Karissa suffered from anorexia nervosa. Anorexics typically lose a significant amount of weight due to extreme dieting and a harsh regime of exercise. Although she may become disturbingly thin, an anorexic patient will consider herself fat, no matter what her actual weight is. Even at 80 pounds, a woman suffering from this disorder will perceive herself as overweight and continue dieting -- even to her deathbed. An estimated 10 to 20 percent will eventually die from complications related to this illness.1
Karissa became emaciated and gaunt within several months following an abortion. Her eating disorder was a disturbing metaphor that symbolized the emptiness she felt inside. After her abortion, Karissa said:
Nothing matters anymore. I feel so empty inside. I regret what I have done and the pain is deeper than anything I could ever imagine.
By cutting off her own life giving nourishment, Karissa reenacted the withholding of nourishment from her baby. Anorexia became a slow draining away of life that echoed the life lost because of her abortion. Karissa hid her protruding bones beneath bulky sweaters and baggy sweat pants -- repeating the way she had tried to hide her swelling pregnancy and concealing her need for help, love, and protection.
Angela had also battled anorexia since age 16. Before her abortion at age 15, Angela was a well endowed, curvaceous young lady. But her body had betrayed her by becoming pregnant against her will. Anorexia provided a means to symbolically de sexualize herself. In Angela's case, starving her body reflected an unconscious effort to get rid of her body: her breasts, her hips, or any part of the body that made her sexually attractive. In the past, her sexuality had only brought forth pain and conflict, so she needed to get rid of it. Her body, admired and taken for the sexual pleasure it offered, had brought forth an unwanted pregnancy, abandonment, and death by abortion. It did not deserve to be fed.
In addition to de sexualizing herself through her unattractive, skeletal appearance, Angela's anorexia also caused her menstrual cycle to cease. Amenorrhea (the cessation of a woman's menstrual cycle) is common in anorexics and often reflects their need to be little girls again, not yet ready for sexuality. By refusing to eat, Angela was able to revert to a pre menarchial (pre menstruation) state of development.
While amenorrhea can be associated with a more childlike, pre sexual state, it can also be associated with the desire to recover the aborted pregnancy. A woman's missed period is generally the first symptom that calls her attention to her pregnancy. In this regard, some postabortive women who suffer from anorexia may experience the absence of a period as a reason to fantasize about being pregnant, or conversely, obsess over fears of being pregnant. Either may provoke an obsessive concern over any bulges in her abdomen. The slightest evidence of abdominal swelling symbolizes early pregnancy. This unconscious preoccupation provides some understanding about the panicky response of post aborted anorexic patients to the slightest evidence of a tummy and their zealous attempts to starve it away.
Nicole's anorexia was rooted in issues of control. Her parents had made the choice and forced the abortion upon her. Since her abortion represented a complete lack of control over her own future and ability to fight, Nicole took control with food, the only thing in her life she felt she had the right to command. Through her drastic control over her food intake, Nicole was declaring her right to control what went in and what came out of her body.
In the truest sense, Nicole was a survivor of an abuse/death experience. She survived, but her child did not. This traumatic encounter buried the seeds of acute survivor guilt. Her body, emaciated from starvation, signified her hunger to not exist. Through her self destructive wasting away, she was also punishing her parents: "If I couldn't have my baby, you can't have yours!" In recovery, it was essential that her parents participate in the grief process and validate her loss. Her condition gradually improved only when her family dealt with the trauma and began to reconcile the experience.
Compulsive overeating is distinguished by uncontrollable eating and consequent weight gain. Those who engage in chronic overeating usually feel out of control and incapable of monitoring their intake. They feel a disturbing sense of powerlessness, shame, guilt, and incredible failure. They typically exist from diet to diet, struggling with continual stress over the desire to lose weight. Compulsive overeating for many people begins in childhood when eating behaviors are formed. Many never actually learned effective ways to deal with stressful situations and so use food as a way of coping. On the other hand, I have encountered many women who reported that their impulses to gorge on food began only after stressful abortion experiences.
