How Life Can Improve For People With Anorexia Ė Free Self-Help

By Diana Holbourn

Article Summary

Welcome

This article covers several issues. It discusses both how a disgust for fat can make people desperate to be thin, and underlying issues that can contribute to the development of anorexia such as unhappiness. It also says a bit about how genes might play a part in predisposing a person to problems like that.

It talks about several different types of unhappiness that are thought to contribute to some people becoming anorexic, such as feeling that some important life situations are out of control and going badly, when anorexia can be a means of at least having one thing in life it's possible to have charge and control over.

Parts of the article go into detail about just what can happen to the body if people starve themselves too much, and how the body can be damaged by over-use of laxatives and regularly vomiting up food.

It gives lots of advice on how to build up to eating normally again, and on ways of trying to overcome several difficult life situations that can contribute to people expressing their feelings through anorexia or another eating disorder.

Part of it gives advice to parents who've got a child with an eating disorder.

The Main Contents

Background Information About This Article

The Self-Help Information in the Article

  1. Someone's Attempts to Help a Boy Who Says he Got Anorexia After Getting Depressed at School
  2. Someone's Attempts to Help a Girl Who Says she Got Anorexia When She Was Too Timid to Stand Up Against Her Parents' Wishes For Her Career
  3. Someone's Attempts to Help a Girl With Anorexia Whose Main Concern Was That She Felt She Couldn't Compete With Her Older Sister
  4. Someone's Attempts to Help a Girl Who Says she Got Anorexia Because Her Mum Thought Fat was So Disgusting, who Also Sees Not Eating as Good Self-Discipline
  5. Someone's Attempts to Help a Boy Who Says he Got Anorexia After Teasing From Classmates About Being Fat and Health Concerns From his Doctor
  6. Someone's Attempts to Help a Parent of a Daughter With Anorexia Who Worries About Whether she and her Husband Could Have Caused it and What to Do Now
  7. Someone's Attempts to Help a Girl Whose Parents Argued a Lot but Got Closer When she got Anorexia, Who's Scared They'll Quarrel Again if she Gets Better
  8. Eating in the Middle of the Day Made a Woman Feel Lethargic at Work, so she Thought She'd be More Efficient if she Stopped
  9. Someone's Attempts to Help a Girl Who Says she Became Anorexic After the Death of a Loved One
  10. Someone's Attempts to Help a Young Woman Who Says she Got Anorexia When She Felt Depressed and Unable to Control Life After her Boyfriend Left Her
  11. Someone's Attempts to Help a Girl Who Says she Became Anorexic After Feeling Under Pressure to Please Her Mother Who Was Obsessive About Appearance
  12. Someone's Attempts to Help a Girl Who Doesn't Want to Recover From Anorexia Because Being Ill Gave her the Attention she Lacked When She Was Well
  13. Someone's Attempts to Help a Girl Who Says she Got Anorexia When She Wanted to Make Herself Look Less Attractive After Having Been Sexually Abused
  14. Someone's Attempts to Help a Girl Who Says she Got Anorexia When she Felt Trapped Because her Parents Were Over-Protective and Too Restrictive

Part One
Someone's Attempts to Help a Boy Who Says he Got Anorexia After Getting Depressed at School

Thinking

Susan thinks:

It's interesting; some of the forum members here seem to be quite insightful about why they got anorexia. Or why they think they got it. But they say they like having it so they're in two minds about whether they want to give it up. But it seems to me that they could get the benefits they're getting from anorexia from other things instead that are more healthy, that might work even better for them. I've got some ideas I'll discuss with them, to see what they think.

I know I won't be getting the whole story about why they got anorexia and why they're not too keen to get rid of it from just a few little messages on an Internet forum. But I'll discuss what I've read of what they've said with them anyway, and see how things go.

Fed up

There's a message here from a young man, who says he goes to a boarding school. He says he used to love running. He used to run for miles, and it gave him confidence, because he knew he was good at it. But he had to give running up after he injured his knee. After the injury healed, it was still painful when he ran, so he was advised by a doctor to give it up. He was depressed about that, and his self-esteem fell, because he wasn't feeling the confidence he used to get from it, and he didn't think he was much of a success at other things.

His self-esteem and confidence fell to an all-time low when he got a condition that made clumps of his hair start falling out, and the other boys started teasing him about going bald, calling him granddad and saying he'd never attract a girlfriend. He became quite withdrawn. Whereas before, he'd been able to put up with the competitive environment in the school where people were under pressure to prove themselves and excel at something, and people were made fun of a lot and expected to stand up for themselves when they got teased and give as good as they got, now, he didn't like it. It stressed him out and he began to feel inadequate.

He felt worse when he started putting on weight because he wasn't running any more. He became obsessed with wanting to be fit, and started skipping school meals to lose the weight again. He bought slimming books and went on some extreme diets. The weight loss gave him back some of his confidence, because he found losing weight was something he could do well.

I think I'll try responding to this, and try to give him some ideas on what he could do, from ideas I've got from the self-help information I've read, and from other things I know about. I think I'll say:

A Story About a Depressed Man Getting Support on an Internet Forum and Recovering

You know, your story reminds me of something I read on another Internet forum once. I'll tell you about it. Reading about it might give you a bit of encouragement that things might work out for you in the end.

Crying

A young man put a message on the board saying he felt really depressed and needed help. He said he was upset particularly because he had repetitive strain injury so using his hands was painful, and he had back problems which made things worse, and he thought he was going to have to give up playing the guitar which he loved. He said he'd already had to cut down on the amount of sports he played because of his back problem, and he couldn't do as much typing and other writing and drawing as he used to. He said he'd had the back problem for a couple of years and he'd been getting more and more depressed about it. But he said he just didn't think he'd be able to cope with not being able to play the guitar any more, because he'd loved that.

He was worried he wouldn't have much of a career, because he didn't know what he'd be able to do if he couldn't use his hands that well and his mobility was restricted because of his back problem. He thought he might keep having to take breaks all the time from any job he did.

He said he felt so depressed he would often start crying, especially at night when he had less to distract him. He said he often thought about dying and that made him cry the most. He said he couldn't imagine living much longer as he was, having to give up things he loved because of the pain he was in, and he wondered how he would die, and sometimes thought about how he might help the process along by committing suicide.

He said he had school exams coming up and he couldn't concentrate on revising, especially because he couldn't imagine what he might do after them so it seemed pointless doing them. He said he was just feeling a sense of despair a lot of the time.

Glum

Several people posted messages of support to him. There was one person who was usually angry and rude, but who posted a really nice message to him, wondering if there were things he could do about his RSI, telling the man his dad suffered from arthritis, and he wasn't sure what he was saying would help, but he thought that if RSI was like arthritis it might, because his dad found doing simple exercises to flex his joints and rubbing them helpful. He suggested that going to therapy might help with the man's depression. He also asked if he was getting enough sunlight, since his wife tended to get depressed when she didn't get enough sunshine. He asked about whether the depressed man was stressed about other things as well. He said that giving up playing the guitar didn't have to mean giving up music altogether, because there were other things he might be able to take up instead, and there were computer programs where you could write music by saying each note. He advised the depressed poster to go to the doctor to find out whether there might be any underlying causes of his physical problems that could be sorted out. He asked him not to end his life since the world would be worse without him.

Other posters reassured the depressed poster there must be other forms of music he could take up as well so giving up the guitar didn't mean giving up music altogether. And they encouraged him to look into different types of careers, and ways his physical problems might be cured or relieved, since he might find things out that he'd never thought of before that would help him.

One person advised the depressed poster to stop his thoughts wandering onto thoughts of despair so much by changing his environment a bit to shake up his routines to stop him continuing in the same old patterns where his mind started wandering whenever he did certain things. So he suggested that the depressed poster maybe could, for instance, go and revise for his exams in a different place. He made the point that thinking too much must mean a lack of action, a sign that he wasn't taking control of his life. So he advised him to take control and start looking for solutions.

One poster advised the depressed poster that if he really had to give up music, there must be other things in life he'd enjoy - it couldn't be as if 'guitar player' was his entire identity - if he looked, there might well be other things he could get involved in that he'd enjoy.

Support

One poster advised him that if at all possible, it would do him good to surround himself with people he loved and who loved him when he was feeling depressed. She advised him to phone someone up who he felt fairly sure would cheer him up a bit when he was feeling down. She said one thing that gave her a good feeling personally was interacting with babies and little children. She said holding a baby or a child's hand gave her hope and was one of the best feelings for her. She urged him not to give up, but to look for things that would help him. She said she sent her love and hope, as others on the board had.

Another poster said it was very important that if possible, the man didn't isolate himself, since isolation would lead to him thinking more and more depressing thoughts till he felt really bad. Being with people would stop his mind getting ever deeper into the same despairing thoughts that would end up making him think there was no hope.

A couple of people were unsympathetic to him. But most people were helpful.


He thanked them for their advice. He said he thought the pain in his hands might be caused by typing with his wrists below the keyboard, and things might improve if he changed his posture and perhaps got some supports for his wrists. He said he'd been looking into new techniques of playing the guitar, including a technique he'd heard classical musicians use, where when fingers aren't being used, you imagine them draining of tension and energy so they get more relaxed. He said he'd recently been re-trained to play the guitar differently to the way he had before, so he thought it was more the typing causing the problem. But he said he'd started doing exercises he'd heard might help, and taking vitamins, since he'd heard they might help, and that day, his arms felt the least painful they had for some time. So he was feeling more hopeful. He said his mother had started massaging his hands with almond oil and that seemed to be helping as well. He said she liked doing it because it meant she could have time to talk to him since he wasn't being the usual teenager shutting himself in his room.


Happy

That was two years ago. He's obviously found solutions to his problems since then, because I read a recent message from him talking enthusiastically about how he'd just been for a weekend of "jamming sessions" with other musicians. He mentioned a re-training technique he'd done to help him with the way he positioned his hands when he played the guitar. I don't know what that involved. I read that the pain caused by RSI can sometimes have quite a lot to do with stress and holding muscles too tensely for a long time, and that back pain can get a lot worse when people are under stress and when their back muscles are tense and their posture isn't good. I know muscle tension can cause quite a bit of pain. But I don't know how much that had to do with it. Anyway, whatever solutions he'd found to his problems, they must have been good. He was talking enthusiastically about playing and writing music again, and joking around about how nice it would be to have a party for one of his online friends. He was at college, and last I knew, he'd just come back from a holiday he'd really enjoyed.

It might have taken him quite some time to get from the despairing mood he was in two years ago to the happy optimistic one he seems to be in nowadays, where the things he cares about most seem to be really looking up for him. But he got there! So your own life might be looking completely different in a couple of years' time, if you have a look around for solutions to your problems.

I know emotional support can make people feel a whole lot better. So you might feel a lot better and get a lot of support too if you discuss your problems with people you can trust, or anonymously on Internet forums you've had a look at, and where you think you might get a sensitive response and maybe good advice from some people. Even just knowing people are on your side and feeling supportive of you might be very comforting.

Being Teased at School

Making fun of someone

Has the teasing you get at school really been getting you down? It sounds as if they're saying silly ignorant insensitive things!

It might not make you feel much better about having to face them, but it might satisfy you a bit to think you can fight them with logic. I mean, for instance, it sounds as if your hair loss condition's different from the balding people get when they're older. And who says it can't be cured. Have you seen a doctor about it? As for getting a girlfriend, anyone worthwhile won't just be going for looks but will be going for someone with a compatible personality as well and won't be put off by a bit of hair loss! Never forget that the teasers are the ones in the wrong, both in what they're saying and in the fact they're teasing you at all. They probably don't even believe what they're saying, but just think it's fun or something.

You know, I've heard that one reason people can tease others is if they're a bit fearful of a difference in them and don't understand it. They attack because being on the offensive's a much better feeling than hanging around feeling scared or uncomfortable. So some people might come across as big and intimidating and nasty, when really, they're just frightened and insecure. It might not be like that with the kids teasing you. But it just might be, at least with some of them.

I read about a therapist who questioned some children with leukaemia about what their worst experience related to the leukaemia was; and a surprising number of them didn't say their worst experience was the chemotherapy or other unpleasant treatment, but they said it was going back to school after their hair had fallen out and being teased. The therapist asked some of the other school children why they teased the kids with leukaemia whose hair had fallen out, and some admitted they were scared of their new appearance. One boy said he was coming out with all kinds of things, saying whatever came into his head, just because he was scared.

She said some kids managed to stop themselves being teased though. Some of them were allowed to speak at the front of the class on the first day they were back about what had happened, why it had happened and how they felt; and once people understood their condition better, and realised how they felt about it, they stopped teasing them.

Do you think you yourself would feel calmer about things if you knew more about why things were happening to you?

For one thing, is your hair loss problem something like alopecia? Has your doctor been helpful, and does he/she seem optimistic about treating it? I've heard alopecia can be inherited, and is thought by some to sometimes be an auto-immune disease - one like some types of arthritis where the immune system gets over-zealous and attacks parts of the body rather than just germs. Some people think vitamin B5 deficiency can sometimes have a role in the cause of it too. But it's thought that stress can trigger it off.

Anyway, I don't know how much you already know about it; but perhaps if you do some research into it on reputable medical websites, and into anorexia, you'll feel more in control of the situation, and you'll have more comebacks for the teasers, and you might find out more about possible solutions to your problems.

Changing Lifestyle

Do you think it was at least partly the teasing you got at school that made you obsessed with your appearance? And do you think that perhaps the fact that you couldn't do running any more, which was the thing that had given you confidence, made you obsessed with fitness, because you thought fitness was the way to get your confidence back, and you thought losing weight would make you fitter? It's just a theory.

But there might be lots of other things that could give you more confidence, - knowing the people teasing you are talking nonsense, for one!

Exercise

Do you think that if you had a good think about what other types of exercise you might be able to get involved in and tried them and discovered you were really good at them, you'd gain your confidence back, and feel more in control of your life, so you wouldn't feel the need to try and feel better about yourself by losing so much weight? My sister's boyfriend used to do a lot of running, running for miles every weekend, but he's had to give it up because he had cartilage problems in his knees. He does a lot of walking now though. I think he was thinking of trying cycling as well. There must be quite a few other exercises that don't put pressure on your legs, that you might discover you're really good at once you start. Have you ever thought of taking up rowing, for example?

But don't forget that eating too little means the body isn't getting enough fuel so you'll get weaker, so you won't be so good at exercise in the end. When you think about how good you were at running when you were eating normally, you'll know you could eat normally again and be just as good at any other exercise.

Or is there anything else you could take up that you think you'd enjoy and be good at that would help you feel less depressed and more confident that has nothing to do with exercise? Do any of your family and friends do anything you think you could start and would enjoy? It might be worth thinking about. Are you artistic at all? Do you think you might like painting or pottery or learning a new language? Or are you more interested in science? What about visiting science museums and that kind of thing? Well, I don't know what kinds of things you'd like best, but can you think of some things you'd like doing?

Those are just a few thoughts anyway.

Relaxing

And if the competitive environment at your school's really getting to you, is there any way you could take a break from it for a while and go somewhere where you won't feel pressured to perform at your best? For instance, would it be convenient for you any time soon to take a break at home, and are your parents supportive enough to let you relax and de-stress with them for a while, free from the pressures of having to be the best you can? Or do you have any other relatives or friends you could stay with for a while in a relaxing environment? I heard about a boy who got anorexia, and he stayed home from school during the time when he was revising for his exams; and away from the environment where people were being teased a lot, he found it much more relaxing; and his parents were loving and supportive, and that helped a lot, and he started putting on weight.

The care and support of people can help and encourage people a lot when they're feeling down or upset in some way. A supportive therapist might be helpful. Or people on an Internet forum, even people you don't know that well. I know people have been comforted a lot on Internet forums sometimes when they've talked about their troubles, besides the one I've spoken about; but you'd have to be careful about what forum you posted your troubles on, because there are a lot of unpleasant people around who might say things that made you feel worse. There are lots of nice caring people around though as well.


Part Two
Someone's Attempts to Help a Girl Who Says she Got Anorexia When She Was Too Timid to Stand Up Against Her Parents' Wishes For Her Career

There's a post here from someone who says she felt trapped because her parents wanted her to go for a legal career, but she wasn't really interested, but she didn't know how to say no to them. She says they can be a bit harsh at times, and even threatened not to support her financially if she did something unrelated at university. She wanted to do teaching. But she felt as if she was being pressured to go into a legal career. She didn't think of it like this at first, but anorexia was a way of getting her out of the dilemma of either going her own way and seriously displeasing her parents, or doing what they wanted against her own wishes which might lead to her going into a career she'd be unhappy in. She began to get too ill to do either.

And becoming anorexic did mean going her own way on something, which was important to her, because it at least meant standing up to her parents on one thing. Also, when she had all her attention focused on the anorexia, she could forget about other problems for a while, which was a relief to her.

I think I'll try responding to this. I'll say:

A Similar Story

The high life

There's a story a bit like yours in a book I've been reading. There was a girl who was about to leave school whose parents had both been in show business. They'd loved it, and thought it would be really good if their daughter followed them into it. She thought she'd really disappoint them if she went against their wishes, so she tried training as a dancer, just as they wanted her to. She'd always been good at dancing. She went to stage school. But afterwards, she found it difficult to get a job. She kept meeting the same people who said they'd got jobs but they were only short-term so they were often out of work, and they were often put out of work without notice. She became really disheartened, but didn't want to give up because she knew her parents would be upset. They kept encouraging her to continue looking for a decent job. Her anorexia relieved the pressure on her from either having to face seriously disappointing her parents, or carrying on doing something she didn't want to do, because she became so ill that everyone knew she'd never get a job with a body looking like a skeleton, so she didn't have to go to auditions. That meant she didn't have to tell her parents she didn't actually want a career in dancing.

In therapy, she had a think about how she could get out of the dilemma of either carrying on looking for a career she didn't want, or going her own way and risking annoying and disappointing her parents. She thought about what different options she had - to continue trying to get a job in dancing as she had been doing; to look for other careers; or to discuss the matter with her parents.

After talking more in therapy about how it wasn't really her who wanted the career in dancing but only her parents who wanted it for her, she started thinking about new ideas for careers. After she'd talked them through with her therapist, she began to talk them through with her parents.

At first, her parents were opposed to the idea that she should have a different career and argued against any change in her plans. But she suggested that she try out an alternative career as an experiment to see how she got on - she could always go back to dancing if it didn't work out. After more discussion, she persuaded them to go along with the idea.

She quickly got a job in insurance and was quickly promoted. She slowly got better from her anorexia, and enjoyed her new life. Her parents accepted her decision to stay in insurance, and in fact were really really pleased about her promotions.

So maybe your parents could come around to your way of thinking in the end, and in fact might end up being pleased for you.

Parents can be like that sometimes. - I remember when I was about 21, my mum used to say things to me like, "What are you going to do with your life? When are you going to get a proper job?" But I'd planned to work towards a job that was a bit out of the ordinary instead, that would take a bit of time to achieve. At the time, she'd have preferred I knuckled down to something at once. But now, some time later, my mum's really proud of me because of what I've done!

Bringing Parents Around to Your Way of Thinking

Classroom

If you decide to try to persuade your parents to come around to your way of thinking, it might be good to write down a list of all the reasons you can come up with why you want the alternative career and memorise them before trying to talk your parents round. Then you'll be able to put a better case.

Perhaps one thing you could do is to ask if you can do a bit of work experience or work shadowing in a classroom, perhaps as a classroom assistant, to see if you really do think you'll do well or like teaching. my sister's teenage daughter's thinking of becoming a teacher, and she recently did some work experience as a classroom assistant at her old primary school. She loved it. Her mum's a nurse, and last year, she arranged for her to do some work shadowing in the hospital where she worked, spending a day or two or sometimes just several hours with different people, like someone in the X-ray department and an occupational therapist, finding out a bit about what the work involved, to see if she might want a medical career. She still ended up preferring the idea of teaching. So now she's been doing a bit of work experience in a classroom to see if she still likes the idea when she's finished.

Maybe you could ask your parents if they could get you some kind of work experience or work shadowing in some kind of legal setting to see how you liked it, and if you don't, perhaps you can write down a list of all the reasons why and discuss them with your parents. How willing do you think they'd be to listen if you said you weren't keen, if they thought you'd shown a willingness to compromise with them by trying something out for a little while? If they arranged for you to do a bit of work experience in some kind of teaching setting and you liked it better, maybe you could discuss it with them, comparing and contrasting the two?

Teacher

I know teaching isn't thought of as a particularly good career, with pupils misbehaving, and teachers getting a bad press every time schools are shown up as not performing well. But maybe you could think of all the positives of being a teacher you can, and discuss them with them? For instance, it might be rewarding to know you've helped children learn and be better prepared for later life, provided your classes aren't so big you feel there are people you can't help as much as you'd like to. You'd get long holidays, although you'd have to spend quite a bit of time outside work marking children's work. There are probably other advantages of being a teacher you could put to your parents. You might feel more confident about discussing the matter with them if you've thought through things like the advantages first so you feel more able to argue your case. They might come up with several disadvantages, but all jobs have disadvantages. That includes legal careers. And anyway, work experience might give you at least a bit of a better idea of how well you'd get on.

Do you think that would work - do you think you could ever have a discussion like that with your parents? If they can think of discussion over the issue as more of a negotiation process than a battle between two opposing views, they might be more willing to see things your way, because it won't mean immediately losing face.

If you don't think what I suggested would work for some reason, maybe you could try doing what the young woman in the story did, thinking of several options for what she could do, and then picking the one she liked the best.


Part Three
Someone's Attempts to Help a Girl With Anorexia Whose Main Concern Was That She Felt She Couldn't Compete With Her Older Sister

Here's a message from someone who says she always felt inferior because her older sister seemed better than her at everything, and she was always being told her older sister was better at things by others, so she didn't feel very confident or much of a worthwhile person. She says she went to the same school as her older sister, and a couple of teachers there were always criticizing her, comparing the two of them, saying she wasn't as well-behaved or good at her work as her sister, and that her grades were never as good as her sister's.

She says what triggered her to start slimming was that she was in a race where her sister was also participating, and she'd trained quite hard for it, whereas her older sister hadn't trained at all; and her sister won.

Surely her sister would have been better in the race than her because just by being older than her, she'd have been likely to have been bigger and stronger. Anyway, she says she decided she really needed to get fitter after that, so she started doing more exercise and slimming. Then it turned into anorexia. She came to think of anorexia as being like striving for perfection, because her anorexic urges kept making her think she had to do better.

But she was pleased because she found losing weight was something she could excel at, so she was motivated to lose more. She found at first that people admired her for being able to lose weight, especially since some of them had been on a diet and hadn't been able to keep it up. They thought she must have a superior kind of self-control, so she began to feel pleased with herself.

She also says it was as if anorexia was her friend, because it gave her an individual identity, something that marked her out as different and someone with a skill in her own right, rather than just the less successful younger sister, always in the shadow of her older one. People started treating her more as a person in her own right, and then when her weight loss made her start looking ill, she still liked it, because people were concerned about her, rather than as critical as they'd been before.

Dejected

And now she's so used to having anorexia that she says she's scared of what life without anorexia might be like - she'll be expected to behave as if she's more confident and intelligent than she feels. She's worried about what new responsibilities she might have to take on, - whether it'll mean she'll have to go out into the world and meet new people, for instance, such as if she goes to college. She Lost touch with friends because she was so ill she stayed away from school for a while, so she thinks she'd have to make new ones. It seems a bit daunting, because she isn't confident about being able to make friends and be any good at anything. She'd have to pick up her education again as well, and feels awkward because she's fallen quite a bit behind the others now. She isn't sure what to do about that. She also worries about whether she's clever enough to go on and get a good career. It all seems a bit overwhelming for her.

I'll try writing a reply:

Thinking About Whether Your Critics Were Right to Say What They've Said in the Past

Unpleasant teacher

Those teachers who criticised you at school don't sound very nice! Chances are, what they said wasn't even true!

I think sometimes, it's easy to be too accepting of what other people say, rather than questioning whether it's true. It's easy to get so emotional about the horrible things people say that it's difficult to think critically about them; but if you step back and try to see things as an outside observer who knew all the facts might see them, do you think you might see things any differently? For instance, if someone was listening to your teachers making those comments about your sister being better than you, do you think they'd think the comments were justified, or do you think they'd think that even if the teachers had a point, they were just being mean and they'd be better teachers if instead of spending their time making unpleasant remarks, they tried to encourage you and help you do better? Encouraging kids and helping them with anything they're not so good at is a far better way of teaching them than being nasty to them!

