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Written by a mother whose daughter suffers from an eating disorder, Anorexia and Bulimia Nervosa is a supportive, helpful guide for families of those with eating disorders. Framed by the personal story of Gráinne Smith and her daughter, the book describes the onset and symptoms of the two disorders, as well as the typical situations family and caregivers can expect on the long road to helping the sufferer to recover. Readers will learn about the effects on family life, in particular the common feelings of isolation and helplessness, and get strategies for coping and finding more information and assistance.
About the Author
Gráinne Smith has worked for several years on the Eating Disorder Association helpline as a volunteer, putting to good use her training and experience as a former Samaritan. During that time she has spoken to hundreds of carers and sufferers as well as to many professionals.
A founder member, now chairperson, of NEEDS Scotland (North East Eating Disorder Support) and a member of the Mental Health group that developed the Scottish Executive Health Department framework document for eating disorders services in Scotland, she has also taken part in Mental Health and Well-being Support Group visits to health boards and presented a petition on eating disorders to the Scottish Executive. She currently works to raise awareness of how poor mental health affects whole families while good mental health underpins physical well-being.
During a long career in primary education, including nine years as head teacher of Fyvie Nursery and Primary School, Aberdeenshire, she enjoyed working with whole families and children aged from 3 to 12. As a writer, Gráinne has had short stories and poems published in magazines and anthologies; while working with Grampian Region she helped write and present courses for teachers and head teachers; she has also written many educational materials including coordinating and contributing to the pack ‘‘Fyvie Castle – Its Life and Legends’’.
Read an Excerpt
Anorexia and Bulimia in the FamilyOne Parent's Practical Guide to Recovery
By Gráinne Smith
John Wiley & SonsISBN: 0-470-86161-4
My life was opening up, I had lots of friends and an improving social life, a job that gave a lot of satisfaction as well as hard work, and I began to plan for my own future ... Work abroad for a children's charity? Write full-time? Move house?
I felt I'd come through some very tough times (some day if you have a spare week or so, I'll tell you my life story!), but my horizons were expanding, growing and I was looking forward ... then Anorexia came, uninvited, to visit my home.
Just a few years ago in 1993 I was living alone - my daughter married, my son working in Glasgow. At 48, I was working full time at a high-profile, high-energy, high-stress job (primary head teacher). Having brought up my kids from an early age on one teacher's salary, for the first time in my life I was enjoying having some money at the end of a month and had bought one or two luxuries, total unnecessaries, trying hard to get over the Scots prudence that says Save.
Having survived various teenage traumas, both my children seemed happy with their respective life choices. I felt I'd put into practice my strong belief in teaching a mixture of rights, responsibilities and respect for others. From an early age they were both expected to take responsibility in keeping our home, andtheir own rooms in particular, reasonably clean and tidy (our views of "reasonably clean and tidy" often differed - which led to me keeping their bedroom doors shut rather than look at the clutter!!). Each week I listed the chores that had to be done and asked which they'd prefer to do ... in their rush to avoid the ones they hated, they volunteered for the ones they regarded a bit more favourably, at least taking a couple of chores off my shoulders. Despite a few grumbles, they saw the fairness of helping around the house, which made the environment better for all of us. From the time they could count, they helped set the table for meals and from 12 years onward they cooked a weekday meal once a week. As they also got to choose what that meal was, they seemed happy to learn to cook at the same time as making a valuable contribution to the running of the house. (Especially at the beginning, it did mean that sometimes we ate sausages and beans rather more often than I would have preferred ...)
Training our children to be able to cope in the Big Bad World out there is an important part of being a parent as well as loving them, and I thought I'd done an OK job in bringing up my children. OK. Not brilliant - I could think of several things I felt had been mistakes along the way, but I'd always loved them, demonstrated that love often with hugs and cuddles as well as bedtime stories, games and so on, encouraged them in their individual strengths, tried to help them with things they weren't so good at. If they did their best that was good enough.
My son seemed to grow through the teenage years as he had done everything else, with good humour (and an increase in his accustomed untidiness and lack of organization), but major rows with my daughter had been part of the picture at that stage, as she stayed out until 3 or 4 in the morning and refused to even look at homework, let alone do it. But those days were now past and she appeared happy in her marriage at 19 to the boy she'd gone out with since she was 13 (the reason she had wanted to stay out at night). Unfortunately, that marriage, so much looked forward to, was a very unhappy experience and two years later Jay asked to return home. Unknown to me, Anorexia and Bulimia also came to stay.
