Relationships - Surviving anorexia
Anorexia is a debilitating condition, both for parents and the sufferer. Charlie Azzopardi offers some advice to parents of anorexia sufferers.
Eating disorders are various, and so are the persons who suffer. Eating disorders are often associated with anorexia nervosa and bulimia and hardly anyone thinks of obesity as an eating disorder. The reasons why eating disorders have gained so much attention recently are simply because the number of people suffering is on the rise. The reason why anorexia attracts more attention than bulimia is because it is a terrifying illness.
Yet, in spite of the limited psychotherapeutic resources many people survive it. This article will focus on the how parents can survive anorexia.
First it is important to say that anorexia is so diverse. The clinical picture ranges from a mild single transient episode to a terrifying life-threatening illness or chronic and incapacitating condition which can afflict women of any age. Anorexia often develops in crisis points in life, particularly around adolescence. Anorexia is when an individual finds it extremely difficult to maintain a healthy weight. Gaining weight becomes a terrifying prospect and appetite becomes overwhelmed by the desire to lose weight. Weight becomes the centre of the anorexic life.
Parents often understand immediately that something is wrong but don't know what to do. Anorexia can be as incapacitating for the parents as it is for the sufferer. A common occurrence is that parents, in their desperation to "make" their daughter eat, have problems coming up with an agreed plan of action. This disagreement often fuels anorexia rather than curbs it. Speaking from a parental perspective, accepting that a daughter is psychologically ill is very hard, particularly with all the stigma that is associated with psychological problems.
Without going into much detail, no one really knows exactly what is to blame. Several factors are thought to be implicated. A genetic component has been found by some studies. Some colleagues of mine at the Institute of Psychiatry and the Maudsley Hospital in London have been studying, and are still studying, twins for some years. Their findings suggest that identical twins are more likely to have the illness than non-identical twins.
Cultural factors may be implicated too. Western culture has increased its emphasis on thinness. Super skeletal super models have been equated with Venus and this might have some perpetuating effect on those suffering from anorexia. My experience while working in a central London clinic for eating disorders tells me that those suffering from anorexia are often highly interested in fashion and design and some eagerly follow the scene.
The way the west promotes health may also be working against some people. The message transmitted is often "the lower the weight the better the health". Messages against obesity, though well intended by the media and health promotion services, may act as scaremongers to those with anorexia predisposition, increasing their fear of gaining weight.
Eating disorders are also associated with other psychological disorders including personality disorders, particularly the borderline, the narcissistic and the obsessive types. All of these disorders are linked to attachment problems suggesting a link between anorexia and the person's sense of intimate connectedness with those around them and the world. Some parents often feel guilty that they might have been the cause of the illness and waste time blaming themselves.
Some clinicians often reinforce this idea and support the parents to ponder on the past with the hope of identifying the source of the problem. While it is important to tell your psychologist and psychiatrist about any difficulties that you think are relevant, there is no point in self blame as it will not make anyone get better. This is relevant to other mental health problems. What is important, however, is to concentrate your resources on the present and on recovery.
Anorexia definitely affects family functioning and this needs to be looked into and healthy patterns of relating re-established in spite of anorexia. In spite of all the research done to understand the causes of eating disorders none actually shows great differences in family functioning.
Families are, therefore, not to blame. It is often when anorexia strikes, that families, in their attempt to solve the problem, actually contribute to it and reinforce it. This is understandable considering the parents' concern, and therapeutic attempts should be made to restore healthy dynamics.
Parenting a child or an adolescent with anorexia is difficult and often disheartening. It often demands a great deal of effort including cognitive, emotional and financial effort. I've seen so many parents who get so absorbed by their child's anorexia that they actually stop having a life for themselves. This feeds depression and hopelessness. It is, therefore, vital that you continue to have your own life if you want to help your child. Make sure you spare some time to have fun.
Don't neglect your spouse and the other children. Make sure you spend time with them having some fun. It is also essential to pursue your own interests as often they serve as re-fuelling for the demanding life of helping someone with anorexia. Meeting other parents with similar concerns may be helpful. I'm not sure if there's a support group locally dealing specifically with anorexia-concerned parents.
Don't try to be the best friend of your anorexic child. Don't look to them for support, particularly support due to problems in your marital relationship. Seek separate marital therapy if that is the case. So it is important that you continue to provide parenting for your child. You cannot be a parent and a friend at the same time. Being a parent means establishing a framework of rules for living. They may initially fight against them but that is fine, adolescents need rules to rebel against. Yet children feel more secure when parents are able to stand firmly by what they believe is good for the children.
Avoid splitting. It is paramount that parents present a united front to all children, particularly to the sufferer of anorexia. Avoid making decisions on your own when you know your spouse will disapprove.
