Changing Ourselves/Expectations - Guest Post by Marjie Ruth

Before I print Marjie Ruth's latest post, I want to spend a moment to reflect that I had to learn to change myself before I could effectively relate with and to my daughter who has a severely entrenched eating disorder.  I worked on this in private therapy as well as attended a fabulous support group.   Marjie highlights how many of us, as mothers, think we can change everything and fix everything when, in fact, we cannot.  We can certainly, as she says, affect the outcome as does the long-time image of a pebble hitting a still pond of water.  But in the end, the final filter is the brain of the person who needs to change course to get well....

In the long run we shape our lives and we shape ourselves.
The process never ends until we die. 

And the choices we make are ultimately our own responsibility. - Eleanor Roosevelt

Question: what did you expect from [a] support group when you first attended (or would you expect if you were to attend)? 

Of course, initially we don't really know what to expect. I think it's safe to say that most of us were seeking answers and some kind of direction for finding our way out of the nightmare of dealing with someone we love and their entanglement with an eating disorder. At a support group we might reasonably expect to get more information about disorders and some measure of comfort through interacting with other folks in a similar situation. Of course, what we're really hoping for...even though we might keep this one unspoken...is to learn of some very concrete way to get out of the nightmare. Perhaps there's a treatment program that does the trick, or maybe there's a medication that's out there, but no one has mentioned it to you yet. Yes, a blueprint for a cure would be wonderful.

Once you've attended a meeting, you soon come to know that the "quick fix" answer is not there for any of us. But whatever your expectations were, perhaps the most surprising thing for many of us is that while we do talk about our loved ones and where they are in their journey through the disorder, when it comes to discussing doing something the subject of the conversation is about changing ourselves rather than the disordered person. That comes as a bit of a shock for some of us as we are not the ones with the disorder, the problem. We are the caretakers, the problem solvers, the providers, the one who kisses the boo-boo and makes it all better.

And that's perhaps one of the most frustrating factors when dealing with a person in the grips of an eating disorder (though it really is applicable to all relationships)--we cannot effect change in another, only within ourselves. Please read that again and make certain you understand the full implications of that statement as it is the very cornerstone of the foundation for successful relationships. I can work at and choose to make changes in myself. I can not choose change or institute change in another. Of course, every interaction I have with another human being affects them in some way, however great or small depending on the nature of the contact. But how the other person will choose to respond to my convergence with their life is entirely up to them. Guess we could simplistically call that "free will".

Likewise, our own inability to fully grasp the independence of every other human, even those we have birthed and reared as well as those we have co-habitated with for what seems like forever--that short coming in each of us is a form of egocentricity. We live life from inside out, meaning every perception is filtered through our own mind and seen from the vantage point of our own emotions as the core. In other words, the concept of walking in another person's shoes is never really achievable in the purest sense. But, in the best of cases we can develop a higher degree of empathy for and understanding of others, along with a heightened appreciation of their separate nature and unique validity.

What does all of this psychological/philosophical babble mean for real life? For me it means that I must constantly work at accepting my offspring and my husband as independent and unique people who have a right to make their own choices, whether I agree with them or not. Moreover, it teaches me that I must accept full responsibility for my own actions and attitudes, for these are the factors I have a choice about. It tells me that while I cannot change another, I can--if necessary & so motivated--change myself and how I interact with them. I do not need to remain a victim of their bad choices. And by more effectively choosing how I interact,  I can take care to be a good influence in other lives as opposed to being a proponent playing into the very kinds of behaviors that upset me.

To sum it up, each person has the power to choose to change. We cannot effect (make that choice happen) for another. We only have that power of choice for ourselves. We can and do affect (have an impact on) other people through our choices and the resulting actions. This may all sound very basic and almost too simple, but the implications of these truths is crucial. I may hate and despair over my loved one's eating disorder, but I cannot make her change. That must be her choice. Once I get past the ranting & raving that is part of my own grieving, I am left to try to figure out how to deal with the reality of where she is. Then I must examine myself. How do I interact with her? What are my limits? Where do I draw the line for what I am willing to do and tolerate? With thought, careful deliberation, and guidance from respected sources I slowly make my decisions and draw my boundaries. These are my choices. I decide the changes I will make in my behavior. Once solidified and communicated to my loved one, she will then have to make her own choices. She is affected by the limits I have placed in her path. She will decide how to deal with them and what changes she is willing to effect. To be sure, much of the thought that goes into my boundaries is spent contemplating the possible affect on her. I know what I hope her decision will be, but I am powerless to make the decision for her. And that means I have to accept the outcome, whether or not it is what I wished for.

