In my practice as an online therapist, I "see" quite a few women whose seemingly unrelated issues include concern about their weight and bodies, a history of growing up in an alcoholic or otherwise dysfunctional family, and feelings of depression. They also identify themselves as having codependency issues or difficulty forming intimate relationships. If asked the right questions, these women will often reveal that they experienced some form of sexual abuse as children or teens. These painful problems and concerns are united by the common thread of shame, which can be devastating in its impact on a woman's attitude toward herself and her ability to live her life.
Our whole society is a setup for eating disorders, especially for women. Food is only one prong of this insidious fork: craving food, obsessing about it, self-soothing with it, using it to celebrate and console, turning it into an art form, avoiding it. The other prong is body image: how we look, how we think we should look, how society and the people around us tell us we should look. The health professions pay attention to anorexia, starving to exercise control when there's pressure to be perfect, and to bulimia, maintaining an appearance of being "normal" or "beautiful" by getting rid of excess food through purging, laxatives, or compulsive exercise. Health problems are also acknowledged when a woman is what's often called "morbidly obese." Very fat women are shamed for their body size and urged to "do something about it," fueling a multibillion dollar diet industry that depends on repeat business for its financial health. And millions more women who believe they are overweight because of distorted body image and our culture's unrealistic standards are also struggling with largely unacknowledged eating disorders. It's easier said than done to "just lose weight."
For women who have been sexually molested, compulsive eating can become a way to blot out feelings of shame and self-blame. And excess weight can become a way for women to hide out from sexuality--both from their own sexual feelings and from attracting sexual attention from others, who can't be trusted not to violate or hurt them. The invisibility of being fat is a defense, even a survival mechanism, that may have started in childhood and can be very painful and scary to give up. Such women may want to lose weight but feel consciously or unconsciously ambivalent about revealing themselves to the world without the layers of protection that kept them invisible and therefore safe. At the same time, the act of eating is a mechanism for comforting ourselves. Our culture even acknowledges that there are "comfort foods," usually the same foods that must be given up in order to lose weight. The feelings that come up when they are no longer blocked by constant snacks or intermittent binges can be particularly intense and frightening for sexual abuse survivors. Women dealing with weight and body issues must also learn how to handle strong feelings and work them through in a healthy way. Otherwise, more food is the obvious way of pushing down the anxiety and shame they may have been masking by overeating. On the other hand, sugar in particular, like other substances of abuse, can cause a brief high and then a crash in mood. Some women are amazed to find that their depression lifts when they let go of that nightly pint of ice cream or the chocolates in the drawer at work. That in turn can make it possible to do effective therapeutic work on deeper issues, hopefully with some professional help.
So what part of this should you tackle first? Compulsive overeating can be usefully regarded as an addiction, which means that whatever the original cause, it takes on a life of its own. Behavior modification, as incorporated into diets and weight loss programs, can help with losing weight initially. But it's not enough. The catch is that artificially restricting food is experienced as deprivation. When you're on a diet, you can hardly wait to get to the goal weight or target date so you can go off it--and go back to eating the foods that you find most soothing, like ice cream or fried chicken or lots of bread. At the same time, you swear you'll never go through this again, you're determined to keep the weight off and will never be fat again. This contradiction is a form of denial, a very characteristic symptom of addictions in general. One alternative is to work out a healthy way of eating that you enjoy. It can't be restrictive enough to make you feel deprived and resentful as so many diets do. Consult a nutritionist or your doctor if that will help. Try it out for a while to make sure you can live with it. Get as much ongoing emotional and spiritual support as you can for remaining conscious about this and doing it every day, one day at a time, no matter what. Then throw away the scale and live your life. Put the energy you save into finding positive ways of nurturing yourself.
If memories and buried feelings from an abusive childhood start coming up as your sexual self becomes visible, it's advisable to get help from someone who's experienced in dealing with sexual abuse and trauma. Self-help groups can also provide support, as can reading about the process of recovery. The important thing is that you control the process, taking all the time you need, even setting the work aside for a while if you find you can't handle it. The bottom line about childhood abuse and sexual violence is that it was not your fault. You may have internalized messages that did blame you for what happened. Recovery is about empowering yourself, transforming yourself from a victim to a survivor. Some survivors need to be very angry for a long time, and it's important not to let anyone rush you toward forgiveness before you're ready. In fact, some compulsive eaters act out their anger with food. Whether and when to confront perpetrators from your past is another issue that you need to spend a lot of time processing with supportive helpers, so that whatever you decide is in your own best interests.
Whatever your timetable for dealing with the eating disorder and the history of abuse, you can start right now to work on issues of identity, self-worth, and boundaries. Discovering who you are, learning to love yourself no matter what, and creating and maintaining personal boundaries that keep you safe and protected--without the barriers of weight or excessive eating--yet allow you to reach out to others and form nurturing relationships that enhance your growth--can be the most rewarding journey you will ever take.
Note: This article first appeared in the Survivors' Voices Newsletter at CyberChoices.org.
©2004 Elizabeth Zelvin