Food for Thought: Eating Disorders Awareness
“The Magic of Allowing Imperfection”
Kip Rasmussen
The following is a transcript is a presentation given at
I’m very grateful to be able to speak on eating disorders and perhaps offer something of help to those who might hear this conference and might be struggling with these issues or might be trying to help those that are struggling with these issues. The subtitle of my address is, “understanding relationships in eating disorders.” But I’d like to add another subtitle if I could, and it would be something on the order of “What clients with eating disorders teach us about healthy psychological and family development.”
When I first began working with those with eating disorders I was startled. I walked into my first group. I was a fairly experienced therapist with eight years of work with a very difficult population. And yet I was shocked at the level of talent in this group. I sat there in this group and watched these people with incredible intellects, with great spirits, with great insight into psychological and social relationships and I thought, “What could possibly take spirits of this caliber and crush them so utterly?” And it was a mystery to me and it was probably a year and a half of working full-time with this population before I felt like I was not a rookie.
These disorders are very complex, very difficult to understand, to the point that people get frustrated and discouraged in working with them rather than feeling hopeful. When there is indeed cause for great hope in working with them. I would have appreciated hearing some of the things that I want to deliver today said to me early on—even though I had access to people who were saying these kinds of things to me. I’d like to offer a working definition of eating disorders because it’s critical to know the issues involved in order to understand them. You won’t find this definition in the diagnostic manuals but I have found it immensely helpful in understanding the issues involved.
Eating disorders are a complex way to manage intolerable emotion. They are thoughts and behaviors involving food and appearance but not about food or appearance. That is, they are deep and painful emotional issues which manifest themselves in areas of diet and exercise. The root of these disorders is emotional trauma, events so painful that they have often shattered a sense of self of those who are suffering. One of the great keys to eating disorders is that the symptoms are intended as a remedy for emotional pain clients feel.
I imagine that all of us could readily think about a time when we were dating and a boyfriend or girlfriend rejected us. Or, a time when we failed or made mistakes that were costly to us and either our personal or professional lives. How did that make us feel? Serious mistakes in our lives can overwhelm us. I can readily remember some of those times of failure in my life. How did we cope with those intolerable feelings when we felt like we were the kind of person who messed up, we were – I hesitate to say it – but we felt like losers. What do we do with those emotions? Well I imagine that we can all hark back to some of those times and readily know how we tried to cope with that emotion. If we were to take that intolerable emotion that we felt at that time and times it by a very high number, you would get the feeling of how eating disorder sufferers feel. They live with this intolerable emotion that they are somehow bad, that they are far from not only not being good enough, but far from good enough.
One client who gave me permission to use her story told me about a yearning for closeness with her mother over the years, over the decades, she had wanted a certain kind of approval and acceptance from her mother but her mother was busy, her mother was a bundle of energy who was involved in career and many other activities and never seemed to be able to give this client what she needed. This client was yearning, was desperate for it. The only thing that helped this client through this difficult issues was that she had what she considered a close relationship with her father and her brother, and this was very important to her. She would spend time in various endeavors that her father and brother enjoyed including a love of baseball. She got a boyfriend that she cared deeply about and the unfortunate thing and what brought her to me was that she had in the space of days lost this relationship with her father and her brother and her boyfriend all at the same time through a series of very, very difficult events.
This wonderful client sat on my couch weeping with tears she hadn’t shed in perhaps decades being so numb to her emotions and said, “I just want someone to love me the most.” This to me, if we can hold this in our minds, is the key to the problem central to most eating disorders, to be loved completely by at least someone. To know that we are worth it. I believe that what goes for people with eating disorders goes for the general population as well; we all want what they want. What can those who are suffering from eating disorders teach us? Before we go further I want to address also an issue which plagues those experiencing an eating disorder. Most people with eating disorders have an intense sense of shame surrounding their disorders, they feel broken and unlovable. They are the ones that have been struggling with the symptoms themselves - the restricting, the purging, for years and sometimes decades. They feel an intense shame about this.
Let me just say that no one chooses an eating disorder, despite how the disorders make them feel, there is no shame in having one, the processes involved are extremely complex and difficult to understand, even when a client is in her twenties or even later. These issues are far too complex for the analytical abilities of even very bright 12-14 year olds, the age at which eating disorders often begin to develop. Moreover it’s important to remember that the deficits in their emotional lives which lead to the development of eating disorder symptoms usually begin much earlier in life. It’s just too much to ask children of 5-7 years of age to understand these complex and intra-psychic and familial processes. Children don’t understand why they don’t feel good about themselves. They don’t take a look at their environment and say, “my environment is insane, I’m okay.” They always turn it toward themselves, “there’s something wrong with me.”
