I am sharing these thoughts with the good parents, who suddenly found themselves
in a hell known as anorexia. The great families who loved and did the right
thing when it came to raising children. The parents who were and are fully
committed to each other and their children. Those very parents who laid awake
nights searching for where it was that they failed when it came to their child.
This is not meant for the families where violence, incest, alcohol and drug
abuse were present. Or for those who failed to commit fully to each other and
their children. I am writing to the parents of fully functional families, that
are seeking answers to why their child became anorexic.
You as good parents did nothing to cause this disorder. Please stop beating
yourselves up. In the study of anorexia there are many theories, and very few
answers. Out of those few answers the experts cannot seem to agree unanimously
on many of them. Most of the questions surrounding this disorder are still
unanswered. Much of the research that was conducted 20 years ago is being
updated and challenged today. Anorexia is theorized to be caused by any number
of complex reasons: an endocrine dysfunction, societal pressures, media, the
need for control, obsessive compulsive tendencies, fear of growing up, inability
to cope with outside forces, over sensitivity to change.
The causes fall into two camps 1)biological and/or 2)enviromental. Biological
studies have been on the increase. Much weight is being placed on the possibilty
that the anorectic is born with a biological predisposition and societal
pressures (example:media) trigger the disorder. The most recent study results
released April 14, 1997, announced that Bryan Lask and colleagues at London's
Great Ormond Street Hospital found brain links to anorexia. In their findings
12 anorexics had reduced blood flow to areas of the brain believed to govern
visual self-perception and appetite (the anterior temporal lobes). Lask stated,
"We believe the possibility is it's genetically determinded. People are born
with this predisposition and then other factors come into play...around the time
of puberty. That's when the condition starts. We can say to people with
anorexia nervosa--this is not your fault. You're not making it up. Parents can
be helped by saying to them that it's not their fault.".
Similar studies are being conducted at Gothenburg University in Sweden and the
Institute for Clinical Radiology at Mannheim in Germany.
The single area where all experts seem to be in agreement is when it comes to
treatment. Anorexia cannot be fought alone. Professional help is a necessity.
This must include medical and psychological treatment. When our daughter was
diagnosed with anorexia, the only knowledge I had on the subject was the
superficial information gained from talk shows, and I remembered hearing that
Karen Carpenter had died from anorexia. Since that sad day at the pediatricians
office, I have learned more on the subject than any human should have to know.
It seemed the more I learned the less affirmed answers there were.
From the start I sought knowledge on the subject. Top of the recommended reading
list, from 2 psychiatrists, 1 psychologist and 2 licensed clinical social workers
was "Surviving An Eating Disorder, Strategies For Family And Friends". Written
in 1988, this was a well organized overview of eating disorders, with much
useful information, and seemed to be the Bible in the industry. However it has
one huge flaw. The authors assume that all anorexics come from dysfunctional
families. WRONG! This was the first book I read on the subject. My wife and
I were already in great pain, searching desperately for answers. Believe me
reading the following passages did not help:
"When someone in a family develops an eating disorder, it is a sign that
something is wrong-not just with the individual, but with the family as well.
The eating-disordered person is not the only one under stress but may just be
the only one who shows it. If someone in your family has developed the symptoms
of an eating problem, it is time to listen. It is time to recognize that the
person with the eating disorder is not the only one in trouble."
"Families with an eating-disordered child vary tremendously. In some families
everything looks okay on the surface. In others the picture is overtly chaotic,
with alcoholism, drug addiction, gambling, or family violence obvious to the
onlooker."
"However, in all families in which there is a symptomatic child, there is a
common thread: The existing rules and practices that bind the family together
are not accommodating the shifting needs of the individual members." (page 54)
"In family therapy, the eating disorder is seen as a "red flag". It signals
that trouble exist in the family as a whole, not just with the eating-disordered
person. Difficulties in the family may include marital problems, lack of ability
to communicate feelings, difficulty setting rules, difficulty in expressing
conflict, or the inability to enjoy one another. These types of issues are
explored openly with all family members; to solve the family's problems all
members are encouraged to change, not just the member with the eating disorder." (page 114)
The Suggested Reading under Related Subjects contained four sections:(page 211-212)
Alcoholism
Children of Alcoholics
Incest
Change
Note: In 1997 this book was revised and updated, the authors toned down the above
quotes and added; "No one knows for certain what aspects of family life
contributes to a child developing an eating disorder." I was pleased to see that
the antiquated theories are being re-thought, and are not so all inclusive.
