Academic journal article The International Journal of Narrative Therapy and Community Work

Uncovering Bulimia’s Demanding Voice: Challenges from a Narrative Therapist’s Perspective

Academic journal article The International Journal of Narrative Therapy and Community Work

Uncovering Bulimia’s Demanding Voice: Challenges from a Narrative Therapist’s Perspective

Article excerpt

This paper presents an overview of challenges I faced as a therapist during my work with 17-year-old Kiki, who was on a journey to reclaim her life from Bulimia's demanding voice. In this paper I discuss some of the narrative principles and practices that contributed to our therapeutic conversations, as well as some difficulties. In order to highlight the usefulness of certain narrative ideas, I trace the history of Kiki's determination to unmask Bulimia's demands and fake promises. I describe how Kiki was able to undermine Bulimia's whispers in her life, how she positioned herself according to her preferred values and commitments and, finally, how she went on to make a contribution to other people suffering from the constructed 'Hell' Bulimia has set for them.

Notes and transcripts from each session (which were kept in collaboration with the people involved) helped me to accurately describe some of the dialogues and documents that emerged during the therapeutic process. I would like to thank Kiki, both for helping me understand some of Bulimia's tactics and also for collaborating with me in developing some counter practices for resisting Bulimia's influence. I am also grateful to Kiki for her willingness to share aspects of our work together.

My first contact With the story that Buitmta has been telling about Kiki

When I first met Kiki, she had been struggling for almost two years with what psychologists had described to her as 'bulimia'. During this time her weight often fluctuated by up to 10kg. Three or four times a week Kiki felt 'unable to resist' having 'irregular', 'large' meals, which were followed by purging. Kiki let me in on her struggle, which she described as involving a sustained feeling of 'being imprisoned' and 'not being myself'. Kiki also described her understanding of the factors and events in her own history that brought Bulimia/ purging into her life. These included: negative comments that she received at school about her body; a complicated relationship with her ex-boyfriend; strong competition she experienced with the female athletes of her school; and stomach problems that had made her lose a large amount of weight.

My first contact with Kiki's story was not direct. Instead, I had a phone conversation with her 17-year-old boyfriend, George. George called me, quite upset, to ask for advice on how he should handle the situation with his girlfriend. As he explained, he had recently noticed 'significant differences in her behaviour in relation to food' and he did not know how to help her. I asked him about the impact of these changes on his own life and thanked him for giving me a clear picture of the situation. During our conversation I made it clear that I was not in a position to provide advice without knowing more about the help he was seeking and what kind of help Kiki herself would like. I asked if he and Kiki would like to come together to my office to continue our conversation. He said:

That's the problem, Kiki doesn't want to come. She hasn't talked to anyone about her problem, not even to her parents... I accidentally caught her throwing up. She doesn>t believe that she can do anything about her problem. Neither she, nor anyone else. How can I persuade her to come?

I told George that I was impressed by his willingness to stand by Kiki and I suggested that he come to an appointment to discuss:

1. his concerns about Kiki

2. the kind of help he would like to provide to Kiki during this difficult period of her life

3. suitable ways he could think of to invite Kiki to join a shared effort in resisting the problems.

There was enthusiasm in George>s response: 'Yes, let's try that!'.

Therapist's challenge

How can I invite a person to take part in a therapeutic conversation when they are not willing, despite the fact that it concerns their life?

Kiki refused to come to the first appointment. As she explained to me later, Bulimia had convinced her that no one could ever understand the 'devious ways' it controlled her life. …

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