How can I help my anorexic sister when she doesn't want help?
January 3, 2010 10:52 AM Subscribe
My sister has been anorexic for two years, and has just recently confided in me about it over the holidays. She says she's the worst she's ever been, and has stopped menstruating and rarely eats anything. I've talked to her about it, and our parent made her go see a doctor, and while she's open and honest about it (I think) she is adamant that she doesn't want help and doesn't want to see a therapist.
She's moving out on her own with a friend, and I live in a different province, and I'm scared that it's just going to get worse and worse until one day I get a phone call saying that she's had a heart attack.
I feel helpless and worried and angry and frustrated. She'll talk to me about it but I feel like I'm alienating her whenever I bring it up.
I need help.
Oh and our parents are useless to help. And wouldn't go to family therapy. What can I do?
Response by poster: Yes she has been making me wait when we are supposed to meet up. Why does she want control over me? We've always had a great relationship.
posted by whalebreath at 11:22 AM on January 3, 2010
posted by whalebreath at 11:22 AM on January 3, 2010
Yes she has been making me wait when we are supposed to meet up. Why does she want control over me? We've always had a great relationship.
IANAD (and someone please correct me if I'm wrong) but I think anorexia has a lot to do control, control over what goes into your body, your body-fat, etcetera. Making you wait when you meet up could be another way for her to extend control into her life.
posted by kylej at 11:42 AM on January 3, 2010
IANAD (and someone please correct me if I'm wrong) but I think anorexia has a lot to do control, control over what goes into your body, your body-fat, etcetera. Making you wait when you meet up could be another way for her to extend control into her life.
posted by kylej at 11:42 AM on January 3, 2010
I went through exactly what you are going through about seven years ago and my sister is much healthier now after years of therapy. How old is your sister? If your parents can force her into therapy, they should (although they sound like there are in some denial).
It is a long struggle with many setbacks, but your sister can be helped. Also, don't take anything strange or manipulative your sister does to you personally (don't put up with it necessarily, but don't take it to heart). Her mind is disordered and the expression of that disorder, primarily through control games, can often feel like an attack on the people that love her the most. It is a good sign that she is acknowledging her disorder to you and your parents rather than completely hiding it. Hopefully, that will be a first step for her seeking therapy.
posted by Falconetti at 11:43 AM on January 3, 2010
It is a long struggle with many setbacks, but your sister can be helped. Also, don't take anything strange or manipulative your sister does to you personally (don't put up with it necessarily, but don't take it to heart). Her mind is disordered and the expression of that disorder, primarily through control games, can often feel like an attack on the people that love her the most. It is a good sign that she is acknowledging her disorder to you and your parents rather than completely hiding it. Hopefully, that will be a first step for her seeking therapy.
posted by Falconetti at 11:43 AM on January 3, 2010
Short answer is: just wait. I know you feel helpless, but that's the best thing you can do.
Long answer: I don't agree that she's trying to control you by letting you in on the secret. That says to me that she's starting to see there's a real problem here, and might be willing to seek professional help in the future. Be there when she wants to talk about it. Don't talk about it unless she brings it up. Most importantly, like Acer_saccharum says, do not comment on physical appearance. Saying she's looking too thin is just as much motivation for her to keep it up as saying she looks 'healthier'. Saying she's looks too thin says to her 'what you're doing is working', saying she looks healthier says to her 'you're not doing enough, so you'd better step it up'. Just be there for her when she needs you, and that's all you can do.
Good luck, and feel free to memail if you want to talk more about it.
posted by sunshinesky at 11:51 AM on January 3, 2010
Long answer: I don't agree that she's trying to control you by letting you in on the secret. That says to me that she's starting to see there's a real problem here, and might be willing to seek professional help in the future. Be there when she wants to talk about it. Don't talk about it unless she brings it up. Most importantly, like Acer_saccharum says, do not comment on physical appearance. Saying she's looking too thin is just as much motivation for her to keep it up as saying she looks 'healthier'. Saying she's looks too thin says to her 'what you're doing is working', saying she looks healthier says to her 'you're not doing enough, so you'd better step it up'. Just be there for her when she needs you, and that's all you can do.
Good luck, and feel free to memail if you want to talk more about it.
posted by sunshinesky at 11:51 AM on January 3, 2010
IANAD and I wouldn't say this is the case for all anorexics or your sister, but often times anorexia is about controlling something because everything else feels beyond their control. If there have been significant life events, traumas, or limitations placed on her, it's a bit more obvious why she would feel the need to exert control in this manner. On the other hand, there could be more subtle dynamics that make her feel she has little to no agency, except in this one regard. Acer_sacchrum's advice is spot-on. The most important thing is to be there for your sister and not increase pressure on her about anything that directly relates to her disease.
