I’ve been working with people with and affected by Eating Disorders for the last 35 years. I started the work in the mid-1980’s, before there were any treatment centers devoted to working with this illness and its’ permutations. My experience over this time is that the Eating Disorders of Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder have morphed and changed right along with the Diagnostic Criteria from the Diagnostic and Statistical Manual (of the American Psychiatric Association) Volumes III through V.
What hasn’t changed is the impact these illnesses have on families and friends of the patients. In Rochester, NY, where I started working with this population, I was educated in Relational Cultural Theory. It was here I began to understand the challenges faced by patients, parents, families, loved ones and their treatment teams.
If we presuppose that when helping a patient we are all on the same team, the same “side”, then understanding how the disconnections from self and others becomes an essential part of healing. It is so easy to become “unplugged” or disconnected in current culture. We all do it, multiple times a day. We look down at our electronic device and we’re somewhere else. We don’t all sit together and talk, let alone eat meals together. We are so busy, too busy to prioritize “eating” let alone communicating (aka: listening and hearing each other). That is, until we have to, when a patient is in our office, program or home begging for help.
Disconnection of the patient from her/himself: The illness involves starvation which causes numbing, depression, increased anxiety, mood fluctuations, irritability and promotes all or nothing thinking. Bingeing and purging can dehydrate, distract, disorient and exhaust the patient. These create the disconnection of the patient from herself, breaking the normal “mind-body connection”.
Stay tune next week for part 2.
Ann F Flosdorf, LCSW, MAEd, CEDS
Clinical Director of Partial Hospital Program and Intensive Out-patient Program