For years this man sat on his unhappiness, afraid to address the issues that were troubling him and making him feel angry, sad or alone. I thought to myself how sad this situation was. Not only was this man’s inability to address conflict causing him pain, it had affected the whole family negatively, not only through the break-up but by modelling conflict avoidance. His wife described herself as a “basket case”, his daughter had anorexia, and his other children were also negatively impacted.

Over the year working with eating disorders, I am struck by these very simple, everyday, almost trivial interpersonal dynamics that can lead to such profound misery that not only effects this generation but others.

By the father not addressing his own frustrations directly with his wife, his frustrations grew while his wife was powerless to prevent them as she had no idea what was wrong. On the other hand, if this man had been able to effectively communicate his conflicts with her, steps could have been made to strengthen their relationship, and a better outcome for everyone could have been possible. This is not to say that the marriage break-up is all based on the husband failing to communicate, it is a lack of communication from both of them. Trust me; I am sure that his wife had equal frustrations that she also didn’t address.

So let me re-emphasise the importance of addressing issues directly with the people involved. Ideally, it would be good to have a person to support you as you do this as it is not always easy, especially if it means setting up new communication patterns that can feel strange or awkward and leave you open to being vulnerable. However, dealing with these issues before they escalate, even by becoming upset and expressing this, can be very valuable. It can be a way of re-directing a system.

This poor wife had no idea about what was bothering her husband so she had absolutely no way of addressing it.

Please share your thoughts.

Yours in health,

Charles

Women often tend to spend time with their girlfriends complaining about their partner. While this may let off steam and help the woman feel better in the short term, it does nothing to address the issues in the relationship.

The partner needs to be told of the woman’s frustrations so that they can make alterations in their behaviour or work with their partner to form a partnership where both parties are feeling loved and supported. Remember – if the partner has no idea then they have no ability to remedy the situation.

If the woman does not directly address her difficulties with her partner, nothing can change. In fact, at times, venting with friends can actually increase anger towards the unassuming partner.

I remember working with two couples years ago. Frequently I would see them back to back in my practice. I would always know when the two women had had lunch together as they would work themselves up with anger about their husbands, making the situation worse as it became harder for them to talk calmly with their husbands. Their husbands however had no idea about what was going on and did not have the opportunity to change.

I had this discussion with some of my female colleagues and spoke about how dangerous only venting to friends, rather than talking to their partner can be for relationships. The best friend can become like a short-term safety valve – they allow steam to be let off, but change nothing in the problem. My colleagues replied, “Well if we don’t talk about our relationships, what do we talk about?”

Again I encourage you to bite the bullet and deal with the issues head on. This way you empower yourself and liberate your partner as well. In fact true intimacy is based on honesty.

For the mother above, she found that to the extent that she avoided conflicts, there was a cascading effect for both her and her children. As she failed to create boundaries and responsibilities for her children, they floundered; and the more distressed and angry she became, the worse her eating disorder became.

She blamed herself for all of the problems in the family. The fact is that no problem is ever all one person’s fault. If you take on all of the responsibility and guilt for everything, it is much harder to see a solution and it is much harder to change.

When this mother started asserting herself with her children, the family members benefited. For example, when she told the children to clean the dishes, not only did she have one less chore, her children felt more empowered and were much happier as their mother was happier. And her eating disorder improved.

In families, as in all human systems, everything is connected. Even if those around you don’t seem to budge, there is always one part of the system that you can modify – yourself. And when you change yourself, the rest of the system will change, as in the case above when the Mum changed so did the rest of the family.

Please give us you experiences.

Yours in being true to yourself,

Charles

The fact is that you do better if you say to yourself, “I am making progress”. It doesn’t matter how small each step is, it is a benefit if you can recognize that you are making progress towards your goal. If you relapse, that happens sometimes. What is important is that you don’t let it make you feel like a “failure”, and you get back on the road to reaching your goals.

Sometimes it is difficult to notice your own progress, as we get too caught up in imperfections, or end we ignore the small steps that we have made in the right direction.

It can help to track your progress so that you don’t forget all of your strengths and progress. This gives you a sense of direction, and you can see that even if you relapse a few times, it is not the end of the world and you can get back up again.

We all need to understand that we as human beings are fallible and we all make mistakes. We want to go in, to take small and consistent steps towards our goals and making a better life for ourselves.

Use of the tool Bulimina Nervosa and Compulsive Overeating Worksheet will help you follow you progress.

Dealing with the issues rather than being symptomatic is a mark of a step in the right direction. Don’t foget to involve your support person.

The new laws aim to prevent inducing eating disorders in young girls who seek to emulate emaciated models.

While there is definitely more to anorexia than food and dieting as has been noted extensively on this website, I nevertheless told the reporter that there was a good rationale to do what whatever is possible to discourage the practice of using emaciated women as role models.

