March 9, 2015
By Amy Lewis
First Published: Irish Examiner, 07-March-2015
Amy Lewis speaks to professionals, parents and former sufferers of eating disorders about how they can be healed.
One in 10 of eating disorders are diagnosed as anorexia nervosa, the remainder comprise binge eaters and bulimics and there are at least 200,000 sufferers diagnosed per year in Ireland alone.
Eating Disorder Awareness Week may be over for another year but for many people in Ireland, the mental illness continues to be part of their everyday life — not only for the 200,000 individuals who are experiencing it, but also for their loved ones, family and friends.
As eating disorders have the highest mortality rate of any mental illness, it’s an issue that only recently has begun to be taken seriously in terms of an overall, cohesive, social and medical policy. However, for some, approaching the subject with a loved one can prove difficult.
Ciara and Lucy Whitty: Ciara says that going through recovery and coming out the other side has given her a renewed appreciation for life and says it’s important that people know that recovery is possible.
The right approach
Take a look at social media and it’s clear that a food and fitness craze is sweeping our nation, with young people in particular jumping on the clean-eating, weight-lifting bandwagon.
While some parents may delight in their child’s newfound interest in health, others may be concerned that they are on the road to developing a problem. So, how can one distinguish between an eating disorder and a harmless quest for a healthier lifestyle?
“The danger of the information in the media is that families can overreact,” says Dr. Terence Larkin, Consultant Psychiatrist involved in Eating Disorder Recovery at St John of Gods Hospital. “Only if it seems that the person is becoming obsessed should they be worried.”
Emma Murphy, psychotherapist at Counselling Care Cork, agrees saying that “it’s the level of the person’s preoccupation with health that makes the difference.”
“Also, it’s the extreme behaviour — the temper tantrum, walking out of the room and slamming the door and refusing to eat anything,” adds Emma, who offers specialised eating disorder counselling at her private practice in Douglas.
Other warning signs include a marked change in personality.
“They may become down and not be engaging in their life in the same way,” explains Harriet Parsons, services co-ordinator with Bodywhys.
“People may notice changes in eating behaviours, such as skipping meals and not eating with the family.”
If somebody feels that their loved one has an eating disorder, the first thing they need to remember is that it is not about food. According to Harriet, it is important to understand that an eating disorder is a coping mechanism.
“If you focus on food and weight, they are going to get defensive and shut down,” she adds.
So, what is the right approach? Dr Larkin advises people to start sentences with “I”. Emma also recommends this method as it can be an effective way of communicating concerns.
“Sentences like, “I can see that you’re not yourself”, work well,” she says. “Help them to work out the solution to the problem instead of taking over.”
Although one may be met with strong resistance, Trish Sheil explains that it is important to remain calm and compassionate.
“Remember, you’re up against the disorder, not the person,” adds Trish, who is the Clinical Manager at the Eating Disorder Centre in Cork (EDCC).
It’s quite natural for a parent or other loved one to have feelings of guilt. However, according to Dr. Larkin, blame is not helpful to anyone in recovery. “Blame is not constructive,” agrees Harriet.
Helping somebody who is battling an eating disorder takes time. Carers must remain patient and not expect an immediate change. Trish advocates the dolphin approach: “Nudge and swim beside them, don’t push and demand,” she explains.
Education and self-care are key.
Anna* knows what it is like to be a carer. At the age of 16, her daughter opened up to her about her struggle with an eating disorder.
Four years on, with the help of some ‘brilliant’ therapists, she says that her daughter is making positive steps. Though she admits that it has been a ‘rollercoaster of recovery’, she says that the days do get better.
Anna recommends that carers learn more about the illness.
“A lot of people are fearful. I would urge them to educate themselves,” she says. She also feels that an education about recovery is important saying that “others don’t tell you that you can put it behind you.”
