The Voice: News and Support Magazine for Eating Disorders by Talking EDs (Glasgow and West Eating Disorder Support Service)

The Voice

support and education magazine for eating disorders

FIRST EDITION

SEPTEMBER 2011

Editor and Designer: Alexandra O’Brien

No-Body’s Perfect

Eating Disorders in your Family

What is Recovery?

The Value of SupporT Groups

On Emotional Eating

Book Reviews SNAPSHOTS OF INSPIRaTION

Just Ask.... Poems

LETTER TO MY EATING DISORDER

Recovery Blog Male Eating Disorders Interview with an Eating Disorder Survivor

POSITIVE THOUGHTS on the bookshelf AND LOTS MORE....!

About

The Voice The Voice is a support and education magazine journal for eating disorders. It is a completely new magazine journal and this is the first edition. It has been compiled with no funding or finance whatsoever, and was created through the generosity of other people submitting their own articles and volunteers who took out time to help create this new magazine journal. To date, there is nothing like this in the UK and so we see The Voice as a new and innovative concept in the world of eating disorders. Our focus is pro-recovery and providing support and education that promotes challenging the eating disorder â&#x20AC;&#x2DC;voiceâ&#x20AC;&#x2122; and encouraging recovery on all levels. We hope to continue publishing future editions of this magazine journal and welcome submissions from far and wide. We also welcome potential funding sources as we would like to

2 | THE VOICE

make this magazine journal a significant UK eating disorders resource one day. When I first started my voluntary work with The Positive Steps Eating Disorder Support Group (Glasgow) I had the idea of writing a newsletter for group members and anyone else in the Glasgow community who might be interested in a small newsletter about eating disorders. I think the idea stemmed from lots of things - my own personal experience with an eating disorder which I had for 13 years (I am now 33 years old and my eating disorder started when a teenager); talking to group members; my own campaigning and interest in eating disorders; and my undergraduate and postgraduate training in psychology, stress counselling, clinical hypnotherapy, and other mental health voluntary work. One week, in the middle of June 2011, I placed a small

advert about this 'newsletter' on my official support group website (private), on the Facebook publicity page for the group and the websites for the Eating Disorder Activist Group (Scotland), Eating Disorders Network UK and Eating Disorders Activist Network. Within five minutes of placing these small posts asking for contributions towards the newsletter, I was bombarded with lots of requests from people who wanted to contribute - from the UK, the US and Australia.

for her help and support with this magazine and her great article on the television programme ‘Supersize Vs Superskinny’. Rachel encouraged me to continue writing The Voice even when things seemed too much and never-ending – her strength and dedication to eating disorders is wonderful and she always remains a great inspiration to me. Thank you also to the volunteers who help me with The Positive Steps Eating Disorder Support Group (Glasgow) and their enthusiasm, support and encouragement during this time. It So, the small 'newsletter' I initially is great to have their help with the imagined has now turned into a support group and I thank them 'magazine journal' and so I have for all their hard work. now produced the first 'magazine journal ' for eating disorders in the I would also like to give a speUK: a support and education mag- cial thanks to Paul Robb and his azine journal for eating disorders. help, support and encouragement I decided to call it ‘The Voice’ be- throughout the writing and design cause that was the name that came of this magazine. to me immediately, and I think it represents eating disorders in The Voice also includes some of many ways. It has taken a lot of my own work and I hope what I work to produce this, and I would have written is valuable to some not have been able to do it without of our readers. I know what is like all the fantastic submissions that I to have an eating disorder and received – many of which I could other significant mental health not include, simply, because there problems, and I feel that I underwas just not enough space. I would stand what people may be going also like to thank Rachel Lloyd, through. I think that is one reason who is a BEAT Group Facilitator why the support group I organand eating disorders campaigner, ise is a success – it is organised

3 | THE VOICE

by people who understand what it is like to have food and eating difficulties and many other mental health issues. I always feel the best support comes from those who have had similar experiences. Many of you will know what it’s like to finally pluck up the courage and visit your doctor or therapist about your food and eating problems, only to be met by a lack of interest, empathy or understanding. Blank faces who either don’t understand how to help or read it from an outdated textbook. I am sure many of you recognise this scenario. For me, help, support and education for eating disorders should come from those who really understand – who have been there and won the battle.

zine’s email address below. We welcome anything and everything, provided it does not advocate or glamorise eating disorders. The purpose of this magazine journal is to increase awareness of eating disorders, provide support and education and promote self-help and recovery. Anything goes really, as we want it to be interesting and appeal to a large audience. We are keen to hear from more males with eating disorders as we feel strongly about helping to raise awareness of male eating disorders. We want to show that males do experience eating disorders too, that they can get help and support and that they are not alone. We welcome your comments and thoughts about the magazine: did you like it, dislike it, what would you improve, what would you like to see in future editions. Please feel free to email your comments, submissions and funding suggestions to us at: thevoicemagazine@ymail.com

I do hope that you enjoy reading this magazine journal. I feel it covers a range of topics and that there is something for everyone. As I mentioned above, we would like the opportunity to develop this initiative in the future, so we would be looking for potential funding or financial assistance and are keen to speak with anyone who might A special thanks to the following: be interested in future projects. Dr Paul Robb Rachel Lloyd Anyone who would like to contrib- Lora Owens ute to future editions, please feel Mhairi McDonald free to contact me on the maga- Klaudia Suchorab

4 | THE VOICE

David Carmichael Sarah McKee Patricia O’Brien Alexander O’Brien Helen Winters University of Strathclyde A special thanks also to everyone who submitted their work (published and unpublished) and to everyone who believed in this project and who demonstrated faith and interest in what we were hoping to achieve. Thank you to everyone involved – your support means such a lot to me and I am truly grateful to everyone who has had a part to play in this magazine journal. Alexandra O’Brien (Editor) Dr Paul Robb (Editorial Assistant)

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About The Voice My Journey To Freedom Letter to My Eating Disorder On Emotions and Purging A Voice Deep Down Value of Life Experience in Treating Eating Disorders

4-7 Book Review: Bodies 8-12 Thoughts on My Eating Disorder 13 Interview with an Eating 14-20 Disorder Survivor 21 Snapshot of Inspiration 22-24 What is Recovery?

48-49 50-51

52-58

59 60-68

Tips for Recovery

69-74 75-79

Supersize Vs Superskinnny

Eating Disorder in Your 26-35 Family?

Poem

36-38 No-Bodyâ&#x20AC;&#x2122;s Perfect

80-91

Strathclyde Telegraph: Support Groups

39-42 The Pyramid of Peace

92-95

A Snapshot of Inspiration

Just Ask Waiting Rooms

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A Happy Thought Journal

96-101

Value of Support Groups

102-119

43-46 47

Tips: Support Groups

120-121

Introduction to Male Eating Disorders

122-125

Male Eating Disorders

126-130

Jamie’s Story

131-135

On The Bookshelf: Males

136-137

Hey Skinny!

137-141

Jamie’s Tips: What Worked 142-143 For Me Positive Thoughts

144-147

On The Bookshelf: All Eating Disorders

148-151

News Bites

152-153

C O N T E N T S 7 | THE VOICE

my journey to freedom by Kasia Laviers Kasia Laviers attends The Positive Steps Eating Disorder Support Group (Glasgow) on a regular basis, but not because she has an eating disorder. You see, Kasia has recovered from bulimia and now wants to give hope, support and encouragement to others who are struggling with all forms of eating disorder. Kasia experienced bulimia for 5 years and is now fully recovered from her eating disorder. She attends the support group to show fellow members that recovery IS possible and changes CAN be made over time. She has been very kind enough to allow us to include instalments of her ‘recovery blog’ here. We will include instalments of her Journey to Freedom in each edition of this magazine, although her whole story can be found at her Blogspot: ajourneythroughbulimia.blogspot.com for those of you who can’t wait to find out what happens!

Five years of my life were totally ruled by bulimia my biggest, darkest secret that I fed, looked after and protected passionately. I really thought I would never regain control over my body, mind and life... But I HAVE, and I want to share my story with you just because you may relate to it, because you may find something here that may help you to change, because it may give you hope that you can improve too... and I believe you CAN.

8 | THE VOICE

Beginning.... When does an eating disorder start? Does it start with the first bar of chocolate wolfed down secretly because something did not go the way we wanted.... Does it start with refusing dinner just to feel more attractive and confident? Or maybe it starts before we even remember, with a dysfunctional family, lack of love and affection and giant pressure to fit in and feel accepted? Everyone of us suffering from an eating disorder has a different story. We all are wonderful individuals with our worries, insecurities and huge concerns that mean nothing to others but a world to us. We all have our battles, trying to make sense of everything around us, and desperately searching for our own place in the world, for our own meaning. Usually, we are oversensitive, overambitious and overcritical towards ourselves with a huge luggage of unresolved issues and, at some point in our lives, food becomes a comfort that at least, for a while allows us to forget about everything else.... I've been there. Five years of my life were totally ruled by my biggest, darkest secret, that I cultivated, looked after and protected passionately. At the beginning I loved my eating disorder but my love affair with bulimia quickly turned into a nightmare and there was no help, as I was too ashamed to share my tragedy with others. I really thought I would never regain control over my body, mind and life... But I HAVE, and I want to share my story with you just because you may relate to it, because you may find something here that may help you to change, because it may give you hope that you can improve too... and I believe you CAN. 9 | THE VOICE

Programmed to fail....? I believe my bulimia didn’t just appear out of the blue... I feel it was brewing throughout my life, getting ready to pounce at my weakest point. I feel my childhood ‘made’ me eating-disorder-prone and I feel with a different past, I could have avoided my five years of self destruction. I know I was luckier that many: I had roof over my head, food, education, but dad’s drinking problems affected family security, stability, peace, love, affection and quality time - all the things I wanted and needed most. Alcohol affected every aspect of our family life and I spend my entire childhood day dreaming about a perfect family and a better life. I grew up too quickly.... always the peacemaker trying to make everybody happy.... struggling with my littlebig problems but not wanting to worry my mum as she had enough on her plate. Worrying about everything made me insecure, closed up, overcritical towards myself and my body – I was covering myself up most of my childhood and teenage years - avoiding relationships, avoiding getting closer to people - at the same time crying out inside for a hug, love and some affection. I was a perfectionist, always seeing room for improvement. Although my body image was distorted, at that time, at least, I could still eat like a normal human being. Even though, at that time I didn’t even know that bulimia existed, I was already perfect material for an eating disorder to come and take over my life.

10 | THE VOICE

My weakest point.... Although my less than perfect childhood affected me in many ways, at the same time it made me peculiarly brave and determined. At the age of 22, I decided to leave my country and start a new life in London. I came from a little village right into a heart of one of the biggest cities in the world. It was scary but exciting. I was really lucky to get a job as an au-pair almost straight away so at least I didn’t have to worry about food and a roof over my head. At that time, I would never expect that the luxury of having an abundance of food would turn into my worst nightmare. Although, I wouldn't admit it to myself at that time, that radical change in my life affected me more than I expected. At that time, I was telling myself that everything was great, that I was doing well and life was just fantastic. Now, reflecting back on everything, I allow myself to admit that things weren't as great as I wanted them to be. I missed my family, I didn't have friends, I was anxious about the future and lived under one roof with complete strangers with whom I couldn’t even communicate properly with because of my poor English. There was also plenty of tension because of their marriage falling apart. I suppose the worst bit was the fact that I was too proud to admit these things to myself so I couldn’t talk to anybody about my loneliness, anxiety and insecurity. I would never tell my family about my true feelings because I didn’t want them to worry about me. As usual I was putting on a brave happy face just to keep everybody calm and happy.

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On the top of everything, my distorted body image was causing me big trouble, especially whilst witnessing all the fashion and glam of London. I just didn't like the way I was built and as the majority of young girls are, I was scared of getting fat. That was my weakest point. All these things were affecting me in many ways and I just didn't know how to make myself feel better. So naturally I turned to food. Unfortunately, when I discovered that food was giving me comfort and pleasure, the fear of putting on weight immediately would cause even more anxiety and negative feelings. To make things worse, I started putting on weight so I started to feel guilty every time I ate. The pleasure of eating was quickly followed by guilt and anxiety about getting fat... Despite all this, the high I was getting from eating was allowing me to forget about my loneliness and insecurities so I would want to eat more and more… To be continued in the next edition of ‘The Voice’..... A big thank you to Kasia Laviers for sharing her story towards recovery with us. This story will be published in instalments, and we will include more instalments in the next edition of ‘The Voice’. However, if you can’t wait until then for the rest of the story, it can be found at Kasia’s Blogspot, by following this link: ajourneythroughbulimia.blogspot.com

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Dear You,

LETTER TO MY EATING DISODER

It’s been a while. Can’t say I missed You at all. So good You are not around. I still remember the first time You came over. Love from the first sight. You brought fun, pleasure, happiness, freedom, guilt free indulgence…. so liberating… But good things never last long, do they? You showed your true face…. your angry colours.. I thought You loved me too…. I thought You cared.... But You just wanted another slave… how could You be so cruel... Your constant attention seeking destroyed my strength and self-control....You ruled my world… You didn’t care that I was getting sick, that my body was giving up…. You loved the look of teeth marks on my hand. I thought I was lost forever. I hated You so much…. When You had me on my knees You thought You had won… But You were wrong my dear....I was stronger than You thought.... I tricked You. I prayed for the strength to stand up and fight – and my prayers were answered…. The sun started to shine again.... Even though You managed to bring some stormy clouds many times, You knew You were losing.... Our love/hate affair was over. And You know what? Don’t think you could just steal 5 years of my life without paying any price.. I can laugh in Your face now because You gave me experience and tools for recovery, and I can assure You that I will use these tools to battle You over and over again in other people’s lives. Not Yours Anymore,

LITTLEBIGBEAR

(Written by Kasia Laviers who has recovered from an eating disorder) 13 | THE VOICE

On Emotions and Purging.... By Rachel Nolan

The

following is a response to a question asked today on the

forum

frequent.

‘‘Does anybody else’’, (the poster wanted to know) ‘‘experience ‘extreme emotions’ after purging?’’ She described them as both crazy and scary, and I really, really knew what she meant.

know that any conversation about the details of an eating

disorder

can

rattling

for

people.

Please,

to read this article, remember that recovery

you

MUST

choose be your

orientation, and hopefully this article can be a tool in your recovery if you apply its suggestions.

you have an urge,

than just being a collection of words

some of which are

this article has some ideas what to do with them.... rather pretty ugly.

also know that not everyone struggles with purging, but it

has been the most pervasive part of my eating disorder, so viewing it this way has been very helpful to me.

hope that

this little rant about my ideas about emotions might be helpful to others.

14 | THE VOICE

Finally, I’d

like to apologise for some profanity.

to talk in detail about eating disorders without it. is not too offensive.

So,

in reply to the poster,

can’t seem

hope it

said this:

The last time I purged, which thankfully was a while ago and isolated at that, I totally had this experience. It’s been kind of illuminating to observe how this plays out, how it really affects me, how I really am in relation to it, now that it is not a part of my normal life. And yes: while in retrospect my emotions were rising beforehand, after purging everything seemed to go to shit. I was having horrifying thoughts and the emotions were hellish. I couldn’t even tell you what I was feeling. Shame? No. Guilt? No. Sadness? No. Terror? No. Grief? No. Anger? No. What the hell? All of these things and none. A scary, crazy experience of emotions, just like you said. Here’s what I make of it.

Taking

an action like purging comes when you can’t deal with something emotionally overwhelming

Now, I

would argue with myself on this point, so you don’t

need to: erm, it’s not about emotions, it’s about the desire to get the food out! emotions,

just that

It’s

I don’t even I needed to

about physical relief!

know what

It’s

not about

was feeling before purging,

purge, it was after purging that emo-

tionally the whole bloody universe fell on top of me!

Right. Ok,

cature of the thoughts to see that in got to do with emotions. they’ve

got

[very] fact, of

well possibly it only takes that

some

weird

Nobody

emotional

Right?

slight cari-

course it’s

throws up their food unless shit

going

on.

Don’t

fall

15 | THE VOICE

for that.

it feels like it’s not about the emotions, it’s not

because it really is

‘just

about physical relief’ or whatever,

it’s because you’re not in touch with your emotions, because somewhere, are

mechanistically,

choosing,

though

with them.

you

are

probably

not

Maybe you feel self, I often, even most of

shutting

consciously,

like you can’t.

down,

them

not

Speaking

you deal

for my-

the time, really truly wouldn’t find

myself to be feeling overwhelming emotions before having and purge.

This isn’t because it wasn’t about emotions. It’s because it was. acting

The

thing is,

urge

I’m

coming at all of this with the idea that we

want not to be purging at all, right? of approaching this response

that’s how

I’m

kind

it’s useful to note this experi-

ence of a hellish emotional state post-purging, and it’s only

BE purging. But it’s hardly enough to say “don’t purge”. What I mean is, embedded in this discussion topic IS what I believe can be one of the most helpful possible tools to get you to stop purging. To not to have purging be a part of your life. To bring you to life as a person who does not purge. I don’t purge. It’s bloody awesome. Here’s how: useful if the end idea is to not

this point,

day, on

I average,

still have an urge to purge probably every to varying degrees

think about how long

that behaviour.

When I

16 | THE VOICE

which makes sense when

was sick and how long

relied on

have an urge, it usually presents itself

as the offer of relief. training myself to

No emotional attachment. So I am NOTICE that. To wheel around and STARE

at it.

Not

ignore it

not just have that urge.” hello urge.

my emotions.

You

“no - to

not say

want to know what

I’ll

here’s my theory.

Oh,

need to check in on

the last thing during

But

that

want to do

urge

urgency

purge. feel,

“don’t

stop and think

your

you

about

emotions,

ACT! NOW!” - I really don’t trust that. Do you? It sounds awfully deceitful and I do not like to be deceived. It is worth it got to

to is

actually

situation.

am really feeling.

This

so did

admit, that tends to be

what it takes to get at the truth.

And

look at it squarely:

are a reminder that

The idea is to then figure out what I am (or what you are) feeling. Most often it’s stress, or anxiety. At this point in my recovery that usually isn’t about food, it’s about moving or relationships or something. Or it could be shame or guilt about something I did or something someone said. Or it could be anger. Or a feeling of helplessness and despair. All of these emotions - any or all or some - are what I might find if I go looking for them, “triggered”, by my urge, to stop and pay attention to what I’m actually feeling.

urge, fuck you,

figure

out

true

about

Especially

is just me talking,

what the

if that is

don’t actually

know if other people have this experience, but over the last

months or so

of this all.

don’t

am starting to think

am making some sense

think that if you do face those emotions, before

purging

and/or just on a regular basis, period

- I

you

get quite the same experience as that chaotic hell

think

17 | THE VOICE

you feel post-purging.

and those, you can deal be painful, but they are and ride them out.

“true emotions”, with. They won’t kill you. They might your emotions, and you can feel them think you get the

Purging is a release, physiologically and emotionally. And to me, it seems to unlock the blockage that is keeping ALL the emotions at bay, and so it does feel like a relief, only it’s totally chaotic and also you’ve just “messed up” by purging so there’s all this guilt or shame or fear or confusion from THAT thrown in to the flood of pre-existing emotions you’ve just unleashed by purging. It’s an avoidant way of dealing with emotions, I think. It’s something that we turn to when we kind of think it’s a “given” that we can’t handle whatever we’re being faced with in our actual lives. Instead we turn to this crazy and damaging act that consumes us, distracts us, and deeply, deeply affects us. The emotions that buffet you around when you purge are hard to make sense of because you haven’t gone looking for them with compassion and care. They’re

unwieldy and unmanageable, they’re emotions you have

already

communicated

yourself

that

you

can’t

handle

that’s why you turned to a self-destructive act instead. is a quality of emotion that,

This

believe, is different from the

emotions themselves, if only they didn’t get messed up by the behaviours order

and

ideas

about

“cope”. Those

ourselves

behaviours

confusing chaos of emotion.

And I

that

make

we it

engage

unintelligible,

don’t know about you, but

that’s so overwhelming it totally feeds itself, and

18 | THE VOICE

in,

become

more convinced of despair, and live like this.

And

really do think, wow,

can’t

that’s not a pleasant avenue of thought.

I agree with you that after purging there is an emotional shit

show.

“high” happens if avoidant. Because um,

think the

be emotionally

you are still managing to

let’s face it, you’re leav-

ing something out of the account if you just forced yourself to vomit and you don’t feel a little upset about that.

But I don’t have to live like that. Neither do you. WHAT I SUGGEST IS IF YOU TRY TO MAKE THE URGE TO PURGE A BRIGHT FLASHING INDICATOR, ‘I NEED TO CHECK IN ON MY EMOTIONS’. YOU CAN AVOID THAT HELL AND YOU CAN MANAGE THE URGE. YOU END UP “VALIDATING” YOURSELF, IF YOU GO IN SEARCH OF YOUR EMOTIONS. IF YOU DO IT COMPASSIONATELY, YOU CAN FIND THAT YOU MIGHT BE FEELING FEAR, SHAME, GUILT, SORROW, ANGER OR WHATEVER, AND EVEN THOUGH IT’S AWFUL, IT’S KIND OF MANAGEABLE. UNDERSTANDABLE.

After

you figure out what you’re feeling,

you have to deal with it compassionately express it somehow.

write about it,

it’s too massive for that, go ahead

and use methods like putting ice on your face or something.

I’ve

done that and been grateful

did.

And I think that if you do this, consistently, you won’t have a big evil emotional spiral that demolishes you, and urges will be more and more manageable, too. 19 | THE VOICE

Long

answer!

But

that’s what

got.

Sometimes it’s really easy to find the emotions because they’re not even that shut down. For instance, I felt fear and revulsion after the results of the Canadian election, as well as anger and guilt and grief, and I totally had an urge to throw up. I

realised

just needed to deal with all those emotions, and

it was quite easy.

Also

one day recently something triggered

one of my core beliefs and urge to purge.

realised

felt overwhelming shame, and an

just had to deal with the shame

in an accepting way and it would pass.

I hope this doesn’t seem tangential. It really is my response to the issue of that crazy emotional experience post-purging, and I hope maybe it helps you/ somebody get saved from that experience in the future.

20 | THE VOICE

A Voice Deep Down A voice deep down A drumming of anger, An order to obey, bowing down, Or stand rigid righteous for punishment, Is it me? What is it? Am I going mad? A weak whisper in the beginning, Barred behind a wall by rationality, Time bonds the ends, Pride for control pushes through the crumbling wall, The voice is not an ‘it’ it’s you, Denial + refusal = an ongoing tunnel, Years down the winding line, It weakens, tears in hope of survival for happiness, A journey of heart, head and back breaking relapses, Can you fight the shrieking insults? Can you find beauty? Hope rushes through the wind, Through every particle, Harmony blocks the unsettling dialect, Beauty is not a measure of worthiness, It’s your soul, voice and strength of mind, Life is unfair, not easy, Death is carefree, A quick fix, No escape from complications, Peace cannot be obtained without amending the past, Repression ensure psychosis, Only deciphered through a lengthy natter. Anonymous

21 | THE VOICE

Recognising the Value of L Eating My driving force in writing ‘ A Girl Called Tim- Escape from an Eating Disorder Hell’, apart from standing tall and showing my eating disorder that I was no longer its captive – that I was free – was the desire to connect with and inspire one person to recover. If I helped to ease the torment and improve the quality of life of at least one person, I felt my own suffering would seem worthwhile. My wish was to let others know they were not alone, and to raise awareness so they would not suffer as long as me. In the few months since ‘A Girl Called Tim‘s’ release, the reader response has been truly heartening. Women and men across the spectrum, from age 20 to age 80, are sharing their thoughts and feelings and describing their experience, often identifying strongly with mine. The result is a warm, fuzzy feeling; we all feel less alone; we feel empowered; we feel understood; we feel okay; and we definitely feel we want to live another 22 | THE VOICE

day. My eating disorder journey began in 1962, at age 11. I was 55 when I reclaimed my identity. Five years on I continue to embrace every day, like I cannot get enough hours in each one, in my joyous bid to catch up on life. I tell my four beautiful children (now in their thirties) that I am ‘twenty-eight years old’ and they smile understandingly; they are happy for me. Life is not easy for children when their parent has an eating disorder. I feel truly blessed that my children’s father, George, is stable, secure and safe, a truly wonderful man. He was the anchor for our children when my ED ran rampant in my life and in their life as well. The effect on family members when a loved one has an eating disorder has become recognised only in recent times. Everyone is affected. The eating disorder sees to that. The love of the family, coupled with education and coping skills, are vital tools in isolating and conquering the illness.

