339: Sexual Abuse / Emotional Eating, Part 1 of 2

Sexual Abuse / Emotional Eating Personal Work with Orly, Part 1 of 2 In today’s podcast, you will hear the first of a two part series on Emotional Eating, featuring Orly, an Israeli psychologist who experienced sexual abuse at age 6 when she was a “skinny little girl.” After that, she began devouring her grandmother’s delicious cookies, and suddenly gained a great deal of weight. She continued binging for more than 50 years whenever she was excited or upset. This led to a pattern of dramatic swings in weight of 100 pounds or more over and over again. And now, Orly has decided she wants to end this pattern. My dear colleague, Dr. Jill Levitt, will be my co-therapist in this single, 2 hour-session that was conducted in front of my TEAM-CBT Tuesday training group at Stanford. Part of therapist training involves doing your own personal work, although this is not a requirement, it is recommended. That’s because the patient experience gives you a much deeper appreciation for how the therapy works. Rhonda, Jill and I want to thank Orly for permission to publish her highly personal work, and hope you find it immensely educational—so you can see exactly how TEAM-CBT works in real time with real people—and inspirational as well. Nearly all of us are pretty flawed in one way or another or many, and learning how to accept our flawed selves and celebrate is one of the deeper goals of the therapy. Today, we will cover the T = Testing and E = Empathy phases of the treatment. Next week, you will hear the exciting conclusion of our work with Orly, as well as the follow-up. Will she really be able to resolve a severe problem that has defied a solution for more than 50 years in a single TEAM therapy session? Let’s check it out! Part 1 of the personal work with Orly T = Testing At the start of the session, we reviewed Orly’s scores on the Brief Mood Survey that she completed just prior to her session. She scored only 3 out of 20 on the depression test (minimal), zero on suicidal thoughts and urges, 5 out of 20 on anxiety (mild), and 2 out of 20 on anger (minimal.) Her happiness score was 16 out of 20 (very happy with a little room for improvement), and her relationship score with her daughter was 18 out of 30, indicating lots of room for improvement. She indicated she'd done a great deal of homework in preparation for the session. You can also see her scores on nine mood dimensions if you take a look at her molestation Daily Mood Log. As you can see, her scores were quite high, and you can also review many of her negative thoughts when she was growing up. For example, at age 8 she told herself, “I am the fattest kid here. I will never be beautiful or desirable.” You can also see her Habit and Addiction Log (HAL) just prior to binging after a backpacking trip if you look HERE. Once again, you can see that all of her negative feelings were intense, and rated in the range of 90 to 100. You can also see her tempting thoughts, like “I can afford it since I spent so many calories during the hike.” E = Empathy David and Jill empathized while Orly told her graphic story of sexual abuse from a young man while growing up on a farm in Israel around the time of the “Six Day War” in 1967. She explained that he had been like an “older brother,” and she didn’t quite understand what had happened, since there was no Hebrew word for sexual abuse, and the subject was never discussed in public or with children. As she grew up, she learned to be independent, and felt like she was “different” and never really fit in. She developed a strong connection with nature and with spiritual values, and served as a park ranger during her military service in Israel. After her military service and an undergraduate degree from the Hebrew University, she set out to backpack in South America for a year and then settled in Los Angeles. She was married, and had a daughter who she considers her most important relationship, However, it was a troubled marriage and Orly and her husband were divorced when her daughter was 6. For quite a while, her daughter “blamed me for the divorce and for many  other things.” Eventually, she settled down in the United States and decided to become a psychologist after going to therapy, which was “the only diet I had never tried.” In 2020 she got some medical help from her doctor and started hiking extreme distances and heights, and lost a tremendous amount of weight. Nonetheless, she still finds herself “eating her feelings” and engaged in binge eating every once in a while. She also joined our Tuesday training group at Stanford, and said that it made an enormous impact on her life and on her clinical practice, and began at times to think, “Maybe there’s NOT something wrong with me.” She said the group made her an effective therapist and “I got to liking myself just a little bit!” She said the group also helped her tremendously with relationships. I believe she was referring to the five Secrets of Effective Communication that we have demonstrated so often in our podcasts as well as other tools such as the Relationship Journal She shared she was feeling terrified and had a number of negative thoughts during our session, since she was really hopeful that she could finally end her Emotional Eating. Her thoughts included:

1. I don’t belong. 70%
2. Something is wrong with me. 70%
3. What I do is not good enough. 60%
4. Now that I’m more than 60 years old, most of my life is over. 60%
5. If I don’t get over my emotional eating, I’ll never feel normal.
6. If I fail to solve my addiction, I’ll fail in my most important existential tasks.
7. That would mean I’m a failure.
8. That would mean that didn’t make a positive impact on the world.

Jill empathized, using Thought Empathy, Feeling Empathy, and warmth, and then we asked, “What’s our grade? How good a job have we done in understanding how you think, how you’re feeling, and accepting you?” She gave us an A, meaning it was time to get on to the next phase of the session. Orly also shared that she never told her parents about the abuse, and never felt really close to her mother, who had her and two boys, all within 19 months. She said, “I was a problem for her, and always challenged her. Orly told friends about the abuse, but not her folks because she was desperately afraid they might not empathize or support her. She added, “Deep down, I fear that I am not really lovable, and that it might be too late for me.” I would add that feelings of hopelessness are so common in all of our patients, and this is what makes our work so challenging for us and painful for our patients—and also so rewarding when we can provide genuine, rapid, and profound relief. But will that really be possible for Orly? Next week we will set the agenda for the session and select some methods that might be helpful for Orly. End of Part 1 Thanks again for listening! Warmly, Rhonda, Jill, Orly, and David