No seven-year-old would venture to begin thoughts of disordered eating if she were shown the terrible price she would eventually have to pay. They begin eating disorders because they have cast about desperately for anything that can help them cope with this intolerable emotion that they are not good enough. And eating disorders work to numb the pain, at least at first, although they steal everything later. One of the hardest things about working with eating disorders is to help clients understand the connection between the emotion they feel and the symptoms which occur as a result. They feel this intolerable emotion, they feel they are bad people, and for some reason they can’t understand that the purging, the restricting, is related to them. This connection is one of the firs things we have to do in their recoveries. When people say to them, “Why don’t you just eat? Why don’t you just pick up a fork, insert it in your mouth, chew and swallow? And keep it down?” It’s almost infinitely more complex and that and it’s something that is not helpful for them to hear. This is very hard for those of us who haven’t suffered through eating disorders to understand however.
And so given that this is difficult to understand, I would like to read a paper that one of my clients, who also gave me permission to read this, has listed regarding the benefits of her eating disorder. These are very intelligent people. They don’t turn to eating disorders as a way to just pass the time. They work, at least at first that is, the very nature of any addictive process. Let me read this, “My eating disorder started out as a hobby but soon grew to be an obsession. It gave me a sense of control in my life when everything else seemed out of control. I was able to regulate my daily tasks around meals and set standards for myself. It was similar to a power-trip one might say as I began to skip meals. I would say, ‘My fellow classmates simply aren’t as strong as I am.’ It gave me a sense of accomplishment and security.” People often feel like eating disorders are about control. I would say they are partially about control. They quickly lead to lives that are of course out of control but they give the semblance of control.”
She goes on to say, “When I felt vulnerable or uneasy, my eating disorder was always there, almost serving as a companion. “You will hear this a lot about eating disorders from those that are suffering, they say it is a friend, it’s something I have, it’s something that is there for me when everyone else isn’t. “It would never leave me and so I learned to depend on it whenever I felt alone. Emotions and feelings that scared me or that were too painful invited me to turn to my eating disorder to numb me.” We have to remember that word – numb. That’s what they would rather feel than any kind of this intolerable emotion that indicates that they are not good enough somehow that they do not measure up. She goes on to say, “The over-exercising, restricting, and occasional purge kept my body so occupied that my mind didn’t have the energy to think about stressful or painful things.”
Another thing that this eating disorder gave her was a sense of self-punishment. “My eating disorder served as a punishment. I’ve hated myself for so long that this became a way in which to hurt myself. My body had been used and degraded and I had been denied unconditional love from my family. As a result I unconsciously denied myself necessary nutrition that my body needed to live. This was my cry for help. Lastly, my eating disorder gave me a feeling of worth and value. Family and friends would comment on how disciplined I was, how beautiful I looked being significantly underweight at the time.” Imagine what it would be like for a person who has rarely felt acceptance and approval and love, to lose some weight and get this intense reaction from her environment. It’s addicting. “They wanted to know the secret of my thinness and accepted me.” There’s that word again, accepted. “I felt that they accepted me solely based on my physical appearance. Little did they know that my secret was starvation and that I was ultimately bound for death?”
At this point I’d liked to offer a general description of those suffering from eating disorders because it reveals much about the disorders and how to recover from them. As I said, when I first began to work with this population I was struck by their intelligence. These are some of the brightest people you will ever find, with great insight and incisive intellects. These are people a therapist should listen to and learn from. They can teach a lot, not only about eating disorders, but about healthy functioning as well. I also found them, incredibly enough, as a group, some of the most compassionate, kind and caring people I have ever met. Almost always willing to help people they see suffering, even when they themselves are in agony. As mentioned, they are also some of the most haunted, with by far the most profound sense of inadequacy and worthlessness I have ever worked with. The depth of their trauma can be staggering. The incidence of abuse is high and their stories are harrowing. Their stories, once heard, do not leave your mind. Finally, I am also inspired by the courage that they employ in facing these difficult issues. Although the stories are heartbreaking, they generally forge ahead with incredible bravery that is if they’re going to recover.
