1 10 Critical Steps When Helping a Friend Wh May Have An Eating Disrder 1. KEEP AN OPEN MIND: N matter hw strng yur suspicin that the individual has an eating disrder, d nt make a decisin withut first speaking privately t the persn. If pssible, select a time t talk when yu will nt feel rushed. Ensure sufficient time and try t prevent interruptins. 2. CLARIFY YOUR ROLE: Rmmates r friends shuld select the persn wh has the best rapprt with the student t d the talking. D nt intentinally r unintentinally becme the student s therapist, savir r victim. Attempts t mralize, develp therapeutic plans, clsely mnitr the persn s eating, adjust ne s life arund the eating disrder, r cver fr the persn are nt helpful. 3. SPEAK PRIVATELY: Dn't cnfrnt the persn with a grup f peple, all f whm are firing cncerns and accusatins at the persn. Unless the situatin is an emergency r therwise very negative fr many peple, cnfrntatin by a critical grup withut prfessinal guidance shuld be avided. 4. AVOID JUDGEMENT BY USING SPECIFIC OBSERVATIONS: In a direct and nn-punitive manner, indicate t the individual all the specific bservatins that have arused yur cncern. Allw the individual t respnd. If the individual disclses infrmatin abut prblems, listen carefully with empathy and nnjudgmentally. 5. USE I STATEMENTS: Statements that begin with Yu ften feel accusatry. Statements that begin with I are much less threatening and cmmunicate t yur friend that yu care and are cncerned abut their well-being. "I have nticed that yu have been leaving the table abruptly after every meal. 6. REMAIN SUPPORTIVE: Thrughut the cnversatin, cmmunicate care, cncern, and a desire t talk abut prblems. Yur respnsibility is nt diagnsis r therapy, it is the develpment f a cmpassinate and frthright cnversatin that ultimately helps an individual in truble find understanding, supprt, and the prper therapeutic resurces. 7. REFLECT YOUR CONCERN: If the infrmatin yu receive is cmpelling, cmmunicate t the individual: a) yur tentative sense that he/she might have an eating disrder; b) yur cnvictin that the matter clearly needs t be evaluated; c) yur understanding that participatin in schl, sprts, r ther activities will nt be jepardized unless health has been cmprmised t the pint where such participatin is dangerus. 8. RETREAT FROM CONFLICT: Cnflict ften results in resistance. Avid an argument r battle f wills. Repeat the evidence, yur cncern, and if warranted, yur cnvictin that smething must be dne. Terminate the cnversatin if it is ging nwhere r if either party becmes t upset. This impasse suggests the need fr cnsultatin frm a prfessinal. 9. EMPHASIZE HEALTH: Thrughut the prcess f detectin, referral, and recvery, the fcus shuld be n the persn feeling healthy and functining effectively; nt n weight, shape, and mrality. 10. DO YOUR HOMEWORK: Be knwledgeable abut cmmunity resurces t which individuals can be referred. In discussing the utility f these resurces, emphasize t the individual that, since eating prblems are very hard t vercme n ne s wn, past unsuccessful attempts are nt indicative f lack f effrt r mral failure. Cmmunicate t yur friend that yu are pen and willing t discuss their cncerns again in the future.
2 HELPING THE HELPER: GOOD ADVICE TO GIVE TO THE FRIEND OF A STUDENT WITH AN EATING DISORDER Ds and Dn'ts D: Speak t the persn privately and allw time t talk. Tell the persn yu are very cncerned abut him r her. D nt be cnfrntatinal. Allw the persn time t respnd. Listen carefully and d nt be judgmental. Keep the fcus n prblems (fr example, withdrawing frm thers). If the infrmatin yu receive suggests an eating disrder, share with the persn that: yu think she/he has a prblem with eating (r bdy image r weight management) yu are cncerned abut his r her health and well being yu are feel that the matter may need t be evaluated by smene wh understands eating disrders. Knw abut sme f the resurces t which she/he can be referred. Tell a qualified prfessinal (physician, nurse, cunselr) immediately if the persn has prblems that scare yu, fr example, if the persn is: bingeing and thrwing up several times per day passing ut r cmplaining f chest pains cmplaining f severe stmach ache and/r vmiting bld suicidal. Dn't: Dn't threaten r challenge the persn Dn't be judgmental: dn't tell the persn that what they are ding is "sick," "crazy" r "stupid. Dn't give advice abut weight lss r exercising r appearance. Dn't diagnse. Dn't get int an argument r a battle f wills. Calmly repeat yur evidence, yur cncern and yur strng belief that the persn needs t have the prblem evaluated. End the cnversatin if it is ging nwhere r if either f yu becmes t upset. Dn't prmise t keep what yu have bserved a secret. Dn't try t keep track f what the persn is eating r try t frce the persn t eat r nt eat. Dn't let the persn mnplize all f yur time and energy. Dn t cast a net f awe and wnder arund the existence f an eating disrder: keep the fcus n inefficiency, misery, and disturbance. Dn t versimplify. Avid thinking r saying things such as Well, eating disrders are just an addictin like alchlism r All yu have t d is start accepting yurself as yu are. Dn t imply that bulimia nervsa, because it is ften assciated with nrmal weight is smehw less serius than anrexia nervsa.
