Di life script currency analysis

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One and Only ++
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Food +++
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Words ++

Analysis

Food
Games - Obesity, anorexia, bulimia
Stage - Oral
Lifestyle/occupation - body builder, dietician, cook, calorie counting, mother
Illness - stomach problems, mouth ulcers, IBS,
Therapist - eating disorders, weight loss counselling, alcohol/drug/cigarette counselling
Personality - Schizoid, borderline, antisocial, narcissistic
Issues - can life and death, control, sexual avoidance issues.



As this is an oral issue stage the consequences can vary considerably. Some who have an oral stage fixation can have few difficulties at all and have a work life like Jamie Oliver. On the other hand there can be very real life and death issues. This can result from over eating, under eating or highly restrictive diets and exercise regimes that can be dangerous. Or drug issues like alcohol and cigarette addictions can all result from oral stage fixations.

In females there can be issues around sex. Sometimes (but not all ways) the anorexic woman is protecting herself from sex (and a sexual relationship) by making herself unattractive to males and trying to make herself prepubescent again. The overweight woman may be also trying to make herself unattractive to males so as to avoid sex.



Dependency in relationships can be problematic. The two extremes by either being overly dependent on others or never being dependent on others. Oral stage issues can respond well to therapy and can include working out the relationship dependency issues in the transference with the therapist.

Graffiti

The male anorexic

Last year I ran a workshop in Serbia where I did an in-depth examination of anorexia nervosa and a variety of other clinical states. At the beginning of each different condition I gave the usual statistics about the condition. For anorexia one was that 95% of anorexics are female.

A little later on in the workshop one of the participants asked me about the nature and psychodynamics behind the male anorexic to which I had to answer that I did not know. I cannot recall ever reading such a thing nor recall ever working with such a person.

Well as it happens in the last month I have a new client who could be considered to have some of the criteria of anorexia and he is male. As you can imagine he is of considerable interest to me. Upon some reflection it seems that the way anorexia is currently defined it rules out the vast majority of males. So one reason why 95% are female is simply because how the condition is defined.



Thus one could argue that there are indeed more anorexic males but they are not diagnosed because of how the condition is currently defined. Its not that male anorexics don’t exist its simply a definitional problem for the condition that is heavily weighted towards the female psyche.

The usual criteria of anorexia is:

Refusal to maintain a minimal normal body weight for age and height
Intense fear of gaining weight or becoming fat
Disturbance in the way one perceives ones body weight, shape and size.
In females the absence of at least three consecutive menstrual cycles.

This man is in his late 20s and is currently quite thin. He reports that he has had trouble gaining weight since his late teens. At times he has been dangerously thin. He has never been hospitalised but he has always led a very isolated life so he is unlikely to be identified as in danger of dying. He reports that he simply does not eat. There have been times where he has eaten nothing for up to 5 days at a time.



He states that this is a rebellious act as in childhood mother was very forceful about him and his siblings eating all their food at the dinner table. There are many memories of mother demanding that he eat up all his food. Physical punishments were used when food was not correctly eaten. He has a low self esteem, a self hatred and passive suicidal urges. That is he does not actively plan suicide attempts but he has consistent and strong wishes that he was dead.

If one looks at the four criteria of anorexia, obviously number 4 is about females. Number 2 & 3 one could argue are much more female oriented. As a group women are more interested in how much they weigh and about their body shape and size. One simply has to survey the media and one sees endless images about female weight, body shape and size. In comparison there are very few images involving men. Cosmetics, clothing, plastic surgery all indicate the same. That women are much more focused on weight, body shape and size compared to men.



As a result one could say that the current definition of anorexia is sexist. Very few men are going to meet the criteria because the intense focus on body weight, shape and size is much less common in the male psyche.

However there maybe men out there who refuse to maintain a minimal normal body weight for age and height but the other criteria are different. Maybe I have begun to identify some of the other criteria with my single male client. Low self esteem, self hatred and suicidal urges. He is but one person and thus one is most cautious in generalising. However, when I run my next workshop on eating disorders and I get a question about the male anorexic I can now at least give a partial answer.