The question is, “What has happened to these bright, caring, compassionate and intelligent people who feel so terrible about themselves?” To answer this question I think it is important to discuss what hundreds of clients suffering from eating disorders have taught me. That there are fundamental facts of human development which we as a culture fail to adequately acknowledge and address. We’ve done work in these directions, but we haven’t done it adequately. The first of these is that childhood is a developmental realm which is much more difficult to survive than many of us have previously imagined. I suspect that without too much effort nearly all of us in the room today could tell numerous stories about the painful shocks and embarrassments we ourselves experienced in childhood. Moreover it never ceases to amaze me how fresh the memories of being hurt, frightened, or threatened are in the minds of those I meet. And not just in my therapy office but on basketball courts, in meetinghouses and among gatherings of my friends. I believe we are much more fragile as children than has ever been generally recognized.
Even in a present-day culture which is much more aware of protecting children than ever before—but this is not limited to children. People of every age are vulnerable to trauma if threatened by forces which are overwhelmingly powerful or so beyond the normal scope of human experience that they are difficult for our powers of reason to adequately grasp. We have learned through the experience of combatants in war and victims of crime and natural disasters that experiences involving acute threat cause fundamental and chronic disturbance of our thought and behavior. It’s always interesting to me to watch movies in which throughout the movie the protagonist is fighting a very, very powerful antagonist. The threats and shocks that these protagonists go through seem to be negligible given the subjective sense of threat that nearly all of us would feel. And when they finally triumph at the end, they go on about their lives just relieved that it’s over. Most of us who have experienced an intruder in their homes or crime or some kind of deep shock or threat, realize that we lose sleep, we lose our ability to think, we are rattled, we are shaken, sometimes forever.
These memories are often experienced as being stored and felt in the nervous system or brain chemistry. These traumas can be immune, seemingly to the effects of the passage of time, preventing us from the growth we would have made had the trauma never occurred. It seems singularly strange to me that everything seems to deteriorate over time. Everything except trauma memories. The human mind is a place that once scarred, heals only with tremendous effort. And these memories stay with us, forcing themselves out in ways that are often unpredictable and which appear unrelated to the trauma. Eating disorders are two of the ways that these traumas emerge. For those suffering from eating disorders, the traumas stem from four major sources.
Now in recounting these I don’t mean to blame those who have sometimes traumatized the clients with eating disorders. Most of us don’t try to hurt each other. We certainly very seldom set out to hurt each other. However, trauma occurs and it’s important in understanding the disorders to find out where this trauma occurs. Rejection from peers is one of the most common sources of trauma. We know kids in elementary school and even older can say and do things that hurt beyond their intent. Kids don’t understand the far-reaching results of how they interact with each other. Comments about weight, appearance, or a variety of other issues have often scarred my clients. This progresses through high school.
High school—that four-year popularity marathon with kids who have not yet learned the truth about high school, which is that high school far from being the only world that will ever exist, which is what a lot of us feel when we’re in the halls—is really only a very small part of our lives. Isn’t it interesting how five minutes after we graduate from high school the experience becomes childish and silly? But while it lasts, high school is the only thing that matters and approval from peers—especially based on completely superficial weight and appearance issues—sets up young women for eating disorders.
Again the message is that they are not good enough the way they are. Things must change for them to measure up. Most teachers and coaches are a positive influence in the lives of those they teach. Some however can have a catastrophic effect on those they are supposed to lead. I had a wonderful client who was driven and willing to sink tremendous amounts of effort in any endeavor she chose if she was given a little praise. She recovered very quickly from her eating disorder due to the state of affairs at the center for change which is basically based on a nurturing model. She responded to this nurturing, she responded to this praise, as many do. She had chosen basketball for one of her endeavors in life. She worked hard at it. She learned to shoot a deadly outside shot. She lived in the gym and gave almost total effort. Again, she was praise-oriented, yet her high school coach decided that the way to motivate her would be to humiliate her regarding her weight in front of the rest of the team. Ostensibly to improve her speed, she took her coach up on her order and turned the tremendous resolve she possessed toward losing weight.
And lose weight she did, although she had always been at a normal weight, over the months this client grew more and more depressed because, of course, the extreme weight-loss from anorexia led to a marked decrease in her performance and the team’s former best-player was reduced to sitting the bench. She was too physically weak to even take the court, and this began a four-year struggle with anorexia that almost claimed her life.
