The Detriments of Eating Disorders

Note: This article was first published in Life in the Delta in November 2008.

Body dissatisfaction plagues most women as well as a rising number of men. While it is normal to care about appearance, there is a point at which normal caring can turn obsessive and interfere with daily life and, more importantly, relationships.

Before discussing the negatives of eating disorders, let’s first lay a foundation by defining what they are. There are two major eating disorders – bulimia nervosa and anorexia nervosa. They share a common component – compensatory methods to prevent weight gain. However, the main difference that divides the two is that bulimics use extraordinary means to maintain their proper weight while anorexics use extraordinary means to maintain a below normal body weight. Also, bulimia is characterized by binge eating, which is then followed by inappropriate means to keep from gaining weight, with self-induced vomiting being the most common method. Other means include the misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. Anorexics primarily lose weight by the reduction in their total food intake or a diet restricted to only a few foods. They may also lose weight in ways similar to bulimics, such as purging and excessive exercise. (Note: exercise may be considered excessive when it significantly interferes with important activities or occurs at inappropriate times or settings or when the individual continues to exercise despite injury or other medical complications.)

Anorexics and bulimics are both intensely afraid of weight gain but for anorexics this fear is not eliminated by weight loss. In fact, concern about weight gain often increases even as their actual weight decreases. They have a distorted body image and think they are overweight when indeed they are underweight. Anorexics can lose weight in similar ways as bulimics but are “more successful” as they are prone to perfectionism and love the sense of self-control they have over food. Bulimics often binge in secret. While binging, a person may feel a sense of euphoria but later feels ashamed and depressed and out of control. They then take control with compensatory methods to prevent weight gain. While eating disorders may arise due to living in a culture where there are pressures to be thin, they more often also have a past history of abuse at their source.

To understand disordered eating, it is helpful to understand what natural order has been disrupted. When one thinks of food and its purpose, food is basically fuel for our bodies. However, food is also a source of pleasure and is often used for celebration purposes. When someone has an eating disorder, food changes from its normal function: it changes from a gift to a weapon and rarely is it something celebratory. For people with eating disorders, food becomes their focus. They think about food all the time, but they control it.

So why are eating disorders harmful if they achieve successful weight loss? For one, bulimia can cause ever-increasing harm to one’s health over time, including erosion of dental enamel due to recurrent vomiting, calluses on the surface of the hand due to stimulating the gag reflex, menstrual irregularities and amenorrhea, electrolyte imbalances, and a tendency to be depressed, just to name a few. And anorexia can be even more harmful, with many of the same symptoms as well as the symptoms of starvation, such as emaciation, cold intolerance, renal and cardiovascular problems, osteoporosis, and potential death.

In addition to health concerns, when food becomes one’s main focus, then other life goals and purposes slip in importance. Eating disorders also interfere with marriage and family relationships because it is almost impossible to have a close intimate relationship with a person who has an eating disorder because their attention is on controlling the food. Eating disorders are serious detriments to one’s health and to healthy relationships, and people who have them need to seek help – usually medical help as well as professional counseling.

A Fair and Balance Childhood

Note: This article was first published in Life in the Delta in September 2008.

To borrow an expression from a popular television network, I’d like to discuss what I would call a “fair and balanced” approach to parenting children. Children come into this world completely reliant on their parents for food, clothing, shelter, teaching, love – virtually everything. They are truly dependent in every sense of the word. Yet it is not long before a toddler can walk and talk and begin to interact with us. And by 5 or 6 years old, children can even seem quite “adult like.” A serious error can be made if we as adults assume they are and we begin to rely on them and treat them as small adults.

There is a therapy term I often use to describe the child who is treated like an adult – the “parentified” child. This is the child who often becomes the junior parent – who takes care of smaller children, who prepares meals, who worries about money, who stays alone for long periods of time. Of even more serious consequence, this parentified child often becomes the companion or confidante to one or both parents. While a child is able to do this – and I have seen children as young as 3 years old become the caretakers of their parents’ feelings – it is simply not fair to a child. Childhood is the time for being “child like” – to slowly grow, to learn by playing, and to work alongside parents with age appropriate responsibilities. Parents should give to their children and not manipulate children to meet their needs.