On the other hand, this does not mean that she can't be held accountable for the way she treats you. If she's late all the time, say something about it as calmly and neutrally as possible. If she continues the behavior, then find a consequence you are comfortable with like leaving if she doesn't show in 15 minutes. It's a tricky balance to maintain when you are so concerned about someone, but if you can accurately separate what is related to her anorexia and what's not, it will help you all in the long run. Best of luck to you and your family.
posted by katemcd at 11:54 AM on January 3, 2010
On the other hand, this does not mean that she can't be held accountable for the way she treats you. If she's late all the time, say something about it as calmly and neutrally as possible. If she continues the behavior, then find a consequence you are comfortable with like leaving if she doesn't show in 15 minutes. It's a tricky balance to maintain when you are so concerned about someone, but if you can accurately separate what is related to her anorexia and what's not, it will help you all in the long run. Best of luck to you and your family.
posted by katemcd at 11:54 AM on January 3, 2010
I agree with the control thing. having control over something is a big part of anorexia for some sufferers, so they micromanage their food intake, and I do think it sounds like your sister is trying to extend control over you too.
In my personal experience of having had disordered eating, I had a lot of people try to help me and closed my mind to any help for a while. When I confided in someone finally, I was already on the (very slow) upswing. I talked about food and weight nonstop before then, but admitting to my disorder was big, positive, and when I talked about it, it helped me towards healing. So based on my experience, your sister confiding in you would be a positive step and I would keep engaging her in those conversations as long as they are about how she feels and not just how many calories she ate and didn't eat.
Your sister realizes the danger of the disease, so I would be tempted to ask her something I wish someone had asked me: When will you have "won"? You know death will stop you if you don't stop first: is that the only time you will feel successful? She might not answer, the answer might be scary, but she herself might not know the answer, and that could be a productive thought process.
But I also see what others are saying, that if she confides in you without ever getting outside help or trying to stop, she's just exercising another window of control. I can't tell you to disregard the advice to stay at a remove, just offering my 2c.
On another note, can you talk to the friend your sister is moving in with? Is she/he aware of your sister's disorder (people can be surprisingly unseeing), informed about it? Does the friend at least have non-disordered eating?
posted by lilbizou at 12:14 PM on January 3, 2010 [1 favorite]
In my personal experience of having had disordered eating, I had a lot of people try to help me and closed my mind to any help for a while. When I confided in someone finally, I was already on the (very slow) upswing. I talked about food and weight nonstop before then, but admitting to my disorder was big, positive, and when I talked about it, it helped me towards healing. So based on my experience, your sister confiding in you would be a positive step and I would keep engaging her in those conversations as long as they are about how she feels and not just how many calories she ate and didn't eat.
Your sister realizes the danger of the disease, so I would be tempted to ask her something I wish someone had asked me: When will you have "won"? You know death will stop you if you don't stop first: is that the only time you will feel successful? She might not answer, the answer might be scary, but she herself might not know the answer, and that could be a productive thought process.
But I also see what others are saying, that if she confides in you without ever getting outside help or trying to stop, she's just exercising another window of control. I can't tell you to disregard the advice to stay at a remove, just offering my 2c.
On another note, can you talk to the friend your sister is moving in with? Is she/he aware of your sister's disorder (people can be surprisingly unseeing), informed about it? Does the friend at least have non-disordered eating?
posted by lilbizou at 12:14 PM on January 3, 2010 [1 favorite]
My sister has been battling anorexia for around 7 years, and I am nthing the suggestions to wait it out. I have found that for my sister, who is no longer at a dangerous weight but is still underweight and disordered, avoiding mentioning any weight loss or gain on my part, not discussing food, and making sure not to eat any food that is 'hers' at my parents house, all help. Her weight increased post-discussion with my parents about her disordered eating, so it is a good sign that your sister has confided in you.
Here is advice from the English National Health Service [pdf] on dealing with an anorexic, and I also spoke to my own doctor about how to deal with it when my parents reached their limits. The system that my mum agreed with my (23yo) sister was that as long as she was seeking treatment from her doctor my mum would not pester her with questions.