Siblings and families can all contribute to this intense sense of shame. All too often those suffering from eating disorders have been targeted by their older siblings, especially brothers, from mistreatment and even abuse. Parents often think that sibling squabbles don’t do damage, but siblings can say things that can stay with younger siblings for the rest of their lives. This mistreatment ranges from verbal belittling and denigration to physical and sexual abuse. In these cases as well the young girl does not question the sanity of the world around her, she is too young. Instead she subconsciously says to herself something to the effect of, “There has to be something wrong with me that people would treat me that way, how could they do it if I didn’t deserve it?”
What all these sources of trauma have in common is the invalidation of the person. In more common language, they tell a person that she somehow does not measure up. Finally, parents often serve to invalidate their children, but before I start out on this tack, let me make it clear that parents rarely set out to make things harder for their kids. A psychologist friend that I work with says often that no parent sits in front of their kids crib and says, “How can I mess this one up?” In fact those of us that are parents generally consider parenting to be the most important aspect of our lives. We care about them, they occupy our thoughts. We vow as we welcome them still in the neo-natal units of the hospital that we will rear them with love and protection.
I remember looking at my own daughter as she was born and offering a silent prayer of gratitude for this wonderful soul. And I got the impression, “Don’t mess this one up Kip.” And yet despite our best efforts, despite our resolve, despite trying to make them our first priority, we fail to honor the best in our parenting. We make mistakes sometimes in the heat of a disciplinary moment and sometimes in our entire approach to the parenting process. We as parents make decisions in what we say and do which don’t lead to the best chance of development for our kids. For those with eating disorders their families usually land on the outskirts of the parenting spectrum on the tails of the normal curve - generally either distant and disconnected or hovering and controlling.
With some of these families oftentimes the fathers fail to do the hard work of establishing a relationship with their daughters. These daughters look to the most important male figure in their young lives and no matter how hard they try to impress him he is sometimes focused elsewhere towards his career or hobbies or just due to personal issues. Or he may have a deficit, a lack of ability to give praise at all. The end result is that the praise and approval we all crave from our fathers never does arrive for these clients with the result that clients seek for it more and more desperately from other sources. Eating disorders, with the numbing that it provides can serve as an effective substitute at least early on. Approval and seeking for love is a force which is terrifying to me in its power for motivating, either good or bad. People would literally rather die than face rejection or lack of approval.
I have seen clients drive themselves to exhaustion, not eating and sleeping a pitifully few hours of sleep a night to look perfect enough and to get the highest Grade Point Average. All in the frantic hope that someone somewhere will finally tell them, “You’ve done it, you’re good enough.” The great irony is that they get so locked into their patterns that even when people do say these things it doesn’t help. Many of us as parents fail to acknowledge the good our kids do. We expect the status quo to be one of general excellence which leads us to looking at a report card full of A’s and ask about the one A minus or B on it. Rarely do we say, “Tell me about your effort, how hard did you work to get these grades? Does this represent your best effort?” A C minus might be more important to our kids than the A because they had to work harder for it. Instead we say, “Why isn’t this perfect?”
Of course as mentioned one of the most common traits of those suffering from eating disorders is an intense perfectionism, a focus on achievement that more truly could be called an obsession. Don’t be fooled if someone has called you a perfectionist, it could crush you. If left unchecked the perfectionist burden leads to paralysis and being unable to venture for fear of doing imperfect work and being criticized for that. We must allow imperfection in our families because that is exactly what we are going to get. Every time, there’s no other option, and because there’s no other option, it has to be okay. Most of the damage done is in the attempt to force perfection on kids. Kids will be far happier if they are allowed to give their best efforts and when we as parents are satisfied with that. But, although demanding perfection is one ways in which parents make mistakes, far more serious to emotional functioning is when parents—again, in the emotional whirlwind of the every-day of parenting of multiple children generally—resort to harsh discipline, extreme attempts to control or outright verbal abuse.
So, although it’s agonizing, we must trust the reality that all of us will make mistakes as parents, some of which are serious and some of these can contribute to the development of eating disorders. Given that, how can we be part of the solution? It is not my intent to create a sense of hopelessness in working with these clients. It is not hopeless by any stretch, but we need specific ideas as to how we can repair the damage that was done so long ago without the ability to revisit the past.