Life Experience in Treating Disorders By June Alexander I grew up in a time when little was known about Anorexia, and Bulimia did not even have a name. Thanks to passionate researchers, dedicated clinicians and devoted advocates, there is greater awareness today. The illness itself, however, remains extremely scary for families suddenly confronted with an eating disorder in their home, and remains challenging for clinicians. An unexpected but very welcome outcome of A Girl Called Tim is the growing the interest by health professionals. While the cause of eating disorders remains elusive, there is increasing evidence that collaboration of all involved – people living with an eating disorder, their loved ones, and carers, the clinicians, the researcher – is vital. Eating disorders are brilliant at isolating, dividing and conquering lives and relationships. We have to be more brilliant, and outsmart the illness – to save lives and relationships. It gets back to that one word: collaboration. We all have a role to play; we each have a purpose; by respecting each oth-

er, and listening, we move forward. ‘A Girl Called Tim’ carries a strong message that recovery is possible at every age. That a growing number of clinicians, as well as people living with the eating disorder, are recognising this, as a giant step forward. Early intervention with Family-Based Treatment was not around when I developed Anorexia. Clearly, if health professionals had given up on me, I would not be here to tell my story. Never, ever give up! Reach out, communicate, share with people you trust and who understand your illness. An important tool in recovery is knowing when to reach out for help. With practice, and the development of self-awareness, this skill can be acquired. Accomplishing this challenge was a crucial step in gaining freedom from my illness as it enabled me to defuse the eating disorder’s triggers before they went off. I had been living with my eating disorder for 23 | THE VOICE

more than 30 years when a wonderful therapist, Belinda Dalton, suggested I try to separate the thoughts that belonged to the real me, from those that belonged to my eating disorder. Belinda was one of my team of wonderfully patient health professionals who did not give up on me. Eight years passed while I learnt to identify which thoughts were mine, and which belonged to ‘ED’, and to acquire the skill to intercept and defuse those ‘ED’ thoughts before they translated into action. Another of Belinda’s gems of wisdom was: ‘Take care of your feelings, and food will take care of itself’. For decades I had automatically turned to food thoughts to cope with anxiety. I had used food to numb painful feelings instead of dealing with them. Learning to attend to feelings is another part of our recovery journey. A support team is essential. Reaching out takes courage as the eating disorder likes to isolate us from all who care about us. I am glad that today the opportunity exists for us to communicate at any time of the day or night on the Internet with friends around the world who can support and empower us. Among the many wonderful women I have ‘met on the ‘Net’ 24 | THE VOICE

since gaining my wings five years ago is PJ, a brave and determined mother who is on her path to freedom and inspires me with her blog. Love your self, and know that you can be free, too.

June Alexander first experienced an eating disorder at age 11. Now, aged 60, and after a 44 year battle with an eating disorder, she is now free from the illness. In 2006, after a long career in journalism, June turned her attention to researching eating disorders and writing books on the subject. June is author of ‘A Girl Called Tim - Escape from an Eating Disorder Hell’, ‘My Kid Is Back Empowering Parents to Beat Anorexia Nervosa’, and is co-editor with Professor Janet Treasure of ‘A Collaborative Approach to Eating Disorders’. The full article and further information can be found by visiting June’s website: www.junealexander.com

A SNAPSHOT......

of inspiration

TODAY IS IMPORTANT A tree as big around you starts with a small seed; a thousand-mile journey starts with one small step. You are where your thoughts and actions during the last few years have brought you. Whatever you will be experiencing in your next ten or twenty years will be influenced by what you do today. Your friends, your family, your job, your bank balance, where you will be living, all these things are being shaped by what you choose to do. Life is a building process. What you do today affects what you will have tomorrow. Life doesn’t happen on twenty-four hour water-tight compartments. Today’s effort creates tomorrow’s results. Whether you eliminate a nasty habit, whether you spend an hour with your family, whether you set some goals, whether you save or spend, whether you exercise your body, whether you stretch your mind – your decision makes the difference. The ignorant never see it. Astute people know it. What we do today IS important. You can get away with being casual and careless for a while but, sooner or later, things will catch up with you. Leave your bills unpaid, your work undone and your problems to everyone else and you manage for a while. Then one day the walls fall in and you wonder why there is no fun in your work, no money in the bank and nobody is very friendly anymore. It is life reminding you that one day plus another has an accumulative effect. Wherever you are, it is the place to start. The effort you expend today does make a difference.

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Supersize Vs Superskinny Helpful or Hindering? By Rachael Lloyd

Why would a show produced to help those

Before this, they are measured and weighed – the programme with eating disorders and eating distress informs the viewer of each paractually be the one thing that triggers suf- ticipant’s weight and BMI measurements. Both participants are ferers further and actually be a contribut- then shown - via a large transing factor to guilt, self-hatred, and com- parent tube - what they eat in a week. Of course, the difference is petition for those who view it? Rachel Jane outstanding. Viewers are inLloyd investigates what viewers of the show formed of the total calories that each participant eats in a week, think. and the programme describes, in detail, what they do actually eat.

Supersize Vs Superskinny is a As the programme progresses, documentary shown in the UK on Channel 4. Briefly, the programme involves a “supersize” person who is usually clinically obese (male or female), and a “superskinny” person who is usually incredibly underweight (male or female). The programme opens by giving some background information on both participants and then stripping them down to their underwear. Both participants then meet each other in their underwear.

26 | THE VOICE

both participants are asked to “swap” their diets. As they grapple with the changes in diet, Dr Christian Jessen uses shock tactics to show both participants what they are doing to themselves with regards to their lack or overlevel of intake. The middle of the programme introduces dietician Ursula Philpot, and a collection of eating disorder sufferers. Emaciated images of the eating disorder sufferers are shown, and as an audience

we are to be shocked by just how thin some of these sufferers really are. The idea behind this section, is to show Philpot, over the course of the programme series, confronting various aspects of the eating disordered behaviours that the sufferers actually struggle with. The show concludes with each participant grinning happily at the magical changes that took place over a handful of days. Three months later, we remeet the two participants who ‘swapped’ diets at the top of the programme: freshly made-over to meet Jessen at the “feeding clinic” in awe of their newly changed lives and the weight gain or loss they have achieved by following their meal plans. It is not for me to judge whether this is realistic, however, from the viewpoint of the viewers that we surveyed, this part of the programme certainly needs consideration. In response to the significant number of comments made by viewers of the programme, primarily highlighting the negative impact of the programme, Alexandra O’Brien compiled a series of questions directed towards viewers of the programme. Myself and Alexandra O’Brien are both sup-

port group facilitators and my group is affiliated with BEAT (the national charity for eating disorders in the UK). My Manchesterbased group, H.O.P.E (Hold Onto Power Everyday) and Alexandra’s group, The Positive Steps Eating Disorder Support Group (Glasgow), come face-face, daily, with those who suffer with eating distress. A number of viewers of the programme wished to express their concerns. Some of these viewers attend our (and other) self-help groups, others are in recovery and some are Beat Young Ambassadors. In response to this demand, Alexandra compiled a number of questions, designed to deduce some of the thoughts and feelings held by viewers of this programme. Myself and Alexandra both feel that, given the responses we collected, crucial changes do need to be made to the programme before the next series is aired. Whilst we both appreciate and realise, as do viewers, that those who are vulnerable to eating disorders, who currently experience an eating disorder, or who are in recovery from an eating disorder, cannot be protected from anything that could potentially trigger them, we feel that care needs to be taken

27 | THE VOICE

and that the following viewer re- aspects to the show that viewsponses are considered before ers felt were helpful, or that had further programmes are aired. been improved from previous series. I will then try to reason with As a recovered Anorexic, and our respondents and the producsomeone who works, on a daily ers of the show on the best move basis, with sufferers of eating forward and how to improve the disorders, I was horrified by just programme if it is to continue and how distressing, upsetting and to NOT cause the level of distress triggering the programme was that it has so far. for certain people. Given that the show is about education, health Responses from viewers were and awareness, it seems to be mixed. Some commented that the having completely the opposite ef- show was incredibly interesting fect on many viewers. because it was a subject personal to them and that it provided useMost concerning is the fact that ful and practical advice. The show most viewers watch it because it is seen to be a good education“feeds” their eating disorder. This al show that; ‘teaches people the about is perhaps something few can understand or relate to, but is a real the risks of extreme dieting’. Some comfactor when it comes to managing mented that, in the current sepotential triggers for those who ries, ‘the focus on health is a lot better’. are trying to recover or manage The most interesting comment in their eating disorder. support of the programme came from an anonymous viewer who I am now going to try to discuss wrote; ‘I think it’s good because it raises aspects of the programme that viewers felt were particularly dis- awareness about eating disorders. I never saw tressing or triggering and back anything on eating disorders when I was 14 and this up with comments made by actual viewers of the programme. anorexic and felt like I was mentally insane and I will follow this up with why they different from everybody else. I’m now 24 and felt this way. I will try to build an seeing other people with eating problems on this objective view of the show, because I did find that there were show helps me to see that many people do strug gle with food, so it was not just me’.

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Although many found the programme triggering and disliked the negative influence of it, one respondent did feel that there were good and bad parts to the

Almost all respondents felt that the show was incredibly triggering for those with an eating disorder, or to those who are recovering from one.

show. ‘I like the fact that it shows what

damage a bad diet can do, in people who eat un-

healthily but with no food issues it may actually do them so good. I like that it shows you can eat

less/more if you need to (for health benefits), and gives people who want to become healthier a

bit of hope and encouragement. However, I dislike Some even felt that those predisposed to eating distress could the fact that it exploits people with a problem, be further triggered into behav- you wouldn't do it with a drug addict and an iours connected to eating disoralcoholic. I dislike that it has the 'supersize' ders, because; ‘it fails to be sensitive and the 'superskinny' stand in underwear while to their needs’. The most interesting forced to look at what they eat in a week. I dislike response generally was a feeling of irresponsibility on behalf of the the way they show eating disorders, even in this

producers of the programme:

‘I

think it is irresponsible and not right that they take someone who clearly has issues with their weight and makes them eat the diet of someone who overeats.

I also don’t think that it is right

series they are sticking to the most well known

ED's Anorexia and Bulimia, when they could look at so many others too. I also dislike the amount of numbers the show uses, as it makes me feel extremely uncomfortable.’

that the supersize person gets given minimal

The most controversial responsamounts of food and I think it encourages people es concerned the exploitation of with eating disorders to restrict and compare children in the mini-series preceding the ‘adult’ show. One viewer their eating habits and weight with that of the wrote; superskinny’.

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‘Dislike – The way they portray eating disorders, using numbers, pictures etc. The fact they did so in the programme on children as well!’ Another powerful response came from one respondent who spoke brutally and honestly about how seeing the “Superskinny” is an incredibly negative trigger:

‘Personally I like the programme even though I know it's probably not good for me to watch it. It has given me ideas as to how I can potentially replace food with caffeine which many of the "skinny" people on the show do. The part

where they focus on the group of people who are

trying to recover from an eating disorder I find helpful. It allows me an insight into possible

ways in which to overcome my eating disorder. It

allows me to see that I am not alone. However, this is a very small part of the show and for

the most part I watch for tips from the "skinny" person on it’.

This was not an uncommon response. Many of the respondents, whilst openly admitting that they had eating disorders, also spoke of how although they knew they ‘should not’ watch the show be-

30 | THE VOICE

cause it triggers them negatively. However, they felt ‘compelled’ to watch it because of the nature of their eating disorder. As a recovered Anorexic, a BEAT self-help group facilitator, and someone who has worked with eating disorder sufferers for a long time, I am well aware of the pull of such programmes in order to feed the illness. To those who do not recognise this: it is a trait of having an eating disorder, and some people can find it difficult to understand why a person would watch the show. For

example,

one

respondent

‘I can feel rather suicidal after this programme – it just serves to make my eating disorder worse. Yes, I can choose not to watch, wrote;

but the very nature of eating disorders means

you ‘have’ to watch it, it’s an addiction, and you can’t help watching these things.

I feel they

taunt people with eating disorders with this programme, and

I know lots of people who feel the same. You wouldn’t treat people with other serious illnesses, such as cancer or ling disease or brain damage in this way, so why keep trivialising eating disorders and treating us this way. Something really needs to change here’.

Part of educating the producers of the show, and part of why this piece is being written, is to help them understand the symptoms of the eating disorder that are usually unnoticed or overridden.

However, it wasn’t just sufferers who struggle with the show. Those in recovery are also heavily influenced by the content of the show. ‘As a person suffering from Anorexia and Bulimia I find that the mentioning of clothes sizes and weights extremely triggering as I find myself unintentionally comparing my weight/previous weights to the “superskinnys” resulting in my Anorexia deciding that I am not “thin” enough to continue recovering or receive any kind

of help’. Clearly, this is a troubling response, and this respondent

wasn’t alone: ‘Not now, but in the past

and it has been detrimental to my physical and mental health. I found the programme triggering

in the past. Now I am well I can rationalise it

people who watch and must find it upsetting and triggering’.

During this research, it came to the attention of myself and Alexandra that some people feel that the programme was not only triggering, but could actually influence eating and food behaviours and other very difficult feelings

‘Yes, I do feel it triggers all sorts for me, guilt, shame, worsens by depression, lowers my self-esteem further, makes me feel inadequate, and the very ‘wrong’ and inaccurate representation of eating disorders makes me feel I am even more alone and misunderstood, as my eating disorder, and most people I have spoken to with an eating disorder, feel the picture of eating disorders by this programme is nothing like the reality of living with an eating disorder’. All of those within the individual:

who completed the survey, found the programme triggering. The significant and generous mention of clothes sizes, weights, BMI’s, calories consumed, habits and behaviours were seen as ‘tips’ on how to lose weight. Respondents who found the show triggering mentioned issues such as:

but I now feel for the poorly eating disordered

31 | THE VOICE

‘I like the programme even though I know it’s probably not good for me to watch it. It has given me ideas as to how I can potentially replace food with caffeine which many of the “skinny” people on the show do’. We also asked viewers if they felt that the programme adequately addressed the psychological aspects of eating disorders or problems with food and eating:

was actually on the show and she thought they just used emotional tactics to try to get them to change their eating habits in the short-term, but not addressing the long-term, and it made her feel more guilty’.

The biggest issue that concerned respondents was the use of emaciated pictures throughout the programmes, and the showing of participants in their underwear. They felt that this took the viewer away from the psychological aspects of eating disorders, and reinforced the belief that you have to look “sick” or “emaciated” to suffer from an eating disorder:

‘I found the showing of the emaciated pictures of eating disorder sufferers very triggering and I don’t think that this should be included as part ‘Please, no emaciated pictures of Eating Disorof the programme, as it detracts from the fact der sufferers please! More focus on how Bulimia that eating disorders such as anorexia are menand Anorexia are PSYCHOLOGICAL disorders tal illnesses with a physical manifestation (not and that you do not have to be at an incredibly physical illnesses)’.

low weight to be suffering side effects physically

A number of viewers felt that Ursula Philpot and Dr Helena Fox served to help educate viewers on eating disorders, but the whole focus was on weight, numbers and images. One respondent wrote: ‘I

and mentally’. The viewers are finding that there is little focus on the psychological aspects of eating disorders. Respondents also asserted that much more could be done to raise awareness of eat-

know personally that it doesn’t [help educate ing disorders: ‘I would expand the section viewers on eating disorder] because my cousin that deals with eating disorders. In this series

32 | THE VOICE

”supersize”

to meet

‘It makes me feel even more misunderstood and a

fects their life. I think the same should be done

disorders it paints’. Other suggestions concerned focussing on the psychological issues related to eating disorders in much more depth, for example: feelings of powerless and being out of control, the lack of voice and the use of food and behaviours to dissociate from feelings that may feel too much or overwhelming. Respondents feel that the programme’s researchers have totally neglected to understand the pain, torment and debilitation that eating disorders actually cause.

is flown over to

America

another overweight person and to see how it af-

with the “superskinny” so that awareness can be raised about eating disorders’.

Another viewer felt that all numbers should be taken out of the programme and should focus far more on the thought processes of those who suffer.

‘It portrays an inaccurate representation of eating disorders and makes me feel I am even more alone and misunderstood, as my eating disorder, and most people I have spoken to with an eating disorder, feel the picture of eating disorders by this programme is nothing like the reality of living with an eating disorder’.

‘freak’ because of the distorted picture of eating

It is clear from what is written that the programme is having a detrimental effect on sufferers of eating disorders and those that are still vulnerable from eating disorder (such as those who are in recovery). What is also of interest is the anger that the programme evokes from those who are supporting a sufferer or from those who are recovered. There are many initiatives in the UK tryThe focus on weight alone can in- ing to educate producers and dicite viewers to engage in more rectors of such programmes and eating disordered behaviours, giv- who suggest that they should conduct more accurate research en the guilt it evokes: and with a far deeper sensitivity.

33 | THE VOICE

Some viewers found the section underweight person gain weight and genuinely focussing on the group of people be happy about it’. who are trying to recover from an eating disorder helpful: ‘It allows me As participants on the programme an insight into possible ways in which to overcome are addressing their destructive relationships and emerging on the my eating disorder.. It allows me to see that I other side with a healthier relaam not alone. However, this is a very small part tionship with food, it does motivate some viewers in adopting a of the show and for the most part I watch for healthier relationship with food tips from the “skinny” person on it’. themselves. However, despite this, the question most often One of the final questions offered asked was: why no moderation? to respondents concerned what Respondents seemed confused they would change about the pro- as to why there was not more gramme. Some felt that, because emphasis on moderation. Viewthe programme addresses eating ers are only shown extremes as disorders, it does help them be- opposed to what a healthy diet cause they feel they can relate to actually is: ‘I think there needs to be more people on the programme. These respondents felt feel less alone: emphasis on MODERATION of diet. As an Eat-

‘I love the section where it shows people with ing Disorder sufferer, there are some foods that Anorexia/eating disorders because it’s really I find particularly difficult to eat and am still good to see other people who are also struggling struggling to introduce into my diet now that I (so to kind of identify with them). I’m obsessed am in recovery. An example is cheese, where I with any mention of eating disorders on TV so felt that the programme made out that, eating it gives you a good insight into what people are high fat products, such as cheese, would immereally going through and seeing them get help is good’. Another viewer said: ‘I enjoy the programme, as you see success, and the show

is addressing issues personal to me’ Another

viewer asserted:

‘I

34 | THE VOICE

enjoy watching the

diately lead to heart disease whilst there was

no emphasis that fat is a necessary component of a balanced and healthy diet.

I would also like

there to be more information about exercise in the programme, for example, is it okay for incredibly

overweight or incredibly underweight people to

and the ‘superskinny’ stand in underwear while

is a suitable starting point?’.

like the way they show eating disorders. even in

throw themselves into exercise, and if not, what

I would like to leave the reader with a quote which I think best summarises how the majority of respondents felt, and feel, about the programme. It is impossible to quote every response here, and I have tried to offer the triggers of the show, the feelings many viewers are left with, and also what could potentially be changed in the programme to ensure it’s more appropriate to those who are vulnerable and trying to fight a mental illness that has one of the highest mortality rates of a mental health struggles.

‘I

like the fact that it shows what damage a

bad diet can do, in people who eat unhealthily but with no food issues it may actually do them so good. I like that it shows you can eat less/ more if you need to (for health benefits), and

forced to look at what they eat in a week. I dis-

this series they are sticking to the most well known Eating Disorders of Anorexia and Bulimia,

when they could look at so many others too. I also dislike the amount of numbers the show uses, as it makes me feel extremely uncomfortable’.

A big thank you from Alexandra and Rachel to everyone to agreed to participate in this survey and who provided us with a great deal of interesting and fascinating information. Thank you to all who took the time out to complete the questionnaires and fill them in with honesty and sincerity. We would not have been able to conduct this survey and write this campaign article without you. Big thanks!

give people who want to become healthier a bit of hope and encouragement.

However, I

dislike

the fact that it exploits people with a problem:

you wouldn’t do it with a drug addict and an alcoholic.

I dislike that it has the ‘supersize’

35 | THE VOICE

Poem This is a wonderful poem written by Rachel Nolan. It describes the first few days of her initially reintroducing meals into daily life and how she struggled terribly with her urges to purge. Despite her struggle, Rachel ultimately decided (with the aid of poem-writing) to freeherself from the eating disorder.

off guilt. staving by starving saving by harming. No, there’s no girl here but me and a wish. What of this?

I do not wish to reject this. there’s too damn much for me to miss. Or maybe I do. Maybe I’m through with trying and failing and old thoughts prevailing careful angles, facing discomfort concessions wrangled, and pacing, I’ve done far too much to lose my touch! to lose this, such a home, a world, a play, this girl, her world, a girl, her world... But I do not wish to reject this! I miss the bliss of something built for some other purpose than staving

36 | THE VOICE

Trying and failing, old thoughts prevailing. trying and failing, old thoughts prevailing. I think, maybe I want to just sink into them, drink up nothing but them. If they’re coming up when I am running from them, if it’s coming up when I am flying from them, if it’s coming up when I’m denying of them well then, why? Why can’t I just deny? Why should I even try? Let them come! Why not, Why? I mean, it’s clearly a lie

I made up, just to whine, there’s no problem with thoughts that I’m thinking, they’re fine! You’re fat. And you’re mine. Who said that? Wait, wait.... “mine” ? For real? This is fine? That’s not over the line? Am I really fine with that thought in my mind? I’m a failure without it. I fail every time. I won’t give it up. It keeps me in line. Yet the failing and trying and failing again is my life people crying because I failed again, every time, every act, you have failed, and you’re fat. ‘cause you’re fat. Don’t react. You’re too much take it back. Everything is an act

There is never a time when I feel

genuine says the thought: ‘cause you’re mine ‘cause you’re mine

‘cause you’re mine. And there’s terror at everything, truth, lies in kind there’s terror at leaving the terror behind. There is terror of food there is terror sometimes there’s been terror at moving an inch Terror’s lying. Look: behind what is said about better off dead in my head behind that is the crying unsaid. Look behind that: I’m trying. It’s terror again. But of what? Not of dying. I know that, so then well, it’s living, I guess. Which I’m loathe to confess. Yet with each choice I reject this life I love. Unless... Imagine.

To sustain; to retain, to remain and to fly in the face of the pain that I welcome except

37 | THE VOICE

when I’m faced with the lies. I hate them, the lies. Yes, I hate them, the lies, the way that old refrain that keeps all this the same, makes me rely on the pain comfortably insane and a liar, for shame. See? I try and I fail and the old thoughts prevail. I try? And I fail? And the old thoughts....prevail. Imagine.... to be ruled by possibility to no longer be fooled by faded prophesy. The weary old words that keep themselves true and keep me from feeling connected to you. The idea of trying and failing itself this black-and-white shit is toxic to my health. It’s all a continuum

38 | THE VOICE

and these pigeonholes are the very same lies that have been in control. To still be unwell to still feel like hell does not negate hope however hard to tell. These notions are potions that poison the now. What would it be like instead to allow? Trying and failing is nonsense unless I am clinging to just what’s constricted my breath. I feel like I’m shining a very dim beam that is threatening my darkness, as thick as it seemed... And I don’t. I don’t wish to reject this reveal. There is too much to miss. I’m embracing the real. No, I do not wish to reject this. There is far too much much too much to miss.

