Treating Anorexia Nervosa with a Myth
by Stephanie Jourdan, Ph.D.
Loosely translated, this condition is a nervous loss of appetite.
In order to treat anorexia, you must have a prescription from a medical doctor to rule out any possible physical illness that could account for the weight loss. Since most anorectics have a sleep disorder, you should be able to bill their medical insurance through a physician.
Statistics indicate that one out of 250 girls between the ages of 12 and 18 will develop anorexia. One out of five dies.
In my experience of treating anorexia, all of which involved teenage girls, the majority had introverted personalities with very extraverted mothers.
There is usually a problem in the parents' marriage and the anorectic teen seeks to embody the ideal that holds the family together (the identified patient as mediator or star of the family).
The mother has usually been rejected by her husband and is unconsciously jealous of the attention that her husband gives to their daughter. The husband senses this and withdraws his attention and approval from his daughter.
In his own anger with his wife, he often utters passive/aggressive comments about other women, perhaps TV or movie stars, looking great.
The hurt and angry wife has subsequently stepped into her masculine self in order to fight back. She has become more dominant in her family role and manages the family with a more righteous than nurturing attitude. She has unconsciously rejected her daughter as an individual, seeing her daughter instead as a mirror of her own sadness for her unlived life.
Anorexics seem to be very bright and sensitive and understand that their domineering mothers are actually powerless as a result of having been rejected by their husbands. (Many times the mother also becomes a client and it has also been my experience that the mothers were rejected by their mothers and had no role for feminine nurturing.)
The girl does not want to compete with her mother or put herself in a similar situation when she grows up.
Her mother may also be stuck in girlhood and secretly fantasizes about being rescued by a fairytale prince. She might force her daughter into the maternal role. After a while, the daughter rejects the role of being her mother's mother and her father's partner and desperately seeks to define her boundaries as a child.
Finally, the girl's feelings are channeled into fantasy. Her sexual feelings are transformed into fairytale proportions of the whole world offering its approval in the way it offers famous models or other media figures approval.
The anorectic is afraid of her body. She wants it to obey her mind, which seeks a state of goodness and perfection (emphasis on perfection). She has tremendous judgment about her humanity, so the feeling side of her becomes subjugated to her mind. She loses her connection to her primal, intuitive, and instinctual nature . . . her inner feminine. Often her dreams reflect this in interactions with a gigantic chocolate lady, signifying the black Madonna, the symbolic life force of the feminine shadow.
I have found that the key to reestablishing balance in her young life is to offer her indirect suggestions that help her to feel safe about reconnecting with her inner feminine in the form of intuition, cycles, and instincts.
The client is desperately seeking her own identity, both physically and psychically. She feels alone and lonely. She needs to know that others' ideas about being good are meaningless for her if her motivation doesn't come from her own heart. The Snow White myth is perfect for the imbedding of these kinds of suggestions. I prefer to change the ending, where Snow White is passive, awaiting rescue from an external male, to one where her own internal power awakens her.
I also embed indirect suggestions regarding the reversal of some of her symptoms. I assume that she will identify with Snow White, so I talk about Snow White having the inner resources to grow thick, lustrous hair. Since most anorectics have thinned hair as a result of malnutrition, the inference is that she will be guided to resource herself in a way that enables her to grow thick hair.
1. Loss of menstrual period.
2. Thinned hair.
3. Dry, scaly skin.
4. Peeling nails.
7. Lanugo (due to loss of body heat through loss of fat).
8. Low blood pressure (as low as 80/50).
9. Low body temperature (as low as 95 degrees).
10. Low pulse rate (30 to 60 beats per minutes).
11. Insomnia from hunger.
12. Dental decay if the condition is accompanied by purging from bulimia.
1. Devouring mother complex.
2. Family mediator, nurturer or star.
3. Only sense of self is intellectual achievements, popularity and appearance.
5. Overcompensates, especially for one parent?s failure to meet the needs of the other parent.
6. Sees everything polarized in black and white.
7. Fears criticism.
8. Passive/aggressive behavior.
9. Fears growing up and becoming her mother.
11. Obsessive/compulsive behavior.
14. Phobic about impending sexuality.
I should probably mention a little more about the mother, since the client is usually brought to you by her terrified mother.
The mother's identity is wrapped up in her role as wife and mother. She already perceives herself as a failure because she failed to attain her goal as her husband's ideal (no woman can be a man's ideal given that she is human - or at least not for long). She is scared that she may have to face her fear that she has also failed as a mother. Since hypnosis is often a last resort, the girl's condition may be extremely serious. The mother needs her daughter to live to confirm her success as a mother. The anorexia is very threatening to her reputation as a good mother and her daughter knows it.
You will feel the mother's need for approval and attention even from you. The girl will be watching to see whether you can hold your boundary with her mother. She needs to see that you are strong enough to protect her. Focus on establishing rapport with her, the daughter, even if it means losing rapport with the mother. When the mother sees her daughter respond to you, she will have to be supportive.
You will be faced with the same dilemma the daughter faces: you will have to listen to your heart and not the mother's cries for approval.
You will have to risk disappointing the mother. You will have to role model how this is done for the daughter.
It is imperative that the daughter, the client, decide to continue with the hypnotherapy and schedule her future appointments herself as a sign that she is committed to the success of the therapy.
Do not let the mother persuade you to offer suggestions about weight gain, consumption of bigger portions, eating with the family, reducing exercise, halting diuretics, increasing caloric intake, etc. You will lose rapport with your client.