We had always taken pride in how well we had raised our young ones. We had
always put family first. Family had simply been the most important part of our
lives. My wife and I have always been committed, as boyfriend and girlfriend, as
husband and wife and as daddy and mommy. When we were thrown into this anorexic
hell, the theory set forth above added insult to injury. I understand that many
anorexics come from these sad homes, but to lump all people developing this
disorder into such a narrow category is remiss. Most literature indicates that
anorexia along with eating disorders are on the rise in our society. And not
surprisingly media is always right there at the top of the blame list. I believe
that with the increase in anorexia many more good families are being touched by
this disorder. The narrow thinking that all anorexics come from dysfunctional
families is simplistic and will have to end. Psychology needs to focus on the
complex reasons why this disorder is on the rise, not to just simply blame it
on mom or dad, and throw in the catch phrase "dysfunctional family".
Statistics indicate that in this health conscious society 20% of women athletes
are anorectic. If the dysfunctional family theory was correct, then 20% of all
woman athletes come from abusive dysfunctional families. Another recent
statistical theory is that up to 50% of all college coeds develop an eating
disorder. Once again if the dysfunctional family theory is true, then 50% of all
college coeds come from abusive dysfunctional families. Examine it from another
angle: Divorce. If divorce equals the ultimate dysfunction in families, and
anorexics are a product of dysfunctional families, then why are there not more
anorexics in the huge number of marriages that end in divorce?
This old adage not only causes unneeded guilt and worry to good parents, but also
muddies up the diagnosis and advice given by the professionals. When my daughter
was in the hospital (medical, pediatric ward), the day nurse in charge had
experience with anorectics over many years. In our first meeting the RN stated
that my wife was a very attractive woman, and questioned if this might have had
some baring on why my daughter (at 9 1/2 years old) became anorexic! Two weeks
later when we were discussing rewards or restrictions that might entice my
daughter to eat solid food, I brought up the possibility of limiting parental
visiting time. The professional I was discussing this with said that there is a
good chance your daughter is too angry at you as parents to care! Nothing was
farther from the truth. In fact it was the simple reward of a 20 minute walk
with Dad around the hospital, every afternoon, that got my daughter off Ensure
and back onto solid foods. When I told my daughter that many people assume that
anorectics come from unhappy, dysfunctional families, my daughter could not
believe it. When I told her that some people believe that mommy and daddy may
have done something to cause her to become anorectic, she said, "That's so
stupid. Why would anybody think that?". From the mouths of babes!
Being lumped in with dysfunctional people rocks your world. You go on a soul
searching expedition that examines every aspect of your life. It takes the wind
out of your parenting confidence. But when you and your life partner come out
the other end, you both know that you did a great job, and that shit simply happens.
All families are not perfect, but there is a Grand Canyon difference between
being human and being dysfunctional.
The media psycho babble found on talk shows continue to pump out the wrong
information to the masses, causing more confusion. My wife's sister taped a
recent Oprah show dealing with anorexia. A number of close friends who know
about our daughter also mentioned the show. When my wife and I viewed it we were
shocked at the message it put forth: All anorexics started as self-loathers.
Once again simply wrong. Many anorexics may indeed hate themselves, especially
if they have been anorectic for a long period of time. Who wouldn't? Your
whole wold demanding that you eat; you scared to death of eating. They live in
a dichotomy: eat and be a good daughter, but fail as an anorexic. Succeed as a
good anorexic, but fail as a daughter. After years of this, of course you would
become a self-loather. But to assume that all kids become anorexics because they
hate themselves is simply putting out the wrong information on a very complex
issue.
My message to you as good parents, is to stay strong. You are the front line
therapists for your child, on duty 24 hours a day, 7 days a week, 52 weeks a year.
Though there are plenty of holidays (all based around eating), there are no days
off. As good parents you have done nothing wrong, your baby still loves you.
She is just going through her own little hell. She will need you as the guardian
angels who will help her find her way back.
Good luck!
Mike
Note: Because I have an anorectic daughter it was easier for me to write this
using the female gender. I understand that 6% (a number that is also growing) of
anorexics are male. I am not excluding or ignoring the parents of boys, I
realize that having a male anorexic has it's own built in frustrations, added to
the usual hell of anorexia. My heart goes out to you. We are all in this together.
Copyright 1997
