The Problem with Tough Love in Eating Disorder Recovery

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Caralyn is the writer and speaker behind the blog, BeautyBeyondBones. She’s a twenty-something actress and writer in New York City. Having battled a severe case of anorexia herself, she now uses her story of total restoration to positively impact others, and offer hope and encouragement for those with eating disorders, and other forms of adversity. When she’s not writing and acting, she enjoys exploring the city with friends, singing, and living in the abundant freedom of a life, free from ED! Read on to hear some advice Caralyn discuss tough love in eating disorder recovery…

When I talk to people who lived through my anorexia with me, the overwhelming theme is that people didn’t know how they could help me.

They felt their hands were tied. They saw their friend/daughter/sister rapidly wasting away right before their eyes, and they felt helpless.

They didn’t know how to get through to me. They didn’t want to say the wrong thing and trigger a blow up or melt down. And yet they wanted to express their concern.

Meanwhile, I was pushing everyone away, withdrawing from the world, so that I could be alone with my eating disorder, not having to show my friends how sick my mind really was.

And people had their different approaches. Some worked. And some definitely didn’t.

But looking back, I’ve come to realize that above all else, there is one thing that is paramount when it comes to dealing with eating disorder sufferers. And that is tough love vs. tender love.

And I think my perspective will surprise you.

I think there is a grave misconception about eating disorders. That the girl (or boy) just needs some “sense” knocked into her. She’s choosing to starve herself for vanity reasons, or “for a guy” or whatever. She just needs to be set straight. Enter: tough love.

You take away privileges. Ground her. Threaten with consequences. Maybe you’ll even go as far as drawing up court papers to turn her over to become a ward of the state.

Not that I would know anything about that…

But here’s why none of those tactics ultimately work:

They are feeding into the self hatred that fuels her eating disorder. That lack of compassion – that toughness – is exactly what she thinks she deserves.

I wish I could express to you what the mindset is like for someone in the throes of anorexia. Because spoiler alert: it is a desolate place full of fear and obsession, and an underlying abhorrence of self.

There is nothing gentle, everything is harsh — inflicted willingly on the self.

I saw to it that my life was a living hell. After all, that’s where I believed I belonged.

So…tough love was exactly what I thought I deserved. Of course my loved ones were acting as though they were emotionally unavailable…because that’s exactly what I should be receiving.

If there is one thing your daughter or friend needs, it’s tenderness. Gentleness. Which, I know is hard to even fathom, as you look at your loved one, and not recognize the angry, hollow shell of who she once was. But now is when she needs that compassion more than ever.

And when it’s life or death, I know that words can get the best of you, and emotions run high, and sometimes we utter things in the heat of the moment that can be hurtful or too harsh. That’s to be expected.

But soft love is crucial. Tenderness, patience, gentleness is so foreign to her, and yet vital to her healing.

She needs to be reminded what that feels like.

I remember for probably about 2 years during my disease, I wouldn’t let anyone touch me. No hugs. No foot rubs. No gentle touch. I was too ashamed of my body.

There is a time and a place for tough love.

And yes, there are probably times when it seems like the only solution. An intervention, for one. But even that can be finessed with the gentleness she needs. Because it’s true, there are some decisions that she is incapable of making in her present state that you will need to make for her – like going to inpatient. But find the grace to be gentle and compassionate rather than slip into Stone Cold Steve Austin mode.

Her journey to recovery is going to involve learning how to love herself.

The greatest gift you can ever give her is showing an example of just how to do that.

 

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


A Day in the Life: Recovery Coach

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Clementine Portland Lead Recovery Coach Alexa Fleming offers an inside look into how she spends her days. Alexa works closely with the Portland team to provide the highest quality care to the adolescents working toward full recovery. Read on to learn more about Alexa and Clementine Portland…

 

What is your your role at Clementine?

My name is Alexa Fleming. I am the lead recovery coach at Clementine Portland. I have a Bachelor’s degree from the University of Portland. Being a recovery coach for both Monte Nido and Clementine over the last 2 years have been the most rewarding job I have ever had, so here is a glimpse into a day in the life of recovery coaches.

How does your day start?

