Welcome

When I created this blog, I was "getting on" in my early sixties, hence the blog name. However, my adult daughter's eating disorder and co-occurring emotional dysregulation disorder and other co-morbidities - ongoing for about 33 years - became and was our focus as we attempted to help her get into recovery. By learning about, reflecting on, reading about, attending conferences and writing about eating and brain disorders, I created a place to blog what I've learned. I hope this blog will be of use to others, especially families of and adult sufferers themselves to help them get into recovery. I update posts from time and the update date will be present at the top of the post.

Sadly, my daughter passed away in early October 2021 mainly because her body became so malnourished that she was immunocompromised, contracted a severe infection that was not properly addressed during an earlier hospital stay the month before, and developed an overwhelming non-covid pneumonia following surgery to save her life. I believe she should have been able to receive palliative care but Arizona, our country, and even the professionals trained in the treatment of eating disorders, particularly anorexia, are not "there" yet. I address the issue of palliative care in a recent post below, initially written in November 2021. I am not a certified eating disorder specialist. I am an Expert by Experience and college-educated with a BA in Community Work with an additional certificate in a one-year program in Business Administration from the same institution.

I am passionate about all of this because, as Shakespeare wrote in The Taming of the Shrew, Act 4, Scene 3: "My tongue will tell the anger [and sadness] of my heart or else my heart, concealing it, will break. And, rather than it shall, I will be free even to the uttermost, as I please in words."[2016]

Travel Guide

If you're new to my blog, I recommend you begin on the right side and take a look at the "Of Note" offerings. Read Dr. Cynthia Bulik's recent published interview (5/4/22) "Rethinking Eating Disorders" if you want to print an easy-to-understand professional's expert opinion about anorexia for your family doctor or the therapist. [Early intervention is absolutely critical. For those whose eating disorder is categorized as entrenched or severe and enduring, read the editorial comment by Stephen Touyz and Philipa Hay for a new approach about treatment. It is possible for your loved one to recover! I have also attached a link here for additional papers on the subject of severe and entrenched eating disorders. If you are a family member or friend of an adult with an eating disorder and have been at this for awhile, I refer you to the posts within the title "Adult Eating Disorders and Recovery Tools" found in the Index on the right hand side of this site. As well, in the "Of Note" section take a look at those posts with an asterisk. If you're a parent and need support, look for posts in the Index about parent support or parent toolbox. In my opinion, the best book to buy, to refer to constantly and to share with members of the medical/psychiatric profession is "Sick Enough: A Guide to the Medical Complications of Eating Disorders" by Jennifer L. Gaudiani MD, CEDS, FAED. "Dr. Gaudiani aims to improve medical diagnosis and treatment, motivate recovery, and validate the lived experiences of individuals of all body shapes and sizes, while firmly rejecting dieting culture." I recommend two groups who will support you on your journey - F.E.A.S.T and the National Alliance for Eating Disorders. Both maintain websites and Facebook private groups.

Wednesday, July 25, 2012

Parents - Setting Your Boundaries, Marjie Ruth

Marjie Ruth's posts always provide me with valuable things to think about.  Here's her latest, again on boundaries.  Note that she coordinates a support group in Tampa, Florida so if you live in the area, you might want to check it out.



"...Nothing can be said to be certain except death and taxes."
~Benjamin Franklin

Dear Family & Friends of the Eating Disordered (ffed);

Our support group will be meeting again this Wednesday (7/25) at 7:00pm at the Hyde Park counseling Center in Tampa (for directions , chk out their website: HydeParkCenter.com). The ABA 12-step meeting for those battling a disorder will, as usual, be meeting at the same time at the same facility. All our welcome. If you expect to attend the ffed meeting, please drop me a brief line to that effect. The meetings are free, fulfilling, and even sometimes fun.

The topic of boundaries is recurring and for important reason. Our understanding of and ability to establish healthy boundaries for ourselves will affect all of our relationships, but none more so than that with our eating disordered loved one. ED's are a disease that involves the whole family. While we didn't cause the disease, we most certainly can and generally do find ourselves caught up in it,
to a greater or lesser degree, and contributing to it through our unwitting enabling (see definition in 11/2 email: doing for someone what they could & should be doing for themselves).

As we think and talk about boundaries, the discussion ultimately leads us to the tough need to identify where boundaries are needed and the tougher still act of defining the boundaries in no uncertain terms. As the saying goes, this is where the rubber hits the road, and for many of us that's exactly when we find ourselves spinning our wheels. We know that things are out of kilter, and we rightly sense that we've become enmeshed in the problem. But we're still unable to see what would seem to us to be a viable option. In fact, it's generally not a matter of lack of options, but more of our inability to recognize that it's our own fears & worries--our own emotional baggage--that we allow to keep us stuck in the mud of enabling. The possibility that our loved one won't respect the boundary we set keeps us from drawing the line. What if we set a boundary and it is broken? We are ultimately afraid that our loved one will carry through on her/his implied threat of self harm (ie. starvation, emotional breakdown, maybe even suicide, etc). We think that our involvement will somehow prevent any such cataclysmic event. We cringe at the thought of having to actually follow through with the consequence. After all, it's always been our intent to make things better, and that could be the worst thing ever...or so we think.

And therein lies the problem, it's with our thinking, our perspective. All responsible folks live with rules and consequences. If we don't pay our electric bill, first there will be a late fee added; eventually the power will be turned off. If it were not so, if there wasn't any penalty for not paying our bill, if it were just left up to us to pay if we wanted but at no risk of being fined or having to do without power--how many people do you honestly think would be sending off that hefty check each month? But for most of us, we know and accept the boundaries the power company, the bank or landlord, the city & state government, etc. have set for what we can and can't do and for the consequences that will be administered should we cross the line. We may not always like the rules, but we respect them if only because we know what the result of disobedience or neglect will be.

