“Would you see Anorexia as an Inner Critic?”
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A Reader writes:
“I have an inner critic question — or is it the inner critic? I have a client with anorexia — she has been in hospital care for a short time and the psychiatrists recommend she fight the voice of ‘Nervosa’ all the time, every step of the way, never ever listen to it. Now, on the surface this seems like good advice — Nervosa is trying to kill her after all — they say. But nagging away at me is an ‘I’m not so sure about this.’ It feels to me like this constant fighting keeps the fighting going. And the fighting has been going on for about a year now and not letting up, in fact seems worse — although they may argue it’s working as she is still here. I’m interested in what you think. Would you see Anorexia as Inner Critic, albeit a particularly vicious one? Is it perhaps something other and ‘fighting it’ has a place?”
Dear Reader,
I cannot speak from direct experience with this serious condition. But I do know this much: There is nothing inside us that wants to kill us.
What I am hearing in your report is a lack of distinction between “listen to” as in do what the voice is saying, and “listen to” as in find out what it is feeling and let it feel heard.
When they tell her not to listen to the voice of Nervosa, they mean don’t do what it says, and don’t believe what it says about her body being too fat, etc. But the simple suggestion to “fight” the voice gives her too few tools, too little help, and doesn’t really make her stronger, in my view.
What would really make her stronger would be the experience of being Self-in-Presence, being her larger Self, able to turn toward a part of her that is so worried about something that it attacks her about body image all the time. My guess would be that there are emotions underneath that this part of her is afraid will get out of control.
Yes, this is absolutely an inner critic; it’s a part that is criticizing, belittling, demeaning, and giving orders because it is terrified of what will happen if it doesn’t, and it is locked in an inner war with another part that alternately collapses and rebels against this attempt at tight control.
Maybe you can help your client cultivate Self-in-Presence, that sense of being a larger self who can hold a space for all the inner voices without having to identify with any of them. The part of her that might need special attention is the part that feels attacked, abused, demeaned, or criticized by a voice that says she is too fat. You could help her acknowledge that part, and let it know she knows it is there.
And you would also help her turn toward that part of her that is terrified and feels the need to be in absolute control because of that terror. When she is Self-in-Presence she can be compassionate toward this terrified part without feeling the need to obey its orders.
As her therapist, you can help enormously by being Self-in-Presence when you are with her and helping her be a containing space for contacting the emotions (scary to many parts of her) that are underneath this fight for control. Focusing is great because it lets her go just as slowly as the slowest part needs to go, not rushing or pushing. I’m grateful she has you.