My shift starts at 7am, I am the first person on shift in the morning, so the house is usually quiet and just waking up for the day. While the nurse is waking up the adolescents I make some coffee, read the communication log, and start heating up breakfast. While the food is warming up I get ready for the adolescents that portion their meals to come in and get their plates ready. Two by two the adolescents who portion their meals come into the kitchen to prepare their plates, following the clear guidelines for their portion, posted on the kitchen whiteboard. During breakfast, we sit and talk about silly things that happened the night before, dreams that occurred overnight, or whatever else they want to talk about. Once everyone is finished eating, the adolescents that have kitchen privileges are responsible for collecting the dirty plates and putting them in the dishwashers. After breakfast the adolescents go to school for the next 2 hours, and I have time to get the clinical office prepped for the day ahead. Recovery coaches are either in the kitchen helping prepare meals and snacks, or in the milieu spending time with the clients.

What is the best part of your day?

The best part of my day is spending time with the adolescents during their free time. I really cherish this time because I get to see the adolescents outside of their eating disorders. They’re (for the most part) not engaging in eating disorder behaviors and are just hanging out, being teenagers. If they are choosing to engage in their eating disorder, I get to help them see the benefits of connection (or choosing their healthy selves) by playing games, watching silly YouTube videos, and just sitting and engaging in conversation. During times like these I really get to know the clients as people and it gives all of us a break from facing the eating disorder head on. During this time, it reminds me that full recovery is possible and gives me hope that someday these adolescents can live full, happy and recovered lives.

Tell us about any groups you run.

One of the best parts of my week is facilitating Movement Group. In this group we do everything from capture the flag, to water balloon fights in the summer, to low impact circuit trainings. The main purpose of this group is to get girls back into their bodies and begin rebuilding their relationship with movement and provide an example of healthy/balanced exercise. Many of our clients report over-exercise as a behavior in their eating disorder, so this group can be rather challenging at times. We always start off group by setting intentions for the activity and finish group by reflecting and doing an eating disorder vs. healthy-self dialogue as a group.

How do you work with your team to support your clients?

One of the best ways that we work as a team to support our clients is by having a weekly Recovery Coach meeting. In this meeting, I make sure to provide time for the RC’s to process any challenging situations that may have occurred throughout the week and offer feedback and support on how to handle these types of situations in the future. We also go over the adolescents’ contracts and talk about any challenges or privileges that they have for the week. By going over this information it allows all of us to get on the same page before the new contract week starts.

Can you remember a unique challenge that you helped a client overcome?

Throughout my time with Monte Nido and Clementine there have been many instances where I have helped adolescents overcome unique challenges. In fact, I would say that this is the reason why each program has recovery coaches. Our jobs are to handle these challenges, whatever they may be, in the moment, with the adolescent. Sometimes this can look like de-escalating a screaming adolescent in the parking lot during a meal outing, or sitting in the pouring rain with someone who thinks they want to throw in the towel and give up on their recovery. Being a recovery coach is being there, every day, whether it’s a good day or a bad day and facing whatever challenges come up, head on.

How do you wrap up your day?

My day wraps up by giving the report to the next RC that is on shift. We talk about what happened throughout the day and what needs to happen in the evening. Report is often given while portioning afternoon snack.

Do you have a passion or hobby of yours that you are able to draw from when working with your clients?

One of my biggest passions and hobbies is nature. Whenever I can I am outside camping, hiking, backpacking, and exploring the beautiful landscapes of Oregon. Being at the Clementine house surrounded by forest and little Christmas trees has really helped me bring my passion into my work at Clementine. A coping skill that I use in my life is stepping outside and breathing in the cool air after a good rain, feeling the sun on my face in the summer, or going on a walk and shifting my focus onto my senses; and being in this environment at Clementine allows me to teach and pass on this skill to all of our clients.

 

For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.


Identifying Eating Disorder Red Flags in Your College Students

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Becky Henry, a coach for parents of kids with eating disorders, and Kathleen MacDonald of the Eating Disorders Coalition identify potential red flag warning signs that your college student might be developing an eating disorder. Becky and Kathleen bring over 30 years of combined personal and professional experience in the field of eating disorders, as: parent & coach and someone who suffered an eating disorder while in college, is now recovery & previous policy director.