Positive Steps STRATHCLYDE TELEGRAPH

ISSUE 7

APRIL 2011

By Iain Ferguson

Jane Jurechova was fourteen when she first developed a problematic relationship with food. She hated her body image, starved herself in order to lose weight, and more worryingly, found that self induced purging became anextreme, but therapeutic coping mechanism. Today, however, Jane is an attractive, confident woman, who oozes charisma as she breezes into the GOMA library in Royal Exchange Square. She smiles as she greets fellow members of The Positive Steps Eating Disorder Support Group, and it’s obvious from their rapport, that there is a mutual appreciation. Alexandra O’Brien, the group’s founder, believes that such unity between the members is due to an overwhelming sense of empathy. Alexandra said: “The group

started because we saw that it was important to have a service that was organised and managed by people who know what it was like to experience an eating disorder personally and who understood what fellow sufferers were going through. Group members found this very helpful as they could identify with me and with my experiences and vice versa - we understood each other, and this in itself, was helpful for members. They felt that someone was actually listening to what they had to say, who understood and identified with them, and who genuinely listened and understood their worries, difficulties and concerns in a caring and non-judgemental way.” Although, the group provides vital support, the members feel let down by

the government and the Na tional Health Service’s failure to acknowledge the severity of eating disorders. Too often doctors and mental health professionals dismiss an individual’s symptoms because they are not visibly emaciated. Such flippant attitudes, however, fail to recognise the profound impact having an eating disorder has on a sufferer’s life. Rose Little, 29, who has suffered with anorexia for ten years, believes that there is little help available in Scotland for people suffering from such destructive illnesses. Rose said: “I have had NHS and private treatment, but this has been unhelpful on so many levels. Basically, the ‘professionals’ don’t really know what to do with people with eating disorders. They don’t really know what they are talking

39 | THE VOICE

about, because they’ve never been there, and they don’t understand what it’s like to have an eating disorder that torments you every second of every day.” Although Rose is talking from personal experience, she is far from being the only one to have been mocked by snide or disdainful comments from blasé doctors. With a high percentage of victims opting to suffer in silence, such apathetic viewpoints are arguably to blame for many cases going unreported. According to BEAT, the leading UK charity for people with eating disorders, around 1.6 million people in Britain suffer from eating problems such as bulimia, binge-eating, anorexia, obesity, compulsive eating, and other problems that may not fit these categories. With Western society seemingly obsessed with celebrity culture and body image, one may be shocked by the damming statistics, but are we really surprised? For the members of the members of The Positive Steps Eating Disorder Support Group, the answer is a resounding no. They are unanimous in their verdict that the me-

40 | THE VOICE

dia, with its promotion of underweight models and airbrushed pictures, are responsible for the levels of eating disorders amongst young women. Kate Brady, 23, said: “I hate when magazines and newspapers glamorise eating disorders, because there is nothing good, exciting, glamorous or pleasant about an eating disorder. In fact, it can ruin your life. It has done for me and for many others.” Recently, the group’s fears were echoed by The Royal College of Psychiatrists, who called on the media to stop “glamorising” eating disorders. Dr Adrienne Key (Royal College of Psychiatrists Eating Disorders Section) said: "There is a growing body of research that shows the media plays a part in the development of eating disorder symptoms - particularly in adolescents and young people. Although biological and genetic factors play an important role in the development of these disorders, psychological and social factors are also significant. That's why we are calling on the media to take greater responsibility for the messages it sends out’’.

Although the media are not solely to blame, they are undoubtedly hypocritical when it comes to the issue of eating disorders. On one page the reader is confronted with images of thin and glamorous celebrities modelling a beauty product. Consequently, the individual is led to believe that one must, at all costs, achieve a similar look. However, turn the page, and we are presented with an undernourished model who is quite clearly suffering from an eating disorder. Instead of receiving the reporter’s sympathy and understanding, they are condemned for promoting the wrong message to young girls. It is little wonder that such conflicting information leads to women and men questioning their own body shape and image. The Positive Steps Eating Disorder Support Group, therefore, aspires to change such attitudes whilst providing help and advice in a safe and friendly environment. The group is voluntary and independent from Strathclyde University, but meetings are held every Monday evening in the Arbuthnott Room, Level 8, the Union, from 5.45pm-7.45pm. The

group’s leader, Alexandra O’Brien, who herself has suffered from an eating disorder, contends that the meetings give members a platform to discuss their individual worries. Group sessions enable members to share their experiences and explore the recovery process. According to Alexandra, this process involves members leaving the meetings feeling like someone has actually listened to them; cared and offered them hope and support. She said:”Some members have never discussed their eating disorder with anyone before, and they feel that the meetings offer a haven to discuss their concerns and problems with other people who really understand. I had a text a few weeks ago from a new member who said that, even after one meeting, he felt that a weight had been lifted off his shoulders, and that he felt such relief at having been able to talk to someone about his problems. He said that, even after one meeting, things had changed for him in so many ways, and he felt more positive about making progress and making changes. He said he was able to

tell a friend about his eating disorder after the meeting - he had never told anyone about his problems before.” Although, the group’s members are predominately female, Alexandra has seen a rise in the numbers of men attending meetings. According to BEAT, approximately 10% of people with eating disorders are men. Historically, the general consensus has been that only women suffer from eating disorders. However, in the past ten years, more and more men are suffering from anorexia and bulimia. Males are under increasing stress to conform to unreal. As Mark’s positivity speaks volumes of the constructive influence of the group, special mention must go to Alexandra for her hard work and dedication. Her determination and commitment to provide a facility for people in desperate need of help is deserving of praise. Without individuals such as Alexandra, too many people would be suffering in silence. However, for the members of The Positive Steps Eating Disorder Support Group, I think it’s safe to say that they have found their voice.

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Iain Ferguson is a journalist with the Strathclyde Telegraph, which recently won Student Newspaper of the Year award. Iain Ferguson also recently won the Writer of the Year 2011 award for this feature article and some other health articles he has written. For more information, contact Iain on: iain. ferguson@strath.ac.uk About The Positive Steps Eating Disorder Support Group Glasgow.

For more information about The Positive Steps Eating Disorder Support Group (Glasgow) which meets every Monday evening in Glasgow city centre, email i_would_like_to_enquire@ yahoo.com for general details about the group or if you or someone you know would like to attend support meetings. The group does have a private official website (www.meetup.com/ Glasgow-Eating-DisorderSupport-Group) with lots of resources, details of meetings, help-lines, help and advice, inspiration, projects and lots more, that is accessible to group members, of which there are currently

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95, consisting of men and women from all over west central Scotland. (The website is for current or potential members: it requires registration, and we respect the privacy of our group members). The Group Manager and Organiser is Alexandra Oâ&#x20AC;&#x2122;Brien, and we have four volunteers: Klaudia Suchorab (Group Facilitation Volunteer); Mhairi McDonald (Group Facilitation Volunteer); David Carmichael (Research and Publicity Volunteer) and Lora Owens (Senior Research and Publicity Volunteer). They have completed training with the national charity for eating disorders, BEAT, and have backgrounds in psychology,, depression support, anxiety management, clinical hypnotherapy, stress management consultancy, amongst other things. We would like to thank Iain Ferguson for all his hard work and time with this feature article: we are very grateful indeed. Thank you Iain!

Just Ask.... (Please note that these concerns have be reproduced with permission and names have been changed)

Dear The Voice, I always feel guilty around food - I feel if I eat in front of people, I am in some way inferior to them or not feminine enough, or I feel dirty or bad for eating, like I am ‘giving in’. Does anyone else feel like this? I am interested in how to get over this and any tips to get me started with this one thing would be great. I never talk about my eating disorder with other people much as they don’t understand, even people who are supposed to be ‘professionals’. How do I change these thoughts? How can I change my view of food and, especially eating, from being ‘dirty’ and a ‘weakness’ into something more positive? Any advice would be so appreciated. It is terrible we all have to experience eating disorders - it is such a waste. Thanks.

Lucy xx

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Hello Lucy, Thank you for your letter and for your openness and honesty about your difficulties and how things are for you at the moment. It is such a brave thing to acknowledge you are having these difficulties, and by asking for some support, you are already taking small steps to reach out and get some help. Iâ&#x20AC;&#x2122;m sorry to hear things have been difficult for you regarding your eating and food issues. I understand some of the things you talked about because I used to feel like the way you do - guilty about food and feeling that it was something 'dirty' or 'bad'. It is not an easy feeling to deal with, and I understand much of your struggle, so please take some comfort in that you are not alone in your feelings. I have spoken to other people in the past, in various situations, who have reported similar thoughts and feelings. One idea might be to record your thoughts and feelings in a journal when you are/have just eaten, or even before you eat. This might help you to establish whether there is any pattern in your thoughts and feelings around food, and whether there is anything in particular that has happened that day that may have triggered your 'guilty' thoughts. Sometimes this can help us at least try to make some sense of how we feel and have a record of such. It might also be useful to consider if you always have these feelings about eating and food, or whether there are times when they are more powerful or stronger. Maybe writing a list of what is 'bad' or 'dirty' about food/eating and what 'guilt' means for you - what do you associate with guilt, and is there anything else in your life, past or present that evokes the same type of guilt in you? There is nothing bad, dirty or guilty about having to eat food in order to survive and remain healthy. It is part of nature. The only 'thing' 44 | THE VOICE

that tells you this is that of the voice of your eating disorder. Your eating disorder thinks it has the upper hand, that it is stronger and more powerful than you. Yes, that may seem so at the moment, especially if you are struggling so much with these difficulties. However, the eating disorder is like the bully we see in workplaces, in the school playground and so on. They put on a facade of being powerful, stronger, better, braver than you. But the bully is none of these things. In fact, they are usually very weak people, who have their own difficulties, who are scared themselves, and who bully others to try and make themselves feel better through power and status - albeit 'fake' power and status. The bully usually gets his/ her comeuppance in the end - either someone stands up to them, or they are 'found out' for being the weaker person after all. Eating disorders are a bit like this. They are a 'bully' who makes sure that their voice is heard above all others; who force you to do things you don't want to do; who manipulate you and make you feel scared and worthless. Like the bully, the eating disorder is just projecting its insecurities onto trying to control you and your life in every way possible. The eating disorder is a 'nothing' - it is weak and has no worth, no qualities whatsoever-in fact, it is rather evil and destructive and is definitely not a 'friend' - I know I would never want a friend who was intentionally evil or destructive. It seeks to destroy through its seemingly powerful voice. As soon as someone stands up to that voice however, the voice is weakened, even if ever so slightly. The more you stand up to the eating disorder voice, the weaker it becomes - it realises it does not have as much power as it once did. Yes, it will do everything in its power to manipulate you and trick you into thinking it can cope with you standing up to it, but with strength and perseverance, you can continue to weaken the voice of the eating disorder. Just like the bully who 45 | THE VOICE

starts to retract bit by bit when s/he realises s/he is no longer getting the reaction from you as s/he once did, the eating disorder voice too, begins to become weaker, it is not as loud as it once was. It is a weak voice after all: the voice just needed to be challenged a little to begin it's 'cracking' - the more you challenge it, the more the eating disorder voice begins to 'crack' under the pressure of you challenging it and telling it how worthless and destructive it is. The voice will become lower and lower over time, weaker and weaker, so that YOUR voice becomes louder and louder and begins to overtake the eating disorder voice. YOUR voice that tells you how worthwhile, valuable, unique and special you are as a person; YOUR voice that tells you that you have so much to give and contribute in life; YOUR voice that tells you that you are important and that you are a million times better than anything an eating disorder can do or say; YOUR voice that tells you that you only have ONE LIFE and that you have so much living to do. It won't be easy, I won't pretend it is, but if you stay brave and as strong as you possibly can, and continue to believe in yourself, to believe that you CAN do it, even when times are rough, or when you are feeling bad, or feel tired or like giving up, remember YOU ARE SPECIAL AND ARE SUPERIOR TO YOUR EATING DISORDER IN EVERY WAY POSSIBLE. Have the courage to believe in yourself and believe you are special and that you deserve the best life possible. You have only one life. Don't let an eating disorder take up any more of it. Best wishes,

The Voice 46 | THE VOICE

Waiting Rooms By Becky Henry

Tiny little rooms Like jail cells All taupe and fluorescent lights Nothing to look at A symbol of the jail I feel ED has put us in So scary So incredibly alone So helpless—losing hope Knowing I’ll have only a few minutes Of some professional’s precious time To ask our questions. Want to jump out of my skin So trapped, so tired Will they ever help us? We must help ourselves Sad Sadness Hopeless Is this how all parents of chronically ill children feel? I am the parent of a child with an eating disorder And I need a hug!! Becky Henry is the National Award Winning Author of Just Tell Her to Stop: Family Stories of Eating Disorders (2002 reproduced with permission ©).

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I have just finished reading a book by well known author Susie Orbach, who has also written ‘Fat is a Feminist Issue’ and ‘On Eating. Her most recent book, ‘Bodies’ (2009), published by Picador, is a very interesting read and I think it is worthwhile to read if you struggle with body image issues alongside your eating disorder. I have given a short review by me.

I picked up Bodies not really knowing what to expect, as I have read some books of a similar nature and found them either to be too feminist in their viewpoint, too patronising or found that the issues raised did not apply to me. However, I found this an enjoyable book, which I feel had many insights and promoted some stimulating thought regarding our relationship with our bodies. The renowned psychotherapist and psychoanalyst examined the current ‘beauty terror’ and how it manifests itself in various forms of eating disorder, body dysmorphia, body image distress and most disturbingly, the body shame that many of us experience. I admit that some of the issues and arguments raised were not for me: the topic of the mother-child relationship is not something I am sure I agree with. How-

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ever, it was interesting to read about some very extreme examples of body shame and the actions people take in order to try and 're-connect' or come to terms with their body. Orbach tells us tales of people who are uncomfortable in their skin - uncomfortable in the sense that they look into a mirror and say "that's me?’’ with some astonishment, anxiety, shame, hatred and disgust. The seamstress who feels so unreal she scratches her breasts with a needle to remember her physicality. The person who can't have sex unless packed into a car or in a public restroom. The body builder who spend hours in the gym to prove he is alive. The man who feels so alien from his legs that he fights for years to have them amputated in order to feel some 'connection' with his body. It is a powerful insight into the world of body shame: not just feeling a bit unhappy about how you look, but feeling and knowing that something is ‘not right’ with how you see, feel and experience your body and occupy it. A disconnection; a dissociation; a feeling that your body is not yours or that you are occupying something so alien to you that you either wish not to ‘exist’ or that you feel a strong desire and wish to change it in every way possible. The book offers some insight into how such body shame and hatred has become a phenomenon

Bodies by Susie Orbach Reviewed by Alexandra O’Brien

that torments and debilitates the lives of so many people - people who look seemingly ‘normal’ and able from the outside, but who are struggling with the shame of their body on the inside.

that there are people out there who feel such a need to self-destruct in often extreme ways because they cannot connect with their body, cannot accept it, and feel such self-hatred towards themselves because of their Bodies is a universal look at bodily body. It makes me sad to think about anxiety, body shame and the body it, because I was one of those people distress that, undoubtedly, influenc- too. es not only our view of our physical body, but our view of our ‘self’ as a This book is definitely worth a read whole. It is a compelling and interest- and actually made me think about ing examination of those difficulties my own past and present issues difand experiences that arise from such ferently, especially in relation to my shame and anxiety over one’s physi- own 13 year experience with an eatcal self. ing disorder and my ever-pervading body image issues. While there are Through her case studies, Orbach some things I don’t agree with, I think shows how subtle influences in child- that it is a valuable book to read if hood and later life can shape the you are struggling with body shame mind’s conception of the body to the and anxiety or have issues regardpoint that it turns against itself. It is ing body image or body dysmorphia. fascinating to read just how destruc- While some of the focus is on women’s tive such body shame and anxiety bodies, I think that it is also valuable can be. Reading about such torment to men experiencing similar issues. makes me unhappy: it is sad to know

b o o k r e v i e w

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Thoughts....

on my eating disorder By Rachel Nolan

Here you are, you come to this moment feeling agitated destined. But you have a choice.

You can look at your history and point to where your flesh showed through, AHA! I am ugly! Here's where I spent too much. Here's where I said too much. Here's where I was late. Here's where I hurt you. You can confidently point back at it all, over your shoulder, indicating with your thumb, you don't even need to tease it apart into examples all it is to you is failure. You can do that. You can take that thumb and stick it in the eyes of those who beg of you just eat the meal. They beg you to be there with them. Fed. Letting your body work in the right direction. Sober. Letting your mind drive and not the infection. You can say no. You're wrong. You don't see what I see. You don't know what lives in that mind. And why that body doesn't deserve to work. Most times you find you can't blind other people though, the way you blind yourself. Not unless they were pretty unperceptive in the first place. They don't believe in the exclusive truth of the stories you keep on hand to fill in the blanks when you try to knock out their vision of what they love in you. And you have a choice.

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That thumb can make music. It can hold hands. Hold a pen, sign your name. It has an etching of you on its surface. You have a choice. Are you going to choose to hate the swirls your skin shows? Do you believe your thumb should be ashamed of its print? Absurdity (such as this) can get you dependability: there is always misery to rely on. Your choice promises you that even when it falls apart on every other gurarantee. Order? No. it creates chaos. Justice? No. suffering is not justice. Modesty? There is nothing modest about changing the rules because you are the great exception. You have every right to the print of your thumb. You have a choice. In this moment, are you going to let the old way be right, because it is so damn convinced everything depends on it. Are you going to believe it when it says You're stuck with me. You need me. Lies become so much more transparent when you realise how necessary they are to the purpose they serve. Without them it's nothing. Without you it's nothing. Without it, you are infinite possibility. Or are you going to say to that instinct, that confident No. Are you going to say, Fuck you. I'm independent. I have a choice. I have a right to this moment.

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Kel is an eating disorder survivor Despite a past plagued with the poison of anorexia nervosa, Kel can now confidently say that she lives a full life: and she really means it. Kel is from North West England and is involved in so much, that it’s impossible to mention it all here. She is a BEAT Ambassador, is training to be a counsellor, and is in the process of setting up her own support group in Wrexham. Kel is passionate about letting other people know that recovery from an eating disorder IS possible. Kel talks to The Voice about her recovery. Hello Kel, thank you for agreeing to talk to us today and sharing some of your experiences with our readers. Can you tell me a bit about how your eating disorder started? I was around 18 when I developed Anorexia Nervosa. I’d had problems with eating on and off throughout childhood actually: not eating when I felt upset and such. But it didn’t become a huge issue until my first year at univer-

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sity. I was having some other difficulties which I now know to be depression and anxiety-related and certainly self esteem stuff as well. I was eating a bit less as was usual for me when I was unhappy, but this time, I found that it numbed down my anxiety and really it grew into a problem from there. What was it like when you first realised you had a problem with food and eating? What was life like? When I first became ill I didn’t really understand that I had an eating disorder. I knew that I was unhappy and that I wasn’t managing, but even as somebody struggling with the issue, I had such a stereotypical idea of what Anorexia was that I didn’t identify with it. It was actually a lecturer at university who approached me and expressed some concern, and although at that point I wasn’t really ready to talk about it, it really opened a door for me both literally and emotionally. It opened my eyes to the fact maybe something was wrong, something I needed help with and it also gave me someone to turn to. At that point I wasn’t actually hugely physically unwell, most of it was mental and emotional. I think that helped me deny anything was wrong; because the media portrays eating disorders with

Interview with an Eating Disorder Survivor By Alexandra O’Brien extreme thinness and I didn’t fit into that bracket at the time, so I thought people might not take me seriously or that maybe I wasn’t actually ill and the lecturer was being overly worried. I think looking back, I was just quite confused about what it meant to have an eating disorder. How did life begin to change for you when anorexia started taking hold and gaining control? As the eating disorder got worse I started withdrawing; I wanted to hide what I was doing because I was so ashamed and also worried people would take away my only coping mechanism. I was at university and should have been doing all the typical student things but I basically just went to class, came home, spent hours obsessing about not eating and battling all this self hate going on inside my head. It consumed my life. I know people might say “well, why didn’t you just stop?” but it was out of my control. This illness had taken con-

trol and I felt completely trapped. As irrational as it is, I thought it was helping me, I thought starving myself was the only thing that could make me feel better. So it just kept getting worse. Even when I started to look awful and feel really physically ill I just didn’t care because I truly believed once I got down to a low enough weight I would magically feel better about everything. In reality, I just got more and more depressed and the self-hate grew, as did the desperation to reach that magic weight and feel better. But of course that never happened however low my weight got. What were the disadvantages of your eating disorder? I lost so much to my eating disorder, in the short term and the long term. Of course, I lost weight and not just weight made up of fat but also your muscles waste away and your body starts to eat your organs. It’s not glamorous. I lost

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out on the experience of university, I lost any sense of identity; I became my eating disorder and nothing more. I lost the ability to think clearly. I lost the trust of people who loved me. I actually lost years of my life spent ill; and I even have an entire year of my life which I have no memory of. I think the worst thing I lost was my interest in life; and by this I mean for so long I really didn’t care if I lived or died and that could have been devastating. To think I actually could have lost my life to this illness is terrifying.

I was ‘beyond help’. How long did you experience an eating disorder for? I had issues even as I child and I now identify that as the beginnings of an eating disorder but I had actual diagnosable Anorexia Nervosa for about 4 years. What was the ‘trigger’ that made you decide you didn’t want to struggle with anorexia anymore and wanted to get better?

When you were in the grip of anorexia, how did you view yourself? Did I never actually wanted to be ill, I just this differ from how family/friends/ thought it was the only way to manage other people saw you? how I felt. I saw Anorexia as my only option. I think really my turning point I hated myself. I thought I was worth- was when my partner arranged for me less and useless. Obviously the people to see a private counsellor. I’d had othwho love me never agreed with that er treatment – a couple of years of it in but I just didn’t believe them. fact - but it’d been unsuccessful and I think the problem was no one had ever How bad did things get for you? seemed to actually believe I could get better, and no one had been willing to Things got really bad. I am still amazed see my treatment through. There were I’m alive to tell my story. I was hos- always limits to the number of sespitalised a couple of times first on an sions, or a limited expectation of how ED unit (which I didn’t feel suited my well I might get. Yet, when I met this needs, so I sought different treatment) counsellor, she truly believed in me, and on a general medical ward. It even believed I was strong enough to beat got to the point where professionals my eating disorder and was willing were implying I couldn’t get better, that to help me through and out the other

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side. She really was with me every step that. Of course I also had some amazand I couldn’t have done it without her. ing people around me and they served as my crutches. What ‘rules’ of anorexia did you eventually break in order to start How did you cope with feelings and getting your life back on track again emotions during the recovery peand working towards recovery? riod? I think the most significant rule I broke was in trusting in someone else. The eating disorder led me to believe that I couldn’t trust anyone else because they would take my coping mechanism away. But I trusted my counsellor and, with time, I chose to give up my eating disorder….since then, well, I’ve broken EVERY rule there ever was. And you know what? I survived and I am okay!

For me my eating disorder was about running away from my feelings because I thought they were too scary. But in actuality, I was able to feel, and survive and move on. I did lots of things to help myself of course: talking to my counsellor and my friends, writing and expressing myself creatively. I think a big thing for me was actually letting myself cry; it’s okay to cry.