At that time, they were just words on the edge of my vocabulary, I had never heard the phrase "an eating disorder", so I did not recognize Anorexia or Bulimia when they entered my house. I look back in incredulity at my complete ignorance and at the very steep learning curve I faced. But that ignorance was definitely bliss ...
If you have picked up this book because you are a carer and have also met Anorexia and possibly Bulimia too in your home, I hope what I have written will be helpful - it is a summary of what I have learned the hard way since first meeting Anorexia and her pal. My heart and thoughts are with you on the long road.
If you are a sufferer, I know you will recognize the pain and misery inflicted by the illness, and hope you find the help you need to fight off the attentions of Anorexia and Bulimia.
If you are a professional who works with people who develop eating disorders, I hope you will read it with compassion for the carers who struggle to cope, as well as for sufferers who live in a dark, unhappy world.
And if simple curiosity has made you pick this book up, if you have never had personal experience of the devastating effects on family and friends as well as those who suffer from anorexia or bulimia nervosa, be thankful, very very thankful. And perhaps say a little prayer that whatever causes anorexia nervosa - despite hundreds of years of debate and research no one really knows - does not enter or affect your own family.
First introductions ...
In 1994 when my daughter asked if she could move back home, I agreed - but made a few extra house rules to go with those that had applied before she married. The new rules mainly concerned television: I prefer reading, music or radio. I am very choosy about programmes and will happily spend whole evenings without watching it. I knew my daughter liked the TV on as a companion. No matter how well behaved the children, working as I did in a school meant noise - bells, voices, feet. And constant communication. I had enjoyed the silence after work during my daughter's two-year marriage, so when she returned to live at home I said the TV should not go on after my return from work until I felt like it. She brought home a small set for her room - and we got along much better than we did in her teens! Having been responsible for organizing and running a house for two years Jay had developed more appreciation for the work involved and she was much happier and more willing to do a share of the housework than she ever had been before. After discussions, we settled on a split of chores. Since then Jay has faithfully hoovered the main rooms and cleaned the bathroom, taken her weekly turns whatever else was happening in life, at washing dishes (in our house, whoever cooks does not do dishes) and recycling.
She decided to diet, having put on a bit of weight during her marriage. She told me that, with her husband away a lot at work, she often nibbled in the evening. To my eye, she didn't need to, but Jay wasn't happy with her weight and felt it was important to be slimmer. Later that year she met an Interesting Man who felt she was an Interesting Woman. The relationship developed rapidly, and at weekends I rarely saw her as she waved an airy cheerio and disappeared with IM. Obviously happy, she glowed as she lost weight and exercised. She lost the weight she wanted to, enjoyed all the attention and was very flattered when she was asked to do some modelling. A very attractive youngster, Jay now looked absolutely stunning.
In spring 1995 I began to notice that the weight was still falling off and Jay was exercising even more. Each evening I could hear the exercise bike going in her room as she "cycled" miles and miles, then she did hundreds of sit-ups. Never a keen exerciser - walking the dog is quite enough! - I watched her dedication and stamina with amazement.
Over the next few months I suggested several times that the dieting had gone far enough, she really didn't need to lose any more. Each time I was dismissed as fussing. I never needed to complain about the TV being on - but the drone of the exercise bike in the ever-longer sessions was a constant irritation. When I complained, I got a very short answer.
Hindsight is a wonderful thing - these are classic symptoms of early anorexia. Would things have been different, would the course of the illness have been any shorter or taken a different course had I previously met Anorexia? I'll never know.
Anorexia moves in ...
In summer 1995 I looked forward to visiting my sister in France. The tickets were bought, my suitcase half-packed, when Jay told me that IM had "finished with her". There were no explanations and I didn't like to pry, Jay would tell me in her own time and when she was ready, as she always had in the past over what was happening in her life. But I could see how very unhappy she was. Jay assured me she would be fine in the fortnight I was away on holiday, not to worry, she would be working and that would take her mind off things. I should go, she knew how much I had looked forward to seeing my sister. As I hugged her goodbye at the airport I thought how thin she looked, thin rather than slim ...