The answer to this question I would like to discuss is in something I think is one of the true miracles of social relations. It’s the apology. Apologies are absolutely incredible in their power to heal. As a committed but imperfect parent, I’ve had to lean on them a lot. I’ve had to apologize for times when I didn’t really listen, for times when I mediated arguments unfairly because I was too tired or preoccupied or lazy to take the time to get it right. For times when I assumed I knew what was happening, for times when I failed to notice the positive and instead relied overmuch on correcting the negative. Apologies are miraculous in this way. As they are made, the past is transformed somehow and memories of trauma can lose their toxicity. The events were real, they happened, but they are now somehow changed and have miraculously lost much of their power to hurt. There’s something healing in the words, “I’m sorry, I wish I hadn’t done that.”
Part of the trauma of being mistreated seems to lie in the thought that somehow, someone thought that we deserved the mistreatment, that there was something in our nature so bad or so wrong that it would illicit this maltreatment. I frequently hear clients say as I’ve already said, “What was wrong with me that this happened to me?” If things happened when they were children, it is eve harder because all children are often legitimately disciplined for something they did wrong, but due to their young age still had no understanding of. Sometimes kids are just too young to understand what it is we’re trying to correct. In this way the power in apologies might be that someone who acted as though we deserved maltreatment or punishment admits that we didn’t. This can dislodge old pain and undeserved guilt.
I should also note that if the abuse was severe or ongoing apologies are often inadequate in place of other more appropriate and therapeutic and legal interventions. We all possess a private definition of what it takes to be loved. Sometimes those with eating disorders don’t know how to express what they need from parents and so their needs go unmet. And sometimes even when parents do their best to meet their kids’ needs, the kids continue to feel bereft of the love and approval that they seem to praise. Sometimes we need to understand and accept that most parents loved us the best they could. I have with great reluctance come to the realization that it is rare that any one person can love another person in precisely the way that they crave.
Now having said this so quickly, I want to make it clear that I believe that most parents don’t withhold their love out of malicious intent. Rather, it is either out of lack of knowledge or lack of ability. Some of us are better at loving than others. Some of us—I think all of us—need to work at learning how to love. Some of us never really get to where we would want to be. Let me add that coming to this resolution that perhaps our parents have loved us the best that they could, can be a years-long process and that in my experience it is hard to have enough emotional distance from this issue before we are in our early, to mid-twenties to come to this realization and accept it.
Now, unfortunately there are clients who parents have indeed abandoned them. Sometimes this was at birth, sometimes through divorce or other circumstance. These clients almost always feel terrible loneliness, so terrible that the only thing they feel they can turn to for some sense of relief is the great numbing effect of their eating disorders. It is critical to stress to these haunted souls that no matter what has happened, no matter how deep the abandonment goes, there is hope, there are sources of acceptance they can still turn to. There are four basic sources for this acceptance. First, clients often need to turn to whatever family network they do possess. There may be aunts and uncles, grandparents, cousins, or siblings, or husbands as they start their own families, many of whom actually do get married and start their families. Second they need to reconnect with their circle of friends or start the process of building a circle of friends, something which can take years. I think it’s hard for true friends to be established in a short period of time.
It’s also very common to see, as we have already heard today that clients with eating disorders begin to isolate themselves from other people. They begin to push other people away, they don’t feel worthy, they don’t feel worthy of having friends who care about them. They feel worthless to the point where they don’t return phone calls. There’s in almost every case that I’ve ever had I’ve said, “You need to make a list of the people that are waiting for a phone call from you that want to hear from you and want to be your friend but which you have pushed away for so long that they are sick of your rejection.” There’s almost always a list of at least 5 or 6 people. They need to make these calls.
In talking to clients about what has helped them recover, many credit turning to God and spiritual sources of strength as being one of the most helpful elements of their recovery. Many of those with eating disorders, due to feelings of worthlessness have felt distance from God. Although they feel it is almost an impossible task, with help that is respectful of their network of beliefs, clients with eating disorders can relearn to make contact with a being who will never abandon or forsake them. And the bottom level fact is that no matter how much they have felt abandoned by those in their lives, they must never abandon themselves. It can be helpful to ask them to learn to care for themselves as they would a child entrusted to their care. They must learn to do all the things that they have felt unable or unworthy of doing for themselves.
They have to learn to get enough sleep. Those with eating disorders, obsessed with achievement and grades, cut the ends of their sleep to the point where they are getting only 3 or 4 hours of sleep a night. This lack of sleep, coupled with of course, the ingestion of far too few calories, leads to periods of exhaustion. They must also learn to set some time aside for themselves. Believe it or not, holding some time for themselves everyday for hobbies or relaxation, is almost as difficult as getting them to eat.