How did you first feel about recov- How long did recovery take? ery and getting better? It’s hard to say at what point I actually I was terrified. Recovering was basical- started recovery so it’s hard to quantify. ly facing up to my worst fears. I didn’t It took a long time…years…but I think believe it was possible to come out the what is important to acknowledge is other side…but here I am! that the disorder took years to develop and so it couldn’t be fixed over night. What made you strong enough to win the fight against the eating dis- What was difficult and easy (if anyorder? thing) about recovery? I believe that strength is inside every one of us. It takes a huge amount of strength to live with an eating disorder and recovery was just about redirecting

Everything was difficult, but truthfully never as difficult as I feared it would it. I think though, the hardest thing was finding out who I was without my eat-

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ing disorder. Finding a new sense of ferred to – as well as a couple of othself. ers along the way - and my partner and my closest friends. They were all amazAt what point did you feel recov- ing. They didn’t have all the answers ered? What was it like? How did it but they gave me all the support and feel? love that they could, even when I was frankly horrible! They never gave up I’d been stable in recovery for about on up. a year when I was hospitalised with a delayed medical complication. While I How do you feel physically and was in hospital I realised that I no longer mentally now that you have recovhad any desire to engage with my eat- ered and come out the other side? ing disorder, I didn’t need it anymore. I believe at that point I was recovered… It’s fantastic. Mentally I just feel free, but I was too scared to say “I’m recov- and I accept myself as I am, flaws and ered” till about a year later for fear of all. It’s a beautiful place to be and diffisaying it only to relapse. When I even- cult to articulate. Physically, I still have tually did say it, it was an amazing feel- a few long lasting issues but I think ing. what’s most important is I treat my body with care. It’s especially great to I knew I was recovered when I no have so much more energy. longer had to use food or my body to cope with or express my feelings. There What are the advantages and posiwas the instance I just referred to but I tive things about recovery and think really it was a gradual process. I about being recovered now? say I was officially recovered on March 6th because that’s the date my Psychia- I finally get to live the life I would have trist finally agreed with me and I was, hoped for myself. I can imagine a fuI suppose, officially undiagnosed. We ture and I am taking steps to get there. now celebrate that every year. The most astonishing thing is to have a more positive view of myself; that’s Did you have any help and support such a life changing shift. during recovery? What can you do now that you were I had the counsellor I’ve already re- unable to do when you had anorexia?

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Even though I’ve been recovered for a few years now it is still amazing to be able to do all the things I couldn’t. Since recovering, I’ve been able to go back to university, I’ve worked as a lecturer, I’ve volunteered, I’ve reconnected with my friends…I couldn’t have done any of that when I was ill.

Do you experience any long-term health consequences as a result of your eating disorder?

Yes, unfortunately I do. I have some stomach problems and a mouth full of fillings. Additionally, the Anorexia also contributed to my osteoporosis. It isn’t the sole cause – which I think is imporWhat does being ‘recovered’ mean tant to mention - but it definitely sped to you? up the degeneration. They are not nice to live with but I am just thankful every When I say I am recovered I mean I day that I am alive. am totally free of my eating disorder. I have no thoughts related to food or my Any advice on how to take the first body and I cope with my emotions in a step? healthy way. I am content with myself as a person and live a full life. The first step towards recovery is in asking for help. You can’t do this alone What are the best things about re- and that’s nothing to be ashamed of. covered? Find someone who you trust and tell them what’s going on for you. If you Really I could sum it up in one word - don’t know who to turn to you could Freedom. even contact b-eat (www.b-eat.co.uk). How do you feel about food and eating now? How do you feel about your body now? How do you feel about yourself now?

Do you have any tips, techniques or advice that you could pass on to others who are thinking about following the road to recovery? Was there anything you found especialFood isn’t an issue – I eat what I want, ly helpful? when I want in healthy amounts. I am content. I accept myself as I am and I I think the key thing I learnt that I’d finally have a sense of some self worth. hope to pass on to others is that in the end you know what you need. You cer-

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tainly need the support of other people but they can’t fix this for you, you have to put in the hard work. Whatever YOU need, give it to yourself: you deserve it. Your deserve recovery and health and happiness.

ery is actually possible. There is hope. It’s hard work, but entirely worth it. Don’t give up. If I can beat it, so can you.

To carers reading this – don’t forget YOU need support as well. Attending Something I did early on in recovery to your needs in looking after somewas create a list of steps towards recov- one with an eating disorder in the long ery – all the fears and issues I wanted term has a positive effect all around. to beat – e.g. – eat 3 meals, eat a piece of my own birthday cake, go back to More than anything I just want people university etc. Then I shuffled the list to know eating disorders are mental into the most attainable to the most illnesses. I want sufferers to know this difficult and worked my way up. It felt so that they can realise they deserve great for me to be able to tick things off treatment and support whatever their as I could do them. Might not work for weight. And I want everyone else to everyone but it did for me. know this so that they understand that having an eating disorder isn’t about Do you have any advice to offer vanity it’s about serious emotional pain. about coping with changes in body shape and size during and after recovery? A big thank you to Kel for sharing Focus on what you gain in addition to weight, and the things you can do because you are allowing your body to be healthy. Those gains are far more important than any number on a scale. What would be your message to anyone struggling with an eating disorder just now? Recovery is possible. True 100% recov-

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her experiences of recovery with us. Kel will be launching her own eating disorder support group in Wrexham (in early autumn 2011). For more details of this group, contact Kel on wrexhamgroup@ hotmail.co.uk or visit the group’s webpage at wrexhamgroup.moonfruit.com

A SNAPSHOT.... of inspiration IF I HAD MY LIFE TO LIVE OVER I I’d dare to make more mistakes next time. I’d relax. I would limber up. I would be sillier than I’ve ever been. I would take fewer things seriously. I would take more chances, I’d take more trips, I’d climb more mountains, I’d swim more rivers, I’d go more places I’ve never been to. I would eat more ice-cream and less beans. I would perhaps have more actual troubles, but I’d have fewer imaginary ones. You see, I am one of those people who lives sensibly and sanely hour after hour and day after day. Oh, I’ve had my moments and if I had to do it all over again, I’d have more of them. In fact, I would try to have nothing else! Just moments – one after another, instead of living so many years ahead of each day. I’ve been one of those persons who never goes anywhere without a thermometer, a gargle, a hot water bottle, a rain coat and a parachute. If I had to do it all over again, I would travel lighter than I have. I would start barefoot earlier in the spring, and stay that way later in the fall. I would go to more dances. I would ride more merry-go-rounds. I would watch more sunrises and I’d pick more daisies, if I had my life to live over again. But, you see, I don’t. This was written by an 85 year old man who learned he was dying. It is such an inspirational and powerful message that reminds us all that we only have so long in this life. The old man realised that to be happier, he didn’t have to go and change the world, because the world is already beautiful. He had to change himself so he could experience the beauty of life, fully and completely, that was already around him.

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WHAT IS RECOVERY? Group Session with... The Positive Steps Eating Disorder Support Group (Glasgow)

person may develop and use their self-determination to grow beyond and thrive, despite the WHAT DOES RECOVERY presence of the limitations and challenges invited and imposed by distress, its treatment and MEAN? the personal and environmental understandings There is no universally accepted definition of made of them’ (www.mind.org.uk). what ‘recovery’ is. It is one of those terms and concepts that is open to interpretation and Anorexia and Bulimia Care (ABC) states that: can mean different things, to different people, 'Perhaps the most common difficulty with thinkat different times. Recovery means different ing about recovery is having a clear idea of things to each of us. However, in basic terms what it actually is. For those in the middle of it means ‘getting better’ and living and learning an eating disorder it can seem as if (for eveto live and cope with everyday life without an ryone else) recovery is about weight and eateating disorder. I did a bit of research on what ing - about gaining weight for those who are other organisations thought ‘recovery’ meant struggling with anorexia, or about regulating and and I have included a small selection of these controlling eating for those who are fighting bulimia or binge eating disorder. In fact, eating definitions below. and weight are just a small part of recovery The National Institute of Mental Health in Amer- and really are more of a symptom of how well ica says that recovery is: ‘The uniquely personal recovery is going rather than the main feature and ongoing act of claiming and gaining the of recovery’ (www.anorexiabulimiacare.org.uk). capacity to take control of life that is personally meaningful and satisfying, with opportunities to According to Aceda: 'Recovery is a deepenperceive her/himself as a valued citizen. The ing process where you can learn a lot about

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yourself, relationships, food, and life in general. Recovery from an eating disorder is unlikely to mean restoration to the person you were before, but to a more enriched, resilient, capable and self expressive person' (www.aceda.org.au).

steps towards change and ‘getting better’ and seeing all the other things we can have in life that we may be missing out on because of eating and food difficulties and exercise dependence.

For Bodywhys, recovery requires 'a will to change; an acknowledgement that the eating disorder is a problem working to build up a strong sense of self and a new, healthy way of coping that does not need the eating disorder to feel safe. Recovery requires working on underlying issues, building self-esteem, and learning to manage and express feelings, as well as addressing the physical and nutritional aspects of the disorder’ (www.bodywhys.ie).

We followed our art session with a brainstorming session and discussion about what recovery means to us, and what the barriers to recovery are. I noted what the group brainstormed and have included their answers to both questions. Below is what The Positive Steps Eating Disorder Support Group (Glasgow) said was ‘recovery’ and what barriers they faced to recovery. Do you recognise any of these? What does recovery mean to you? Do you face the same barriers to ‘getting better’? How can you break those barriers? There are also samples of some of the posters we made representing what we though recovery meant to us. Why not try making your own picture or poster? This was actually one of our busiest meetings, with 15 members, and everyone really enjoyed it and had fun. It also helped some members talk to other members they had not spoken to individually before and whilst doing the task, members chatted amongst themselves. So, while there was a serious element to this session, it was also very relaxed, lots of fun, very social and helped some members challenge their own social anxiety barriers. Give it a go – make your own poster – it’s fun!

WHAT IS RECOVERY? During one of the support group meetings that I organise, we talked about what ‘recovery’ and ‘getting better’ means to us. What is ‘recovery’ and what does this mean for us? What are the barriers to recovery and what do we want our future to be like? During this meeting, we had a creative/art therapy-based task, whereby we had lots of art materials and pictures to make our own posters and collages representing ‘What Is Recovery’? What does our future without an eating disorder look like? Such representations may act as a motivation to make changes and take small

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RECOVERY IS

....

Group members said recovery included the following:

Fun/laughter Freedom Being healthy enough to live in the moment Taking responsibility Being content Not feeling guilty To know when to feel full Being able to treat yourself to something nice Being ‘ok’ More confidence

Not feeling so lonely Being able to cope with life when things go wrong

Not being obsessed Admitting you have a problem Not worry about numbers on the scale Not being restricted Liking/accepting yourself Developing meaningful relationships Accepting you can be good enough, not perfect At peace with yourself

Not thinking about food all the time

Not being invisible

Seeing ‘failure’ as an opportunity/learning Adapting to change

Trusting yourself

Realising there are other important things in life 64 | THE VOICE

Being able to do things you missed because of the eating disorder Being able to relax

Get your ‘sparkle’ back

Being good to your body Good/balanced nutrition Being able to sleep better More mentally/emotionally stable Physically healthier Able to tackle other health issues Feeling connected with other people Enjoy eating with other people

Deal with problems in a ‘healthy’ way Shutting up the critical voice in your head

Think/look after other problems Caring about other aspects/parts of yourself

Being able to ask for help/support and knowing/feeling it is ok to do so Improved concentration Balance Being able to grab your dreams

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BARRIERS TO RECOVERY We brainstormed what we thought were the barriers to recovery and had a discussion about this. Some of the ideas given are below:

Feeling you don’t deserve good things Fear of gaining weight Can’t identify triggering moments Fear of change Fear of not being able to cope on your own Lack of support Feelings of guilt Feeling ashamed Your eating disorder being a ‘friend’ Media Not knowing what the causes are No alternative coping mechanisms Relying on eating disorder when things go wrong High expectations Unable to control your thoughts Comparing yourself to others Too much pressure Perfectionism Afraid your world with fall apart Fear of unknown Safety of eating disorder Physical changes Psychological difficulties Not being ready Not seeing yourself as you really are Motivation Eating disorder part of your identity Comments from other people Not fitting stereotypes/roles Not being ‘special’ enough Other people’s awareness/sensitivity/expectations Looking ‘well’ but still having problems/issues – physical ‘recovery’ before psychological/ behavioural ‘recovery’. I conducted a small online survey recently asking people the question ‘What is Recovery?’ I received a lot of response from the UK and USA, and I have included some of the responses from both males and females. If I asked you the question, what would you tell me: what would you write? Try this exercise for yourself. Write on a piece of paper: What is Recovery? Answer your own question. Write down the answer: it might be bullet-points; it might be in first-person; it might be a random assortment of thoughts, feelings, behaviours, goals and dreams; it might be a story; it might be a song. Whatever method you chose, ask yourself the question – then you begin to realise just how much you are actually missing out on in life because of the eating disorder. It doesn’t have to be like that. You only have one life. Live it to the max!

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order for Being recovered from an eating dis in my own me is the ability to be comfortable not to skin without having to change it. To urs of an have to use the destructive behavio ressors eating disorder to cope with lifeâ&#x20AC;&#x2122;s st to know and the ups and downs of life. And is body, that I am so much more than just th both the and accept and embrace all of me, light and dark sides. Christina Weiss bennison

not

caring anymore.

John Evans

Recov ery for me wo pain, n uld o more sleeple mean no mor worryin ss nigh e g abou ts due t how NEED to mu to do! the wo Recov ch exercise ery wo I rld to me. It uld me away t an just ho take it ugh at the m seems so fa . r o ment. I can â&#x20AC;&#x2122;t

peace of Recovery to me is LL of me A g in v lo d n a d in m acceptis It y. ll a n io it d n unco nd have alance that I am (a just as I t c e rf e p ) n e e b ys wa am. Jacqueline Carly

Recovery

Wattimo

Vickie

Cairns

Recovery for me is to live each day with a sense of happin ess within m yself, for w ho I am and not who o thers are. Jamie Wo od

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Recover y to me is accepting ourselves for who we are. It is realising and acting upon the strength we have within ourselves for the health and happiness that each of us deserves. Hannah Rushbrooke

Recove ry is, to m ing to live li e , learnfe with letting out this di sordere haviou d be r take over: l ing lif e ivly bin without actu gei aladoptin ng/purging a nd g heal thy ea pattern ting s again . Freyja E lizabeth

frees n a e m covery e r , e m my life e v To i l o t e l ing ab down d e dom. Be g g o b I’m not e s rcise. u e a x c e e r b o d ts of foo h g u o h t ete my l p by m o c le to g Being ab gree. And bein de university happy. e b o t e l ab Lizzie

Recovery is physical a tional fre nd emoedom: it ’s the ending o f a battle between your bod y and yo ur mind. And mo st import antly, it’s complete ly possibl e! Kel

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Tips I

for recovery By Alexandra O’Brien

have included a list of

recovery.

‘tips’

Some

tips that may be helpful during your period of

of these are my own ‘tips’ and some are from my array of

I was unwell with anorexia, but adapted in various ways. I will include 20 tips in each edition of the magazine. Try them out – some will work and some won’t, but there will be at least one you can try and find useful in your days of recovery. collected by myself when

Recovery is a long process, and no one said it was going to be easy. However, your choice in taking this challenge on is a testament to your will and your belief that life can and will be better. So congratulations on choosing your health and life, and just remember you aren’t alone! You CAN do it if you really want to: believe in yourself, believe in your inner strength (because it is in there) and believe you CAN have power over your eating disorder. If you really do want to change, then you can. Noone will say it’s easy, but the only person standing in the way of change is you. Go for it – you deserve the best!

1. Adopt the Boy Scouts’ motto, ‘Be prepared’. Before taking each new (small)

step, do your homework. Find out what you need to do, where you need to go, what resources you require, whether you need support or extra information and acquire the relevant knowledge. Ninety per cent of the outcome in any activity depends on the quality of the preparation undertaken. Goals and steps that work and are successful are called SMART goals with support. SMART stands for: SPECIFIC, MEASURABLE, AGREED, RELEVANT and TIMEBOUND. Write down each step you want to take – no matter how small it is. Do your homework; write the goal down exactly as you wish to achieve it and in what timeframe. However, when working on your small goals and steps, ensure you have appropriate support at hand for when you need it. Being prepared in this way will lessen any disappointment you may experience if a step or goal doesn’t go to plan – you will know what didn’t go to plan, learn from it and perhaps you just need to take a slightly different approach. All the time you are learning, even when mistakes or set-backs occur.

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Do something practical to increase your self-esteem and self-confidence every day. Write down a list of all the small things you would like to do, try, learn or experience again – things that you enjoy and that will challenge you just a little bit. Perhaps you used to love horse-riding or cycling or visiting the theatre or always wanted to try one of these activities – plan to try it within the next week or month – it gives you ‘me’ time to do something you really enjoy, allows you to have fun, feel good about yourself and do something that does not involve your eating disorder.

Feeling tense, stressed, angry, upset or worried about something? Put on your favourite music on loudly and dance about like you were 10 again. It will help release the negative feelings and tension and will make you laugh. Try it – it’s fun and you will end up smiling and feeling much better.

Make a telephone list of people you can call for support – family, friends, a counsellor, colleague, helpline or support group. Keep it handy and allow yourself to use it when you need to – people are there to listen and provide support.

5. Write a letter to the person or problem upsetting you.

Don’t mail the letter though. Once you have written it, scrunch it up, tear it up, stamp on it, scribble over it, throw it away, bury it, or set it on fire. It will help you to express lots of the thoughts and feelings you have inside of you that you may really need to get out. It will help you deal with these feelings and destroying or defacing the letter in some way after you have written it can help you put the feelings in the ‘right’ place inside of you so you can deal with them and manage them more effectively in the future. It can be a very cathartic exercise.

Try to think of healthy ways of getting out your feelings and emotions. Write these down on a little card or something small that you can carry around with you in your pocket or purse as a reminder of positive ways of expressing your thoughts and feelings. Some ‘positive’ ways of expressing the thoughts and feelings you may be experiencing include: writing a diary, journal, story or letter about what you think and feel: writing; reading or writing poetry; being creative, such as drawing, painting or photography; exercising (moderately); going for a walk alone; dancing; learning self defence; record your

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thoughts and feelings by talking into a voice recorder (playing it back can be very effective, as things often sound different once we have verbalised them – it can be very helpful when looking at things from a different perspective).

Plan regular activities for your most difficult time of day. Do you find morning a difficult time? Or maybe evening is a difficult time of the day for you? Rather than dread this time of day and perhaps feel down or unhappy during these periods, change it – interrupt the automatic response we often have towards certain times, days, places and situations. For example, if you feel upset, down or alone in the evenings, plan ahead to fill in this time. The list is endless and there is so much you could do – it depends on what you enjoy, what interests you and so on. Read a book; call a friend and go to watch a film; join a jewellery-making class or drama class; do some writing, visit someone. It doesn’t matter what it is, as long as you enjoy doing it and it’s something you are interested in – don’t choose something that seems like a chore.

When you are feeling upset or down or perhaps ‘recovery’ seems to difficult and you want to give up, take you mind off these thoughts and put on your favourite film or watch a comedy that will make you smile and laugh for a little while.

Build a support network around you when you are working toward recovery. This might involve friends, family, a therapist, making a list of telephone useful telephone helplines, bookmarking valuable resources on the internet, buying some ‘recovery’ books, or attending a support group or online chatroom for eating disorders.

10.

It is ok to ‘feel’ feelings. This is absolutely allowed and part of recovery. A large part of recovery is acknowledging your feelings and allowing them to express themselves and be felt by you. Often we have kept our feelings hidden inside for so long that letting them out can seem like a scary prospect. However, it’s part of recovery and while these ‘new’ feelings may seem intense and overwhelming a first, that’s ok and normal – that’s just because they have been kept inside for so long. It won’t always be like that though – you will start to get used to these feelings over time and they won’t seem so overwhelming. Feeling these emotions will help you work towards a more

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healthier, fulfilled way of life, without an eating disorder and bring you new ways of thinking, seeing and experiencing things. So spending quiet time with your feelings is very important during recovery. If you find them difficult to deal with, try writing them down, writing a diary or journal, singing the feelings, talking into a voice recorder, crying, using relaxation tools or creative visualisation – anything that will let the emotions out but help you to cope with them and no feel so overwhelmed.

11. Just as a car needs petrol to run smoothly, the human body needs food

to work properly and optimally. If a car is running on the last few drops of petrol, the engine will not run as well and will eventually cease up when the petrol runs out. Allowing the petrol to keep running low in this way will eventually cause unrepairable damage to the engine. We can replace a new car engine, but we can never replace a human body. It needs nutrients from food to keep it health. Starving yourself and restricting your eating and the type of food you eat will leave you feeling more tired, having less energy, having more headaches, feeling more depressed, and vulnerable to colds and infections because your immunity is so low. In the long term you could be causing damage to your internal organs, and undereating could lead to infertility problems and osteoporosis. Food and eating can seem frightening at first, especially when, during our eating disorder, we have attached all sorts of labels to different types of foods: good, bad, healthy, safe, dirty, pure and so on. There is no such thing as bad food in the strictest sense of the word. So often it can be helpful to look at food purely from a scientific viewpoint. Take each type of food, and don’t think of it as ‘good’ or ‘bad’, but investigate it, get information on it, like a scientist would. What nutrients, vitamins and minerals does it contain and how much? What is the benefit of these to my body? What foods will make my hair grow and shine; what types of foods will give me energy; what foods will strengthen my teeth and bones; what foods will help me to have clear skin; what food will strengthen my muscles and so on. Look at what food REALLY is and not the distorted labels we attach to them.

12.

Try not to put too much pressure on yourself. You don’t have to be perfect and nobody is perfect. Who wants to be perfect anyway – how boring! If we were all perfect, we would all be the same, and we would get bored with each other and probably have less fun generally in life. The real beauty of life comes from the uniqueness and differences that exist around us. Everyone makes mistakes, everyone has off days, and everyone at some time in their life wishes they had done things differently or better. Trying your best is the

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best thing you can do – we are all different remember, and so it’s impossible to compare ‘like with like’ because it doesn’t exist. Be YOU!!

13.

Be kind to yourself - talk to yourself as you would talk to a friend. If you are having a tough time or perhaps something didn’t go to plan, don’t beat yourself up about it – it’s part of the learning curve – and learning is constructive, not destructive. During hard times, think about what you would say to a friend who came to you with the same problem. Take yourself out of the situation and look at it from an objective standpoint – what would your friend or a stranger say?

14.

Be prepared to say ‘no’ to food or invitations that you know you are not ready to handle yet – don’t put yourself under pressure. It is fine to do this – why put yourself under unnecessary pressure. There will be invitations in the future that you CAN accept when you are in a better place within yourself – and when the time is right.

15.

Take time out. If it is all getting too much for you, remove yourself from the situation. Go for a walk, take a relaxing bath, listen to some relaxing music, go to the park, call a friend and go shopping, visit the library. Look after yourself. Remove yourself from the situation – by doing this, YOU are gaining control and taking responsibility.

16. Learn when you need space and take it. Space can mean any-

thing: personal space, emotional space, physical space – leaving a location, person, situation or event. Space might mean being alone or with other people. It’s different for everyone – but take it when you need it.

17. Make lists of good things you have done. I can hear you all say-

ing now ‘I haven’t done anything good’. You have – everyone has done something good in their life. When you really get down to thinking about it properly and taking the time and space to do so, you will see all the good things you have gone – I bet there are lots of thing. Write them down. Write down what you have achieved in life. It might be difficult to start with, but you CAN do, because you have achieved so much and

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done many good things. You have!

18. Avoid any negative encouragement. What about the magazine you

read? Do they have pictures that trigger you or made you feel ‘bad’? Avoid buying it or cancel the subscription – you don’t need it – and think of the money you will save to spend on things you enjoy doing and that DO actually make you feel better. Don’t visit any triggering websites – much of what you see on these is distorted and manipulated anyway. Avoid reading books or watching television programmes that you feel might trigger or encourage your eating disorder or make you feel guilty or bad in any way – just don’t watch them – watch a funny comedy or an interesting documentary instead. Extreme as it may sound, ban all of these from your life, starting now! You don’t need them....ever!

19. Avoiding mirrors on ‘bad’ days is avoiding the problem. Uncomfort-

able as it may sound initially, try this instead. Set aside a decent 5 to 10 minutes to go over your body from head to toe, and try to describe yourself out loud without being negative. You don’t have to say you “love” anything. Just make regular observations such as: “my eyes are green, my hair is blonde, my face is oval, I have 2 thumbs and 8 fingers, my hair is straight, my lips are pink and so on”. Looking at yourself objectively can help overcome the negative feelings and make it easier to face your reflection.

