cases that follow of clients struggling with overeating challenges, some may seem more relevant to your situation than others. It is, however, important to read them all carefully. Each case illustrates key concepts and principles that will facilitate your understanding of your own relationship with food as a source of comfort.
Even though your personal history is unique, you’ll find elements in these cases that you can relate to. Some of them may bring up unpleasant emotions and memories from your childhood. This is normal and to be expected. Be gentle and patient with yourself as you work through the book. Take it slowly; there is no rush. Hopefully, the path will be exciting and illuminating as you begin to see the pieces of your own emotional eating puzzle.
What’s Love Got to Do with It?
Children whose parents are reliable sources of comfort and strength have a lifetime advantage — a kind of buffer against the worst that fate can hand them.
— Bessel van der Kolk, The Body Keeps the Score
I could tell when I entered the waiting room of my office that Liz was having a bad day. Her eyes were puffy, and her mascara was smudged. Usually she sat comfortably in the large, cushioned chair, distracting herself with her phone or a magazine. Today she was sitting on the couch, her body tense and rigid and her hands clasped tightly on the edge, like a bobcat ready to pounce. When her eyes met mine, her body softened, and she began to cry.
As we walked down the hall to my office, I could feel her desperation. On her drive home from work, she had an argument with her mother, and on her way to see me, she did something that she hadn’t done in six months. She stopped at her favorite donut shop and bought a coffee, four donuts, and two cream puffs. Only one cream puff was left in the bag. She had begun to lose weight in the past couple of months, and she was furious with herself for slipping back into old patterns.
Her mother, whom she described as a “controlling and domineering woman,” had offered to throw a fortieth birthday bash for her, and in trying to firm up the plans, Liz asserted herself and suggested a restaurant she liked. Her mother quickly dismissed her choice as too expensive. And she shamed Liz, accusing her of choosing “an overpriced hole-in-the-wall with fattening food that you don’t need to be eating.” Her mother continued the tirade by highlighting Liz’s high blood pressure and failed attempts at weight loss, reminding her that she wouldn’t have many birthdays left if she didn’t change her ways.
Even though Liz described feeling some anger toward her mother, the bulk of the feelings that came up as we discussed the conversation were about herself and about how she couldn’t ever measure up. Liz often doesn’t feel heard and understood by her mother, who regularly overreacts and dismisses, criticizes, or ridicules Liz’s feelings. As Liz put it, “My mother always wins every argument.”
These repeated misses in communication with her mother, which began as far back as Liz can remember, always leave her feeling bad about herself. Her mother’s support is unpredictable: at times she is very supportive, but at other times she can be highly critical. Liz personalizes these attacks, which leave her feeling ashamed, inadequate, unworthy, and lonely. She feels bad about her abilities to make “grown-up” decisions, ashamed of her body (she inherited a body type very different from her mother’s naturally slim figure), and sad about her relationship with her mother.
Liz’s mother has shown little patience for discussing and processing their troubled interactions. They rarely transition from these negative interactions back to positive ones during the same conversation. After an interaction like this one, Liz and her mother typically go through a week or more of what Liz describes as “cold war” before reconciling, and Liz is the one who “crawls back” and tries to please her mother. It’s just too difficult for her to tolerate her mother’s displeasure and risk abandonment. Liz regularly abandons her own needs for understanding and validation in order to seek approval and secure the attachment with her mother. And Liz shames herself even further because she feels that as a social worker, she should know how to create a healthier relationship with her mother.
Liz’s mother has had difficulty offering Liz a type of care and attention essential to the development of the brain’s self-regulation circuits: attunement. This is the subtle process of adjusting to and resonating with another person’s internal states: that is, being “in tune” with someone else’s internal world. It’s an instinctive process for a parent, but it may be lacking when a parent is stressed, depressed, distracted, or impatient.
Love is not the issue: Liz has never had any doubt that her mother loves her and would do anything she could for her. And Liz likewise loves and respects her mother, whom she describes as “a bright, articulate, and funny woman.” They often have very pleasant times together. The problems generally arise when Liz is anxious or upset and turns to her mother for comfort and soothing, or when her mother strongly disagrees with the way Liz is handling something, like the upcoming birthday party.
Poor Attunement, Insecure Attachments
Attunement is an important component of another process that begins in infancy and childhood and continues throughout our lives: attachment. A vulnerable infant has an innate need to be close to a nourishing and protective other. Our drive for attachment is essential for our survival. Compared to most other mammals, we depend on our caregivers for an extended period. Yet, according to the child psychiatrist Daniel Siegel, a founding co-director of the Mindful Awareness Research Center at the University of California, Los Angeles, only about one-half to two-thirds of the general population have had what researchers call a “secure attachment.”
When we have a secure attachment to a caregiver, we feel safe: we can count on them to protect us from harm and to calm, comfort, and soothe us when we are distressed. We feel that another person senses and observes our inner world and that our needs will be met. We develop positive expectations of interactions with other people and trust that these too will be fulfilling and rewarding.
In contrast, when we have experienced repeated, highly stressful interactions with our caregivers, our ability to form safe, secure relationships with them becomes compromised. This is true even with kind and well-meaning caregivers if they don’t have enough time for us or have difficulty relating to us and meeting our needs. Liz’s father, for example, is a kind and gentle man, but Liz has trouble relating to him because he is forty-five years older, often distracted, and a bit out of touch with her world.
Early attachment patterns create mental maps for our relationships throughout life and guide our expectations of others. Because of her insecure attachment to her parents and a history of being criticized and shamed by her mother, Liz has persistently high levels of anxiety and shame. She doesn’t feel safe and secure in her body or in the world. The shaming she has suffered has created what John Bradshaw, the author of Homecoming, calls “toxic shame: the feeling of being flawed and diminished and never measuring up.” Her shame makes it difficult for her to embrace both her strengths and weaknesses and to develop a healthy level of self-esteem and self-acceptance.
Liz is hyperreactive to intense emotions like shame and their associated bodily cues, such as heart palpitations, muscle tension, and what she describes as “a frozen feeling.” Her internal world is fragile: she is easily derailed by external stressors like her mother’s aggression and her boss’s unpredictable moods. Neural pathways connecting the emotional region of Liz’s brain to the thinking and regulating region have failed to form properly, while other circuits, geared toward
