SENSING THE SELF

Shame is the villain and persistence the heroine in this analysis of 13 women who recovered from bulimia nervosa.

Reindl (Psychology/Harvard Univ.), however, would probably prefer to speak of women who “are recovering” from bulimia, since, as with many addictions, a return to the eating disorder is always but a binge and a purge away. The author selected women who had been free from bulimic symptoms for at least a year and asked: What motivated them to begin changing their behavior? What helped? What set them back? Why did they develop the eating disorder? Bolstering the stories of her subjects with other research and writings as well as her own clinical experience, the author detects a pattern that resembles, but does not mimic, the patterns of other addictions. What she found was a sense of shame, of being “inadequate and bad.” In most cases the feelings of worthlessness arose not from childhood physical or sexual abuse, but from emotional deprivation. The decision to stop and seek help comes about because the person is “fed up” with her behavior, but it can take many false starts before symptoms are under control. Such therapeutic interventions (whether via a psychologist, a nutritionist, or Overeaters Anonymous) kick in to help bulimia sufferers rebuild a positive “sense of self.” Reindl cites the tale of “Beauty and the Beast” as an apt and rich metaphor for the struggle to also accept the ugly side of the self. There is also a section directed to therapists who treat those with eating disorders and specifics on what the recovering women found most useful in their therapeutic encounters. She lauds the importance of good nutrition and exercise as recovery proceeds, noting the terrible damage that years of an eating disorder can do to even a young body.

Though not a definitive study of bulimia, it is sensitive, informative, and likely to be helpful to both client and therapist.