20. During recovery you may have days where you slip back into ‘old

habits’. It is important that you don’t see these lapses as failures and give up. They are a natural part of recovery and you can learn from them.

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Is there an eating disorder in your family? June Alexander talks about treatments and support on caring for a loved one with an eating disorder, and in seeking help for yourself, as a carer of someone with an eating disorder. June Alexander draws on information and research from her book A Girl Called Tim © Eating disorders are serious, sometimes fatal, mental illnesses that usually develop in childhood or adolescence but affect people of all ages. Prompt intervention is crucial for the best hope of a full recovery. Families can help! If worried about your child, educate yourself, especially on Family-Based Treatment, (sometimes called the Maudsley Approach), which is currently the most effective evidencebased treatment for children and adolescents with eating disorders. In this treatment, the family consults with a therapist who helps parents take an active and positive role in restoring their child’s health. The later stages of treatment centre on re-establishing independent eating and addressing concerns that interfere with resumption of healthy life and development. With good treatment and family support, there is every reason to be hopeful. If you are a parent or partner and feel concerned, make an appointment with a doctor, preferably one with experience in treating eating disorders. Above all, trust your gut instinct and seek help immediately.

Signs of an Eating Disorder You do not need to be thin to have an eating disorder. This manipulative illness comes in many shapes and forms. Anorexia nervosa is not the most common but is the most serious, with the highest death rate of any mental illness. It is a very visible illness while bulimia nervosa and binge eating disorder are easier to hide. All three illnesses – together with variations under the umbrella of Eating Disorders Not Otherwise Specified (EDNOS) – are isolating for not only the sufferer but also the family. Anorexia nervosa: This illness is characterised by self-starvation and excessive weight loss, or failure to make expected weight gains in children or younger adolescents. Worry signs: limiting food portions, cutting out groups of foods, avoiding family meals, exercising excessively, and becoming secretive. There may be anxiety or uneasiness about eating, or preoccupation with food, calories, or exercise.

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Bulimia nervosa: This can be even more secretive, and any signs of bingeing and purging should be taken seriously. This illness is characterised by a cycle of bingeing and compensatory behaviours such as self-induced vomiting designed to undo or compensate for the effects of binge eating. Binge eating disorder (BED) is characterised by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.

When an eating disorder develops in your family Eating disorder symptoms are frightening, intrusive, anti-social, anxiety-provoking and frustrating and the behaviours involved in limiting calorie intake or increasing calorie expenditure take many forms. The physical consequences are alarming and distressing; all semblance of normality disappears, social life evaporates, future plans are put on hold and interactions around food increasingly dominate family relationships. Carers often have difficulty coping, and unfortunately can get trapped into a cycle of behaviour and emotional responses that can inadvertently perpetuate the illness. Professor Janet Treasure and her team at the Eating Disorder Unit of the Department of Psychiatry at King’s College, London, have created a collaborative care skills training approach to help carers identify ways of reducing stress. Animal analogies are used to show how different patterns of emotional response by parents and carers can help or hinder the recovery process. A short explanation of this important work follows. Anorexia nervosa has a profound impact on other people both through the direct effect of the symptoms and indirectly by changing the person that families know and love. It can seem as though the loved one has been taken over by an “anorexic minx” who thrives on feeding misinformation. A family’s reactions to this anorexic minx can change the course the illness takes.

Impact of anorexia nervosa on the sufferer Brain starvation affects the core being of the sufferer, causing some aspects of personality to be accentuated or new facets to emerge. For example, at a low weight, behaviours often become ritualised and rule bound. Attention becomes focused on small details, particularly relating to food and weight and it is hard to see the bigger picture of life. The cognitive resources that humans use to make complex decisions and to understand the perspectives of other people are depleted secondary to a low physiological reserve. Communication and social interactions are less rewarding and the sufferer withdraws, becoming isolated.

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Furthermore, the loss of self-esteem and cognitive introspection that follows makes regulating emotions difficult. Frustration escalates into anger. Anxiety ascends to dread and fear becomes terror, sometimes manifesting as a panic attack. For other sufferers, there is too much inhibition of emotions. They may rely on their eating disorder to numb unpleasant emotions and therefore appear emotionally ‘apathetic’ or frozen; neither expressing pleasant or unpleasant emotions. Parents, siblings and partners may think the person that they have known and loved is lost or transformed because of these deficits in complex aspects of brain function.

Causes of eating disorders Pinpointing the root cause of an eating disorder remains an enigma, although recent research into genetics and neurobiology is beginning to shed light on these biologically based mental illnesses. Several factors play a role. Certain temperament and personality traits, including childhood anxiety, are common in those who develop anorexia nervosa : • A person who is more sensitive to punishment or threat. There may be many causes of this excess sensitivity including genetic or even indirect difficulties experienced while in the womb or during childhood. • An enhanced ability to perceive and analyse detail. This may be associated with a tendency to be focused and somewhat rigid. • Stress (minor or major) can trigger onset, especially if it occurs during adolescence. Many questions remain and misunderstandings abound. What is becoming clear is that it may not be possible to reverse this causal chain … but treatment can be effective if it focuses on factors that cause the illness to persist, rather than those that have caused it.

A Message for Parents, Partners and Close Others Banish any assumption that you are to blame for the eating disorder. You are part of the solution. Re-feeding is a vital first step. Our brain needs nourishment to think clearly and rationally, and our bodies function best at a healthy weight. Stand up to the illness on the sufferer’s behalf until weight is restored, and eating disorder behaviours diminish, and then remain vigilant. You can help to interrupt the vicious circles that maintain the illness. Breaking through these traps will not be easy but the more heads that are used in this process, the better. You can gain skills to assist with the re-feeding and to recognise and respond to behaviours which are traits of the illness and not your loved one.

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Animal metaphors help define effective responses Eating disorder symptoms and their consequences may lead family members to react in particular ways, and the sufferer may feel increasingly alienated and stigmatised, retreating further into eating disorder behaviour. Professor Janet Treasure and her research team at King’s College, London, have developed animal metaphors to illustrate how these instinctive reactions can be unhelpful. Altering these responses is a challenge but with awareness and skills training, life-changing results can be achieved: The jellyfish - too much emotion and too little control The ostrich - avoids emotion The kangaroo - tries to make everything right The rhinoceros - uses force to win the day The terrier - uses persistence (often criticism) Inspirational animal metaphors include: The dolphin - just enough caring and control. The St Bernard - just enough compassion and consistency Looking back, my family of origin seems to have resembled the ostrich. Living in a family of ostriches, where emotions were not discussed, was difficult and confusing for a child who was very anxious. To survive, I had to climb a mountain to escape the triggers that fed my illness. Only since reaching the summit of that Recovery Mountain at age 55 in 2007, did I start learning of evidence-based research, and begin to understand WHY I had to climb that mountain. I wish my family had climbed with me. But I am fortunate, for my family of choice comprises a great line up of dolphins and St Bernard dogs. And this, together with a supportive, progressive health team and loyal friends, has made all the difference. What does your family comprise? Changing your behaviour and response requires hard work

but the reward—that of saving and uniting your family—is priceless. In challenging times remember the adage, ‘every mistake is a treasure’ and as Martin Luther King said: ‘You don’t have to see the whole staircase—just take the first step.’

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A Message for Sufferers Whether you are 16 or 76, the strength and willpower required to break free from an eating disorder is immense. The first step is to reach out for help. Secondly, accept that—as in preparing for and attempting any great mountain climb—a support team is essential. I hope your family is there to support you but if not, create a surrogate family from trusted friends and a health team. Self-awareness and mindfulness will help prevent eating disorder thoughts from sabotaging your progress. If you become aware of feeling lost, alone or vulnerable, be brave, reach out immediately and allow your support team to guide you. Recovery is complex. First, there is our physical self, requiring a regular and balanced eating pattern. This essential ‘medicine’ of three meals and three snacks a day is as vital in maintenance as in recovery. Then there is our psychological self. We must acquire skills and tools to cope with life and its resulting emotions without depending on our eating disorder. We must guard against anxiety build-up by exploring, addressing and resolving any underlying emotional problem. Dealing with problems immediately reduces the risk of eating disorder thoughts creeping in. I have found that being a few kilograms over the ‘ideal weight’ also helps provide a buffer and alleviates feelings of anxiety that can drive eating disorder thinking. Set-backs are common, but even without the ideal of support from one’s family of origin, recovery is achievable. Moreover, the temperament and personality traits that might create a vulnerability to develop anorexia nervosa may also have a positive aspect. These traits include attention to detail, concern about consequences and a drive to accomplish and succeed. Take heart from knowing that many people who recover from anorexia nervosa do well in life.

Empower Yourself Maudsley Parents has information on eating disorders and family-based treatment, family stories of recovery, supportive parent-to-parent advice, and information for families who opt for FamilyBased Treatment (Maudsley Approach). Maudsley Parents holds an annual conference to bring together leading researchers, families and community clinicians. www.maudsleyparents.org

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NO BODY’S PERFECT Changing Body Shapes Throughout The Ages By Lora Owens (Please note selected images may be distressing to some readers) The causes behind an eating disorder can vary widely among individuals, almost as much as the type of disorder itself. We know of cases stemming from a traumatic incident or issues with pressure, stress, control, and selfesteem. An area of recent debate is social influence, in particular, the media. Although many agree that there is no scientific proof to state that eating disorders share a direct causal link with media influence, its overpowering influence cannot be ignored. A spokesperson from the Royal College of Psychiatrist’s Eating Disorders section states, ‘Although biological and genetic factors play an important role in the development of these disorders, psychological and social factors are also significant’. What’s more, it has been documented that in societies where there is no culture of thinness, eating disorders are found to be very rare. So what’s the connection? Just as other cultures bear the pain of neck rings and small shoes to conform, we as a western society, are attempting to conform to the newest trend that is potentially dangerous for anyone who suffers with food issues: when I’m thin, I’m in. And who holds the key to this damaging and potentially life-threatening message? The media. Take, for instance, dieting. Recent research has shown that dieting is a key factor in the development of an eating disorder. Not only that, but it has been suggested

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that at least one in seven girls aged 11 is on a diet, showing dissatisfaction with their body shape as the main reason for doing so. But from where is a girl, aged 11, hearing the message that they are simply not good enough, pretty enough, and need to lose weight to conform? We all know this answer. This message that is beamed onto our television screens, plastered on billboards, on the cover of every magazine and the constant stream of advertising can very quickly become confused with our own opinion. This message provides visual reinforcement of our expected role in the society we surround ourselves in, and preys on our psychological need for approval and social acceptance. The fashion and media industry united make a killer force in which we come to measure our worth not by physical character, achievement, or even intelligence, but by body shape. Not only that, but this message of making the ‘impossible possible’ through means of dieting, strict exercising, even plastic surgery, reinforced by the image of a beautiful, size zero and ever-smiling model, constantly re-instates the fact that today’s society does not accept women as they are naturally. According to Michelson (1984), ‘We must try to achieve the impossible, for without physical beauty, finding love and acceptance is hopeless; without physical perfection, we are worthless’. Yet, the most frustrating thing of all is that this ‘impossible standard’ is ever-changing. As society grows older, so does the actress/performer/ model of the moment, making way for the new wave of the ideal body. Images of idealised female role models are paraded in front of us, and we are seemingly told they are the ideals to which we should strive for. Let’s journey as far back as the 1920’s in order to demonstrate how the ‘ideal body’ is one of our society’s greatest resources, yet an even greater myth.

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The 1920’s introduced the idea of female rights: women, consequently, projected a more masculine look. A slim figure was expected of women in the 1920’s. What’s more, women would be required to find a balance between respectful and masculine clothing as well as feminine makeup and hairstyling, so hair became shorter and breasts were bound to make women appear more flat-chested.

By the late 1920’s, the women’s movement began and moved away from a more masculine look in order to liberate women into become sexual beings. This was called the ‘flapper’ period. Women were expected to exude more sex appeal, so as to be seen as sexual objects by both men and other women. This was a competitive time period, as it was accepted that women had to look sexy and available in order to become socially accepted and deemed attractive enough to ‘deserve’ a husband and keep him. This type of philosophy can still be seen in today’s social values.

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2. By the 1940â&#x20AC;&#x2122;s, World War 2 was now in full swing. As men were called off to war, women were now expected to be bread-winners for their homes, and return to work. This called for a return to the masculine look, in order to appear tougher and gain more respect.

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However, upon the war ending, women returned to their homes and subsequently restored their womanly housewife image, and petite figures returned.

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The 1950’s saw the first remarkable change towards women’s body image. This was referred to as the “baby boom era”, as figures were seen as more “womanly” and nurturing, perfect for child bearing. This type of body was expected to be more nurturing, yet oozed sex appeal for men. Typical examples of this would, of course, be the ever-glamorous 50’s starlets, such as Jane Russell, or Marilyn Monroe. This voluptuous figure was desired by all, a bigger bust, wider hips, and bigger thighs were all part of the ample package.

5. The 1960’s and 1970’s seen the new wave of fashion models. For example, Twiggy’s ultra slim and boyish frame became the new idealised female figure. This reflects the 1920s women’s movement and the message appears clear when women demanded equal rights, women became more boyish to demand it.

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The 1980â&#x20AC;&#x2122;s saw a whole host of varied female ideals. One formed, with the turn of the 20th century, a more toned, healthier and stronger body image. Take, for example, the infamous Madonna.

6. As women now had more say in the participation of sport, figures became more muscular and athletic, an image that can still be seen today in the likes of Venus and Serena Williams, the tennis duo.

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Not only that, but thanks to the likes of Marilyn Monroe, the image of the voluptuous sex goddess was still very much at large. And large it was: breasts became bigger, and the plastic surgery field was established. This type of image gave rise to the idealised figure in the porn industry, as it is still expected that a curvier women appeals to men as a more sexual women. Lastly, the increase in demand of fashion models, due to the likes of Twiggy’s success, led to an army of boyish and skinny models.

10.

All three body images were perceived as ‘ideal’ and as ‘perfect’, but in very different ways. The new wave of athletic women were seen as healthier, which may seem ideal to some. To be found sexually attractive, the curvier women were paramount. For the model business, a boyish, skinny frame were found best, perhaps due to the fact that a smaller body mass equals less material, so overall a cheaper option.

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The 1990’s marked the era of ‘heroin chic’, the thinnest of the thin. In the past, wealth and status were reflected in a fluctuation of weight, when food was scarce. Thinness was considered a sign of illness and poverty, therefore the larger the woman, the more luxurious a lifestyle she led. As the agricultural and industrial revolutions reduced food shortages, the wealthy no longer strived to be fat; the body image flipped. As it is still seen today, thinness became the sign of a more motivated character, and who used more resources with more determination to avoid the stigma of fatness. The billion dollar fashion industry still thrives on this body ideal to this day. However, to be honest; what’s the true difference between this:

And this:

11. 12.

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13.

The fashion industry and their size zero army have since reigned the catwalks and advertisement agencies across the world. However, they have not been alone. The fight against the size zero model ideal is fore-fronted by a new wave of women, who send a far more positive and frankly, more powerful message. Thanks to performers such as Beyonce, Fergie and Rihanna, we welcome the age of the Amazonian Warrior Woman.

14.

15.

Not forgetting the most sought-after body of recent years, the beautiful and curvy Kim Kardashian! This type of body exudes confidence, power, and feistiness. All of these women are considered successful, sexy, and super-curvy, making them ideal role models for this day and age.

16.

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As we can see, the leading role models across the decades have since come and gone, taking with them an army of body ideals. The message delivered is this: the ‘perfect’ body just simply does not exist. Which one of these women can be considered as more beautiful than the other? Each appeals to different types of women, who live different lives, and have different goals. The media’s constant pressure to pursue the image of the ideal woman cannot possibly be achieved when no one woman can possibly follow all of these body types. Our own body image is considered as the ever-changing total of conscious and unconscious information, obtained from our social environment. It is the perceptions and feelings about one’s own body, which we consider different and individual from all others. It is no more than a mere social creation, developed through reflected perceptions of others, and the extent to which we differ from our ideal. The media industry thrives from pure insecurity. This ‘perfect’ body image is as ever-changing as it is everpresent. Therefore, to base our own self-worth and body image upon this harmful message, is to be harmful to ourselves. Poor self-image then leads to poor self-esteem. According to Convisser (1983) women who focus their attention on hating their bodies also tend to separate their body from their person, as if they are not the same entity. Therefore, depersonalizing from your body leads to a loss in identity. BEAT's chief executive, Susan Ringwood, said: ‘The media is a powerful influence and we know how vulnerable some people at risk of eating disorders can be to its visual images in particular’. Here, the media has a lot to answer for. However, changes have begun. Dove’s most recent advertising campaign looks to celebrate the average woman,regardless of her shape, size, and skin colour.

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18.

Bruch (1973) makes an excellent point: ‘Worrying about dieting, worrying about being skinny or fat, is just a smoke screen. The real issue has to do with how you feel about yourself’. So it would seem the media are re-focussing their attention towards a more positive message: whoever you are, whatever your size; be body confident and love yourself. They’re doing their part. Now the rest is up to you. Photograph Resources: 1. http://vwab.com/women-fashion-in-1940s-how-did-they-do 2. http://familysecuritymatters.org/publications/id.2078/pub_detail.asp 3. http://glamourdaze.blogspot.com/2009/08/1940s-fashion-womens-dress-code.html 4. http://www.artflakes.com/en/products/woman-1942 5. http://egotvonline.com/2011/06/01/a-gallery-of-marilyn-monroe-photographs/ 6. http://www.catwalkqueen.tv/2008/08/galleries/cq_gallery_icon.php?pic=2 7. http://www.victoriawhiteland.blogspot.com 8. http://gototennis.com/2009/03/03/fight-the-power-williams-sisters-maintain-indian-wells-boycott/ 9. http://www.archonia.com/comicshop/en/article/111716/ 10.http://sashdashfash.tumblr.com/ 11.http://news.softpedia.com/news/Auschwitz-Pret-a-Porter-37588.shtml 12.http://www.realbollywood.com/2010/09/refaeli-upset-skinny-models.html 13.http://www.glogster.com/glog.php?glog_id=6533151&scale=54&isprofile=true 14.http://www.goggle.co.uk/beyonceonstage 15.http://www.style.uk/msn/com/health/photosRihanna 16.http://www.style.uk/msn/com/health/photosFergie 17.http://www.graphicshint.com 18.http://womenscosmeticsinthemedia.blogspot.com/2011/04/dove.html

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The Pyramid of Peace By Alexandra O’Brien Here is an easy, yet effective exercise that you can use on your own or in lots other of situations. It can be done when you are feeling stressed , anxious, nervous or worried about something – an interview, an exam, a social event, meeting new people , giving a talk , going to your GP or therapist or any other situation that you feel causes you to feel anxious, stressed or even frightened .

It is also an effective exercise to use to help you to draw the mind away from stressful, anxious, or fearful thoughts surrounding your eating and food behaviours. Perhaps you are feeling you have binged on too much food and have to urge to ‘get rid of it’ by making yourself sick, or you are trying out a new meal plan that means increasing the amount of food you have to eat. Whatever the situation may be, this simple exercise can be used when your eating disorder voice starts telling you to do things that are not healthy or that could potentially be damaging to your health. You CAN challenge the eating disorder thoughts and feelings by intercepting them using a simple exercise such as this when you are feeling especially nervous, anxious, worried or tense around food and eating. It can help distract you from those thoughts and feelings and calm you down, letting the eating disorder thoughts and feelings pass for the moment. The more you intercept the eating disorder thoughts and feelings during the moment you think and feel them, the more likely you are able to challenge the eating disorder voice and gain your own power and strength over it. Give it a try! 92 | THE VOICE

Challenge The Eating Disorder This Pyramid of Peace distracts you from the anxiety and fear you may be experiencing by making you focus intently on something quite different. This exercise can be used day or night, and suitable for many situations, including those that evoke food and eating distress and anxiety. The Pyramid of Peace consists of visualising the four main geometric shapes contained within the structure of a pyramid â&#x20AC;&#x201C; the oval, circle, square and triangle. The Pyramid of Peace is best done either standing up or sitting down. Start by imagining each shape being drawn 7 times around your whole body while you are breathing as described below.

Oval *Breathe in and draw one half of the oval from your head down to your feet. *Now breathe out while you draw the other half from your feet up to your head. *Repeat 7 times. Count each completed oval by pressing a finger down on your leg.

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Circle *Breathe in while drawing one half of the circle from your head down to your feet. *Breathe out while drawing the other half of the circle from your feet up to you head. *As a circle is bigger than an oval, your breaths should be deeper as you imagine drawing the circle in your mind. *Repeat 7 times. Count each completed circle by pressing a finger down on your leg.

Square *The in- and out-breaths are split into four counts now. *Breath in and draw the base line under your feet. *Keep on breathing in and draw the right side of the square up to you head. *Start breathing out and draw the top line of the square over your head. . *Finish breathing out while drawing the left side of the square down to the base beneath your feet. *Repeat until 7 whole squares have been drawn. Count each completed square by pressing a finger down on your leg. 94 | THE VOICE

Triangle *Breath in and draw the base line under your feet. *Keep breathing in and draw the line up your right side to the apex over your head. *Now breathe out and draw the line from the apex down to the left side . *Repeat until 7 whole triangles have been drawn. Count each completed triangle by pressing a finger down on your leg.

Give it a go and see how it works! It can be a simple, yet effective way of calming you down and grounding you when stress and anxiety levels run high, especially around food and eating. It may be something that really can help interrupt many of the eating disorder thoughts and behaviours that have become ‘automatic’ to you over time. Only by intercepting these ‘automatic’ behaviours and disallowing them to continue , can we start to challenge the ‘automatic’ eating disorder thoughts and feelings and give them less power over time .

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Let’s Write....

A Happy-Thought Journal

By Alexandra O’Brien

Inspiration and motivation is very important and useful to all of us, but especially so when we are going through difficult times. It’s also very important if we want to ‘get better’ and embark upon the road to recovery from an eating disorder. Inspiration and motivation are essential for our sense of worth and our selfesteem. They both remind us of what we want to accomplish in life and are ex 96 | THE VOICE

cellent for helping us to develop and build upon what we have already achieved in life. We ALL have achievements – big and small – and they ARE all important and worthwhile. Unfortunately, during difficult times, and especially when we are experiencing an eating disorder, we often do not feel or believe that we are worthwhile or that we have achieved anything positive in life. This happens for lots of reasons, and although many of us may experience these feelings, they are not reality, because we HAVE all done good, positive and worthwhile things in our lives. One very valuable and practical thing you can do yourself during the days of recovery, and especially during difficult days when things might not appear to be going well, is to get yourself A HAPPY-THOUGHT JOURNAL. When someone mentions a journal, we often think of writing as a form of catharsis – getting your thoughts and feelings ‘out’ so that they don’t upset, anger or depress you as much. However, the purpose of A HAPPY-THOUGHT JOURNAL is a bit different. It is an excellent practical way of helping you to think and write about the good and positive things you have done in your life: your achievements and successes: a way of increasing your self-esteem and feelings of worth. If you find it difficult to give yourself compliments, praise or engage in positive self-talk, then A HAPPY-THOUGHT JOURNAL may be a useful, practical way of starting to think more positively and compassionately about yourself. A HAPPY-THOUGHT JOURNAL is a space where you can experiment and have permission to look at and perceive yourself without an eating disorder visor clouding your perception. It is starting to think about yourself as you really are – as a unique individual who HAS achieved, who HAS done good and positive things in life, who IS worthwhile, who HAS meaning and purpose in life and who IS a special and unique person in our world. 97 | THE VOICE

It is a space where you can start liking yourself and finding out more about yourself, who you really are and what you really want from life. Writing A HAPPY-THOUGHT JOURNAL is very unique and personal to you and there is no right or wrong way to do it. No-one has to know about it – it’s your special space for exploration and experimentation that no-one else has to worry about. It’s a space where you can begin to learn how to like yourself and to rediscover all the positive and worthwhile things about being you. It can help break any self-limiting thoughts and beliefs you might have – thoughts and beliefs that might have been created during your experiences with an eating disorder, but which, in reality, are not actually ‘true’. When you are feeling down, unhappy, uncertain or negative about yourself, get out your HAPPY-THOUGHT JOURNAL and read what you have written at a time when you felt a bit better about things. There may even be pictures, drawings or photographs of things in there that you included when you were have a ‘better’ day. It’s up to you how you write, design or use your journal; however, there is one rule: everything in A HAPPY-THOUGHT JOURNAL must be positive – no negatives allowed at all. Only writing, drawings, photographs, pictures, quotes, and poems etc that make you feel more positive about yourself and your life are permitted in the journal. If you are feeling a little uncertain about how to start A HAPPY-THOUGHT JOURNAL or apprehensive about starting one in the first instance, here’s a few ideas to get you started. Writing the journal will become easier and more natural to you the more you use it. Use it often though – the more often you read and use it, the more effective it will be in helping to increase your selfesteem, self-worth and overall confidence in yourself. Here are some things you can use as a starting point: but remember, there’s so much more you can do and add and there is no right or wrong way to do it – it’s YOUR special place. 98 | THE VOICE

*One helpful way to start is by writing your achievements in it – no matter how small or unimportant you think these might be. I can hear some of you saying right now, ‘But I haven’t achieved anything!’ You have – I guarantee it. We all went to school at some point and learned lots of things – so that might be a good start to build upon. We all achieved something at school – albeit different things. So you HAVE achieved things in life. FACT! Even if someone else said to you, ‘You did a good job there!’ or ‘Well done passing that exam’, even if you don’t completely believe it at first – the point is that you are trying.

