Recently, Dr. Phil featured a program about sixteen-year-old twins, Taylor and Tricia, who both have an eating disorder. It was tragic to witness how these girls’ lives have been swallowed up in an anorexic bulimic vortex. The visual images of their binging and purging behavior were graphically stunning. While we certainly cannot know all of the circumstances that contributed to the girls’ eating disorder, the producers of this program focused on the parents’ divorce, the mother’s boyfriend, and the father’s geographical move, which apparently limited his visitation and involvement with his daughters.

As I was writing this piece, I came across an interesting article written by a therapist named Mary Anne Cohen who treats clients with eating disorders.

The following paragraph relates to the questions that she asks incoming patients in hopes of getting a detailed history:

I want to know if there are events in your life that have made you want help at this time. Some people can make the connection themselves, others cannot pinpoint “why now?” although their problems can often be traced to a recent loss in their life. The death of a loved one, an illness, a move or a separation can cause people to become more vulnerable to developing an eating problem or can worsen an already existing struggle with food.

The girls’ father looked and sounded robotic, impassive, and rigid. Their mother seemed angry, overwrought, and helpless. Dr. Phil accused both parents of lying about things they had said. He admonished both of them for perpetuating petty, inconsequential arguments. He stridently underscored the importance of their becoming united again as a family to confront the girls’ dangerous and deadly eating disorder. It almost seemed as if the family opportunistically agreed to be on the show in order to get some paid intervention for the girls. One has to wonder why nothing had been done prior to this time in light of the fact that the girls’ weight loss had been significant.

I believe that twin dynamics contributed to and exacerbated this deadly situation. The fact that the girls have always been inseparable and best friends was reiterated during the show. Also, the girls ostensibly started this competitive game so that they could look identical. They were tired of being identified or labeled as the bigger one—so what better way to fight this differentiation than get into a deadly competition?

Dr. Phil alluded that Taylor must feel guilty for dragging Tricia into this life-threating game. Tricia cried about missing her former life—when she had friends and lived in the present. The shaming aspects of this disease for both the girls and the family were touched upon. The preexisting twinship proved ripe ground for the development of this shared eating disorder. I imagine that on an unconscious level, Tricia longed to become differentiated from her sister. Perhaps Taylor tuned into this threat and orchestrated a competitive challenge that Tricia could not resist.

Their wish to be defined as identical in order to put an end to labeling and comparison intensified their compulsive need to outdo one another. Ironically, the tragic consequences led to increasing isolation and sadness; their compulsion propelled them to be out of touch with everyone except each another in pursuit of this misguided goal.

I sincerely hope that the residential treatment program will help the girls work through the connection between their behaviors and their emotional struggles and longings to be self-efficacious individuals.

The image in this post is courtesy of Courtney Emery (CC BY-ND 2.0).