Dr Manish Bajpayee: Could my sister have a binge-eating disorder?

Here are questions from readers that were addressed by leading psychiatrist Dr Manish Bajpayee. The identities of the solution-seekers have been withheld to protect their privacy. You too can send your questions at editorial@pune365.com

Dear Doctor, my sister has a weird impulse of finishing off whatever food that is kept in front of her be it healthy or unhealthy. In her words, she says that she feels the urge to just finish off the food and this leads to her overeating. Could this be some sort of a binge-eating disorder?

This is probably a binge-eating disorder if she cannot control herself whenever she sees food in front of her. This could result in obesity and lead to self-image issues. This is also the base for several other eating disorders, for example, if she feels out of control she might seek a way to be in control which could lead to a diagnosis of anorexia nervosa. Whether you’re eating too much or too little, an unhealthy relationship with food can be dangerous and you should get help with it as soon as you can. In my sister’s case, she has put on weight so she must consult a doctor as there is medication to treat this.

Dear Doctor, I have two sons, both 18 and 14 years old respectively. The elder one gets violent very often with the younger one. This is often very scary because he gets physically violent with my younger son, causing several bruises. I have told him to stop several times but he doesn’t seem to understand. How can I resolve this problem, please help me.

In such cases, the younger one should also take a stand against his older brother. This behaviour certainly must be stopped and it should be talked out with both of them so they can understand the risk factors for eating disorders. They must know how to respect each other’s boundaries. Other than this, firstborn children are known to be bossy. They tend to parent their younger siblings and that should be avoided because they should understand that they too are children. This needs to be told to them by their parents.

I’ve been taking therapy since the past three months now. My doctor is a qualified psychoanalyst subscribing to the psychoanalytical school of therapy. She has a strict policy that I cannot miss a session, and if I have to, I need to inform a week in advance. Once informed, we are to try and look for a fresh slot. If no other slot can be accommodated, I will still be charged for it. So, because of this, I’ve had a constant ego issue with her. We’ve often found ourselves unable to find a slot because I can’t compromise with regard to my working hours. And I keep on arguing with her regarding the same. She takes Rs 1400 a session, and that feels far too steep for me. Many a times I can’t help not attending, no matter how much I try. Also, I find her tone very fake and her empathy a facade. In fact, I can’t help get a rather ‘bitch vibe’ from her. I hate her. But I know it’s my ego talking. Today, I was headed to her session and met traffic because of Durga Puja. I realised, I would’ve missed the entire session by the time I reach. So I asked for a session at the next hour. She refused. I then said then I’ll head home. She said ‘that’s your decision’. I just hung the phone on her and messaged “I can’t come. It’s not my decision. It’s the traffic. Bye”. Now I hate her even more. What do I do?

From a psychoanalytical point of view, it’s like having a strict parent. The whole act of the therapy is to make sure that you get treated. Why didn’t you plan earlier? Yes, I can understand your sentiment towards your therapist but you will meet such people. The maturity of understanding the importance of planning has to be there. This is a long and tough process for the psychoanalyst as well as for the patient. I feel that this is a kind of resistance you have towards your therapist.

Yes, the amount you mentioned per session is quite a bit and I’m assuming that the session is just for 45 minutes. All therapists have their own way but I feel your therapist should give you some leeway. It is good that you are venting your frustration and you should be able to do so openly. You shouldn’t cancel an appointment just because you are late. You should have the ability to talk about this with your therapist.

It has been three months since I separated from my husband. Unfortunately, my daughter is caught in the midst of this. She chose to stay with me but her behaviour has changed completely. My ex-husband and I have tried to talk to her about our separation and we do not want to let it get into the way of her growth. She is 14 years old. The separation came to her as a shock. How do I make her come to terms with this? Please tell me.

Children are the most affected when parents go through a separation or divorce. Parental Alienation Syndrome (PAS) is a condition wherein the child ends up hating either the mother or the father without any reason. You should take care that this does not affect your child. Sometimes children tend to blame themselves for the problems between their parents. You and your ex-husband must make your child understand that you separated because of problems you had and not because of the child. The child should understand that relationships can fall apart and they do not last for eternity and both parents need to be mature about the separation.

Dr Manish Bajpayee

Dr Manish Bajpayee

Dr Manish Bajpayee is a consultant psychiatrist in Pune with over 20 years of extensive clinical experience in assessing and treating clients with a range of psychological problems and other mental health related issues. He is currently a consultant with Inamdar Hospital and Ruby Hall Clinic. Dr Bajpayee addresses reader queries every other Thursday on Pune365.
Dr Manish Bajpayee