3 Advice fr Friends/Helpers Remember that she (r he) has the fd prblem, and it is up t them t d the wrk Make a pact f cmplete hnesty. Be patient, sympathetic, nn-judgmental, and a gd listener. Let her knw that yu care and have her best interests at heart. Accept that recvery is a prcess and des nt happen quickly. Help her t be patient, as well. D nt be cntrlling f her life; yu are limited in what yu can d t help. Yu may need t learn abut letting g When her behavir affects yu, express yurself withut placing guilt r blame upn her. Try nt t take her actins persnally. Use "I" messages, explaining yur feelings and cncerns. Yu may need t disengage frm her t take care f yurself. Have cmpassin. Yur lved ne may be verwhelmed as she gets in tuch with the painful issues underlying the behavir. She will need yur lve and supprt at these times mre than ever. Always remind yurself that yur lved ne uses their eating disrder as a substitute fr cnfrnting painful feelings r experiences. Ask what, if anything, yu can d t help. Encurage her t find healthier ways t deal with her pain. D nt try t guess what she wants. Encurage her t express her needs. If yu have questins, ask. Encurage her t enter prfessinal therapy, keeping in mind that n single apprach t recvery wrks fr everyne. Be available fr jint cunseling. Be flexible and pen in supprting her t d whatever appraches she chses. Fr example, yu may knw smene wh ges t a particular therapist, but yur lved ne might relate better t anther. Frm Bulimia: A Guide t Recvery by Lindsey Hall and Leigh Chn
4 Appraching Smene Yu Care Abut Here are sme things yu shuld think abut when appraching smene abut yu re yur cncern that they may be suffering with an Eating Disrder. Be gentle and caring, and be prepared t listen withut ffering munds f advice. Yu are nt the persn's therapist, nr shuld yu pretend t be. Being a gd listener means yur ears are pen and yur muth is shut, yu are nt intervening with "yeah, I knw what yu mean, that happened t me nce when..." - just listen. Mre things t keep in mind If they then finish talking and ask what yur thughts r pinins are, be hnest and caring. Dn't make the persn feel threatened. It is nt yur jb t dictate what they shuld and shuldn't d. If this persn has finally decided t talk t yu and trust yu, cherish it and uphld yur rle in hlding their cnfidence. Be encuraging. The recvery rad can be a lng and uphill battle, with pitfalls and setbacks. Dn't be disappinted r disapprving when a victims displays signs f falling back, just encurage them t cntinue pushing frward. Recvery is nt nly hard wrk, but can be very cnfusing and painful, be sure t remind them that yu understand this, and that "yu cannt always cntinue t stride frward withut a stumble frm time t time. It's kay." Read as much as yu can n the tpic f Eating Disrders. The mre yu knw, the mre equipped yu will be t ffer a helping hand. Phtcpy r print ut articles f interest and if time presents itself share the inf with yur lved ne, but d nt verstep yur bundaries. If the persn has asked yu nt t d certain things, r talk abut things, then respect their wishes. D nt talk abut fd and weight! Dn't cntinuusly ask what the persn has r hasn't eaten, hw much weight they have lst, r hw great r bad they lk after gaining r lsing. This is rude and threatening and yu cannt win either way. Saying they lk "healthy since yu've put n sme weight" is heard as "yu are fat," and expressing disappintment r cncern in weight lss cmes acrss as "yu're a failure" r "yu're a burden." By the same tken, dn't be afraid t talk in frnt f the persn abut yur wn day t day living (such as, "yeah, Fred and I went ut fr dinner last night and the steak was s gd.") Yur stumbling t avid tpics will be as nticed as yur persistence in discussing them. Dn't watch the persn "like a hawk" when they are eating, r give lks when they excuse themselves frm a meal r frm the table. Recvery is nt easy and des nt happen vernight! Be respectful and curteus and d nt try t be The Fd Plice. If yur lved ne is lking fr recvery resurces try nt t let him/her get discuraged. Unfrtunately, there are dctrs and therapists ut there that d nt knw what they are ding, r wh d nt recgnize Eating Disrders as the serius issue they are.