It’s also critical that they set some time every week for social activities, for letting peers in, for letting family in. For a variety of reasons, primarily because of the profound sense of worthlessness, those with eating disorders have isolated themselves from those who love them as we’ve discussed. In order to recover, I believe that those with eating disorders must learn to contact people who care about them. Most importantly, in order to take care of themselves they must learn to pursue their dreams. They have generally been so lost within their eating disorders for so long that they have come to see themselves in terms of their eating disorder. The look at themselves and say, “This is my identity, this is me, this is who I am. I am the girl with an eating disorder.” They must get back in touch with what they love. They can’t rely on their eating disorder which looks like it’s a life, but really isn’t. It can only be a mirage which will eventually destroy them, sometimes literally. They have to look at their dreams; they have to refuse to look at themselves as too broken to move on.
Now I’d like to shift gears a little bit and indicate how we as parents can prevent eating disorders and problems in our children in general. We need to catch kids doing things right as I’ve already alluded to. My clients have taught me that the central developmental question of childhood is, “Am I worth loving?” And that many of us can spend the bulk of our lives trying in various ways—healthy and unhealthy—to answer this question. In fact, strange as it may seem, numerous addictive processes are related to this question. If people feel they are unlovable, they often turn to a number of ultimately self-destructive things in order to numb the pain. This can be drugs or alcohol or eating disorders. Our opinions of our kids go a long way toward determining countless aspects of the way they approach every aspect of their lives. Kids care desperately about their parent’s opinions of them whether they are 14 or 40 or 74. We want our parents to be proud of us, so as we raise children we need to be generous with our approval. That doesn’t mean that we always have to be positive. Rather, it means that we need to learn to notice the positive that is always there to be found. Everybody does more right than wrong. Many of us seem to believe that we are somehow more insightful, that we are more intelligent if we can find what is wrong with something and criticize it, even when the things to be criticized are all too often apparent to everyone.
Let us not be accused of in the words of Frank Layton, “possessing a marvelous ability to state the obvious. It’s always easier to note the imperfection than calling attention to what is going right in their lives. What gets attention generally gets repeated even if it’s negative.” Therefore as parents, make certain that despite their mistakes we remember to tell our kids when they are doing things well. That doesn’t mean, by the way, that we can’t correct them or discipline them appropriately. The trick is of course to help them understand the need to correct a certain behavior without feeling that they as a person in totality are bad.
I’d like to talk to you a little bit about spending time with kids and that sometimes spending time is not quite enough. As we have discussed, the human mind is fragile in our culture, much too harsh and predatory for kids to make it to adulthood without emotional scars if parents are not there to buffer some of the shock. We place an appropriate value on communication with kids, but in today’s culture, to prevent serious problems such as eating disorders I believe we need more in-depth discussion about how to do this. President Ezra Taft Benson once exhorted parents in heartfelt ways to “Be at the crossroads.” It would be hard for me to overstate how important I think this is for our kids. The crossroads for our kids are times in their lives when a choice either way may send them down a path which may be difficult for them to reverse. However, as if it weren’t hard enough to take the time to really be with our kids, it’s even more important to know when a particular moment constitutes a crossroad.
So, we have to be there with our kids often so we don’t miss the start of something big. We can’t always tell. We hope that kids will come to us when they are struggling with issues. But where we make mistakes is that we fail to establish channels of communication. We don’t form the habit. If we listen to kids when they are young, telling us about the countless things that interest them, not necessarily those things which interest us, they will be much more likely to come to us when they are older. If we don’t know what they care about, do we really know them? Do we listen to their monologues? In my case about star wars and panda bears, do we try to answer their questions about koalas and prehistoric mammals? Are we familiar with their struggles, their insecurities and fears, their dreams and aspirations? What looks like an innocent chat can turn into a discussion that turns out to be a critical crossroad. Again we can’t always tell. It takes at least two things, our time and our physical presence. I guess I should probably add our patience to that. Listening without rampant advice, giving or judging, is one of the clearest messages about love we can send to our children. And if kids feel loved, problems including eating disorders are much, much less likely to occur.