Another notion that is prevalent in today’s thinking is that lots of praise will help children grow in their self-esteem. While it is all right to praise when praise is due, it can become out of balance. When every kindergarten drawing is treated like a Picasso or every T-ball game is treated like the major leagues, the child gets the message that he or she is expected to fulfill their parents’ expectations of them. They even sense inside that something is wrong – they know what they’re doing is not that special. Praise can be a subtle form of manipulation that causes children to become people pleasers. I have heard many grown clients share how their parents did not help them by giving them so much focused attention and by telling them they were wonderful all the time. They would have preferred that their parents had helped them develop their true talents and abilities and had been more honest about their shortcomings. This would have better prepared them for the real world where their peers and bosses are not as enamored with them as their parents. In fact, some studies have shown that praise and criticism are the flip side of the same coin and that too much of either one is damaging. Hence, a more balanced view is in order.

I recently had the opportunity to observe my two-year-old granddaughter over our summer vacation. My daughter remarked how happy her daughter seemed and I said I thought it was because she was part of a large group of aunts, uncles, cousins and friends. It naturally gave her a sense of security – of having a settled feeling that there was something bigger than her going on that did not depend on her. To quote John Eldredge, “ You’ve heard that children care more that their parents love each other than that they love them and this is the reason why. It’s the assurance that there is something grand and good going on that doesn’t rest on your shoulders, something that doesn’t even culminate in you, but rather invites you up into it.”

We have come a long way from the generations that viewed that “children should be seen and not heard” to the current generation of kid worship, albeit with the added burden of kids bearing responsibility for their parents’ happiness. But a more fair and balanced view, I think, should exist: children should be a part – not the point.

How to Fight Fair

Note: This article was first published in Life in the Delta in July 2008.

The well-known saying that everything is fair in love and war may be widely accepted, but I beg to disagree. And contrary to what many married couples think – that avoiding conflict is the most peaceful thing to do to promote harmony – just the opposite is true: conflict actually promotes intimacy! It is all right to have a fight, but not just any approach will do, and some approaches may cause lasting harm to a relationship. Knowing how to fight fair is critical to your survival as a happy couple.

So what do most couples fight about? When it comes to the big list, research shows that money is the number one issue regardless of income. Couples are constantly faced with financial decisions and many have conflicting spending and saving styles, usually based on how their families of origin handled money. Other big topic issues include sex, in-laws, children, and chores. But not all conflicts revolve around big issues – many erupt over relatively minor issues. Often couples simply bicker about things that do not seem to matter. These are signs that you are not getting to the real issues.

Successful couples have learned to resolve conflict without leaving battle scars. First of all, they don’t run from strife. The rule of thumb is: when one spouse brings up an issue, the other has to respond. However, one of the most destructive things in a marriage can be the growing sense that you are walking through a mine field and your spouse might explode with an issue at any minute and without warning. Instead of having arguments whenever issues come up, you should agree to deal with them when you are both able to do it well. Trying to force an issue when the other person is tired or not prepared only generates more tension. However, it then becomes incumbent on the partner who is not ready to set another time, preferably within a day or two, that is agreeable to both. Sometimes the length of time you will discuss the issue needs to be set, such a one hour, only to pick up the discussion at a more convenient time, rather than talking on and on. Having a rule that either partner can call a time out if the discussion gets angrily out of hand can also be helpful.

Another thing successful couples do is to define the issue clearly. When you feel the tension rising inside, ask yourself what is really bugging you. Often it is not the event but a hidden issue beneath the event. For example, if a wife complains about her husband coming home late from work, the real issue might be that she does not feel cared for. Also, stay on issue! Do not move from one issue to another, saying perhaps “And another thing: Why do you always . . . ?” Escalation occurs when partners negatively respond back and forth to each other, continually upping the ante so that conditions get worse and worse. And once negative abusive comments are made, they are hard to take back and usually threaten the lifeblood of the marriage.

Once you have contracted to discuss a defined issue, be sure to discuss it fully. And be sure to state your feelings directly. The “X, Y, Z” formula is one way to do this where you fill in the blanks: “In situation X, when you do Y, I feel Z. For example, “When you work late and you do not let me know, I feel unloved and lonely.” Instead of being defensive, the partner should be willing to listen. Softening your tone and validating your spouse’s point of view are powerful tools to end escalation. Sometimes the very process of understanding the issue itself becomes the solution. At other times, it is necessary to brainstorm for solutions and to compromise with the solutions that best take into consideration both partners.

In conclusion, fighting is not bad in marriage – and can even be beneficial, but how you fight is the primary indicator of the future happiness of a marriage. Fighting fair opens the door to a more vital and intimate marriage.

Growing in Intimacy

Note: This article was first published in Life in the Delta in March 2008.

