Grace, a 30-year old graphic designer, leads a busy single life. Approximately 2.5 years ago, she developed GERD and Irritable Bowel Syndrome (IBS), the latter a functional gastrointestinal
disorder. She is plagued with symptoms of severe stomach pain, cramping, bloating, and nighttime acid reflux, and she sometimes feels as though “acid is burning a hole” inside her. Despite various treatments, including medications, dietary adjustments, and breathing exercises, Grace’s GERD and IBS symptoms persist, denying her a good night’s sleep. “I haven’t comfortably laid flat in two years,” she said. Her love of food has turned into fear, with the thought of even a simple meal provoking her anxiety about the likely aftermath.
Grace’s stomach is clearly a source of torment for her. This was made clear when I asked Grace
what her anxiety feels like to which she replied, “Like my stomach is tied in knots.” To understand the roots of her anxiety, we explored Grace’s formative years when she recalled at 12 years old her father’s layoff from work and descent into alcoholism. Things had always been lean in Grace’s home growing up, but the added burden of her father’s growing addiction led to deeper financial insecurity and a palpable tension between her parents. Mealtimes became angst ridden as Grace’s mom did the best she could to adequately feed Grace and her sisters, and Grace recalled feeling considerable guilt when her mom often went without food to help the family.
“I learned to take what was offered,” she said. I asked her what guilt felt like to her, and she
responded, “like a burning hole inside me.” Grace had learned as a child to accept less in the face of adversity, but what little she did have caused her distress. This in turn seemed to “fuel my anxiety” around mealtimes, an activity that Grace once recalled enjoying prior to her father’s layoff.
When I asked Grace what significant event in her life might have coincided with the onset of her
symptoms, she said it was Christmas and her family had gotten together for a shared meal.
Although her parents’ financial situation had improved and everyone contributed to the substantial amount of food on the table, Grace’s mom commented to Grace about her meal size, suggesting she “lay off the portions, hon” before making a critical remark about her waist size. Grace had felt conflicted, her “stomach suddenly tied in knots,” the exacerbation of a cruel despair over her relationship with food.
As Grace learned to make meaningful connections between her guilty and anxious feelings around food and mealtimes, she began to understand that before her father’s layoff, food was a source of fond connection, which she equated with a loving family. Leaving home to make her own way in the world, food had become a comfort for her, especially when dealing with anxiety. However, her mother’s comment about her weight had hurt her deeply, particularly as she had learned to always “take what was offered.” She further made a connection between her father’s “layoff,” her mother’s comment to “lay off the portions,” and her own misery when “laying down.” But as Grace learned to process her feelings of anxiety and guilt, and to redevelop a healthy relationship around food, Grace noticed her IBS and GERD symptoms start to disappear.