Eating Disorders - fieldi

Individual Psychotherapy 141
vomiting. Upon leaving school, she had moved back into her parents’
home.
Laura’s father, a lawyer, was described as quiet, reserved, and
absorbed in his business, his computer, and his projects. Her
mother, a homemaker, was characterized as demanding and critical
of Laura, unhappy, socially inactive, and a heavy drinker. One sibling,
a married brother ten years older, lived several hours away. I
met with Laura and her parents on a few occasions during the initial
phase of our work. They impressed me as reserved but responsive
people, who were obviously concerned and perplexed by Laura.
Both parents came from deprived and depriving backgrounds. They
had overcome the adversity of their earlier lives by dint of their ability,
hard work, and sheer will. There was a history of alcoholism in
her mother’s family that figured significantly in the physical abuse
her mother had endured. Several members of Laura’s extended family
had committed suicide. Laura was deeply affected by the death
of a favorite uncle the week she started to see me.
Laura’s experience with death in her extended family and her
exposure to suicide as an option when life becomes unbearable was
reinforced by the suicide of her good friend during the Christmas
holidays. Laura had been devastated and had continued to feel
guilty that she hadn’t done more to help her friend. Having known
three people who killed themselves, she found herself wishing she
were dead when she felt really bad, as she did when she left school.
Since Laura’s depression lifted somewhat over the early months of
treatment, I did not refer her for a medication consultation at that
point, but I did so later. Her vulnerability to agitated depression has
been a theme throughout our work, even when she was on medication.
In time, she found code words to describe these states: “The
blue meanies are coming,” “I’m having UMS” (ugly mood swings),
“I’m on the pity pot,” or “I want to throw myself in the garbage pail
like a piece of trash.” She also found code words to describe her
body in order to express her feelings; “My body feels like a space
suit.” The ability to use language rather than symptoms and selfdestructive
behavior to express her feelings was a major step in her
developing a more integrated self and ultimately recovering.
Laura described her childhood as very unhappy. Her mother was
demanding and critical of her but never clear about what she