*Maybe you did have some negative thoughts about yourself one day.

We all know that’s the eating disorder talking and what the eating disorder ‘voice’ is telling you is neither fact nor reality. So whatever you think of during that day that was negative about being you, think of the exact opposite and write it in your journal (the same thought but positive instead of negative). The positive thought is likely to be closer to the truth about yourself than the negative thought about yourself that you initially had. Over time, you will gather lots of positive thoughts about being you. It may sound difficult at first, but it will get easier over time. Don’t give up! You are re-learning about who you really are – the special person that is in there beneath the eating disorder.

*Another thing to do is to write down three ‘good’ or ‘positive’ things that

happen to you each day. Some days you may feel that nothing positive happened, but there will always be something that you can pick out, no matter how small or unimportant it may seem. ‘Drinking fresh water’, ‘reading your journal’, ‘enjoying a walk’, ‘patting your pet’, or ‘looking at a beautiful picture’ are all small, simple examples of something positive you might have experienced that day. 99 | THE VOICE

*Note down your favourite or most inspiring quotes in the journal.

They might provide an additional boost and some hope and strength when you are having a difficult day. They are a great way to help you to ‘un-stick’ any negative, automatic thinking, and can let in some hope, strength, and motivation for change and help you to rethink some of the negative, unhelpful and self-limiting beliefs that you may hold about yourself.

*Think about the following questions and include them in your journal: * Name 5 things I would like to have experienced/done in the next 5 years. * What mistake have I learned from and why? * What are my successes and achievements for the day/week? * Name 10 things I like about myself. * What are my interests? What things do I like? What do I enjoy doing? What new experience would I like to have? What new things would I like to learn? * Make an ‘I am grateful....’ list – write down everything you are grateful for. * What are my favourite songs/poems/books/films etc? How do they make me feel? * What is my favourite place (real or imaginary)? Write about it. Describe what you see, hear, feel, smell, taste. Describe every detail. Go to your own special place when you are having a difficult day. Read what you have written about it in your HAPPY THOUGHT JOURNAL. Go there when you need to. * Stick some favourite pictures, photographs, poems, stories, quotes, colours, patterns, people, animals, places and so on into your journal. Make the journal vibrant, interesting and colourful – make it look ‘happy’ and ‘alive’ – have pictures, drawings and photographs as well as writing. Use different colours of pens, glue on some pretty fabric or some colourful stickers. Make it a ‘happy’ positive place to visit when you need and want to.

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Try this exercise too – It’s called ‘Self-Understanding’ – be honest though and nothing negative – WRITE ONLY POSITIVE THINGS! 1. One thing I like about myself is.... 2. One thing others like about me is.... 3. One thing I do very well is.... 4. A recent problem I’ve handled very well is.... 5. When I am at my best I.... 6. A compliment that has been paid to me recently is.... 7. A value that I try hard to practice is.... 8. People can count on me to.... 9. Something I’m handling better this year than last is.... 10. One thing I’ve overcome is.... 11. I’m best with people when.... 12. One goal I’m presently working towards is.... 13. A recent temptation that I managed to overcome was.... 14. I pleasantly surprised myself when.... 15. I think I have the guts to.... 16. If I had to say one good thing about myself I’d say that I.... 17. One way I successfully control my emotions is.... 18. One way in which I am dependable is.... 19. One important thing I intend to do in the next two months is.... 20. They say I did a good job when I.... A HAPPY-THOUGHT JOURNAL is a place to go where you can feel better about yourself, even for a little while. The key is to build it up over time to create something that will represent a more accurate, positive and worthwhile picture of you and what you have achieved – to help erase the distorted picture of you painted by the manipulative eating disorder. A HAPPY-THOUGHT JOURNAL, will, over time, reflect back the unique and special you; the worthwhile and valuable you; the ‘you’ who has many skills and abilities who has so much to give and who has many past achievements that can now be built upon to help you to achieve what you really want in life. 101 | THE VOICE

The Value of Eating Disorder Support Groups A mini-study into the value of support groups to those experiencing eating and food difficulties

By Alexandra O’Brien

INTRODUCTION My name is Alexandra O’Brien, and whilst I am the Founder and Editor of The Voice, I also manage and organise an eating disorder support group in Glasgow, Scotland, called The Positive Steps Eating Disorder Support Group (Glasgow). The group started in June 2010, and we meet weekly, every Monday evening, in Glasgow city centre. It is fairly well-established now, with over 95 members in our support community. The group I manage is only one of four non-NHS groups in the whole of Scotland.

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I know many of you are probably thinking the same as me – that’s a disgrace! And you are right, it is a disgrace. I get emails from enquirers all over Scotland, asking about support groups in their area, and I oftten have to be the bearer of bad news and inform them that there are no support groups in their area, and to get to the nearest group, they will have to travel for hours on a train to get there. We do not have an eating disorder support group network in Scotland. Neither do we have a Scottish charity or social enterprise

specifically for eating disorders. This is very sad and unfortunate. Hopefully, this will change one day. I, and some great people I know, have lots of ideas that we want to develop and implement in Scotland.

all members have similar experiences and can identify with each other in many ways, they are all unique and special and they all demonstrate a wide range of eating disorder thoughts, feelings and behaviours.

The severe lack of support groups in Scotland encouraged me to start thinking about the value of support groups to those with eating disorders. I have been organising our support group for over a year now, and seen many members come and go. Some members come along once or twice and one never sees them again. Other members attend frequently, every few weeks or so, and have done so for a while. Other members attend almost every week. Everyone is different and that is what makes support groups special. The group I organise has male and female members, of all ages, backgrounds, cultures and occupations.

During my time with the group, I can honestly say that I have witnessed change and progress in many members. Some members change their eating disorder thoughts, feelings and behaviours relatively quickly, while other members do this by working through a series of small steps. Everyone is different and the key is to work at your own pace and make the changes that are right and appropriate to you at that point in time. However, I can say that I have witnessed change in many members, and some of them really starting to leave their eating disorder behind. There are other changes too: self-esteem improves; confidence increases; a new readiness to explore new options and perspectives; increased motivation; new ways of coping; increased openness and emotional expression; improved physical and psychological wellbeing; and the development of new ways of thinking about, and coping with, life without an eating disorder.

We have had members who are Scottish, Irish, Welsh, English, American, Canadian, Spanish, Chinese, Indian, German, Polish, Czech amongst others â&#x20AC;&#x201C; so we are very multicultural. We are all different, and no-oneâ&#x20AC;&#x2122;s eating disorder is the same either. While

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It’s amazing how just talking to people who truly listen and understand, who are caring, supportive and encouraging and who have personal experience of an eating disorder, can really be so beneficial, valuable and have such a positive impact on some group members. I used to attend a support group a long time ago when I was very ill with anorexia nervosa and had dropped to the depths of despair. It was a group offered by an NHS community mental health hospital at the other side of town. I attended every meeting for approximately six months, until I decided to leave my hometown alone and live on a wee Scottish island for a while. Yet, while I attended every meeting, I didn’t find it helpful or valuable. The people who organised the group had never experienced an eating disorder and hadn’t a clue what I, or other group members, were going through. In fact, one week, the counsellor began the session by announcing that she had joined a well-known slimming club because she felt that she was getting too fat and could do with losing a bit of weight. I won’t comment further on this as it still makes my blood boil and renders me speechless even though that was over 10 years ago! Support groups, however, must be of

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some value to those who are experiencing eating disorders. If they weren’t so many people wouldn’t attend them and actually even enjoy going to session. I believe that eating disorder support groups should be organised and facilitated by leaders who know what it is like to have an eating disorder. After all, the leader is never going to understand, empathise or identify with the issues and concerns raised during meetings if s/he has absolutely no idea of what if feels like to live with an eating disorder every day. This brings me to the mini-study: The Value of Support Groups in Eating Disorders. Are support groups valuable, helpful and of benefit to those with eating disorders? If so, in what ways? If not, why not? What do people think about support groups? What do they like or dislike? What are the advantages and disadvantages of support groups? Are there any recommendations for changing or improving support groups? There are lots of questions to be asked and answered to determine whether groups are a valuable source of help and support to those experiencing eating disorders.

Questionnaires About Support Groups I designed a short questionnaire consisting of 36 questions examining various aspects of attending a support group for eating and food difficulties. This may be part of a potential larger future study I would like to do that would statistically analyse the data and examine various other factors and combinations of factors. However, for the purpose of a magazine article, I decided to report upon the percentage of respondents who either agreed/strongly agreed and disagreed/strongly disagreed with each statement, since the main aim, at this point, was to determine what aspects of support groups were thought to be valuable and not valuable.

The questionnaire was designed to examine the value of support and self-help groups to those who were experiencing eating disorders and eating and food difficulties.

The questionnaire was voluntary and anonymous, however, it did include some classification ques-

tions at the end that could potentially be statistically analysed during follow-up studies. The questionnaire consisted of 36 short statements examining various aspects of support groups for eating disorders. Each statement was accompanied by a 5-point Likert rating scale, ranging from 1 (strongly disagree) to 5 (strongly agree). A Likert rating scale accompanied each of the 36 statements. All respondents were asked to provide a rating score of between 1 and 5 for each statement. A total of 59 respondents completed the questionnaire. I only had two weeks in which to distribute questionnaires, which was done electronically. There were 49 female respondents and 10 male respondents. Each of the 59 respondents had 36 scores and they were all required to complete the classification questions at the end of the questionnaire. Space was also provided for further comments. Respondents were also asked what they liked and disliked about their support group and what, if anything, could be improved. I have selected some of these comments

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to include in the article below, al- This section also asked how long though, unfortunately, not all could they had been attending a support group for. It was difficult to analyse be included here. this data because many of those Anyone not fulfilling this criteria who responded had attended supwere eliminated from data analy- port groups on and off for many sis. The mean age of the respond- years, some attending regularly ents was 31.4 years. The mean for years, then having a break for duration of their eating disorder a year or two. Therefore, it was was 8.81 years. Furthermore, out difficult to determine any pattern of the 59 respondents who par- regarding attendance in this participated, 19 were experiencing ticular group of respondents. bulimia nervosa, 16 anorexia nervosa, 15 eating disorder not otherwise specified, 7 with anorexia and bulimia symptomatology, and 2 experiencing diabulimia. The section at the end of the questionnaire also asked respondents how long they would be willing to travel to support group meetings. The results were: less than 30 minutes (2 respondents); less than 1 hour (21 respondents); 1 – 1.5 hours (10 respondents); 1.5 – 2 hours (2 respondents); and over 2 hours (5 respondents). This section also asked how long should support group meetings be. The results were: 1 – 1.5 hours (10 respondents); 1.5 – 2 hours (47 respondents); and more than 2 hours (2 respondents).

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The questionnaire also asked whether respondents received any other help for their eating disorder. 25 of the respondents had never received any other help for their eating and food problems outwith the support group they attended. The remaining respondents had some experience of the following – private treatment and some provided by their local healthcare system, such as the NHS: psychotherapy; CBT; dietician; EMD R; nutritional counselling; individual counselling; psychopharmacological treatment; psychiatry; hypnotherapy; and 12-step therapy.

So....Do People Experiencing Eating Disorders Find Support Groups Valuable? Now all the method and research stuff above is out the way, what did the questionnaires find? Are support groups valuable to those experiencing food and eating problems? If so, in what ways? What do we like about them? Why are the helpful? The results from the questionnaire, undoubtedly, demonstrated that support groups are indeed valuable to those with eating disorders and eating and food problems. The vast majority of scores lay at the top end of the rating scale for almost all of the 36 statements. For simplicity, I have included some statements below, accompanied by the percentage of the respondents who answered that they agreed or strongly agreed with the statement. I have displayed it in this way below so we can see clearly what respondents thought and what they found valuable.

*81% agreed/strongly agreed that talking to other people who were also experiencing eating and food problems was a helpful experience.

*53% agreed/strongly agreed that they learned new things during their support meetings.

*22% agreed/strongly agreed that they didnâ&#x20AC;&#x2122;t think there was enough access to information and other resources at support group meetings.

*88% agreed/strongly agreed that they found it helpful to hear about what other people in their situation have done.

*80% agreed/strongly agreed that they received support about how to make small changes in their life.

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*81% agreed/strongly agreed that the support group they attended was non-judgmental.

*92% agreed/strongly disagreed that the support group helped them to feel more positive about things temporarily.

*97% agreed/strongly agreed that they were listened to during support group meetings.

*76% agreed/strongly agreed that the support group helps them to better understand their self.

*98% agreed/strongly agreed that the support group they attended was friendly.

*97% agreed/strongly agreed that the support group they attended addressed issues that related to them personally.

*100% agreed/strongly agreed that attending a support group made them feel less isolated.

*88% agreed/strongly agreed that they would recommend attending a support group to other people experiencing food and eating problems.

*97% agreed/strongly agreed that attending a support group made a difference to their life.

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*98% agreed/strongly agreed that they felt welcome at the support group they attended.

*88% agreed/strongly agreed that they learned skills at support group meetings that they can use in their daily life.

*98% agreed/strongly agreed that they felt listened to when raising a point during meetings.

*83% agreed/strongly agreed that they had learned and heard things

during group meetings that helped them to challenge some of their eating disorder thoughts, feelings and behaviours.

*95% agreed/strongly agreed that they found it helpful to hear about how other people with eating and food problems feel.

*85% agreed/strongly agreed that meetings helped them to feel more positive about their situation in the long-term.

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*63% agreed/strongly agreed that attending meetings helped them to feel more hopeful and positive about their future.

*63% agreed/strongly agreed that they felt comfortable talking about their problems and concerns in a support group.

*92% agreed/strongly agreed that they enjoyed attending support group meetings.

*98% agreed/strongly agreed they find group meetings encouraging. *97% agreed/strongly agreed that the group organiser and/or volunteers were friendly and approachable.

*73% agreed/strongly agreed that they looked forward to attending support group meetings.

*92% agreed/strongly agreed finding group discussions interesting. *73% agreed/strongly agreed that support group meetings were important to them.

*47% agreed/strongly agreed that they would like the support group to offer either services in addition to support group meetings.

*24% agreed/strongly agreed that attending support meetings helped them to make decisions about their life.

*56% agreed/strongly agreed that attending meetings made them feel better about themselves. 110 | THE VOICE

*98% agreed/strongly agreed that the group organiser and/or volunteers were knowledgeable and understood eating disorders.

*98% agreed/strongly agreed that group discussions related to their eating disorders and their own personal problems and concerns.

The above is a summary of the findings revealed by the questionnaire. It seems that, from the above, support groups are highly valuable to those with eating disorders, given the very high percentage of respondents who agreed/strongly agreed with the statements. However, we can also learn a number of things from the findings above. Firstly, only 22% agreed/strongly agreed that there was enough access to further information and other resources at support group meetings. It would be interesting to find out more about this. I think this finding is interesting to compare against the following: 47% agreed/strongly agreed that they would like support groups to offer other services in addition to support group meetings. Almost half of respondents want ‘extra’ services from support groups. Perhaps support groups, at the moment, are concentrating more on being a ‘support’ group rather than an ‘information-giving/resource’ group. I think this needs to be examined more closely, and we need to look at the potential of support groups not only providing ‘support’ but perhaps have an allied information ‘service’ that could, perhaps, provide members with leaflets, booklets, posters, and other resources and information. I know this can be difficult for some groups that receive no funding and there is the expense of printing leaflets, handouts and so on. This is definitely something to look at in a follow-up study of the value of support groups to those with eating disorders.

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WHAT ELSE DID PEOPLE THINK ABOUT SUPPORT GROUPS? As I mentioned above, there was a section at the end that asked for further comments, what respondents like/disliked about support groups and what, if anything, could be improved. Many respondents wrote a great deal of information in this section and it is impossible to include it all here. Therefore, I have included WHAT DO YOU LIKE MOST ABOUT a sample of further comSUPPORT GROUP MEETINGS: ments offered by respondents. I feel all of these Respondent said: ‘It was so good would be good to include in to talk about things that I don’t a larger scale study and we normally talk to people about – can examine much more even my psychologist and other members of the clinical team. information by conducting Helps me release thoughts and a larger study of the value feelings and express myself of support groups in eating without being judged, but aldisorders. This will take the ways being listened too – really listened to by people who actuform of a follow-up study ally do understand! Take heed that I and others hope to NHS health professionals – you

conduct in the near future. 112 | THE VOICE

could learn a lot from the people who organise these groups’.

Respondent said: ‘It is a place where it is ok to talk about my eating disorder, without feeling self-indulgent or narcissistic. I don't feel judged by relative strangers in this setting’. Respondent said: ‘I always enjoy meetings. It is so great to chat with other people and the organiser knows what she is talking about and is so lovely and welcoming and always puts people at ease. I wish there was more recognition for the person that organises this group as she is a gem. Fantastic group and better than any other treatment I have ever had – hospital just made me worse, and being part of this group gives me hope, helps with my social anxiety and lets me hear other people’s stories and learn from other people. It is so pro-recovery and I’ve heard of people going to groups before and members competing with each other – but this never happens in this group – there is mutual respect and appreciation of each other and I feel I belong. Thank you to the organiser – thank you so much!’

Respondent said: ‘The best thing about support groups is undoubtedly the people. No matter what the mix of people, their issues and personalities there is something so wonderful and encouraging about knowing that you are not alone and something completely unique and amazing about simultaneously offering support and being supporting. Through sharing experiences, problems, solutions, inspiration and friendship there is a rich environment in which allows for growth, learning and change’. Respondent said: ‘Bonds and lifelines can certainly be formed- particularly when the individuals involved are determined and heading in a positive direction in their recovery. An invaluable part of my experience withwith support groups was that my individual therapist led the one that I attended most often, so it served as another way to “check in” regarding my progress and gain additional support when I was in need’.

Respondent said: ‘I feel I always learn things at meetings, and often new ways of looking at things, often because of listening to other people’s stories, because of what the organiser says, and also because of the topics we discuss and the little tasks we do every other week. Great!’

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IS THERE ANYTHING YOU DON’T LIKE ABOUT SUPPORT GROUP MEETINGS? Respondent said: ‘A group I attended some time ago was run by a lady who had no personal experience of eating disorders and because of this the group became fairly chaotic and was actually a really triggering place to be. I think group leaders need to be very well trained and if they don’t have personal experience of eating disorders, which I feel is preferable, then they should have spent extensive time with sufferers in order to best understand the mind set and the problems it brings. I also feel that groups should be focused on education, empowerment and support and should not be a place where people come together to whinge and moan about where they’re at week after week since this isn’t constructive for anyone – and I have experienced groups which have been like this’.

Respondent said: ‘It can be very difficult when people are in different stages of recovery, particularly when someone is on an upward trend but is unsure or afraid of that change’.

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Respondent thing I don’t

said:

‘The

only

like is the trav-

elling from my where

live as

it’s difficult to get to but it’s worth it in the end though.

feel

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meeting nights as op-

posed to one meeting every

week, it would be beneficial to some people who have cer-

tain commitments on the same nights that meetings are usually held’.

HOW CAN SUPPORT GROUP MEETINGS BE IMPROVED? Respondent said: ‘I find some group members quite discourteous towards the organiser of the group who does this in her free time and gets no money for it. They take advantage a lot and never say thank you at the end of the meetings, even though when we all chat outside ourselves, everyone talks about how much they like the group and are so appreciative of it being there, as there are virtually no groups in the country I live in. I think members could improve their appreciation a bit as I see all the hard work the people who run it put in. Some manners from members would be nice – I must admit I do express my appreciation to the organiser every week as the group she organises is a life-line to me’.

Respondent said: ‘Personally, as a male eating disorder sufferer, I find it slightly difficult speaking in front of only females as I have not came across any male sufferers yet and makes me feel a little isolated, but everyone at the meetings are superb and can’t highlight how much I appreciate their patience whilst listening to me speak and also contributing’.

Respondent said: ‘My support group is amazing in terms of the group dynamics and its openness to new-comers. I do think though that sometimes it would be helpful to have education on other issues which intermingle with eating disorders in order to best understand each other and ourselves. I also think that it’s important to have a contract between members with regards to conduct and commitment to recovery since sometimes certain members who are still fairly unwell can negatively impact other members who were previously in a better place. I also think having a second stage of support meetings for people who considered themselves ‘recovered’ or are strongly in recovery where members can deal with the ongoing issues post eating disorder, relapse preventions and support in an environment which isn’t peppered with issues that they themselves have already dealt with and moved beyond’.

Respondent said: ‘Diabulimia is a very specific eating disorder, and I feel that some of its aspects are often misunderstood or misinterpreted and can play into the 'sicker than thou' aspect of the eating disorder 'culture'. By educating the facilitators and other patients a bit and setting limits about this aspect can be really helpful. Diabulimia is a very difficult disorder and since it's so rare among eating disorder patients, I sometimes feel a bit isolated even being among other patients with the more mainstream eating disorders and that's very frustrating. Perhaps being able to provide some info about DWED and other online resources might be able to help? OR perhaps DWED itself can help give some guidelines for the facilitators that might help these people? I DO know that some groups I went to were excellent at staying on topic pointing out the similarities between ALL eating disorders helped a LOT’.

OTHER COMMENTS Respondent said: ‘The group I attend is superb all-round – welcoming, friendly, helpful, funny at times, interesting, and there is never any pressure – it’s like meeting with a group of friends for a chat.

am so happy and

grateful to have this group’.

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Respondent said: ‘I feel support groups are a key aspect in recovery and the lack of support from local governments and lack of funding and acknowledgement of eating disorders is a total farce where money and resources are being wasted to a mental health disease that needs to be properly addressed. The people who volunteer for eating disorder support Respondent said: ‘I think univergroups should be on the news sities and mental health services channels for appraisal to the high should do more to fund these groups level of support they provide’. – I think they are hugely beneficial and cost effective. They reduce the isolation’. Respondent said: ‘The

Respondent said: ‘The group attend isone only group I attend is Ionly one of a few in my country of Scotland. I of a few in my country think this is terrible and it would be great if of I think this the Scotland. organiser was recognised for her work got some sortand of grantitorwould something to isandterrible helpgreat start moreifgroups I really feel be thebecause organiser the value of the group and it basically has was recognised for her saved my life – I would not be in the place work some I am nowand if I hadgot not found this sort group and of orme, something the grant organiser, for is a saint and I to feel she would be suchmore an ambassador for helphelp start groups ing us do more in Scotlandfeel – so listen because I really theup anyone who wants to fund this. I love the value of the group and group I attend and have met so many great it basically has saved mydo people – it’s very pro-recovery and we different each week at the life – Ithings would not begroup in and have little tasks to do toonow which Iif findIhelpthe place I am ful. Thank you again for this group!’ had not found this group 116 | THE VOICE

Respondent said: ‘Attending group meetings was the best decision I have made in years. Much more valuable and helpful than any treatment I’ve had from medical services which just want to put weight on you and get you out! This great really listen and take time with each person and really provide support and understanding. I don’t feel alone anymore’.

