Mike, a teacher in his early thirties, came into therapy saying that he was "disgusted and upset" with himself because of his problem with overeating. Almost immediately he spoke of being laughed at by some of the cafeteria workers at the elementary school he had attended. He described himself as functioning "fairly well" at present, but as having little social life away from his wife and five children. Mike claimed to be angry with himself for his failure to abandon his bad eating habits even though he had been able to quit smoking, presumably a more difficult addiction to overcome.
Mike was careful to point out the connection between some of his poor eating behavior and the demands of his life. It is difficult to escape the impression, however, that his claims about pressures in his life have provided him with a "perfect" cover for poor eating behavior. He said that had to eat fast food for lunch, because he had to hurry from one of his two teaching jobs to the other; he was punishing himself by eating his lunches in the car as he drove. Although he said he liked teaching in spite of the low pay, worries about finances were occupying him. According to him, he ate in times of stress and to escape anxiety.
At several times in the intake interview, Mike emphasized the importance of cultural factors in his life. He comes from a strict Orthodox Jewish background, and today teaches in a religious school. When he was an adolescent, his family's strict beliefs limited his experience of dating. He has never had sex, with anyone except his wife, although he mentioned two earlier close relationships with women, relationships that presumably did not eventuate in intercourse. One senses a deep guilt when Mike speaks of his desire to be attractive to the women he meets in his present life.
His own parents had always been controlling and manipulative, and have continued their attempts at control into his adulthood. He spoke...