I think I'll talk to my analyst....

OK, friends, kudos to the first person who post a comment with the song and artist
(title of blog is line of a song). Bonus points if you know the next line to the song. Anyway, I'm just starting out on the Eating Disorders day program at a local hospital for my psychiatry rotation. It's mostly women from age 20-25 who have anorexia, bulimia, or binge eating disorder. Kind of overwhelming. These poor women use restricting food, overexercising, and binging and purging as a way to cope with issues and events that they can't deal with in a healthy way.

And what issues. I think a lot of people think a woman with an eating disorder is selfish and narcissistic. And there definitely is a self-centered component to it. She basically spends all of her time hating her body, counting calories, obsessing over her hunger, planning meticulously the next binge. She can't go to the same McDonalds two days in a row or they'll know. What lie can she tell? Ordering for a big family? Or her son's baseball team? And how can she throw up without anyone knowing? Good thing she's trained herself to throw up silently.

But she's not doing this for the heck of it. She can't deal with what happened...not with those feelings. If she "practices" her eating disorder, she won't have to feel. Among my patients, there are women with alcoholic parents, abuse and rape victims, women who have seen loved ones die, all sorts of horrible past experiences.

Today was a day dedicated to addressing body image issues. Hearing these feelings of self-loathing and disgust that these women had for their bodies was eye-opening. And as much as their eating disorder is their issue, current societal ideals of what feminine beauty is really does not help them. How can they believe that it's okay and beautiful for them to be in their healthy weight range when most of the women who are lauded as beauties are underweight? It's a pretty awesome expectation to have of them. I mean, when your boyfriend has a huge crush on Cameron Diaz it's kind of hard to embrace achieving a healthy body weight. I think it's very confusing for them...to figure out what to believe...when they have only believed the lies that they have told themselves for so long.

This experience is forcing me to deal with my own body issues. While I don't have an eating disorder, I at times have pretty intense body dissatisfaction. When people around me who are much thinner than I am talk in a hurtful way about their own bodies, it reinforces the message that my body must be really awful. And the fifteen pound weight gain that has happened with third year (admittedly by not exercising as much as I did last year) hasn't helped things either. I am certainly not immune to the messages that thin=good, that there is only one way to have a beautiful body. And I am also aware that I sometimes use hunger as a way to deal with (or avoid dealing with) hard feelings. Strange, huh?

So what do we as women believe? Who do we believe? How's this for a start? "The Lord does not look at the things man looks at. Man looks at the outward appearance, but the Lord looks at the heart."--1 Samuel 16:7

Oh, back to my title, which ended up having very little to do with my post. My attending is a psychoanalyst...she's really into subconscious conflicts and those sorts of Freudian and Jungian theories. I'm a skeptic, I admit. But she's also an amazing therapist and a great doctor and teacher. I'm privileged to learn from her.