Eating disorders are prevalent among women who were sexually abused as children. They seem to have components of other symptoms such as obsessions, compulsions, avoidance of food, and anxiety, and they primarily include a distorted body image and feelings of body shame.For some women, eating disorders are related to the loss of control over their bodies during the sexual abuse and serve as a means of feeling in control of their bodies now. Eating disorders can also be indicative of the developmental stage and age at which the sexual abuse began. Women with anorexia and bulimia report that they were sexually abused either at the age of puberty or during puberty, when their bodies were beginning to develop and they felt a great deal of body shame from the abuse. By contrast, women with compulsive eating report that the sexual abuse occurred before the age of puberty; they used food for comfort.

When you have a persistent sense of heartbreak and gutwrench, the physical sensations become intolerable and we will do anything to make those feelings disappear. And that is really the origin of what happens in human pathology. People take drugs to make it disappear, and they cut themselves to make it disappear, and they starve themselves to make it disappear, and they have sex with anyone who comes along to make it disappear and once you have these horrible sensations in your body, you’ll do anything to make it go away.

The reasons for Emma's illness and for her decision to allow life in, rather than die, are intertwined and involve the beginnings of her feelings of belonging, of safety and of competence to be in the world.

When faced with choosing between attributing their pain to “being crazy” and having had abusive parents, clients will choose “crazy” most of the time. Dora, a 38-year-old, was profoundly abused by multiple family perpetrators and has grappled with cutting and eating disordered behaviors for most of her life. She poignantly echoed this dilemma in her the