It may at times be difficult for us to believe, but in spite of the complaining and dramatics and even outright hostility we must endure, our loved ones will ultimately respect us far more for our leadership (as in leading by example--setting an example of healthy boundaries) than they ever will for our pandering to their addiction's dictates. But, you may be asking, what if the boundaries we set seem to make their disorder worse? First, thank you for being open and honest enough to voice that fear. Secondly, it's critical that we come to understand that the addict will always seek to protect their addiction. One of the keys ways this is done is by manipulating us into thinking they're doing better when in fact they are merely doing a better job of fooling us, of hiding their addictive behavior from us. When we stop "cooperating" (that's what enabling really is--cooperating with the enemy), they may very well lash out in anger and even seek to exact retribution on us by hitting where it hurts most: they will act upon our fears by showing us just how disordered they can be. This doesn't necessarily mean that they're getting worse, only that they've quit hiding what they've been indulging in all along.

While life doesn't come with many guarantees (opening quote being an example of two exceptions), but there are some absolutes I can offer. Nothing earth shattering or that you didn't know already but keeping these in mind may be a help as you struggle to see more clearly just where your boundaries should be:

1. If your aim is to please everyone, you can be certain you'll fail.
2. If your goal is perfection, you will never attain it.
3. Everyone has second guesses and some regrets.
4. You can't change other people, only how you respond to them.
5. Enabling an addiction will never cure it, but only insure it's continued existence.
6. When you stop enabling, you will be able to take better care of yourself.

Hope you have a decent week.

Marjie Ruth
727-244-9011 (c)

Sunday, July 22, 2012

Against Their Will - Another Essay re the Challenge of Treatment Refusal

The on-line edition (July 22, 2012) of Psychology Today carries an article by Emily Troscianko titled, "Anorexia and the Right to Die".

This discussion again evolves from the decision by Justice Peter Jackson previously discussed here on my blog.  


Emily's position is the same reached by several of us; that is, the brain of one with severe starvation syndrome resulting from anorexia leaves the mind incapable of rationally making the profound decision to end one's life.  It behooves scientists/doctors/researchers/caregivers to find a way to re-feed the individual and from there to assist that individual to reconnect with life and recovery.

The how is another question......

Saturday, July 7, 2012

Traits...... introversion and extroversion and how this information meshes with family-based therapy

Yesterday one of my favorite bloggers connected her readers with another TED talk session.  After watching a remarkable presentation by Elyn Saks (Yale Law School Graduate; Professor, USC College of Law; and MacArthur Fellow among other accomplishments) and about her life's journey with schizophrenia, I decided to browse around and see what else I could find before dinnertime.

I noticed that Susan Cain had been a presenter (more than 2 million views at this point) - The Power of Introverts - and I remembered that I had not yet finished reading her book, Quiet - The Power of Introverts in a World that Can't Stop Talking (Crown Publishers, 2012).  In fact, I'd barely started a few weeks ago.  After watching her talk, I vowed I'd pick up her book again.  So, this afternoon, I did.

I'm not finished yet, actually.  But I am quite grateful to Charlotte for leading me to the TED site and for a few minutes of my own yesterday afternoon, because I've learned more not only about myself, but have come to understand a lot more about introverts, developmental psychology, and perhaps even about my family member.

I don't think I would have picked up the book this afternoon if I hadn't also attended my usual Saturday morning meeting and realized how far I'd come in the program (and how much more work I needed to do).  I know myself far better than I did eight years ago.  I've also come to understand at a much deeper level how different my family member and I are.

She's an extrovert.  In fact, she confirmed this yesterday when we talked.  I'm an introvert.  And, Susan Cain has helped me to understand better what these two words mean developmentally and how we differ.

I've also just realized how this knowledge fits so aptly into the concepts of family therapy and communication, topics that I've written about on my blog (links provided earlier in this sentence) - e.g. "All in the Family and Elsewhere."  Susan Cain provides terrific examples of how both children and adults respond to experiences, depending on this part of who they are.   For example, I rarely have either the television or the radio on.  Sometimes I'll listen to music while doing something.  My husband, also an introvert, often remarks about the peacefulness of our home and how much he looks forward to coming home after a long, busy, interactive day.  When my family member comes to visit, however, her first comment is something along the lines of "it's too quiet here!"

She likes to be with people a lot; I need time-outs and relish days at home after spending other days with groups of people in meetings.  One might ask, how does this translate into what you daughter or son needs as part of their recovery?  their experiences at home following a stint in a residential treatment center?  These are important questions for the family to address before their loved one returns home.

Backtracking a bit, I wrote a piece on States and Traits after hearing Dr. Kate Tchanturia's talk on Cognitive Remediation Therapy at the NEDA Conference in New York City a couple of years ago.  I hadn't thought much about traits lately until I listened to Susan Cain's talk.  I'm thinking a lot more about traits now that I've read her book and about the research of scientists like Dr. Jerome Kagan.

Dr. Kagan's studies have revealed that one can pretty much forecast whether one will become an introvert or an extrovert from infancy and that fMRI's and the work of one of his colleagues, Dr. Carl Schwartz, have shown that the processing of the adult brain really hasn't changed that much  - in other words the traits are fairly intact in spite of a lot of other things we call environment.

I'm still reading (Chapter 6 and sensitivity as well as empathy) and will probably come back here with more to say.  In the meantime, I've found reading Cain's book to be very helpful as I unravel the puzzle of my family member's journey.