Let the daughter know that you are there to serve her. Ask her whether she would like a suggestion that she easily attain what she considers her ideal weight. Of course, she may give you an ideal weight in the form of a particular number of pounds. That's fine. Your client assumes that her ideal weight is her conscious mind's idea of an ideal weight. Remember Dr. Erickson's words, something to the effect that your conscious mind is very smart, but your unconscious mind is a whole lot smarter? Well, her conscious mind is thinking her ideal weight as a number of pounds, but you are offering her suggestions thatthe wisest part of her will instinctively choose the most ideal weight for her greatest beauty and happiness.
The wise part of her will direct her to nurture herself in a way that reestablishes her health so that she will naturally have a beautiful and healthy body.
Give her the impression that all you are going to do for the first couple of sessions is some stress reduction as everyone benefits from relaxation and improved sleep. Explain that all you are going to do is tell her a story, a fairy tale, and then, at the very end, when she feels deeply relaxed, you will give her a suggestion for her ideal weight.
The fairy tale of Snow White is a wonderful metaphor. The anorectic girl wants to identify with the purity, goodness, beauty and perfection of Snow White. Especially since Snow White is a victim of an absent father (workaholic) and a devouring mother figure (the evil queen step-mother).
When the queen asked the court hunter (the part of the psyche that finds what it needs) to take Snow White into the woods, it symbolized Snow White leaving her past and entering her subconscious. The seven dwarves represent the seven avarices of greed, sloth, pride, envy, vanity, gluttony and lust. (Not exactly Disney's portrayal.)
When Snow White finds a way to live with them, it represents her new-found ability to accept and exist with her human faults and frailties. Remember, the anorectic has sought to live out perfection.
Snow White's stepmother lacks soul. All her worth is determined by her reflection. Appearance is everything. She lives for male attention. She has no sense of self and cannot give her stepdaughter a sense of herself either. The stepmother fears aging and teaches her daughter to fear the process of evolution as it eventually betrays you.
The stepmother has been consumed by the darkness of fear. She turns herself into an evil sorceress, as that is the only power she knows, the seduction of others' power. She symbolizes Snow White's repressed feminine. The feminine is the giver of life. It demands expression in one form or another. Her repressed feminine is a wicked witch because it has not been safe for Snow White to experience femininity as a growing sense of empowerment, i.e., the evolution of the female body and the accompanying hormonal changes and feelings of sexuality.
The anorectic has a mother who also lives in fear of rejection. She is the over-expression of the feminine that counters the anorectic's under-expression of the feminine. The mother is out of control of her emotions, so the daughter must be very in control of hers.
The apple is a traditional symbol of the temptation of the feminine. The anorectic's repressed inner feminine wants to be tasted. The power of sexuality, as embodied in the red, ripe apple, is too frightening to chew and digest.
All Snow White knows of the energy of the mature feminine is her abandonment by her mother, who died in the fairy tale, and the competition (jealousy of appearance) of her stepmother, her only source of possible love and nurturing. She tries to please her. She wants to be perfect. She tries to avoid being her competition by not developing. Still, she finds no love and believes something must be wrong within her. She is not deserving of nurturing or life. She doesn't want to grow up and be devouring like her stepmother. There is no role model. There is no way to grow up and feel good about herself. She has to find a way to be safe until she can figure it out.
The witch tempts her with the red, ripe apple assuring her that it will bring her heart?s fondest desire. Snow White dreams of her Prince Charming and takes a bite. She gets a taste of the fruit and becomes paralyzed by her desire for passion and her fear of where it will lead. This is Snow White?s coma.
The anorexic has compartmentalized her emotions in the same way that Snow White has been kept in a glass coffin. She appears sweet and pretty, but she is unable to feel or interact. She can only be rescued by love, by feeling... Snow White's Prince Charming.
And here is where the suggestions can be buried in the story. Alter the story so that the onset of springtime brings new growth and strength to Snow White?s heart. The rays of the sun gently awaken Snow White and fill her with hope. The energy of the sun, which represents her conscious self, helps her safely feel the loss of real nurturing and the lack of protection from her father.
As days go by, the beauty of nature's return in the spring enables Snow White to feel her mother's love for her return and grow strong inside her heart. Snow White becomes so strong inside that she is able to deal with her feelings about the betrayal of her stepmother, who would not recognize her true value and make a space for her in the world.
Her rage raises her body temperature and her blood pressure. It sends new life into her bones, her skin, her nails, and her hair. Even as she lies in the coffin, Snow White's thick, long, hair takes on a life of its own (symbolic of a woman's crowning glory).
She feels her loving mother's presence inside her. The feeling of love nurtures her on every level. Her radiance glows through the coffin drawing the prince to her. She knows the power of her mother's love is stronger than that of the devouring stepmother. She knows that love will create her ideal body for her. A body that she loves and feels good in.
The anorexic needs to stop pleasing others. She needs to disappoint her mother. She needs to feel. She needs to reconnect with her senses. She needs to let go of ideals of being good and perfect and stop using her spirit to judge her body. Encourage her desire to be physical and human with all her human frailties and imperfections.
Again, if you talk to her about the disorder, you will lose her. Forget target weights and condemnation of her rituals and ideals. Introduce the concept that she deserves love and attention just for being alive, even if she were not so smart and not so accomplished. Discuss an assignment where she can purposely disappoint her parents (law of reverse action).
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