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Mothers, Daughters, and Eating Disorders

Mothers, Daughters, and Eating Disorders

As we all know, there’s no single reason a person develops an eating disorder. There’s a combination of cultural pressures, genetic predisposition, and relational factors that come into play. For the sake of this post, we’ll focus on attachment to the primary caregiver and its impact on the development of an eating disorder. 

Of course, there are homes where the father is the primary caregiver but in much of the Western world, the mother is the primary caregiver.  Mothers are the first attachment figures and their goal is to keep us safe, happy, and healthy. But if our needs aren’t met early on, food can get very wound up in that.

Insecure Attachment 

The majority of people develop a secure attachment with their primary caregiver – Judy estimates 80% of people in the world. Mom doesn’t have to be perfect; she just has to be “good enough.” When a person’s needs of safety and security are met, their emotional, cognitive, and psychological processes will all develop appropriately.

But when the primary caregiver is not attuned enough – they’re not feeding the child when they’re hungry, holding them when they need it, helping them sleep when they need it etc. – the child develops an insecure attachment. The child doesn’t develop the ability to soothe themselves and doesn’t trust that their caretaker to be able to do it for them. These are the kids who are most vulnerable to developing an eating disorder – because they’ll look to food for self-soothing. And food is soothing. 

To be clear, all people use food from time to time to soothe themselves. It’s only when a person has no other way to self-soothe that it becomes a problem.

BTW, there are many ways that people can self-soothe. One person might develop an eating disorder while another person becomes a workaholic. Perhaps there is a genetic component here, but we don’t know fully yet why one person does and another develops a different self-soothing mechanism.

The Past Matters

It can be easy to feel like what happened 25 years ago shouldn’t matter today. But understanding your past is a key to changing your present.

Judy gives a great example about a young client she worked with years ago. During therapy, the girl was able to pinpoint the day her eating disorder behaviors began (so rare, I know): it was the day after her sweet sixteen, when her friends stopped talking to her. To cope, she ate two bags of potato chips. 

When she retells the story in therapy, she’s able to experience the pain again, but now in a new way. She’s experiencing it with someone who is listening and attuned to her needs. As she’s telling it in the presence of a caring person, she’s having a different experience… and that can be healing.

The very definition of trauma, to me, is less about actual events but more so about how one experiences reactions to the events. Were they able to tell a caregiver or adult about it and be soothed, listened to, and reassured? If we think of trauma in this way, the healing is all about having to “reexperience” the event by retelling and having someone respond in a way that was needed the original time. 

Let’s take the example a step further. Let’s say this client is ashamed of crying. Instead of crying and finding a friend to comfort her, she’s eating. Judy would work with the client to pinpoint the moment(s) she learned it wasn’t okay to cry – in this instance, maybe it was her dad telling her not to cry because it makes her mother sad.

So how does that relate to the day she binged on the potato chips? Because the tendencies we develop as children will follow us for the rest of our lives. She learned that it wasn’t okay to cry, so instead, she used eating as a way to soothe herself. (By the way, when we explore this it’s rarely as clear cut and simple as this.) 

Becoming Curious About Habits

What much of therapy does is help someone recognize and understand their own habits, and put words to it. In that way, they can create new habits.

For example, from Judy’s recent book, The Girl in the Red Boots: Making Peace with My Mother, Judy describes a therapy session where a girl discusses her relationship with her mom. She says “She’s the greatest,” but her foot immediately started tapping nervously. 

Through therapy, Judy helped her patient find language for what her foot was trying to say. The goal is eventually to help her put words to all of her feelings regarding her mom.

Moreover, it’s important for someone to pivot away from the feelings of shame around their behaviors and rather question why they displayed those behaviors in the first place.

When Daughters Become Mothers

Mothers and daughters relationships can shift dramatically when the daughter becomes a mother herself.

For some people, It’s not until a daughter becomes a mother that she understands what being a mom entails. It can be a significant piece of the healing journey and she can develop a new level of understanding for her mom.

For example, we still live in a culture where gender roles are a thing. In that way, some women who may feel powerless, teach their daughters to be powerless. The daughter may have strong reactions like feeling anger toward her mother for this. Perhaps only until going through more of life and having kids of her own, does the daughter resonate with some of her mother’s powerless experience. She may then begin to process her relationship with her mom in a whole new way.