A vital part of a strong marriage is the component of intimacy. So many young couples never learn this skill and inevitably grow apart. This results is a couple, years down the road, living parallel lives – that is, they share the same children, house, meals, checkbook, even bedroom, but they live their own separate lives, with separate friends and interests, and never really “know” each other. These couples then wake up one day to the realization that something is missing and often look for alternate sources of intimacy, either in another romantic relationship or an addiction.

Intimacy is the “best friends” aspect of marriage. Sometimes couples confuse physical intimacy with the type of emotional intimacy to which I am referring. Ideally, married couples should be best friends as well as lovers – sharing dreams, interests, fears and hopes. But often many women seek out friends or relatives before confiding in their husbands. Similarly, men are more likely to talk to their close friends about their future dreams and ambitions than they are their wives. Does this mean we shouldn’t have close friends – of course not. But it does mean we should place priority on cultivating intimacy with our spouses.

One way to do this is to spend time together. Studies indicate that marital happiness is highly correlated with the amount of time spent together – one on one time. Spending time with the children as a family is important too but should not take the place of couple time. I encourage couples with young children, who have limited time, to postpone some hobbies and social interests until their children get older. For example, many a marriage have been harmed by a husband who leaves his wife with small children while he goes hunting. He can instead earn valuable deposits in his wife’s love account if he stays home and helps at this crucial stage. Then later he can hunt at will, as many older women do not mind, and may even welcome, their husbands leaving for a hunting trip. Do you know why? It’s because the young wife is looking for reassurance that her husband chooses her first – above anyone or anything. Once this question is settled in her mind – settled by many experiences of being chosen first – then she is less likely to mind the short separations that work, hobbies or other interests bring.

Another thing that promotes intimacy is heart-to-heart talks. These do not happen on the go. Intimacy is cultivated when we carefully listen to our partner – not just to their story but also to their feelings. So be sure to cultivate intimacy by sharing your heart with your partner – your beliefs, opinions, emotions, experiences and deep desires. Also, each person should be able to voice a complaint to the other and not fear being ignored, discounted or angrily attacked. Often one or both partners fear conflict and avoid it at all costs. The sad irony is that avoiding conflict seems like the peaceful thing to do to promote harmony in the relationship, but just the opposite is true – conflict promotes intimacy! The reasons are that being open and honest with one another clears the air as well as brings a deeper knowledge of the other person, while holding things inside keep us more frustrated and isolated. Of course, the fighting must be fair. (I’ll address that in a future article.) The inability to talk in these heart-to-heart ways is an early red flag signaling later marital difficulties.

Partners who do not cultivate intimacy are doomed to live in an “empty-shell” marriage. They may coordinate the practical details of their daily lives but they live in an emotional vacuum, never really enjoying the full beauty of married love. And another unfortunate side effect is that it may eventually affect the physical aspect of the marriage – all the more reason to grow in intimacy.

How Well Are You Connected?

Note: This article was first published in Life in the Delta in March 2008.

The title may sound like a wireless internet ad, but I want to apply the idea to relationships. Last year in my articles I spent a lot of time discussing “attachment theory” as it applies to parenting. An attachment bond was explained to be an emotional connection between a child and a parent which provides comfort and security and from which a child then is able to develop a healthy sense of self in the world. However, this inborn need for attachment continues to follow us into our adult lives, usually transitioning from the parent-child relationship to the marital relationship. Emotional dependency is an innate part of being human rather than a childhood trait we outgrow as we mature.

Adults generally need an irreplaceable other who continues to provide comfort, care and support. This explains why a grown person who is otherwise successful, competent and independent in their working world can become upset, clinging and despairing when they fail to evoke responsiveness from their attachment figure.

Attachment relationships do not have to be marital but can also be close relationships with other family members or friends. However, all marital relationships should be attachment relationships. Certain criteria distinguish an attachment relationship from a casual friendship, which include the following: the proximity or closeness to this caregiver is sought, especially in times of trouble; this person provides a felt sense of security; any threat or separation from this person induces fear and anxiety; and the loss of this person induces grief and sorrow.

Attachment injuries can become the downfall of many a marriage. An attachment injury is a specific type of betrayal experienced in couple relationships, characterized as an abandonment or a violation of trust. It is not a general trust issue but instead concerns a specific incident in which one partner is inaccessible and unresponsive in the face of the other partner’s urgent need for the kind of support and caring expected of attachment figures. Some injuries may appear trivial to an outsider, or they may be more obvious betrayals of trust, such as infidelity. Some may occur at times of physical illness (for example, after a cancer diagnosis) or during times of loss (such as a miscarriage or the death of a child). When a person is most vulnerable and cries out for help or understanding and there is no response, the basic assumption of the whole relationship – “that my partner will be there for me” – is undermined. The couple are then caught in a drama in which the injured spouse sets tests and the offending spouse is usually found wanting. It appears that these kinds of wounds cannot be left behind, according to therapist Susan Johnson, originator of emotionally focused couples therapy. If such events cannot be resolved, trust remains tentative and relationship distress increases.