Another thing I think we need to do is encourage their voices. We need to give them permission to have and express opinions without mockery or failure to listen. We don’t have to agree, but we can listen with respect. I believe that if every young girl were truly heard, the incidents of eating disorders would be almost negligible. There would of course still exist self-defeating ways of dealing with intense emotion, but I believe they would be far less serious than disorders which can literally kill. We need to teach kids that we don’t value people based on superficial qualities. We need to be careful about how we talk about people in general. We need to teach kids that they are loved no matter what they look like, that weight is not how we decide their worth. There are many more traits far more important than how we look.
As parents and grandparents, we mean well. We want our kids to know how much we love them and all too often we focus on their appearance and tell them how lovely they look. But we have to focus as well on things that aren’t superficial so they don’t come to the conclusion that their appearance is why they are valued. We need to value kids for their personalities, their talents, their effort, the desires of their hearts and how they treat people. Now there are many families where eating disorders already exist within their homes and I would like to address a little bit about what we can do to not just prevent but also help if the eating disorder is already well-established. One of the great difficulties in treating eating disorders is to walk the middle ground between failing to empathize with their pain and expecting them to just get over it, and then giving them too much empathy and saying, you will never recover. We need to empathize with their pain, without offering too much advice. They’re bright; they don’t need necessarily too much advice. They need permission to feel.
We need to work on our own approach to food. If we have a preoccupation with dieting, weight-loss, or appearance, or emotional overeating or any other kind of issue with food we will almost certainly be triggers for her. We need to let her know how much we love them, even when they don’t feel very loveable as has been discussed. We need to refrain from being the food or purge police, even when we can see that she is binging, purging, or restricting. We need to not be fooled by the outward manifestations of these very difficult disorders. Again, they are not about food, they are not about appearance; they are about being acceptable and lovable. We need to refrain from making judgments about why she is engaging in her eating disorders. We need to refrain from being overly concerned about deciding for her what her emotional state is and what it should be. We need to spend time with her without expectation or rigid goals.
I oftentimes tell clients and their families that they should go for walks, that they should go for drives, that they should talk together, sit on the couch, hold hands, cry on each other’s shoulders, or go to the park. Many of my clients want their fathers to push them in swings. There are certain developmental milestones that sometimes didn’t get met, and that could be one of them. We need to inquire often about her emotional well-being and welfare and be there for her when she is struggling. We need to assume that people are struggling with these issues unless we know that they are definitely not—unless they have let us know in ways that are convincing that they have begun the long road to recovery. We need to also ask her for specific ways that she can give us that can help her in the way of support.
Now I’d like to turn again, a focus to some recommendations I would make that might help those who are struggling with eating disorders that might be listening. I encourage you to turn to people. Don’t isolate. Return the phone calls you have not been answering and contact your old friendship network. Try to reconnect with them. It’s extremely difficult because you know friendships revolve oftentimes around food. People go out to eat, people go out to lunch, and you don’t want them to ask you why you’re not eating, you don’t want that scrutiny and that level of intrusive behavior. However these people want to love you, they loved you before and they will love you again. If your family is supportive and is trying to support you—even if imperfectly—allow them in, even if you do not feel worthy of their love.
Realize that your appearance and achievement will never deliver what you crave except in lovability and approval. It’s a mirage; it’s a façade that will never deliver on its promise. I’d encourage you to turn back to the spiritual approach you might have become estranged from. I’d encourage you to learn to trust your emotions and honor your voice. Those who are struggling with eating disorders have generally had their voices removed from them through childhood trauma. They don’t feel like they have boundaries, they don’t feel like they can speak their mind. They lack assertiveness, they have great difficulty in feeling their emotions, particularly the more unpleasant emotions of anger, frustration, pain, and so they don’t feel at all. I would encourage you to get in touch with those emotions. They will not overwhelm you like they seem they will. You can handle it. It won’t be a volcano that erupts and buries you.
Learn to not judge yourself so harshly. You would never treat another human being as harshly as you treat yourself. Start the long-haul toward ridding yourself of the voice in your head that constantly criticizes you in ways that you would never criticize another human being. I would encourage you to get help, be open, be honest. Allow someone to see your turmoil, you won’t be judged. Other people who don’t understand about eating disorders don’t look at you with the disgust that you think that they look at you with. Therapists with experience with eating disorders will help you understand why it’s happening and what you can do to change. You will have to be brave but when you have proven your strength beyond all reckoning by living with this nightmare for so long. I believe that everyone deserves to be loved the most. Thank you.