There is no one better suited to write this post than the person struggling with an eating disorder. No, it's not my post; it's a heartfelt, insightful guide from someone really in the know about what those in recovery desperately need from their caring community. This post didn't come easily. It was 'Thursday's Patient's suggestion that it be written, and my invitation for her to write it. And it took guts to put it out there, to stand naked, so to speak, and shout out that help is needed.
Read it and respond--on this post and to your loved ones. Email, FB, Twitter--share it however you'd like. But do share it. Because the more you express your needs, the more you can be supported; the more you withhold, the safer your eating disorder is, maintaining the status quo. Enjoy!
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It's going to take more than this to recover. But it's
certainly a start. |
Someone you care about has an eating disorder, maybe she is anorexic or
bulimic. Maybe she abuses or misuses laxatives, diet pills, diuretics or
compulsively exercises. Maybe he eats when he is with you but you are not sure
if he eats when he is left to his own devices.
I know how difficult, painful, and maddening it can be to watch someone you
love engage in such unhealthy behavior. I also know that you are aware of and
afraid of the risks, both to
their health and survival as well as to their emotional well-being. I know how
you feel, because there are people in my life, whom I love, who suffer from
bulimia, anorexia or ED-NOS (eating disorder – not otherwise specified). They
exercise for hours a day, restrict their intake, and/or purge if they perceive
that they have 'overeaten'. I get mad, frustrated, scared and sad. And the
trickiest part is that I behave the same way - because I also have an eating
disorder. And I know what it is like to desperately need support from my loved
ones, the people who are mad, scared and sad because of my disease. See the
conundrum? I can’t make you understand what having an eating disorder is like
but as someone who has struggled with this disease for over twenty years I can tell you how difficult it can be to
ask those closest to me for help when I am struggling.
It's an Uphill Climb
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The door to change may be open, but you just might need support
breaking out. |
Eating disorder recovery is a series of ups and downs. We climb the mountain,
trip on a stick, land on our asses and sometimes slide all the way back to the
bottom (and the slide down hurts). Sometimes we can pull ourselves up, dust
ourselves off, tighten our shoelaces and gain elevation back up the mountain.
We do this with the help of our providers. These are the people that really do
keep us alive and accountable - and they hold the hope for us when we feel like
even just standing up (never mind climbing) is impossible. We see them often;
as Lori always says, “recovery is a full time job”. Weekly, I see Lori (my
trusted rock-star dietician), I see my therapist, and a clinical hypnotherapist
to work on issues that contribute to my eating disorder. When things are not
going as well as my team would like I may also have to throw in a visit to the
medical doctor and a second appointment with Lori. I spend hours and what feels
like a million dollars a week.
Sometimes, despite this high level of support,
I'm still a dusty mess sitting at the bottom of the mountain. There are
times when we need more. Sometimes that means a higher level of care, and
other times it means a higher level of support from the people in our
lives.
Needing Support – Not Wanting Support
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"I'm so ashamed asking for help! If only you could read the signs that
I'm struggling." |
Have you ever had to ask someone to help you move a heavy piece of furniture?
Do you remember feeling like you should be able to manage it on your own? Maybe
you tried. You pushed with your entire upper body and it moved a smidgen. You
decide you will make more progress if you push at an angle - you shift to the
right, you shift to the left. You're sweating. You sit down, put your feet
against the wood, bend your knees and push with the strength of your lower
body. But all that happens is your own bottom slips out from under you. The
furniture has not moved. You have two choices, leave it in the middle of the
room or ask for help.
For me, asking for help during a relapse or a major slip is painful,
humiliating, and exposing. I feel like I am admitting failure and weakness
(AGAIN). My pride has shriveled. I feel like a source of unending concern, burdensome
and unworthy. My friends/family are supposed to love me no matter what though –
and my treatment team says I have to call in the troops. So I reach out. For
those of you on the receiving end of this plea for support – you might feel
lost. You are afraid to say the wrong thing, you want to say the right thing,
and you don’t know which is which.
Please know that the eating disorder (often referred to
as 'ed') always tries to boss us around. He is an uninvited guest. We try
to ignore him and tell ourselves that he lies to us and is not really on our side, but sometimes we
might need you to remind us. Even
as I write this I am forced to edit out my eating disorder voice. The thing is,
he knows that if you follow some of these suggestions, then I won’t be so
aligned with him and may not follow through with his demands. My eating
disorder is threatened by your knowledge – and if recovery is my ultimate goal
then this is a very good thing.
The suggestions below assume that your loved one is asking
for support and is motivated to move toward recovery. If this is not the case
then it may be that your only choice is to encourage your friend that more
intensive treatment is warranted.
1. Think with your heart.
It sounds strange to think with your heart; don’t we feel with our heart and
think with our brains? But your heart is where your compassion lives and the
friend who sits before you, having just revealed what feels like a gaping wound,
needs compassion, or she's going to bleed out.
2. Depending on what
point in recovery your loved is in, the grocery store can be a major source of
anxiety (think being in a room filled with your most feared animal!). In my
early recovery days, having a friend with me while grocery shopping was the
only way I could make it up and down every aisle and to the register. With
someone there I also couldn't get caught in the trap of studying nutrition
labels - which could not only take up hours but could lead to me shutting down
and walking out of the store without any food.