Some women might gain weight after an abortion as a means to insulate themselves from others, particularly men. Overeating is an unconscious attempt to distance oneself from the traditional features and social situations that oblige a woman to be sexually desirable. Carla, an artist with a large advertising agency, gained 55 pounds after her abortion. She explained:
I used to weigh 120 pounds and I loved to work out. Since my abortion I have gotten into the habit of eating when I am not even hungry. I realize now that getting fat has been a way for me to protect myself. I have been afraid of intimacy. Since my abortion, it has been hard to trust people, especially men. All this extra weight keeps me off the beach and at home on weekends . . . it just seems easier. The abortion changed my personality as well as my eating and exercise habits. I'm not the person I used to be . . . I don't even look like her.
Compulsive overeating may provide momentary comfort and nurturing. People can use eating as a way to calm and soothe anxiety, tension, and emotional pain. It can also become a nervous compulsion that provides a gateway to protective defenses. Overeating may satisfy an unconscious desire to isolate oneself from the source of trauma. After a painful abortion, a woman may try to disconnect fran the sexual appeal of a beautiful body. Extra weight can provide a sense of protection from the risk of emotional intimacy.
Barbara became obese following her three abortions. Her hefty weight gain progressed for 12 years until she reached the dire point where she could no longer walk. Eventually, Barbara was fired from her job and ended up on disability. She was also plagued by severe health problems arising from her obesity. Barbara had an unconscious desire to punish herself by becoming as ugly, vile, and defective as she felt inside. Fortunately, Barbara recovered from this insidious expansion once she began to hoist her painful memories and feelings out from under layers of denial, repression, and avoidance.
Laura's boyfriend accused her of allowing pregnancy to occur in order to trap him. She immediately took all the blame and decided it was her job to fix the problem. Certainly she did not want to "force" him to marry her. The pressure to abort was quite subtle. Driven by guilt for a mistake for which she accepted all responsibility, Laura had an abortion. She felt compelled to do this in order to make her boyfriend happy. Conditioned to please, Laura did not want others mad at her. In addition, because her pregnancy was devalued by her boyfriend, she became ashamed of her unique and beautiful capacity to bear children.
Within one year of her abortion Laura had gained 105 pounds. Nothing seemed to fill her emptiness. She described seeing herself in the mirror: ripples of flesh hanging over each other, stretch marks ingrained in deep hues of purple. The sight of her naked body generated intolerable disgust and shame. Laura wrote in her diary:
I feel so pathetic. I'm tired of fighting. I'm dying inside -- weak, misunderstood. No one understands how much I miss my baby! My soul? Anguished and screaming. I hate it so much. I can't accept myself in this state. I've let people control me and shape me into this horror, this angry person who can only hate those I used to love.
Laura's dramatic weight increase and personality changes were indicative of an attempt to show her internal devastation to the external world. The painful death of her former sense of self reenacted the death of her unborn child. She was trapped in an obese body which she could not escape, heartbroken that her embryonic motherhood had been crushed and pillaged. The grief and disgust she experienced over her body image was a metaphor for a soul entangled in intolerable affliction. Her figure became her symptom -- an outward display that invited the criticism, loathing, and rejection of others. Her body had been reshaped to keep people at a distance, even though the resulting isolation and rejection drove her to despair.
Obviously, not all women who have eating disorders have experienced an abortion. Certainly there is a legion of complex sociological and cultural factors and media influences that may contribute to the development of an eating disorder. However, whenever an eating disorder begins after an abortion, it is essential that the issue of post abortion trauma be explored. Recovery can be challenging, because using food to devour emotional pain can become an entrenched addiction. Through psychotherapy, however, the woman is helped to talk about these underlying feelings so they can be exposed and understood. In this way, she will begin to develop new coping skills to replace the addictive, repetitive nature of the eating disorder. This is why the treatment for eating disorders is often referred to as "the talking cure."