Sound a little like jumping out of the plane and hoping you can figure out the parachute and that it will open? Yes, it even feels that way in the doing. But to continue the analogy, others have explained the parachute, & I know that they usually work. Besides, I have come to see that the plane is on fire and going to crash anyway, so I'm ready to take my chances. We often talk about whether or not a person has "hit bottom" thinking that's the point at which they will make a change. But maybe what we need to focus on is whether or not we are ready to jump out of the burning plane and make some changes in our own behavior.

Marjie Ruth
727-244-9011(c)
sruth1@tampabay.rr.com

You can send this on to anyone you want, if you wish. Be sure to include my name & number so that they will know who to blame for the content. If you're tired of receiving my ramblings, just email me back asking me to remove your name from my super confidential very special list. Thanks.

Is your child leaving for college?

Several of us who have posted regularly to the parent's bulletin board on Something Fishy advocate for the delay of going away from home to college when a soon to be adult child is in the throes of an eating disorder.

Dr. Sarah Ravin wrote an important piece about this on her blog on August 25, 2011.

Http://www.blog.drsarahravin.com

Dr. Ravin's blog is a terrific resource!

More on Responsibility

I have spent a lot of time this week thinking about responsibility, particularly in terms of what's mine and what's not.  Consequently, when Marjie Ruth's post arrived in my email box earlier this week, the timing was perfect.  Not only that, but this topic rose again during a conversation among a group of women on Thursday and yet again this morning at my meeting.

While reading Marjie's post, which is here on my blog,  I especially focused on the sentence I highlighted, which was: 

" ....For us, we may want success so badly for our loved one that we usurp their responsibilities."

I realized through a lot of work with my therapist these last two years and by listening to others dear to me and by listening to the experience, strength and hope of still others, that I usurped my daughter's responsibilities in many areas of her life.  I also know that others usurped her responsibilities, too.  I did not want her to be hurt.  I did not want her to continue to be ill and to decline.  I did not want her to die.  Of course not.  But I extended my reach into her world so much these past several years that she didn't have to face reality on several fronts to figure out what to do to fix things herself. 

Marjie wrote:

While parents readily desire to provide an environment for their children that will foster their success, they sometimes can't seem to bear having their offspring deal with failure. It's with good intentions that they'll jump in to avert an impending negative outcome from a misguided sense of helping. When they step in to rescue their child from the consequences of his or her own inappropriate actions, they're often teaching them that they can get away with it...that they're not subject to society's rules. Such actions engender a moral lack of personal responsibility, hardly the intended outcome but a very real one nonetheless. 

Wow, the above paragraph strikes home for me, too.  There were times when I was able to step back and see the bigger picture and draw everyone who interacted into that picture to understand what was going on.  But more recently, I took myself over my own edge by somehow believing that I could change what was going on.  In fact, I certainly could contribute to the possibility of that change, but not actually change the situation.  That's what I had to learn.   That is truly up to her.

I continue to need to be reminded that I, as Marjie wrote,

.... all too often jump in to do it for our loved ones with the hope of getting them to a happy place more easily. And this, folks, is called enabling--doing something for someone else that they can and should be doing for themselves. When we help someone else circumvent accepting personal responsibility--when we make excuses for them, lie for them, do their work for them--we may actually be doing more harm than good by derailing that person's emotional growth. 

I did this, too.  I thought I was helping.  In fact, I was enabling.  Sure did take me a long time to finally "get" this:

Helping occurs when we do something for someone that they are incapable of doing for themselves. We feed and cloth a baby. We guide the blind person through traffic. We assist the elderly with housekeeping. The problem occurs when we are unable or unwilling to discern the difference between enabling and helping. And it is a problem because, ultimately, recovery is about accepting personal responsibility. 