I had a short-tempered teacher at school, and one day, a little group of us were sitting with her outside, eating some food. I had a cup with a drink in it, and I accidentally spilled a few drops without realising it was spilling. She said that was stupid and said,

"It's allright to spill a drink, as long as you know you're spilling it."

Oh really? Grinning

That just shows that teachers can say silly things sometimes. Do you think a sensible person listening to what your teachers were saying to you who knew you and your sister would think everything the teachers said was even fair? Do you think they might realise that though your sister might be better than you at some things, there are other things where you might be better than her?

Do you think they'd think she was better than you in things that really count, or aren't the differences all that significant really?

if your sister's a lot better than you at certain things, are they things that mean the fact that you're worse at them is going to blight your whole future? I mean, she might be better than you at certain subjects at school, but if you're good at other things, you could end up with a good career anyway. Perhaps there are some things you're far better than her at? Or maybe with some of the subjects you're not so good at, you'll be better with practice?

Thinking

If there really are things you're not so good at as her that are going to make a big difference to your life because you're not that good at them, what ways can you think of that could help you improve in those areas? what might be holding you back?

In other words, what would have to be different for you to be able to succeed better? What would you like to change?

Asking yourself questions like that might help you plan out how to be more successful, (well, apart from possibly giving you brainache!). If you can try planning how things could improve in small steps, it might not seem so daunting. I mean, what would be the very first thing you'd do to get your life back on track? When you've thought that one through, then perhaps you can think of more things that would gradually improve your life, - gradually so you don't take on too much and get discouraged if you don't do as well as you're hoping at first.

Increasing Confidence

Confidence

As for your worries about not feeling confident enough to try anything in the future, I read a book that says people can increase their confidence quite dramatically sometimes.

It says people who don't think they've got any confidence can often be underestimating their real confidence, because they can be confident in some aspects of their lives but not in others. It says they might be able to think of things they're confident about doing if they try, like playing a musical instrument, doing a sport, using the computer, making things, gardening, cooking, being good at planning or organising things, or other hobbies and activities they do, or skills they have. If they can think of things they do confidently, they can be more sure that they can be confident in other areas of life too.

It says that if they know they can be confident in some things, then it's a mistake for them to think of themselves as unconfident people. It'll be more accurate for them to think of themselves as confident in some things, and lacking confidence in others. And if they know they can be confident in some things, they'll know they are at least capable of confidence, so it just needs to be transferred across to the other things.

Nervous

But the book says that some people might not think things like activities count, because it's self-confidence they feel they lack, which means they feel cautious about approaching anything and reluctant to try anything new, being more likely to be uncertain they can achieve difficult things, and often wanting reassurance from other people and being worried about people seeing their weaknesses, as if they think they're inadequate and inferior or incompetent compared to everyone around them. That sounds like the kind of thing you were saying about yourself in your message.

But it says that part of the reason you might feel you don't have any self-confidence is that you undervalue the things you are good at. Can you think of things you're good at, perhaps not things that are immediately obvious, but things that are definite skills? I mean, for instance, some people can keep children amused all afternoon, or they're good with plants. Some people are especially patient, or good listeners. And some people have more self-confidence because they don't undervalue things like that.

But the book says even confident people sometimes have doubts about themselves, because the amount of confidence they have isn't the same all the time, but can depend on their moods, what they're doing, and how important they think it is to get what they're doing right. It says that even people who usually seem confident can feel as if their confidence is ebbing away at times when they feel tired or discouraged or lacking in energy. It says that sometimes their confidence can bounce back as soon as their mood changes, but sometimes it's slow to return. And everyone's confidence can be shaken if they suffer things like rejection or a run of misfortunes, or they make a mistake they should have known to avoid. So everyone's confidence comes and goes, and sometimes confident people even start worrying about things that wouldn't normally bother them.

It says that most people can look confident even if they don't feel confident, though. It says that some people manage to stay confident in public because they assume that even if they do something badly, like stumbling over their words, or introducing someone to another person but sounding awkward while they're doing it, it won't matter. They just forget about it as soon as it's happened and move on to the next thing, assuming other people will do the same, which they probably will. They might just shrug it off by thinking that everyone does embarrassing things sometimes, and other people will know they do as well, so they probably won't make too much of it.

Some people can give an impression that they're confident, because they act as if they're confident when they're not really. The book says a good strategy to use could be to ask yourself just before you walk into a room or join a conversation how you'd behave if you were feeling really confident. When you've imagined how you'd behave, you can act the way you'd feel if you were feeling confident.

It says that when you're imagining what it would be like to be really confident, you should take into account things like the way you'd move, how you'd look, what your body language would be like, how you'd stand, how you'd behave, and other things like that.

It says that if you adopt a bold, confident posture and act as if you're ready to meet another person's gaze, it can change a whole situation. When you're acting more confidently, you can often begin to feel much more confident. It says that's even more likely to happen if you think confident reassuring thoughts instead of anxious ones. So you could try to think of encouraging messages to give yourself, or think thoughts you know will make you feel better, like maybe, "None of these people are out to threaten me", or, "I'm going to do my best to be friendly", or, "It's OK to be the way I am". Or whatever you like. When you're thinking more confident thoughts, it says you'll be encouraged to behave more confidently. And it says when you do, it can make a big difference to the way you feel, what you do, and what happens to you next, since people will behave differently towards you if they think you're confident, and their different behaviour will make you behave differently and feel more confident, and it'll probably get better from there.

It says the more confident you get, the happier you'll be to go to more social occasions you'd have felt too anxious to go to before. And the more difficult things you manage to do successfully, the more your confidence will grow.

It says another way you can build up your confidence is by doing things you feel fairly sure you can be successful at.

It says it can also boost confidence if you spend time with people you don't think of as threatening, until you're more used to communicating and happier about doing things you find more difficult. It says that the kind of people seen as unthreatening will vary from person to person, but they could include younger people or children, old people, people with young families, people who live in certain neighbourhoods, people who need help in some way, and so on.

So if you spend more time with the types of people you find the least threatening, perhaps family members, or maybe doing voluntary work of some kind, perhaps in a club for disabled people or something, which might raise your self-worth as well if you're good at it and get on well, because knowing you're helping other people might make you think of yourself as a better person, you'll get more confident that you can be accepted and good at some things and that you can communicate well, so you'll be happier about doing things you wouldn't have wanted to do before.

Imagining the Future

Graduating from university

One thing some people find helpful is to imagine it's ten years on into the future and they're doing something they'd really love to do in life, to encourage themselves to take gradual steps towards it. If you like the idea, you could imagine you've got a nice career or a family, and that you enjoy yourself doing things you like in your spare time.

Then, one thing you could do is to write a letter, imagining you're at this time in the future and you're writing to a friend, telling her how you got to be where you are now. You can describe all the steps you took to get there. So that would mean imagining and writing about how you got over your anorexia, perhaps what subjects you took in college, and what you've done since. You could imagine yourself starting out not feeling very confident, as you are now, but then imagine and write about things that happened that made you feel more confident and convinced you were more intelligent than you thought.

Perhaps you could write about how you got into a nice relationship with someone you're living with now, and how you made new friends, and do hobbies you enjoy with them in your spare time. You could write about what the hobbies are. Imagine the friend you're writing to is someone you haven't seen for ages, so you need to fill her in on all the details.


Of course, what you actually end up doing in real life might be completely different. Even the best plans can go wrong. But at least it'll give you something to work towards, so you don't just feel stuck in your present situation. In ten years' time, life might have moved on so much that your feelings about your sister just aren't an issue any more. You'll have both got new lives. Perhaps you'll be doing very different things from each other, but be successful in different ways, and good friends with each other. In just a few years' time, you might have moved to a different part of the country, hundreds of miles away from her, or you might go off to university, perhaps, and hardly ever see her, and you might find lots and lots of ways to express individuality, because probably no one will know her there so no one will compare her with you, or even if she does happen to go there, there will be so many people there that it's very unlikely to happen; and there are lots of interesting things to do in your spare time in places like that, so you'd probably be doing different things anyway.

I mean, for instance, when my brother was at university, he was in a canoeing club, a hang-gliding club, on the university radio station, and lots of other things. I think he was in nine things altogether. In fact, he enjoyed himself so much in his spare time that he didn't do enough work and failed his exams. He tells people that now, as a cautionary tale about how they ought to give some time to working as well as enjoying themselves. Smiling But that just shows how your life could be completely different and much more fun, without the problems you have now, in just a few years' time.

Improving Things Now

But if you want things to change now, I expect there are things you can do.

Your falling behind at school might not be such a problem as you think. There are probably quite a few ill students who do that every year, so I don't suppose it's a problem your school doesn't know how to handle. If you talk to them about it, they might be quite supportive, you never know. Even if it means going in the class below where you were before to catch up, it's not as if you haven't got a good reason for it. But perhaps you won't need to do that.

Sculpting

As for anorexia marking you out as an individual, can you think of positive things that could do that? what are you good at? I expect there are some things you can do well. Perhaps there are things you're good at that you haven't discovered yet. Have a think about these questions: Are there spare-time activities you'd like to try that you've never tried before but which you might enjoy if you did, and they could help give you a separate identity? Is there any group you can think of that you could join that does something you think you'd like, that your sister isn't in so no one will compare her with you, or that she is in but you expect you'll be just as good at what you do there as she is?

Are any of your friends involved in any hobby groups you like the idea of joining so you could join as well, or have you heard of any in your area on the Internet or anywhere? It could perhaps be just recreational, or maybe educational, or caring in some way for others.

How much do you think your parents would let you do? Things like that could raise your self-esteem. My brother was quite miserable at school for a while, so he wasn't very happy at home either. One of his teachers used to criticise him a lot, so sometimes he got miserable and said things like, "I'm just a piece of trash". He became a lot happier after he joined a couple of local amateur drama groups so he was out a couple of evenings a week, and he got on well with the people there so he had some new friends, and he starred in some plays. In fact, he was the leading character in one.

If you think of trying to improve your confidence in small stages by gradually taking on more things, and they're things you personally enjoy, then you might be quite encouraged in the end.


Part Four
Someone's Attempts to Help a Girl Who Says she Got Anorexia Because Her Mum Thought Fat was So Disgusting, who Also Sees Not Eating as Good Self-Discipline

Here's a message from someone who says her mother seemed quite paranoid about her and her sisters putting on weight. She was brought up to believe fat was really disgusting. Her mother was highly critical of any fat people they saw, always remarking to her daughters about how disgusting it was to be fat. The house was littered with fashion and slimming magazines with pictures of stick-thin fashion models, so she and her sisters grew up believing people ought to grow up looking as thin as them, and that there was something very wrong with people who were fat. Every time she noticed any fat on herself, she would criticize herself severely for having let it happen, and feel revolted, and eat less to try and lose it. So it turned into anorexia.

She also says her mother was very critical about other things about her daughters too and she learned the habit, becoming very critical of herself when she didn't feel she was doing something as well as she should be. She's noticed she criticizes herself lots of times a day about something or other; but she's discovered that when she's lost more weight, it gives her a sense of achievement so she feels better and doesn't criticise herself so much, so she feels less stressed and unhappy, and that's another motivation for losing weight.

She'd like to recover from anorexia in a way, but she's worried that if she puts weight on again, apart from becoming more self-critical, she'll feel bloated, and might put it on in places she isn't happy with. She's worried that people might say she's fattening up nicely, perhaps meant as a cheerful compliment, but it might make her feel disgusted with herself and bring on her anorexic urges again. And it might make her embarrassed to be around people, because she might become fearful that they're criticising her behind her back for being too fat.

Queasy

Besides that, she feels disgusted at the idea of eating fat. She can think about eating vegetables without feeling sick, but the thought of putting fat in her body makes her feel disgusted and sick and anxious, since it seems so unhealthy and impure.

Also, she had a few therapy sessions with a school counsellor, and realised she'd developed the belief while she was being brought up that if you have a problem, it's entirely your responsibility to solve it, and if you only try hard enough, you will. So she can easily feel a failure if she has a problem she can't solve, and tends to blame herself. So she often thinks she must be an incompetent or bad person. The stress of that makes her not want to eat. But also, she developed the attitude that going without food is a form of self-discipline that could toughen you up morally, thinking that once you have more moral fibre, you'll be able to deal with your problems better. Bored She gives the example of when she wasn't getting good enough grades in school because she was bored of her schoolwork and so she found it difficult to concentrate hard enough on her homework. She thought the discipline of going without food might help her learn to discipline herself in other areas of life as well. It didn't work, but she thought that meant she needed to discipline herself more, so it made her try harder not to eat.

Also, because she blamed herself for such problems and thought they must mean she was inadequate, she didn't like to confide in other people about them, so she didn't get their support. She's learning to do that now, although she prefers to remain anonymous, so she only talks about her problems on forums like this.

But after disciplining herself not to eat, she became weaker. But she had the attitude that the physical weakness that goes along with starvation was imperfection that she needed to be punished for. She thought it must mean she has lax control over herself, and that she could stop it happening if only she disciplined herself more, so she thought she needed to get it under control by eating less and less. She became more and more depressed and irritable as well, but she thought again that those things were weaknesses she needed to punish herself for and eradicate in herself by disciplining herself more by eating less.

She discussed how such thoughts weren't really true in therapy, but she still gets them and it's easy for her to slip right back into that way of thinking, forgetting what the therapist said.

She's scared to start getting better in case she can't resist the temptation to relapse or progress is slow, so feels like a failure. At least with not trying, you don't feel like that.

I'd like to reply to this as well. I think I'll say:

Children Can Just Accept a Lot of Unfair Criticism Without Criticising It

Shouting

You know, I don't want you to think I'm bad-mouthing your mother, but it does sound to me as if she criticises you far more than is healthy. Maybe she thinks and behaves the way she does because of the way she was brought up - maybe she somehow came to believe as she was growing up that fat's a terrible thing, and that the best way to bring her own children up would be to criticize them all the time. Or maybe she just learned to be critical and didn't give a second's thought to whether criticising her children all the time would be good for them or not!

Maybe she's never questioned her beliefs about fat, to think about how much sense they really make and whether they're far more extreme than necessary. And I expect that when you were growing up, you wouldn't have automatically questioned what she was saying. I mean, children often just assume adults know best. They can just accept what adults say as if it's the absolute truth. They think that since adults have been in the world much longer than them and so they've had far more experience of the way the world works and what's right and wrong, they must know what they're talking about and they can be trusted to know what's best. So questioning whether what an adult says really is for the best or whether it really makes sense often won't come naturally to a child.

That's a shame in a way, because it means that a child can accept really negative messages from adults without questioning them. For instance, if an adult says they're no good, or that they'll probably fail all their important exams when they get older, most children will be more likely to believe it, especially if it's repeated a lot, than to challenge what the adult's saying so they can show it up as being not fair and not sensible and based on faulty thinking. Then again, criticism can make adults lose all their confidence as well. If you tell anyone something often enough, they can start to believe it.

Then they can start telling themselves those things! For instance, the child might start telling themselves they're no good and that they'll probably fail important exams, and all the horrible things they've been taught by the adults they trusted, as if they believe them without question.

You can see how unhealthy that can be, because if you keep giving yourself messages like that, you'll probably get depressed and discouraged, so you won't feel like trying new things, because you haven't got the confidence to believe you'll succeed. So what the adult said will turn out to be right - you won't succeed, but not because they knew what they were talking about, but because what they said drained you of your confidence, so you didn't try as hard to succeed as you would have done otherwise, so you don't.

I don't know if that's going on in your life, but you say you criticize yourself a lot. It might be worth you thinking about whether the criticisms you make of yourself are really fair. Even if you think they're not though, the critical thoughts might still keep running through your head, getting you down. Talking back to them in your mind when you catch them doing that can sometimes help.

Criticism isn't bad in itself. Some criticism's valuable, because even though you don't like to hear it and it might not be put very tactfully, it's worth hearing, because it can give you ideas about how to do things better in the future. But some criticism's just worthless, because it criticizes you about silly little things that aren't worth criticizing someone over really, like that you've got a little bit more fat on your arms than you had before; or it says things that aren't true but just make you feel bad, like, "You're worthless". That isn't going to help you learn how to do anything better in the future! So the criticism itself is worthless! So if you get told things like that or have thoughts like that, you don't need to accept them.

Talking Back to the Critic in you When you Criticize Yourself

Disagreeing

Here are some examples of depressing thoughts that can go through people's heads without them even wanting to think them, and the kinds of things they might say back to them:

Another technique is called the "empty chair technique", where you sit where there are two chairs, (or at least two), and you sit in one chair saying the bad things about yourself that you normally think, and then you sit in the other chair and pretend that you're a defence lawyer speaking for you as their client. So it might go like:

Or you can pretend to be the prosecution accusing you of being far too fat, and the defence lawyer denying it. You could do that especially if you realise you keep thinking you're far fatter than you really are. I think it's quite common for people with anorexia to do that.

So, for example, the conversation could go:

The claims of the prosecution can get less and less exaggerated until they're the kinds of things you really do think about yourself, and then you as the defence lawyer can analyse the claims and speak out about whether they're unfair.

You could pretend you're a good friend or supportive family member instead of a defence lawyer if you like, imagining what they'd say to you.

Thinking of Anorexic Thoughts as If They're Being Whispered by a Tiny Monster or Animal

Goldfish bowl

Or you could imagine the thoughts that make you think you're fat and ugly and worthless are really thoughts coming from something else, like a miniature monster or animal sitting on your shoulder or something. Every time you have a thought about yourself that depresses you and makes you think badly about yourself or gives you an urge to lose more weight, you could imagine it's this little monster saying those things. Then you could talk back to it, being defiant of it, telling it the truth. Maybe you could give it a name, Mini-Nessy or Ana Monster or something. Maybe you could draw a picture, imagining what the anorexia monster who keeps tempting you to be more anorexic looks like. Perhaps it could be a really ugly little thing. Or perhaps it could look quite cute but have really cunning eyes. Or perhaps it could be a friendly well-meaning little thing, but just look ignorant, as if it doesn't really know what it's talking about or what's best for you, but just thinks it does. Whatever you like. Then every time you think you look fat and ugly, or feel the need to eat less, or anything like that, when you remember, you could try to imagine your thoughts as this little monster whispering to you, and talk back to it, like you would if you play the role of your defence lawyer, only you can pretend you have authority over it so you can tell it off and order it around.

It might take a while to get used to not taking anorexic thoughts seriously enough to just obey them; but another thing you could do is think something like, "Oh, this is an anorexic thought", whenever you have one, as if it's just some error that's popped up in your mind like a computer error.

Other Techniques for Challenging How Fat you Are and Whether Fat Really Is That Disgusting

If you start thinking you're fatter than the average, you could challenge that belief by going into a shop and trying on something which is a size 16. I've heard that's the size of the average woman in the UK nowadays. (Other countries might use a different numbering system. But it's probably easy to find out what the average size is in different countries.) So you could see how you compare.

You could get a photo taken of yourself now and compare it with a photo of you before you got anorexia, to see how much thinner you are than you were then.

A few hundred years ago, it was fashionable to be plump in some sections of society, it seems. If you visit Hampton Court and look at the portraits in the house, or look at a collection of paintings by Rubens - he's particularly famous for it - you'll see a lot of the women painted were fat by today's standards, and yet beautiful. In those days, most people would have been thin because food was more scarce and they would have done a lot more physical work; so plumpness was a sign of wealth and ease, so that was one reason plump women would have been thought of as attractive by some. But I don't think that was the only reason.

I don't know how true it is, but I've read in more than one place that a lot of people in the fashion industry are gay men, whose idea of what's attractive will of course be a male figure. So they'll want the females who pose for them to look more like males - tall, with small breasts and buttocks. Women have to slim down a lot to look like that. But that isn't the natural shape for a woman.

As well as that, a lot of photos of celebrities and models in magazines have actually been manipulated to look better than those people look in real life. The photos can be taken in certain lighting that makes them look a bit different to how they'd look normally, and the images can be elongated to make the people look taller, and they can have other things done to them. If you met those people in real life, they might look a bit different. The wonders of technology, eh? So when you compare yourself with celebrities and models in fashion magazines, you often won't be comparing yourself with a real person but with a doctored image.

Advantages of Having Some Fat On You

You know, fat isn't all disgusting. Whatever your mother keeps saying, it's actually very useful if we have some fat on us, and some fats are important to eat.

Cold

For one thing, fat can help keep us warm. Actually, my parents have got a cold house, and I've noticed that the thin people always think it's cold and often want the heating turned up, while the fatter people think it's perfectly warm enough and if anything, want it turned down. Fat might not be the only reason though. But I know it's common for people to feel the cold a lot more when they get a lot thinner, anyway. Do you feel the cold a lot?

And fat's like a shock absorber - if we bump into something or fall over, the bits of ourselves with fat around them are probably less likely to get hurt. It shields the things like bones from taking the full force of the blow. And people who haven't got much fat on their bottom find it uncomfortable to sit on a hard chair for long because their bones aren't cushioned.

And fat cushions the vital organs. So it can be like a protective thing.

Actually, I've put on a bit of weight in the past few years, and now, I've got fat in places where I've never had it in my life before. I've got a cushion of fat around my hips that I've never ever had before. Perhaps it's middle-aged spread. I was a bit depressed at first when I noticed I'd put on weight, but it could have its advantages. My dad used to come up behind me and squeeze me hard around the hips/waist, and I think he was just doing that to be affectionate or boisterous or something, but it sometimes felt afterwards as if something had been a bit damaged. Once or twice it felt uncomfortable for days afterwards. Now I've got fat around my hips, I think that would be less likely to happen, not that I'd want to try it. But I think the fat would be like a squishy foam rubber cushion that would squash up when he squeezed it so his hands would slip off, and then it would bounce back into place again. Or something. Smiling It might not be as protective as I think, and I don't think I'd want to experiment just in case, but I think it might be some kind of protection for what's underneath.

And fat provides the body with a reserve energy source, so if the body falls on hard times and you don't get the fuel for it from food, it can do something about it while you've got fat on you.

Eating certain fats can be healthy as well. I think some vitamins the body needs only dissolve in fat. So you need a certain amount of fat in your diet to help the body absorb them.

I've read that the body needs fat for energy, tissue repair and to transport vitamins A, D, E and K around the body. And I read that fat can help to maintain healthy skin and hair. So it seems it isn't just a useless squishy pointless substance, but can carry valuable nutrients.

That's interesting: Now I know fat can carry vitamins around in it, and isn't just a load of useless squashy stuff with no nutrients, I've got a bit more respect for it. To think that those flabby bits on me could contain vitamins!

Actually, I've just found out one more interesting thing. On a medical website, I've read that some researchers have found that fat in the lower abdomen and inner thighs contains a lot more stem cells than are found in the rest of the body, that could be used to help fight diseases, because they could be made to turn into cells of various parts of the body that could be used to replace diseased ones in people.

I've read that women need to eat as much as seventy grams of fat a day to be healthy, and for men it's about 95. That sounds quite yucky, but it doesn't sound so bad when you remember that there are 25 grams to just 1 ounce, so it's really about just under three ounces for women and nearly four for men. Still, that's quite a lot. I used to do cake baking with my mum when I was little, and she showed me what two ounces of butter was like, and it was about the size of a matchbox.

I even read on a medical website that a leading dietician says that a third of our calories a day should come from fat! Yikes. The dietician says some fats are a lot healthier than others though, like the ones you get from olive oil and avocados. And the web page says nuts and seeds contain fats that are healthy for you as well.

I know the kinds of fatty acids you get from oily fish like sardines are good for you as well.

So it seems fat isn't really as disgusting as we might think. It sounds as if you're being too hard on yourself, trying to get rid of the lot.

Problem-Solving Skills

It does sound as if you're too hard on yourself in other ways as well. You know, various problems you blame yourself for could have a whole variety of reasons that aren't your fault at all. And it sounds as if you're saying that if you can't think of how to solve your problems straightaway, you think the best solution is to starve yourself more harshly as a discipline, so you'll make yourself stronger and more able to cope with them. So starvation is your solution to any problem you can't think of a way to solve. But really, researching into possible solutions would be a better way, and some problems you blame yourself for might have a lot to do with other things as well or instead, things you haven't thought of yet, but that other people might be able to help you with. For instance, my brother was always late with his homework at school because he didn't like getting around to doing it. He got quite a reputation. But he said one of his friends had had the same problem, and they solved it when they started doing their homework in their local library instead of at home. They realised they had so many distractions at home that it was easy not to be able to concentrate on it. (My brother never actually followed his friend's example and did that himself though.) Smiling

I thought I had a problem with being lazy once, because I didn't feel like getting down to doing things sometimes because I didn't feel energetic enough. But when I next went to the doctor, I got a blood test, and they found out I was severely anaemic, so no wonder I didn't have any energy!