Most college students, have been primed on how not to gain the “fresh man 15.” But likely haven’t been primed on just how dangerous trying to avoid gaining weight as a freshman can be. If you are reading this article you likely have some concerns about your college student’s health. We want to help you feel capable of helping your child, and give you motivation to take action if you notice any of the following “red flags”:

  • Isolating from friends and family, or events
  • Dieting and/or skipping meals
  • Cutting
  • Anxiety and/or depression
  • More prominent or obsessive exercising
  • Becoming very secretive and irritable, especially about food or meals
  • When your child comes home for their 1st break (ie: fall, winter), you notice a change in weight that you haven’t noticed before (this could be a gain or loss)
  • Abrasion on knuckles (a result of self-induced vomiting)
  • Use of laxatives, diet pills/diuretics, self-induced vomiting, enemas
  • Trips to the bathroom during, or immediately following, meals
  • Increasing criticism of their body or the body’s of others
  • Increased talk about food, weight, calories, fat, etc.
  • Complaining of being cold (especially fingers and toes)
  • Increased consumption of diet soda or water
  • Increased perfectionism
  • Rules and rituals around food
  • Avoiding eating favorite foods
  • Discomfort in fitted clothes, wearing loose clothing

What happens if you see a few, or more, of these red flags? Your heart rate might have increased and your mind is racing with thoughts like, “Oh my gosh, does my child have an eating disorder?!”  We encourage you to take a deep breath. Many of the signs and symptoms we listed above can unfortunately be typical of a college student who is experimenting with behaviors that they witnessed on campus, and they might not indicate a full blown eating disorder. Still, these are very dangerous behaviors and signs, which need to be monitored closely, especially if your child is predisposed to developing an eating disorder.

How do you help?

You’re already doing the first right thing by reading recent articles from respected leaders in the eating disorders field. We encourage you to be careful of older, outdated, information on eating disorders, as there is a lot out there that is inaccurate and not based on current research. For example, in the past, the dieting that college students engage in to avoid the media-devised, “freshman 15” was seen as “a phase” and something all women did. Now we know that dieting can evolve quickly and be the precursor to developing an eating disorder.

Next, you want to talk with your loved one. Share your concerns and what you have noticed. Be direct and compassionate. Listen but do not let them brush off your concerns with classic phrases such as, “I’m fine!” or, “There’s nothing to worry about, just look at me!” Those phrases deserve further conversation, ask what they mean by that and tell them what you don’t think is “fine” about their behaviors, mood and symptoms.

Be mindful not to “kvetch” with your son or daughter about your weight-loss goals, body dissatisfaction and/or suggest dieting together. Too often these things are seen as a sign that, “See, if mom is doing it, then it must be OK. I must be fine.”

Then, you’ll want a plan in place for next steps if indeed you discover that your loved one is suffering from more than just a few unhealthy behaviors regarding their body, nourishment and the freshman 15. If you realize that the red flags you’ve noticed are signs of something more serious (trust your gut), then you need to get your student to an eating disorder professional ASAP. You can find great resources here and on our websites at www.eatingdisorderscoalition.org and www.eatingdisorderfamilysupport.com

During this process, remember that boundaries are a beautiful thing. Boundaries are not mean or uncaring, (though it may feel that way when you’re learning them). And sometimes boundaries include invoking “tough-love.” You may need to dig deep and find a strength you didn’t know you had, in order to set some tough love into place and help motivate your student to participate in seeking an evaluation and potentially stay home from school to attend treatment.

These are just a few tips for how to recognize an eating disorder and how to get help for your loved one if they are suffering.

The better informed you are, the better you can help your loved one.  

Remember that eating disorders are serious, but there is hope. People can and do recover and treatment works. There is a wide-range of treatment options available, including on college campuses, so please know you are not alone and there is help available.

Most of all we encourage you to remember that: If your loved one isn’t healthy enough to return to college, it’s OK –there is NO harm in taking time off for treatment.

Remember:

  • College will be there, waiting for you to pay tuition, when your loved one is healthy.
  • If your college student had cancer, a semester (or two, or five) off in order for them to receive chemotherapy wouldn’t likely cause you to think twice; in fact you’d likely view treatment as “urgent.”
  • A semester (or two, or five) off, in order for your loved one to get treatment for a dangerous and all-too-often deadly eating disorder, is just as urgent.
For more information about Clementine adolescent treatment programs, please call 855.900.2221, visit our websitesubscribe to our blog, and connect with us on Facebook, Twitter, and Instagram.