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Again I am asked: How can I help my bulimic friend without her going into treatment?
Example: (not real names) Miranda and Trudy are both in their late twenties, married and in their late twenties. They've been close friends for 16 years. Trudy recently revealed her 12 year struggle with bulimia to Miranda. Trudy only speaks to Miranda about the bulimia. Miranda feels she is helping by being the confidante and pitching in to help Trudy with family, household and business responsibilities. She also keeps a careful watch on Trudy's behavior and emotional states. After two months Miranda is happy that Trudy has six weeks of not throwing up and pleads for help in knowing how she can help Trudy continue to get better without her going into treatment.
Please note that in this example, Miranda asks for help not Trudy.
When I hear this plea for help my heart aches for the suffering Miranda, Trudy and their family members experience. What is it that makes Miranda and Trudy desperate to avoid treatment for an illness?
My open letter to all friends asking this question:
Dear Miranda,
You and Trudy are not alone in thinking that bulimia is a behavior that can be stopped through will power and love. Bulimia is a serious illness that only grows worse without treatment. The acting out behavior involving food is only part of a long list of symptoms. Plus, as you understand from your knowledge of other illnesses, reducing or removing symptoms is not the same as healing.
When you say Trudy has made it for six weeks now! with an exclamation point, I feel an emotional aching because of the all too familiar false hope in your inferred sense of victory.
Trudy is doing her best to remove a defense, to stop a coping mechanism that helps her deal with unbearable feelings. Without the healing work that occurs in treatment, she has no defense against inner issues that plague her. She probably doesn't even know what those issues are. Bulimia blocks not only her pain but also will block awareness of the source of her pain.
Your valiant efforts in helping her cope with her daily life tasks ease some of her stress. Your attentive and well meaning actions allow her to live without some of her bulimic defenses because you are providing the support she previously received from the binge/purge cycle. But you can't carry the responsibilities of her life and yours indefinitely.
You�ll get tired. You�ll be under pressure to put your energy into your own needs or the needs of your family or your business. You�ll remember how much of your energy is required to tend to your own life.
As Trudy grows dependent on your energy as a replacement for the numbing caretaking of bulimia her needs and expectations will increase. Your energy and motivation will decline. You�ll want and finally, I hope, start putting more of your energy into your life and less into hers.
Gracefully or ungracefully, you will both will struggle with the effects your withdrawal.
And by withdrawal, I mean easing up. For example, you might do her laundry once a week rather than every day, or watch her children for two hours once a week rather than several hours four or five days a week. You might talk to her once a day rather than five times or even talk to her only once or twice a week.
When Trudy�s stresses - even normal everyday stresses - are present for her to deal with without your constant presence and without her eating disorder coping mechanism, she will go back to the binge/purge pattern to protect her psyche.
When the binge/purge cycle returns she will feel guilt, shame, humiliation, sorrow - and even despair. She might also feel angry with you for letting her down or feel bewildered and grief that you abandoned her. Those feelings can be unbearable and will only increase her need to binge and purge.
She will feel like a failure. But she hasn't failed. She just tried to let go of a lifeline without developing muscle and ability to learn how to swim. Anybody who is drowning will reach for a lifeline.
And your being the lifeline doesn�t teach her how to swim or help her understand why and how she came to be so over her head in the first place.
So please, if you can, please, please help me understand why the way to get solid recovery, i.e. treatment, is something you both so actively avoid?
I would so appreciate hearing what you have to share about this vital question. So many people suffering from bulimia get well because of treatment.
Thank you.
Joanna
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