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Watching The Crown’s Portrayal of Bulimia as a Sex Therapist

Princess Diana’s Bulimia Disorder

The Crown‘s latest season shows Princess Diana’s longtime cycle of Bulimia, an eating disorder involving binging on food then vomiting it up soon afterwards. The depiction of Diana’s patterned rituals is quite graphic in its detail.  In this period of social distancing, increased loneliness and upcoming meal-based holiday season, here are some psychological concepts  audiences can learn from the Netflix show.

After eating emotionally during a hearty holiday meal, it is all too easy for a person suffering from disordered eating and eating disorders to engage in a litany of self-criticism and potentially binging. The intensely negative self-talk often leads to internal negotiations around forms of restriction. Inevitably, the unforgiving rules imposed on oneself in moments of harsh guilt will reach a tipping point. At that moment, the person’s shame and rebellion lead to an overthrow of the restrictive policies leading to new overeating or binging. This is the cycle of eating disorders and disordered eating.

We see extreme cycles of Bulimia in the latest season of Netflix’s The Crown. The introduction of Lady Diana to the royal family was presented as a fairy tale romance in the press. Her public image, however, was somewhat a foil to her private life. In the television drama, we see Princess Diana in a secretive isolating cycle, experiencing years of intermittent bulimia. Starved of physical touch, kindness, sympathy, and sexual intimacy from Prince Charles, Diana sought control, expressing hurt, anger, loneliness  and possibly vengeance by binging on royal delicacies and then making herself throw up afterwards.

The Connection between Infidelity, Betrayal and Eating Disorders

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Eating disorders (like Bulimia and Anorexia) and disordered eating patterns are interpersonal as well as intra-personal disorders, meaning that they are triggered by feelings of betrayal or abandonment by others then turned inward as hatred or humiliation of oneself. What Diana experienced was an extreme sense of  isolation almost immediately after she first became engaged to Prince Charles. Soon after the engagement announcement was made public, she became aware that Prince Charles was still romantically involved with Camilla Parker-Bowles. In Diana, In Her Own Words, a documentary also on Netflix featuring secret recordings of Diana, she states that: “The bulimia started the week after we got engaged.”

After discovering that the whole engagement and courtship was totally fake and that the marriage was solely “a call to duty” and nothing more, Princess Diana experienced infidelity’s pang of betrayal as a deeply interpersonal wound. Turning Charles’ rejection against herself, she tried to be more of what she thought her husband wanted, hoping to win him back. As a sex therapist working with couples after the discovery of infidelity or an affair, the betrayed partner frequently takes out feelings like self-blame and anger at their partner out on their own bodies.  At times they begin behaviors of binging, purging or restrictive diets to lose weight in an effort to compete with their partner’s lover or a paid sex worker, who they assume are thinner than they are.

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In a BBC1 Panorama Radio Interview Diana gave in 1995, she described how after spending her days fulfilling her royal duties visiting charities which involved comforting others, she was left feeling emotionally depleted and rejected by Charles who was giving his emotional and sexual attention to Parker-Bowles.

“I’d come home feeling pretty empty, because my engagements at that time would be to do with people dying, people very sick, people’s marriage problems, and I’d come home and it would be very difficult to know how to comfort myself having been comforting lots of other people, so it would be a regular pattern to jump into the fridge.”

Eating Disorders in the Media

 

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While in reality, Diana’s eating disorder thrived in secrecy and shame for years, The Crown’s decision to portray bulimia in graphic scenes could be seen as glamorizing the disorder. Mary Anne Cohen LCSW, author of French Toast for Breakfast, says: “[Depictions of eating disorders in the media] can be a tremendous relief and, hopefully, become the first step to make the decision to get help and share one’s burden.”

Generally, eating disorders are treated by therapists who are specialists through individual and group therapy with a focus on healing a client’s attachment style, learning regulation skills, and mindfulness techniques while creating new habits.

Attachment Styles and Eating Disorder Treatment

Secure attachment to caretakers extends to one’s secure attachment to comfort in eating and feeling comfortable in one’s own skin. Insecure attachments, on the other hand, come from early unmet developmental needs. Diana revealed through her secret tapes In Diana in Her Own Words that she had been treated like “the virgin, the sacrificial lamb” by Prince Charles, the royal family and her own family.  “Isolation with pastry needs to be replaced by intimacy with people,” writes Cohen.