My reasoning has to do with the slippery slope phenomenon of anorexia. While there are a variety of things that lead a person to develop an eating disorder, once the body weight gets low enough, a compulsion takes over. The sufferer no longer has free will, and the eating disorder is fuelled by compulsion driven by the starvation.

It certainly does not help to have endless pictures of emaciated bodies plastered all over the media for young girls to emulate.

• They need to be evaluated by a GP.
  • This is to ascertain their physical health and is very important. Anorexia is the most fatal per capita of psychiatric disorders. Bulimia nervosa can be extremely dangerous especially to the heart because of low potassium levels.
• Wherever possible, the family needs to be involved.
  • Family are ultimately the most influential people in most people’s lives and therefore have the most influence in changing a person’s mind about seeking and engaging in treatment.
• An intervention can help.
  • Interventions may start by getting all of the people who care about the person with the eating disorder to come together to persuade the person to seek treatment. Try to let them know your fears for their safety, try to reason with them, and try to encourage them in a way that they will respond to best.
  • In cases where there is extreme resistance to treatment, the mental health act can be used. This mandates the person to intensive, inpatient care for their problems.

These are just general guidelines and each case will require something slightly different to get through to your loved one how important it is that they find the treatment that they require.

Please let us know your thoughts and other suggestions for engaging people in much needed treatment.

Let me tell you what I do when people come to see me with problems like this.

I look for areas of conflict. Very frequently people minimize conflicts. I can’t tell you how many times I’ve heard this answer when I query what needs to change: “nothing needs to change”, or: “its me who has to change.”

This of course is how we all live to some extent. We see ourselves of the as the prime movers of our lives.

Nevertheless, I gently ask, might there be some areas of discord?

Fiona mentioned: “well, there’s my aunt… she calls all the time, she’s very critical… but it doesn’t bother me.”

Her husband, incredulous, blurted out “it sure does bother you; you’re just afraid to confront her.”

We then proceeded to find where there were other conflicts. Work had began.

Of course I strongly encouraged her to enlist supporters as she began to address her issues. She chose her husband.

How about conflict in your life?

In your life it may be you have areas of conflict you just pretend would go away.

And as we said many times on this site, to the extent you address these conflicts, the more control you have over your eating disorder.

So so if you haven’t already done it, use the spreadsheet in the tool section.

Let us know how you proceed.

Yours in strength, Charles.

Thank you so much for this website. I have a long history of swinging between bulimia and compulsive over-eating. I am currently a compulsive over-eater.

I have been using your scorecard and I have been trying to address the conflicts in my life as you suggest. I have found it very valuable.

However, one issue that I have is that I always feel afraid when I do try to address the conflicts. I always feel that I will hurt somebody, or that, not so much that they will explode, but that I will explode.

What do you suggest?

Mary

On closer examination, this woman had been through a number of changes in the preceding few months. Her siblings had just moved overseas, and her two best friends had just moved out of town. Furthermore, her flatmate had been spending more and more time out of the flat and with her boyfriend.

Although they may seem unrelated, these are the kind of factors that can exacerbate eating disorders. This woman’s life had changed in ways that she had no control over, and she was socially isolated. Her feelings of loneliness were increasing as were her feelings of desperation and depression. She had no idea what to do.

In therapy we talked about her options, and where she could start. The first thing she needed to do was to go from being passive to active in taking control of her own life. The more passive people are, the more depressed they become; the more active they are, the better they feel about themselves and the world. She made a list of all of the things that she could address in her life that were causing her difficulties – frustrations at work, her social isolation, dating and so on. Next, she needed to find practical solutions to overcome the difficulties on her list. For example, she could try internet dating or speed dating; she could talk to her boss to solve some work problems; and she could make more of an effort to make re-new old friendships that she had let slip. Each of these steps involved her being proactive in her life.

Social isolation is a big issue for eating disorders. Being socially isolated is depressing for most people, and usually exacerbates eating disorders and loss of control. Therefore, addressing social isolation is crucial. This may involve working with the family to help the person build up support networks.

Finally, I encouraged this young woman to use the Bulimia/Compulsive Over Eating worksheet.

A poster shows a beautiful mountain scene with a young girl bending down to pick a wild flower. The caption reads:

“I bend down to pick a flower and realise that it is attached to the universe”.
(Sierra Club)

I received an email over the holidays from a woman who said that she had battled bulimia for many years, and wanted to meet to deal with her difficulties. As many of you will know, just sitting and talking about the difficulties does not help.

What helps is addressing the problems, dealing with the relationships; it is focusing on people people people. And it is how you address these problems. To do this you need support. And you need to realise that it isn’t just you that needs to change.

So join our website, give us your feedback, your queries, your suggestions, and help us to help you and make this website as valuable as possible to our community.