National Eating Disorders Association

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MMTF98
help getting wife back into treatment

I met my wife 15 years ago and found out on our first date that she had an ED a few years prior in college, but she was recovered. Throughout our dating and marriage she always cared about what she ate and how she looked, but it was never her focus, she was present with me and in our life, and became a great stay at home mom to our three kids. The last few years things started to change as the kids got older and were more independent at school. I thought she lacked purpose and tried to encourage her to develop more interests, get a job, or set personal goals she could feel good about accomplishing. What I didn’t realize was her ED was only ever in partial remission and late last year it came back.

So far this year she has been in In-Patient (IP), Residential, Partial and Out-Patient (OP) care. She felt forced into IP and RES by me, family and friends, and her OP team. She fought against IP everyday and it took her a week to finally accept RES treatment, where she did make some psychological and physical progress for several difficult weeks. Being away from our kids was so tough for her and dealing with the frustrations of RES and the guilt of abandoning our kids was too much for her. It pushed her out of RES before she had made enough physical and psychological progress. She quickly regressed in day and eventually insurance said “no more, go back to RES.” She adamantly said “No” and I gave her the chance to do it OP with her team. Again she made progress but only limited and her ED self seems to get stronger each time we go around (eat for few days and be present, then feel very guilty and restrict).

Her treatment team has now drawn a line in the sand and I know I have to do the same – basically saying she has to move out because she is putting the disease in front of herself, me and the kids. I have talked to my therapist about how to do it and I have plenty of family and friend support – all on the side of her committing to getting healthy regardless of what it takes.

I am looking for advice from others who have been through this. If we force her into treatment and she still doesn’t buy in, where does that get us? If I do nothing and she continues to muddle through and the ED continues to get stronger, her health will fail and I and the kids will have to watch her slowly die. I feel like I am dealing with an addict and I don’t know what rock bottom is going to have to look like and if she will make it back.

BobJ48
Committed to treatment.

MMTF,

Oh brother, I'm so sorry to hear this. It has to be a source of frustration and upset for all who are involved, including your wife.

And yes, as you've seen, this sort of thing really can etch itself into a person's brain, particularly if they fall under it's spell when they are young, and their brains are still forming.

How one approaches it now is difficult to say. For the last few years . I've been talking with a person who has horrific problems with self-injury. If you saw the things she does, you'd freak-out too. Which is what all of her "helpers" are doing. And the more they freak out, and try and impose their will upon her, the more it creates the very sort of stress that causes her to self-injure. I got a note from her today, and she mentioned that as a result of certain circumstances, now that she's having a break from the demands of all of these "helpers" her urges to self-injure have almost disappeared.. So there you go I guess. Sometimes all of the external pressures to "get better" only serve to produce the exact opposite results that everyone is hoping to accomplish. And I'll be if you asked her about this, she might agree.

This all may get down to the "control" thing. Folks with EDs will often tell you that EDs are about having control. So when others try and remove that control, and exert their own control on the person, you can kind of understand why their minds might rebel.

On the other hand, what are people expected to do ? Just sit back and do nothing ? That's an unreasonable expectation too.

This may seem like an obvious question, but to what degree are people asking her what she thinks would be the best course of action ?

Sorry, but answers like "I'll just kill myself"….Hopefully she'll understand that that's not a very practical answer. So hopefully when asked, she'd be able to take a more reasonable look at her situation, and come up with some suggestions that do involve her being willing to take some risks with this, rather than thinking that just going back to the same old set of behaviors is going to solve anything.

So the "being willing to take some risks" may be a theme that's worth trying.

Most people with EDs are not particularly happy that they have them, so thats' something to keep in mind as well, even if they often see them as their only method to cope and feel in control during times of stress.

As you said, everyone is interested in seeing her commit to recovery, but what everyone else thinks and hopes she will do may also be the sort of source of stress that keeps her depending on her ED.

Remember too, you have a right to want to see things better for yourself and for the children. That's not an unreasonable wish on your part at all. While having her move out may sound to her like one more way to try and exert control over her, hopefully you can frame that idea in terms that don't sound punitive or manipulative, as you really do have some emotional rights of your own that are worthy of consideration.

In any case, I'd certainly ask her what she sees as the solution. She may say that she dosn't want to recover, so you may want to say something like "But if you did want to recover, what might you see as the best way to go about that ?"

