LIVING BEYOND – A DEADLY COMBINATION: EATING DISORDERS AND ADDICTION

Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.

RIVERS KNOW THIS: THERE IS NO HURRY. WE SHALL GET THERE SOME DAY

“Rivers know this: there is no hurry. We shall get there some day.”

~ A. A. Milne

One spring evening in mid-2000, I was driving up the Interstate-5 corridor returning to my home in British Columbia; when I received a call from a panic stricken mother. As a psychologist, I have always been very liberal with my contact information, and this particular evening, it was a long term patient who had reached out to me. As I answered my phone, I soon realized that the caller was on the verge of a nervous breakdown. Let me clarify, while a nervous breakdown is not a psychological or medical diagnosis; it provides the clearest image of what was unfolding.As I was familiar with this patient, I could tell that the mother’s anxiety and level of stress were at a heightened state.

The mother’s uncontrollable sobbing brought me to tears as I listened and learned of her painful experience involving her daughter’s lifelong struggle with an eating disorder and addictive habit.The mother explained that her daughter had struggled throughout her adolescence and early adulthood with an eating disorder, issues of self-esteem and self-image and an addiction to drugs and alcohol.

The mother went on to explain that she had nowhere else to turn and felt at odds with her own emotions. Prior to calling my number, the mother had received a call from a distraught roommate of the daughter. The roommate had explained that her daughter had been taking a cocktail of barbiturates, alcohol, and sleeping pills. She further explained that the daughter had not eaten much in weeks and that she was skin and bones. Unfortunately, the mother lived in an entirely different province and had no particular ties to the community with which the daughter was currently residing.

The helplessness experienced when a parent is unable to curtail a child’s behavior is unexplainable and unimaginable unto most parents. Losing a parent is always difficult, but losing a child is beyond comprehension. I have heard countless parents weep and plead for mercy. I have sat with an untold number of children and parents to discuss his or her addictive habits, but it’s the combination of chemical addiction and an eating disorder that seems to bring forth a profound challenge. Which do you treat first is always the question? Why must my son or daughter have this particular and deadly combination? Is it not bad enough that my child have an eating disorder, but also to have a comorbid issue like alcohol and drug addiction?

EATING
Eating is a natural and essential part of life. The function of food is to nourish the body, but was created to be enjoyed by human beings, as well. For many, few thoughts are more exaggerated or obsessed than those who struggle with eating disorders. An eating disorder cannot only consume your every thought, but it can, and often does, consume your very existence. You become a prisoner of your own thoughts, and are robbed of many of the joys of everyday living. Liken to its counterpart, a chemical addiction drives a similar urge within the mind of the individual. For some, the urge is so uncontrollable that they would rather be high than eat. Therefore, the eating disorder may be a combination of an eating disorder, as well as disordered eating.

REFLECTING BACK
As a clinician, I have worked with many who have struggled with eating disorders and disordered eating. Eating disorders can be defined as disorders that are characterized by abnormal or disturbed eating habits. “An eating disorder is a collection of interrelated eating habits, weight management practices and attitudes about food, weight and body shape that have become disordered. This disordered eating behavior is usually an effort tosolve a variety of emotional difficulties about which the individual feels out of control. Males and females of all social and economic classes, races and intelligence levels can develop an eating disorder.”.Hollywood perpetuates many of these distorted ideals by placing a high value on vanity and perfection. Teenagers are especially impacted by these unrealistic standards, and are daunted by societal pressures to the point of self-sabotage and self-abuse. Unfortunately, in the case of eating disorders, food is the weapon of choice and the individual is the victim of faulty generated beliefs.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has three primary classifications for eating disorders. They are: Anorexia Nervosa, Binge Eating, and Bulimia Nervosa.

The DSM-5 has defined the primary types and symptoms of eating disorders as being:

Anorexia nervosa: Anorexia nervosa, which primarily affects adolescent girls and young women, is characterized by distorted body image and excessive dieting that leads to severe weight loss with a pathological fear of becoming fat.

Binge Eating Disorder: Binge eating disorder is defined as recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control. Someone with binge eating disorder may eat too quickly, even when he or she is not hungry. The person may have feelings of guilt, embarrassment, or disgust and may binge eat alone to hide the behavior. This disorder is associated with marked distress and occurs, on average, at least once a week over three months.

Bulimia Nervosa: Bulimia nervosa is characterized by frequent episodes of binge eating followed by inappropriate behaviors such as self-induced vomiting to avoid weight gain.

