What's Eating You?

Theresa Burke
with David C. Reardon
Forbidden Grief: Chapter 15
Reproduced with Permission

Abortion And Eating Disorders

At 23 years of age, Candice was a woman of striking natural beauty. Like the Ivory soap girl, she had a flawless complexion. A tinge of black roots hid beneath the blond ringlets that surrounded her face. Although petite (about 5'4" tall and barely 100 pounds), she was also quite athletic. At first glance, one might wonder what in the world this beautiful young woman could possibly have to complain about. Yet Candice was thoroughly unhappy. Her impeccable appearance concealed a harsh inner demand for perfection. As she spoke to me, she quickly began to express confusion, guilt, and her fear of being hopelessly crazy.

I'm a miserable bitch. I am never happy. The most miniscule things make me furious. I have absolutely no tolerance or patience. I have no reason to feel this way. I never had any major traumas in my life. It's not like my parents abused me or were divorced or alcoholic or anything.

I do weird things. Food is definitely a problem. It's so disgusting how I am with food. It makes me totally hate myself. I can eat a whole cake or a gallon of ice cream. I get mad at myself and wonder why I am doing it . . . but I can't seem to help myself. Then, when it's over, I feel so gross and so disgusting. I look in the mirror and feel like I want to rip my eyes out of their sockets so I don't have to look at this disgusting person.

I hate myself and I feel so guilty . . . so ashamed. I am uncomfortable in my own skin . . . with my own self. This is so hard to describe. What is wrong with me? I must be crazy. I read a lot of stuff on eating disorders. I wrote a huge paper on binge eating in college. I just don't understand. None of this makes any sense. But I keep doing it. I even leave empty food containers around, half under my bed, and my mom finds them. I get so angry at myself for being so stupid.

Sometimes I think I must want to get caught. But that's crazy . . . of course I don't want to get caught! Who in their right mind would want anyone to see how gross they are!

I've heard this kind of story dozens of times: an eating disorder that becomes the cause of unrelenting shame, guilt, and self hatred; a pressure, organized around food, that is uncontrollable despite the fact that the person seldom enjoys -- and even abhors -- the activity. The food and the surrounding rituals become the obsession that torments. The meal is not used for nourishment or to sustain life, but to punish after a brief period of relief.

I asked Candice why she had come to me for counseling. She responded:

My mom thought that my abortion might have something to do with my problems. I don't know . . . maybe she is right. I never used to be like this. I used to be happy.

Her mother was a nurse who had heard me speak at a conference on pregnancy loss and unresolved grief. What sparked her interest was my discussion of the correlation between abortion and eating disorders. Candice had confided in her several years earlier about an abortion she had undergone as a teenager. At that time, Candice could no longer bear the weight of the hidden event that had turned her world upside down with grief and heartache. She had sobbed for hours as she shared her "terrible secret" with her mother. After that evening, Candice and her mother never spoke about the abortion again, but her mother noticed that Candice was still often angry, depressed, and short tempered. Furthermore, Candice developed bulimia, with episodes of binge eating and purging followed by radical restrictive fasting.

After hearing my presentation, Candice's mother realized that all of her daughter's symptoms had taken root following the abortion. When her mother suggested that the abortion might still bother her, Candice protested with resentment. "I already dealt with that. It's not a problem anymore," she insisted. But her mother's urging, combined with Candice's own doubts, had brought her to my office.

I asked Candice when her abortion had occurred, and she began to tell me her story. Tears surfaced, slowly at first, but within moments she was grieving so intensely that she quickly depleted the box of tissues on the small table at her side. I replaced it quietly as she continued to share her pain and tears.

When I first found out that I was pregnant, I was shocked. It was hard to believe that my body was actually making a baby. Initially, it was mysterious, frightening . . . but also exciting.

My boyfriend and I had tickets to an outdoor concert the night we found out. I remember lying on the ground watching the stars and feeling so special, even though I was afraid. We drank wine out of little cups I brought, left over from my aunt's baby shower. While all the fear and joy swirled round in my heart like a dizzy merry go round, my boyfriend Jim was seeing things differently. While I was picking out cute little names, he was using words like our "circumstance" and "accident." From my perspective, it was not really an accident. We used to talk about having a baby all the time . . . but it was always some future event that would happen after we got married. His apprehension soon turned to coldness and distance.

It happened all in one night. The next morning, we were on our way to an abortion clinic to take care of the problem. Jim did not feel we were ready for the emotional and financial commitment of marriage. He wanted to go to law school and thought it would be hard enough without a baby to distract him. I had to agree. This was the only way that we could secretly rid ourselves of the crisis at hand, continue our education, and defer marriage until we were ready. I would also spare my parents the embarrassment of an unplanned pregnancy. Jim reminded me how hurt they would be. It was becoming clear that abortion was the logical thing to do.