Podcast aired March 28, 2023

Rachelle Heinemann


Listen to the podcast here.

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Renfrew Perspectives Winter 2022 Article – The Unexpected Gift of My Freudian Slip

The Unexpected Gift of My Freudian Slip

By Judith Rusky Rabinor Ph.D.

Elegantly dressed in a long black wool coat with a lush fur collar, Ella swept into my office that windy November morning, “I’ve come to a decision,” she said. “I’m leaving Al when Jeremy goes to college next September. I’m getting divorced.”

You can read the full article here.

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Humor as a Pathway into – and out of – Pain.

Humor as a Pathway into – and out of – Pain.

(Article originally published in Perspectives: A Professional Journal of The Renfrew Center Foundation, 2019 Edition)

What did we learn from Freud? If it’s not one thing, it’s your mother.
– Robin Williams

What on earth went on in your group tonight?” my husband asks.

We are having dinner and he is referring to my binge-eating group that’s met for sixteen years on Tuesday nights at 5:30 pm. “It sounded like you were having a hilarious time,” he said. “What was so funny?

My office is in our Manhattan apartment and, although two closed doors separate my therapy office from our living space, his curiosity was piqued by what he described as “raucous laughter.” He was correct. Notwithstanding the fact that the group had initially coalesced that evening around a dark and dreary theme, we had ended a somber group with everyone laughing. It was a humorous quip I made that flipped the mood.

The therapeutic use of humor is not a new idea. Sigmund Freud saw humor as a means of expressing unconscious desires and fears. Viktor Frankel, a holocaust survivor, suggested that humor has the capacity to lift the human experience above suffering. An old supervisor of mine recommended I help clients see their life through the eyes of a cartoon character to bring levity to life’s hardships.

So join me in my office as we examine the healing power of humor.

Back in 2002 when our binge-eating group began, we focused, for the most part, on over-eating. What were the emotional issues that triggered binge eating? As members became less symptomatic and developed deeper levels of self-awareness, trust and intimacy, triggers and self-regulation strategies held less of a center stage.

This group session had begun with Marie, age 75, talking about her husband Jack’s deteriorating health. Jack, diagnosed with Parkinson’s disease had suffered a terrible fall. A broken shoulder and long rehab followed his hospitalization. Marie was already worn out. Now, he faced Alzheimer’s. “How are you managing as a caregiver?” I asked Marie, shifting the focus from Jack back to her. She shook her long blond hair. “Often I’m kind and gentle but sometimes, when I’ve had it, I become a bitch—or even worse— a witch.

Group members offered words of empathy: care-taking family members was a familiar theme. Three of the six people present that Tuesday evening had lost parents during the sixteen years we had met and one had a chronically ill spouse. I had shared some of my own trials as a caregiver to my mother, who had struggled with Parkinson’s disease for a decade before her death, six years prior to the present meeting.

Next, Eloise, a tall brunette also in her mid-seventies, gave an update on her cancer treatment. She was drained and exhausted from the chemo. Thankfully she wasn’t binging. Cancer was another topic familiar to the group. Sam, a 67- year-old beloved group member had died a decade earlier from metastasized lung cancer.

76-year-old Ben spoke next about the retirement package he’d been offered by his accounting firm. “The package isn’t bad but retirement? I don’t have a lot of hobbies, except over-eating,” he said. The group laughed. “Really, work has consumed me for decades. I’m going to have to revamp my life,” he said grimly.
Being useless has never been my M.O.” He sighed. “Now what?

Minutes before the group was to end, Marie spoke up again. “I don’t know what I’d do without you guys. You are all dear to me, and our group is so special.” Her remark triggered others to articulate the support they got from one another.

Sixteen years… a lot of history,” I commented after listening to the others. The group had journeyed from being composed of mostly 50-year-olds to, now, a group mainly of 70-somethings. Four of the six members present had been in the group since our first meeting sixteen years earlier. “We are moving through life together,” I added.

I’m 85! —The oldest one here,” said Bonnie. “I think I’m doing pretty well except— I am continually losing names. I run into people I’ve known for years and I remember them, but can’t always remember their names! My memory is fading and it’s scary!” Everyone began speaking at once, sharing memory loss moments- cell phones, eyeglasses, keys, birthdays of loved ones, library books. The group was abuzz.