3. Cook with your friend
or prep with your friend, or even just sit nearby while s/he organizes and
cooks meals for the week. Your presence is incredibly helpful. A social
distraction is always a good way to help get through a stressful situation.
4. Plan for meals
together and push through excuses - ed hates this. Your company and the
structure you provide just by being there goes a long way. When I left
residential treatment my friends and family were ready to have dinner that
night and breakfast the next day. They didn't smother me and it wasn't every meal (although some do need this some
of the time), but it was consistent support. I was transitioning from
residential to day treatment and it was the weekend, we all knew I had to get
in every meal and every snack between Friday and Monday morning when I would
return to the day program. I was so grateful for their help.
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We need support, but we need to move from our complacency! |
5. Do not ignore signs
of slipping! I know this
puts you in a precarious and uncomfortable place and I am sorry for that – but
for me, the longer I feel like I am “getting away” with engaging in eating
disorder behavior the worse things get and the louder my eating disorder's
voice becomes (“You're fine, see, no one even noticed that you skipped
lunch, lost weight, went running, threw away your snack, spilled out your
juice”). So, call us out on it, gently but confidently.
6. Ask questions without
assumption. I know you don't trust ed, and you shouldn't; but remember that
your loved one is in there, too. So ask, instead of accusing (“Is it ok with
your treatment team that you joined the gym, went to yoga, walk every morning,
eat diet food, etc.”). Asking helps us to feel safe enough to tell you the
truth. We don't want to lie to you, but even more we don't want to disappoint
you.
7. Keep it Simple Sweetie
(my therapist says it all the time) When s/he asks for support don't complicate
the discussion. She says, “I'm struggling, I need your support”. You say,
“thank you for telling me. Of course I am here for you”. Use the voice that
says you care, not the one that says “AGAIN?!” Maybe you are feeling that, but
let that be your’s, she can't hold that for you at this moment. Ask, “How can I
help?”.
8. Know that your friend
is not asking (at least most aren’t) for you to be her therapist, her dietician
or her mom. She is asking for your love, patience and company.
9. Check in – for me this
sounds like, “How is the meal plan going”, “Are you managing to resist the urge
to exercise?” or “How was your appointment with Lori?” or “Does she feel like
you are headed in the right direction?” or “How is your team feeling about
where you are at?”- those last two are really safe because they put the
ownership on the provider's opinion rather than your friend – who, let's face
it, you don’t always trust. Insert sad face here.
10. Don’t assume that this go at recovery will look the same as
the last. Remember that each step toward recovery is different than the one
made three years ago, a month ago, or even last week. There are times that we
want it so badly but truly, despite our best efforts cannot get out of our own
way. Sometimes, we just need someone to hoist us up off our butts, hand us a
walking stick and hike beside us as we start back up the mountain.
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It's easier to get down when you have some support
and accountability. |
11. Make sure we know we are not alone. Having an eating
disorder is very isolating - it’s part of the trick of the disease. Recovery
can feel equally lonely without the proper support. If you notice that your
friend is becoming more isolated please reach out, their eating disorder won't
let them reach out to you. Say, “I miss having lunch with you,” or “I noticed I
don't hear from you about having dinner together – can we make a plan?” or “Can
we talk about how I can help you get back on track by us eating together?” Please
don't take it personally (hard, I know) – we want to be with you and miss you,
but ed doesn't like when you're around – he knows you’re stiff competition.
12. Do not criticize, blame, or yell. Don't use “you”
statements: “You just have to eat,” or “You are acting so stupid”. Do use “I”
statements: “I'm afraid the next time you purge you could die”. “I feel like
your team should know you started running again” or “I'm worried about you, I’ve
noticed you've been eating less”, “I'm worried about how much you’ve been going
to the gym”.
13. When all else fails call your mother! In all
seriousness, when more intensive treatment is not on the table for your loved
one (no matter what the reason) suggest to him/her that they stay with you for
a few days (or vice versa if logistics are not a hindrance). If that won't
work suggest that s/he stay with family until they are back on their feet.
My mom and ed really don't like each other; as a result when she is with me
skipping a meal is never an option as I cannot bear being in conflict with her.
So, if I need a 'reboot' she will come stay for a couple of days -
Lori always knows that when mom's here no meals are skipped or skimped!!
There are so many 'do's & don'ts' in supporting eating
disorder recovery - and just like everything else, they vary from person to
person. When in doubt why not just ask your friend how you're doing? Ask
him/her if she is finding any of your conversations triggering or unsupportive.
Allowing for this openness not only supports her recovery but nurtures your
friendship. It's a win/win, right? Writing this forced
me to remind myself how important my support people are
to my recovery process. I am stubborn...and I often tell my team "I
am fine" and "I can do it on my own; no need to involve anyone
else". And while sometimes this might be true
- everything is easier and more enjoyable with a bit of help and support.
So,
as uncomfortable as this all can be, reach out to your friend/loved one and
support his or her journey to a better life.
It is my hope that this
post has given you some hints on how to do just that. Lastly, if you are suffering
with an eating disorder, remember that you are not alone. Reach out to
someone who cares about your well-being, show them this post, their
support might be just what you need to get to the top of the
mountain.
Thanks for reading,
“Thursday’s Patient”