So you might not be to blame for some of the things you think of as your faults at all. Or if you change certain circumstances, you might find you can discipline yourself better without having to resort to harsh measures.

I heard that people with addictions find it much easier to give them up if they've got something they like doing that they can do as a replacement, or some emotional support from people around them that makes them feel more contented. It's easier to give up bad habits or to stop craving things that are going to harm you if you've got something to turn to that'll make you think life's worth living and enjoyable.

So you don't have to think the solution to your problems is to discipline yourself more. You might actually find it much easier to sort your problems out and improve yourself if you go easier on yourself.

Thinking

If you've got a problem with your circumstances or yourself, there are systematic ways of going about solving problems that might help. Here's a problem-solving technique you could try. This is what you do:

  1. Write down exactly what the problem is. Write it down in as much clear detail as you can so you don't forget bits when you're thinking about it.
  2. Then think of all the possible solutions you can, and write those down as well. Even if some of the possible solutions you come up with don't seem that likely or sensible, write them down anyway, because you might get an idea based on one of them that is a good one.
  3. Then take each solution in turn, perhaps have a separate sheet of paper for each one, and think of all the pros and cons of each one you can come up with. Perhaps write the pros on one side in one column, and the cons on the other side in another column.
  4. Then, you can decide how much each pro and con matters, so you can rate how good each solution is, depending on whether the pros significantly outweigh the cons or vice versa, and by how important each one of the pros and cons is. For instance, one important pro might count for two cons.

    I heard that someone's technique was to take a sheet of paper for each possible solution, write the pros on one side and the cons on the other, and then look through them, searching for pros and cons of equal importance. When he found a pro and a con of equal significance, He would cross both of them out. He'd carry on like that till he only had ones left he couldn't match up with each other as regards how important they were. Then he'd look at the ones left and have more of an idea of whether the pros outweighed the cons or vice versa.

  5. When you've done something like that with all your possible solutions, look at each one, and decide which has the most outstanding pros and the least cons.
  6. Then decide whether you want to pick that solution, or whether you're unhappy with it and would like to go through the others again to see if you can think of more pros and cons you didn't think of before.

    It's possible you won't find a solution with no cons. If you have perfectionist traits, you might find it hard to accept that there might not be a perfect solution. But you might find the best one does quite well, and you might find ways of working around any problems it has. You could always do this problem-solving technique on any problems you find with it if you want.

  7. After you've decided on your solution, set a time to think back later, to see if you really did make the right choice and how you're getting on with the solution. You might discover you have new information about how good it is that you can think about then, based on experience of trying the solution out and seeing how well it worked. if it worked well, you can stick to it, or decide to review it again at a later date. If it failed, you can always try another of your solutions.

Gradually Eating More Again

If You're Scared You're Gaining Weight Too Quickly and Think you Must be Getting Fat

Scared

When you start to eat more, you might be alarmed at first because it might seem as if you're putting on weight quickly. But you can be reassured, because it won't be as bad as it seems. For one thing, quite a lot of it will be fluid, not fat, caused by the body wanting to replenish its water stores to help it function better, and also because the body's ability to process things through the gut will have been impaired, so fluid might take longer to leave the system for a while. You might feel bloated and be scared you're putting on loads of weight, but it's really just wind and fluid, which the body will get to cope with better as it recovers. The body will find a healthy balance after a while.

For another thing, because the gut will find it much more difficult to cope with food because the digestive system shrinks when people starve themselves, and because anorexia slows the system down so things take longer to leave the gut, you might feel quite bloated. A lot of that will be wind, not fat at all. It'll be caused by the gut having difficulty handling food it isn't used to dealing with any more. You might experience some discomfort or stomach pains while it gets used to handling more food again, and it could even take a few months before it's completely back to normal, but it should get there. During that time, it might be best not to eat food containing a lot of roughage, like bran, because it'll be harder to digest and might leave the gut feeling overloaded.

For a third thing, people can put on quite a lot of weight at first because the metabolism is slowed so the body doesn't burn much energy, which is something the body does when it's starving to conserve energy; but as it recovers, the metabolism speeds up, so the body will use up more energy, so it'll take more calories to put on the same amount of weight.

Eating small meals several times a day is better for speeding up the metabolism than eating one or two large ones.

It might be easier for your gut to take if when you start off eating more again, you begin by eating sloppy food like scrambled eggs and milk puddings. It'll probably be best to start off slowly, and then gradually introduce foods that take more effort to eat.

If You're Scared You're Going to Over-Eat

Eating little and often will probably be best, for instance, eating three small meals and three snacks a day. When some people start eating again, they suddenly become really hungry and feel like eating lots at once, and then they can get bulimic, vomiting to get rid of what they've just eaten, because they're worried about how much they've eaten. But eating little and often will hopefully cut down the risk of getting very hungry and wanting to over-eat.

Also, it's been found that when people do eat what they can think is a huge amount when they start eating again, often, though it's big compared to what they were eating before, it's less than the amount most people eat in a day.

Getting very hungry and wanting to over-eat is only a phase the body can go through anyway. It won't mean you'll be like that forever.

You might be pleasantly surprised when your weight returns to a normal level and you find out you're good at controlling it so you can keep it at a fairly constant healthy level for a long time. Weight will always go up and down a little bit, but it takes quite a bit more than that to have a significant effect on how fat you are, so you might end up finding it easy to stay at a healthy weight for years.


Part Five
Someone's Attempts to Help a Boy Who Says he Got Anorexia After Teasing From Classmates About Being Fat and Health Concerns From his Doctor

Here's another message from a young man. He says he was always plump, and the boys at school used to tease him about it. He learned to joke along with them, but he didn't feel very good about his weight. He became far more self-conscious about it when a doctor asked him when he was 17 if there was a history of obesity in his family. The doctor seemed concerned about his weight, but also a bit contemptuous of him. He really started to feel ashamed of himself then, and started making very serious efforts to lose weight. It was as if the doctor's attitude triggered off a fear in him, and he started to feel phobic about fat. He got really self-conscious and worried about what people must think of him, to the point where he didn't like going out in public. It got to the point where if he thought he detected a little bit of fat on himself, he felt very anxious and thought he really needed to get rid of it, and he started wearing baggy clothes to try to stop other people seeing it.

At first, he was pleased when people complimented him on how thin he was getting, so he was motivated to lose more weight. Then when they started worrying about him being too thin, he became even more withdrawn than he had been before and didn't want to see anyone. He wore baggy clothes to hide how thin he was getting now.

Media messages about how much better it is to be thin encouraged him to lose more weight; and media scares about what foods containing high levels of fat and sugar, and other things, can do to a person's health, put him off food altogether. He began to feel disgusted every time he had to eat some.

I think I'll try replying to this. I think I'll say:

Being Teased at School About Being Fat, or Anything Else

Embarrassed

I know you probably can't help it, but I don't think you need to be nearly as anxious about putting weight on and what people will think of you if you do as you might think.

You say you used to get teased about your weight at school and used to joke about it but you didn't like it really. Well, although it's true that very fat people tend to be looked down on by quite a lot of people and thought of as ugly, you might not have been all that fat, and chances are that wasn't even the reason you were teased. I heard there was a survey of bullies that found that over half of them said they did it because they were angry about something or other and wanted to let off steam at the expense of anyone who happened to be around, or to get back at the one they were angry with, or they were jealous; and lots more said it was because they were bored or thought it was a laugh. None of them said it was anything to do with anything wrong with the people they were teasing. Maybe those things had a lot to do with the reason you got teased.

I've heard that some people tease other people to be admired as witty or clever, or to get attention. Some people are so desperate for attention, it seems, that even negative attention will do. You know, as long as they get your attention by teasing you, it doesn't matter if your response is to tell them what a pathetic person they are; they'll be pleased that at least they got your attention! I think I know someone just like that. Well, I mean I know him from another Internet forum. He puts stupid brainless messages on the board, and sometimes tries to get you to argue with him, and it doesn't seem to matter to him that much if someone calls him a brainless twit - the important thing to him seems to be that he got noticed!

I've read that often, the popular kids in school are actually often not very nice people. They're popular because they put some of the other people down a lot so people think they must be the cool ones, especially if they manage to be funny or clever when they're being bitchy, so other people want to be around them so they'll feel cool as well.

Picking a fight

Some kids think it's fun to tease others, and think it's more and more fun the more the person reacts by getting into a temper or something. They don't think about how the person they're teasing is feeling; they just think about how much fun they're having. If they stopped to think about what effect what they were saying was having on the person they were teasing, some of them might stop. Some of them probably wouldn't care though. I have to admit that I have sometimes teased someone who was bugging me, and thought it was fun. They never seemed to be upset about it though.

I think some kids tease because they like to feel better than other people to make themselves feel good, because they can't think of other good reasons to feel good about themselves. So they make people look bad, so they can feel better about themselves because they think that at least they're not as bad as the people they're teasing. It doesn't seem to matter if they're teasing those people about silly little things that really don't matter, like whether their hair's a bit longer than the average, or what type of shoes they're wearing! Kids tease other kids over a whole variety of really stupid things!

Some kids tease other kids because they've grown up in an environment where people teased each other or they've seen a lot of it on television, even in children's programmes like cartoons, so they've just come to think it's normal. They're just copying what they've seen other people do really, without thinking about what effect it might be having on the one they're teasing. They just assume it's normal behaviour.

Or some kids tease others because they get teased at home and it makes them feel humiliated, so putting other people down will compensate, making them feel big.

So you don't have to think that when you were plump, being teased at school meant there really was something wrong with you.

The Attitudes of Other People to Fat

As for that doctor who you say seemed contemptuous of you, some doctors are a bit like that, but that's not very professional! I mean, if you were a bit too fat, it didn't necessarily mean you had an irresponsible family who eats too much! It might have been partly to do with your school not having as many lessons where you could get some good physical exercise as they should have done; and it might have been partly to do with your genes. I've heard that quite a lot of fat people have got a gene that doesn't function as well as the ones in thin people so they don't get signals that make them feel full like other people do. There are probably other reasons you could have been fat that weren't really anyone's fault. So the doctor didn't have the right to make judgments. And that goes for any other member of the public.

Grinning Smugly

Would it really be so terrible if you put on lots of weight and went out and then you saw someone sneering at you for being fat? They might be just losers who haven't got anything better to think about. They might be idiots who make hasty judgments about fat people rather than thinking of all the possible reasons you might be fat. They might be people you'll never see again so it doesn't really matter what they think.

If a girl rejected you once she'd got to know you just because she thought you were too fat, she probably wouldn't be worth having and you'll be having a lucky escape. After all, someone who judges entirely by looks, rather than making decisions on who she goes out with based on personality as well, probably isn't a very sensitive and wise person. Of course, it would be different if she just said she'd like you to slim down so you're more fanciable. But if a girl said that to you, would it really be so bad? Since you've been so successful at losing weight, you could probably be just as successful at getting your weight to a healthy good-looking balance between too thin and too fat if you wanted.

Reducing Anxiety About Being Out in Public

Anxious

I know all that won't necessarily stop you feeling anxious or fearful around people. I can think of some other things that might help.

I know one thing that can get people really anxious when they go out in public is worrying for some time beforehand about what people will think and say, and all the things that could go wrong. I've heard that often, it works well if people do things to distract themselves from thinking thoughts they don't want to think, because otherwise, they might start dreading all kinds of things that won't happen, and the more panicky they end up feeling, the more likely they are to do things wrong and feel bad when they're out.

Distracting Yourself From Anxious Thoughts

One way to distract yourself is by getting involved in a boisterous game of something, if there's anyone around to join in, or doing some other kind of exercise. That'll help work off nervous energy as well. Mind you, you need to be careful about energetic exercise when you've got anorexia, because when the body gets weaker and it's starved of nutrients, the bones get thinner so they can break more easily, and there can be other complications. So that's one reason why putting on a bit of weight again could be an advantage.

Maybe if you feel anxious before going out, you could find other ways of distracting yourself. I know some people find it helpful to look at pictures of nature scenes, or to watch videos of things that make them laugh if they can. Playing games on the computer probably helps as well. I'm sure you could come up with some ideas.

Plant pot

If you start feeling panicky, there's a distraction technique you could use where you make more effort to focus all your attention on specific things, so you're not worrying about your panicky feelings so they get worse. It works this way: As soon as you feel panicky feelings coming on, you focus all your attention on something near you, and try to notice specific things about it. For instance, if there's a plant on the window sill near you, you could count all the leaves on it, as if knowing how many leaves it has on it is the single most important thing in your life right now - that's how hard it's best to try to focus your attention on it. Or, to give another example, if you're in the kitchen, you could count how many cups there are in the cupboard. And so on. Getting the right number wouldn't be important. The idea is just to take your mind off the panicky feelings. It wouldn't have to be anything to do with counting. It could be typing a load of jumbled-up letters on the computer and then finding as many words in it you can, or anything you have to concentrate on hard. The idea is just that it's something you can concentrate on hard enough to keep panicky feelings from intruding so they fade away.

But one specific technique is to just focus all your attention on looking at a few things one by one, and then when you've done that, to turn your attention to listening out for what you can hear, whether it be cars going past outside, a conversation in another room, or whatever. You could give all your attention to trying to distinguish what you can hear as clearly as possible. Then you turn to the sense of touch and pay more than normal attention to what your feet feel like as they're resting on the ground, the sensation you notice caused by your body on the chair you're sitting on if you're sitting down, and so on. Also, you can touch things and pay attention to what they feel like, for instance a computer keyboard, a desk in front of you, and so on. Then you can go back to paying attention to what you can see, or whatever you like.

The same would go for if you were already out in public, as long as someone wasn't talking to you at the time so you'd look as if you were ignoring them.

Relaxation Techniques

Another way of calming anxiety and panicky feelings is to slow down your breathing. When people are anxious, they automatically start breathing too fast, and that makes the body feel jumpy. But it can calm down again if you start breathing slowly.

It helps if you close your mouth and just breathe through your nose if you can, because then you won't be breathing in so much air at once. And some people find it helpful if while they're breathing slowly, they focus all their attention on counting to four or a similar number very slowly as they breathe in, and then a similar number very slowly as they breathe out again. It doesn't work if you gasp lots of air in at once at the beginning of the count, because that's just like breathing too fast again - it's best to breathe steadily and slowly the whole time.

If you do that for a few minutes, it can help make you feel calmer.

Another way of relaxing and being distracted from anxiety is to close your eyes and try to imagine yourself somewhere where you really enjoy being, either an imaginary place or a real one you like, like a place of natural beauty, perhaps, or somewhere you once enjoyed going on holiday, or somewhere you'd really like to be; and it helps if you try to imagine every detail you can about the place to make it as realistic as possible, to give you more of a chance of getting engrossed in your day-dream and forgetting your anxiety. So you can even imagine details like colour, subtle shadings, amount of daylight and sunshine, temperature, types of sounds, their volume, the time of day, the movement of objects and other things, what the objects around you are like to feel, what smells you can smell, and how you feel about being there. It can be a day-dream you can go into for a few minutes whenever you feel anxious.

Feeling Fearful in a Group of People

Flying

One thing you could do if you're in a group of people and you start to get anxious about certain people talking to you is to imagine they've changed a bit in ways you find amusing. For instance, if there's a man sitting next to you, you could imagine he's wearing a frilly dress and high heals; or you could imagine he's wearing a necklace made of bananas. You could imagine someone sitting near you's got rabbit ears, or that they're a dog. Or you could imagine them doing somersaults in the air, or standing on a table singing. You might be able to think of lots of amusing ways of thinking of people, to stop yourself feeling so anxious about them once you start.

Or you could talk back to your anxious thoughts. For instance, if you catch yourself worrying that someone near you might be judging you harshly because of your weight, you could think of it as anorexic thinking rather than sensible thinking, and talk back to it with the sensible part of your mind, saying things like, "Oh of course he isn't likely to be judging me harshly. And if he does, so what? I've stood up for myself before, so I know I could do it again if I had to." I've read that the thoughts people get in their minds when they've got anorexia or phobias or depression or other things like that are often distortions of reality, as if there's a part of your brain that's frozen in some kind of mold that won't let it out to start changing its thinking to make it more realistic. But you can still talk to it with the part of your brain that's thinking sensible thoughts, telling it it's just thinking anorexic or phobic thoughts, and that they're not true, so it calms down.

Fear of Actually Eating

Hiding

If you're scared of eating itself, I expect there are several techniques you could use to cope with that.

One that might go partway to helping is where you have a serious think about how bad it would really be if you ... say, went out for a meal, or accepted a chocolate from someone, or anything else that scares you. The fear can be so strong it can hinder you from thinking about things realistically because fear can stop people thinking clearly, but if you think of it as something you have to get control over, and something you can control, then perhaps it won't dominate you so easily. And if you're fairly relaxed at the time when you have a good think about what would be so bad about eating in public or whatever, it might not be the block to thinking rationally that it could be if you were feeling worked up with anxiety too much to think clearly.

So you could ask yourself questions, and answer them for yourself, perhaps saying things like:

What's the worst thing that could happen if I eat a piece of cake?

Perhaps the worst is that I'll put on a pound in weight.

A whole pound?! It would have to be a huge big cake!!

But if I ate one, I might not be able to stop eating, and eat three or four or five!! Then I might put on that much weight!

But even if I did put on a whole pound in weight, why would that be so bad? What's the worst thing that could happen to me if I put on a pound in weight?

I might feel fat and ugly.

Well, what's the worst thing that'll happen if I feel fat and ugly, when, no matter how fat the anorexia makes me feel, there is a sensible part of my mind that can contradict it and tell me my bones stick out so I'm more like a skeleton?

Well, I might forget to listen to the sensible part of my mind.

Why would I?

And so on.

Grinning

Or you could think up humorous answers. So, for instance, you could think to yourself something like,

If I eat this chocolate, my stomach might swell up so much that I could walk around balancing a piano on it.

If I eat a meal out, I might swell up so much I might sink through the floor, and be so heavy I'd just keep on going downwards faster and faster till I went right through the earth and shot out the other side in another country.

If I eat this slice of birthday cake, I might get so fat that I could lie down and people might mistake me for a bouncy castle, and children might jump up and down on me.

If I eat all my dinner, I might fill up the whole room so my fat stretches wall-to-wall and floor-to-ceiling.

If I eat normally, I'll get so fat I could rent out the space on my stomach to a family of four who could build a house on it and live there.

And so on.

Media Food Scares

Reading a paper

As for your worries about the food scares you've read about in the media, I wonder if you could have an exaggerated impression of how harmful some of those foods are. Sometimes, people can get a one-sided view of things from certain sections of the media. That's partly because some newspapers in particular like to sensationalise things so they sell more, so they'll go on about the worst aspects of things rather than giving people a balanced view. Or sometimes, they won't give you a full picture of things simply because they're trying to get a particular point across, and not everything about the topic would be relevant to it. For instance, if they're trying to encourage people to eat more healthily, they might talk about how salt can give you high blood pressure, which it can, but they might not tell you that you have to eat more than the recommended daily amount over time before it starts to do that, so you could get the impression that just putting more than a normal amount of salt on a meal one day could do it. Or they might warn that certain foods raise your cholesterol levels, without making a distinction between healthy cholesterol and unhealthy cholesterol; so you might end up thinking all cholesterol's bad, so you might think some healthy foods are bad for you because they raise your cholesterol levels, when in reality they only raise the level of healthy cholesterol. That kind of thing.

It's not always the media's fault that their reports are more one-sided than they should be. They often can't fit everything into an article that they might do, because of limited air time or limited space to print things, the pressure of working to deadlines which prevents as thorough an investigation of stories as might be done otherwise, human error, and the difficulty of making a complex story interesting to everyone. It would actually be impossible to cover every angle of things all the time. Argument For instance, if an argument was reported between two influential historians who kept disputing all the research findings of each other, where would you stop reporting? If the argument was too complicated and detailed for there to be an obvious clear winner near the beginning, and it could still go on and on past the time you wanted to get your report out, you'd be bound to end up favouring one side or the other whether you wanted to or not, because the side you gave the last word to wouldn't necessarily be the one that won the argument in the end, but it might look like it.

Sometimes, parts of the media could do a better job than they do though.

But there are some stories it reports where you just wouldn't expect it to cover all angles, because certain facts just aren't relevant to what they're reporting. For instance, some newspapers might report on the amount of obesity in the country and rail against the amount of sugar we eat, without pointing out that sugar's allright to eat in moderation. So some people might get the idea that it's bad to eat any at all. Or a newspaper might report on how the amount of obesity's increasing in the country, and report on all the health risks associated with obesity, without reporting that eating disorders like anorexia are also increasing, and the health risks of starvation are just as bad if not much worse.

The effects of eating too little food are bad. I've been reading about them. Here's what a book I've been reading says:

The Effects of Starvation

Be warned, this gets worse and worse. It's quite yucky in the end.

Some of the milder symptoms anorexia can bring on are:

Queasy

The book says people who try to get rid of food by vomiting may well also suffer erosion of their teeth due to the stomach acid in it; a sore throat which might sometimes bleed; a hoarse voice; and heartburn because the stomach acid that the body produced when something was eaten has no food to digest because it's been vomited, so it starts attacking the stomach walls instead. Eventually, that can lead to the development of stomach ulcers.

It says using laxatives regularly to get rid of food before it's properly digested can cause things just as bad. Far more fluid leaves the body than is healthy, that can lead to severe dehydration, and it can cause the bowel to become lazy, relying on the laxatives, so it stops working properly when a person stops using them. So the person can suffer from retention of too much fluid, constipation and a feeling of being bloated.

It says anorexia can have some marked effects on the physical appearance apart from causing people to look like skeletons. They include dry hair and skin, hair loss, lanugo, which is fine body hair - something to do with being caused by lack of oestrogen, which is caused by ... er, I'm not sure about that one; dry cracked lips, orange palms / yellow skin caused by one of the liver enzymes not being able to break down something as well, a green tinge to the skin and a swollen face. I'm not sure what causes all those.

It says worse symptoms, that you won't even know you've got at first for some time, can include:

Crutches

The book says less common symptoms include:

Horror

Well, that was horrible. I hope it didn't depress you too much.

The book says people who die of anorexia usually do so because of late-diagnosed infection that they got because their immune system wasn't functioning so well, hypothermia, extremely low blood sugar, or suicide, rather than from malnutrition.

But once you get better, any horrible symptoms you're suffering will hopefully go away.


Curing Health Problems Caused by Anorexia by Beginning to Eat Normally Again

When you start eating normally again, it's best to build up to eating average-sized portions gradually, because the body will have adapted to starvation conditions, so the stomach will have shrunk, and will have adapted to making do as best it can with having a lot less of the essential minerals it needs, especially if a lot have been lost because of laxative use and the like. So if the balance of minerals is changed too quickly, for instance if attempts are made to get the levels back to normal immediately by using a drip feed, the body will be overloaded. So it's best to introduce them back into the diet gradually, not through supplements, but by eating foods that contain them.

One mineral it can be dangerous to have too little of is potassium, since having a severe deficiency of that can even cause heart trouble. But foods that contain it that'll help restore healthy levels of it include oranges, bananas, some other fruits, nuts, Bovril, marmite, chocolate and coffee.

A mineral that can help repair the problem of the bones becoming too thin is calcium. Foods that contain that include milk, cheese, nuts, peas and beans and lentils.

I wish you all the best.


Part Six
Someone's Attempts to Help a Parent Of a Daughter With Anorexia Who Worries About Whether she and her Husband Could Have Caused it and What to Do Now

Here's a message from someone who says she has a teenage daughter with anorexia. She and her husband have had long discussions, agonising over whether they could be to blame in some way and what they might have done wrong; and they wonder what the best thing to do now is to help her in her recovery.

I'll try replying to this. I think I'll say:

Genes Seem to Play a Role in Anorexia

I don't think you should assume you were the cause of your daughter's anorexia because you did something wrong. Actually, some people are looking into whether genes play a role in making it more likely that some people will get anorexia than others. It tends to run in families a bit. Can you think of any ancestors you've got who had anorexia?

One thing that makes people think there's a genetic link is that in studies of twins, it's been found that among those where one or both has anorexia, both were more likely to have it in pairs of identical twins than in the others.