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Anorexia and loss of control - Part 4

Some anorexics report a sense of being out of control. They may say things like:

“I had to gain some control back from my body while I could.”

In Transactional Analysis terms this is quite clear to explain.



The diagram shows a person with weak Adult and Parent ego states. This leaves the Child ego state on its own and it will feel a sense of anxiety. It may also feel a loss of control because the Child ego state does not have the ability to regulate itself.

In the usual functioning personality it is the Parent and Adult ego states that regulate the Child. It is the Adult and Parent who tell it what time to go to bed, what foods to eat and not eat, when to be polite, courteous and so forth.

Even if the Child ego state protests against the restrictions it will also like them because it gives a sense of stability and a sense of control in its life. What would happen if you said to a six year old girl, “You can eat what you like and go to bed whenever you like?” It is quite likely the child would live on lollies, soft drink and pizza and go to bed at any hour of the night or day. The Free Child ego state runs rampant. Whilst that may feel good for a little while sooner or later the youngster is going to have a sense of loss of control because it is out of control.



With the anorexic for some reason the same situation is being played out in adolescence and adulthood. For some reason a strong Adult and Parent did not develop. Or at least for some reason they are not currently functioning in a robust way.

This is quite easy to diagnose and a treatment plan is quite clear. There is a need for Adult ego state strengthening such as described here.

One also would want to develop the Parent ego state. This can be done by the client introjecting the therapist into their Parent ego state. Alternatively the person can practice imitating others who function well in their Parent ego state. This will build up the strength of the Parent ego state tapes. This is described in much more detail here.

As the Adult and Parent ego states develop the individual will report more of a sense of safety inside and thus the sense of internal control increases.

To observe how the three ego states or parts of the personality are relating one can set up a simple 2 chair exercise. In one chair sits the Child ego state or the small child in the client. In the other chair sits the big person which is a combination of the Parent and Adult ego states.



The person then sits in each of the chairs and speaks from that part of self reporting what they think and feel and dialogues to the other chair. Those who sense a lack of control when asked to speak from the P/A will present as ineffectual, lack a potency or be at a loss to say much at all. Then when in the C chair the person will report a lack of trust or faith in the P/A to look after them or deal with life's problems as they present.

This is quite an easy and simple technique to do and can be used reasonably often to assess what is happening between the different parts of the personality and to do self parenting exercises to build the Parent and Adult. Once the person has done it once or twice they can easily slip into the parts of the personality and perform the exercise.


Loss of control?

Graffiti

The anorexic relationship - Part 2.

The internet really does provide some interesting insights into the human psyche at times. An example of this is the Pro-ana (Pro-anorexia) websites. I had look at these a few years ago and then a couple of days ago. There are now hundreds which I found in a few minutes so there are probably many thousands of them out there.

For example:

Pro Ana Tips and Tricks

Pro ana sites here’s a list of great sites

A most interesting social phenomena to arise via the internet.

Here is some information from them

There is no such thing as an eating disorder. People have anorexic and bulimic life styles because they pursue perfection. Just like elite athletes, musicians and others pursue it. Perfection is beauty

Pro-ana 10 commandments
1. If you aren't thin you aren't attractive.
2. Being thin is more important than being healthy.
3. You must buy clothes, style your hair, take laxatives, starve yourself, do anything to make yourself look thinner.
4. Thou shall not eat without feeling guilty.
5. Thou shall not eat fattening food without punishing oneself afterwards.
6. Thou shall count calories and restrict intake accordingly.
7. What the scale says is the most important thing.
8. Losing weight is good/gaining weight is bad.
9. You can never be too thin.
10. Being thin and not eating are signs of true will power and success.



Secrecy tips
Don't bring up the subject of food around other people. Have your excuses for not eating ready in case they should bring the subject up. Some excuses I use : "My stomach's a little upset", "I'm too (tired, excited, nervous, busy, etc) to eat", "I don't feel like (whatever food it is), I'll get something later", "I did eat, didn't you see?", and "I stopped by (Burger King, Subway, etc) earlier".

