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crave2017

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Reply with quote  #1 
Hi,

This is my first post on this site, having been a "lurker" for some time; I'm posting not for advice per se, but just support and solidarity - put simply, I don't know what else to do. 

I'm in an unusual situation: having suffered from AN myself for many years as a child and adolescent, my sister (16) has now come to me admitting that she herself is - and has been - struggling with an eating disorder for some time. This is something that has been incredibly difficult to deal with - first and foremost because I, as her older sister and the token "fucked up" one (good old Family Systems theory!) hoped that she would (or could) be "protected" in some way from going down the same path. Ironically, this may have prevented her from coming forward sooner - when asked why she denied this previously, she said she felt guilty because it was her "job" in the family to "be the healthy one". Likewise, having seen me very physically and mentally debilitated by AN and BPD, she may have struggled to validate the legitimacy of her own experiences (although she has not expressly stated this - merely implied it). I feel incredibly guilty not because I believe that this is my "fault", but because I fear that my own issues prevented her from having the space within the family to be heard-as-her, and feel deeply sad and regretful about this. I know that I cannot change this and I am thankful to be in a healthier place now, but that doesn't diminish the emotional impact of this discovery. 

Previously, when I confronted her about her eating/exercise habits, she would just vociferously deny it; she (and I) have always been slim, and we both have a difficult relationship with our parents that means that communication is limited. As a result, I am the only person in the family who is aware of her issues - and I am becoming more and more worried about it. It really does feel like a burden - especially because, as a former sufferer, I am aware of how little I can do. My parents' involvement would make things worse; them food-policing her would just make it into more of an issue and heighten the tension in the house further - they were never "good" with my issues, having difficulties with food and other psychological issues themselves, and they have enough on their plate already (no pun intended). She is willing - and wanting - to seek help, and we are going to the GP next week to get a referral put in; I am lucky enough to, having had substantial treatment for my MH issues, "know the right people" and therefore have been able to speak to an old clinician for advice and confirmation that his team would accept a referral were it to come in. However, it is so painful to see (from an external perspective) how debilitating this illness is - I see all the signs so clearly in my own sister: the baggy clothes, chewing excessive gum, irritability, exercise, veganism (with only a few "safe foods")... etc. etc. I wish that something could've been done earlier, but I am incredibly glad that she herself has been able to note that there is a problem - a huge step in the context, and something (ironically) that was ascertained "properly" having watched To The Bone - the moment when she, quote unquote, realised 'how abnormal all this was'. 

[Note on my recovery: I personally only managed to recover when I took control and decided that I needed to for myself, because - put simply - this was/is my life and no-one was going to save me. It was a long process, but I am finally getting there and am very committed to maintaining my health and happiness - my life is so different from how it was when I was ill, and I am so profoundly grateful for that. I have a life worth living; I have a future; I am happy. Food is not the enemy, and nor is my body - but it never was: these things were just a scapegoat for me. 

Likewise, as a former sufferer, I refute the premise that AN is solely/predominantly biological in origin; whilst genetic factors undoubtedly play a part, environmental factors (whether overtly societal i.e. so-called "media influences" or more personal/insidious i.e. invalidating environment or other trauma) cannot be disentangled from the equation (so to speak) - attempting to reduce such complex disorders to cause-and-effect is damaging in and of itself, because it negates the fact that biology in and of itself cannot be wholly deterministic. Just as alcoholism is not "about" alcohol, eating disorders are not "about" food; I can't speak for all eating disorder sufferers (and do not pretend to be able to) but I want to be clear that for me, my anorexia stemmed not from "feeling fat" or the stereotypical glorification of a thin beauty ideal but the desire to make myself, quote unquote, "as ugly as I felt inside" - both to protect myself and punish myself simultaneously.]

So, what am I asking for? I don't know. She doesn't want our parents to know or to be involved (something that I genuinely do not think would be helpful in this context), but I am not - and cannot - be legally responsible for her/this; moreover, it is not appropriate for me - in my recovery or as her sister - to shoulder that responsibility for her. I am incredibly worried about her, but pressurising her will just make things worse. I know that what I (would have) needed was the space to speak honestly, to have someone I could go to etc. - hence why I am so glad that she was able to speak to me about this, because that genuinely shows progression in and of itself. It's just really hard having such a big secret on my shoulders, and I hate how, since finding out, her behaviours etc. have become more obvious (/triggering?) to me. What I - or others (e.g. my parents) - would've previously dismissed is now just symptomatic of the disorder; context really is all! I am not her parent, and do not think it would be healthy for either of us for me to impose myself in that kind of role. I guess I'm not sure of what to do - or rather, everything that I can do I have already done - and just wanted to vent about what's going on. 