There are cases of anorexia in the animal kingdom as well. There are cases in pigs, particularly a certain type of pig, bred for its leanness, where the young females sometimes go off food and become extremely thin when they're stressed because they've been taken away from their mothers too early. They'll only eat low-energy feed like straw, and they become hyperactive.

So stress might trigger anorexia off, but the genes might play a role in who responds to stress by getting anorexia, who responds to it by drinking, and so on. The stress won't necessarily be anything to do with the parents though. I've just been reading an article about how stressful school can be for lots of people, even stressful enough to make them want to drink or take drugs!

But how stressful life is for a person is thought by some to depend on the temperament people were born with as well as their circumstances. Some people seem to be born with more anxious temperaments than others, for example. Some think that someone born with an anxious temperament might feel uncomfortable even in an environment where no stresses are put on them, because they'll worry about why they feel more anxious than people around them, so they might begin to feel defective.

Even where the behaviour of parents was what stressed a child out most or gave them certain attitudes that triggered off anorexia, that doesn't mean they caused it. And if they contributed to it, they can put that down to experience and work to help their child recover. That'll be far better than spending time brooding on the past.

And just because genes play a role in anorexia, it doesn't mean people can't make a full recovery. Certain genes might just increase people's vulnerability to getting it, but won't hinder recovery.

Seeking Professional Help

So agonising over the past won't be nearly as productive as concentrating all your efforts on discussing what to do now. Whatever mistakes might have been made in the past, the important thing is not who's to blame - there's no point tormenting yourselves - but what steps you can take now to help your daughter recover.

Have you visited your doctor? If she's seriously ill, professional help might be the best first step. Therapy might help, either for her, or for you as a family. Also, there are support groups around for parents and other relatives of people with anorexia as well as for people with eating disorders themselves.

She might particularly need professional therapy if she's depressed, since depression robs people of the motivation to do anything about their problems themselves.

Besides recommending other professionals who can help, a doctor can check her physical well-being often, especially if she develops obvious signs of poor health.

If she's severely ill, her brain won't be functioning highly enough to respond very well to psychological treatment, which will involve a lot of thinking and trying out new things. So the first priority will be to persuade her to eat more, with the support of your doctor and others.

Denial of the Eating Problem

If she's only in the early stages of anorexia, she'll probably be denying she has a problem. That's common. You can't really blame her. After all, she knows you'll disapprove, and she won't want to be put under any pressure to stop being anorexic, because it might be the only way she can think of to cope with something, or it might be something she really wants in her life at the moment for some other reason.

I remember when I first went to secondary school when I was 11, I was quite podgy, and decided to have a go at losing some weight. I lost 3 pounds a week for several weeks in a row. I was pleased. I didn't eat abnormally or anything; I just ate small portions, not at all difficult at school where I didn't like the food! But I lost weight so quickly that one staff member was a bit concerned. I told her I'd been trying to lose weight at first, but then when she seemed to think I was losing weight too quickly, she asked if I was still trying and I said no, because I thought if I told the truth, she'd only tell me not to, and I wanted to lose a bit more weight before I stopped trying. I did stop trying soon after that and my weight stabilised. But if your daughter really wants to lose weight and thinks anorexia's a good thing, and she knows you won't approve, you can see it would be hard for her to admit to having a problem. But then, I think a lot of people with anorexia genuinely don't think they have a problem and don't understand why people around them are worried about them. Or at least don't want to see it.

Discussing Problems Besides the Eating Disorder

Talking

But even if she doesn't want to discuss eating more with you, she might be willing to discuss other problems, which might be what she's using the anorexia to try to mask. Or she might be willing to discuss the symptoms she's getting from not eating much, like feeling the cold more. You might be able to gradually persuade her to accept that she has an eating disorder if you ask her questions that encourage her to slowly confide in you more about whether she has concerns about her health. If you confront her, especially if you get angry, then she'll probably just get angry and obstinate and deny she's got a problem even more. But if you ask her questions that encourage her to talk about herself, she might start confiding in you.

So you could try to find a time and place where you won't be interrupted, and then ask her questions like,

Have you got any concerns about your health?
Are you worried about anything in particular?
What about school? How are things going there?
Do you have any problems concentrating on your work there?
How are things with your friends? Are you finding it as easy to go out with them as you used to?
What about work? Have there been any difficulties there?
What about here at home?
Do you have any other problems?

Don't think you have to move onto another question in a hurry if one question starts off a good conversation. Try to get as much detail of anything related to her eating problem as you can, without sounding as if you're prying or turning it into an interrogation. Showing you're concerned about her problems might encourage her to talk more. It might take several conversations before you have the full picture, but patience might well pay off. If she tells you about a problem she's stressed about, you could ask her if being stressed about it makes her want to eat less.

If she admits to having anorexia, you could ask her a question like,

What are the good things and the not-so-good things about having anorexia?

It'll be very important to listen to the reply, no matter how stressed you feel at hearing her talk about what she likes about having anorexia. Afterwards, when she's confident that you're understanding and concerned and you've got a full picture of her worries, you can go about making suggestions about alternative methods of solving the problems she's using anorexia to cover up.

When you have your meeting, there are a few things a book on anorexia I've been reading suggests that might make the communication easier:

Don't feel hurt if she's reluctant to talk to you. It's normal for teenagers to want to have secrets from their parents.

If she says something you don't like to hear, don't confront her angrily, since that could put her off telling you anything.

Try not to pay so much attention to her that you neglect any other children you've got. It might be good to set aside a time to be with them so they don't feel left out.

If you and your husband can both work together as a team, supporting each other and coming to some agreement on ways of handling the situation you're both happy with, then the atmosphere in the house will be less fraught, and a less tense atmosphere might be what your daughter needs to start to recover.

Being Patient Because Eating More Again Has to be Gradual

Try and remember to compliment her with every small step she makes towards eating more, because that'll encourage her. I don't mean telling her she looks healthily fatter, because she might not see that as a compliment; it might make her anxious instead, because she doesn't like the idea of getting fatter. But you can probably think of compliments you can make that don't refer to fat.

Don't be impatient with her if progress isn't as fast as you'd like. The stress might make her worse. And anyway, when people are starting to eat again after they haven't for a while, progress has to be gradual, because the stomach will have shrunk, so even small amounts of food will cause stomach aches.

Also, any psychological problems she has might take a while to work through; so you might have to think of her recovery as a fairly long-term thing rather than something that can happen quickly.

But if you do see her doing something that pleases you, like eating a bit more, it'll encourage her, - provided you're sincere about it, - if you say something like, "I'm pleased you were able to eat a bit more tonight. It makes me feel happy to think we're moving forward".

Also, if you want her behaviour to change in any way, it might make her more willing to please you if rather than criticising the things you think she's done wrong, you tell her what you'd like her to do, in words that sound positive, such as, "It would make me happy if you could ...", or "I'd be grateful if you could ...", that kind of thing, to make it sound a bit as if she'd be doing you a favour. That might make her happier to do what you want than if she feels as if she's doing it reluctantly, just because she has to.

Beginning to Eat Gradually Again

It's important not to devote so much time to trying to sort out your daughter's psychological difficulties that you ignore her weight loss. The more anorexic people get, the more difficult they can find it to work through psychological problems. So finding ways of persuading them to eat more should be a priority. A dietician could convince her it's possible to have a healthy diet and control weight without having to starve herself. They might also have an insight into what kinds of foods she'll find it easiest to tolerate now.

Small snacks will probably be easier for her to eat than ordinary meals for a while, partly because of any stomach discomfort she gets when she eats, and partly because she'll find it less daunting to contemplate eating something little. She can gradually work up to eating more.

At first, she might find it easier to contemplate eating foods like vegetables that don't have any fat content. Perhaps you could gradually introduce fatty and sugary foods, perhaps first by trying to persuade her to eat bread with a low-fat spread on it or tuna fish, or to drink semi-skimmed milk, or to eat a muesli bar or a fruit yoghurt, so you introduce fats and sugars back into her diet by giving her things that still sound healthy.

She might be scared when she starts eating more because sometimes, people who start eating more after hardly eating anything for a while get very hungry. She might worry she'll never be able to stop eating and get obese. But this doesn't happen. It's a well-known phase the body goes through; it's just trying to make up a bit for its loss. It gets back to its normal hunger patterns soon enough. Eating little regular snacks rather than eating big meals less often will help the hunger not to get out of hand. Potatoes are a good food for keeping hunger at bay.

One thing that might entice her to finish the food you've set before her is if you make plans together with her so if she finishes in a certain amount of time, say an hour, you'll all do something enjoyable together.

It'll be good for you to have regular meetings all together to update your plans.

If she finds all eating too difficult, one thing you could do in the short term is to get high-calorie drinks from the chemist for her as a food substitute. She might not like to drink them; but it's better than starving.

You can reassure her that the body will use the food she eats to rebuild the muscle and bone lost during starvation at first, rather than making her fat.

If she keeps insisting she's getting fat when she isn't at all, it might be helpful to imagine she has an anorexic part and a sensible part. You can say to her that it's her anorexic part saying things her sensible part will know aren't true. You could even suggest to her that she thinks of the anorexia as being like a little monster sitting on her shoulder trying to deceive her by whispering lies into her ear.

Also, you could try doing things like standing in front of a mirror with her and trying to persuade her to have a long think about the way she really looks. She might say she looks fat even though she's more like a skeleton. It's quite typical for people with anorexia to do that. But she might start to see things a bit differently if you ask her to imagine she was you looking at her, and to tell you how she'd think she looks if she was you.

Also, it might help if you discuss with her how fashion models often aren't really as thin as they look in magazines, because the images have been manipulated to look thinner.

Making Mealtimes More Bearable

Mealtimes can be made easier if you can find something to do during them that'll mean she doesn't have all her mind on her food but she's thinking about something she enjoys. For instance, one mother sat with her daughter for each meal and told her all about things that had happened when she was young, and things that happened to her when she herself was a child. Whenever the daughter stopped eating, she would talk to her gently and reassure her that it was her anorexic part doing that to her, but she wanted her to eat so her normal part would grow and develop and get healthy again.

Another family decided that their anorexic daughter could go and eat her meals with her grandmother. She preferred eating there, because mealtimes were much less tense and her grandmother could spend more time with her, so the atmosphere was relaxed. She managed to put on weight again there.

Don't feel she's let you down or take it personally if she doesn't finish her meals. Eating's bound to be difficult for her.

Thinking Through Solutions to the Eating Problems With Your Anorexic Child

If your daughter deliberately vomits after meals, negotiating with her about the best ways of stopping would be best, for instance, asking if she'd like you to spend time with her after each meal, or whether it would cut down her temptation if you locked the bathroom door for a while, or if she could promise not to vomit for, say an hour, at the end of which her urge to vomit might have gone.

Exercise shouldn't be encouraged, since starvation thins the bones and depletes the body of muscle, so exercising a lot can damage it more easily.

If no progress is being made, just think of it as meaning you need to move on to trying something different. You could discuss with her what might help her eat more - whether that be having different foods, having you spend more time with her while she's eating or having someone else come around to be with her, going into hospital, or whatever. You can spend time with her thinking up possible solutions to the problem. It'll be best to write them down, so if one doesn't work, you can remind yourself of what the rest were and try another one.

If she decides she wants to put on weight, she might be discouraged if progress is slow; so point out to her any little steps towards recovery she's made. If you keep records of what she eats, after several weeks, you may be able to look back over the ones for several weeks before and realise how much she's improved, so you can all be encouraged. For instance, she might be eating more, or trying new foods.

If she's isolated from old friends because she's had to spend time at home, it might help her if you arrange for them to call round sometimes. It might take her a while to feel confident socialising again.

Don't try to force her to do anything though. It's best to discuss every idea you have about what might help her in her recovery with her. Otherwise, she'll feel she isn't in control, and might try to get more control over her life by getting even more anorexic. If she's a bit more like an equal partner in the discussions about her recovery, and is able to make some of the decisions herself, then she'll feel happier about working towards recovery.


Part Seven
Someone's Attempts to Help a Girl Whose Parents Argued a Lot but Got Closer When she got Anorexia, Who's Scared They'll Quarrel Again if she Gets Better

Here's a message from someone who says her parents have always quarrelled, and it got so bad at one point that they separated and her mother took the children and moved in with her parents for a while. They got back together, but they still argued a lot. She says she was scared her parents would separate for good, and she wanted to stop them arguing but she didn't know how. The stress of not knowing what to do and having to put up with it made her lose her appetite. Then she became anorexic, and she liked it, because she found that when all her thoughts were focused on food and losing weight, she wasn't worrying so much about the arguments. But she found that her parents stopped arguing and became close, focusing their joint attention on caring for her. She was in hospital for a while because of her anorexia, but it didn't make her want to recover. Her parents were both caring towards her and got on much better than they did when she was well. She says she's scared of getting better, in case her parents start arguing again, and maybe separate for good.

I've got some ideas on things I could suggest about this. I think I'll say:

Thinking About Making Suggestions for Improving Communication Skills Between Parents to Cut Down Arguments in a Marriage

An idea

Is there any way you can see yourself as being able to help your parents improve their marriage? I've read a couple of books about improving marriages, and I could tell you quite a bit of what they say about improving communication skills in a marriage to cut down arguments, and maybe you could pass on the information to them.

Perhaps expecting you to take on the responsibility of helping them improve their marriage would be unfair though. But giving them a few suggestions without raising your expectations of success too high might mean that if you do succeed, you'll be glad, but if you don't, at least you won't be worse off, unless they get annoyed with you for making the suggestions.

I've heard that marriages have improved when couples learned to communicate with each other better, so divorces were prevented. I've heard a lot of marriages break up over a whole load of trivial things that led to lots of arguments, because the couples weren't skilled at communicating in ways that would mean they could come to solutions about them without antagonising each other and arguing. If you could learn more about communication skills, do you think it would be possible to pass the information on to your parents in ways that could make them enthusiastic about trying them out? After all, I don't know what your parents argued about, naturally, but if the issues were that serious, they wouldn't have been able to put them aside to care for you - they'd still be arguing about them, I'd guess, though I might be wrong.

Actually, that would be a big responsibility - trying to teach your parents communication skills to help them improve their marriage! If you'd find it difficult to talk to them, family therapy might help. It's where you all see a therapist together, and the therapist asks each one of you questions and helps you explain your points of view to each other without it turning into an argument, and helps you find new ways of communicating with each other. So maybe you could ask your parents if they'd be willing to do that with you, saying it might well make you happier so you'd recover from anorexia more quickly.

But maybe if you think you could get your parents interested in learning about better communication skills from things like self-help books and what people say about them, their relationship might improve without it. See what you think would be the better idea.

These things might not have anything to do with your parents' problems, but I'll say something about what I've read about communication skills and ways of solving problems without resorting to arguments, because it might give you ideas on ways of moving forward. I mean, even if nothing I say is relevant to your parents' situation, it will hopefully at least make you more optimistic about coming across something that is, because it'll give you an idea on the kinds of advice around and how much of it's out there.

If it is relevant to your parents, maybe you could just print out the part of this message that talks about them for them, or show them where it is and encourage them to read it. You wouldn't have to say you're the one the message is about.

Don't Feel Under Pressure to Help Your Parents Though

If nothing at all works in the end, then maybe it would be best if you concentrate on building your own life and future and making friends outside the family, and making plans for improving your life that don't involve your parents, and leave them to live their own lives and to be responsible for their own futures as much as you can. After all, they're adults - they're supposed to be the ones taking care of you, not the other way around.

If one of them ever complains to you about the other one, as if they want you to help them solve the problem, then they're putting more pressure on you than is fair. It's not as if it's your responsibility to do that - it's theirs. They're the adults, the ones who've had more experience of the way the world works, and so they're more likely to have more ideas about how they could solve their problems than someone much younger! So it would be irresponsible of them if they ever made you feel as if you needed to try and help them. They might not be like that at all. But I knew a man who said when he was a little boy, his dad used to complain to him about what a bad state his marriage was in. As if a nine-year-old could do something about it! Upset No wonder he grew up so depressive! Well, that was probably one reason. I hope your parents aren't like that.

But if one of them says nasty things about the other one to you, bear in mind you're only hearing one side of the story, and it's not fair for them to talk about the other person like that when they're not there to defend themselves. So it might be best if you say you'd rather they didn't talk about them in your presence, and leave them to sort their own problems out.

But then, you might be able to help them improve their relationship by giving them some ideas.

A Book About a Bad Marriage That Got Better

Angry

I read a book by a woman who said she wanted to divorce her husband at one point. She said she was angry with him because she didn't think he was loving enough, so she felt unhappy and took it out on him by criticizing him more and more for all kinds of silly little things, and being sarcastic about any efforts he made to improve. Of course he didn't feel loving after that! But she entirely blamed him for the problems.

She said she used to buy self-help books and underline the bits she thought he ought to take notice of and give them to him, thinking he was the only one who needed to change. Of course, he wasn't impressed!

But she started having a good think about what was really going wrong, and then she realised she was doing things wrong as well, and in fact her behaviour was ruining the relationship much more than his was. She ended up changing the way she communicated quite a bit and her marriage improved. Then she wrote a book about it, to give people ideas on doing similar things in their marriages.

The Problem of Storing Up Anger

Tantrum

She says one reason she was the way she was was that she'd grown up believing that nice people don't get angry but keep unpleasant emotions to themselves and are nice all the time. She'd had terrible tantrums when she was a child and not only kicked and screamed, but held her breath till she passed out. People would say it was shameful and that she was spoiled. She misinterpreted that as meaning that anger was shameful, not just terrible temper tantrums. So she thought nice people don't get angry. She thought that meant never expressing her feelings when she was annoyed. She tried not to express them, but it meant she just stewed over little things she was angry about, and her stew of resentment grew and grew the more little things she had to be angry about, until she couldn't hold it in any longer, and her husband would only have to say one little thing that annoyed her, and she would burst out in temper and a great torrent of angry accusations would pour out from her that had nothing whatsoever to do with what he'd just said. And the arguments could go on for hours.

Then, she'd feel bad about what she'd done, so she thought even more that anger was shameful, so she'd try even more to hide it, and the stew of resentment would build up and up again, till she had another great outburst of temper. And things would go on like that, but the amount of time between the times when she had angry explosions grew less and less, till she was angry all the time.

She said that while she'd thought being a nice person was to do with trying to hide negative emotions, she realised after a while that it was to do with being more forgiving of little things, and expressing her feelings more, so resentments didn't build up to the level where she'd suddenly burst out in fits of temper. She hadn't wanted to forgive her husband because she didn't think he deserved it; but when she thought of all the things she'd done, she realised he probably had more to forgive her for, so she couldn't put all the blame on him.

Thinking About What Caused the Anger

She said she stopped thinking anger was bad in itself, realising that it's the way people express it that makes the difference. She said that now, when she finds herself feeling angry, she finds it refreshing to admit to herself that she's feeling angry, and to accept it. Then, she asks herself what the anger's telling her about what's wrong in her life, and whether there are any constructive ways of fixing it, like requesting more help around the house, for example. She says her anger motivated her to get a new job once, where she became a lot happier.

She said she also finds it helpful to ask herself what emotion came before her anger, because she often realises that one did, and then her anger goes away. For instance, she says if she thinks her husband's ignoring her, she can get angry with him, but she's really scared he's angry with her.

Anger Caused by Misinterpreting Things

She said another thing that helped was realising that it wasn't her husband himself who caused her to be angry, but her interpretation of the reason he was doing what he was doing, for instance, if she thought he was just doing something to be annoying. She said one example is that she used to like to stop to buy donuts on the way back from a church she went to with her husband, but often, he just drove straight past the donut place without stopping. She thought that must mean he didn't care about her feelings, so she felt angry with him. Her whole day would be ruined because she'd have angry thoughts going around in her head all day about it, thinking he was thoughtless and stingy and mean.

She got over it when she realised things weren't like that at all. She realised donuts were nothing special to him like they were to her, and when he got out of church, he was thinking about what to do with the rest of the day. He never gave donuts a thought.

She started just reminding him to stop to get some after that, and found he was happy to stop, and enjoyed the time eating them together as much as she did.

Distracting Yourself From Angry Feelings

If my experience is anything to go by, and I've heard similar things from others, distracting yourself by doing something else can also help with anger sometimes. It's easy to have angry thoughts going around and around and around in your head working you up more and more, even about little things, but sometimes, if you do something completely unrelated, the little things fade from your mind and they just don't seem so important any more, as if you can get a proper perspective on them when you step back from them. It can seem as if they were just little things after all, not worth getting worked up about. Well, at least that's what I've found. For instance, I can spend several minutes thinking angry thoughts about some offensive thing someone said on an Internet forum. But when I go off and do something that gives my brain something else to do with itself, what I was thinking about before goes to the back of my mind and I realise it's just not important. Then I start realising I was getting it out of proportion. I mean, is it really that important if someone who doesn't seem to have that many brains and doesn't have much influence over anyone thinks offensive things? Is it more important than things that are actually worth getting angry over, like con-men cheating old ladies out of their life's savings? Even if it is important, will mulling it over angrily do any good? Won't it just ruin the moment? The brain can go over the same little thoughts over and over again sometimes, so you can get the impression that some things really matter that don't really matter at all. And when you go off and do something that means you aren't thinking about them for a while, you can start to think they're not really important after all.

I think it's the same with other types of thoughts as well.

Explaining Why You're Angry Rather Than Keeping Quiet About it

Driving

The woman who used to get angry all day about the donuts said another thing that helped her deal with anger was explaining why she was angry soon after the angry feelings came on, rather than letting them build up. She said the first time she did that was when her and her husband were out with friends one evening, and he said something about her cooking that they all laughed at. She laughed along at the time; but really, she was hurt by what he'd said. While her and her husband were driving home, she pondered over whether to say something about it. She thought it was too petty to make a fuss over really, thinking she'd been over-sensitive; but she was still upset about it. She argued with herself about it for miles, but since she'd just learned that it's important to clear the air over small issues, she decided to say something in the end. So, going against her nature, she said, "What you said tonight hurt me and I feel angry".

Her husband wasn't defensive or angry, and he didn't laugh at her. Instead, he was amazed, and then he apologised, saying he hadn't meant it to be hurtful. She knew that, but she'd just wanted to hear him say it. They held hands and talked the rest of the way home.

Keeping to the Issue an Argument Started Over

Annoyed

She said another thing it's important to do is to keep to the issue an argument started over, instead of doing what she used to do and bringing up all kinds of things that made the arguments go on for hours. She said the real issue the argument was over could get forgotten in all that, and so it wouldn't get sorted out.

If the other person brings up something that has nothing to do with the issue, they could be told something like, "If you want to discuss that, let's discuss it after we've finished talking about the main issue here." That can help calm things down a bit.

Having a Break in the Middle of an Argument

She said sometimes, it's important to have a break in the middle of an argument to put off talking about the issue for a while, either till tempers have cooled, or till one person has thought more about what they'd really like to say. She said she needs to do that, since in the middle of an argument, she sometimes realises she isn't clear about what she thinks, and needs time to think through it more. Trying to think it through in the middle of an argument just makes her confused and more angry.

But she said that if people do postpone their discussions, it's best if they try and muster up the courage to bring the matters up again at some point if there's a possibility they'll lead to buried anger that causes problems later.

Actually, I read a book by another author who said she used to get annoyed with her husband because he used to walk away in the middle of an argument when she wanted to carry on talking to him. She used to follow him, still talking, but he just got more annoyed. But then she realised he just wanted to go away to calm down. When she started just letting him go away and bringing up the issues again later when they were both calm, she found he was willing to discuss them then and things were much more likely to get sorted out than they were before.

The Importance of Listening to Explanations of Things Before Expressing Anger

A short fuse

The author who used to get all annoyed about the donuts said another thing she's found it's important to do is to listen to a husband or wife's explanation of something before expressing anger. (or anyone else's, I presume.) She says that once, she was standing on a street corner and saw her husband drive by. She'd expected him to give her a lift home, but he just drove right past. A little while later, she phoned him up. He was at home, just about to go out swimming. She had a fit of rage at him, and it caused an argument.

She got angry about what he'd done whenever she thought about it afterwards. She said it took years to forgive him for that. Years? Wow!

She said that years after it happened, she realised the whole thing was just a misunderstanding. He'd thought someone else was picking her up. She said that if she'd held her anger back on the phone a while longer and listened to what he was saying, she'd have realised that right at the start, and it would have saved her all that anger later.