I assume that by now you are already involved with a professional. If not, make sure you get in touch with a specialised professional. Anorexia requires the involvement of various professionals. Each case is very specific to itself and there are no hard and fast solutions. Getting professional support upon the very early signs can make a big difference.
• Dr Azzopardi is a systemic family therapist.
Yet, in spite of the limited psychotherapeutic resources many people survive it. This article will focus on the how parents can survive anorexia.
First it is important to say that anorexia is so diverse. The clinical picture ranges from a mild single transient episode to a terrifying life-threatening illness or chronic and incapacitating condition which can afflict women of any age. Anorexia often develops in crisis points in life, particularly around adolescence. Anorexia is when an individual finds it extremely difficult to maintain a healthy weight. Gaining weight becomes a terrifying prospect and appetite becomes overwhelmed by the desire to lose weight. Weight becomes the centre of the anorexic life.
Parents often understand immediately that something is wrong but don't know what to do. Anorexia can be as incapacitating for the parents as it is for the sufferer. A common occurrence is that parents, in their desperation to "make" their daughter eat, have problems coming up with an agreed plan of action. This disagreement often fuels anorexia rather than curbs it. Speaking from a parental perspective, accepting that a daughter is psychologically ill is very hard, particularly with all the stigma that is associated with psychological problems.
Without going into much detail, no one really knows exactly what is to blame. Several factors are thought to be implicated. A genetic component has been found by some studies. Some colleagues of mine at the Institute of Psychiatry and the Maudsley Hospital in London have been studying, and are still studying, twins for some years. Their findings suggest that identical twins are more likely to have the illness than non-identical twins.
Cultural factors may be implicated too. Western culture has increased its emphasis on thinness. Super skeletal super models have been equated with Venus and this might have some perpetuating effect on those suffering from anorexia. My experience while working in a central London clinic for eating disorders tells me that those suffering from anorexia are often highly interested in fashion and design and some eagerly follow the scene.
The way the west promotes health may also be working against some people. The message transmitted is often "the lower the weight the better the health". Messages against obesity, though well intended by the media and health promotion services, may act as scaremongers to those with anorexia predisposition, increasing their fear of gaining weight.
Eating disorders are also associated with other psychological disorders including personality disorders, particularly the borderline, the narcissistic and the obsessive types. All of these disorders are linked to attachment problems suggesting a link between anorexia and the person's sense of intimate connectedness with those around them and the world. Some parents often feel guilty that they might have been the cause of the illness and waste time blaming themselves.
Some clinicians often reinforce this idea and support the parents to ponder on the past with the hope of identifying the source of the problem. While it is important to tell your psychologist and psychiatrist about any difficulties that you think are relevant, there is no point in self blame as it will not make anyone get better. This is relevant to other mental health problems. What is important, however, is to concentrate your resources on the present and on recovery.
Anorexia definitely affects family functioning and this needs to be looked into and healthy patterns of relating re-established in spite of anorexia. In spite of all the research done to understand the causes of eating disorders none actually shows great differences in family functioning.
Families are, therefore, not to blame. It is often when anorexia strikes, that families, in their attempt to solve the problem, actually contribute to it and reinforce it. This is understandable considering the parents' concern, and therapeutic attempts should be made to restore healthy dynamics.
Parenting a child or an adolescent with anorexia is difficult and often disheartening. It often demands a great deal of effort including cognitive, emotional and financial effort. I've seen so many parents who get so absorbed by their child's anorexia that they actually stop having a life for themselves. This feeds depression and hopelessness. It is, therefore, vital that you continue to have your own life if you want to help your child. Make sure you spare some time to have fun.
Don't neglect your spouse and the other children. Make sure you spend time with them having some fun. It is also essential to pursue your own interests as often they serve as re-fuelling for the demanding life of helping someone with anorexia. Meeting other parents with similar concerns may be helpful. I'm not sure if there's a support group locally dealing specifically with anorexia-concerned parents.
Don't try to be the best friend of your anorexic child. Don't look to them for support, particularly support due to problems in your marital relationship. Seek separate marital therapy if that is the case. So it is important that you continue to provide parenting for your child. You cannot be a parent and a friend at the same time. Being a parent means establishing a framework of rules for living. They may initially fight against them but that is fine, adolescents need rules to rebel against. Yet children feel more secure when parents are able to stand firmly by what they believe is good for the children.
Avoid splitting. It is paramount that parents present a united front to all children, particularly to the sufferer of anorexia. Avoid making decisions on your own when you know your spouse will disapprove.
I assume that by now you are already involved with a professional. If not, make sure you get in touch with a specialised professional. Anorexia requires the involvement of various professionals. Each case is very specific to itself and there are no hard and fast solutions. Getting professional support upon the very early signs can make a big difference.
• Dr Azzopardi is a systemic family therapist.