No doctor, no therapist, no hospital, no residential treatment program can make an eating disordered individual well. They can support a person in their striving. They can offer training and tools that can be used by the person to recover. They can even point out they way. But in the end...or should I say, the beginning, because real recovery only begins and happens when the ED sufferer accepts the reality of their addiction and accepts personal responsibility for the tough road that is recovery. Successful recovery only comes with a price that entails many failures along the way. That is learning. That is growth. You may walk beside someone, but you can't walk for someone on the recovery road.

The most difficult step for me now is to simply walk beside her.  Yesterday I handed over a very important (to me) article that was published in Scientific American  (June/July 2008, pp. 60-67) by Trisha Gura titled, "Addicted to Starvation."

Many parents, including myself, have been to Family Week at residential facilities where we've been reminded that it's one thing to be able to recover from an addiction to substances like drugs and alcohol by abstaining and working, for example, a 12-Step Program but quite another to recover from an eating disorder when one needs to eat to live.  

The piece that must be reflected upon by many people is, I believe, that these illnesses are addictions that are evidenced by extreme disordered eating.  In the case of anorexia, the addiction is to the sensation of starvation.  How else can one starve oneself if not for some kind of reward, if only the reduction in anxiety that comes from eating?  How else does self-preservation fall by the wayside?  To put it simply, the person's brain sends a message that starvation is "feels good or at least better" and eating is "bad."  There are complicated explanations for this and more research is continuing in hopes of figuring out how and why.

Meanwhile, it seems to me, that the goal of the person who has chosen to live and fight (once they have been re-nourished enough to understand where they are and/or have reached a spot in their decline where their alarm bells are still going off) is to learn to immediately switch thoughts when they start to eat from "this is bad for me or feels terrible" (whatever form that thought takes) to "this is good for me.  I love myself.  I need to eat to show my love for myself.  I am worth it."

Getting to this internal language is hard.  It involves practice and practice and practice and repetition until the thought totally replaces the thoughts that are so harmful.  The voice of one so many of us call  ED.    Yet it can be done.  Although we read the alarming statistic (that may no longer be true and rather a myth because of lacking up-to-date information and better treatment modalities), the known statement is 80 percent survive these illnesses and 20 percent die.  The more we all know the more we can all work together in some role to increase that success rate.

My responsibility is to continue to shine the light and to love her, which I do.  So much.

Guest Post by Marjie Ruth - Responsibility

"There are two mistakes one can make along the road to truth...not going all the way, and not starting."

~Hindu Prince Gautama Siddharta, founder of Buddhism, 563-483 B.C.

....Last week, I wrote about our culture's preoccupation with instant gratification, a tendency that is complementary with over simplifying. The more stressed we become, the more we desire that all things be simple and quick. Let's get rich over night without the bother of hard work, and let's get well right now without the pain of long suffering.

The third cultural thinking trend I'd like to discuss that, I feel, plays a major role in how we see and deal with many aspects of life, is the general reluctance to claim personal responsibility for many of our actions. This characteristic is nurtured from a very young age when we first experience the contrasting pleasure of being rewarded for doing something deemed good against the negativity received for doing something bad. Even our pets quickly learn that good behavior brings good things, and better hide under the couch when the angry voice is heard complaining about the shoe that was too good to resist being chewed.

Positive reinforcement is so easy to give for good behavior. The dog gets a treat; the child is praised and gets an ice cream cone. What's much more difficult to do is to provide positive reinforcement when the behavior exhibited isn't what we desired. Instead we commonly revert to negative reinforcement, ie some type of punishment. It may be a scolding, an angry look, or withholding of the treat. No ice cream for you, we announce to the tyke. Your grounded for a month, we tell the teen. No job for you--you're fired, says the boss. Is it any wonder we learn to strive for reward while hiding and denying failure? "It wasn't me." "It's not my job." "I don't want to be involved." "I couldn't help it." "It's your fault I did it." There's no end to the rationalizations and lies that are told to deny responsibility.

