Tuesday, June 18, 2013

Anorexia & Bulimia: Early Abuse & Perverse Disturbance!

In years of Child Psychiatric work, the saddest thing about abuse is the perverse disturbance that seem to affect many victims. The number of children that were physically abused and yet found themselves married to abusive partners is well known, often repeatedly.

The sadder picture is that of sex abuse!

©2008 Am Ang Zhang
      That Chris’ mother should have been the patient was obvious from the first time I met her. She indeed saw a psychiatrist before moving from Dorset. She had been hospitalised for Anorexia Nervosa.
      She was cured. She got married. Then she had Chris.
      If she did not tell me, I never would have guessed she had Anorexia Nervosa.
      At first I did not even know how I knew.
      “She was a very good looking woman,” my secretary told me one day, “she hasn’t got a bad figure either.”
      Doctors are not supposed to notice these things and if they do they have to keep it to themselves.
      That was the discordance. She had a good figure. Many recovered anorectics cannot maintain a nice balanced figure and I am quite sure it is to do with the various hormonal upsets from the extreme dieting, a sort of gonadotrophin stimulating hormone problem.
      She did have fertility treatment in order to have Chris. She would feed me with information now and again.  Perhaps that had something to do with it.
      Chris was difficult, but no more than the average single parent child. His father had long since disappeared.
      Was Chris’ behaviour one of the reasons she consulted me?
      She was one of those mothers with lots of questions, and I am one of those psychiatrists who wanted parents to find their own answers.
      In psychiatry knowing the answer is no guarantee to a cure. In fact it is the same in many branches of medicine as we still have so many incurable diseases. Parents do want to have the answer and of course in the commercial world there are now doctors that cater for that desire. A nice label, be it ADHD, ME, Autism or Asperger.  As long as there is a technical sounding name people are happy. If you can have a specific drug, so much the better.  If not you may get special education, benefits or both.
      As long as it has nothing to do with “upbringing”.
      But upbringing could be trans-generational.  What happens to one generation can have an impact on the next generation.
      Many parents want to look at the here and now and a quick fix answer.
      One day mother told me, “I am bulimic!”
      Then she took out some capsules and said that she could not have those as she could not have an orgasm.  She had been seeing an adult psychiatrist but came to me for the problems she found too embarrassing to discuss with her own psychiatrist.
      She had a new boy friend who was much older than she was and he was a pilot.
      She wanted me to see him to explain about the side effect of her medication.
      “I am taking 60 mg.” she told me.
      I did wonder, as the 20 mg dosage might have been less problematic.
      I declined the request and she was rather disappointed. She accepted my reasoning – I did not initiate the treatment.
      Three weeks later she told me she broke up with him.
      Then she told me she normally could not have an orgasm unless she imagined she was having sex with an older man. She then thought it might work with having an older boyfriend.
      As I listened mother decided to tell me more.
      She had been abused by her father from about the age of twelve and the awful thing for her was that she actually enjoyed the sexual side of things. It was an abuse she found hard to come to terms with. She could not hate her father because when she came out of hospital after her Anorexia, she had no breasts to speak of. Her father paid for implants, twice.
      When Chris’s father left he bought a house for them.
      He paid for her private treatment for Bulimia.
      Worst of all, she had to imagine her father whenever she made love to have any chance of an orgasm.
      No. She had never told anyone else before.

                                                   From The Cockroach Catcher 

You may also want to read about  Amanda.

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