A pivotal goal in recovery is learning to speak up and find words for the soul to express its pain and release its inner agony. The nature of trauma is that it violently shocks the foundation of our beliefs about safety and shatters our assumptions of trust. A fortress of defenses can skillfully keep a woman from acknowledging her trauma by deflecting all her attention to another arena, where the unwieldy dynamics of something like an eating disorder will demand all her energy and attention.
Whether the pain results from a childhood of abuse and neglect, sexual betrayal, fears of growing up, the death of a loved one, or the loss of one's child because of an abortion, all these injustices, wounds, and violations to a sensitive human heart must filter somewhere. For those who use eating disorders as a means to cope, the chore becomes an arduous task of distraction, calorie counting, obsessing, controlling or forfeiting command, and the vicious, destructive cycle to where all eating disorders eventually end -- a prison that assaults its convicts with daily failure, disease, and self loathing.
What complicates healing for so many women is the difficulty in connecting their eating behavior to their abortion experience. The moral and ideological battles surrounding the abortion issue have led to an almost total blackout in the media, academia, and medical community of any negative repercussions from abortion. This makes it very difficult for women to connect their current emotional or physical symptoms to their experience of abortion, and fosters a disconnection from the body and heart.
And so people turn toward readily available food as the medication to provide control, to inflict punishment, to create indulgence, to vent frustrations, to escape painful feelings, or to recreate a traumatic sense of helplessness. Others strive to find the perfect image in the body that will disguise a deep sense of inadequacy felt in the soul. Eating disorders serve to protect, to defend, to control, and, sometimes, to punish and inflict devastating feelings of failure.
Thankfully, women are not doomed to a lifelong sentence of disordered eating. Recovery begins with the establishment of a sense of personal safety. Feelings and emotions related to one's losses -- anger, fear, shame, grief -- can then be examined with honesty.
The poet Adrienne Rich once wrote, "I came to explore the wreck. The words are purposes. The words are maps. I came to see the damage that was done and the treasures that prevail."
For those readers who may struggle with food issues, exploring the wreck is more than simply making better food choices and implementing new lifestyle habits. The expedition will entail spending time to get to know yourself better and learning how to communicate feelings, frustrations, isolation, and pain. It will entail digging for subconscious motivations, privately hidden fears, and buried feelings that you have stuffed down with food or camouflaged behind layers of fat. It might mean that you have to assimilate how true physiological hunger feels. If those sensations that you have been connecting and appeasing with food are truly something else, the exploration must become a search for what you are really hungering to satisfy, no matter how uncomfortable or distressing those feelings are.
Indeed, you may need to learn new ways of expressing your emotions. It might mean confronting your fears, anxieties, deeply repressed grief, or churning pockets of anger. At the end of the journey, you just might learn how to trust yourself and how to listen and respond to your "inner voice" and your body's natural cues that intuitively know what is right, good, and nurturing for you.
Much of the focus in counseling attempts to give a person encouragement and permission to explore and experience that which she fears. When a woman experiences and expresses something she had previously tried to avoid, she loses some of her fear and sees that avoidance is not as necessary as she had thought. Healing of the abortion experience itself requires an intense journey of the body, mind, end spirit. Ongoing professional medical treatment and therapy support for the eating disorder are also an important part of recovery.
Confronting the past of any trauma is always a difficult and painful expedition, but only those who embark on this voyage will be able to discover the elusive key to freedom. You will not only survive the expedition, but you can flourish by developing the skills to express and assert your deepest, truest self with respect, confidence, and dignity.
1 Michelle Siegel, Judith Brisman and Margot Weinshel, Surviving an Eating Disorder: Perspectives and Strategies for Family and Friends (New York: Harper & Row) 1988. [Back]
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Theresa Burke, Ph.D., is a psychotherapist and founder of Rachel's Vineyard, a post-abortion training and healing ministry that annually serves thousands of women and couples throughout North America and overseas.
David C. Reardon, Ph.D., is one of the nations's leading researchers and authors on post-abortion issues and the founding director of the Elliot Institute.
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