THE BLOG
04/25/2010 05:12 am ET Updated Nov 17, 2011

Anorexia: Starving For Love

"Place your right hand on your stomach, then place your left hand on top of your right hand, close your eyes and start to breathe slowly and deeply through your mouth," I said to the anorexic 19-year-old woman who weighed barely 85 pounds in front of me.

It was 32 years ago. I was a psychiatry resident at UCLA's Neuropsychiatric Institute and I had finished interviewing a young woman I will call Nancy, and her parents in the emergency room and was now waiting for a bed to be opened up in the In Patient unit upstairs. We had sent her parents home and started an IV on this waif of a girl.

Nancy had been fighting anorexia for four years and this was her second hospitalization. She spoke a little, but what was clear was the conflict between her and her parents -- and between the parents themselves. When I interviewed the three of them together, the more adamant her mother became and the more her father argued with the mother, the more Nancy withdrew.

When I spoke with Nancy alone, she was a little more verbal, but not much more. She answered my questions politely, but flatly with a vacant, defeated look in her eyes. She had hidden her skeletal condition in loose clothes, but there wasn't a place to hide now that she was in a hospital gown.

It was an unusually quiet evening for me, so I had time to spend with Nancy while we awaited for the transfer orders. I had recently taken some training in Guided Imagery, which is a kind of guided hypnosis and a powerful image came to mind as I sat with her.

I told her that I wanted to try a relaxation exercise with her that I thought might help her relax and all she needed to do was visualize what I told her.

I gave Nancy the instruction from the beginning of this blog and continued.

I would like you to imagine that you are laying on your stomach in a crib as a six-month-old and you are experiencing a deep, crampy, stomach pain (colic) and crying from the pain you feel. As you cry you are staring at the door to your room that is slightly open and you can see light coming in from the hall. Now imagine your mother coming in and tenderly picking you up and holding you against her left upper chest and lovingly patting you on the back. You place your arms around her neck as she holds you.

Now visualize that your own arms which are on you stomach are your mother's arms holding you. As you visualize that, breathe in from your stomach with deep slow breaths feeling your hands and arms on your stomach as if they are your mother holding you at six months. Take in a deep breath to a count of six: one...two...three...four...five...six. Now hold your breath for a count of three: one...two...three. Now exhale slowly to a count of seven: one...two...three...four...five...six...seven. Now relax.

I would now like you to visualize and feel that the arms you have on your stomach are your arms as you put them around your mother's neck and pull her close to you, to feel the safety, security and warmth. Take in a deep breath to a count of six: one...two...three...four...five...six. Now hold your breath for a count of three: one...two...three.' Now exhale slowly to a count of seven: one...two...three...four...five...six...seven. Now relax.

Now I would like you to visualize your father coming into your room when you are six months old going over to your mom and putting his hand and arm on top of your mother's as she holds you and visualize your left hand over your right hand on top of your stomach as his hand on top of hers and both of them tenderly holding you. Take in a deep breath to a count of six: one...two...three...four...five...six. Now hold your breath for a count of 3: one...two...three. Now exhale slowly to a count of seven, one...two...three...four...five...six...seven. Now relax

.

As this was happening I could see her eyes quietly crying as if a lot of the pain she was feeling inside her was being comforted and relieved.

"Now I would like you to visualize your parents and you, being connected and everyone caring about each other and visualize you sealing that caring into you. Take in a deep breath to a count of six, one...two...three...four...five...six. Now hold your breath for a count of 3: one...two...three. Now exhale slowly to a count of seven: one...two...three...four...five...six...seven. Now relax.

"Now I am going to count from one to 10 and when we get up to about seven you will start to flicker open your eyes and come back to where we are. One ... two ... three ... four ... five ... six ... seven ... eight ... nine ... ten ... and back to where we are.'"

Nancy gradually opened her tear filled eyes, which now seemed less dull. There was even a faint smile on her which I think was more about relief than feeling happy. I asked her how she was feeling.

Nancy responded, "I feel a little better and do you think it would be okay if I had a chocolate bar before I go upstairs?"

I smiled back and said, "Sure."

And then Nancy was admitted to our In Patient unit.

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