The Vine: June 15, 2011
My sister has, after about 14 years, finally admitted to being anorexic. I love her, and I’m so glad she is ready to get help.
Unfortunately, she lives in a very remote area, a good 200 miles from where I am. Although she’s seeing a doctor, she doesn’t have much in the way of a support network; she only has a few friends in the area, and not many she trusts enough to really open up to.
What I wanted to know is, does anyone know of any good online resources for people recovering from eating disorders? She’s tried a few places, but only found teenagers, and she really needs some adult dialogue.
Also, does anyone know of anything I can do to help? I want to be there for her, but how do you know if being quietly supportive is right, should I be trying some more tough love, how can I tell when I should really worry? She’s my big sister, I love her dearly, and we’ve always looked out for each other, but I just don’t know what to do on this.
L
Dear L,
Good for you for supporting your sister — and good for her for seeking help.
We’ll see what resources and suggestions the readers have to offer, but in my admittedly limited experience, the journey away from an eating disorder can take a long time and go through a bunch of twists and turns. That can make friends and family feel like there’s something they haven’t done or said that they should have done or said, but I don’t think it works like that. Just hang in there with her, as you’ve done until now, and let her know she can find you there.
Readers, thoughts and links welcome.
Tags: Ask The Readers health and beauty the fam
Someone in the doctor’s office (if not the doctor him-/herself) may have info on support groups in the area or other resources.
While this isn’t a support group, this blogger is in recovery from her ED and is very open about her struggles. She talks a lot about what it is like in her head, and the strategies she has developed to help her push past the obstacles.
http://www.icametorun.com/
L might want to check out Al-Anon meetings. Depending on where L lives, there might be a specific meeting for people who have loved ones in recovery from eating disorders. The type of information that Al-Anon offers can greatly assist L in offering support to the older sister while setting & keeping healthy expectations & boundaries.
I come from a family with addictions. I married into one as well. We have two family members currently in recovery, one of those two still in rehab. The lessons & tools that came from Al-Anon have helped me support the recovery of those around me without getting swamped with guilt and blindsided by unrealistic expectations.
All of my best wishes go out to L & the older sister. I think that eating disorders/body image issues must be so difficult to overcome. Good on L for wanting to support Sis from afar.
It may seem counterintuitive, but Overeaters Anonymous is a recovery program not just for compulsive overeaters, but also for those suffering from anorexia and bulimia of all stripes (e.g. exercise bulimia, not just use of laxatives or vomiting). I know many people who have years of abstinence from restrictive eating and anorexia thanks to their active participation in OA. Meetings are scarce in remote areas, but there are many online and phone meetings that are great. You can do a general search, and OA itself has comprehensive listings at http://www.oa.org/meetings/find-a-meeting-online.php.
Something-Fishy!!!
http://www.something-fishy.org is an awesome resource. It has an online community for ED sufferers in all stages of recovery, as well as a separate community for friends and family. Something-Fishy was INSTRUMENTAL in my own recovery from anorexia and I helped moderate the online community for several years. It’s beautifully run – they have a no-numbers policy to prevent members from triggering each other, and all discussion is directed toward recovery and healing, not just comparing who’s worse off than whom. Seriously, send your sister the link – and visit yourself!
I have a close friend who has struggled with anorexia for well over ten years now, and I have to say that Sars is right that it is likely to be a long and wonky journey, with relapses and struggles along the way. Anorexia is about secrecy, privacy, and control, so – I don’t know how else to say this – be prepared that you may find your sister lying to you at various stages in the journey.
In my friend’s case, and I understand in many cases, anorexia is not really about food and weight, but in fact is a magnificent distraction from the anorexic’s real concerns and problems. It is easy to end up begging the person to eat and reassuring them they are not fat rather than addressing the real emotional issues, even in inpatient therapy.
I quizzed a clinical psychologist friend about what to do or say, and she told me that it’s OK to challenge the person at times, to say, “I can’t pretend this is normal. You are killing yourself, and I can’t watch. I know this isn’t really about food, I’m not going to talk to you about food. We need to talk about what this is really about”.
All the best to your sister in her recovery and to you for wanting to help.
I second the advice to check out Overeaters Anonymous and/or AlAnon. When I went to the OA meetings a good many years ago, there were a lot of people at the anorexic/bulimic end of the eating-disorder range. Also, and mind that this was 15-20 years ago, they had a lot of good books and even a few periodicals for those in recovery. A number of the meditation journal/daily reading type of books that are generally for people in all sorts of addictions, are also applicable to those with eating disorders. And even if your sis is in a remote area, if she can make it to at least a couple of OA, AlAnon, or even AA meetings, maybe she’d meet someone with whom she can have a phone or cyber friendship. Good luck to her.
I just finished this book:
http://www.amazon.com/Unbearable-Lightness-Story-Loss-Gain/dp/B004Q7E0TA/ref=sr_1_1?ie=UTF8&qid=1308157953&sr=8-1
It’s not the best written book in the world, but Portia de Rossi is brutally open and honest about her struggles. It may help you understand her thought patterns better, and it may help her to read about someone else’s struggles.
