Tuesday, September 6, 2011

What Happens When Mom Has an Eating Disorder?

Flight attendants have it right – and the advice is just as useful for those on a plane as well as off. “Remember to place the oxygen mask over your nose and mouth before assisting your child.” In other words, fail to take care of yourself and you won’t have what it takes for your kid. This is especially true for mothers with eating disorders. Anorexia is the most blatant form of self-neglect. Its theme is the refusal to meet the body’s most basic needs (for food) but it often entails the denial of other important needs (i.e. love, pleasure, intimate connection).
While the stereotype is that eating disorders are a current day affliction caused by media images, they’ve been around for centuries. Generations of women have suffered, but they were undiagnosed and untreated. Some wound up in mental hospitals or experienced chronic illness and early death from malnutrition or suicide. Those who were higher functioning got married and had kids.

When an eating disorder goes untreated for decades it becomes an entrenched and defining quality of one’s self-concept.
I’m the thin one.
I’m the one who resists the treats at the restaurant.
I’m the one who cooks for others but never succumbs to temptation.

The “pride” in being able to achieve these victories over the body’s needs is a substitute for self-worth. Like saccharine, its momentary sweetness has no real substance behind it.
Unfortunately, the older generation of moms had little awareness of how living on nicotine, caffeine, saccharine and adrenaline would affect their offspring. Their adult children often struggle with a deep and abiding sense of emptiness.
Olivia sits in my office, the daughter of one of these moms. “I’m grumpy,” she starts off one summer morning. “Actually, I’m hung over, as in ‘Food Hangover.’ Had dinner with Mom last night.”
A successful, attractive professional in her late 40’s, Olivia secretly binge eats whenever she spends time in the presence of her mother. That night before, Mom had come through town and taken Olivia out for dinner, ordering a side salad with no dressing and black coffee (“…always the damn black coffee!” Olivia fumes). Her mom excused herself several times to step outside for a cigarette. She looked with judgment and disdain as Olivia ordered dinner off the menu. By the time dessert arrived, Olivia was planning her post-dinner binge back at the house.
Olivia felt like her mother wore her anorexia like a badge of honor. During her childhood Olivia’s mother never ate dinner with the family. When they went on vacation, her mother would avoid eating all day, admonishing the kids, “You’re not hungry!” when they started asking for lunch around 2:00 p.m. Sometimes Olivia would discover her mom quietly eating a box of crackers late at night in the dark kitchen; she’d hide the box like it was heroin.
Because she was chronically hungry, Olivia’s mother was often irritable and short-tempered, blaming Olivia for being “overly dramatic” or “too needy,” a trait most loathed by someone with anorexia. Because her mother’s cup was empty, she perceived her daughter’s normal needs (for love, food, attention) as burdensome. Because Olivia was a bright, sensitive child, she could come to no other conclusion than that she was faulty, unlovable, too much, a disappointment. Despite her many friends, her professional success, and her delightful and effervescent personality, for 47 years Olivia has held firmly to this core belief.

Thankfully, today there is less shame and greater awareness about treating eating disorders. Moms who are suffering are seeking help.
Kerri, a mother of three, had become so depressed from her food rituals that she was not able to parent her kids, spending hours every day in her darkened room. She avoided family meals, then binged and purged when they were otherwise occupied. She sought therapy when she became frightened by her suicidal plans. She’d written the good-bye letter to her kids and staked out the bridge she was planning to drive off. But her eldest daughter was on the verge of puberty and starting to worry about her body image. This was Kerri’s wake-up call. She did not want to abandon her daughter at such a crucial stage. She remembered feeling emotionally neglected by her mom at 13 and believed that this contributed to her bulimia.
She called me for help, petrified to reveal her secret to her husband, but ready to break bulimia’s 30-year grip.
Kerri has worked hard in therapy these past two years. She is now fully engaged as a mother because she is trying to meet her needs by getting sleep, eating meals, exercising, taking medication for depression (and having hot dates with her husband!). She has meaningful discussions with her daughters about their changing bodies, saying the things that she wished her mother had told her at that age. Her kids now see her as a source of love and support rather than a source of pain.

Meanwhile on a summer morning, I try to help Olivia stop taking her mother’s inability to love her personally. Even as the Adult Olivia knows her mother has an untreated illness, the Kid Olivia still believes the faulty messages that her mother conveyed. So Olivia will need to fill the emptiness with real acts of love. She can nourish her body with rest and exercise and delicious meals (with no guilt). She can fill her heart with the love of her close friends. She can feed her soul by making a difference in the world.
Food is as essential as oxygen for our survival, but you never hear people feeling guilty for breathing too much, or making ridiculous statements such as: “Wow, you look great! Are you cutting back on oxygen lately?”

Maybe when a woman decides to become a mother, her doctor should say something like: “You are about to embark on an important journey. Please be sure to feed and nurture yourself before you attempt to nourish a child.”

Dina Zeckhausen is a nationally-known clinical psychologist and author who specializes in treating eating disorders and body image in both adults and adolescents. She is a weekly columnist for ShareWiK.com and www.mindfullivingnetwork.com.  You can visit her on the web at dinazeckhausen.com and MyEdin.org.


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