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Aura presented herself as a freshman who was having problems adjusting to university life. The bulimic symptom which ultimately became a central focus in the treatment went unmentioned initially, an uncommon pattern in bulimic patients.
I saw Aura between the ages of 18 and 22. She was a dark, curly-haired, freckle-faced, petite young woman, who was large-breasted with a tendency toward chubbiness. Although the bulimic symptom began when she lost weight at age 15 as a consequence of pneumonia, she never starved herself nor were any of the other classic anorexic symptoms present, such as distortion of body image.
When she began therapy, she had just matriculated as an undergraduate at a state university where, depending on her mood, she planned to major either in psychology, or English, or business, or engineering. She fretted about her studies and her achievements, but always managed to do better than she expected, and had a grade-point average of over 3.5. Although this is certainly adequate by most standards, she knew it to be inadequate by her father's. He felt that even a 4.0 was inadequate, since she was not attending an Ivy League school. He never quite said this, and in fact would deny it, but it was true. I met with the father three times, whenever he felt that Aura was changing too much, or changing in a way that threatened his complete domination over her. He paid for her therapy, and he used his payment, and money in general, as a weapon to dominate Aura, her siblings, and her mother.
Father was a hospital pathologist of national reputation. Aura's experience of him as a child was one of being victimized by the