Eating disorders are rarely caused by food consumption, weight preoccupation, and preoccupation with food.In a majority of eating disorder cases, the patient is suffering, coping, or afflicted with a much graver psychological dynamic. The dynamic may ignite stress or an anxiety causing an unmanageable pressure, tension, or an emphasis on a specific aspect of one’s life. Furthermore, the stressor may be related to a social, environmental, behavioral, interpersonal, or intrapersonal event.

The thoughts of someone struggling with an eating disorder often reflect the following sentiments:

  • “I am feeling overwhelmed by my degree plan.”“I
  • feel pressured by my boyfriend to have sex.”“My girlfriend tells me not to worry about
  • my weight, but it consumes my every thought.”
  • “Food is my only ally.”
  • “I have never felt likable, acceptable, or approvable.”
  • “I feel unattractive.”
  • “My life is out of control.”
  • “I don’t deserve happiness.”

Eating disorders have no allies.

THE DEADLY COMBINATION
The eating disorder alone is a powerful weapon. However, this weapon is not fighting good-and-evil, but rather the precious life of the individual. According to the National Eating Disorders Association, NEDA, “Up to 50% of individuals with eating disorders abused alcohol or illicit drugs, a rate five times higher than the general population. Up to 35% of individuals who abused or were dependent on alcohol or other drugs have also had eating disorders, a rate 11 times greater than the general population.” While these particular statistics are concerning, there always remains a glimmer of hope.

Moreover, the answer is not a punitive approach towards recovery. “In fact, studies have not found evidence in favor of harsh, punitive approaches, like jail terms, humiliating forms of treatment and traditional ‘interventions’ where families threaten to abandon addicted members.”.Punitive approaches are never the answer. The brain circuitry of individuals struggling from addiction and eating disorders are already struggling with self-defeat and negative experiences, one more punishment will not curtail the addictive process.

THE MIRROR

“We mirror what we see in life, and our empathy expands or contracts in response to our early encounters.” As children, we are behaviorally and psychologically conditioned, to think the thoughts we think, to ponder the ideas we think upon, and to perceive the world as we perceive it.“When our caretakers are inattentive, depressed, or filled with anger and resentment, the mirror they hold up for us offers a distorted vision of reality. Looking in the mirror of their confused thoughts and feelings, we see a distorted, unrealistic image of ourselves.” As the child begins to develop, they transform into the image that the parents have projected. Often times, this perception is illusive. When illusion is combined with disparaging beliefs about oneself, this delivers a detrimental blow to the child’s psyche.

Eating disorders affect all ages, populations, genders and sexual orientations. “Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males.” For far too long, eating disorders have been considered to be gender specific, but the reality is, eating disorders do not discriminate or differentiate between peoples.

The challenge is to distinguish between healthy and unhealthy eating and learning the distinction between maintaining a normal weight, diet, and lifestyle. Moreover, a greater challenge occurs when you try to determine the catalyst of the eating disorder and the addiction. The mental health of the individual is the primary pursuit; they set out on this journey for a particular reason. What is the reason that this individual has this deadly combination? What really is the underlying issue?

THE HEALING AND RECOVERY PROCESS

There are no absolute cure-alls that will be the remedy for an eating disorder and/or an addiction.The truth is, the complexities surrounding an eating disorder and an addiction go well beyond what is presenting. Those who are struggling with such a combination
of disorders could benefit from an eclectic body of practitioners (e.g. psychotherapy, medical management, social support and encouragement, and nutritional and health related education).

The following are suggestions for encouraging those with eating disorders and issues of addiction.

  1. Recognize that you are not alone.
  2. Be willing to seek out professional services.
  3. Do not isolate yourself from the world.
  4. Relinquish your need for control, allow yourself to be vulnerable.
  5. Avoid environments and people that are hostile, unfriendly, and antagonistic.
  6. Learn to develop friendships for support, rather than seeking food or an addictive substance to be an ally.
  7. Be aware of your limitations and identify areas that need strengthening.
  8. Consider journaling your thoughts, feelings, and emotions. When journaling, be certain to journal a positive entry for every negative thought, frustration, or agitation.
  9. Maintain realistic goals and ambitions.
  10. Always be considerate of your person. Avoid placing unnecessary stressors upon yourself.
  11. Practice daily affirmations, breathing, and actions that will positively influence your person.

“Begin each day by saying a positive affirmation in the mirror. The following is an example of a positive affirmation.
I am a person of worth.
I am a person of value.
I am a person deserving of respect, love, and kindness.
I am a person deserving of friendships and relationships.
I am a person made up of my human mind, body, and spirit.”

As a person, you are deserving of unconditional acceptance, love, approval, and grace.

Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S. Website: www.asadonbrown.com
References Provided Upon Request