5 Even mre things t keep in mind Be supprtive. If yu feel it's within yur bundaries, ffer t help - find names f lcal supprt grups and therapists, and ffer t g with them their first time if they'd like the cmpany. If they are getting discuraged be patient, supprtive and dn't push. Recvery is a very persnal chice each victim will need t make fr him r herself. Encurage them t find supprt in thers wh share the same experiences, thrugh supprt grups, n-line bulletin bards r chat rms, r thrugh larger meetings like thse f Overeaters Annymus. Dn't pretend t understand, if yu have never had an Eating Disrder yurself... it will sund cndescending and ingenuine. Yu can be supprtive withut living with Anrexia, Bulimia r Cmpulsive Overeating yurself, and yur lved-ne will appreciate that mre than yu putting n a facade f empathy. Sme final things t keep in mind The victims f Eating Disrders can d better in their wn recvery with a gd supprt netwrk behind them... cnsider it this way -- dn't we all d better in life when we knw we have peple we can cunt n? Learn t be a gd listener and what "being there" fr smene truly means.
6 D I Cntribute t Anther's Eating Disrder? The culture f disrdered eating is pervasive in ur sciety. The fllwing are ways we might encurage eating disrders withut even knwing. Praising r glrifying anther s appearance based n bdy size r attractiveness. Cmplementing smene when they lse weight r diet. Encuraging smene t lse weight. Talking negatively abut ur bdies. Discussing measurements, weights r clthing sizes. Thinking f fds as gd r bad. Making fun f anther persn s eating habits r fd chices. Criticizing ur wn eating. Cnsidering a persn s weight imprtant. Saying smene is healthy r well because they are thin. Expecting perfectin. Pushing mre exercise than necessary. Assuming that an verweight persn wants r needs t lse weight. Allwing the media t dictate what bdy type is in.
7 Eating Disrder Resurces Bskind-White, Marlene. Bulimarexia, The Binge/Purge Cycle. WW Nrtn, Bruch, Hilde. Eating Disrders: Obesity, Anrexia, and the Persn Within. New Yrk: Basic Bks, Chernin, Kim. The Obsessin: Reflectins n the Tyranny f Slenderness. New Yrk: Harper and Rw, The Hungry Self: Wmen, Eating, and Identity. New Yrk: Harper and Rw, Hansen, James C., Series Editr. Eating Disrders. Maryland: Aspen Publishers, Harkaway, Jill Elka, Vlume Editr. Hirshmann, Jane. Are Yu Hungry? Randm Huse, Overcming Eating. Fawcett, Jhnsn, Craig and Mary E. Cnnrs. The Etilgy and Treatment f Bulimia Nervsa. New Yrk: Basic Bks, Levenkrn, Steven. The Best Little Girl in the Wrld. Cntemprary Bks, Orbach, Susie. Fat is a Feminist Issue. Paddingtn Press, Bk I, Bk II, Hunger Strike. New Yrk: WW Nrtn, Rth, Geneen. Why Weight? A Guide t Ending Cmpulsive Eating. New Yrk: Signet, When Fd is Lve, Explring the Relatinship Between Eating and Intimacy. New Yrk: Duttn, Siegel, Michele. Surviving an Eating Disrder: New Perspectives and Strategies fr Family and Friends. New Yrk: Harper and Rw, Stuart, Richard. Weight, Sex, and Marriage. New Yrk: WW Nrtn, Online Resurces