by Donna O’Connor-Hunnisett
INEDA is a community-based organization run by ex-sufferers of anorexia nervosa, bulimia nervosa, compulsive overeating, their families, carers and health-care professionals. We have six facilitated, support group meetings per month for sufferers and their families and carers, at two locations in Dublin and one in Clonmel, Co Tip. We plan to have two more located in Galway and Cork in the Autumn. We also plan to begin a men’s group in the Dublin area shortly. We currently have two help and information lines, a hospital visiting and support group and organize public information and awareness lectures. During the past year, we visited twelve secondary schools to give talks to students, teachers and parents on prevention, early detection and intervention. We usually take two girls who are doing well in their recovery from eating disorders to these venues to give teenagers and young women a positive role model of recovery. Our approach to the area of eating disorders is based on a choice theory model, which incorporates the concepts of unconditional love and acceptance to sufferers from group members and facilitators.
Although we accept new members exactly where they are in their food behaviour, we encourage them to express themselves openly in a safe, confidential environment and encourage them to learn new, more effective ways of dealing with their negative feelings and traumas. This takes place in the meeting-room environment through interaction and dialogue with others who are further in their recovery process. Trained facilitators are also present, should someone need to talk over an issue of a sensitive or personal nature on a one-to-one basis.
Anorexia and bulimia nervosa, contrary to popular belief, are not about food or weight, but rather about negative feelings about one s self and life situations and “traumatic” experiences. People who develop eating disorders are usually those with a genetic pre-disposition, sensitive nature, people pleasers, high achievers and perfectionistic and yet they have a seriously flawed self-perception. They usually hate their body shape and size, and try to distort and minimize it. They have no regard for their personalities, opinions and decisions. They will therefore readily abdicate most of their responsibilities to others, whom they will then perceive as controlling. After a period of time, they begin to control the one aspect of their lives they feel they can, which is the intake of food. Thus develops a potentially debilitating and sometimes fatal eating disorder.
In anorexia nervosa, the person becomes obsessed with starvation and food avoidance in an attempt to exercise control and obliterate feelings such as rejection, insecurity, self-loathing, loneliness, anger and inadequacy: They gradually become totally centred in self, in the mastery of sell denial and body-reconstruction, ie, “The less space I occupy, the less of me there will be to hate…” As this situation progresses, the sufferer loses touch with reality and their self-evaluation process becomes flawed. Even at five or six stone, they still feel the need to continue the minimizing and reconstruction of their body. At this point it may be necessary to seek medical intervention for blood tests and physical assessment. While in- hospital treatment serves an essential function, if the sufferer’s condition has become life-threatening, there is controversy and doubt as to the long term effect on recovery that the present therapeutic approaches to changing the patient’s eating behaviour may have.
People suffering from bulimia, although they have similar feelings and issues around self-hatred, perceived ineffectiveness and failure, have different patterns of behaviour in that they are more aggressive and are often seen by those around them as “disgusting and bordering on madness.” This leads the sufferer of bulimia nervosa to engage in elaborate scenarios of secretive planning, timing and cover-up behaviours to camouflage their illness. They often go unnoticed for this reason, and also due to the fact that they are usually of normal or excessive body size.
Bulimia manifests itself in the progressive use of laxatives, diuretics, appetite suppressants, prescription medication, relaxants and alcohol binges, as well as the predominating binges on high-caloric carbohydrate foods, followed by vomiting in an attempt to control weight gain. It is not rare for such a sufferer to ingest well over 5,000 calories in a binge or to take as many as thirty laxatives on a daily basis. (We are petitioning the Health Boards to consider limiting such over-the-counter medication to prescription only, as the addictive use of such medication can lead to serious side-effects.) We have a very effective “Coming off laxatives” programme that we use with the monitoring and support of the medical profession, involved in the sufferer’s recovery programme.
Both anorexia and bulimia sufferers have mood swings and bouts of depression. However, these would usually be more pronounced in the area of bulimia, where the level of anger directed at oneself and those around one is more intense and can lead, in some chronic cases, to self-cutting and mutilation, which requires specific intervention on a one-to-one basis with a trained therapist.
Recovery from an eating disorder is a slow process and requires patience and encouragement from those closest to the person. It also involves focusing on the issues and perceptions underlying the symptomatic food behaviour, the learning of more effective choices of behaviour to deal with these issues. This procedure best takes place in the safe, supportive environment of meetings on a facilitated, self-help basis. At these meetings the sufferers learn to talk openly about their feelings, the attempts they have made to anaesthetize those feelings with food, starvation, etc., and step by step, they learn from those who have been there and are still recovering, how to get well.
At these meetings we also introduce exercises and programmes on building the self-esteem, self-awareness, self-acceptance, self-love and self-belief which are essential for full recovery and a positive, happy life-style.
Donna O’Connor-Hunnisett is the Director of the Irish National Eating Disorders Association. Their address is 47 Harrington Street, Dublin 8, and their phone number is Dublin 497 5667