Don't deny everything if confronted. People will believe a little truth with a big lie much easier than a huge lie. Act as if it's no big deal instead of reacting emotionally and people will tend to believe you.

Watch where you dispose of uneaten food or other "evidence", make sure that it isn't going to be seen or found by anyone. Wrap food up and throw it away outside the house. If you live alone, always take the trash out before anyone else comes over.

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In the previous post on the anorexic relationship I mentioned how food refusal was a very primal and basic act of rebellion. I think it is safe to say that these comments placed for public viewing on the internet are a rebellious and defiant act at least in part. These people know how some others will react to them and that will be with the Critical Parent ego state.

Guess what?
Now we have Anti Pro-ana websites or comments on the internet

Anorexia on the internet

Pro-ana website dangerous to young women

Pro-ana websites

This last one makes the interesting statement
“Many sites treat eating disorders as lifestyle choices, rather than the illnesses they truly are”. (end quote)

Two things I would like to say. First this demonstrates the anorexic relationship dynamic of the RC and CP transactions. The pro-ana sites are being ‘naughty’ and doing things which they know authority wont like and that authority will respond by ‘scolding’ them.

RC: “I am going to hurt myself in front of you and you try and stop me”.
CP: “You shouldn’t do that and I will try and stop you, (in this instances by trying to ban Pro-ana websites)”.



This transactional dynamic will perpetuate the anorexic behaviour such that the psychology behind the anorexic behaviour is reinforced. In this case the dynamic is being played out over the internet instead of between counsellor and anorexic in the therapy room or hospital and anorexic on the inpatient ward. This model presents anorexia as a relational experience.

It also shows how the anorexic can force the authority to become involved. The anti pro-ana sites are correct. The information provided by the pro-ana sites will adversely affect some young girls who read them. So what does the authority do?

If they do nothing, thus avoiding playing into the anorexic relationship and thus don’t reinforce the anorexic behaviour young girls will continue to be adversely effected. If they act to have the information stopped then they play into the anorexic relationship. Then it is highly likely the authority will be perceived as CP by the anorexic even if they are not being CP.

In addition.
Why aren’t there pro-depressive or pro-insomniac websites which provide secrecy tips or promote insomnia and depression? Why are there no websites promoting an insomniac or depressive life style?

Maybe because these conditions do not have a rebellious aspect like anorexia and anorexia involves a style of relating whereas depression and insomnia do not. Depression and insomnia don’t need an insomnia relationship or depressive relationship for the condition to continue like anorexia does.




There is however also a healthy aspect to pro-ana websites. A person with anorexia has been told over and over either covertly or overtly that she is sick, dumb, naughty, bad, selfish, neurotic and so on endlessly.

At least some of the Pro-ana websites are saying:
“I’m anorexic and I’m OK”, with comments that follow the statement before:

“Many sites treat eating disorders as lifestyle choices, rather than the illnesses they truly are”.

This may be the Free Child aspect of the anorexic saying, “I want to survive and grow towards health”. They reject what the helping professionals say to them about being sick, neurotic and so forth. They say I am a good person even if I choose the anorexic life style. From a therapeutic point of view this is a most positive move. It is going to reduce the psychopathology due to the acceptance of self as OK no matter how they live.

This exposes an inherent contradiction in all psychotherapy and counselling. On the one hand the therapist says to the client that they are ok and good and acceptable. However, the therapist also says there is actually something wrong with you or you wouldn’t need to come to therapy in the first place. By the very act of me being a therapist I am saying to the client that there is something in you that needs to be changed and the Child ego state of the client is very likely to take this as it having something wrong with it or is bad about it.

The pro-ana websites are rejecting this contradiction and thus it is a healthy move by them.

As you can see the pro-ana movement is a most interesting phenomena which is quite complex and has both good and bad aspects to it.

Graffiti