Tuesday, October 16, 2012

Separating the eating disorder from the person

Patients will come in, and some will joke in an embarrassed way that they sound like they have schizophrenia (though they usually call in multiple personalities). They are able to identify that there's this separate voice in their heads, telling them what to do with food. They do not have schizophrenia. I think Jenni Schaefer, in her book Life Without ED is the first person (that I know of) that really clearly put into words the separation between the person and the ED. And this is such an important distinction. Lock and LeGrange, who have really advocated and research Family Based Treatment (aka Maudsley Method), have also emphasized that parents needs to make this separation in order to best help their child with an eating disorder.

But, this is a hard separation. We all know that. In the moment when the ED is acting up, it is happening in the body of the person you love. And, let's be honest, some moments you want to yell at them, scream at them, shake them, and perhaps wring their necks! (It's okay, you can admit it). So, most parents/loved ones do indeed end up yelling, screaming, and threatening the person they love who has an eating disorder.

But, the patient on the receiving end of all this, kind of has two choices at that point. Okay, three, but #3 is a bit of a huge feat to accomplish.

  • One, they can fight back, and essentially further embody the eating disorder. They can yell and scream and stomp their feet, which only serves to reinforce the idea that he/she, the patient, is setting out to torture those around him/her. 
  • Two, they can take the anger in, blaming him/herself for being a "bad person," which again, gives the ED more power. 
  • Three, they could assume the very, very best of their loved ones, be able to understand they really are mad at the disorder, not them, and choose to fight the disorder with their loved one. Sounds great, huh? 
I'm a parent, okay stepparent, of a teenager, and I'll easily confess that, at times, strangling her has seemed a viable option. So, there you go, even the psychologist admits that even she cannot do what she is about to say flawlessly. But, in the end, strangling someone doesn't really accomplish much, right? So, what do you do instead?

You separate the disorder from the person. You realize the person is in a battle with that voice inside his/her own head, and doesn't like the battle any more than you do, though some days he/she is more convinced that voice is right than wrong. So, some days, he/she may not join your "team" as much as she might the next day. But, if you can remember it is you and your loved one against a terrible disorder, then hopefully you can each get mad at the disorder. I promise you, the person is also mad at the disorder; it has taken away things that are important to him or her. But, she still is likely to respond to you in anger if you get angry at her. I want to be clear, I am not saying be soft, be lenient, let things slide. Those of you who know me are laughing right now because you KNOW that's not what I mean. Be very hard on that disorder, fight it with all you have. But don't fight the person, fight the disorder. You are more than welcome to despise, hate, want to destroy the disorder. Just as you would if your child had cancer. But, just as you wouldn't yell at your loved one for having cancer, try your hardest not to yell at your loved one with an eating disorder. 

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