Thank you for reading/listening,
Crave2017




Kali

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Reply with quote  #2 
Dear Crave2017,

Welcome to ATDT. So sorry that you have struggled with an eating disorder and that your sister is currently suffering. 

First, a couple of questions: Who does your sister live with? Who can support her with mealtimes and refeeding at home? Can she be evaluated by a medical Dr. who is knowledgeable about eating disorders to see whether or not she is in medical danger?

As a parent of a teen with anorexia, my advice to you would be to encourage your sister to eat, encourage her to be in treatment, encourage her to build a support network, and encourage her to tell your parents. What resources can you help make available for her because of your own illness? How can you communicate with her about what helped you? And if this is triggering for you, how can you encourage her to get others involved in her care so that you are not burdened and alone with this problem? It is a great first step that your sister has confided in you and agreed to pursue treatment, but as the saying goes, it takes a village. Will you accompany her to some appointments?

Many of us parents have found that we were best able to help our kids by helping them to be fully nourished and seeking the appropriate dietary, psychological, and medical professional help. 

Have you read decoding anorexia by Carrie Arnold or looked at some of the recent brain imaging studies which came out of Columbia in 2015? Or looked at some of the research results released in 2017 after an extensive study of anorexia and the genome at UNC? Here are a couple of links.

http://nymag.com/scienceofus/2015/10/neuroscience-of-anorexia.html

http://news.unchealthcare.org/news/2017/april/for-anorexia-nervosa-researchers-implicate-genetic-locus-on-chromosome-12

What I am trying to say by recommending that you read some of these materials, is that you should not feel guilty about what has happened in the past. 

warmly, 

Kali

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tina72

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Reply with quote  #3 
Hi crave2017,
welcome to this forum. I think Kali is right, you should not look back and think you are guilty for anything. Noone chooses to get Anorexia. Its a gen defect and when you have that defect, you can develop anorexia if you lose too much weight. There are 1000 causes why our kids lost weight. There shurely may be some social causes, but most of our kids are living in normal middle class families and had no trauma or something like that in past.
So you are not guilty for your sisters disease. Its genetic. A lot of families have a mother-daughter genetic line or more than one child suffering from anorexia because its genetic.
If your sister doesn´t want help from your parents (no question why), maybe she could get into an IP program?
From which country you are writing? Please post your country or town region, so others might better help you.
"Food is not the enemy, and nor is my body" - congratulations! Its great that you see it this way today and are able to keep yourself on a healthy weight.
Tina72
crave2017

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Reply with quote  #4 
Quote:
Originally Posted by Kali
Dear Crave2017,

Welcome to ATDT. So sorry that you have struggled with an eating disorder and that your sister is currently suffering. 

First, a couple of questions: Who does your sister live with? Who can support her with mealtimes and refeeding at home? Can she be evaluated by a medical Dr. who is knowledgeable about eating disorders to see whether or not she is in medical danger?

As a parent of a teen with anorexia, my advice to you would be to encourage your sister to eat, encourage her to be in treatment, encourage her to build a support network, and encourage her to tell your parents. What resources can you help make available for her because of your own illness? How can you communicate with her about what helped you? And if this is triggering for you, how can you encourage her to get others involved in her care so that you are not burdened and alone with this problem? It is a great first step that your sister has confided in you and agreed to pursue treatment, but as the saying goes, it takes a village. Will you accompany her to some appointments?

Many of us parents have found that we were best able to help our kids by helping them to be fully nourished and seeking the appropriate dietary, psychological, and medical professional help. 

Have you read decoding anorexia by Carrie Arnold or looked at some of the recent brain imaging studies which came out of Columbia in 2015? Or looked at some of the research results released in 2017 after an extensive study of anorexia and the genome at UNC? Here are a couple of links.

http://nymag.com/scienceofus/2015/10/neuroscience-of-anorexia.html

http://news.unchealthcare.org/news/2017/april/for-anorexia-nervosa-researchers-implicate-genetic-locus-on-chromosome-12

What I am trying to say by recommending that you read some of these materials, is that you should not feel guilty about what has happened in the past. 