This happens to me, too! And I’m only 76!

Me too and I’m not even 70”!

Age is just a number. 85 are the new 65.” More laughter.

Beth, the youngest person in the group spoke up. “Seriously, I hope my mind is like yours when I’m 85,” she told Bonnie. “How many 85-year-olds can drive 300 miles” Ben said, jumping in and referencing Bonnie’s lengthy weekend drives to her daughter’s Vermont home. More supportive endorsements of how well Bonnie was aging followed:

And you still do you own taxes!

You are my role model!

Bonnie persisted. “You are all so kind, but truly, I hate losing names. It’s embarrassing!” she paused. “And I’m terrified: what’s happening to my mind?

Then the group was silent.

I paused. Took a deep breath. Then, I gave myself permission to follow my spontaneous urge.

With a straight face, I turned to Bonnie. Then I gazed at the group members, slowly. I made eye contact with everyone. “I’m going to make a promise,” I said seriously. “It’s a commitment. If we are all still here and still meeting ten years from now, I’ll supply the name tags so none of us will be embarrassed when we can’t remember each other’s names.

Peals of laughter broke out. Of course, I laughed too. When the laughter died down, I said: “What’s in a name, anyway? Maybe it won’t even matter if we remember each other’s names—as long as we can remember each other’s stories. After all, it’s our stories that bind us together.

Writing this article has offered me the opportunity to reflect on the role of humor in our group. Most of us are aware that laughter releases endorphins, the feel good hormone which reduces tension and stress. Joking with patients and allowing them to feel a kinship can offer a remedy to long-standing frustration, pain and isolation, the issues most people with eating disorders struggle with. Our work is serious, but when we, as therapists, are able to laugh at ourselves and accept the absurdities and unknowable aspect of life, we offer our clients a unique gift.

My humorous quip had its positives: it was certainly a bonding moment. As a group leader, I generally disclose my feelings about what happens in the group, yet, I rarely disclose my personal experiences outside the group. This quip was an unusual “me, too” moment. It leveled the playing field. “Life is tough, aging is hard and unpredictable, and we are all in this together” was my message.

Second, I communicated that it’s ok to verbalize our unknown fears, i.e., what will I be like when I’m a decade older? I normalized the fear of aging.

Third, I communicated that, although aging will inevitably take its toll, we can survive, and thrive. My message was “We will adapt. I will be here for you. At least I will try. I am an anchor.

In writing this article, I was pushed to question my own motivation. Why did I spontaneously come up with a funny line at the moment I did? What would have happened had I stayed with Bonnie’s concern about memory loss? Did she or others feel dismissed? Upstaged? Did I abandon Bonnie’s concern because the topic personally scares me? Perhaps I had an unconscious need to step away from the dread of deterioration, frailty and uselessness—the topics raised.

As my own questions multiplied I noticed a pit in my stomach, for aging is a topic rarely off my radar. My inbox too often carries the subject line “sad news” and, frequently, I find myself mourning a deceased friend or colleague, perhaps even younger than I am. Conversations with friends are increasingly filled with medical concerns. One good friend typically ends phone conversations with the line, “Don’t buy green bananas.” Another has incorporated a telling phrase as part of her email signature, “The road ahead is shorter than the road behind.” On a more personal note, my husband has been coping with a painful backache and we have been educated by innumerable medical experts to face the truth: back pain, like an assortment of other medical maladies, is increasingly prevalent and predictable as we age. Acceptance is key.

I wondered: did I make a humorous remark as a way of avoiding my own feelings of grief, anxiety and frustration around aging? Was my quip a mistake?

Fortunately in life and in therapy, mistakes are always opportunities for exploration and repair.

The following group session offered me an easy segue for investigation. Marie had arrived wearing a heart monitor. A “scary incident” had sent her to her cardiologist. Once again, we were plunged into the world of aging anxieties.

I had an opening and I took it.

I asked if there was more that needed to be said about Bonnie’s concern with memory loss. When no one spoke up, I made a confession: I might have unconsciously sidestepped this daunting topic. While no one admitted to feeling slighted or put off, I was glad to have planted a seed: therapists, as well as patients, often have a hard time sitting with what is truly painful and frightening.