The Importance of Standing Up for Yourself

She said that hiding anger for the sake of "keeping the peace" can make things worse in the end. She said some people avoid conflict because they think they're peacemakers, and then get so fed up that they think divorce is the easy way out. But if they'd stood up for themselves a lot more, without necessarily expressing themselves in ways that annoyed their husband or wife, things wouldn't have got to that stage.

But she said when people stand up for themselves, although it's best to do so in ways that won't antagonise the other person, people have to speak plainly, explaining exactly what they mean, or the person they're talking to might not understand, so things won't get settled.

She said a time when standing up for herself worked out for the best was one day after her and her husband had gone to bed, when her son who was just about to go to college phoned up because he was having a bit of a problem, and she wanted to talk about his problem with him. Her husband was irritated and told her to hang up and come to bed.

After the call, she thought she had two choices: either to defend her behaviour in staying on the phone with her son, or to say nothing and lie awake fuming about what her husband had said for hours as she used to.

She decided to express her anger, and after a few angry words, her and her husband made up, and even felt closer than they had before. If she'd just kept quiet and fumed about it, she might have been moody with him for ages.

The Importance of Choosing What to Express Anger About

Angry

But she says while it's important for people to stand up for themselves, there are things that just aren't worth getting angry about. She said for years, she would get angry and hurt over the slightest little thing her husband said, like a slip of the tongue, or a facial expression or tone of voice that seemed critical. She said she wouldn't bother to ask him what the truth was, because she thought that her opinion of what had happened was the important thing. So her husband had to choose his words carefully, be cautious around her and sometimes avoid her altogether.

She was upset that he was avoiding her and thought he was ruining her dream of marriage. And she thought he was weak for not standing up to her. She thought he was slow for pausing to consider his words before replying to her. So she felt superior to him.

But after a while, she started asking herself whether she could be turning him into the person he was becoming and realised what was really going on.

So she now recommends that people choose carefully what they allow themselves to get angry about, and make sure the other person really is at fault and it's not just to do with a misunderstanding. She says becoming angry about every little remark or sideways glance she didn't like just created tension in their home and did nothing to change her husband.

She said that since then, she's learned to become far more forgiving, and her anger has slowly become much less of a problem.

Being More Considerate

Angry

She said another thing that caused difficulty in their marriage was the way she spoke to her husband when she was stressed.

For instance, when she was looking after two small children and he came home late from work late for dinner, she would snap at him, calling him thoughtless for not phoning and letting her know he'd be late. He'd just get annoyed. But she's realised since that a better way would have been to stop thinking about how it had affected her and express concern for him when he came in, saying she was glad he was home and asking how the traffic was. That would have given him a chance to explain why he was late. She could sympathise with him when he told her, and only after that say she'd been worried. Later on, when the atmosphere was relaxed, she could ask him to call when he's late in future because it would take a weight off her mind.

She said he's much more likely to take in what she says and do what she wants when he doesn't feel attacked when she says it.

She said it might take practise to start communicating more healthily, but she's found that with perseverance, the results can be encouraging.

Making Suggestions on How you Think Things Could Improve, Not Complaining About What you Don't Like

Complaining

She said one thing that often caused arguments in her relationship was when she would complain that her husband wasn't helping enough in the house. She never actually suggested anything she'd like him to do; she just complained that he wasn't doing enough. He would promise to be more helpful, but nothing changed. But one day she asked herself exactly what it was that bothered her so much, and she realised that just walking upstairs and seeing the bed unmade ruined her whole morning. So she simply asked him if he could make it every morning. One simple specific request instead of an angry vague complaint about not getting enough help made all the difference. She says now, he makes the bed every morning and she feels much happier.

The Way Things are Phrased Can Make a Big Difference

She said one thing that helped her learn to communicate for the better was learning to change the way she phrased things. She used to say things that provoked her husband, like,

"You make me angry."
"You never help around the house"
"You're always late."
"You are thoughtless."

She said statements like that sound like accusations and would always put her husband on the defensive and irritate him, and when he was irritated, good communication would stop. She says that particularly irritating to him were words like always and never, since they're extreme statements that are very unlikely to be true. She said when she used words like that, her husband would remind her of times when he did do what she wanted, or wasn't late or whatever, so the real issue didn't get discussed, because they ended up arguing about whether she was right or wrong when she said he never did the things she wanted or always did something irritating.

She found that when she started phrasing things in a way that didn't make them sound like accusations, it made a big difference. So instead of phrases that sounded as if she was blaming him for things, she instead said things like,

"I'm feeling angry."
"Will you empty the dishwasher?"
"I was worried because you were late."
"I'm feeling like no one wants to play with me."

Phrasing things that way stops things sounding so much like criticisms. It turns them into requests, or expressions of feeling that aren't necessarily implying that anyone's to blame for them. She said her husband started listening to her much more when she phrased things like that.

Making Plans on How to Improve Things Rather Than Getting Bogged Down in Arguments About the Way Things Are Now

Arguing

The other author, who's a marriage counsellor, gives some examples of how much better it can work when people focus their efforts on finding solutions rather than on always thinking about what's wrong.

She says she learned early in her marriage about how much better the results can be when you ask for change rather than complaining about what's wrong, when one day she wanted to ask her husband if he'd go out at weekends more with her. He worked hard during the week, so he just liked to relax at home at weekends, whereas she wanted to be more active. So one day, she sat him down and said she was fed up that they didn't go out much and that all he wanted to do at weekends was to hang around the house. He'd go out to dinner occasionally, but not much more than that, and she thought it wasn't very exciting.

When she told him that, he started defending himself and it turned into an argument, until After a while, she said in a loud voice that she didn't understand what all the fuss was about, since all she wanted them to do was to go into the city every four to six weeks and do something out of the ordinary. He said, "That's fine. Why didn't you just say so?"

She was surprised that he was so willing to do what she wanted, and wondered why he'd made such a fuss at first; but then she realised that she'd annoyed him by criticizing him so much about his perfectly justifiable behaviour in wanting to relax at weekends, while the reason she was criticizing him was because she was trying to justify asking for what she wanted, when she didn't need to justify it. She just needed to ask for a small change.

She says that after that, she would always try to just ask for what she wanted, rather than going through all the reasons why she was unhappy at not getting it.

Annoyed

She says she saw a couple in therapy who had argued for years about their finances, always trying to work out why they had such difficulty over money. The wife thought it was because the husband liked to spend too much of it on things to entertain himself, like his father had, which she thought was a waste of money that they could be saving for the future; and the husband thought it was because the wife behaved like a parent, trying to stop him enjoying himself with money. The trouble was, they'd never tried to work out what to do about it; they just argued about whose point of view was right and whose was wrong.

Instead of trying to understand why the arguments had gone on so long, the author says she just moved straight to helping them decide what to do about the situation. She told them they were both right to some extent, because it was important both to enjoy life, and to save money so they could feel secure about the future; so they had something valuable to teach each other.

They each thought about little differences that would make them happier if the other made them. The wife said it would be nice if the husband looked at the bills with her so he could understand why she was concerned about saving money, and the husband said it would be nice if his wife could sometimes encourage him to spend some money so he didn't always feel he had to ask permission to.

During the next fortnight, the husband did pay the bills, and was taken aback to realise how much they had to pay. The wife said they weren't even paying as much as usual. He seemed to be starting to understand why she was so concerned. And she did encourage him to spend money on something she thought he'd like, but having looked at their bills, he even said he'd be happy not to, because it would be expensive.

The author says that once they'd decided to stop trying to analyse the reasons they were arguing and try to work out good ways of stopping, solutions became easy for them to find. They planned a budget for themselves to stick to. And when, a few months later, they realised they were slipping from it, they made a fresh commitment to it.

The author says people might think their problems are much worse than that, and that they wouldn't even know where to begin to solve them. But she says it doesn't matter where people start, because small changes in one area of life can lead to changes in other areas, just as changes in one person can lead to changes in another. She says that that happened in the lives of the couple she mentioned she saw in therapy about finances. She says when they started understanding each other's attitudes more, they became more loving towards each other in general. They started spending more time together and going out more together. They started being more thoughtful towards each other. The wife stopped complaining when the husband spent hours in front of the television watching sport, but brought him snacks, and even sometimes sat down and watched the programmes with him. He appreciated her thoughtfulness and started doing more thoughtful things for her in return, like scraping the ice off her car on winter mornings and warming her car up before she had to get in it, which she was very pleased about, because she hated having to stand around in the cold getting the ice off it herself. They started doing more and more thoughtful little things for each other.

With the increase in thoughtfulness and compassion between them, when arguments did occur, they found they were more forgiving towards each other. The children responded well to the change in atmosphere as well, becoming less anxious, less argumentative and more playful with each other.

The author says she's seen that kind of thing happen in a lot of families, and she's sure it will happen once people start making efforts to change. She says she asks people who come to her for therapy what the very first small sign will be that things are moving in the right direction, and she feels sure that once couples have achieved that, things will start to snowball from there.

Working Out What Triggers Off Arguments, and Doing Something Different at Those Times

She says there was a woman who thought every time her husband was quiet, he must be angry or upset with her. So she would always ask him what was wrong. He would say nothing was wrong, but she would say she was sure there must be something wrong. He'd deny it and tell her to stop asking the question, but she would insist there must be something wrong, until he exploded angrily, and their day would be ruined.

One day, she decided to do something different. They were just about to get in the car when she noticed he was quiet. She asked what was wrong, but when he said nothing was, she didn't press the matter further, but turned the radio on and began to sing to the music.

A few minutes later, he asked if she minded if he turned it down because he wanted to discuss his feelings about something that had happened earlier. They discussed things, and it was the first time ever in their marriage that he'd shared his concerns with her without being asked.

The author gives another example, of a husband and wife who argued about money every Friday night when they came in from work. Because they started off the weekend badly, the whole weekend was always miserable. It had been for months. But one day, the man decided to do something different in the hope of having a good weekend for a change. So when Friday night came around and his wife started the usual conversation about money, he said, "I'd like to talk to you about this, but I'd prefer to wait till Sunday. Will that be allright with you?" She was surprised by what he said, and said it would be allright.

They went out for dinner on Friday night, and for the first time in months, really enjoyed themselves as a couple. On Saturday, they went shopping together and again enjoyed themselves. By Sunday, they were feeling better about each other than they had for a long time. That might be the reason why when the wife brought up the subject of money on Sunday night, they managed to settle the disagreement instead of having the same old argument.

So what had started out as a simple change in the time they had their argument had brought them closer together.

The author says someone else wrote her a letter about how doing something different had improved his marriage. He said he had often had arguments with his wife, but one day, he suggested to his wife that they should make a rule that in future, every time they argued, they would have to take all their clothes off. He thought that would stop them arguing in public or when it was cold, so it would cut down the number of arguments they had. Since all their children had left home, she agreed.

An argument started and he decided to try it. So while making serious points, getting into the argument, he took each one of his clothes off, one for each point he made in the argument, and threw them all on the floor. She was surprised when he started, but then she started laughing when he didn't stop. She laughed more and more. He laughed as well while continuing to put his side of the argument. They soon found they totally agreed with each other!

In the next few days, they kept laughing about it, and his wife said she was sure she'd never be able to keep a straight face in an argument again.

The Importance of Listening Properly

The author who would get upset all day about her husband not stopping to buy donuts said another thing she's tried to do since she started trying to make improvements in her marriage is not to react angrily to criticism herself.

She said one thing that's very important for people to do is to listen, or husbands or wives might give up talking about anything deep and meaningful with them. She says her husband used to get irritated with her because she sometimes didn't pay enough attention to what he said, or would interrupt him, or she wouldn't wait for him to think of answers to her questions before she started talking again. But she learned to be more willing to listen patiently.

Calming Someone Who's Shouting at You

Angry

Another author says it's often possible to calm down someone who's shouting at you so you can stop arguments getting out of hand, if instead of raising your own voice because they're shouting and you're annoyed because they're being abusive, you keep quietly and calmly just insisting they calm down before you'll talk to them, whatever they say. So a conversation might go:

Husband: "You're so stupid; when will you get things done on time?"
Wife: "You're really angry; I'm not sure what particular things you're referring to. How about you sit down and we can talk about it?"
Husband: "Talk about it! I'm not sure you're intelligent enough to understand a simple sentence! I want you to have things done when I need them!"
Wife: "You know, I want to talk about this, but I really can't when I'm being bawled at. Sit down, and let's talk about it calmly."
Husband: "I am calm, you idiot! Can't you do anything right?"
Wife: "I'm willing to talk to you about this if you'll sit down and stop shouting at me."
Husband: "What if I don't want to stop?"
Wife: "Then let's talk about it later when you're not so angry. I want to get this sorted out, but only if you're not yelling at me."
Husband: "I want to sort this out right now."
Wife: "Then please sit down and stop shouting, so we can sort it out."
Husband: "Allright, I'm sitting down and I'm not shouting. Why wasn't my shirt ironed?"

Not Letting Yourself be Controlled by Your Feelings

The donuts woman said it'll often be the way that something in a person is causing their angry feelings or any other feelings, not really their husband or wife.

She said one morning, she woke up feeling depressed and angry, but she didn't know why. While her husband was making their breakfast as usual, she felt irritable with him and could have shouted at him. She was trying to read an article in the paper and she thought he was interrupting it with boring conversation and wanted him to just go to work. It was a big effort for her to keep from shouting at him, but she kept quiet. After he'd gone, she realised that the reason she was feeling the way she was was because she'd been upset by things she couldn't do anything to stop, but which were nothing to do with her husband. For instance, someone often came into the library where she worked and looked at pornography in front of everyone, including children, but she'd been told by the boss that she wasn't allowed to do anything about it.

So her feelings could have made her shout at her husband, and their breakfast time would have turned into an argument and been ruined, when really, what was upsetting her had nothing to do with him.

So she now recommends that if people feel like behaving more angrily towards someone than is really fair, they ask themselves what's really behind their feelings.

She said a friend of hers got very angry because her husband kept leaving the toilet seat up, even though he knew it irritated her a lot. She thought it was a sign that he didn't love and respect her, whereas really, it could have just meant he didn't see why it was a problem and was forgetful.

She said sometimes, feelings can go back to childhood or teenage years. She said another time when she reacted unfairly with more anger than she should have done was after she decided she ought to do some weeding in the garden. To her surprise, she enjoyed it. She was proud of her efforts, and thought that if she was going to enjoy gardening that much, she'd buy some plants. She planned what to get and where to put them, and couldn't wait to tell her husband, thinking about how proud he'd be of her for having done so much weeding.

He was pleased about that, but when she told him about her new plans for arranging the garden, he told her they wouldn't work. She says she was hurt and angry with him, far more than necessary. But after she calmed down, she had a think about why she had reacted so strongly, realising that he hadn't meant his comments to be hurtful. She realised that when she was told her plans wouldn't work, she'd started feeling like she had as a child, when her big sister, who was good at everything and thought it was her job to teach her, had often criticized her ideas and undone things she'd done and done them properly. So that had made her feel stupid, and her husband's comments brought back the old feelings. So really, she was angry with him for something that wasn't really anything to do with him.

She said another thing she used to do was to blame her husband when she felt unhappy. But then she realised she could take more control of her own emotions and life. So she started doing things to make herself happier, going out with friends sometimes, sitting in the sun, visiting art museums, and other things.


Part Eight
Eating in the Middle of the Day Made a Woman Feel Lethargic at Work, so she Thought She'd be More Efficient if she Stopped

There's a message here from someone who says she felt she wasn't as efficient at work after she'd eaten, because she felt lethargic, so she stopped eating. She noticed she felt a bit lethargic at other times as well, so she stopped wanting to eat at all, not just at work.

She finds that at times of stress, or if she feels she's made mistakes at work, she wants to eat even less.

Sometimes, she gets depressed, and binges on food when she gets home; but then she feels disgusted with herself, and sometimes vomits to try to get rid of it.

I'm going to try replying to this. I think I'll say:

Foods That Give You More Energy, and Other Ways of Staying Alert

You must have been seriously worried about your lethargy problem if you even stopped eating because of it!

Sleepy

I know the feeling of feeling lethargic after lunch. Actually, I sometimes get a problem where I get really drowsy and drift off to sleep. But I've noticed I get it when I haven't eaten anything as well. I heard a lecture by a psychologist once who said it's natural to get sleepy in the middle of the day, so people might think it has more to do with eating than it does, although I'm sure heavy meals can make you sleepy.

But I've heard that some types of food give you more energy than others. There was a television programme on once about how two people swapped eating habits for a while. One of them loved junk food, and the other one ate a lot more vegetables and salad. The one who loved junk food ate salads and vegetables instead for a few weeks, and found he felt quite a bit more energetic. I think the one who swapped to eating the junk food diet felt less healthy.

Pears

I know my mum started eating a lot more fruit recently, and said she felt more energetic. And my older sister recently switched from eating sandwiches in her lunch break at work to eating fruit.

There might be quite a few different types of food you like which will give you more energy, not leave your energy store feeling as if it's been depleted. It's best to eat something, or you'll eventually become weaker, and then you'll be much less efficient at work than you are now.

Other Things That Can Help You Feel More Alert

But besides changing your eating habits, I know there are other quick things you could do to increase your alertness at work. Taking quick walks every now and then could do it; so could sticking your head out the window and breathing in some fresh air, if the air outside's fresh where you work. That might mean taking a little bit of time out from working, but if it makes you more alert so you perform better when you come back, it'll be like a time-saving device really. I know listening to music can help people feel more alert, and it can make work a lot more enjoyable as well. Are you allowed to do that? Having a fan blowing cool air on your face could help as well - anything that engages your senses.

Some Causes of Tiredness During the Day

Boring work

One thing that makes people tired sometimes is being bored or fed up. Does your job interest you? Do you find it stimulating? If the lethargy problem's quite bad and you think it might have something to do with boredom, or with being in a more stressful environment than you think the job's worth, then would looking for a new and better one be an option for you? It might be worth considering. Or there might just be things you could do to make the job less stressful or more interesting, and so on. I heard about someone who was really fed up because her boss would come in just before the end of the working day and give her something to do, which made her late for her train home. She was even thinking of leaving her job because she was so fed up, but then she thought of speaking to the boss when he was in a good mood and asking if he could give her the work earlier in the day.

I read that fatigue can sometimes have to do with emotions like resentment, worry, boredom, a feeling of not being appreciated, anxiety, futility, pressure to meet deadlines, and things like that. Emotions can cause nervous tensions that can be exhausting. I don't know if any of that applies to you; but if you think it might, can you think of things you might be able to try doing to reduce your stress levels at work?

Or if you think you've got a more serious tiredness problem, perhaps you ought to see your doctor about it or investigate disorders that make people feel sleepy during the day.

Then again, you only said you felt lethargic, come to think of it, didn't you, not really really tired. Smiling

Starvation Can Very Seriously Damage Your Health

I'm sure this is obvious, but if you carry on not eating, the effects of starvation will be far worse than feeling lethargic - that'll be the least of your worries. Your efficiency will end up dropping much further below what it could have been before because you'll get weak and ill.

I don't want to worry you; but I think it might be worth me mentioning some things I've read about the effects of starvation on the body. I've just been reading a few books on anorexia. One says the effects can include:

The Dangers of Exercising With Severe Anorexia

When a person's lost a lot of weight and their energy reserves are depleted because their body's having to burn off fat and then muscle, over-exercising can lead to dangerously low blood sugar levels, which can result in coma and death. It can also lead to bone fractures because the bones have become thinner. Muscles and joints can be damaged.

Some people with anorexia want to exercise to keep in shape. But over-exercising when you're starving yourself can destroy your body shape, since the body starts digesting the muscle to use it for energy after it's burned off a lot of the fat.

The Damage Done by Vomiting up Food and Using Laxatives to Get Rid of Food

Queasy

Vomiting up food and using laxatives can set up vicious circles that mean people can want to do them more and more, all the while damaging their health more and more.

Vomiting straight after eating means the vomit contains stomach acid that erodes the teeth, leading to tooth decay. It can also lead to water and salt imbalance that can disturb the functioning of the heart, liver and kidney. Some people who feel weaker because of what it's doing to their bodies interpret that as a sign that they're not mustering up enough control over themselves and vomit more often to make up for it. But that just makes things worse.

It can even get to the stage where potassium levels in the body are so low that the functioning of the heart and brain is so disturbed that it can lead to heart attacks and fits.

The glands in the face can swell up painfully. This, though a consequence of starvation, can make the face look rounder and so some people think it must mean they're getting fatter, so they make even more efforts to lose weight!

In some people, regular Vomiting can lead to tears in the stomach that can lead to life-threatening bleeding.

Because vomiting deprives the body of food, it gets hungry, so you might want to eat more and then vomit more, which will put you at more risk.

Taking laxatives, like vomiting, can cause serious water and salt imbalances. Laxatives mainly get rid of fluid, so people can be fooled into believing the weight they've lost is fat when it's really fluid, and the severe dehydration the loss of a lot of fluid can cause can even lead to kidney failure or kidney stones.

Regularly using laxatives can also damage the bowel, so it ends up not working properly on its own so severe constipation results. The effort of straining can cause piles.

Yuck.

The sooner you get back to eating normally again, - although it's best to do it gradually because the body will have adapted to starvation conditions so too much at once could put too much of a strain on it - the less risk of developing the most serious health problems anorexia can cause you'll have, and the sooner you'll recover from the ones you already have. I wish you all the best.

The Effects of Starvation on the Brain

Starvation affects the brain by slowing it down. Concentration can be impaired, as can learning, memory and problem-solving abilities. So judgment might be clouded. It becomes more difficult to think rationally. Thinking can become simplistic. So it's more difficult to think of solutions to problems, and people can find it more difficult to put solutions into operation. Thinking impairments brought on by starvation can stop you realising how important it is to get treatment. Ability to learn will be impaired. It'll be more difficult to think in different ways.

When people start putting on weight, the thinking abilities will normally come back, although it might take a while before they're as good as they were before, and in the severest cases, it's possible that they might never get quite back to normal. So the sooner people start putting weight back on, the better really.

Coping With the Distress of Beginning to Eat Again

In a bad mood

Because the digestive system shrinks when people haven't had much to eat for a while, it'll be best to start eating more by eating small but regular meals, so the stomach can cope better. Anything too large would give you severe stomach pains.

Another advantage of eating small amounts of food but eating several times a day instead of just two or three is that you might start feeling very hungry once you start eating again and be scared you're going to lose control and binge. Eating little but often will stop you feeling so hungry.

If you get fearful at the thought of beginning to eat again or you think you'll get very anxious while you're eating, or if eating turns out to be physically uncomfortable because of feelings of bloating or that kind of thing, there are things you can do to take your mind off things while you're eating and make it a more enjoyable experience, so you're not concentrating all your attention on disliking it.

Some people who are beginning to eat again have found they're happier eating while they're watching television or listening to the radio, or eating with close friends; or some start writing a novel or directing a film in their heads while they're eating, carrying on the story from meal to meal. Or some read something enjoyable while they're eating. Some people recommend people concentrate their attention on how enjoyable their meal is though. Maybe you could experiment and come up with ideas of your own, and see what works best for you.

Nervous

I read that one young man would always eat with someone else, and when his anorexic urges threatened to get the better of him, he'd concentrate really hard on what his friend was saying. He would encourage his friend to talk about things that had amused him. He even developed a secret code with his friend so he could signal to him when he was feeling tense, and his friend would step up efforts to divert him.

A young woman distracted herself from anorexic thoughts by imagining herself walking away from her anorexic part, and getting into all kinds of adventures. She would carry on the day-dream from one meal to the next.

One young woman who kept feeling guilty after she'd eaten imagined she was having arguments with her anorexic part, thinking of it as a little animal on her back trying to pull her back into anorexia. She would say things to it like,

"I know it's only you trying to make me feel guilty. You're frightened you're losing your grip on me. You're right! I'm determined to pull you off my back! I'm going to ignore your voice now so you stop tempting me back into anorexia."

Perhaps you could come up with your own or similar ideas and see what you could do to try and make meals a pleasurable time as much as possible.

Don't Be Discouraged If You Relapse Into Anorexia Again

Once you start eating more, that doesn't necessarily mean you'll make steady progress towards a normal weight. Sometimes, perhaps in times of extra stress, your anorexic urges might well be stronger than usual, and you might stop eating for a while again. Don't feel a failure if that happens, thinking you may as well give up trying. Everybody probably relapses a bit sometimes. If someone gave up smoking, and a few weeks later he was at a party and everyone was smoking around him, and someone offered him a cigarette and he gave into the temptation to smoke one, you wouldn't tell him he may as well give up trying to stop and go back to smoking twenty a day, would you, because you'd know his giving into temptation might just have been a temporary thing and he might do better in the same situation next time; so in the same way, one relapse doesn't mean you're going to sink back into full-blown anorexia again, and it doesn't mean you're a failure.