There are several attachment styles we can have, depending on the one we brought from childhood. Some people may have an anxious style and be too clingy, always desperately trying to get the attention of an attachment figure. This may explain why some people are not willing to leave an abusive relationship, for fear they will have no relationship at all. Another style is the avoidant style – people who put up walls and become detached from close relationships. They may look to possessions, work, or success to satisfy but almost always fall prey to addictions to fill their deep felt attachment needs. Then there is the preferred style – the secure style, in which people strike a healthy balance between being needy and not needing anyone. Secure people can easily transition to God as the ultimate attachment figure – the one to whom they primarily turn as the source of their comfort and security. But they still need people and should desire to seek out close connections with others. The vertical attachment demands that we have horizontal or earthly attachments to other people. Our bond with God can then strengthen and enhance our attachments to spouses, family members, and other trusted attachment figures. To quote Gary Smalley, “Life is relationships; the rest is just details. God made you for relationship.”

So it’s not optional whether we have attachment figures. The real choice is whether we will work to make those relationships great or allow them to cause ourselves and others pain. How well connected are you?

Loving Your Adolescent

Note: This article was first published in Life in the Delta in January 2008.

If all goes well and you the parent have met your child’s emotional needs at each level of development, the period of adolescence should be largely trouble free. I know this goes contrary to popular opinion which views adolescence as a time for teenagers to break away from their parents and become independent. But children who have acquired a stable inner happiness that comes from a secure attachment bond with their parents will not experience an adolescence that is troubled, turbulent, and characterized by protracted conflict with their parents.

Instead the time period for ages 12-18 is still a prolonged developmental state. Teens are not ready to stand alone. In fact, a national longitudinal study completed in 1997 reported that connectedness with their parents tops the list of protective factors for the well being of teens. Those teens who stayed in regular touch with their parents and felt valued by them were less likely to smoke, drink alcohol, experiment with drugs or engage in early sex.

What should be true, though, is that teens should be making almost all of their daily decisions. This is the kind of independence that they do need. Parents who are still micro managing their teen’s everyday decisions should rethink this. You do not want your teenager to arrive at these challenging and life-threatening years with no clue how to make a decision. A good rule of thumb is to try not to impose too many rules, except for important health and safety issues and things important to the family, such as being home by a certain time, not drinking or getting in a car with someone who is drinking, not using drugs, or going to church with the family. As with small children, giving a wide latitude of choices in many areas helps teens accept a few non-negotiables.

A lot of problems teenagers have arise from the re-surfacing of the “all powerful self” – a flashback from toddlerhood. This makes adolescence a vulnerable time. Teens may take unnecessary risks, thinking they are invincible. They may overestimate their knowledge (i.e., they “know everything”), which is disconcerting and may lead to arguments with parents who want to set them straight. But it is better to respond with relaxed affection as you did with the toddler who bragged he was bigger or stronger than you. During this stage teens can be unfocused and forgetful. Try to help them succeed rather than be rigid about their shortcomings. Remember that they will ultimately model your behavior if your relationship with them is a strong secure one.

Signs of inner unhappiness at this age are many and varied but are largely self-destructive. Some examples include dangerous risk taking, substance abuse, eating disorders, failure at school, aggression, cutting, depression, mood changes, repeatedly choosing undesirable friends, or isolation from or hostility toward parents. Many people advocate “tough love” for teens who are exhibiting these behaviors. Occasionally this may work but statistically it does not. It usually only further alienates the teen from his or her parents. A better way to go for parents who have lost control is to let go of some of the rules and to work on strengthening the relationship. It really is never too late.

For those parents who have worked hard and have given their children the right kind of balanced love and discipline, they should find their teenagers developing into young adults who are responsible and who make good choices. They are also flexible and adaptable and largely unaffected by the up’s and down’s of life. Even if they experience failures or disappointments, these will be temporary as they still have your approval and love, which should be satisfying. After two decades of parenting, ideally there will be times when teens can take care of themselves and you can look forward to the satisfaction of having a warm, loyal, enjoyable and appealing friend.