Yet, if you talk to most accomplished people, those who excel in a particular area over time, they will generally tell you that they learned as much if not more from their failures as they did from their successes. And psychologists will tell you that a vital ingredient to psychological maturation is the ability to claim our failures as well as our successes. And that is something that needs to be resolved on an individual level for it to be real. While parents readily desire to provide an environment for their children that will foster their success, they sometimes can't seem to bear having their offspring deal with failure. It's with good intentions that they'll jump in to avert an impending negative outcome from a misguided sense of helping. When they step in to rescue their child from the consequences of his or her own inappropriate actions, they're often teaching them that they can get away with it...that they're not subject to society's rules. Such actions engender a moral lack of personal responsibility, hardly the intended outcome but a very real one nonetheless. When an individual is allowed even encouraged, to own their failures as well as their successes, more is learned and so much more is gained in terms of psychological development. It's a very freeing lesson to learn that we can not only survive many failures, but we can actually learn from them and grow into a more complete and full life as a result of them. Failure is a necessary part of the scientific process. It's also an inevitable part of life, and we're harming ourselves and others when we strive to deny the existence, importance, and even benefits of failing as part of the process of living. 

There are two especially important facets of this as we consider how the way how failure plays out in our own lives. For our eating disordered loved one, failure is often simply not an option. Because perfectionism is such a common trait among the eating disordered, there is just no room for accepting any notion of failure. It is the ED that rages in their mind and shouts: "You are so fat, you are a horrible failure. How can you even eat that lettuce??" -or- "You binged again today! You need to get rid of it. You don't even deserve to go to a 12-step meeting because you are a worthless looser. You can't do anything right. You're a failure and don't deserve anything good." And there are many, many variations on this theme. Perfectionism and failure cannot co-exist; therefore, the ED slowly tries to destroy it's imperfect host. Sound like an Invasion of the Body Snatchers? Yes, that's just the way I sometimes see an eating disorder, too.

For us, we may want success so badly for our loved one that we usurp their responsibilities. [bolding and italicisizing by Jen].  It might be getting the science project right so the grade or ribbon is earned. (Come on, who are we trying to kid when a 4th grader comes in with a project worthy of NASA engineers?? Why not just have a science fair for over-achieving parents?) Or it might be wanting our adult offspring to be happy so badly that we'll pay their rent and buy their food, just hoping that those things will help them to feel better about themselves. Of course, now that we've put them in the position of being kept by us, there is no real sense of accomplishment, no sense of owning their own success by earning a living and paying their way. These things are important to us, but we all too often jump in to do it for our loved ones with the hope of getting them to a happy place more easily. And this, folks, is called enabling--doing something for someone else that they can and should be doing for themselves. When we help someone else circumvent accepting personal responsibility--when we make excuses for them, lie for them, do their work for them--we may actually be doing more harm than good by derailing that person's emotional growth. Helping occurs when we do something for someone that they are incapable of doing for themselves. We feed and cloth a baby. We guide the blind person through traffic. We assist the elderly with housekeeping. The problem occurs when we are unable or unwilling to discern the difference between enabling and helping. And it is a problem because, ultimately, recovery is about accepting personal responsibility. 

No doctor, no therapist, no hospital, no residential treatment program can make an eating disordered individual well. They can support a person in their striving. They can offer training and tools that can be used by the person to recover. They can even point out they way. But in the end...or should I say, the beginning, because real recovery only begins and happens when the ED sufferer accepts the reality of their addiction and accepts personal responsibility for the tough road that is recovery. Successful recovery only comes with a price that entails many failures along the way. That is learning. That is growth. You may walk beside someone, but you can't walk for someone on the recovery road. 

The more we each acknowledge the value of and practice personal responsibility in all aspects of our lives, the better the impact we'll have on everyone around us. And if everyone were to grow in this way, it would be a wonderful world indeed. But again, the ugly reality is that not everyone will. Which makes it important to remember that we're discussing the concept of personal responsibility: acknowledging and accepting our actions and their consequences. What we're not endorsing is the notion of being personally responsible for all the folks near and dear to us. Please, don't go there because this email is long enough already!!!