Thinking About What Triggers You to Relapse

Anxious

One of the books I've been reading says one thing that might help you relapse less often is if you think of what tends to trigger you to want to relapse - whether it be comments someone makes about your weight, a friend starting a diet and eating less, certain situations that put you under stress, or whatever.

After you've thought of some, it might help if you think of and write down all the reasons why those things don't need to affect you, and alternative ways of coping with those things, if you can think of some. Then you'll be better prepared when they happen again. If one alternative way of coping turns out not to work, you could try another.

Since stress can trigger off relapses, at times of stress, if you think about what the stressor is and try to deal with that instead, it might stop the relapse in its tracks.

Also, it can help to plan your meals in detail and decide when you're going to have them beforehand, perhaps sitting down one day and setting times that you intend to have them over the next few days or weeks, to help you maintain a routine of eating so it's less easy to just keep putting it off until you end up not bothering.

You could go back to eating small but regular meals for a while if you relapse after having made quite a bit of progress, because it might be easier to contemplate eating small ones for a while.

Making Gradual Progress Towards Weight Gain

Here's another one of the suggestions the book makes:

One thing that might help keep you making progress is if you day-dream about what you could do better and would be able to enjoy doing if you didn't have anorexia. For instance, you could ask yourself questions like:

What jobs might I like to do that anorexia might make it difficult to do?
What hobbies would I like to take up that would be more difficult with anorexia?
What else would I like to do that I don't feel able to do now?
Do I feel lonely, and know that if I didn't have anorexia, I'd find it easier and have more energy to get out and make new friends?

If you list all the things you'd like to do and keep looking at the list and day-dreaming about how nice it might be to do some of those things once you've got over anorexia, it might give you more incentive to get better and encourage you.

Another thing the book says is that it might take a while to adjust your anorexic attitudes and eating habits and get better, so don't be discouraged if progress isn't as fast as you'd like it to be. One thing that might encourage you is if you congratulate yourself every small step of the way. Even if you have a relapse, you can accept it as normal for people; if the anorexic way of thinking's become a habit, it might take time to change. So be gentle with yourself. If you expect too much of yourself at once, thinking your eating habits should return to normal quickly, you might get discouraged and give up if you don't come up to the standards you want, even if actually, you have made several little steps forward that mean your eating habits have changed quite a bit little by little over time. You might not think each small step is significant enough to feel pleased about, but it will be, because they'll all add up to something big, and maybe every few weeks, if you think about how far you've come since you first decided to work towards recovery, you'll realise you've made quite a bit of progress.

Making a Food Diary

Thinking of eating

The book says thinking about your progress and writing about it in a notebook could help encourage you and remind you of how far you've come since the beginning. It might help to write a food diary several days a week, or if that seems boring, maybe just a couple, making quick notes of what foods you've eaten and how much of them, whether you had any binges, whether you used vomiting and laxatives to get rid of food and how often, and whether and how much you used exercise to try to burn fat off. You're bound to have days where you do worse than you've done over the past few weeks, but it's common for people to have bad days, so you don't have to think it means you've failed and that you may as well give up. If your overall progress over weeks is towards getting better, that'll be what counts. If you can look back in a food diary and see the number of binges getting less over time, though there might be a few reversals here and there, and the amount of food you eat gradually increasing, even though you did have some extra anorexic days, then you'll hopefully be encouraged.

It's best to update the diary a few times a day, since otherwise, by the end of the day, you might have forgotten some of the detail.

In another section of the notebook, you could write down every positive thought you have about your body you catch yourself having. You might not have many at first, but if you write positive thoughts down and leave out negative ones, you'll be able to look back at them and be encouraged.

Defending Yourself Against Criticism, and Self-Criticism

Annoyed boss

Stopping eating altogether because you want to be more efficient does seem drastic, like punishing yourself. Does your boss demand very high standards from you, criticising you a lot to try to spur you on to do better? Or do you think you're quite a perfectionist, so maybe you criticise yourself more than your boss does? If you do think you have a perfectionistic streak, what do you think drives it? Do you feel self-critical and bad about yourself when you don't think you're performing at your best?

Perhaps you know this already, but sometimes, people can feel a lot better if they defend themselves against criticism, whether it comes from other people or themselves. And sometimes, recognising that some criticism is unjustified can make you feel a lot better as well. For instance, if a boss said to you something like, "You've made a complete mess of this! Now you've got to waste my time sorting it out!", he might be exaggerating, and you might blame yourself for how angry he is and get the impression that things really are as bad as he says they are, when the truth is that it isn't a "complete" mess at all, and the main reason he's angry has nothing to do with you - he might be angry because someone else in management has just shouted at him and made him look a fool in front of others, so he wants to let off steam by shouting at someone else, for example.

But because you don't realise that, you might end up feeling inadequate. If you're scared of the feeling, you might try as hard as you can to do things perfectly after that to try to stop yourself feeling the unpleasant feelings again.

I don't know if any of this applies to you at all, actually. Perhaps none of it does.

But if it is criticism or self-criticism that's driving you to take drastic measures to try to get more efficient, then bear in mind that criticism sometimes isn't all it seems.

And as I said, standing up for yourself and defending yourself against the accusations can make you feel better. I'm not suggesting you be aggressive and risk starting arguments. There are ways of stating the facts in your defence but not antagonising the other person.

For instance, if you took longer to do something than was convenient for a boss and they said, "If you worked any slower, you'd be going in reverse! You're really holding things up!", you could ignore the anger in what they said, putting it down to bad manners or who knows what, and as calmly as you can, just state the facts, by perhaps saying something like,

"I'm sorry I'm taking longer than I thought I would; I needed more information than I thought I would to complete the task, so it took longer than I expected it to.", or give what other explanation you have for the problem.

Or if someone talks to you aggressively, one way that can stop them is commenting on the tone in which they said it, rather than on what they actually said. Disputing what they said can lead to an argument, but one thing that can often calm situations is if people comment on the way the person being aggressive is talking to them.

So, for instance, you could calmly use phrases like:

"I'd appreciate it if you don't use that tone of voice with me."

"That's not a nice thing to say."

"I don't deserve to be spoken to like that."

"Don't take that aggressive tone with me, please."

Or if a boss said something like, "You're so inefficient!", you might be able to say something like, "I got one thing wrong. I'm sorry about that. But getting one thing wrong doesn't make me inefficient in general."

If you have an inner critic so you keep telling yourself you're worse than you really are, you can talk back to that in a similar way.


Part Nine
Someone's Attempts to Help a Girl Who Says she Became Anorexic After the Death of a Loved One

Here's another message, from someone who says her grandfather died suddenly and she was very upset. He'd taken her out a lot to fun places and she was really fond of him. She particularly missed him because he'd been like a father figure to her, since her own father often wasn't around. She felt she couldn't grieve because she ought to be strong for her mother who she felt had more right to grieve. But it was stressful keeping her feelings inside, and she lost her appetite. She became anorexic after that.

Another thing that made her feel stressed was that she became afraid of dying herself, or that one of her parents might die as well, especially her father, who's a policeman, so he could be put in dangerous situations.

I think I'll try replying to this as well. I think I'll say:

Soothing Painful Emotions

Mourning

I read an article about grieving that said it's natural to feel several strong emotions when people lose someone or something they were attached to, not only parents and other loved ones, but family pets, and even houses. And it said it's common for people to get depressed and to lose their appetite for some time, (although not to go anorexic).

I've been reading a book that says grief can cause overwhelming emotions, and anorexia numbs emotion because you don't feel things so strongly when you're starving, so it can be like a kind of escape. People can not want to start eating again, because they know that when they do, they'll start feeling the strong emotions again. Bulimia can be like an escape as well, because all that comfort eating can block out the emotions of grief while it's going on, and then the self-loathing and efforts to purge the body of the food that people get preoccupied with afterwards stop them feeling the grief as well.

Do you think anything like that's happening with you?

That book I've just mentioned says it's better to experience the emotions, accept them and let them go in their own time, although there are ways of soothing them so they're more bearable, which is different from blocking them out altogether. But although grieving emotions are strong, allowing yourself to experience them won't necessarily mean becoming so distressed you can't cope or your mother finds it more difficult to cope. Do you think it's possible she might like the companionship of knowing someone else is grieving as well? There are ways of soothing strong emotion she might find helpful as well as you.

Upset

In another book I read, the author says sometimes panic and despair can get really bad, but one thing that might help calm it for a while if it seems that it might get out of hand if you don't control it is to focus with all the concentration you can muster on something else for a while. There's a technique you can do where you close your eyes, and this sounds funny, but then, you focus all your concentration on the big toe of your right foot, thinking about how it feels. You might need to wriggle it about a bit so you can feel it more. But the idea is that you pay attention to how warm or cool it is, and how it feels against your shoe or sock or the air, such as whether it's putting any pressure on the shoe, or whether the air's cooler around it, and that kind of thing.

The author says that that technique can calm even strong emotions for a while, since when people take their focus of attention off their emotions and focus with as much concentration as they can on something totally different, the emotions lose their momentum.

When people still themselves like that, It can also make them aware of sounds and other things in their environment they just hadn't noticed before they became calmer, that they can start to enjoy.

For emotions that aren't so strong, one way of soothing them is to distract yourself from them a bit in other ways. One method is to soothe all your senses one by one, except the sense of taste perhaps, until you're better. Here are a few examples of things you could do from one book:

You might not like all those ideas. But you might be able to think of other ones if you like the idea of soothing emotions like that.

Accepting That it's OK to Have Strong Emotions

Nearly crying

If you've felt under pressure to hide your emotions of grief because you thought you needed to be strong for others, and you felt guilty about getting so upset, it can be helpful to reassure yourself that it's allright to have them after all. Here's what one author said:

She said she found it was easier to tolerate strong emotions when she accepted she was having them, rather than getting worried about them. She said she found that when she started feeling fearful or angry or whatever, sometimes because she'd see or hear something that triggered off a memory that made her feel a strong emotion in the most inappropriate place, like in a crowded room, she'd try to get away when she could to somewhere tranquil where she liked being, and then she'd calm herself by reassuring herself that she had the feeling and it was allright to have it, and then letting herself experience it for a while before moving on.

So if she felt fearful or depressed, or overwhelmed by things, she would reassure herself that it was understandable that she felt that way, sometimes saying to herself things like, "This is how it feels to feel fearful; this is the way I'm feeling"; and then she would reassure herself that it was allright to feel that way. Then she'd feel calmer.

She said the feeling didn't always go away immediately; sometimes it hung around for a bit; but accepting that it was allright to feel that way helped to calm it.

Feeling Angry With the Loved One for Dying

Do you feel angry with your grandfather at all for dying? It might seem strange because it wasn't his fault for dying, but I've heard some people can go through a stage where they feel angry with the loved one for going. Or they feel angry with the hospital and others for not doing more to save them, or angry with themselves or others for not showing more appreciation for them when they were alive. It's OK to feel angry. Anger isn't bad in itself; what makes the difference is the way you express it.

Some people find it helpful when they're feeling strong emotions to write down what's bothering them so they can get it out of the system. Some people find playing the piano loud and energetically or that kind of thing helpful. Whatever you find helps, don't feel guilty if you feel angry but don't think your anger is really justified, because it's just a normal phase lots of people go through.

Writing a Goodbye/Memorial Letter to the Loved One

Missing a loved one

Some people like to get things out of their system in a more systematic way, and write a goodbye letter at the same time that can be a nice memorial to the loved one.

Here's one way of writing one:

One way is to think of all the things you'd like to say to them before you write the letter, so the letter ends up saying all the most important things. So first, you could jot down a list of the things you liked about them, and a list of the things they did that made you annoyed or upset. Then, you can use them to make other lists, using a new sheet of paper you've divided into four sections, or on the computer:

  1. One section's for things you'd like to have said to them or done for them but didn't;
  2. One section's for things you wish you hadn't said and done.
  3. One section's for things they did that you liked them for and things you're glad they did;
  4. And the other section's for things you think you need to forgive them for, which doesn't mean anything they did wrong was allright, but just that you make a decision to stop feeling resentful about it, which will make you feel better.

Then, the idea is to write a goodbye letter to them with all those things in it, expressing apologies for things you said and did that you regret now, or didn't say or do that you wish you had; listing the things you forgive them for; and saying the things you'd like to say to them if they were still here about how much you appreciated them.

Then you end it by telling them you love them and miss them, or whatever sentiments you'd like to sign off with.

Then, you could do something to make it special, like going to the grave-side and reading it, or reading it to someone you trust.

The letter would only have to be short and sweet. Here's an example of the way a goodbye letter could go:

Dear Grandpa

I wish while you were still here, I'd told you how much I appreciated you.
I wish I'd told you how much I enjoyed going to the places you took me to, although I expect you could tell.
I'm sorry I took you for granted.
I want to tell you now I used to love the places you took me to. It was fun being with you.
And I used to love visiting your house at Christmas time when we'd have presents and sweets and there was a happy atmosphere.
And I thought all those stories you used to tell about your life were really interesting.
I just want to tell you I'm glad you were my grandpa.
I forgive you for leaving me.

I love you. I miss you. Goodbye.

Moving On With Life Again

Miserable

You say you're fearful of dying yourself or that one of your parents will die. That's understandable. But you could cut down your own risk of dying by gradually beginning to eat more so you recover from anorexia. After all, you said you wanted to be strong for your mother, and that would help her, wouldn't it.

Grieving can be made a lot worse if people start fantasising about what else might go wrong, and how terrible life might be now the loved one's gone. It can be as if the person grieving's tormenting themselves. Your fear of death might get worse if you fantasise about what might happen, and you'll get more depressed. You might start to forget there are still good things in life that are worth enjoying while you can.

People can also feel worse and worse when they isolate themselves from other people. When people are feeling down, it's natural not to want to be with others. But I heard a psychologist say it can help if people gradually make efforts to go out to places again, because when people are isolated, alone with their thoughts, they can become more and more neurotic, because there's no one around to help them get their fears into perspective. And they can get more and more depressed. Emotional support from others can be comforting and healing, so if you know you had good friends, or family you're close to, it might be worth trying to get back in touch with them again. But even just getting out and doing things you enjoy could lift your spirits.

Grandpa

And after all, would your grandfather want you to spend your time being miserable, or did he love you enough to want you to recover and get out and enjoy yourself? Would he want you to get over anorexia? If so, wouldn't you be honouring him by putting effort into recovering? You don't have to feel guilty about enjoying yourself again instead of mourning him if it's what he'd want.

So what do you think you'd enjoy doing? Besides old activities you could gradually take up again and old friends you could get in touch with again, can you think of new things you'd like to try?

Also, instead of grieving, you might feel better if there was something active you could take part in that you know would honour his memory. For instance, if someone was involved in some kind of charity work that they really cared about, someone who cared about them would be honouring their memory if they got involved in it to carry it on after they'd gone, although they'd have to be careful they didn't take on more than they could cope with. Or anything like that.

And surely you could honour his memory too by doing things you know would make him proud of you, like getting better, and succeeding in life and enjoying it.


Part Ten
Someone's Attempts to Help a Young Woman Who Says she Got Anorexia When She Felt Depressed and Unable to Control Life After her Boyfriend Left Her

Here's a message from someone who says her anorexia started after her boyfriend left her and she got depressed. At first, she felt too listless to eat, and then just didn't feel as if she could stomach food for a while because she felt stressed. Then she felt pleased at the amount of weight she'd lost, and began to feel a sense of pride in it, thinking it made her look more fashionable and was at least something about her life she could control. The control she felt over that part of her life became like a drug fix that compelled her to lose more and more weight.

She says she doesn't want to give up anorexia really because she enjoys feeling the highs, and it takes up lots of her time so it's something she can get happily absorbed in where she can forget that she thinks she's a loser and how upset she is that she lost her boyfriend, so she feels as if it's the way to solve her problems. But she wonders if she should give it up really, since it might do her more harm than good in the end.

I'll think about whether I can comment on this one. I think I'll say:

Anorexia Doesn't Really Solve Problems

Biting fingernails

I think it's quite common for people with anorexia to feel as if it's solving all their problems. But I read that all it really does is numbs emotions of distress so they don't get so upset about them even though the problems are still there, and gives them something to focus their attention on so they don't think about the problems because their minds are too preoccupied. People might think the problems have gone away because they're not bothering them any more, but anorexia won't have made them go away really; people can feel distressed again once they start eating because the emotions come back again, so they might think the solution is to stop eating again and make even more efforts to cut down on food; but then their health begins to fail. So it's best to tackle the problems themselves really.

Or sometimes the problems do go away for other reasons, but anorexia has become such a habit by then that people still use it as if it's a way of coping with problems.

But then, I expect you know all this. What I'm really saying is that you'll be better off doing something that genuinely solves your problems. But then, I expect you know that as well.

Anorexia might be like a drug fix to you. But I've read that the mind can play tricks on the person who's addicted to something, because when they're thinking about how much they enjoy it, they're not associating it with all the bad things that will happen if they carry it on, but with what they're getting from it, so they can forget there are bad things about it; and they can assume they'll get even more highs from it if they carry on, which they might not.

You might think the anorexia's giving you control, but anorexia ends up controlling the person who has it. I mean, think about it: If you decided you wanted to give up anorexia right this minute, could you do it? If not, that means the anorexia's dominating you, just making you think you're the one in control. A challenge might be if you decide to take on the challenge of controlling it.

The Effects of Starvation on the Mind

Depressed

The feeling of depression and loss of control of things you had after your boyfriend left must have been bad. I sympathise. But anorexia/severe weight loss will often do things to the emotions that are worse. Sorry to sound depressing; but you say you're wondering if you ought to try to recover in a way, and this might help motivate you to. Here's what I recently read in a self-help book about anorexia:

The author of one book I've been reading about anorexia says she knew a young woman who had anorexia, who was cheerful until she got below a certain weight, and then she would feel depressed and irritable. But when she would put on weight again, she felt allright again. It happened a number of times. That just shows how depression and irritability can be side effects of losing too much weight because the chemistry in the brain can change.

How Addiction to Anorexia and Other Things Can Fade When Emotional Needs Are Met

I read a book by a couple of psychologists that says addiction to something means you've got needs in your life that aren't being met. It says everyone has certain basic emotional needs that have to be met, at least to a large extent, if people are going to stave off mental health problems. It says those needs are:

The book recommends that anyone who realises some of those needs aren't being met in their lives has a good think about what they could do to slowly build up to getting them met. It says when people are happy and they're doing something that makes them feel as if they have a purpose in life, and they're being intellectually challenged in an enjoyable way, and they've got the support of others, they're a lot less likely to get or stay addicted to things.

It says there was an experiment done on rats to prove that. I'm not keen on the idea of animal experiments a lot of the time, but it's interesting anyway:

The Morphine Experiment

Eek

There was a famous experiment done on some rats where they were split up into three lots.

One group were separated from each other and each given a small cage to themselves. So none of them had contact with any of the others. In their cages, they had plain water, but they also had water with morphine in it sweetened with sugar, that they could drink if they pressed a lever. They all drank a lot of that, rather than drinking the ordinary water.

The experimenters put some of the other rats in pairs in larger pens. There, they drank a lot less of the water with morphine in it.

They put the other rats in groups in a very big enclosure that was as near as possible to the environment rats love best. They called it Rat Park. They found that the rats there always preferred the plain water to the water with morphine in it. In fact, though they liked water that was just sweetened with sugar when it was offered to them, they wouldn't drink the water with the morphine in it.

The experimenters swapped the rats around, and always found that when they put rats who'd been in the single cages in the groups in the big enclosure, they went off the water with morphine in it and drank much, much less of it. And when they put the rats who'd been in the big enclosure in the little single cages, they started drinking lots of it.

For two months, all the rats were forced to drink the water with morphine in it because they weren't given any plain water. But even after that, only the rats in the little single cages preferred to drink that when they were given the choice of drinking that or plain water again. The rats in Rat Park quickly cut down and stopped drinking the water with morphine in it.

The book says the experiment showed that drug use didn't depend on the character or biology of the rats, but on whether or how well their needs were being met. The ones that were put on their own or in cramped conditions in boring environments where there was nothing to stimulate them developed the most dependence on morphine. But even those ones voluntarily cut back on it when they were given food treats.

The Vietnam Veterans

The book says that it was found by researchers that half the American soldiers in Vietnam in the 1970s were taking heroin. The authorities were very worried about what would happen when they all came home at the end of the war, thinking there would be lots of drug users who were used to killing people roaming the streets; so they monitored them closely. But they were surprised to discover that only just over one in ten continued to take heroin once they'd got back with their families and had taken up their old lives again. 80% had given up within a year, half with help from clinics and half by themselves. The ones who didn't manage to give up either had post-traumatic stress disorder, or came from broken homes and so didn't have a comfortable environment to return to.

Focusing on Getting Emotional Needs Met

So if you start to try and plan ways of getting those emotional needs met more, you might stop feeling the need to be anorexic. Anorexia might give you a feeling of control that gives you a high; but if you start feeling as if you're getting enough control from other things you do, you might not be interested in getting it through the anorexia any more.

And maybe you could get some emotional support from friends or people on Internet forums that would be a comfort. And if you find people on Internet forums who've struggled with the same issues and

are now mastering them, you could be encouraged and given ideas about what you could do now.

Thinking of Anorexic Urges and Other Feelings as Babies That Need to be Taken Care of Because They Don't Know What's Best for Them

Baby

Feelings are primitive things really. They're a bit like babies crying. They let you know something's wrong, but they don't tell you what. So, for instance, it's possible to feel down but not to know why - you might not know whether it's because you're depressed at the state of the world, whether you're disgruntled because you won't be seeing anyone for a few days and it's a bit of a drag, whether your body just isn't getting enough healthy food or sunlight, or because you've been dordling around all morning and haven't done any work on that project you really want to finish, and your feelings are telling you you're fed up of doing nothing and it's time to get into it, or something else. Or is it just me that happens to? Smiling Anyway, if a person thinks about what's bothering them most this moment or about what just happened, it can sometimes help them work it out; but if you just do something to soothe the feeling on its own, then you can end up just doing something that'll give you quick comfort, but that doesn't solve the problem, because you haven't thought about what it is and what you can do about it. Anorexia, like drugs or alcohol, can appear to solve problems because it dulls the feelings they might give you, which might make you feel much better, but it doesn't solve the problems that gave you the feelings in the first place - although there can be some benefits to it, such as if parents stop arguing to look after you or something. But if they learned more about how to handle conflict so they didn't start arguing again even when you got well, that would be a better solution.

Perhaps you could think of anorexic urges as being like a baby crying. A person's first instinct when their baby screams might be to quieten it down by sticking a dummy in its mouth, or to pick it up and cuddle it, or rock it, which might be a quick way of soothing it and might seem the most obvious thing to do, but the baby might really be crying because it's a bit too hot, or the music in the room's too loud, or it wants you to take it for a walk, or something. So with anorexic urges or other feelings, a quick and obvious-seeming way of soothing them might be to do what you think will calm them down most quickly, like starving yourself, when in reality, they're telling you something different that's not obvious so it's more difficult to work out. But trying to work out what it is, and then working towards putting it right, will lead to more long-term satisfaction.

Also, if you think of your anorexia as being like a baby, you can think of it as something that might scream and scream for something, but really, it doesn't know what's best for it. Just as a baby might scream and scream to be put in the duck pond with the ducks, its parents will know that just wouldn't be good for it, so no matter how much it screams, they won't do what it wants. Smiling So your anorexia could be screaming and screaming for you to starve yourself, but you're the one in charge, and you know what's best for it, so no matter how much it screams, you'll be taking the best care of it if you don't give into it.

It's the same with other feelings. Sometimes, you might get feelings that make you think everything's hopeless, that your whole life's ruined and there's nothing you can do that'll improve it, and that everything that goes wrong is a major disaster; but really, feelings like that are like crying babies who don't know any better. You're in charge.

Thinking You're Fat

Miserable

I've read that people with anorexia often feel worse about their bodies when they're depressed than they do when they're more cheerful, as if their feelings can make them think things are worse than they are. Or if they're anxious about something, all their thoughts can concentrate on feeling fat and ugly rather than on the thing that really made them anxious. That's another way feelings can make you think things that aren't true. It might be worth remembering that feelings of depression and anxiety can make you think you look worse, making you more pessimistic. When they've gone, chances are you'll see yourself more as you really are.