I allowed Jim to control the situation completely. Although on one level, I felt like he was being supportive of my needs, inside I felt so alone, so utterly alone and abandoned.

Sympathetically I responded, "That must have been difficult." This little acknowledgment was enough to release an eruption of deeply felt shame, anger, and agonizing grief. Candice expressed tremendous relief at finally being able to admit her feelings of loss and to have them validated by someone who did not think she was crazy for feeling that way. She continued her story -- like a twig plunging over a waterfall, there was no turning back. As she finished, she said:

I always think I've gotten over the abortion, and then it all comes back as clear as yesterday and I can't bear the pain. I guess this is why I never think about it. It sucks to feel all this crap. It's easier to push it all out of my head.

Powerful Symbols

As I shared at the beginning of this book, my analysis of abortion trauma began while I was working with women who suffered from anorexia and bulimia. At the time, the subject of abortion was so objectionable and anxiety laden that even my supervisor instructed me to avoid the issue.

In the years that have followed, I have been repeatedly amazed by the intensity of the feelings of grief, anger, rage, and betrayal surrounding clients' abortion experiences. I have also been deeply saddened to see how long women have carried these destructive feelings inside, never to be shared, released, or even recognized. In many cases, these repressed feelings are channeled into eating disorders. In the Elliot Institute survey of women who had been involved in post abortion counseling programs, 38.6 percent of the women reported having had an eating disorder (bulimia, anorexia, or binge eating) after their abortions.

Food is a powerful symbol. It is central to our human experience. We need it. We crave it. But we will also at times reject it -- when it is distasteful or unhealthy, or when we are full, or ill, or dieting, or fasting.

It is no wonder, then, that food and eating are loaded with conscious and unconscious symbolism. For example, the familiar question, "What's eating you?" can truly capture the reality of the gnawing distress in the pit of one's emotional gut. Depression and guilt can devour one's life, both figuratively and literally.

From the moment we are born, we are nurtured with food. For the infant, mother's milk and mother's love are inseparable and synonymous. The caress, the taste, the security, the comfort, the nurturing of body and soul -- all are tied together in a single experience. Perhaps this is why, even after infancy, we often use food to comfort a crying child. We also use food to comfort ourselves. Depression, or simply boredom, will often lead us to seek out the comfort of food -- not to appease any physical hunger, but rather to minister to our emotional hunger, which it never quite fills.

The symbols surrounding food and eating are nearly endless. As children we are often told to swallow our words, and the negative feelings that go with them. Repulsive people or experiences make us want to "puke" or "vomit." When we are angry, we may become "spitting mad."

As described in chapter ten, traumatic reactions are often played out in veiled, symbolic ways. Eating disorders are just another way in which some women recreate emotions (such as shame) or bodily sensations (such as a swollen abdomen) that are connected to their unresolved abortion. In most cases, women will not consciously understand the significance of this physiological reenactment. Compulsive overeating, anorexic tendencies toward starvation, and the bulimic cycle of binging and purging are all usually accompanied by a fixation with food, weight, and body image.

Women generally feel trapped by their eating disorders -- continually doing something they despise and detest. For many, this reenacts the experience of feeling trapped into choosing an abortion.

Food often symbolizes the need for love and nurturing. When the desire for love is not satisfied, it is experienced as having painful consequences, and therefore, is something that must be eliminated. Fear of intimacy can become fear of fat -- and yet the intense hunger remains, always present, like the predictable rising and setting of the sun.

Despite the changes in women's roles in the modern world, many women lack the skills necessary for self preservation. Many give themselves up to the goal of satisfying another and accept "powerlessness" as a way to keep the other person from disowning them. Many women are "pleasers," who will go to nearly any extreme to avoid hurting other people's feelings. Some can only express their feelings of rejection and hurt in a symbolic way, through their bodies, emaciated by anorexia or bloated by overeating. For such women, eating disorders are their primary means of communicating the incommunicable. Through appearance or behavior, the woman is crying out, "I'm not okay! I'm in tremendous pain! Can anyone help me?"

On the other hand, some women feel the need to completely hide their pain. Not only do they want to look normal, but they need to look flawless. Bulimia allows such women to engage in the symbolism of binging and purging without the weight gain.

Vomiting Secrets

Sandra's eating disorder developed shortly after her abortion. It took her nearly two decades to even say the "a" word, which she avoided with fervent commitment. Reflecting on her experience 18 years later, Sandra described her memories:

I consciously put the abortion out of my mind. It was, without a doubt, the most grievous and shattering event in my life. I was appalled by what I had done, but I could not take it back.

