Caretaker Role Makes Intimacy Difficult

“All Kip does is criticize me: `Eat something!’ `You take too many diet pills!’ `Your clothes are too baggy!”’ says Aimee, 27, a fashion photographer’s assistant. “He’s always wanting to change me, and I hate it.”

Kip, a 28-year-old stockbroker, says he’s not nagging his wife - he’s trying to save her life.

“Aimee is wasting away,” he says. “She looks awful - her face is drawn, and there are dark circles under her eyes. Aimee’s the only girl who’s ever meant anything to me, and I don’t want to lose her. But if she can’t stop this selfish, self-destructive behavior, I can’t stay and watch her kill herself.”

Aimee began her secret battle with food and drugs in college. Living in a dorm with other diet-obsessed girls and disgusted with the “freshman 15” pounds she’d gained, she looked at her athletic build with a critical eye, unable to see herself as anything but fat. “My mother has always been very looks-conscious, and I was a chubby kid,” she recalls.

Aimee went on a crash diet and exercised vigorously twice a day. When the pounds didn’t come off quickly enough to suit her, she began popping diet pills. The quick high of the amphetamines took away her hunger, relieved her depression and gave her the energy to coast through her art history and photography classes. “But coming down was such a low that I soon began taking five or six pills a day,” Aimee confesses. “I also experimented with cocaine that I got from some guys I knew.”

At first Kip took an arm’s-length approach to his girlfriend’s addictions, but when she became strung out and dangerously thin, he called her parents, who immediately had her hospitalized. The doctors made Aimee take the rest of the semester off to clean up her act and gain weight. Kip visited her every weekend; after she had regained her health, the two eloped. They lived in an off-campus apartment until their graduation, then moved to New York City.

Aimee stayed healthy during the first five years of her marriage, but recently, she began slipping back into some of her old patterns. In the fashion industry, she works long hours and goes to parties where alcohol and drugs are readily available. “I end up drinking a lot of champagne,” Aimee says. “Nobody really eats at these events, but they do drugs. Every once in a while I’ll do a line of coke …”

She admits that she doesn’t eat much, but sometimes she goes on late-night snack binges and immediately throws up afterward. Kip, who’s developed an ulcer from the stress, blames Aimee’s backsliding on her career.

“Aimee is extremely impulsive and childlike, and being around those models and designers is the worst thing for her,” he says. “She hangs out with that fast crowd … and then she hates me for telling her what to do, because I’m her conscience. She’s lost interest in everything - including me.”

The couple, who used to have sex every night, now hardly find time to be affectionate at all. “We’re so unhappy together, we’ve become total strangers in bed,” says Kip. Aimee agrees: “It’s like all the warmth we had is gone. I know Kip thinks I’m too skinny, but he knows how sensitive I am. How am I supposed to feel sexy when he acts repulsed?” Aimee is willing to work on her relationship, but says she can’t seem to stop hurting herself. “All of Kip’s friends at work have Barbie-doll wives, and I’m surrounded by models all day long. How can I compete?” she says.

“Kip and Aimee need to address the dynamics of their relationship, but Aimee clearly needs to be involved in a treatment program of her own,” says Robin Ude, Ph.D., a marital and family therapist. “I also want to know what’s going on with Kip. He’s been her stabilizer and caretaker, but it appears he’s tired of this role. Acting as a spouse’s `parent’ makes sexual relations and other forms of intimacy very difficult and confusing.

The therapist gave them an exercise to practice at home. Sitting back-to-back with Kip, Aimee was to talk about whatever was on her mind, as he listened without responding. The next night, it would be Kip’s turn to talk uninterrupted. This helped each of them to concentrate on what the other was really saying, and the 24-hour period in between served as a cooling-off period, averting angry arguments.

After about three months, the couple reported that their relationship had changed for the better. Aimee has lost her vacant-eyed look, and her clothes no longer hang off her. “Now we have discussions instead of fights,” she says. “I like myself more; I no longer need the crutch of drugs or food.”