One further point from my own experience.
I think that, because anorexia can seem so irrational from the outside, there is a tendency for people to have two thoughts: to be convinced that, if they can only say the right thing, the person with the ED will “see the light”, or to be convinced that, if they say the WRONG thing, they will push that person over the edge.
L: you can’t do either of those things. You can listen and be quietly supportive, you can challenge some of your sister’s obviously disordered thinking. But her recovery will be down to her. Good luck.
The advice here is really helpful but it makes me sad the thread stalled out at only eight comments. I feel like practically no one knows what to do with this complicated disease.
Since I know people with it (don’t we all?), I was hoping to find some ideas on what to say to someone who has lost weight in a manner that you suspect is unhealthy, while everyone around them gives them tons of positive attention for the weight loss. Conversely, I thought that folks might know what to do when a friend who is fighting the disease is gaining weight and you want to encourage them without making them think they’re getting “fat” again. Or maybe someone knows if it’s better to ignore someone with eating issues who is pointedly not eating at a meal (so as not to focus attention on them and, therefore, feed into a codependent dynamic) vs. address it (so as not to ignore a serious issue), and how to do the latter without being “controlling.”
So many questions, so few answers.
I have to second http://www.something-fishy.org. This website is about as close as you can get to EXCELLENT, free therapy for eating disorders without leaving your home. There are resources for the writer as well as her sister- very active and VERY useful discussion forums, separate sections for sufferers and for relatives of sufferers, and lots of factual information. There are no numbers allowed in any postings, no photos allowed, no diet talk allowed. It is a very safe, welcoming, challenging environment and I cannot recommend it strongly enough.
The advice here is really helpful but it makes me sad the thread stalled out at only eight comments. I feel like practically no one knows what to do with this complicated disease.
I had a longer response written, but when I realized it boiled down to “I tried these things, which all backfired, so don’t do them,” I deleted it.
Our…”cultural,” I guess, for lack of a better word, response to this disease is unique. Maybe it’s because EDs seem to exist at a nexus of other societal anxieties/obsessions — the beauty myth, female sexuality, stigmas about mental illness in general, airbrushing, lookism, delayed adolescence, you name it. Maybe it’s because of the literal disappearance of the sufferer. Whatever it is, I’m struck by the similarities between this group of diseases and actual death in how we react to and talk about it.
This isn’t a judgment (or if it is, I don’t exclude myself). I’m just saying.
And, in case your sister is wondering, there are people of all ages who use something-fishy- there will definitely be people there at her stage of life. The age range I have “met” are teenagers to late sixties, and I am sure there are people there older than that whose ages I just don’t know. (Many are no longer sufferers themselves, but stick around to help out and share their experiences.)
I haven’t had any hands-on experience in EDs, but I highly recommend Caroline Knapp’s Appetites: Why Women Want. It’s available on Amazon.
Knapp suffered from anorexia for a long period in her twenties, and her writing covers a lot of ground: the control, the unending boredom of anorexia, the exhaustion and back-and-forth that came with the decision that she just couldn’t go on like this. It’s her unique voice but for that reason, it really resonated with me. She isn’t trying to excuse or boil down the disease, but work out a way of understanding it. Reading it may help you grasp a bit of some of your sister’s thought patterns.
I second (third, fourth, whatever) Overeaters Anonymous. Some relatively remote areas even have a meeting or two, and if she is too far for a face-to-face meeting, there are online and phone meetings. Information on all of that can be found on http://www.oa.org.
I ran track and cross country for 12 years, including on varsity teams in high school and college while it does wonderful things for many people (definitely made me confident, a better student, etc. etc.) it can also be a breeding ground for eating disorders because of the “lighter is faster” mentality (not always true of course). Needless to say I’ve been through L’s dance many, many times (with “non-biological” sisters of course).
To build on @Sars point, or more accurately to address @Jen’s point, I believe the reason that “no one knows what to do with this disease” is because it’s different for everyone who suffers it. Giving “what worked for me” doesn’t translate well to each sufferer of the disease, much like the treatment for depression is very different depending on the severity of the condition. While plenty of things get lumped into “anorexia” or “bulimia”, etc. but those are just titles and the “eating disorder” is actually a combination of many, many issues or perhaps even just one traumatic event
I echo that all of those resources mentioned above can help L figure out what works best for her and her sister.
Now with that huge disclaimer….
Jen.. towards you’re specific questions, like @Sarahnova said, you’re behavior towards these individuals is not going to dictate their behavior. My friends who suffer with the disease each need different things from me because of their own personalities. Friend A needs me to never comment on her physical appearance and only say “i’m so happy to see you happier now” Friend B is okay with comments on gaining weight on the other hand, because she sees that as part of her recovery. In general, your friends have a personality outside of their eating disorder, and that continues.
