Interrupting the Cycle: Expressing Feelings
Expression of feelings is considered by some to be the foundation of all healing work. In eating disorder treatment, it is crucial. Eating disorder behaviors are a way to manage emotions. Expressing emotions directly reduces the compulsivity behind the eating disorder behaviors. In addition, expressing normal, human feelings and being comforted instead of rejected provides an experiential alternative to the abuses the person sustained, and has a healing effect on the psychic injuries.
People with eating disorders tend to be big-hearted and passionate. They feel the positive and negative sides of life deeply. In a dysfunctional family, this means that the person felt the emotional unrest on a profound level.
Dysfunction in a family comes down to boundary violations occurring between family members. In the case of physical violence, the boundary violation is clear: a child is made to hold the anger of an abusing parent (or sibling) in her body. Physically abused children report feeling worthless and dirty; they have internalized the violence that was done to then. Emotional violence is harder to see, but it has a similar effect on a child. When Mom shares with her child Karen, for example, that she is lonely, and attempts to spend time with Karen in order to assuage her own loneliness, Mom’s emotional needs overwhelm Karen. Even if Mom communicates in a loving way, Karen ends up feeling inadequate because filling up another’s emptiness is an impossible task. Any action that results in a child holding the feelings of another person creates feelings of fear and low self-esteem and is a form of abuse. (For a detailed explanation of the different types of abuse, please see Facing Codependence by Pia Mellody. For a detailed explanation of the effect on children of holding parents’ emotions, please see The Drama of the Gifted Child by Alice Miller). A child who is big-hearted and emotional will take the task of resolving a parent’s feelings very seriously, and it becomes a huge weight in her psyche.
One purpose of an eating disorder is that it provides the sufferer a way to handle the overwhelming job of managing the unresolved emotions in her field. Eating disorders are said to give the sufferer a sense of control. Overwhelming emotions are what she is trying to control. The sense of chaos associated with having responsibility for something that cannot be resolved – such as an emotion belonging to another person - makes an eating disorder seem like a better alternative. The eating disorder provides a distraction, one that is consuming enough to take the place of the Sisyphean task of resolving the emotions of others. Above all, the eating disorder is a way to manage the pain inherent in a family rife with unresolved emotions. Needless to say, any relief from the pain is momentary, as the pain of the eating disorder soon rivals that of the original family situation.
Healing from an eating disorder therefore entails a process of sorting out whose emotions belong to whom, identifying where boundary violations occurred, and expressing the feelings that truly belong to the client. In order for this process to take place, the client must have an outcome that was different from the times when she tried to express feelings in her family. In the chaos of a dysfunctional family, a child expressing an emotion would have been met with some kind of boundary violation on a regular basis. She might have been ignored; or the family member to whom she expressed herself may have “outdone” her emotion, getting more upset than the child; or, having triggered an emotion in the parent, she might have been put in the position of comforting the parent or feeling guilty that the parent got triggered. The healing comes when the client gets to express herself and have a different outcome. This time around she gets met, comforted, and listened to instead of rejected, shamed, or outdone.
One of my most important tasks as a therapist is to provide this different outcome. The main ways I support people to identify and express feelings are through the therapeutic relationship with its various interventions, and with Expressive Arts techniques (my Master’s Degree concentration). A support group and relationship with a sponsor in a Twelve-Step program are also great ways for clients to have corrective emotional experiences. Any healthy relationship becomes part of recovery, including those with healthy family members and friends. These relationships, filled with positive regard, provide a model of self-esteem that teaches the client how to love herself. The goal is a compassionate relationship with the Self that the client takes with her wherever she goes.
Over time, having and expressing feelings become part of a person’s normal experience. “I notice I’m angry. Now I’m sad. Hey, I’m happy!” At a certain point, the person would rather feel her feelings than eat or restrict, because she gets more pleasure and satisfaction from having contact with her heart and soul than she does from contact with food. The part of her that can feel is alive again. Retrieving the ability to feel is essential to recovery and to enjoyment of life, since it is necessary to know how you feel in order to set a boundary. Having a full range of feelings in an inner atmosphere of love also helps develop an identity outside the narrow confines of the eating disorder.