Distracting Yourself From Anorexic Feelings or Soothing Them

Enjoying a bath

Sometimes though, the anorexic feelings will be so strong that it'll be best to do something right that moment to distract yourself from them. They'll probably fade away for a while if you don't focus your mind on them but do something else instead. At least, I think that's what some people have found. I read that some people carry cards around with them with ideas on them for what they can do to distract themselves, that they look at when their anorexic urges are strong. They have the suggestions written on cards in case the urges are so strong that they block out other thoughts from the mind so it's more difficult to think of other things to do at the time. A suggestion on a piece of card will be a quick reminder, if it's always kept within easy reach.

Some of the ideas you think of to put on the cards can be lively things, and some of them quiet and soothing, so you can pick the one you feel most like doing depending on your mood. You could have more than one set of cards if you wanted, so you could have one for home, and one for when you're out somewhere like at work, and so on, since some of the suggestions on your home cards, like having a bath perhaps, would of course be things you couldn't do at work or somewhere like that.

So the suggestions could be things like:

Meditation

Supermeditation

There's a type of meditation that's designed to stop people getting absorbed in depressing thoughts and feelings, and to stop people thinking of them as so important, as well as to calm the mind so you feel more relaxed. It's where you sit somewhere comfortable, where you hopefully won't be interrupted, and for about ten minutes, you focus on one thing that it's pleasant to focus on, like a picture or an object or a calming phrase, so your mindís thinking of that rather than getting absorbed in gloomy or anxious thoughts, so it calms down.

Of course, no one can manage that, or not many people. But the idea is that you try, not minding if you don't succeed, but just having a go.

If other thoughts or feelings do come to your mind, the idea is that you just notice you've had them and let them go, bringing your focus of attention back to what you've decided to concentrate on, as if you're detached from your thoughts for the time being, thinking of them as if they're like cars going past, or something like that, that you notice and then forget.

The idea of concentrating on one thing is that you have something to pull your attention back to when you start getting other thoughts, to stop them crowding in on you and ruining your relaxation time.

Here's how it might work:

You might start off concentrating on the one thing you've decided to focus on, and then a thought about how fat you are comes into your mind. Instead of getting bothered by it, you just think something like, "Oh, there goes a thought about me being fat", and immediately pull your attention back to the one thing you're concentrating on. Then a thought might come into your mind that makes you think you want to lose more weight, and instead of taking notice of it, you casually think something like, "Oh look, a thought about how I should lose more weight!" and then you imagine it's just going past like a car, and pull your attention back to what you've chosen to focus on. Then a thought might come into your mind that makes you wonder what will be on the television that evening. Again, you casually think something like, "Oh, a thought about what's on television tonight has just popped up!" Then you imagine it's like a car zooming away, and pull your attention back to what you're focusing on. And so on.

You can try and do the same with unpleasant feelings that come into your mind during meditation - just thinking to yourself something like, "Oh, I've started feeling anxious now", and then imagine the anxious feeling's like a car zooming along past you, and then pull your attention back to the restful thing you're focusing on.


Another type of thing you could focus your concentration on is a phrase you repeat over and over again to yourself, perhaps in rhythm with slow breaths in and out, like, "I'm becoming soothed and relaxed", for instance.

Some people find it most helpful to focus on a phrase they repeat, while other people prefer focusing on something visual, such as a picture of a nature scene or another nice picture or image, candles, flowers, or even just a spot on the wall. The important thing is that it should be something that doesn't create a lot of activity in the mind. That way, it can help to calm the mind, because people can keep refocusing on it every time their thoughts drift away, so they're not distracted out of their relaxation for long by worries or anything.

When you're used to doing the meditation, you could do it just for a few minutes before meals, or at other times when you feel yourself getting anxious, so it'll calm you down.

Using Meditation Techniques Casually in Everyday Life

After a while, the technique of observing thoughts and feelings and then letting them go practiced in meditation can become a habit, so people can just let thoughts go in everyday life sometimes rather than getting absorbed in them. Doing that could free you from anxiety to some extent, because when worries about things that don't really need to be thought about come into your mind, you could just think, "Oh, I've started to worry about such-and-such", and let it just go past, and focus your attention back on what you were doing, whether that be the housework or whatever, rather than getting absorbed in the worries and getting more and more anxious because of them.

Naturally it's important to think through the real concerns we have and resolve them, rather than pushing them away. But a lot of the thoughts we have are just endless repeats of worries we have, that can go round and round in our heads, never getting anywhere but just making us more anxious, so they can just ruin our day for no good reason. Letting go of things like that can make us feel calmer and happier.


Part Eleven
Someone's Attempts to Help a Girl Who Says she Became Anorexic After Feeling Under Pressure to Please Her Mother Who Was Obsessive About Appearance

There's a message here from someone who says her mother used to keep talking about her appearance, as if that was the only thing that mattered. Her mother was proud of her older brother because he did well at school, but it seemed the only thing her mother valued about her was if she made efforts to control her weight. She says looking attractive was the only way she ever really got her mother's attention and approval. Her mother seemed to favour her older brother and not criticize him, whereas she criticized her about her appearance a lot. So she started slimming. She hadn't been all that fat before, but she thought she could get her mother's love and approval if she slimmed down more. She gave up sports, because though she'd enjoyed them before, they made her feel hungry. So she just focused on losing weight by eating less and less.

At first when she lost weight, she did get her mother's approval, so she was pleased, and that motivated her to lose more. Then slimming became an obsession, till she became anorexic. Then her mother did start showing concern and giving her attention, so it was difficult for her to get motivated to recover, since she might lose it all.

She's noticed she's a bit like that with other people as well - trying to get their approval at the expense of her own needs. For instance, she would help people with their schoolwork if they asked, even when it meant the time she took to do that meant she didn't have much time to do her own, so she didn't do very well. And a couple of the people who asked her were not very nice people and were really just taking advantage of her willingness to help.

I think I'll reply to this message. I think I'll say:

Questioning How Sensible the Attitudes of Parents and Other Authority Figures Are

Child playing sport

You know, I think it's a shame, but I think young children often just accept the way their mothers are and the things they say as just the way reality is, not questioning whether their parents might have got it wrong, and it can be some time before they start questioning. Actually, I think it's a part of human design really, since little children have to grow up not questioning their parents to survive usually. I mean, for instance, if a parent tells a child not to go in the road, or not to climb up the Christmas tree, or not to put their hands on a really hot radiator, the child would get hurt more often if they had such a questioning attitude to their parents that they wouldn't believe them unless they tried it out first or something. So for a young child not to think too critically about what their parents say is part of the human survival mechanism. But unfortunately, it can lead to problems when a small minority of parents use that trust to do things that harm their children, or when a lot more parents don't deliberately do that, but do harm their children in some ways without realising they're doing it, partly by causing them to develop attitudes that make them feel bad about themselves in some way, or that make them want to do things that are actually unhealthy.

Annoyed

This example might not have any relevance to you at all, but, for instance, if when a child gets low marks in an exam, parents or teachers start saying things like, "You're a failure. You're stupid. You'll never amount to anything", they might just be expressing their frustration, but the child might take it to heart, and think they genuinely are a failure who's stupid and will never achieve anything worthwhile in life, even though their parents were completely wrong to draw such a conclusion from just one low exam mark! The parents might not even have meant what they said literally, but chances are, the child will take it literally, because they can't read the parents' minds, and don't have enough experience to realise it's unfair for their parents to say that and that they probably don't really mean it. So the child will start to feel bad about themselves, especially if the parents talk like that quite often. A more sensible way for their parents to talk is if they just express disapproval for the one thing they're not pleased about at the time. For instance, if they're not happy about a low grade in an exam, it would be far better for them to say something like, "We're disappointed that you got that low grade; what do you think the problem was, and how do you think you could improve next time" than for them to say, "You're stupid; you're a failure, and you aren't going to do well in life if you carry on like that!"

Tearful

Talking to a child like that can harm them for life, because if they believe their parents and start thinking they really are a failure who'll never amount to anything, chances are they'll stop bothering to try, because they won't have the confidence to believe they'll succeed, and so they really might not amount to anything, whereas they would have if they'd been more confident. Complimenting children for the good things they do is more effective in encouraging them to try harder than criticising them.

Sorry, I think I'm going off at a tangent here. I don't know if you found any of that useful.

What I really mean to say is that people's disapproving views aren't necessarily rational and sensible. I know you might not think this is a nice thing to say about your mother, but I think you ought to think critically about what she says, I mean, be sceptical about it. When you do, perhaps you'll feel more confident and in control.

So, for instance, instead of just accepting what she says, it might be worth questioning her as to where her attitudes come from. I'm only speculating, but could your mother have an unhealthy preoccupation with her own appearance that makes her concerned about yours as well, perhaps having developed some distorted attitudes as she was growing up, such as the one that women can only be acceptable if they look slim and pretty? Or could she have been overly-sensitive to criticism about having a plump child? Could someone have mercilessly criticised her about it and accused her of not caring about her child to the point where she thought it was of the utmost importance that her child slimmed down so she could show she did care, and to save her from the shame of being criticised some more about it?

It might be worth questioning your mother as to where her attitudes come from like that, rather than just accepting the way she thinks.

Anyway, it's not entirely fair that people should be criticized for being plump, since genetic variations mean some people put on weight more easily than others. And it's common for young people to have "puppy fat" anyway, and to lose it later.

And appearance isn't the be-all-and-end-all anyway. It's true that good-looking people tend to get looked on more favourably, but there are some famous fat successful women. I'm sure you could find examples if you research the topic a bit. What you do with your life is more important than the way you look! If you get to do well in life, doing something completely unrelated to your appearance, you'll be able to show your mother that. Then, she might be proud of you and realise she was wrong to put so much emphasis on your physical appearance. People's talents, and what they make of their lives, and how compassionately they live their lives, are all more important than physical appearance!

The Importance of Standing Up For Your Needs Rather Than Trying to Please Others All the Time

Would you ever have thought of saying things like that to your mother before you got anorexia when she used to go on about your appearance? Or would you have been scared that disagreeing with her might have meant she gave you less attention? It might actually have had the opposite effect, because standing up for yourself might have given her a new respect for you so she wanted to be with you more. Sometimes, people do develop more respect for people who stand up for themselves. I'm not saying she necessarily would have done. But standing up for yourself's worth doing anyway because it would probably make you happier.

Standing up for yourself doesn't necessarily mean being aggressive. There are ways to do it without making the other person annoyed. How would you feel about standing up for yourself more now? I'm guessing you don't do it much, since you just went along with what she said, although I might be wrong.

Do you think you're the kind of person who tries to please people a lot so puts other people's wishes above your own? You've suggested you do. I've been reading that a lot of people with anorexia do that, perhaps often because they feel defective because they have such low self-esteem, so they want to make up for that and feel like worthwhile people and get people's approval so other people will think more of them and they'll feel better about themselves.

Feeling awkward

But seeking people's approval all the time rather than thinking about what you want for yourself can be harmful. I read about a girl who was always trying to pleas other people rather than doing what was best for her, and she didn't do as well at school as she could have done if she'd been thinking about what she wanted, because she focused on trying to be liked by people, so she was always playing the class joker. She did get to university though. But there, she got involved in a relationship with a man who was thought of as cool by other people, but really wasn't very nice. He took advantage of the fact that she was always trying to please people rather than standing up for her own needs, and got her to do what he wanted all the time, even when it was against her best interests. In the end, she realised what was going on and broke off the relationship.

But that just shows you that it's best to stand up for your own needs, rather than always trying to please other people. I didn't hear enough of the story to find out why the girl first started thinking she needed to seek other people's approval all the time. But in your case, do you think you got to be so concerned about getting people's approval because you grew up thinking it was the only way to get noticed? Do you think the attitude of one person, your mother, shaped your attitude to everyone around you, so even though it was just her that only gave you attention if you tried to please her all the time, you started letting other people manipulate you, even though they hadn't given the impression they'd ignore you unless you let that happen, and even when you'd have been better off ignoring some of them, because they weren't very nice people?

If you've never had to play by the same rules to get attention from friends as you felt you had to to get your mother's attention, then you know this thing about trying to please people isn't really a rule of life you have to live by.

Don't worry that it's selfish to stand up for your own needs. It isn't. If you can get some kind of healthy balance between looking after your own interests and doing what other people want, it'll be best, because caring for your own needs will make you happier, and that'll rub off on people around you and make you feel more refreshed, so you'll be able to think about other people's needs with more enthusiasm, and they'll be happier because you're in a better mood around them, so everyone benefits.

Angry

Another reason it's best to look after your own needs rather than trying to gain other people's approval all the time is that if someone tries to please all the time to the extent that they suppress their own needs, it can mean they build up a lot of anger and resentment. It'll be difficult to keep that hidden all the time, so it might build up till it's impossible to keep it in any more and then burst out, where they get far more angry with people than they deserve. So they swing from being meek and mild to quite venomous. Do you think you might be like that? If you stand up for yourself more and express yourself when you're a bit angry, you can stop yourself getting to that stage.

People may well appreciate you expressing your opinions and standing up for yourself more. they'll see you more as an equal, and know where they stand with you, which some people prefer over having someone who doesn't say what they think. So you don't need to worry about being more assertive. It doesn't mean demanding your own way. It just means expressing your needs and feelings clearly. Even if some people do disapprove of you for standing up for yourself more, chances are they'll have forgotten it soon. And if it's a stranger, does it really matter if they disapprove?

Assertiveness Techniques

Saying No

I've heard that one thing people who are especially keen to get the approval of other people find difficult is saying no to things they've been asked to do but would rather not do, in case it sounds offensive or they're disapproved of because of it.

One way of saying no non-offensively is to make it clear you appreciate being asked when you say no. So, for instance, if someone asked you if you'd do something you don't really want to do, like perhaps going shopping with them or something, maybe you could respond by saying something like,

"Thanks for asking; I appreciate you thinking of me, but I'd rather not this time."

You don't have to think you'll always have to give reasons why, because often, it'll be good enough just to say something like that.

But it can sometimes sound better than a simple refusal if they're having a bit of difficulty with something if we express a bit of feeling for their situation. For instance, if they wanted you to help them with some homework but you were really busy yourself, you could perhaps say something like,

"I know it's important to you that you get this done; I understand the difficulty; but I'm really very busy with my own work at the moment."

It can also help if we make a suggestion as to how they could solve the problem, or offer to help them out with part of it. So, for instance, if someone asked you if you could help them with some homework they didn't understand, you could perhaps suggest they look for information about how to do what they'd been asked to do on the Internet, or ask the teacher about it.

It can also be a good strategy in a lot of situations if we ask for time to think about whether we can do what they want. I've heard that often, people seem to want immediate decisions, but really, very few decisions have to be made immediately, so it's reasonable to ask for time to think, and to ask how much time they're happy to give us. When we're not feeling under pressure, we'll be able to think about it more carefully and decide what we really want.

Asking for What you Want in Non-Aggressive but Assertive Ways

If you're always trying to get people's approval and trying to please them, perhaps you find it difficult to ask for something you want, in case it inconveniences them or comes across as rude? You've got every right to have your needs met, and people might be a lot more willing than you think to see things from your point of view a lot of the time. But if you feel awkward about speaking up about them in case people disapprove of you, there are at least ways you can say things that won't sound offensive. For instance, you could phrase things in ways like this:

"I think it would be nice if we could go and see a film I like tonight."

"I'd prefer it if you didn't call me after 8:00 PM on week nights."

"I'd appreciate you not borrowing my belongings without my permission."

"It would be nice if you could pick me up today after work."

"I'd appreciate it if you could keep your voices down."

Standing Up For Your Rights

If someone's doing something that's inconveniencing or annoying you, or you need to tell them something they might not like to hear for another reason, there are ways of doing it that are less likely to antagonise them than others. If you explain the reasons why you feel the way you do, or why you're asking them to do or not to do something, and also, when you can, express understanding of the reason they're behaving as they are so it doesn't sound as if you're just having a go at them, they're more likely to be understanding and so willing to do what you want.

For instance, you could use phrases like:

"You might not realise it, but your talking's making it difficult for me to hear what's going on in the film. Please can you keep your voices down?"

"I know it's hard for you to say when you'll deliver what I ordered, but please can you give me a rough estimate of the time?"

"I know you like using some of my things, but when you borrow something without asking, I can't find it when I want it. Then I feel annoyed. Please can you ask me first in future?"

"Sorry to be a nuisance - I know this might inconvenience you, but I won't be able to go with you after all."

Talking like that will often be quite persuasive. But if they refuse to do what we want without a good reason, we've got the right to take a firmer line. Of course, that might make them disapprove of us, but it might actually make them respect us. And if they do disapprove of us, chances are it'll mean they're being inconsiderate. So our needs should come before what they think.

Rehearsing Being More Assertive

developing more assertiveness can give people more confidence. But it can take practice, so it can be best to rehearse.

Have you got a friend you can practice phrases with? Or perhaps you could just imagine someone's asking you for something and you're saying no to them, or you're speaking up for your needs to someone, rehearsing possible conversations with them in your mind.

Then, talking more assertively will come more naturally when you want to be assertive for real.

Healthier Ways of Getting Attention and Approval

Have you talked to your mother about how you'd like more of her attention? If you could persuade her that it would be an important part of your recovery from anorexia, she might well be willing to give you more. Perhaps she never knew before how much feeling left out upset you. That's not an excuse for her not giving you much attention, but sometimes, people get into patterns of behaviour that they never think to question until someone points out to them what effect they're having.

Here's one thing you could perhaps suggest for the future:

Thanks

Something I know some families have found helpful and that's brought them closer is if they make a special point of complimenting other family members when they do something they like. It doesn't have to be a big thing, but even just little things. One way it could work is if you have a family discussion where you say you'd like to try a scheme to bring the family closer. Perhaps you could say you found out from someone on the Internet that family atmospheres can be improved and people can become happier as a result if each member of the family looks out for good things the others do that they can compliment or thank them for, and then they compliment or thank them each time they notice something. Perhaps you could say you think a better atmosphere in the home would really contribute to your recovery from anorexia. If the family makes a commitment to trying it, it might make every one of you feel more positive, both because you're looking out for good things, and because you're receiving encouragement because of the compliments and thanks you're getting.

I heard about a boy's parents who were very angry with him for his misbehaviour, and they tried the technique, and they found the boy responded by becoming more considerate towards them, even though he still behaved badly at times. But this is the kind of thing they started doing when they started to compliment the child more:

His mother thanked him for helping with the washing-up. The next day, she said he looked good in his new shirt. When he changed a plug, his father told him he'd made a good job of it. The next day, he played in some sports at school, and his father went to watch and cheer him on. The next day, his mother was touched when she found he'd bought her a birthday card and a box of chocolates.

I've heard that the more people are complimented, the more they're encouraged to carry on the behaviour they're doing. Maybe if every time you notice your mother is doing something you like, you thank her and tell her it means a lot to you that she's doing it, and things like that, she'll do more and more of it.

Perhaps you could also ask her if she could set aside a specific time to be with you, where you could go out and do something you both enjoy, but which has nothing to do with the subject of physical appearance. Maybe you could say it would help with your recovery if she'd set aside a specific time, maybe a few times a week, that could be your time, and you could always plan together beforehand what you were going to do with it - something you liked.

Also, how about trying to get your need for attention met more by friends, such as if you just spend more time with them doing things you enjoy, that you know your mother wouldn't mind you doing? What kind of things do you enjoy doing?

I hope you found at least some of that helpful.


Part Twelve
Someone's Attempts to Help a Girl Who Doesn't Want to Recover From Anorexia Because Being Ill Gave her the Attention she Lacked When She Was Well

Here's a message from someone who says her parents both worked full-time with good careers. They were proud of her older brother, because he had a lot of sporting success on school and university teams and had been told he was good enough to play professionally; and he had achieved such good grades in his exams that he'd gone to one of the top universities. His parents were pleased with him and would spend a lot of their spare time watching his team play. She felt as if she wasn't really good enough, and as if her parents gave him a lot more attention than they gave her. She felt a bit neglected. But once she'd developed anorexia, she noticed that she was finally getting a lot of her parents' attention. They visited her in hospital, and her mother reduced her hours at work to spend more time with her.

One thing that worries her is that if she gets better, her parents will forget her again. She thinks it's a selfish way to think so it took her a while before she could admit that, but it's true.

She doesn't like to think of making demands on her parents when she's well, because they're busy people and she doesn't want to feel as if she's being a burden on them. In fact, she doesn't like to tell them when she's unhappy, because she feels guilty that they'll have to spend time worrying about her when they could be doing things they enjoy, and she doesn't feel her worries are significant enough for them to spend time on, because she doesn't feel as if she's a very significant person. But now she's ill, she thinks it's a good enough reason for them to spend more time with her. If she gets better, she'll feel awkward about needing care from them again.

I think I'll have a go at responding to this as well. I think I'll say:

Getting More Attention

Chat

You know, sometimes, when parents hear about what's bothering their children most, they change. I might be wrong about this, but it seems to me that your parents must care about you to spend so much time with you now, so if you just told them you're worried you won't get much attention from them if you get better, maybe they'll think of ways of including you in more things. They must care about you to be spending so much time with you now, so they'll probably be only too glad to hear about one way they could help you in your recovery. It sounds as if they care about you too much to think of your needs as a burden. And after all, it isn't as if you'll have to make great demands on them. I mean, for one thing, maybe giving you more attention wouldn't take much effort at all. For instance, could you tag along with them while they were doing one of their spare-time activities, or learn new things that would mean you could really join in with them? I heard about a girl with anorexia who was worried about not getting much attention if she recovered, who decided to go to sailing classes so she could go out with her father and crew boats with him. Is there anything like that you could do that you'd be interested in?

But maybe you could get more of your needs for attention met if you developed a circle of friends outside the family for your attention needs, and accepted that your parents might not give you all the attention you want. Have they got friends with daughters your age they could introduce you to? Have you got some good friends at school you could hang around with more? When you feel up to doing a few more spare-time activities, maybe you'll meet more people who might become friends.

Feeling as if You're a Burden on People

Tearful

Can you remember where you got the idea that expressing your feelings and needs would be a burden on people? I've read that it's quite common for people with anorexia to feel like that. Was there a time in your childhood when you got the impression that your needs for things like attention, care and love were just too much for someone near you? Were you made to feel it was bad to show emotions like sadness and distress as a child, or that you needed to discipline yourself not to? If so, do you really think that's fair? If you could see yourself as a child and you were able to talk to her when she felt emotions like that, how would you talk to her? Do you think you would reassure her that it was allright to feel emotions like that after all? What do you think you'd say to her if she started saying she didn't want to be a burden on people?

But if you can think back to where those attitudes first came from, can you understand why your parents or whoever it was who caused you to think expressing your needs was bad because it would make you a burden on people might have held such attitudes, like perhaps if their upbringing left them finding it difficult to cope with such things?

A book about anorexia I've just been reading says it's best to get into the habit of expressing feelings and needs really, because adult relationships can be difficult otherwise, since an unwillingness to share feelings and needs can be interpreted as a lack of trust or an unwillingness to get too close. People won't think of it that way in superficial relationships, where people won't think there's anything wrong with taking your time and support and not giving anything back; but in deeper relationships, not discussing needs and feelings might make it seem as if you don't trust the other person to be supportive or understanding. They might feel selfish sharing feelings and needs with you when you're not doing the same with them, as if they're a burden on you.

Anxious

The book mentions a woman whose father left when she was six. Her mother went out to work and left her and her younger brother in the care of a child minder, who turned out to be a bit nasty. The child minder treated her brother and her own children allright, but seemed to have taken a dislike to her and would punish her verbally and physically and make her late for school. One of the scariest things was that the child minder's spiteful moods and attacks were unpredictable.

The girl didn't feel as if she could tell her mother about what was going on, because she thought her mother already had enough to cope with, and she would have to keep working to support the family. The girl developed anorexia when she was a teenager. She managed to stay out of hospital and seemed cheerful.

She managed to keep relationships going when she was older, but things became more difficult when they got serious. In therapy, she admitted to having problems with receiving help from people, and gradually overcame them in small steps by letting her husband do more to care for her. For instance, he started making her breakfast in the mornings and eating breakfast with her. Their relationship started to improve once she started doing that.