... and two weeks later a walking skeleton met me. On one of the rare, really hot days in NE Scotland, Jay was dressed in cut-off shorts and a brief top and people were staring at her as we walked to the car. I had difficulty taking my eyes from the huge joints standing out from stick legs as she changed gear, the rings sliding up and down bony fingers on the steering wheel.
I thought she had cancer. When my father died many years before, he'd been very emaciated.
Remembering Jay's previous cross dismissal of my concerns, I hesitantly brought up my continuing worries about her weight. Perhaps, I said, perhaps she should go to the doctor ...
I've been to the doctor! He's done tests and there's nothing wrong with me!
Perhaps there are other tests ...
Oh Mum, do stop fussing!
Similar conversations took place over the next weeks. Sitting across from me at the table, Jay appeared to eat normally. We were both out working, so I didn't know exactly what she ate during the day - but I saw her making up a good packed lunch each night. Cancer ... what else could it be? Cancer can run in families, I knew that ... Cancer ... By now I was sick with worry and dread. Jay's face was all bone with skin stretched tight, eyes dark and staring, arms and legs like sticks, her hip bones stood out and clothes were hanging off her. She proudly told me one night that instead of the size 12 she'd worn at the time of her wedding, she was now a size 6 and could get into children's clothing. When I held her now, it was like holding a sack of bones; I became afraid to hug her properly for fear she would break.
September brought a visit from my friends, William and Jess. Jess waited until Jay had gone outside with William to smoke (another rule of the house!), then asked if Jay had seen a doctor ... Jess recognized all the signs, as she had a colleague who suffered from ... anorexia ...
The following week, the phone rang while we were sitting at the table. It was our GP, asking to speak to Jay. I handed the phone over and returned to eating. Then I saw Jay's face change. Later that evening she said she had something to tell me. During her marriage she had begun to have problems with food, eating out of boredom and unhappiness. Her husband had told her, among other things, that she was fat and ugly and that he'd slept with other women. When she found him with another girl was when she'd asked if she could come home. But her food problems had continued ... she'd started to diet, then found she could lose weight faster if she got rid of anything she swallowed ... and now she couldn't stop. The doctor had indeed done tests, just as Jay had told me, everything he could think of in fact. Eventually, he had diagnosed anorexia nervosa, with elements of bulimia. On the phone earlier that evening he'd told Jay that her potassium level was so low that, at 23, she was at serious risk of a heart attack. Sitting holding her that evening, we both wept, Jay with fear that she might die. My own fear of the same was mixed with helplessness and horror at my own blindness - how had Jay managed to get rid of all the food she'd eaten in front of me? How could I possibly not have known what she was doing? It was only with hindsight that I remembered that Jay with her fondness for all the TV soaps, left the table after our meal to go upstairs to her room to watch. I know you don't like the programme and you don't want the TV on just now anyway, do you Mum? I'll watch it upstairs ...
Now of course I know that both Anorexia and Bulimia are very clever at covering their activities, and giving plausible reasons for frequent visits to the bathroom.
Later, much later, a long way through the journey with the twin demons, my daughter told me that during my holiday in France with my sister, she had eaten nothing at all. Nothing. Drinking coffee had been her only sustenance. It was only when Dr Brooker said she was putting her life at risk by her eating behaviour, that she had begun to realize that the condition was serious. And she might die if she continued with the behaviour.
But Jay couldn't stop - Anorexia and Bulimia were firmly in control and the behaviour was compulsive.
Excerpted from Anorexia and Bulimia in the Family by Gráinne Smith Excerpted by permission.
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Table of Contents
About the author.
Foreword by Professor Janet Treasure.
3. Prepare for a long road.
4. Living with the volcano.
5. Horrible habits and ghastly games.
6. Family actions and reactions.
7. Control issues.
8. How bad can it get?
9. Can the family survive Anorexia?
10. You are not alone.
11. Read all about it!
12. Research – past and present.
13. Anorexia, Bulimia and self-esteem.
14. Anxious Annie, Soft Sue or Hard-hearted Hannah–the parents’ dilemma.
15. Tips, techniques and strategies.
16. Coming up for air – stress, distress and survival for carers.
17. Pathways to professionals.
18. End of the story . . . or rather, a new beginning . . . .
Family areas affected by anorexia and bulimia nervosa.
More carers’ conversations from the EDA helpline and meetings.
Addiction/compulsive behaviour – going down . . . coming up!
How to be a motivational carer.
Useful addresses, phone numbers and websites.