Good luck with this, it is an exhausting journey. Make sure you are talking to friends/a therapist as it can affect you more than you realise.
posted by ellieBOA at 12:41 PM on January 3, 2010
Here is advice from the English National Health Service [pdf] on dealing with an anorexic, and I also spoke to my own doctor about how to deal with it when my parents reached their limits. The system that my mum agreed with my (23yo) sister was that as long as she was seeking treatment from her doctor my mum would not pester her with questions.
Good luck with this, it is an exhausting journey. Make sure you are talking to friends/a therapist as it can affect you more than you realise.
posted by ellieBOA at 12:41 PM on January 3, 2010
I live in a different province, and I'm scared that it's just going to get worse and worse until one day I get a phone call saying that she's had a heart attack. I feel helpless and worried and angry and frustrated.
Seconding what ellieBOA said. I strongly encourage you to see a counsellor about this--not about how to help your sister, but how YOU can deal with the stresses of your relationship with her. Your own mental health is important too.
My family and I went through a sad and difficult period of trying to intervene and help a self-destructive family member (and I live far away from the rest of the family, so I sympathize with the long-distance issue). It was only after I saw a counsellor on my own that I came to accept that none of us could really help him to recover until he was ready for help. Prior to that, I honestly thought if we just found the right thing to say/do, or if we could somehow make him go into treatment, he would stop the self-destructive behaviour. It turned out that the only thing we could do was be supportive and wait it out. It was hard to do, but in the end, he did get better.
A good counsellor will help you care for your own emotions, and also come up with positive ways for you to interact with your sister.
posted by hurdy gurdy girl at 1:22 PM on January 3, 2010 [1 favorite]
Seconding what ellieBOA said. I strongly encourage you to see a counsellor about this--not about how to help your sister, but how YOU can deal with the stresses of your relationship with her. Your own mental health is important too.
My family and I went through a sad and difficult period of trying to intervene and help a self-destructive family member (and I live far away from the rest of the family, so I sympathize with the long-distance issue). It was only after I saw a counsellor on my own that I came to accept that none of us could really help him to recover until he was ready for help. Prior to that, I honestly thought if we just found the right thing to say/do, or if we could somehow make him go into treatment, he would stop the self-destructive behaviour. It turned out that the only thing we could do was be supportive and wait it out. It was hard to do, but in the end, he did get better.
A good counsellor will help you care for your own emotions, and also come up with positive ways for you to interact with your sister.
posted by hurdy gurdy girl at 1:22 PM on January 3, 2010 [1 favorite]
Did your family do a lot of criticizing about your bodies? The anorexics I have known have seemed to really be trying to prove their strength to people (often family) in the face of feeling like a loser. If there was a lot of judgement in your family about weight your sister may be trying to show how "good" she is.
Maybe you could reassure your sister that you will always love her whatever her size and that it really doesn't matter to you, except that you'd really like her to be alive to share this life with!
posted by MiffyCLB at 3:26 PM on January 3, 2010
Maybe you could reassure your sister that you will always love her whatever her size and that it really doesn't matter to you, except that you'd really like her to be alive to share this life with!
posted by MiffyCLB at 3:26 PM on January 3, 2010
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1. Never comment on their physical appearance. I am into clothes, so I sometimes will say 'nice sweater', because it would be out of the ordinary for me not to, but never on weight, skin, appearance, and when my sister brings up eating, body image, the biggest loser on tv, etc. Last year we had a quick talk where I said that I love her and have always found her beautiful, but that in order for us to keep talking she could no longer bring up subjects related to her disease or anyone's bodies. Now when she starts up (which she does) I tell her that those topics are off limits with me, that I love her, and that she needs to talk to a professional. Do not elaborate or get sucked into explaining further.
2. Don't offer food at all, or just offer once (say "dinner's ready" and don't push further). If your sister decides to be vegan as an excuse to turn down most anything, make sure you have some vegan food in a cupboard that you can offer but don't mention it afterward except to invite her to mealtime.
I am so sorry, it is so hard. Good luck. My friend pulled through in the end, but I still follow the same rules with her.
I also found that when sister couldn't make me grovel and cry over their eating, they resorted to other things like making me wait indefinitely when we are supposed to meet up, etc. - try to avoid catering to these behaviors as well.
For sure it is body image, and dangerous to her health (which she knows) - but it is also about control of those who love her. This is the only part of the disease that you are able to show her is not an effective strategy. I suggest, too, that you get a therapist (if able to afford it) who knows a lot about eating disorders.
posted by Acer_saccharum at 11:09 AM on January 3, 2010 [16 favorites]