After my abortion, I spent the next three days lurched over a toilet . . . and to be honest, I've been there ever since. I heaved again and again until there was nothing left. I wanted to rid my insides of the disgust, violation, and utter revulsion I felt within me. There are really no words to describe the acute agony and nauseating grief. After that, I completely disconnected from the source of my pain. I buried it deep . . . so deep . . . into an unconscious oblivion.

Yet, I was left with an emptiness that needed to be filled. I tried filling it with food, drugs, alcohol, sex . . . anything that felt good and would take away the pain. But those things only lasted a short time, and the pain would return, worse than before. There was no one who could understand how I felt . . . there was no one to talk to. I had to swallow all of it.

Bulimia is an eating disorder that involves a vicious cycle of binge eating followed by purging to try to get rid of unwanted ingested calories. The duration and frequency of binges will vary from person to person. Sometimes they are carefully planned and executed. For others, the binge is sudden, impulsive, or recklessly driven by anxiety. Purging techniques typically involve induced vomiting and the abuse of laxatives and diuretics. Other methods include excessive exercise, fasting, diet pills, and enemas.

Through bulimic behaviors, food is used to symbolize efforts to ingest and then expel disagreeable feelings. Unresolved emotions, like undigested food, must be rejected from the body. Vomiting can be a way to evacuate anger and rage. In Sandra's case, the compulsion to vomit was closely associated with the days immediately following her abortion, when she lay "lurched over the toilet." In the years that followed, even when she was able to repress thoughts of the abortion, the need to vomit was serving as a connector to her hidden grief.

Some women develop eating disorders after their first sexual experience. When a girl loses her virginity to a man who then carelessly rejects her, the experience can be quite traumatic. Perhaps this is due to the fact that, in their sexual nature, women are receptive. When a young woman allows a man to enter into the deepest personal and most privileged space of her being, it can involve a tremendous gift of faith and trust. In giving herself sexually, she is giving all of herself -- her love and affection -- in return for being esteemed and special, connected and belonging. When this sexual covenant -- the gift of her love, trust, and virginity -- is violated or betrayed, she may internalize profound feelings of rejection and unworthiness. When the broken sexual relationship also involves an abortion -- a violation of her maternal nature in addition to the "theft" of her virginity -- this double betrayal is even more likely to be traumatic. Such was the case for Rickyann:

My first love left a real bad taste in my mouth. I was certain that I would never love again. I felt like I had given up my virginity for nothing. When I got pregnant, it was so easy for my boyfriend to dismiss our relationship when he became interested in another girl.

I blamed myself. I was certain that something must be wrong with me. I should be prettier, or thinner, or smarter. I desperately wanted his attention. It was hard to believe that he could so easily just flush it all down the toilet. My eating disorder began after we broke up and I had an abortion.

Rickyann believed that something inside her was bad. She focused this irrational conviction onto the food she ate and felt a compelling need to throw up everything she ate. Keeping it inside her made her feel poisoned and toxic. She had to get rid of it, traumatically recreating the rejected relationship and pregnancy. As Rickyann accurately recounted, "It was hard to believe he could so easily flush it all down the toilet." Yet, through her preoccupation with her eating disorder, Rickyann continued to flush her own life down the toilet. She was certain that intimacy, like food, was toxic to her health. So her obsession gave her a reason to avoid getting involved with another man.

Rickyann's bulimic ritual, whereby she ingested the nourishing comfort of food and then expelled it with tears of shame and humiliation, mimicked both her need for intimacy and her sense of violation and betrayal that followed her own rejection and abortion -- both of which left her grieving and empty.

Joan never thought she would have an abortion. But when faced with an untimely pregnancy, it seemed her only way out. After the abortion, she felt an immediate sense of relief. Her problem was behind her. But in the years that followed, whenever she experienced feelings of anxiety or panic, Joan would calm her terrors by retreating to the kitchen for a prolonged eating binge. There she would gorge on bowls of ice cream smothered in chocolate sauce, microwave pizza, potato chips covered in mounds of gooey onion dip, and chocolate chip cookies chased with milk. (Joan explained that lots of milk made it easier to vomit.) She would eat until her stomach was bloated and full, resembling the pregnant state. When she could no longer tolerate the swelling, she would purge herself by vomiting. This ritual became a deeply ingrained habit. Its persistent repetition was a convincing indicator of the reenactment of an underlying trauma.

Following these binges, Joan experienced a soothing sense of relaxation. Endorphins, chemicals released throughout the body after vomiting, provide a tranquilizing aftermath, calming hostile impulses and soothing agonizing emotions. Endorphins also are a means to medicate depression and provide a temporary relief from sadness and grief.