So just like, you know which friend you say “Hey, that sweater is fug on you” to and which friend needs you to keep a lid on it, the same rules apply.
Sorry so long of a response. It is a terrible, hard disease that takes a lifetime of recovery, and because of that, there are just, in my mind, no simple answers.
As to what you can do to help:
My perspective comes from weight loss counseling, which is obviously different than what your sister is going through. But I think in theory they may have similarities. We talk about building a good support network and what that looks like, and the reality is that it depends on the individual. Some people respond well to tough love, other people need cheerleaders. Some people losing weight appreciate a food cop, others want to punch them in the face. Sometimes our “saboteurs” aren’t really. They’re just…clueless at how they can help us.
My own approach to loved ones is honesty. I think it would be perfectly OK for you to say to your sister “I really want to be supportive of you in this effort. What kind of things can I do to help? What kind of things would not be helpful?” If she doesn’t know now, you can always assure her that if you ever say anything that turns out NOT to be helpful, she’s allowed to call you on it so that you can fix your approach.
A British journalist, Emma Woolf (aged 33) has been writing a brave and interesting series of columns for the last few months about her struggle to recover from anorexia, so that she can gain enough weight to become pregnant. They’re called ‘An Apple a Day’ and a link to the first one is below.
Unfortunately The Times is now behind a pay wall but you could get a one day subscription and download the lot (possibly a library would have free access).
http://www.thetimes.co.uk/tto/health/article2803780.ece
And good luck, L, I’m sure your sister is very glad you are there for her.
L, you sound like a wonderful sister.
Anorexia is, pardon my expression, a bitch to deal with. Actually, I prefer to think of “him” as “ED” (Eating Disorder) the abusive significant other. (I’m hardly the first or the only to make this analogy, btw.)
I myself have dealt with AN/ED-NOS since the end of high school (I’m 31 now), and at this point have walked beside others during their struggles with it, too. I’ve maintained a healthy weight now for 2-3 years (though not without frequent “good god, I’m a fat cow” internal chatter).
Over the last few years I’ve stumbled across the Maudsley approach as well as research on how AN is a disease–a way certain people’s brains are wired, I suppose–rather than merely a psychological cry for help, and THAT, actually, helped me to treat myself as a patient rather than a screw up.
Some resources: Carrie Arnold (http://ed-bites.blogspot.com/), Harriet Brown (http://harrietbrown.blogspot.com/; you can also search for a NYT article she wrote a few years back), and Laura Collins (http://www.eatingwithyouranorexic.com/).
It helps to realize that there ARE things you can do to help your sister, as long and twisted and frustrating as her road to recovery may be.
Good luck!
Hi L.
This has been touched on in other comments, but I want to emphasise the importance of keeping yourself safe through all of this.
You are obviously a good and caring sister and your desire to help is clearly strong.
But do keep in mind that, as others have mentioned, that anorexia shares many characteristics with addictive behaviours.
This means that lying and attempts to perpetuate disordered behaviours are so strong in sufferers that even those who were once inherently honest people find it difficult to maintain norms of close, honest relationships.
It’s therefore important to see your sister as someone different now from who she once was. She is most likely an honest person at heart, but her addiction will make her a different person in that respect now.
This is incredibly difficult for people like you who want to maintain closeness and to believe what the sufferer says. You can feel betrayed and hurt, but such behaviour will retreat as the disease retreats.
The problem is, that with the back and forth nature of recovery, it can be difficult to know what state your sister’s in, in regards to her honesty.
I wish you and your sister all the very best.
@Jen B, the most important thing I’ve learned from my friend and her long-term ED struggle has been my own limits. I’ve had to recognise that her problems go way beyond me, and that nothing I can do or say can do more than maybe make her feel a teensy bit better. I’ve also had to recognise that at times I don’t have the energy to be there for her, and step aside to give some attention and energy to myself.
There really is no one thing to say, I think, bad or good, that will have that much of an effect. Empathy and honesty are always good, and I’d say that trying to avoid getting sucked into the seductive world of the food obsession is good for a supporter. What I mean by that is that it is easy to become as obsessed as the sufferer with the cycle of restriction, purging, compulsive exercising, whatever it might be, and to attempt in return to control those behaviours rather than focusing on the emotions that they’re a coping mechanism for. But YMMV and I most certainly don’t have a degree in the area.
Seconding the recommendation for Caroline Knapp’s Appetites. Quite possibly the best writing on eating disorders I’ve come across – it resonated with me a lot. Definitely check that out.
From my perspective as a recovered anorexic/bulimic: Beware the personal memoirs. I remember reading one that was recommended to me (post-2 week hospital stay with feeding tubes) and thinking, I must not have been that sick. It does strange things to one’s self esteem.
For me, what helped was medication, and moving closer (but not too close; within 2 hours) to my family. The no-numbers online support groups sound like a good bet, too. Good luck to you and your sister.