Hoping you have a reason to smile,

Marjie Ruth

sruth1@tampabay.rr.com

MarjieRuth1@gmail.com

727-244-9011 (c)

Guest Post by Dr. Julie O'Toole, author of Give Food A Chance: A New View on Childhood Eating Disorders

[I requested permission of Dr. O'Toole to reprint her very important post from her blog here.  Although I believe it may be  possible for a person to recover when another immediate family member also has an eating disorder, the process can be much more difficult.  Dr. O'Toole's clinical experience reveals that if the family member is a parent, the outcome can be bleak.  I continue to wonder where a parent in recovery like myself fits into this dialogue.] 

What does it mean to say a family member of a patient with anorexia nervosa is “affected” or “partially affected” with an eating disorder?

 

The last ten years have brought us a lot of new information about eating disorders in general and anorexia nervosa in particular.  One such bit of new information is the evidence of heritability of anorexia nervosa.  In a study published in the Archives of General Psychiatry Dr Cynthia Bulik, a well known researcher from the University of North Carolina,  put it this way: “The heritability finding places anorexia well within the more heritable psychiatric disorders."

After years of taking family histories at Kartini Clinic, it is equally clear to us that anorexia runs in families, but that not every affected family member will have the exact same eating disorder their relative does. If you have a first degree relative (mother, father, sister, brother, child) with anorexia, your risk of your acquiring anorexia is ten times great than someone who does not have such a relative.  If the first degree relative with anorexia is a male, risk to his relatives is even higher (se  Bulik et al; Devlin B et al.).

These being the facts, it should surprise no one that, in the course of treating a child with anorexia, another family member (often a parent) is also found to have an eating disorder.  In the vocabulary of genetics, this is called being “affected.”  There are also cases of eating disorders that do not meet full diagnostic criteria (“sub-threshold cases”).  When we encounter sub-threshold cases we say the person is “partially affected.”  There is absolutely no judgment involved here -- no one can help what they do or do not inherit genetically.

So, back to our opening question,: what does it mean to say a family member is affected or partially affected?  It means someone else in the family has inherited the same illness.  They did not choose it, they inherited it.

If another child in the same family is thought by the treatment team to have an eating disorder the next steps are fairly straightforward:  if the diagnosis is confirmed, that child also gets evaluated and treated. But what if the other affected family member is a parent?

It has been our many years’ experience that if a parent is active in their own eating disorder while their child is in treatment, the child will not get well.  And since the entire reason parents bring their child to us for treatment is so their child can get well, this is clearly a fundamental problem.

The problem is made even more difficult because we are talking about a brain disorder. And one feature of this particular brain disorder (and others) is something called anosognosia.
Enter Anosognosia

Anosognosia is a fancy term for a feature of anorexia and related eating disorders (as well as of some types of stroke and brain trauma) that describes a change to how our brains process information.  In brain conditions with anosognosia, the person’s perception of their own illness is affected. In fact, anosognosia often declares the illness to be gone or to have never been present.  In anosognosia the brain does not perceive the extent of the illness, sometimes not even its presence.  

The presence of anosognosia means an affected parent may not be able to recognize they are ill or that it matters.  This may lead them to refuse treatment -- not because they are stubborn, but because they are unable to perceive their own illness as a problem.  In the case of an affected child, this attitude can be overridden by parental pressure.  If adults in a family feel that their child’s illness is a problem, the child will have to submit to treatment. But if the affected family member is an adult, who can make them accept treatment?

The answer has to be “the family.” Rarely have we found it sufficient to draw attention to an affected parent and simply to ask them to seek help. In fact, in some ways, addressing the issue of an affected parent is the “third rail” of eating disorder treatment: touch at your own risk - you may get electrocuted.  As a provider you  really have to care a great deal about the family (and the child) in order to take that risk.  

Now, how does one convey caring, compassion and non-judgmentalism when drawing attention to an illness which a parent may perceive to be a personal “failing”, “shortcoming” or “flaw”?  How can we preserve a parent’s personal dignity and parental authority while still requesting they seek help? Not in front of their child, for sure, but of necessity in front of their spouse, significant other, and/or participating family member, all of whom will need to support the person’s efforts to get treatment.  Open, compassionate discussion among adults in the family will be essential. An affected parent may either procrastinate getting help, refuse help or say they are “seeing a counselor occasionally” (remember anosognosia!). Even when their child’s treatment aggravates their own illness, to the extent they are unable to follow the family meal plan (a key component of treatment at Kartini Clinic), they may still refuse help for themselves.  They may even get angry at their child’s team of providers. In cases where a parent responsible for food at home refuses treatment for an active eating disorder (or one that clouds their judgment about issues such as weight and meals) the child’s own treatment may need to be halted until such time as the parent can be made to understand that unless they get help for their own condition, their child will not get well.

