Anorexia and Bulimia: The Inner Experience of Eating Disorders

The inner lives and fantasies of people with eating disorders can be intensely vivid, often dominated by disturbing bodily sensations and urgent attempts to regain internal control.

Rather than being defined only by food or weight, anorexia and bulimia frequently involve profound psychological states of internal contamination, fragmentation, and oscillation between control and release.

The Psychological Experience of Bulimia

"Describing his bulimia, Daniel conveyed a vivid perception of being full of inimical foreign bodies. When I started seeing him he was bingeing and vomiting up to six times a day. He was tormented by concrete bodily feelings, of being 'all dirty inside'. Blocked sinuses and nose contributed to his perception. He said he felt 'greasy', 'full of soot', 'disgusting'. Vomiting gave him very temporary relief.

He binged on anything he could find or buy with his limited pocket money allowance. He bought mostly loaves of white bread which, he said, was 'like blotting paper'. It soaked up 'all the nasties' that could then be got rid of by vomiting. After being sick, he felt temporarily 'clean inside'. His mind became clear and for a few hours he could apply himself to his studies. Then 'the buzz', as he called it, would start again.

When 'the buzz' started, Daniel was unable to concentrate. He would press the wrong keys on his word processor, sometimes erasing a file that he wished to put on the memory. He described 'the buzz' as 'thoughts racing through his mind at 150 miles per hour'. It became clear that they were not thoughts he could think or talk about, but something more akin to flying debris."

— Gianna Williams, “Reflections On Some Dynamics Of Eating Disorders: 'No Entry' Defences And Foreign Bodies”

Understanding the Cycle of Eating Disorders

What this clinical description highlights is a recurring psychological loop often seen in eating disorders:

• Overwhelming internal states (contamination, pressure, agitation)
• Compulsive regulatory behavior (binging, purging, restriction)
• Temporary relief (calm, clarity, emptiness, control)
• Return of distress, often intensified

Over time, this cycle becomes self-reinforcing, making it difficult to interrupt without addressing the underlying emotional and psychological structure.

A Depth-Oriented Approach to Anorexia and Bulimia

In clinical work, eating disorders are not treated solely as behavioral problems, but as expressions of deeper emotional organization and internal experience.

While stabilization and symptom management can be important, lasting change often requires understanding the psychological meaning of the symptoms themselves.

In my Manhattan practice, I work with individuals to explore these internal states, reduce their intensity, and develop more integrated ways of managing emotion and self-experience.

Located at 40 West 13th Street near Union Square, I offer in-person therapy in Manhattan as well as secure telehealth across New York, New Jersey, and Connecticut.