My parents, specifically my mother, have denied the seriousness of my eating disorder for all of the eight years I have struggled off and on. She never got counseling for me in high school and, now as a college senior, I have been trying to get counseling on my own, but still feel no hope because of my relationship with my parents. My parents are the typical no-feely, no emotion, “make sure we look like the perfect family” type. Since coming to college, I have met a lady similar in age to my mother who I do music with at church who has become my second mom. She is the first person to force me to get counseling at college and continue during this past summer. She is doing anything she can to help me and get me into recovery, but the relationship with my actual parents is still an issue. I feel like my second mom will react in the same ways as my real mom, and I am getting frustrated with pushing her away as “ED” takes over. I’ve read books about family needing to take action, and I know that’s not possible with mine. My mom has refused to try to understand or read anything because it will make her more upset. My second mom has read lots of books, but I’m still scared to let go of this coping mechanism. I never know what I should do in certain situations because I don’t know if ED is talking to me or my actual self is talking to me. I know so much about my disorder, but I still don’t believe I’m in serious danger since I only purge on average once every few months and only deal with my binges with exercise and only allowing myself to eat certain fat-free, sugar-free, low-calorie foods. My electrolytes have always been normal although I have had a lot of health problems probably due to the years of disordered eating. I just finished reading “Andrea’s Voice” and wonder where I lie on the continuum of seriousness. Can you offer any help on what I’m missing in my recovery to get me feeling like I’m going somewhere? I deserve to get better. I am currently doing counseling at school with one of the head psychologists, but sometimes I wonder what level of therapy I need and how to communicate with my parents. – L.
Dear L.,
It is very hard when our parents let us down in such important ways as your parents have done. I have worked with many girls and women with eating disorders who have similar issues.
As we grow older there is a need to resolve parent issues in order to move forward with our lives. It would be wonderful if the resolution could be that the parent(s) finally understand and there is a wonderful reconnection, but it doesn’t always work that way.
In many instances, the women I have worked with have become stuck looking back to their past, instead of looking at the here-and-now and the future. They often spend a lot of their emotional energy and time focused directly on their family of origin, which prevents them from moving forward in life. Many of these women are in their late 20’s and even 30’s. Developmentally, they should be focusing on their lives as adults – relationships, career, new friends, etc. – but they cannot get beyond the pain and unspoken hopes that things could change with their parent(s).
The wounds in situations like yours are very real and very painful and you cannot simply push them aside. However, you need to consciously move away from dwelling on your issues with your parents – slowly, but surely.
You have to take a look at the situation and determine (with a therapist) what is realistic in terms of what your parents might actually do in terms of changing – and what they are not likely to change.
You then have to go through a mourning process – listing the things you wished could have happened but didn’t. Listing the things you wish you could have done with them, and the type of relationship you wanted with them – but didn’t have.
Like any mourning process, the goal is letting go emotionally.
Many of the patients I have worked with don’t want to do that. They unconsciously hold out hope that things can change. It is the hope, desire and passion that their parents will finally get it and change that keeps them stuck.
Often the ED plays a role. There are always many issues that cause and maintain and ED, but in these cases one of them can be the subconscious hope that the parent(s) will finally see how much they are hurting as evidenced by their depression and eating disorder – and will choose to apologize and nurture them in ways they’ve always wanted.
Again, I want to emphasize that it isn’t something people intentionally decide to do. These individuals do not say, “I will get an ED and be really depressed, then they’ll see –then they’ll change.” The ED develops for a lot of reasons, but when the ED does develop –– there is a normal and natural desire that the parent(s) will finally come through. When they don’t, the ED gets worse. The ED often develops because the parents weren’t nurturing enough.
Ironically, one of the primary factors that caused the ED to develop (e.g., parents not hearing the child, not validating her, not taken care of her) –– can be a factor in keeping it going as they still don’t hear, they still do not validate, they still don’t help her.
When parents don’t nurture or provide a secure environment, the child is wounded. This wound can result in dependency conflicts where an adult child goes back and forth between being overly dependent and overly independent.
There is a desire to isolate and “do it on my own” and, at the same time, a desire for someone to rescue and take away the burdens. They hate being dependent, but because they didn’t have a secure safe environment where their needs were met growing up, they still have strong feelings of insecurity that cause them to want a parent-like figure to come and help.