POINTS ABOUT THE VALUE OF SUPPORT GROUPS * It can feel really good to that know you are not alone and that there are other peo-

ple who are experiencing similar things to you. No-one judges anyone in the group at all – everyone expresses empathy and understanding and members do their best to be supportive towards others in whatever way they can. Group members can actually look forward to attending meetings as they find it is a time and place where they can say whatever they want about how they feel and what they think about their eating disorder. When you attend a support group, you really feel that you are being listened to and understood, and that no-one is telling you to pull your socks up, or that you are being silly or anything like that - no-one judges and no-one would ever say anything like that, because we all understand what you are experiencing.

*Recovery from an eating disorder is never a straight path: things will go well for a

while, then, we might take a step back, for whatever reason. Relapse is common and natural – it means we are learning and developing new skills. Think of it as learning by trial and error: after all, it is a journey towards finding out who the ‘real’ you is – the special ‘you’ who was masked and hidden by the eating disorder identity. This is when support groups can be so valuable. Members can be such a great source of encouragement, support, motivation and information during times of ‘relapse’. You can learn from fellow group members who may have already experienced relapse and discover how they got through it, what worked for them, and what didn’t.

*Groups are a safe place where you can express and discuss your thoughts, feelings,

behaviours, worries, and concerns with people who understand and identify with a lot of what you may be going through. I am sure most of you know what it feels like telling your parents, or doctor, friend or therapist about these thoughts and feelings and getting the impression that they really don’t understand. It can be a bit de-motivating at times. However, talking to people who have similar thoughts, feelings and concerns can be so uplifting and you can often feel like a weight has been lifted off your shoulder – because someone has actually listened to you properly and understood. Support groups also ensure you won’t be judged because of these thoughts and feelings – many other members understand, identify and empathise with what you are going through.

*The safety, security and confidentiality of a support group often has a large role to play in working towards successful recovery – a place where you can say what you think and feel without being judged, feeling ‘wrong’ or ‘abnormal’ or worried about hurting or offending your loved ones.

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*The experience of an eating disorder can often leave you feeling low, depressed,

alone, isolated and withdrawn. A support group is an ideal way of getting out and about, even if just for a few hours, to meet and chat with people who understand and are going through similar difficulties. It can really help with your feelings of isolation and feeling much less alone. Some people even make friends or keep in touch with fellow members. The support during meetings can often extend beyond the group setting and there is often peer support amongst members outside group meetings. This, again, can help decrease your sense of islolation, can help with social anxiety and confidence and improve interpersonal relationships in many ways.

*Some people who attend support groups feel that coming together to chat with other people who are in a similar situation helps their motivation and inner strength to get better and work towards recovery. Being with like-minded others can help them feel better able to cope with change.

*Members can attend group meetings as little or as often as they wish – the flexible

nature of this form of eating disorder support may be what makes it so valuable and beneficial to members – it is there any time they need it.

*Many support groups are organised by someone (or a group of people) who have

previous experience of an eating disorder. This is invaluable. As I mentioned above, many of us will have spoken to someone who’s never had an eating disorder about our thoughts and feelings – a parent, friend, teacher, colleague, doctor, therapist and so on. Often we feel that they do not understand what we are going through. They may mean well in what they say to us, but do not truly understand our struggle and how much pain or torment we may be in because of the control exerted by our eating disorder. It can be such a relief to speak to someone who actually knows what it is like to live and function with an eating disorder. This is where support groups become invaluable and often more important that ‘formal’, clinical treatment: they permit support, understanding, encouragement, and a listening ear from someone who has actually been there and done that. You can’t beat that, can you?

*Groups offer a safe place where we can be truly honest about our eating disorder. We have no-one to pretend to or hide from – we can say it as it is. Honest sharing of personal experiences and thoughts and feelings help fellow group members and ourselves – everyone mutually benefits.

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*Support groups are valuable because they are pro-recovery.

Support groups involve individuals at various stages of illness and recovery and you can learn so much from other people in the group that will aid your own motivation and path towards ‘getting better’. Learning from those who ‘have been there and done that’ is invaluable: we can learn not to make the same mistakes and we can learn from the many positive experiences that are shared by group members. Group members understand that recovery goes up and down, backwards and forwards, and when it does, no group member will ever judge you for it – they will just listen, support and encourage you more.

*Groups also allow us to listen and be with other people who are ‘getting better’ and

who have made lots of changes and thinking more positively about things. They provide us with the opportunity to learn from those who are ‘doing well’ and learn new ways of thinking and coping. They can help us see things from a different perspective - a perspective not tainted by our eating disorder voice. Eating disorder support groups, above all, provide hope.

*Support groups can provide emotional support; may offer practical options and sug-

gestions; improved coping skills; improved adjustment; and help with reducing feelings of loneliness, isolation, social anxiety, low mood, low self-esteem, general anxiety, distress and so much more. Support groups can offer a place where members can gain a sense of empowerment and control over their eating disorder.

*Groups can provide a place of emotional comfort: they allow members to express and explore often powerful and distressing emotions that they may not otherwise admit or acknowledge to themselves or others. Groups are a very valuable emotional outlet.

*Support groups can take a wide variety of formats: some are age or gender-specific;

some meet monthly; some meet weekly or fortnightly; some last an hour, some two hours; some are eating-disorder specific and some groups are open to anyone experiencing eating and food difficulties. Some groups allow carers to join, and some do not. Some groups just chat, and some have topics or tasks during meetings. The great diversity of support groups means we can learn so much from each other about what works and what does not work. By sharing this knowledge, we can all work together to develop support groups that can be of so much value to those experiencing eating disorders.

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TIPS ON GOING TO 1. Look on the internet, in local directories, telephone your local mental health

organisation or contact your national charity for eating disorders, such as BEAT or ANAD for details of local support groups in your area, when they meet, where, at what time, and any other details, such as age criteria or whether they are eating disorder specific. Do a bit of homework first.

2. Most support groups have contact details â&#x20AC;&#x201C; an email address, a telephone

number or a website. If you feel a bit nervous about telephoning them initially, send an email asking for details of the group, when and where it meets and so on.

3. If you are especially nervous or worried about your first group meeting, ask the

Group Leader or Group Facilitator if they can meet you for a chat alone 10 minutes before your first meeting. I do this with new members and it can really help them to relax. It also gives you the opportunity to ask questions and for the leader to give you more information about what happens during the meeting.

4. Read any group reviews you can find.

My private group website has some group reviews on it, and many new members find this helpful. Find out what other people think of the group.

5. Remember, you can just sit and listen during the meeting.

There should be no pressure to talk or reveal any information that you donâ&#x20AC;&#x2122;t want to or feel comfortable with.

6. All support groups should have a Confidentiality Policy in place.

Some may ask you to sign a short form to let you know that what you say during the meeting will be private and confidential and remain within the confines of the group. Of course, there may be some exceptions to this, such as Child Protection issues. The Confidetiality Policy is for your own safety and reassurance.

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O A SUPPORT GROUP By Alexandra Oâ&#x20AC;&#x2122;Brien

7. If you are feeling nervous or apprehensive about your first meeting, or any group meeting, take along a friend or family member with you for some extra support.

8. Go over how to get to the meeting venue the night before your first meeting

to be sure of where you are going and how to get there. You may already be feeling nervous about the first meeting and the fear of being late or getting lost will only serve to increase this, so do your homework and plan in advance how to get there and how long it will take.

9. Remember, everyone at the group meeting is in the same boat and will be

experiencing similar difficulties to you. You are not alone and everyone who is at the meeting will have felt as nervous and apprehensive about their first meeting as you may do now. However, they continue to go along, often after many months, so that demonstrates that first nerves and worries about your first meeting will fade over time, and like most who come to my group, you will probably start to look forward to going to the group and chatting with people who understand and really listen.

10. Some groups (such as my group) also schedule in some online chats for members now and again. It might be helpful to find out if your group provides this and, if you are a bit nervous about your first meeting, it might be helpful to attend an online chat with the group before you go along to your first face-to-face group meeting.

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females

women

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Did Know.... DidYou You Know.... Only Young, Well-Educated, Middle-Class Females Get Eating Disorders?

Only Young, Well-Educated, Middle-Class Females Get Eating Disorders?

By Alexandra O’Brien

123 | THE VOICE

media, the majority of whom have absolutely no idea of what it is like to be tormented night and day by an eating disorder. I don’t know how many people I have spoken to who say that their GP or therapist seems like a nice person, but that s/he has absolutely no idea of what eating disorders are all about except from what they have read Eating disorders are experienced in a dreary and outdated textbook by young females, in their late about eating disorders. teens, and who come from middleclass backgrounds’. This is the de- SOUND FAMILIAR ANYONE? scription of eating disorders declared by most of the books I have I do think this is changing to some read about eating disorders. And extent, however, most of this believe me, I have read rather a change comes from eating dislot! Of course, this description is order campaigners, activists and completely inaccurate, and prob- volunteers, many of whom have ably most of you reading this, will personal experience of an eating agree. Eating disorders do not disorder. The fact of the matter discriminate. They creep upon is this: eating disorders are NOT anyone – male or female – of any only experienced by young females, age or background. Eating dis- in their teens, who are well-edorders don’t care whose life they ucated and from a middle-class destroy. The textbooks, there- background. Eating disorders can affect anyone, regardless of age, fore, have it all wrong. gender, sexuality, education, occupation, religion, culture or ethI think this message is slowly, but nicity. This fact is what makes surely, making itself known, but eating disorders so profoundly there is still a very long way to frightening and puzzling. go, and this is partly due to the ignorance and distorted picture This introduces the next section of eating disorders portrayed by of the magazine: male eating disboth health professionals and the orders – a section that we have

124 | THE VOICE

dedicated to males simply be- or present to clinical services. I know what I think, but I will let you cause: make up your own mind.

MEN GET EATING DISORDERS One thought, however, is that TOO, YOU KNOW! The awareness of eating and food difficulties in males is slowly increasing: a fact that also highlights the non-discriminatory nature of eating disorders. Much of this rising awareness is thanks to UK charities, such as Men Get Eating Disorders Too, and the increasing number of males appearing on television and in the newspapers talking about their struggle with food and eating. It’s a good start, but more needs to be done. Male eating disorders deserve to be recognised just as much as female eating disorders. However, the question remains: are male eating disorders really on the rise? Or is it perhaps that the increasing awareness of male eating disorders has triggered more men to come forward and either talk about their experiences,

there is a significant increase in the number of men attending eating disorder support groups. I have thought about this and have also spoken to men who attend support groups about this issue. I don’t believe that the increase in males attending support groups is because more men are suddenly developing food and eating problems. For me, the reason why we are witnessing such a significant increase in men attending groups is simply because they are being turned away from ‘formal’ clinical and medical support services. Health professionals simply don’t have the knowledge, experience or skills to help and support men with eating disorders. This is, unfortunately, a sad truth in today’s society.

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male eating disorders By Alexandra O’Brien It is difficult to determine how many females actually experience persistent and debilitating eating and food difficulties, or an eating disorder. We will never know the exact extent of this problem for various reasons. However, this is partly due to the secretive nature of eating disorders and the high level of denial often involved, especially during the first few stages of the illness.

medical services, and the likelihood of knowing how many men actually experience eating disorders will diminish. The ability to develop appropriate services, support and training associated with male eating disorders will also be uncertain. So, really, everything is interlinked. We need to increase awareness of male eating disorders to ensure more men come forward and then when can start to determine the epidemiology of To determine how many males ac- male eating disorders and further tually experience significant food develop and offer services, supand eating difficulties is an even port and training specific to men. more difficult task. The concept of ‘male eating disorders’ is still There is a serious lack of accurate somewhat new and there is a long data demonstrating how many people way to go to increase awareness in the UK and USA experience signifiof male eating disorders, let alone cant food and eating problems. determine how many males actually experience food and eating There may be two main reasons problems. This, however, influenc- for this. Firstly, the secretive naes things further down the line: ture of eating disorders means if we don’t increase awareness that many sufferers are reluctant of male eating disorders suc- to seek help and support: many cessfully, fewer men will acknowl- sufferers do not even acknowledge they have a problem, fewer edge that they have a problem will come forward and present to at all. Therefore, there is a whole

126 | THE VOICE

population of people out there who are, in secret, suffering from significant eating and food difficulties and who we do not know about because they are, basically, suffering in silence Secondly, it is difficult to determine how many people do actually experience such difficulties because most of the data available in the UK is based on hospital episode statistics. This only alerts us to the number of people being treated in an NHS hospital, on an inpatient basis, for an eating disorder. As much as 50% of treatment for eating disorders is provided by private clinics, hospitals and therapists. There are also many sufferers who are seriously ill but not in contact with any medical or treatment services.

ment: it is a guessing game determining how many people do actually experience significant food and eating difficulties â&#x20AC;&#x201C; a rather frightening thought, to say the least. This is even more shocking when we think about how only 1 in 10 people with an eating disorder actually receive any form of public or private treatment or therapy (ANAD).

The most reliable data in the UK is reported by NICE (2004). However, again, the data only highlights the number of people who received inpatient hospital treatment for an eating disorder. While this only focuses only on a small percentage of eating disorder cases, the charity BEAT suggest that approximately 1.6 million people in the UK are affected by eating and food difficulties, 11% of which are Many individuals experiencing food male. and eating distress also receive support on an outpatient basis. None of the above are reported in the statistics. The incidence of eating disorders in the UK is, therefore, based upon how many people receive inpatient hospital treatment. Hardly an accurate representation of eating disorders in the UK! There is not data available for those that are not receiving inpatient hospital treat-

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The American charity for eating disorders, ANAD, suggests that up to 5 million people in America experience significant food and eating difficulties. ANAD also assert that an estimated 10-15% of people with eating disorders are male, although this could be as much as 25% of the total eating disorder population (Men Get Eating Disorders Too). So it seems that a significant number of people do experience eating and food difficulties. These statistics should not be taken lightly given that eating disorders have the highest mortality rate of any mental illness. With this data, eating disorders amongst males is clearly a cause for concern.

Eating

disorders are not about food.

They are about experiencing and coping with difficult or painful feelings and emotions. Often we cannot deal with these emotions. They may be too painful, overwhelming, confusing or we may not like what the emotions are trying to signal to us. We might try to numb the feelings; ignore them; hide them; deny them or even try to forget about them. We can only do this for so long â&#x20AC;&#x201C; eventually we have to face

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the feelings and emotions. Eating disorders can often develop in response to what is going on inside of us. We can use food, eating, weight and exercise as a way of dealing with these powerful feelings and emotions. Often we cannot deal with these emotions. They may be too painful, overwhelming, confusing or we may not like what the emotions are trying to signal to us. We might try to numb the feelings; ignore them; hide them; deny them or even try to forget about them. We can only do this for so long – eventually we have to face the feelings and emotions. Eating disorders can often develop in response to what is going on inside of us.

can use food, eating, weight

and exercise as a way of dealing with these powerful feelings and emotions.

Males experience painful feelings and emotions too - so it’s not surprising that they may also attempt to find ways of coping with them. They can then find themselves developing issues around food, eating, weight and body image. This can affect males of all ages, backgrounds, sexualities,

occupations and cultures. It may seem like a way of coping with life at the time, but it is a way of coping that will, ultimately, hurt you. Despite the increasing awareness of male eating disorders over the past decade, the issue of males with eating disorders still receives little attention and too may males go undiagnosed and untreated. This is unfortunate, because, whether male or female, eating disorders can have a major impact on an individual’s health, life and ability to function. The behavioural characteristics of anorexia, bulimia and binge-eating disorder in males are very similar to those demonstrated by females. Many females with eating disorders also experience co-morbid symptomatology – depression, anxiety disorder, borderline personality disorder, bipolar disorder, obsessive-compulsive disorder, self-harm, alcohol and drug misuse. Males with eating disorders are also at an increased risk of experiencing co-morbidity. With this, there is a pressing need to develop and offer specialised support for males experiencing food and eating difficulties. This is all very well. However, it is important to note that, generally, men

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(with or without eating disorders) are less likely to seek help for emotional difficulties than females. This poses a particular problem when we consider that eating disorders are traditionally perceived as a ‘female illness’. This is still a popular stereotype and only serves to strengthen the reluctance of males to seek support for their eating and food problems. It is important, however, for anyone – male of female – with an eating disorder to seek help as soon as possible. Delaying treatment can reduce its effectiveness and increase the likelihood of medical complications, co-morbidity and problematic family, social and work relationships (ANAD). Increasing awareness of male eating disorders and challenging this stereotype is one way of encouraging more males to acknowledge their problems, come forward and access any help and support that is available. The more men that do this, the more likely male eating disorders will be recognised and diagnosed by health professionals. Only then can we begin to develop specialised services specifically for males. It is vital to start working towards understanding the unique recovery challenges that males face and tailor help and support specifically to males. Undoubtedly, however, with increased awareness comes increased specialised training in male eating disorders, which, currently, seems very scarce in the UK.

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Jamieâ&#x20AC;&#x2122;s Story My Story So Far As A Male Eating Disorder Sufferer By Jamie Wood Contrary to most public belief, it seems impossible to say that a male has an eating disorder, right? The popular, well- known definition of what it is to have an eating disorder seems to focus only on the women who strive to attain the skinny body image of their celebrity peers. Well, unfortunately, they are mistaken. Men can also develop eating disorders and more and more men are being diagnosed every year. With a lack of acknowledgement from the public, it is understandable how men feel embarrassed to speak out about what they feel may be classed as a shameful and feminine-driven illness. Unfortunately, I am myself a victim of anorexia nervosa, possibly the most commonly heard type of eating disorder. This all started almost five years ago and has been an up and down struggle, not only for my mental and physical self, but for my family too, who have had to see me go through the painful recovery stages. I can only describe it as a game of snakes and ladders where I go up the ladders only to slip back down the slippery devilish snake. I had always been overweight as a child and as my years progressed so did my waistline which seen me balloon to my heaviest weight of just under 18 stones at a height of 6 feet 2 inches. Iâ&#x20AC;&#x2122;ve always had a happy childhood, great family and friends and a good social life. So what went wrong? One night, whilst out with a good friend of mine, I was viciously attacked by a group of thugs . I sustained a fractured nose and was bruised from head to toe. This gave me a shock to the system as I had always been a confident young guy at the age of seventeen. Of course, this knocked my confidence and I felt that I wanted to get away from

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a life of drinking at the weekends and generally just having a laugh. I wanted to get down to studying, attend college and quit my full time job with an electrical systems company. This vicious attack took place around February 2006. Shortly after this I decided to go on a diet and take up jogging as I wanted to increase my confidence and self esteem. To my delight, I had lost weight and dropped down to a comfortable 12 stones, which, for my height is regarded as a “healthy weight”. All seemed well: I applied to study at a college in Glasgow in the August. I planned to study my intermediate 2 grades because I had previously left high school at the end of fourth year with poor qualifications. So life seemed pretty sound for me then. Yes, on the outside: but not on the inside. I was receiving compliments left, right and centre from people who I had not spoken to since my terrible ordeal. All the compliments gave me the incentive that I could gain weight again, because I loved all of the attention from my peers, and I had always imagined that being slim would make me more popular and generally more happier.

How wrong was I? It eventually made life worse. I decided to restrict my calorie intake to approximately xxxx calories a day (exact calorie amounts have been deleted by the editor) to prevent weight gain. I undertook a brutal exercise regime of running 10k (6 miles) four times a week with the addition of walking vigorously every other day. Everywhere I went I arrived on foot. People started noticing my dramatic weight loss. I started receiving warnings from my loved ones who said that I was taking my ‘healthy lifestyle’ too far. I wasn’t concerned because I was full of energy and I had never looked or felt better (in my eyes). I even managed to get a really amazing girlfriend who made life feel complete for me. A college place, a great girlfriend, slim and fit: who could ask for more? Me of course! I could feel the eating disorder (which I’ll refer to as “The Demons” throughout the rest of this) taking control. Slowly, I was becoming more restrictive with my food intake and my exercise regime was beginning to spiral out of control. It wasn’t long before I became so irritable and food-focussed that I ended up breaking up with my girlfriend. I also lost all contact with my friends. To be honest though, they weren’t true friends and I realise that a mental illness does allow you to see the true

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colours of people and is a decider of who your true friends are. In my case I have NONE. I became isolated as food had taken control of me. I was so secretive about my eating habits and wore baggy clothes to hide my skeletal frame. In my eyes, I couldn’t see the effect of starvation and malnourishment on me. I went from an athletic broad-shouldered 12 stone male, to a skinny 7 stone bag of bones. Something had to be done. But how? I was too scared to speak to anyone. I felt ashamed and embarrassed speaking out as I felt they’d laugh and taunt me for even suggesting I had a lifethreatening mental illness mistakenly only associated with teenage girls driven by attention. It wasn’t long before I was beginning to suffer from digestive issues, mainly constipation. I consulted my GP who prescribed laxatives which worked for a while before my bowels stopped working altogether. I revisited the doctor again, but this time my mother escorted me. The doctor felt that a blood sample was necessary as she couldn’t diagnose what was wrong with me. She admitted recently that the first time I visited her she couldn’t believe how frail and gaunt I looked. She was worried I was suffering from CANCER hence the blood test! The next couple of days passed and my doctor phoned me late at night with my blood results in a panic, reporting that my white blood cell count was extremely high, and my liver was extremely damaged. This was my wake-up call and really gave me a fright. Motivation to get better and seek help was now a priority. The next few weeks were very emotional. My mum was the only one supporting me through the early stages of my recovery as dad couldn’t understand my illness and regularly told me to “just eat”, not understanding how fragile my mental frame was towards food. My mum has been my biggest inspiration. I owe a lot of thanks to her and it is partly because of my mum that I reached a more stable stage in my recovery. We agreed a pact: a family pact, but, more importantly, a promise pact that if I were to start eating better mum would encourage me and help me to develop my running and sporting enthusiasm was present before I became ill. I had a passion for sport and running before I became ill. Being in such a weak state, I could hardly walk the length of myself without a feeling of pain and numbness strike through my body - physically

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and mentally. After a few months, I was running a few miles 3-4 times a week and eventually got back to running 10k races and found the courage to join a local running club, Calder Glen Harriers, who I also owe thanks to for their support and encouragement, despite the fact that they never knew of my past history. To date they are still none the wiser. A few years past and I started exercising more, eating more and generally happier. I had committed myself to eating more only if I could exercise more and it became a cycle. The past few years of my recovery were not pretty and I did go up and down terribly. However, I never allowed myself to become seriously ill again as I knew I’d jeopardise my life...again. I would tell myself that there was a future in front of me and I still tell myself this today. I finally felt ready to follow through my educational plans. I embarked on two years of study at college. This was great, however, during my last year of college, towards the end of exams, I started feeling the pressure to perform to the best of my ability, as I knew decent grades would grant me access to university: my main goal. However, this led me to food control again and I started feeling lost in a battle of my former self . I wish that I had controlled this previously, but I felt I had left it too late and before I knew it I had reduced my food intake once again. I lost approximately 2 stone and I was in a weakened state of 9 and a half stone. Fortunately, I passed my exams and gained a place at university. I suppose this was an upside. However, there was a downside: I felt like a failure, not a winner, because I had chose education over my health. As cliché as it sounds, you’re health really is your wealth and always comes first, it even comes before what may feel like a best friend at the time (the eating disorder). Since then, I have been playing the so-called game I call “snakes and ladders” where I climb the ladders but slide back down the snake. This has been ongoing for the first year of university. I had been experiencing lots of stress with university exams and so on and so it has been a rollercoaster of a year with emotions streaming from all over and mental fights against the demons which I seem to be more in control of, but not completely in control of.