This is hard stuff, but it’s essential to get right.

Guest Post by Marjie Ruth - Instant Gratification

Mindfulness is the aware, balanced acceptance of the present experience.

It isn't more complicated than that.

It is opening to or receiving the present moment, pleasant or unpleasant,

just as it is, without either clinging to it or rejecting it.

~ Sylvia Boorstein

Last week I wrote what is intended to be the first of a 3 part series of emails about what I see as three very common trends in our current thinking or societal temperament. Last week's email dealt with our tendency towards simplification and over-simplification in thinking and reasoning. Like most things, a certain amount of simplification can be a good thing for helping with clarity and brevity. But when over done or misused, it can become a faulty pattern of reasoning that fails to account for complete facts, necessary detail, and/ or important details. 

This week I want to address the pervasiveness of the desire for instant gratification. Now, I most certainly realize that I'm hardly expressing anything new with this topic. There's a reason why today's young adults are called "The Sesame Street Generation" by some educators. While Bert & Ernie and the gang acted as a highly entertaining and educational entourage for this group when they were toddlers, a side affect of the process was the conditioning to short snippets of entertainment that were constantly changing. This, along with many other forms of electronic entertainment, helped to usher in a mindset with an attention span that is sometimes akin to that of a gnat. While older age folks find much of today's media to be jarring to the point of being uncomfortable, tots to teens these days are totally at home with conversations limited to 60 characters at a pop, a barrage of brief videos, shreds of info from short feeds, and the constantly available and changing entertainment of the internet and all it gives access to. Need information? Grab it in an instant from Google or Bing or any number of super fast search engines. Computers have culled our threshold for patience down to a nano second, it seems. See something you want? Order it with a simple click, and request delivery overnight. Remember when we used to wait for days for a letter to come in the mail? Hah! Now you've dated yourself 'cause that's a concept anyone under 30 probably can't relate to at all. How about the days before microwaves & cell phones? Why it even took us a lot longer to dial on a rotary phone than most 25-year-olds can comprehend, let alone tolerate. 

With everything moving so much faster, we've come to accept it as the norm that all things should happen with the ease of high speed. Because news now travels farther and faster than ever before, we can barely begin to understand how different the world is for our children than it was for us at that age. What, for them, will constitute the simpler times? "Hey, remember life before 4G? Man, the days of 2G were so slooooow! Now that was mellow." While we can't all be over night multi-millionaires thanks to a Lotto win, there are far too many who seem to expect that they should be able to cash in young and easily. 

"Ah, but wait", you might be saying, "I'm not that young. Yes, I want my computer to be fast, but I still appreciate the fact that some things have to be earned over time and that good things are worth waiting for." And I completely commiserate. But just because we haven't grown up as entirely submerged in the culture of "need for speed", doesn't mean we haven't become infected through association. Compare yourself to your parents, and you'll see what I mean. And while we may be relatively balanced in our desire for expecting some things more immediately while still retaining an appreciation for the benefit of long term goals and pursuits, there is an area where we may more often find ourselves wanting results and wanting them NOW!

And--as you might be guessing considering the forum for this epistle--those occasions where we may be willing to admit that we crave instant gratification, just might be when it concerns our loved ones and their recovery from their ED. No, of course you don't actually expect he or she to get over it in the blink of an eye. You're not that irrational. (No, irrational is what they are.) But aren't there moments in time when you have honestly hoped that a corner had been turned, a light bulb had gone on, and reason had prevailed? Maybe it was after an especially good day. Or it might have been because of a better phone conversation. Or maybe it was following a course of treatment, a session of therapy, or a period of stay at a treatment center. Have you never thought that, well, it's just ridiculous to drag this out? Can't she see the insanity of even one more hour of such behavior and want to get past it now, right now? Haven't you maybe, just maybe, wanted so badly to be able to say just the words that would make sense prevail, the madness end, the healing be real and complete...in an instant...right now...or is it only me?