Although this relationship with your surrogate mom can be very important and helpful, you have to be cautious. The tendency to go back and forth between feeling overly dependent and independent is probably why you might push her away sometimes. You sense yourself getting too dependent, you don’t like that, and you become afraid that this caretaker – like your parents – will not come through for you.
In terms of your severity, I cannot answer that from a distance. There are two key areas in terms of ED severity – physical and psychological. Be open with your physician about your ED and ask him or her about your physical health. In terms of psychological severity, there is much more to ED severity than how often you purge. Right now I hear a lot of desperation and being stuck in terms of moving forward in your life. In this sense, there appears to severe issues.
I recommend that you continue with your therapy. If you don’t feel that therapy is going anywhere, talk to your psychologist about that. She or he can discuss this with you and come to a resolution. If it is going well, talk to him or her about his or her opinion about a higher level of care, such as intensive outpatient programs or inpatient programs. I have a few other recommendations, but want you to understand that your first source of information is your psychologist as she or he has first hand knowledge.
- As in 12-step programs: Admit your powerlessness to change your mother. Work towards letting go of any expectations that she will change. Don’t try and come up with ways that will cause her to finally “get it.” Be mindful that you may do this subconsciously, and work not to fall into those behaviors. This doesn’t mean that at some point your mother may not change, but the probability of her changing (given what you have said) seems unlikely, at least right now. So don’t spend energy trying to change someone you cannot change. Save your energy for the things you can change. This doesn’t mean to avoid your mother or to give up on her as a person; it means that you resist trying to change her or expecting that she will change. This is not going to be easy and you will need support. You won’t do it perfectly. It involves an awareness of what you expect when you talk with her as well as a change in your focus. You will also likely feel emotional pain as this happens, which is one of the reasons why you need to continue in therapy.
- The second is related to number one. I want to say this cautiously because I don’t know the details about your situation. However, I am basically saying what you have already said: “I’ve read books about family needing to take action, and I know that’s not possible with mine. My mom has refused to try to understand or read anything because it will make her more upset.” You can recover, even if your family does not take action. I have seen women recover time and time again, even when their families don’t change. I have even seen adolescent girls recover in spite of their family.
It appears you have done all you can for now in terms of convincing your mother. So I suggest that you don’t bring up your ED issues to her, at least for now. Talk about college, career goals, and your interests – things you would talk about if you didn’t have an ED. Your doing this isn’t a denial of your ED; it is accepting that your mom isn’t changing, regardless of what you have said in the past. Not talking with her (and your father) is a recognition that talking to them (at this point in time) only makes things worse. Talking about it gets your mother upset. My guess is she pulls away when she gets upset and may do other things that end up hurting you, adding to the significant wounds you already have. In turn, your pain (as understandable as it is) makes you need her all the more, creating a vicious cycle.
Don’t make working on your ED a full-time task. What I mean by that is people can get to a point where they don’t do anything or think about anything that isn’t related to the ED (reading books, talking to people about it, etc.). Those things are good, but they must be balanced.
There are two battle plans in dealing with problems such as and ED:
1) To fight to get rid of the problems and avoid unhealthy behaviors (e.g., purging)
2) Adding good and healthy things into our lives.
Often the second is easier than the first. It is easier to choose to do something than to avoid doing something. It is harder for someone to fight off feelings of depression than it is to go out to a movie or a concert with a friend, even when you are feeling depressed.
That doesn’t mean that you give up on the first strategy (actively fighting against ED related problems). It means that you emphasis adding positive things into your life, even when you don’t feel like it. As Paul said, “Finally, brothers, whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable – if anything is excellent or praiseworthy – think about such things.”
If I asked you to think about a movie that you love – to think about the characters, your favorite scene, etc., you could do that. On the other hand, if I said, “Whatever you do, don’t picture an apple in your mind,” I can almost guarantee that you will picture an apple. What is the point here? Simply, it is easier to choose to think about things than to choose not to think about things. I am not saying ignore the painful issues. Just make time to intentionally ponder things that you like, have conversations that have nothing to do with problems, do things that you enjoy because you enjoy them. If you cannot do this at all, you may need a referral for antidepressants and more extensive therapy.
God bless you and I pray that one day your family comes around. Just don’t build the foundation of your recovery on that.
David Wall, PhD