warmly, 

Kali


Hi Kali, 

Thank you so much for such a thoughtful and empathetic response - I really do appreciate it. In answer to (some) of your questions: 1) My sister and I currently live with my parents, but I am off to university in October and therefore will not be around much. I am of the opinion that it is not appropriate or helpful for me to intervene too much - having spoken to my own therapist about the complexities of this dynamic - given my own history and need to, above all, stay well in myself. I told my parents this afternoon - it sort of just slipped out - and sh*t has well and truly hit the (metaphorical) fan. As expected, it didn't go well, and wasn't productive for anyone, unfortunately. My parents then began to interrogate my sister, who then decided to deny the truth of what I had conveyed... the tension in the house has now increased twofold, and it has suddenly, ostensibly, become both "my fault" and "a big misunderstanding" - neither of which is the case. My parents are emotionally and physically absent in various ways and therefore ill-equipped to handle the task of re-feeding and mealtime management in the way that the FBT treatment method advocates. As a result, my sister and I have both grown up to be very independent - at least in the context of the extent to which we use and rely upon our parents for support. Trying to impose this upon her would just make her more resistant; she needs to feel comfortable and safe - working with the people around her in her recovery rather than going into a maladaptive oppositional place. 2) Having spoken to an old treatment team of mine, they are prepared to accept her if she is referred there. We have booked a GP appointment for this coming Tuesday to facilitate this. 

In terms of who is best placed to help, I personally am at a loss. To be quite honest, she is of the age and personality whereby her friends and/or her friend's mum (who she is very close to) are probably best-placed to support her with this. The fact that both of my parents have issues with food (as well as other things) and are, as I said, very unavailable means that they are not ideal - when they attempted to apply FBT with me when I was younger, my anorexia became more, not less, entrenched. I desperately want to avoid this happening for my sister. 

Although I haven't personally read those books, I am very familiar with Carrie Arnold's work and website and of the potential implications of dispositional influences upon the development of EDs and other mental illnesses. I want to be really clear that I am not blaming myself or my parents for mine or my sister's issues - it is as it is. My comment re genetics was more about the fact that eating disorders are complex and CANNOT be reduced just to one causal factor. That isn't about "blaming" parents but about acknowledging the negative implications of certain developmental environments. 

Thanks again, 
Crave2017
crave2017

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Reply with quote  #5 
Dear Tina72, 

Thank you for your response. Unfortunately, in my particular context, there is/was trauma - but I do understand what you're saying and am not trying to diminish its legitimacy. I am writing from the UK; my sister is 16, almost 17, and I very much doubt that - as she presents currently - she would qualify for IP, especially given the fact that (as yet) she isn't formally diagnosed or in treatment! What I want to do, as someone who cares deeply about her, is ensure that she gets the help she needs as quickly as possible to avoid this spiralling further. 

Eating disorders, in my opinion/experience, are not about food at all; much like how alcoholics use alcohol to deal with difficult feelings and experiences, a person's food/body becomes a way of externalising what they can't put into words. Eating disorders are perhaps more complex than other addictions because food, unlike alcohol/drugs, is necessary to survive - one cannot simply avoid one's fear. The root emotional experience, however, is often the same: self-hatred, shame, despair, and the desire not to survive - such that the eating disorder becomes a form of "slow suicide" through which one has the opportunity to punish and deprive oneself day in, day out. To deny the emotional causes is dangerous, in my opinion; it invalidates the reality of our suffering. Food may not be the enemy, but it is not, in and of itself, "the answer". My personal experience of IP treatment, for example, was that by focusing exclusively on the physical symptoms, the treatment centres were able to "appear" effective - a premise at odds with the rate of relapse and readmission... 


sk8r31

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Reply with quote  #6 
Hi crave2017,

I applaud you for your aim to help your younger sister avoid some of the challenges and pitfalls that you have experienced in your own battle against an ED.

I totally agree that you are not best placed to be the one helping your sister to eat meals/snacks and deal with much of what she will need to recover.  You have got to take care of your own physical/mental health.  

Rather, I see your role as being a 'cheerleader' of sorts and perhaps helping your sister to access those supports and services that will help her.

If you think that her friend's mum would be amenable/able to support your sis with meals & snacks, getting to appointments etc. it would be of benefit to steer her here to this site, or to provide her with some resource materials, such as the FEAST Family Guides and this page from the main FEAST website which provides many links for family, friends and community members on EDs.

I heartily recommend Carrie Arnold's book Decoding Anorexia, at least for yourself if not for your sister at this stage.

Sending warm support,
sk8r31

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