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To date, I rarely ever exercise properly as I know my eating habits won’t allow me to gain the strength or energy to meet the requirements needed. However, I know that I will soon (without any outside pressure) gain weight and establish a more healthy exercise routine without the feeling of guilt of eating food I feel that I am not worthy of. Recently, I have seen a CBT therapist who was superb in helping me learn more about my thinking styles and thoughts. Obviously these techniques aren’t the cure, but just a way of coping more strategically with some mental battles I face in my daily life. CBT works for some people but not everyone and it’s an experimental thing : it works for some but for others. To date, I have been attending a support group in Glasgow, where members and volunteers have all either suffered from food problems and behaviours or have experienced an eating disorder and recovered. The group is a fantastic bunch of individuals, each one with a story to tell and I feel this is a better approach towards my full recovery, although I feel that I am already more than half-way there already. Relapse has been constant over the past 5 years, however, I do not blame myself or anyone else. I feel that relapse is inevitable with mental conditions such as eating disorders but learning how to cope with the bad days will make the okay days feel more bearable. If anyone reading this has any thoughts or comments or would like advice, support or want any more information, you are more than welcome to get in contact with me. I am more than happy to reply (jamiewood1989@ gmail.com).

Recovery is all about taking tiny steps. Patience is the key: don’t rush anything. Always remember that “You’re not alone and help is only a stepping stone away”.

Jamie 135 | THE VOICE

On the Bookshelf.... male eating disorders There is still not a great deal written on male eating disorders specifically, but here are a few books that have been recommended for males experiencing eating and food difficulties COUNSELLING FOR EATING DISORDERS IN MEN: PERSON-CENTRED DIALOGUES By Richard Bryant-Jeffries Published by Radcliffe (2005)

MAKING WEIGHT: MEN’S CONFLICTS WITH FOOD, WEIGHT, SHAPE AND APPEARANCE By Arnold Andersen, Leigh Cohn and Thomas Holbrook Published by Gurze Books (2000)

FIT TO DIE: MEN AND EATING DISORDERS By Anna Patterson Published by Lucky Duck (2004)

THE HGV MAN By Dr Ian Banks Published by Haynes (2005)

THE INVISIBLE MAN: A SELF HELP GUIDE FOR MEN WITH EATING DISORDERS, COMPULSIVE EXERCISE AND BIGOREXIA By John F Morgan Published by Routledge (2008)

BECOMING JOHN: ANOREXIA’S NOT JUST FOR GIRLS By John Evans Published by Xlibris (2011) BOYS GET ANOREXIA TOO: COPING WITH MALE EATING DISORDERS IN THE FAMILY By Jenny Langley Published by Lucky Duck (2005)

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Men Get Eating Disorders Too

Men Get Eating Disorders Too is a newly established national charity dedicated to representing and supporting the needs of men with eating disorders. Their new site contains a wealth of information that is specific to the unique needs of men with eating disorders. It includes definitions and symptoms, treatments you should expect to receive and links to support. In addition, the site is a platform for which men can get their voices heard by sharing their experiences and give/receive peer support through a forum. For more information please see the website: www.mengetedstoo.co.uk or email Sam Thomas, who is the Founder and Project Leader at sam@ mengetedstoo.co.uk Sam Thomas Founder and Project Leader - 'Men Get Eating Disorders Too'

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From A Male Perspective.... Hey Skinny!

By Matt Wetsel

I work at a hospital with a lot of different buildings spread across the medical campus. My job has me going between buildings to different patient units or administrative offices, so I come into contact with a lot of different people throughout a given week but don’t work closely with most of them. There are plenty of people I see regularly, but the extent of our interactions are a friendly nod or greeting as we go about our day, not even knowing each other’s names. One such work acquaintance recently saw me waiting to meet with a patient’s family, and greeted me by saying, “Hey, Skinny!” This caught me off guard. When I was anorexic and dangerously underweight, it was not uncommon for people to make comments or observations on my weight or appearance – compliments if they didn’t know me well, and usually concern if it was from a friend.

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These days, the only comments I get on that subject are from people who haven’t seen me in a long time. I recently got back in touch with an exgirlfriend who knew me when I was still underweight.

She had found some old photos of me, and repeatedly mentioned how much healthier I look now and how glad she is that I am recovered. But, as I’ve been writing and reflecting on the two years that I was sick, I’ve become even more aware to the way people think about weight and observe themselves and others. It has become painfully obvious the degree to which popular culture and common knowledge embraces the idea that being thin is equal to being healthy and that thin is always preferable. This happens to such an extent that few people even question whether or not it’s true – it’s

accepted at face value as an absolute truth. The seemingly harmless greeting from my work acquaintance is the perfect example – she clearly thought she was being friendly. But if someone addressed another person in a way that referenced or drew attention to how thin they aren’t, I anticipate that it would not be taken in a friendly way. When it comes to words like ‘thin’ or ‘skinny’ they are typically regarded as either neutral words or as compliments. However, as much as I rack my brain, I can’t think of any words that are opposites for ‘skinny’ or ‘thin’ that society has not placed an inherently negative connotation onto.

Rather than focus on things like overall health and activity, the focus is on numbers, be it weight or BMI. Teaching children to obsess over these things (particularly an arbitrary measure like the BMI) won’t instill a “healthy” mindset, it just tells them that the approval of their teachers, parents, and peers has more to do with how thin they are.

According to the most recent statistics compiled by the Eating Disorders Coalition, 40% of 9-year-old girls have dieted, 40-60% of high school girls have dieted, and 13% of high-school-age Words like ‘fat’ were at one time neu- girls purge. tral descriptors, much like ‘thin’. These days, though, ‘fat’ has become the scar- When I was going through recovery, eslet letter, the thing of pariahs. Children pecially early on, it occurred to me just who haven’t even started puberty are how obsessed our culture is with body experiencing fat-phobia and learning image. I think many of us don’t notice disordered eating behaviours at very how bad it is because A) we are used young ages. The popular response to to hearing it, B) we don’t think much of this is usually something about obe- it when we see diet ads or hear people sity prevention, but what most people talk about losing weight, and – perfail to realize is that if you are talking haps the most dangerous – C) often we about obesity, then you are necessarily agree with what we’re hearing without talking about eating disorders. really thinking it through.

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The average person can usually hear these things without becoming especially concerned or obsessing over it (though I would not go as far as to say that people succeed at “tuning out” these messages), but for someone with an eating disorder, you become hypersensitive to it. Going out to eat with friends was often a challenge for me before and during my recovery. Just looking over a menu could be overwhelming, but being out with other people was nice because you could focus on socializing instead of the actual act of eating. At least, that was the idea at the time.

I was reminded of this when I was greeted by ‘Hey, Skinny!’ because, although I no longer worry about or even think about my weight, it’s obvious just how much seemingly most everyone else does. What bothered me even more is how comfortable she was in combining a greeting with an observation about my appearance. Our society has a nasty habit of judging and evaluating each other

The way I see it, if it would be considered rude or mean by most people to comment on how thin someone isn’t, then I’m equally conIt seemed inevitable that even close cerned when superficial observations friends who knew what was going on are made which in some way praise or would make comments on how much compliment someone’s appearance. I was eating (usually intended in a friendly or encouraging way but always This idea is explored in enormous detail having the effect of just drawing my at- in Alfie Kohn’s Punished By Rewards, tention back to eating) or would start which mostly focuses on school and the discussing weight over meals. Espe- workplace but is entirely applicable to cially in larger groups, once the subject the topic of body image and eating discame up it seemed that everyone had orders, since it all revolves around selfsomething to say about their weight perception and self-fulfillment. Not to and how much they had lost or gained mention, many weight-loss schemes recently. I eventually learned to just involve incentive-based dieting or exexcuse myself and walk outside for a ercising, a form of self-rewarding or few minutes in those situations, since self-punishing. He argues that it isn’t at the time not all of my friends knew I enough to abstain from punitive pracwas in recovery and I didn’t always feel tices when students or workers underperform, because praise or superficial like explaining it.

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based on appearances.

rewards make people focus on and care more about the rewards themselves, and even rewards can have a punitive effect, such as when someone does not do well enough to earn a reward. I feel this idea translates fairly easily into the discussion of body image and the overall focus of weight with regards to health. Or, as it’s written in the Tao Te Ching, “Recognize beauty and ugliness is born.” It’s impossible to know what kind of perception someone has of their own body image. My co-workers who complimented my extreme weight loss back when I was anorexic were really just reinforcing the disease and giving me excuses to not worry about what was happening. I think if we are to break out of our weight-obsessed culture and move towards something where people are valued for who they are and not what they weigh, one of the first places to start is with our own perceptions and ideas with how we perceive our fellow humans.

Without context (like my estranged ex-girlfriend excitedly telling me how healthy I now look) the only conclusion I have is No, it’s neither appropriate nor friendly, because despite how frequently and casually body image and weight get discussed, it remains a deeply personal subject for many people. Obviously, this may not apply to everyone. Recently, I saw a friend’s mother for the first time in months who had been on a diet. She had noticeably lost weight, and truthfully, she looked like she had more energy and felt healthier. I almost commented on her weight loss and how “good she looked” but then stopped myself. Later, my friend reported that her mother was disappointed that I supposedly didn’t notice the weight loss. Though I felt bad, it made me wonder – did she really feel good about herself and her body image if she was disappointed that I didn’t compliment her weight loss? Or was her feeling of selfesteem less about liking herself and her appearance and more about how other people

Is it really appropriate or even friendly to make random comments on someone’s body, regardless of how short, tall, fat, or thin they are?

perceived her?

I honestly don’t know the answer, but for many people I fear that it is the latter. What do you think?

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Jamie’s Tips: What Works For Me By Jamie Wood As a male with an eating disorder, here are a few things that have helped me over the years.... 1. The Invisible Man: A Self-help Guide for Men with Eating Disorders, Compulsive Exercise and Bigorexia, by John F. Morgan: this book has been my bible during my recovery even to this date. John F. Morgan is an exceptionally experienced and expert clinician who understands what it’s like for a male to suffer from an eating disorder and be alone. It is a useful guide for men in recovery from various forms of eating disorder. His seven stages to recovery have proven to be most effective in dealing with recovery and highlight the main points of how to get better. It also gives a great understanding for sufferers, families and carers of what to expect in recovery and how to overcome any hurdles you may come across. I’ve learned so much from this book and as it is male-focussed, it has proven to be of the highest value to me out of any other eating disorder books I’ve came across. 2. Website: www.selfhelp.org: this is a great website for CBT (Cognitive Behaviour Therapy). It has lots of self-help resources and looks at how to view negative situations from a more positive perspective, as opposed to looking at things in black and white. It is great for anxiety, self esteem, eating disorders, depression, OCD and other mental health problems associated with food issues.

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3. Writing about my thoughts and feelings in a diary when I don’t feel like talking to anyone is a great tool to release thoughts and feelings. I also recommend taking a walk regardless of how you feel – it will help you feel better! Fresh air is exactly what everybody needs and helps clear the cobwebs. Why not take a neighbour’s dog down to the park? 4. Keep BUSY! Find a job; try voluntary work; meet up with friends; reading a book in a quiet room, with slow relaxing music can be very helpful when I’m not feeling up to things. A cold (or warm) shower/ bath can be very beneficial and has been proven by myself to help revitalise myself. 5. I’ve recently started doing yoga a couple of times a week at a local yoga class. This not only helps me stretch out my muscles but helps to release any stress and tension I am feeling. It also helps me to clear my mind and releases all of the negative thoughts I have and helps to ‘clean’ my mind. Meditation is another option. There are plenty of books and resources on practicing yoga and meditation at home. Try it out, what’s the harm? It might just work for you too. 6. Make a plan of what you’re going to do the following day and stick to it! Make a plan of what you’re going to have at meal-times, ensuring it’s based around three healthy, balanced main meals, with small snacks in-between. Plan it and prepare it the night before so that you don’t cheat.

Personally, I feel that you learn what works for you and that it’s only by trying out different things will you benefit from anything that will improve your association with food. 143 | THE VOICE

to aps y a w o w ly only t l a allant e r g e a r a s a e r r e Th victim o s ant a w : e u f i o l y f h i c a pro ust decide m u o n cards Y w . o r r e t u h o g y i f . Deal t c a e if you r d r n o A t . c k a c to cked de a t s a h t i lay with p o t y a or play w which w e d i c e d you. don’t h t i w s y a ays pl life, it alw ) ain (Merle Sh

Perseveranc e is not a long race: it is many shor t races one after an other. (Walter Ell iot)

Positive Thoughts By Alexandra O’Brien

If you wa

nt some thing v can ac ery bad hieve it ly, you . I t may ta a real ke patie strugg nce, le and a long it can be don time; b e. Tha ut t much prereq f uisite o aith is f any u a nderta k ing. (Margo J ones)

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my future. My will shall shape eed shall cc su r o il fa I er h et h W t my own. be no man’s doing bu clear any I am the force; I can r I can be obstacle before me o choice; my lost in the maze. My lose, only r o in w y; it il b si n o sp re destiny. I hold the key to my (Elaine Maxwell)

of The power to hold on in spite dure everything, the power to en Per– this is the winner’s quality. feat sistence is the ability to face de up again and again without giving great – to push on in the face of ory difficulty, knowing that vict eans can be yours. Persistence m ery taking pains to overcome ev cesobstacle and to do what’s ne sary to reach your goals. (Wynn Davis)

In the depth of winter, I finally learned that within me there lay an invincible summer. (Alber t Cam us)

dy, o b y m are of c e k a t fe for y a l s g s n i i t v I w lo ns. I can no nd my emotio da self. y m f my min o e ke car a t o t e m

a good friend. s a y d bo y m e is n g o c I re and know e, m s ll te it at h w to I listen d. I choose to li va is e ic v d a s it at th be healthy and free. nd capable. a l u f r e w o p , t n I am importa th. I love r o w f l se y m e I choose to se myself. and approve of

There is a new a nd better way for me to experience life. I release the past and welcome change an d moving forward towards s uccess.

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creating a am I t, en m o m is th From h new, more new life for myself wit les that toru ve ti si po re o m y, h lt hea low me to be tally support me and al low me to live al d an am ly al re I o h w the life I really want.

I move forward with confide nce and flexibility, knowing that all is well in my future. I m ove beyond past limitations into the freedom of the now. It is sa fe to be me.

be o t e t a l too n. e It’s never e b e v a h ight m u o y t a h w iot) (George El

I am willing to change the patterns in me that cre ated my eating d isorder. I e asily flow with ch ange, and I am always goin g in the bes t direction. I lo ve and app rove of these ne w changes and the person I will be.

gone e v a h u o When y t you can’t ha so far t one more gone manage e v ’ u o y en ance step, th t s i d e h f t just hal e capable of. u’r ) that yo prover b and

(Greenl

Begin doing wha t you want to do now. We are not living in eternity. We h ave only this moment, sparkling like a s tar in our hand and melting like a sn owflake. Let us use it before it is too late. (Marie Beynon R ay) 146 | THE VOICE

Self accep tance come s fr ing life’s ch allenges vig om meetorously. Do numb yours l u f i n’t t u e a lf to your tr be t s o m i a ficulties, n ls and difand ot be n t s n o e r a b c b u d e i ld mental Th worl y e e e x c h h walls to l t u t d e n i p a d s i e n g h f n r c o i m u h t your life. Y find peace ven to he heart. e ou will r o n t o t h seen b t y i trying to e y felt w o u e r b scape p t r s o blems, but mu ) r e l l by confron Ke ing them co t(Helen urageously . You will f peace not i ind n denial, bu t in victory. (J. Donald W alters)

ders r o s i d g n ti ces of ea i o v r e n happy n i e b r The e v e n l l at you’ t your a h t whisper th d n a t se weigh o l u o y l ow you ti h n u y b d e r measu ppiness a h worth is t a h t s i e truth h t t u oving B l . k m o o o r l f e eem com t s e f l e s re – and d a y an l u r t u o r who y very. o c e r yourself fo h t i w possible y l n o ’s t a h t

You do not look like the people you see in the images in th e media because you are real an d actually exist. The images in the media are so photo-shoppe d and manipulated that the pers on in the pictures doesn’t even look like their true selves. In reality, the person in the pi cture does not actually exist. (Rae Smith)

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On The Bookshelf....

Eating Disorders

1. A Collaborative Approach to Eating Disorders. Alexander, June and Treasure, Janet (eds) (2011). Routledge. 2. A Girl Called Tim: Escape from an Eating Disorder Hell. Alexander, June (2011) New Holland Publishing Limited. 3. Anatomy of Anorexia. Levenkron, S (2001). WW Norton and Company. 4. Anorexia and Bulimia: How to Help. Duker, M and Slade, R (2003). Open University Press. 5. Anorexia Nervosa: A Guide for Sufferers and Families. Palmer, RL (1989). Penguin Books. 6. Anorexia Nervosa: A Survival Guide for Families, Friends and Sufferers. Treasure, Janet (1997). Psychology Press. 7. Anorexia Nervosa and Related Eating Disorders In Childhood and Adolescence. Lask, B and Bryant-Waugh, R (eds). (2000). Psychology Press. 8. Anorexia Nervosa: Let Me Be. Crisp, A.H (1995). Lawrence Erlbaum Publishing. 9. Anorexia Nervosa: The Wish to Change. Crisp, A.H, Joughin, N Halek, and Bowyer, C (1996). Psychology Press. 10. Anorexics on Anorexia. Shelley, R (1997). Jessica Kingsley Publishers.

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11. Bulimia Nervosa and Binge-Eating: A Guide to Recovery. Cooper, Peter J (2000). Robinson Publishing. 12. Conversations with Anorexics. Bruch, Hilde (1994). Jason Aronson Inc Publishing. 13. Eating Disorders: A Parentâ&#x20AC;&#x2122;s Guide. Bryant-Waugh, R and Lask, B (2004). Brunner-Routledge. 14. Eating Disorders: Anatomy of a Social Epidemic. Gordon,R (2000). Blackwells. 15. Eating Disorders and Obesity: A Comprehensive Handbook. Brownell, K.D and Fairburn, C.G (eds) (1995). The Guilford Press. 16. Eating Disorders and Occupational Therapy. Martin, J.E (1998). Whurr Publishers Ltd. 17. Eating Disorders: Anorexia Nervosa and Bulimia. West (1994). Office of Health Economics. 18. Eating Disorders in the UK: Review of the Provision of Health Care for Men with Eating Disorders. Cooperman, J. Eating Disorders Association. 19. Eating Disorders: Obesity, Anorexia, and the Person Within. Bruch, Hilde (1979). Basic Books. 20. Eating Disorders: The Facts. Abraham, S and Llewellyn-Jones, D (1998). Open University Press. 21. European Eating Disorders Review (all dates). 22. Feel the Fear and Do It Anyway. Jeffers, Susan (1991). Arrow. 23. Getting Better Bit(e) By Bit(e). Schmidt, M and Treasure, J (1993). Lawrence Erlbaum Associates.

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24. Helping People with Eating Disorders: A Clinical Guide to Assessment and Treatment. Palmer, RL (2000). John Wiley and Sons. 25. Just Tell Her to Stop: Family Stories of Eating Disorders. Henry, Becky (2011). Infinite Hope Publishing. 26. My Body, My Enemy: My Thirteen Year Battle With Anorexia Nervosa. Beeken, Claire and Greenstreet, Rosanna (1997, 2000). Thorsons. 27. My Kid is Back: Empowering Parents to Beat Anorexia Nervosa. Alexander, June (with Professor Daniel Le Grange) (2009). Routledge. 28. One Life: Hope, Healing and Inspiration on the Path to Recovery from Eating Disorders. Feigenbaum, Naomi. (2009). Jessica Kingsley Publishers. 29. Overcoming Binge-Eating. Fairburn, Christopher (1995). Guilford Press. 30. Hang In There....Wherever â&#x20AC;&#x2DC;Thereâ&#x20AC;&#x2122; Is: Anorexia Recovery. Roberge, Nicole. (2010). Chpimunkapublishing. 31. Talking About Anorexia. Maroushka, M (1996). Sheldon Press. 32. The Anorexic Experience. Lawrence, Marilyn (1998). The Women's Press Ltd. 33. The Best Little Girl in the World. Levenkron, S (1988). Penguin. 34. The Golden Cage: The Enigma of Anorexia Nervosa. Bruch, Hilde (1979). Vintage Books. 35. Understanding Eating Disorders. Palmer, RL (1996). Family Doctor Publications.

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Happy Birthday!

News

The Positive Steps Eating Disorder Support Group (Glasgow) celebrated their 1st birthday as a support group in Glasgow, Scotland in June 2011. The group started in June 2010 and meets every Monday evening in Glasgow city centre, at 5.45pm – 7.45pm. They have their own private support website for members, of which there are now over 95. The group welcomes males and females, over 18 years, experiencing any form of eating and food difficulty. For more information about the group or if you would like to attend one of their friendly meetings, email i_would_like_to_enquire@ yahoo.com. Potential members can sign-up to their private website which has lots of information, files, resources, discussions, details of meetings, positive thoughts, help and advice and much more, at www.meetup.com/Glasgow-Eating-Disorder-SupportGroup.

Launch of the Beat Carers’ Forum

Beat have now officially launched their new Carers’ Forum and it already seems to be a welcome addition to those who care and support family and friends with eating disorders. It includes a chat facility, message boards, blog, information and other resources. Visit www.b-eat-carers.co.uk. for more details.

Eating Disorders Awareness Week 2012 Monday 26th February - Friday 3rd March 2012

A week dedicated to eating disorders, including fundraising, conferences, awareness campaigns, discussions, projects, talks, open days, and so much more., Primarily to raise awareness of the negative impact of eating disorders, to campaign for improved treatment and intervention, and reduce the stigma and stereotypes surrounding eating disorders.

Men Get Eating Disorders Too Launch new website

Men Get Eating Disorders Too is a UK charity aimed at raising awareness of eating disorders in males. MGEDT recently launched their new-look website and it looks great. Jam-packed with essential information, stories, blogs, resources, and much more – all specific to male eating disorders. Have a look: www. mengetedstoo.co.uk

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Bites....

Launch of new Eating Disorder Support Group in Wrexham

The Wrexham Group is a BEAT-affiliated eating disorder support group for males and females over 18, and is open to anyone with any form of eating and food difficulty. The group is open to eating disorder sufferers and carers are also welcome. The group aims to launch in early autumn 2011 in Wrexham, England. For more information about this new group, email wrexhamgroup@hotmail.co.uk or visit wrexhamgroup.moonfruit.com.

The Second Eating Disorders International Conference

THIS will take place at the Institute of Education, in Central London from March 15th - 17th 2012. This is an important event in the eating disorders calendar and of interest and value to those living with eating disorders, carers, volunteers, campaigners and professionals alike. For more information and to register your attendance, visit www.edic.org.uk.

NEW!! - Eating Disorders ACTION GROUP SCOTLAND (edags)

a new group was launched in scotland in may 2011 called the eating disorders action group scotland. They had their first meeting in august 2011 which was attended by carers, professional,s sufferers, volunteers, and those who have recovered from an eating disorder. it is a user/experience-led group that aims to campaign for improved resources, services and awareness of eating disorders in scotland. EDAGS are always looking for new members to help out. For more information, email thecoordinators on edags@rocketmail.com or to ask about their new upcoming website.

Scottish Association of Mental Health launch new drop-in centre in Glasgow, Scotland

SAMH launched its brand new Resource Centre in the Merchant City, Glasgow, Scotland, aiming to bring mental health and wellbeing to the high street. The Resource Centre offers: free information on mental health issues; library and free copies of publications; computer stations and chats with Information Service staff over a cup of tea or coffee. Anyone is welcome to drop in and find out more about mental health and wellbeing. For more information about this great new Resource Centre and SAMH, visit www.samh.org.uk.

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