Until recently, I hadn’t spent much time thinking about the value of humor in healing. Writing this article pushed me to think about my work through a new lens. One principle that has guided my work forever is a quote from Psalms, “Joy shared, twice the gain, sorrow shared, half the pain”. Humor is a pathway into pain. It allows us to share it all. A joke well told can lighten the load, facilitate bonding and humanize us as therapists. It can communicate, as Sullivan taught, “We are all simply human.

(Article originally published in Perspectives: A Professional Journal of The Renfrew Center Foundation, 2019 Edition)

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A Meditation on Life, Love and Being a Therapist

Volumes have been written speculating how therapy expands the lives of clients. Far less is understood about the impact of doing clinical work on the therapist’s own life. In the process of the therapeutic journey, clients are not the only ones in the room who contact buried grief.  Therapists too, inevitably revisit their own buried darkness, which offers ongoing opportunities for growth and renewal.  I realized this when I said to one of my clients: “Ella, we have a lot of work to do this year so you don’t make the biggest mistake of your life.” Continue reading →

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Listening to the Inner Voice: The Healing Power of Writing

What is the source of our first suffering?
It lies in the fact that we hesitated to speak.
It was born in the moment
When we accumulated silent things within us.
– Gaston Bachelard

Writing is an axe to break the frozen sea within.
– Franz Kafka

People with eating disorders come to therapy talking endlessly about food, fat, dieting and losing weight, a focus that distracts them from deep wells of pain. Disconnected from their inner hunger, they are isolated from themselves and others. A major goal of therapy is helping them develop connections; to their therapists, to other people, to their inner psychic worlds and eventually, to the larger world – of spirituality, nature and community. Continue reading →

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Honoring Our Hungers

Every person alive has demons; inner demons that gnaw at the soul in the dark hours of the night. People come to therapy when this darkness becomes too black, too bleak to bear. Women with eating disorders come to therapy hoping to escape their inner darkness, with little awareness of deep layers of psychic pain masked, contained and expressed in their bodies and in the three simple words, “I feel fat.” Continue reading →

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Sacred Nourishment

We all have priceless things in our lives. Have you ever stopped to consider what is the most precious thing you have in the world. What is the one thing you have that if it were taken away, you would never be the same again? Think about it. Take a minute.

You may find that a particular relationship you have is the most precious thing in the world. Perhaps it is your health and the health of those around you that is most precious. Perhaps you have a different answer, though when you consider this question very carefully, is there not something that takes priority over it all? Continue reading →

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Helping Our Daughters

It is Halloween, an unusually warm evening for late October, and not yet dark. Answering my bell, I open the front door to find two adorable young girls costumed in long evening gowns and rouged cheeks. A large shopping bag is held firmly between them. The girl wearing long blond braids speaks first.

“I’m Sleeping Beauty,” she says.

“And I’m Barbie,” chimes in the second.

I tell them how wonderful they look.

“Your choice,” I say, pointing to my selection of candy. “M&M’s or Tootsie Rolls.”

‘Barbie’ speaks up. “Candy?” she says, “Oh no – No candy for us! But do you have anything not fattening?”

“Not fattening?” I repeat. “Why?”

“I don’t want to be fat like my mom and my older sisters, so I’m starting to diet early.” Continue reading →

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Imagery as a Transformational Process

“Imagination is more important than knowledge.”
– Albert Einstein

People with eating disorders are frequently described as concrete, flat and difficult to make contact with. Often they report feeling empty inside. Disconnected from their inner worlds, they are isolated from themselves, other people and oftentimes even their therapists. A major aspect of the therapeutic journey involves helping them connect to other people as well as with their disowned thoughts and feelings. Continue reading →

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Turning 80: A Ritual of Renewal

My mother, Peggy, was turning eighty. To live a decade beyond the biblical life span of three score years and 10: a blessing! Physically healthy, mentally alert, adventurously purchasing her first computer (“I think it’s time I got onto the web!”) she was a model of healthy, vigorous aging. Certainly, a celebration was in order. And yet, our family was raw with sorrow, still mourning the recent death of my sister-in-law, Shira, my brother’s wife. How could we celebrate growing older while still grieving the cruel loss of youthful, fifty-two year old Shira? How could we celebrate with the presence of Shira’s illness and death looming, for it was only months from diagnosis to death and then, she was gone. Continue reading →

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