The most important bit of advice that Liam and Lucy Whitty can offer carers is to “have an outlet”. The couple, whose daughter Ciara received treatment in St. Patricks Hospital for a serious eating disorder, recall the frustration they felt when she was ill.
“What used to kill me, especially as a father, was that this was one thing that I couldn’t fix,” says Liam. “You shout, fight and argue but we could never get through to her. You’re helpless.” In order to escape from this tension, the pair turned to walking and cycling.
“If you don’t have any outlet, it can lead to huge rows,” says Liam “You need space to get away from the problem and switch off.”
For Majella Fielding, speaking to friends and family about her daughter was her sole means of support. The concerned mother from Co Wexford has struggled to find any professional help close to home.
“There’s nothing here,” explains Majella, whose daughter is still living with anorexia. “There should be groups to offer advice to parents.”
Despite the lack of resources, Majella says that she has received help from local councillor Tony Dempsey who is supporting her daughter’s campaign to establish an eating disorder unit in the south-east.
For those in recovery, as well as their loved ones, the idea of ever living a normal life seems impossible. Ciara Whitty realised that she had an illness when she was sixteen but says that she just accepted that was the way she was.
Several years on, she says that her life has completely turned around and believes that going through
the process of recovery has given her a renewed appreciation for life. She thinks it is important for people to know that it’s possible to come out on the other side of the illness.
“It’s really important for the person with the eating disorder to know that this isn’t part of them. Try and trust people around you and see that they are there to help you,” explains the 26-year-old from Waterford who now works full-time. “But before you do anything, you have to realise that it is a problem.”
Jacqueline Campion echoes Ciara’s positive sentiments, dismissing the idea that an eating disorder is a permanent illness.
“The idea that this is always a threat if something stressful happens is completely incorrect,” says Jacqueline, who struggled with an eating disorder as a teenager.
“It’s very dangerous for both carers and sufferers to hear that because they are constantly going to be living in fear.”
Jacqueline now works as a therapist and nutritionist at Marino Therapy Centre, using her professional knowledge and personal experience to help those dealing with an eating disorder. Although she feels that there is an adequate awareness of eating disorders, she stresses the need to promote the idea of full recovery.
“It’s not about attending a block of sessions until you have been fed up and the behaviour has stopped,” she explains.
“The way we approach recovery is about full freedom. When you are fully free, no matter whether you have any trauma in your life, you will never go back to self-destructive behaviours.”
“Recovery is about learning about your sense of self-worth and self-value,” she adds.
With statistics showing that more and more men are seeking help for eating disorders, it’s clear that this mental illness is not solely a female issue. In saying that, eating disorders amongst men is still an area that is often overlooked. Jack*, a 32-year-old recovering anorexic, says that people were less likely to confront him about their concerns because he is male:
“It is more difficult for men to talk about anything of importance to each other, particularly mental health or anything private,” he says. “Everything is sort of glossed over when men are talking.”
According to Jack, he was not open to talking about his problems initially. However, he feels that the same approach should be taken with males and females, saying that “sometimes a bit of time and space to think is all that we need to come around.”
Although he feels that his friends have been extremely supportive and understanding, he has struggled to find outlets in Ireland for men with eating disorders.
“I found that in different parts of recovery, I am crying out to speak to other men who are going through it,” he explains. One resource that he recommends, both to carers and men experiencing an eating disorder, is a website set up by a UK-based charity Men Get Eating Disorders Too (MGEDT).
“It’s also an incredibly useful resource for educators,” adds Jack, who works in Dublin as an SPHE teacher. The subject of eating disorders in the classroom is quite a delicate one. When it comes to approaching a student about such issues, Jack believes that the relationship between teacher and student is ‘paramount’. He says that an open, honest approach is best when bringing up the conversation with a student.
“However, it should be remembered that no teacher is alone in their concerns. Schools also have guidance counsellors and an interdisciplinary care team,” he adds. “We are not experts in counselling, we’re merely teachers, but we know that we can refer students onto those with the necessary skills.”
Names have been changed