Oh yes, I know all too well that there are no magic words--there is no instant healing, but that doesn't make me stop craving it deep down inside. Like a tide that ebbs and flows, it's pull is still there, washing up on the emotional beach that is some days eroding beneath my feet. But to give into that desire is to ultimately give in to despair. I choose to step back from the rip tide before its strength gathers and pulls me out to sea. No, I step back. The allure of instant gratification is so, so strong in our culture. But like fools gold, it's reward is not always worth the risk. No, true treasures are most often discovered after long painstaking searches. Dedication, self denial, and perseverance may sound to some like outdated notions. But to those of us who know that our loved one may need lots of time to find their way through the maze that is an addiction, they are words to live and hope by.  

The slogan may be "Just do it", but in reality that's often overly simplistic, a rally cry promoting instant gratification. 

Perhaps for us, the better current phrase to hang on to is: Now wait for it...wait for it...

Still trying to be patient,

Marjie Ruth

sruth1@tampabay.rr.com

-or- my newer email address: MarjieRuth1@gmail.com

727-244-9011

If you are receiving this email directly from me, it's because at some time you asked to be on my super confidential email list. If this is being forwarded to you, that's fine too. And you may feel free to send it on so long as you include the whole email, even this l'il old post script. That way your friends will know who's responsible for these ramblings. Thanks.

Borderline Personality Disorder - another biologically based brain disorder?

For those of you whose loved ones with eating disorders have been diagnosed with the accompanying mental illness Borderline Personality Disorder (BPD), TARA is an organization that offers information and assistance to families.   TARA - Treatment and Research Advancements/National Association for Personality Disorder.

As readers of this blog know,  I firmly believe but of course do not know (yet) that BPD will someday (hopefully soon) be recognized as a brain disorder of biological origin, especially given this article published May 26, 2011 in the New England Journal of Medicine by John Gunderson, M.D. 

This research by Stanley Siever is hugely important, too, and hopefully will lead those who are knowledgeable about BPD away from the early emotional experiences blaming (the mom/family thing again) and more into understanding that the basis of this disorder may instead have to do with neuropeptides like oxytocin and vasopressin.

I had not been familiar with TARA, but noticed a link provided by the Cleveland Center for Eating Disorders.  I now intend to learn more about this organization. 

Meanwhile, here's TARA's link to some other helpful publications including the one mentioned above by Dr. Gunderson.
 

Research Update: Genetics and Eating Disorders

With thanks to Carrie and her weekly blog post specifically about news/research on eating disorders, here's a news release on work led by Cinnamon Bloss, Ph.D. of  University of California, San Diego’s Eating Disorder Treatment and Research Program.  

The conclusion from the study published in the journal Neuropsychopharmcology points to the probability that ....

"An international team of scientists has identified possible genetic variations that could influence a patient’s recovery from the diseases.

Their findings may provide new insights into development of effective interventions for the most treatment-resistant patients with these disorders."

     

New Book: A Collaborative Approach to Eating Disorders

Edited by June Alexander and Dr. Janet Treasure, A Collaborative Approach to Eating Disorders (Routledge, August 31, 2011) will be an important addition to the growing library on family based treatment.

Taking directly from the information provided by the publisher, topics include:

• current research including genetic factors, socio-cultural influences and early intervention
• clinical applications such as family based dialectical and cognitive behavioural treatments
• treatment developments for both adolescents and adults with a range of eating disorders
• building collaborative alliances at all levels for treatment and ongoing recovery. 

June Alexander recently released a book chronicling her own experience - A Girl Called Tim.   Dr. Janet Treasure is a pivotal figure in the study of eating disorders and behavior.  Her work in conjunction with the Maudsley Hospital in the UK has opened the door to a new approach to the treatment of eating disorders.  You can learn more about her work here during an interview on the BBC.  She presented at the NEDA conference in New York City last Fall.

I look forward to reading the book!