In working to understand the psychology of those with bulimia nervosa, I've noted that there is a particular point in time during binge eating at which a person knows that purging will happen. Before this point, a person might choose not to purge, but after it, there seems to be no choice. This "purging threshold" (as I have come to call it) is an important time in the binge/purge cycle.
Feeding the Psychological Cycle of Bulimia
The purging threshold in bulimia seems very similar to certain times in other addiction-like behavioral cycles. It's common to hear a person say, "I knew that if I took another bite, I would have no choice but to purge. And I took the bite."
I also hear this phenomenon when clients talk about their behaviors in sex addiction. For example: "Whenever I drive down Elm Street instead of Ballinger Avenue, I know I'll end up finding a prostitute."
It's clear that this sense of losing freedom to choose isn't actually real. Certainly, those with binge-eating disorder are good evidence that binging can occur without purging. So why does it feel so powerful -- so convincing?
How the Purging Threshold in Bulimia Creates Psychological "Relief"
It seems that a poor self-image and a certain level of shame provide the energy. A person with bulimia will generally live in a near-constant sense of shame, and will hear brutal and degrading messages from the eating disorder. The multitide of examples includes thoughts like, "You're so huge. The only reason you have any friends is that people feel sorry for you."
After a while, living in shame becomes the norm, and living apart from shame is actually so novel that it's a bit unnerving.
Of course, the binge/purge cycle is already in effect when binge eating begins. It follows a consistent pattern, a ritual. More food means more tension, until the message from the eating disorder becomes, "You're pathetic. You know you're going to end up purging, so you might as well go through with it. It's exactly what you deserve."
And the message is very believable, because self-image has already become very poor. So "giving in" and taking that fateful bite brings the shame to a new level. But the person sees shamefulness as normal. So it provides relief, even though it's an awful state. She (or he) knows exactly how to live in it. And that provides a paradoxical calmness, because now she knows exactly what to do -- purge. There are no more decisions to make.
The Purging Threshold Isn't As Real As it Seems
It's far more stressful for someone who routinely purges to choose not to purge after reaching the purging threshold. But I've seen clients do it with success. It's important to note that the discomfort is temporary. The body digests the food, the person finds that it doesn't result in instant, permanent fat, and a new day begins. Instead of deeper shame, a sense of genuine self-control -- and self-respect -- emerges.
You may already know why it's so difficult to continue with recovery, however. These good feelings toward the self are abnormal and therefore uncomfortable. But again, the discomfort is temporary. As the decisions to abstain from purging (and ultimately, binging as well) begin to outnumber the decisions to act out, self-respect can become more normal, comfortable, and sustainable.
