So when I was fourteen I heard about a girl who had vomited to be thinner. I thought that maybe I could do that, so I did!"
Nina’s behavior had been triggered by the actions of her peers and by the emotional neglect she felt in her early childhood development. Think of your Nina. How did his or her childhood development affect her bulimia later in life?
Concept #2 - As a Means to Please
Cynthia, age 17, had started binging in order to please her mother, Jane. Cynthia stated, "Mom always points out skinny people to me in the mall and on television. I know she won’t come out and say it, but I know she wants me to look like those women! And that’s ok. I mean, it’s not too much to try a little harder!"
When I asked Jane if she had wanted her daughter to start this behavior, she stated, "No! I know how bad this forced vomiting can be for your teeth. I don’t want Cynthia to have no teeth at all. That would just look awful!" Cynthia’s mother had placed a high premium on becoming beautiful, and to fit into her mother’s ideal, Cynthia had begun to adopt these behaviors. Think of your Cynthia. Is he or she using bulimia to fit into a certain ideal?
Concept #3 - Secrecy
In reality, the client is subject to severe mood swings which ultimately affect the stability of the relationship. Stealing, which is common occurrence in forty percent of bulimic cases, encourages low self-esteem and hiding. Ultimately, the client fears that if he or she should reveal his or her eating behavior, the relationship will crumble.
Theresa, age 23, had been married to Michael for over a year. Theresa had been diagnosed with bulimia at the age of 21 and still had yet to tell Michael about her behavior. Theresa stated, "I wait until he’s not at home and then I binge and purge to the max! I couldn’t stand for him to see me like this, it’s too humiliating! What if he leaves me? I couldn’t stand to be alone for the rest of my life!"
Theresa’s shame in her own behavior causes her to believe that Michael, her husband, will react with the same disgust and repulsion.
Cognitive Behavior Therapy Technique: Three Screen Comparison and Acceptance
--Best Outcome: Theresa stated, "Well, the best possible outcome would be that he is completely accepting of the disorder, hugs me, kisses me, and tells me everything is going to be ok. He isn’t even shocked.
On this track, we discussed three concepts of interpersonal relationships. These three concepts of interpersonal relationships included: early childhood development; as a means to please; and secrecy.
On the next track, we will examine three aspects of binging as a result of anxiety. These three aspects of binging as a result of anxiety include: generalized anxiety; fortune telling; and source identification.
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