A crucial element of eating disorder treatment involves helping a client learn how to express their emotional needs directly to people they can rely on and to cognitively shift from a diet mindset to an anti-diet mindset. An anti-diet mindset is precisely what eating disorder specialist Alexis Conason Ph.D. recommends for those struggling with this punishing cycle.

A New Year’s Resolution Worth Trying: The Anti-Diet Mindset

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Dr. Conason suggests a sustainable and fundamental shift in mindset. “You haven’t failed your diet,” writes Dr. Conason, “Your diet has failed you.”

An anti-diet mindset is an agreement to eat in a way that honors your body’s needs, connecting to one’s body in a nurturing and peaceful way rather than a belittling, abusive one. Repairing this relationship with your own body is a way to repair the insecure attachment of childhood and the as outcome of infidelity.

People have traditionally created New Year’s resolutions to begin a diet after weeks of emotional holiday (Christmas, Chanukah, Kwanzaa) eating. However, given that 2020 saw an avalanche of COVID-19 weight-gain memes, with people feeling so guilty about their added pounds, we can logically expect  the 2021 New Year’s diet self-recriminations to be even more rigid and punishing.

Many times people who are dieting may feel too weak or less desirous of sexual intimacy. Whether they are waiting to show their body to a partner when their body is at the “perfect” size, or too ashamed to have their partner touch them for fear they will feel a part that has too much fat , many people with eating disorders deprive themselves of sexual pleasure.

Part of their healing is to understand that all emotions are human, including the desire for sexual intimacy and comfort. Helping them to turn toward a person instead of food or dieting to alleviate hurt and express anger is a critical step in their recovery.

The Trifecta: Sexuality, Eating Disorders and Body Dysmorphia

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Sexual disorders, Bulimia, Anorexia and Body Dysmorphia are interrelated issues. Researchers in an NCBI study “Sexual Functioning in Women with Eating Disorders” found that more women with eating disorders had:

  • loss of libido
  • prevalence of sexual anxiety, tension, frequent changes and higher frequency of detached relationships
  • relationships without intercourse and fewer with intercourse
  • avoided sexual relationships

In Diana: Her True Story – In Her Own Words, Andrew Morton quotes the Princess of Wales saying: “My husband [Prince Charles] put his hand on my waistline and said: ‘Oh, a bit chubby here, aren’t we?’ and that triggered off something in me.”

Some of our CLS clients verbally express body disgust for their own bodies in session to their therapist in addition to directly telling their partner their aversions. Most often their partner still feels quite attracted to them, continually trying to reassure them of their desire for them,  yet feeling helpless to have their compliments authentically received. If a comment about one’s weight is made unwittingly by a partner, the partner with the eating disorder catastrophizes and thinks their entire body is revolting.

Another important fact to consider is that Body Dysmorphia (BDD a persistent and intrusive preoccupation with an imagined or slight defect in one’s appearance) is not exclusively a women’s disease. In one American survey, for example, found that an estimated 2.2% for men and 2.5% of women suffered from Body Dysmorphia. Whether the focus is on weight, the thinness of hair or the longing for more muscles, men can be as secretive about their body shame and disordered eating as women. BDD interferes with male sexual desire and connection in similar ways as other eating disorders.

How to Approach the 2020 COVID Holiday Season as an Anti-Dieter

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Understanding the larger context of a meal is the first step to enjoying the holidays as an anti-dieter. With the additional stressors of the COVID-19 pandemic this year, I encourage more self-compassion and present-moment mindfulness. Make sure you have a buddy who you can call on when feeling triggered to binge, purge or withhold food. Give yourself permission to take a walk to ground yourself if feeling overwhelmed.

Coach yourself to receive sexual pleasure. Erotic intimacy should be considered a place to play and feel aroused rather than a space in which one needs to perform or pose. High Sex EsteemⓇ means that one accepts the notion that erotic behavior is a pleasurable, connecting place we go to experience comfort, fun, stress relief and passion, all basic human needs. Given that most Americans won’t be travelling long distances to gather with large groups of relatives this holiday season, use the extra time to have some mindful, sensual touching sessions with a partner who you can rely on, whether that be someone else or yourself.

If you are struggling with an eating disorder, a free resource in the U.S. is The National Eating Disorders Association. They offer extra chat hours over the holidays: https://www.nationaleatingdisorders.org/.