Part Thirteen
Someone's Attempts to Help a Girl Who Says she Got Anorexia When She Wanted to Make Herself Look Less Attractive After Having Been Sexually Abused

There's a message here from someone who says she likes having anorexia because she doesn't want to start looking womanly. She says when she stopped eating, any sexual feelings she had disappeared and her periods stopped. She liked that because it was a sign that she was achieving what she wanted. She says she'd been sexually abused, and didn't want to be reminded of it by having sexual feelings, or to think she might be encouraging others or the same abuser by becoming more sexually attractive. Also, because the sexual abuse was a loss of control because she was forced into things she didn't want to do, she felt anorexia was at least one part of her life she could control.

Also, it was a punishment for the abusive parent, and the other one who she thought should have realised what was going on earlier and didn't protect her when she needed it. So as well as being a means of controlling one part of her life, it was also a way of having some control over them. She says her father was the one who sexually abused her, and he stopped when her mother found out, but she can't be sure he won't do it again.

But she says also, sometimes, she feels as if she was somehow to blame for the sexual abuse, feeling guilt, disgust with herself and self-hatred about it, and using the eating disorder as a kind of self-punishment.

I'd like to try and help her if I can. I think I'll reply by saying:

People Often Blame Themselves Unfairly When They've Been Sexually Abused

Crying

I've heard it's common for people to blame themselves when they've been sexually abused, thinking they should have fought back more, or they should have known what was going to happen and stayed out of the way, or they shouldn't have done this or that. But really, the responsibility for sexual abuse always lies with the abuser. Here's an example:

Upset

I read a book by a therapist who said a woman who'd been sexually abused by her cousin's husband came for some therapy when she was thirty-eight, feeling guilty because she thought she'd been responsible for the abuse. She'd been twelve at the time, and she'd gone into his room. In hindsight, she thought it was possible that Her behaviour could have been interpreted by him as flirting. So she felt guilty, thinking the abuse was all her fault because she must have made him think she wanted sex. The therapist was finding it difficult to convince her it wasn't her fault, till she asked her if she had any nieces or nephews who were around twelve years old, and when she said she did, she asked her whether if she molested them they could be in any way to blame. She said of course they wouldn't be to blame! Then she thought for a few seconds, and realised it was as if she was thinking she could have thought like a 38-year-old when she was only 12, when in reality, she'd been young and naive, and when she'd been kidding around with her cousin's husband, anything to do with sex was the furthest thing from her mind!

Then her therapist asked her if she'd have gone to his room if she'd had even the slightest idea that he'd molest her. She said, "Never!" And her therapist then said that that was proof that she can't have known what was going to happen, since she wouldn't have gone to his room if she'd known she'd be molested. So she couldn't blame herself. She couldn't have prevented it from happening if she hadn't known it was going to happen.

As for not fighting back more, you can't blame yourself for that when you don't know how much worse things might have been if you had. And you were probably so surprised and panicked at the time that you couldn't think clearly what to do.

If you were wearing attractive clothes at the time, that still doesn't excuse him. Fathers are supposed to have a responsibility to take care of their children, to bring them up to be good citizens, and to always have their interests at heart. Fathers are supposed to be the adults who can be trusted not to harm their children but to do what's best for them.

The Problem of Using Anorexia as a Punishment

Crying

If you carry on starving yourself, it'll end up being far more of a punishment for you than for your parents, and you know you don't deserve to be punished. Starving yourself will make you weak and ill, and then, apart from damaging your chances of being able to get away from your parents at some point and live a new and better life, you'll be making yourself more vulnerable. Some abusers don't care whether their victims look attractive or not. What they want is the feeling of power the abuse gives them. You know, it makes them feel big and clever! I'm not suggesting I think your father's more likely to abuse you if you get weaker; but I'd have thought eating a lot more and then working on building up your muscles in the martial arts ring once you're giving your body enough fuel to do that might be a better way to go. Smile Then again, what do I know.

But I know another way you could feel in control of your life would be to find ways to recover from the trauma of the abuse and to work on trying to make a success of your life, to prove to him that he hasn't succeeded in blighting your life forever. Doing that will be like shaking off any lasting control the abuse had over you.

Possible Ways of Working Towards Recovery and Protecting Yourself

I think there are quite a few websites and Internet forums that give advice on recovering after being sexually abused. It might be worth you looking around for a good one.

Your mother must have had a stern word with your father if it stopped him abusing you! Or else, perhaps she pleaded with him not to. But do you think she could be relied on to do the same thing if he ever showed signs of doing it again, although hopefully he wouldn't? I know you can buy attack alarms that might make you feel safer if you carry one. The way one works is that you keep it within easy reach, and then if someone threatens you, you press the top, and it gives off an ear-splitting high-pitched shrieking noise, that will hopefully put an attacker off coming any closer and alert anyone in the surrounding area.

If he shows any signs of attacking you again, hopefully firmly threatening to go to the police if he does will put him off. It might work with some better than others though.

One thing you might be encouraged by is if you imagine it's ten years on into the future and you're your older self writing to yourself now. Or writing to an old friend. Imagine you've done well in life and you've got lots of friends, and you're writing to yourself to encourage yourself that things are going to improve and to tell yourself how you managed it, or to your old friend, telling her how you got to be where you are. Once you've worked out how things could improve, you could gradually work step by step towards making your ideas a reality, as much as you can.

Something You Can Try If You Suddenly Begin to Feel Overwhelmed by Memories of the Abuse

Scared

If the memories of the abuse come back powerfully and really upset you or you tend to start feeling panicky quite a bit, there are techniques you can try that can help. Here's one I know of:

Itís all about refocusing your concentration intently on other things when you get panic that's getting worse or memories that are making you feel worse and worse. The idea is that as soon as you think your feelings are starting to get disturbed, you start focusing on things around you to distract yourself so you're not feeding your memories or panicky feelings by getting absorbed in them, so they fade away again for the time being. The idea of starting to do that as soon as panicky feelings come on is that the less intense they've had the opportunity to get, the easier it'll be to distract yourself from them. You use as many of your senses as you can, trying to give attention to five things with each sense in turn. You name them out loud or to yourself. That way, hopefully your brain will come right back to focusing on whatís going on around you now. Apart from anything else, that'll remind you that you're in the present, where nothing's currently going on to hurt you, rather than getting more and more fearful because of what your thoughts are focusing on.

So first, you could use your sense of sight, and try to concentrate hard on what you can see, quickly counting five things before you move on to trying to hear things. Or since it's things you can see, you could make it ten, since there might be a lot of them.

So, for instance, if you were indoors, you could pay a bit of close attention to what the pattern on the wallpaper looks like, perhaps, or if you're in the bathroom, you could count how many tiles are in one row. Then you could quickly move on and look out the window of whatever room you're in and focus on looking at something outside; then you could look at the floor and quickly try to decide whether it needs hoovering or washing; then you could focus on the colour of the curtains or the door; and then you could count three or more items in the room that need electricity to function. Or whatever. They're just suggestions. Some of them might work better for you than others, and obviously there might be other things you might choose to look at.
Or if you're outside, you could maybe pay a bit of close attention to the colours of things in shop windows; or repeat back to yourself the names of things you can see in a window, or the names of the types of shops around you; or count how many things are in the nearest shop window; or look at the colours of six cars passing by and see if you can remember the colours in order, and do that with a higher number of cars if you can; or look at any flowers in people's gardens; ... There are probably lots of things you could give attention to. These are just a few suggestions.

After you've paid attention to five different things you can see, you could quickly move on to counting and focusing on five things you can hear, if there are that many.
So if you're indoors in or near the kitchen, you could maybe focus your attention on the fridge motor if you can hear it; or if you're in the room where your computer is, you could concentrate on the noise it's making. Then you could listen to see if you can hear the neighbours or anything outside. If you can hear cars outside, you can focus on the noise they're making. You could tap something, and listen to the noise it makes.
If you're outside, you could try to distinguish words the people around you are saying, and listen to the noise cars are making, or if it's quiet, see if you can hear any birds, try to hear anyone's footsteps as they walk by, or listen to any music you can hear. That kind of thing. If you can't hear one thing, like the footsteps of someone walking by, you can quickly move on to trying to give attention to another sound.

If you can't hear many things, don't spend any time trying to hear more, because if your attention isn't focused on anything much, it gives more of a chance for the memory or panic to get more intense.

After you've paid attention to as many things as you can hear, you can quickly move on to giving attention to what you can touch. So you could shuffle your feet and notice the texture of the floor or ground beneath them, think about whether it's rough or smooth, and what it might be made of. You could notice the pressure on your feet from standing on it. Or if you're sitting down, you could think about the texture of the chair you're on, and notice the pressure of your back on it. You can touch it so you give more attention to it. If there's a desk or table or wall or something in front of you or within reach, you can touch that and think about its texture. You could touch part of your clothing and think about its texture.

Then, you could go back to looking at things, and then to hearing them, and so on, until the memory or panic isn't trying to bother you any more.

It might take a bit of practice till you can stop panic attacks and upsetting memories in their tracks; but it's worth trying it out.


Part Fourteen
Someone's Attempts to Help a Girl Who Says she Got Anorexia When she Felt Trapped Because her Parents Were Over-Protective and Too Restrictive

Here's a message from someone who says she feels as if she has no control over her life, as if while her friends were growing up and starting to do more adult things like going out as a group without parents, she wasn't allowed to. She thinks her family are over-protective of her. Up until she got anorexia, they wanted her to spend all her spare time working hard. They seemed to think time with her friends was a waste of time. Her parents obviously cared about her, and were behaving in the way they were because they wanted the best for her and were anxious for her well-being; but she felt miserable under such tight restrictions. She felt as if life was dreary with school all day and then homework all evening, and school stressed her out because one or two teachers were very critical and she got teased by a few people in her class. So life was just a drag.

It wasn't in her nature to confront her parents about how she wanted more freedom to relax and socialise with friends, so she just did what she was told. But she felt trapped. Stress made her not want to eat, and it came to be as if anorexia was one aspect of her life she could have independence over. It gave her a feeling of control. It was a way of standing up to her parents in at least one area of life, and rebelling against what they wanted. She didn't think of it like that until she really thought about it.

I think I'll respond by saying something like:

Being Over-Protected

My mum said she was over-protected when she was a child, and her dad was really strict and didn't like her going out to relax but wanted her to just discipline herself to do schoolwork. At least she got decent grades. But she was unhappy being over-protected. Her dad wouldn't even let her cross the road on her own till she was quite grown-up.

Crying

But then, maybe the reason he was so over-protective was because before she came along, he was married to someone else, and they had five children, and his wife and children all died in a tragedy. The war was on, and one night, they were all in the air raid shelter, when he decided to go back into the house to get the radio. He did, but while he was in the house, the air raid shelter took a direct hit from a bomb, and his wife and five children were all killed. He married again after a while, and had another five children. My mum was the oldest. So maybe he was trying to take special care of her.

Then again, she did have the opposite experience once. One day, when she was little, her grandfather took her and her two younger sisters to a big park several miles away from their home. They had a nice day out, but my mum got lost. Her grandpa couldn't find her, so he went home without her. When her parents asked why he didn't bring her home, he said, "I've brought the other two", as if that made it allright that he hadn't brought her. would you believe it! Smiling They went back and found her.

So maybe that's another reason her dad was over-protective of her.

But she didn't like it. It made her a bit anxious. When she was 16, she was allowed out with some friends to go to a big new year's eve celebration in a park. While she was there, someone in the crowd pinched her bottom. She was so scared that she came straight home again.

So being over-protected meant she didn't build up the confidence she needed, and made her more anxious about things than she needed to be.

Still, it's probably difficult for parents to get totally the right balance. I knew someone who was upset with his parents when he was a teenager because they made him come home quite early instead of letting him stay out till all hours with his friends. But then one day, he realised the difference was that his parents cared about him, and wanted to keep him out of trouble.

That's fair enough; but I think being over-protected can cause harm, because teenagers need more and more freedom to a certain extent, so they can get used to it, to prepare them for when they become independent, so when it happens, they know how to cope better.

And spending time with friends isn't just a waste of time; it gives people practice in communication skills, which can come in useful in a lot of careers.

Trying to be More Persuasive by Talking About Feelings

Unhappy

I don't know how well this would work with your parents, or whether you've already tried it, but I know confronting people can be less risky if the person doing the confronting talks about their feelings, rather than making it sound as if they're accusing the one they're confronting of things and blaming them. The best feelings to talk about are ones that might get you sympathy, because if people are concerned about your feelings, they're more likely to do what you want than they are if you say something that puts them on the defensive.

I don't suppose it always works. I mean, I went to a girls' school when I was 11, and right from when I first went there, several girls clubbed together against me and would tease me and say horrible things to each other about me and shut doors in my face and things like that. One day, I cried about it. There were only a few kids in the room at the time, but word must have got around pretty quickly, because immediately after that, all the bullying stopped. It was as if the air had just cleared. I've got a brother who's about 10 years younger than me. He went to a boys' school. He got teased a lot at first, especially because he used to throw tantrums when he was angry and some boys used to like to provoke him into one for fun. Several years later, me and my brother were talking about things that might stop school bullying. I told him what had happened at my school, and he laughed and said he didn't think that would work at a boys' school.

But anyway, I've read that in a lot of situations, explaining feelings can be a way of helping people understand what you want without you having to be confrontative. So, for example, some parents might listen more if someone said something like, "I know you've got my best interests at heart, but when you don't let me go out with a group of friends at weekends even in broad daylight, I feel sad, and I get anxious, because I feel as if I'm missing out on part of growing up" than they would if they said something angry. You might not like talking to your parents that way. Actually, I'd have felt uncomfortable talking to my parents like that myself. But maybe you'll be able to think of some variation of that that you feel happier saying.

I'm not suggesting you go into great detail about your feelings. When people do that it can sound like whingeing anyway. But just saying a little bit about feelings can help increase understanding between people.

Perhaps you could tell your parents they could help you by letting you get out with your friends more, because you think it would help prepare you for when you leave home in a few years' time - it would give you more confidence if you felt sure you could do more things on your own, and talking with friends would help you improve your communication skills, which will help you in the future.

Also, experts on stress say it's important to do things to relax and unwind. It's actually been found that in the workplace, if people are allowed a bit of time to have a bit of fun, they can actually work harder when they get back to work. So taking a break's good for you.

I expect you could think of other benefits. If your parents can be convinced they're helping you by letting you get out more, they might be more willing to let you have more freedom.

Taking Small Steps Towards More Independence

Suspicious

I've heard that some parents are over-protective and want to keep their children indoors because they're scared of them being attacked outside by paedophiles or other types of criminals. It's actually rare to get attacked by a paedophile who's a total stranger - most attack people they've befriended or relatives. So parents can be more frightened than they need to be about that. But I think lots of parents don't like letting their kids out because the roads are so busy and they're scared they'll have an accident. That's fair enough with little kids. But perhaps it goes on a bit long sometimes.

Still, being over-protected, just think of some of the things you're missing out on - pregnancy scares and unwanted pregnancies, liver-damaging drinking binges where you might do foolish things you regret later when you're drunk, and things like that. Sad really. Smiling

Still, you're probably missing out on nice things as well. But I wonder if there are things you could do that you'd really enjoy, that aren't as worrying for your parents as what you want to do now so it might be easier to persuade them to let you do them.

I mean, for example, are there some organisations you know of that are run by responsible adults for teenagers that they'd be happier for you to go to? You might still have a good time. My younger sister's daughter's in the guides, and she loves it. She's just been away for a week to guide camp. She's done that every year since she joined, so she's used to getting away from her mum for a while. Smiling She went away with a few of her friends on her own to a scout camp not long after that this year - there were scouts there, but they let other teenagers use the site as well. One night, it absolutely poured with rain, but that didn't stop them enjoying it. They had good fun.

Anyway, your parents might not let you do that kind of thing, but are there things you can think of that they might let you do, if you could persuade them they were good for you? My brother was in a couple of amateur drama groups when he was a teenager. Once, he played the back half of a pantomime cow. ... He did play other things as well while he was there. Smiling Both groups were run by responsible adults, and the group ended for the evening at a reasonable time. Do you think anything like that might interest you if you could find something like that, and do you think your parents would let you go to it? I mean, something like drama might increase your confidence, because performing in front of an audience at the end of all the rehearsals successfully might make you more confident that you'd be good at things like public speaking, so your parents might be persuaded that was an investment in your future career. And getting into the roles of other characters while having fun might help you relax, while making new friends might help you improve your communication skills. So there are all these worthy benefits of doing that kind of stuff that might persuade your parents things like that are worthwhile.

It's just a theory though. I don't know whether that kind of thing would really work. It might be worth thinking about though.

Being Criticized by Teachers at School

Unpleasant teacher

It really is about time teachers learned they can do more harm than good by being too critical! I had a twit of a cookery teacher at my school who would always be making snide comments. If she thought someone had made a bit of a mistake, one thing she liked to do was to say, "You're a clot. What are you?" And she'd only be happy if they replied that they were a clot. She did that to me once. I bet it made her feel good! Grinning I remember I shuffled backwards a couple of tiny steps once to open a cupboard door that had been beside my leg, and she criticized me for not walking the right way around, and actually told my class teacher, and who knows what other staff members, that I'd walked backwards twice around the room! At least it seemed that she had, because my class teacher seemed to have got the impression I'd done that. The cookery teacher was a twit! Smiling There were a couple of teachers at the school who I didn't think were fit to be teachers, like her. One of her favourite comments was, "If you go any slower, you'll be going in reverse!" She used to say that when one of us wasn't washing up near the end of the lesson speedily enough for her liking, and about things like that. Perhaps she'd have preferred we washed up less than thoroughly and left a bit of food on things. I mean I can see her point - if we'd been cooking cakes and the next class to come in cooked bacon risotto, what a delicious mixture cake crumbs and bacon would make. what a shame it would be to clean all the cake off and deprive them of such a mixture. Big grin Or perhaps she was just a bad-tempered thing. I gave up her lessons as soon as I could! A few years later, I was running one day and missed my footing and sprained my ankle. I could only hobble along slowly for a while after that. I heard her talking not far away from me soon after I'd sprained my ankle, and thought that if I met her, it might be fun to say, "Look! If I go any slower, I'll be going in reverse!" Smiling

She left the school not long after that, and a new cookery teacher arrived. I had a few lessons with her before I left the school. Things seemed strange, as if something was wrong: She didn't shout and insult people like the other one had. She was nice. It seemed odd to me, as if she couldn't be teaching it properly, like, "Surely this isn't the way to teach cookery. You can't know how to teach it the way it should be taught. Something's missing. You're not shouting and being insulting like cookery teachers should." Smiling

Anyway, some teachers could probably do with a bit of training in communication skills! My brother used to be late handing in his homework all the time. He was always getting detentions for that. He got such a reputation for it that one day he met a new teacher who asked who he was, and when he told him his name, the teacher gave him a look as if to say "Oh yes, I've already heard about you!" Grinning My brother must have been discussed in the staff room the first morning the teacher arrived! But there was one teacher who used to criticize my brother harshly, so he felt bad about himself. He used to get upset sometimes and say things like, "I'm just a piece of trash!" It didn't make him do any better at his homework. But then, after he'd left the school, I asked him if he'd ever send a child of his there and he said he would. I asked him whether he'd really want his child to have to put up with that teacher. And he said that although the teacher had been harsh, he had motivated him to work harder. Hmmm, that was easier to say from a distance! But perhaps it means my brother would have done even worse at school if it hadn't been for that teacher. Smiling

But anyway, I read something that talked about how compliments can get you what you want a lot better than criticism sometimes. That doesn't mean all criticism's bad, but criticism that just makes you feel bad and doesn't let you know anything about what the person wants you to do for the better is just silly. Imagine if you had a teacher called Mrs Temper. Here's what you might say to her if you were instructing her on what the thing I read about criticism said:

Unpleasant teacher

Mrs Temper, Here's a bit of information about criticism and encouragement you might find useful:

If you tell another person how you want them to behave, whether that's a child, your husband or another staff member at the school, or someone else, and they do the thing you want them to do, it can encourage them to do it some more if you compliment them for it. For instance, if your teenaged daughter came in from an evening out with her friends at the time you said you wanted her to be home by, for the first time in some time, you could say something like, "You've come in on time tonight; thank you very much", with pleasure in your voice. That would mean she'd be rewarded for her efforts to get in on time, so she'd be pleased, and encouraged to get in on time more often.

But often, what happens is that the parent says something like, "Well well; so you've actually managed to get in on time for once", in a voice thick with sarcasm. That would probably make your daughter not want to bother coming in on time in the future, because she might think, "Well, if I'm going to be criticised even when I do make the effort to come in on time, why bother?!"

Similarly, Mrs Temper, if you nag such a daughter to do her homework, or you nag us at school, if some of us finally do get down to doing something and you carry on in the nagging tone, it'll seem more like punishment to us - the less motivated of us will think, "If we're going to get criticized even when we do make an effort, why bother!" So if you see us working, and instead of at least complimenting the ones of us who are finally making the effort to work and anything we've done that is actually good, you just say something in a snide way like, "You haven't done much, have you!" or, "I don't think much of that!", some of us will be less likely to make an effort in future.

You might always say things like that and be under the impression that by doing that, you're giving your daughter and students a lot of encouragement to get on with it. But it will have felt more like a punishment, so some students won't see the point in bothering so much after that.

Thinking About the Future

People who tease other people at school can be just as ignorant in what they say.

There were some kids at my school who thought they were the cool crowd and that people who weren't like them just weren't cool. I went to university when I left school and found that things weren't like that at all. I wasn't looked down on because I wasn't in a cool set. There were lots of people who were very different from the people who thought of themselves as more sophisticated at my school, and a lot of them were much more friendly. Maybe when you leave home in a few years' time, things will be completely different and happier for you as well.

Happy being pregnant

Of course, if you recover from anorexia, life could be a whole lot better for you than it will be if you get more and more anorexic. One thing you might find helpful is imagining it's five years on into the future and you're writing to a friend, when you don't have anorexia any more. You could fantasise about things you enjoy and successes in life you might be achieving if you haven't got anorexia, thinking of what you could enjoy that you can't now. You could try adding more nice and interesting things to the fantasy every day. Things often change, so they might have changed a lot for you in five years and you might be enjoying yourself much more.

If the thought of being without anorexia makes you feel anxious, you could imagine a friend's with you who makes you feel more at ease.

If you like, you could also imagine it's five years on and you're writing a letter to a friend but you still have the anorexia. That could be quite a contrast with the other letter, since you might be writing about how you've got weaker and weaker and can't leave your parents' house because you're too ill, and all your friends have left the area so you hardly see anyone, and you're in pain from the effects of starvation, and depressed because your life isn't going anywhere. You could imagine a friend writing a letter to you about all the interesting things she's been doing, things you can't do, like getting a job and going out with friends as well, if you like.

Then you could get back to the nice fantasy, imagining your own life without anorexia, where you could do similar things.

Then you could fantasize about how nice it would feel after successfully taking the first gradual steps to breaking free from anorexia.


Notes

This article is written slightly differently to most articles. It comes with a very short fictional story about someone finding out information about anorexia and other such things, and gives the self-help information as if it's her talking to people on an Internet forum about what she's learned. Though the forum is fictional, The information given to the characters on it is all genuine, taken from real self-help books and stories about real people. The circumstances of the characters in the stories might not match yours, but you'll probably still get some good ideas from the information given to them.

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The Story

Confused

Susan has a friend, Alison, whose teenage daughter has had anorexia for a couple of years. Alison doesn't know what to do. Her daughter's recently left home to go to college, and Alison's worried that with no supervision, her daughter will get worse more quickly.

Susan really wants to do something to help, but doesn't know what to do, until she gets the idea to learn more about the illness and what can be done by reading some self-help books. She gets some from the library and starts reading them. She decides to join a couple of Internet forums for people with eating disorders to get some more insights, and to hopefully pick up some tips on recovery from other members, or to find out why they want to be anorexic. While she's there, she becomes concerned about the people there, and decides to let them know about the information she's found in the self-help books, and things she's learned about from other places.

She reads some of the messages and thinks about what to say.



The End


Note that if you choose to try out some or all of the recovery techniques described in this article, they may take practice before they begin to work.

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Disclaimer:
The articles are written in such a way as to convey the impression that they are not written by an expert, so as to make it clear that the advice should not be followed without question.

The author has a qualification endorsed by the Institute of Psychiatry and has led a group for people recovering from anxiety disorders and done other such things; yet she is not an expert on people's problems, and has simply taken information from books and articles that do come from people more expert in the field.

There is no guarantee that the solutions the people in the articles hope will help them will work for everybody, and you should consider yourself the best judge of whether to follow their example in trying them out.


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