Joan's initial sense of relief, however, was soon replaced by feelings of self hatred and disgust. The traumatic secret of her abortion and all her anxious feelings about it were repositioned and concealed in her frenzied bulimia. Every time, she swore she would never do it again, but she knew she was too weak to resist, just as she had been too weak to resist using abortion as her "easy way out." Joan's bulimia provided an outlet for her traumatic tension. Through binging, she continually reenacted the swelling of her pregnancy. Through purging, she reenacted the "quick fix" relief that followed her abortion, which would then subside and be replaced by self loathing, guilt, and increasing feelings of anxiety.

Brittany, a 42-year-old schoolteacher, also suffered from bulimia. Like Joan, she felt initial relief after the crisis of her pregnancy was over. Yet she admitted feeling a ghastly disgust about the vacuum abortion she had undergone at the age of 20. For many months following the abortion, she suffered from vivid flashbacks and intrusive thoughts of the dismembering and suctioning of her fetus.

Some of my thoughts were so horrible. I could not live with myself if I continued thinking about it -- so I just stuffed it all away. Eventually, I never thought about it anymore and moved on with my life.

Brittany's eating disorder began around the time of her anticipated due date and lasted for the next 22 years. Her repressed grief and disgust became ritualized through bulimia. The feelings she buried would surface again and again. Each retching episode recreated the expulsion of something inside her, something that had once been whole but was now a rejected river of chopped, masticated food, which symbolized her horribly dismembered child.

Brittany's bulimia reduced her to the state of an emotional prisoner. The obsession to binge consumed her relentlessly. Her preoccupation with food interfered with her job and relationships. Above all, her clandestine activity represented a secret she believed would destroy her if it were discovered.

It was easier for Brittany to feel revolted by throwing up than to deal with her disgust stemming from the abortion. She described her abortion as "the sleaziest thing I could ever conceive of," and "my dirty secret." Brittany described her eating disorder in similar words: "loathsome and repugnant." Vomiting after every meal was another "dirty little secret." Brittany went to great lengths to conceal her eating disorder from others, just as she concealed her pregnancy and abortion. She was incapable of asking for support for her emotional pain and spent years tending to an unnamed, festering heartache.

Brittany's emotional trap makes me think of pop singer Fiona Apple shrieking out the lyrics, "I've got my own hell to raise." Since Brittany could not tend to her aborted baby, she created a phantom substitute that demanded her all consuming attention. In her eating disorder she found a nagging and hungry extension of herself (an unconscious memorial to her unborn child) that needed to be constantly fed.

After finally dealing with the loss of her child, Brittany recovered, too. Her first step in freeing herself from the secrets that imprisoned her was opening up a door for support. By opening the locked chambers of her grief, she was finally able to reconnect her mind to her body.

Often, physical reactions originally associated with a traumatic experience will be precisely and repeatedly mirrored in subsequent physical reactions brought on by obsessive behaviors. This was the case with Carrie, whose eating disorder involved the abuse of laxatives to purge. It was not unusual for Carrie to consume an entire bottle of purgative drugs with the hope, as she put it, of "getting it all out." After hearing this, I was not surprised to subsequently hear that Carrie had endured an incomplete abortion. This means that parts of the unborn baby were left inside her during the abortion, causing bleeding and excruciating cramping. She had to return to the abortionist to finish the job and "get it all out."

It was evident to me that the intestinal pain Carrie experienced after her binges and laxative abuse provided a recreation of the cramping she experienced after her abortion. The theme -- a desperate need to "get it all out" -- was a precise echo of her traumatic abortion. The repetition and cramping were evidence of a buried psychic trauma -- an expression of body memories which needed a means to reveal themselves. When I made this interpretation to Carrie, she remarked, "You just made my blood curdle."

Often the significance of physiological reenactment does not reach consciousness. For Carrie, her cramping was a veiled narration of her repressed abortion trauma. My connection of her condition to this traumatic event triggered a moment of truth. As a result, she experienced a tremendous amount of relief. In her 11-year battle against her eating disorder, she had been in hospital treatment facilities, support groups and individual therapy. But it was not until she began to deal with her abortion and the feelings of shame, disgust, and hatred of what circumstances "forced" her to do, that she began to experience relief from her obsessive need to use laxatives to eliminate all the food she had eaten.

Interestingly enough, Carrie's food binges were typically in response to the stress of work deadlines. In recovery, she recalled intense pressure to make the decision about her abortion quickly because she was told she was almost past the abortion clinic's deadline for having one. After that, deadlines became the trigger for an unconscious pattern of trauma driven reenactment. The pressure of deadlines, filling herself up, purging herself, and cramping all reflected key elements of her unspeakable story.

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