“A Starving Madness”

What makes this book about eating disorders fascinating and different is Rabinor’s chronicle of how, when a therapist enters the dynamic with the patient, both lives become enriched.

Creating an empathetic relationship with people isolated by eating disorders, Rabinor writes of helping them “unravel the threads of their unfulfilled hungers that have become twisted into an obsession with food and weight.” The simple belief “I feel fat” stands for complex roots; the stories told here, of seven women and one man, explore causes from parents’ divorce to childhood abuse .Patients range from a bulimic teenager seeking to blot out her inner pain by burning herself toa woman who first sought therapy at age 65 because of unresolved lifelong conflicts with her 90-year-old mother.

Rabinor, director and founder of an eating disorders center on Long Island and professor of psychology at A Delphi University, maintains that anorexic patients may project their own compulsions onto their children, thus catapulting the problems into the next generation. One 31-year-old mother, who at 5’6″ weighed only 95 pounds, was already fixated on her two year-Old’s weight: “I’m worried about Ashley. She’s getting so flabby.” For another patient, who grew up taunted by her glamorous mother for being heavy, therapy was “a big, fat failure, just like me.” Eventually, by recognizing her pain caused by her emotionally absent mother, she was able to have a child without being terrified of gaining weight.

A college student had been anorexic since the age of 10, coinciding with the time her 16-year-old brother started sneaking into her bedroom. His abuse lasted years, but it took therapy for the patient to see its connection to her illness. Eventually her brother entered therapy too. Similarly, a 15-year-old girl suffering from obsessive-compulsive disorder, which is often paired with anorexia, resisted the realization that the onset of her illnesses coincided with her father’s remarriage.

One teenager was able to recapture her lost self through journal writing. Rabin or comments: “If symptoms are a way of forgetting, healing is based on remembering and talking. Freud taught us that. And Becky taught me that talk therapy is not simply about speaking, and journal writing is not just about writing. Therapy is about being listened to by someone who nourishes and nurtures the soul. Writing offers another kind of healing experience—a sustained self-listening.”

Yet Rabinor candidly admits that not all patients are cured: “We tend to expect people’s stories to resolve neatly. Real lives aren’t like that…not every story ends so happily.”

But with its message that caring has tens cure, this book might well be a primer for therapists in general.  

Helen Schary Motro an American lawyer and writer living in Israel, is a columnist for the Jerusalem Post.