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The Quiet Addiction

Deepening Intimacy in Psychotherapy: Using the Erotic Transference and Countertransference
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This article was published in dr. rosiello's sedona times psychology column in 2009.

It took years to figure out why one of my patients never seemed able to lose the weight she was intent on shedding. She had even provided a weeklong list of what she ate at each meal. 

She had gone to a nutritionist who provided her with recipes for her cooked meals. We had agreed on her having ‘hard chews’ for snacks, which were carrots and celery.

Still, my patient was nearly 100 pounds overweight, and it never budged no matter what her diet.

She went to a specialist to see if it was due to any physical conditions, such as thyroid, or diabetes, but there was no evidence of any medical reason for her inability to lose weight.

Then, in one session, I got a peak into her weight problem: She casually remarked that she goes to the local deli each night before going home from work. When I questioned her on 'why,' she took a long moment and then, almost as a surprise to herself, said that she picks up a coffee cake. My patient then related how she sits in her bed and eats the entire cake before falling asleep. This little disavowal of food intake was interesting to explore with her. She didn’t eat the coffee cake at the table; she didn’t eat it with a fork, but rather just picked at it until it was consumed. She just didn’t count it as ‘eating.’

"For many people who are obese, food can take the place of people. " ~fr

My patient seemed surprised when we talked about how her bedtime snack was enough of a food binge to keep her weight maintained. The thought of giving up her cake opened up a banquet of stories on her associations to overeating throughout her life. How she used food for comfort, for discomfort; for hunger, for nonhunger; for pleasure, for punishment; for company, for solitude. 

For many people who are obese, food can take the place of people. Food can’t criticize you, it protects you from sex if you want it to, it gives you a focus for the day on what to eat rather than thinking about relationships, it relaxes you because the oxygen from your brain goes to your stomach to digest, and you can trust that food will always be there when people may not.

Many people who overeat have a mantra that they provide for themselves: ‘I deserve this treat.’  This is a complex statement.  It indicates that the person feels they have been deprived – of something.

If we look at their current life, it’s often hard to detect what they feel deprived of or kept from. But, if we look at their history, it’s fairly evident to what they’re referring. Typically, people who overeat have felt invisible as children. They have often been children of parents who didn’t have either the physical or emotional time for them.  When we’re growing up, we actually ‘take in’ or ingest our parents relationship to us, in that we are developed by their comments.

The child’s developing sense of self is fed by the parent’s nurturing of the child’s feelings of who they are and who they are becoming. If we feel emotionally starved by our parents, if we feel ignored or pushed aside, then we typically try to feed our feelings of emptiness with food.

Often times parents feel guilty about their relationships with their kids and they’ll provide the child with ‘something special.’ For instance, if a parent has spent too much time away from the family, they’ll make it up to the child by buying them special foods. That could mean a trip out for ice cream, a bag of chips, some cookies or ‘let’s go to Burger King’. The message behind this is that the kids will be happy for the treat.

Maybe, but the kids would be happier with time spent with their parents and some quality attention from them. Taking the kids out for a treat in place of spending positive time with them, informs the child that they shouldn’t be angry with mom or dad because they’ve been absent, and they should be pleased because they got ‘something special’ as compensation.

Instead of being angry and verbalizing it, the child is taught to stuff down the feelings with food.  Do this a few times and you’ve got the beginnings of a behavioral pattern that can then continue into adulthood. 

For my patient, she realized that going to bed with a coffee cake was in place of going to bed with a partner. A partner could ignore her, as did her parents, and her coffee cake never ignored her and was always available to purchase. Her relationship to food was primary, and her relationship to a potential partner was elusive.

Food is perhaps one of the most difficult addicitions to get under control because the addiction is silent, just as the 'treat' of cookies was often meant to quiet us when we were kids.

Why didn't my patient tell me that she had a coffee cake addiction from the beginning of our discussing her overeating?

It was because she had silenced her addiction, even from herself. 

It wasn't until she unconsciously told on herself by saying she went to the local deli every night. "Every night?" I wondered.

In that moment, she was no longer silent about her addition, she had spoken out loud what she had previously swallowed.

The coffee cake caper had come to light.