In any case, just some thoughts. Keep writing ?

Bob J.

MMTF98
Thanks Bob

Thanks Bob. I appreciate the perspective. She sees herself "muddling through" for the rest of her life, which is no solution at all. Your idea of taking "little risks" might be the kind of thing that she can embrace. I know she has done work on what things look like 5 years from now if she has recovered and if she has not. Keeping that in focus when she makes decisions throughout her day seems to be the hard part without additional support from a high level of care (PHP or RES).

I just started reading "Codependent No More" by Melody Beattie at the recommendation of my therapist and I think it could be helpful. I would not have thought of myself as codependent but after reading the first 4 chapters, the shoe fits. "They have worried themselves sick about other people. That have tried to help in ways that didn't help. . . .They have tried to make other people see things their way". That is me. I now know that what I have been doing isn't helping and may actually be hurting the situation and bringing about the dire future I fear.

A former colleague of mine is doing a film on PTSD and depression in the military and research found that people with a mantra, a short go to phrase of hope and support, had better recovery outcomes. He suggested I create one for myself. I am thinking about borrowing from the character Dalton in the movie Roadhouse - "Pain Don't Hurt." This seems aligned with what I read in the book "Don't Feed the Monkey Mind" about anxiety. Pain + Resistance = Suffering but Anxiety + Acceptance = Resilience.

I see my wife's suffering with ED as avoiding or resisting some pain through the illusion of control provided by the ED. My suffering is a reaction to resisting the fear, anger, sadness, and frustration that I can't do anything to ensure her recovery. So I guess I have to learn to accept and live with that pain without employing the safety strategies that reinforce my anxiety. I will also hope and pray that she takes small risks and learns to accept and cope with her pain, rather than retreating to her ED.

I do welcome the chance to keep writing.

dittoditto
Hi MMTF98,

Hi MMTF98,

I'm sorry you are having to go through this too. Something that really helped me, and that you might want to ask your therapist about is Al-anon's teachings. I know it is geared to relatives of alcoholics, but they are also codependent type of people. The point of the 12 step program is to learn boundaries.... where your life begins and ends, where your responsibility begins and ends, and putting the focus back on yourself. It will teach you how to detach with love from your wife's behaviors and problems and that is really the best gift that you can give to yourself and to your wife. It will take a lot of the stress off of both of you.

Sending best wishes to you both during this season of eating. Don't let her issues with food cloud your enjoyment.

BobJ48
MMFT

Good to hear from you again, and hope things are going OK there on Thanksgiving. And just to say, I thought there really were some interesting and perceptive insights in your note. As you are probably noticing, it's interesting how situations like this can cause us to think about things that we might never have had to think of before. At the risk of using the "wisdom" word…some of that may be the result of this too.

"I see my wife's suffering with ED as avoiding or resisting some pain through the illusion of control provided by the ED."

Yep, I think that's true. And oddly, I suspect that folks who have EDs themselves might agree with this too. Once they reach a point where they become introspective about things I mean. As you said, the control aspect is such a big part of this, until the tables are turned, that is. And they come to realize they are the ones being controlled by their EDs, instead of the other way around. When you hear about the suicide rates among people with ED, my sense is that it's this realization that's often at the heart of that.

"...the shoe fits. "They have worried themselves sick about other people. That have tried to help in ways that didn't help. . . .They have tried to make other people see things their way". "

That part is interesting alright. Because although the outcome can sometimes be negative, the root of the thing stems from caring. So yes, how odd is that ? I've been talking with people who have EDs for a couple of decades now. People who I often develop a deep sense of care for. So how do I manage to get away with it, in ways that these folks seem to see as helpful ?

My guess is that it's because I rarely if ever try and tell people what they should do. Instead I try and nudge them towards figuring out the answers themselves. This would be a lot different if it was someone I lived with, though. I'd probably be tempted to do the "you should do this, or you should do that" thing myself. I must admit that there are times when I do suggest different ways that people might think about things. But usually I'll say something like…."think of this sort of like a science experiment"….when I suggest other outlooks. That they could try certain ideas on for size, as it were, rather than going with the "you should" part.

Even so, I do have people who I really worry about. But that part is only human I think.

" My suffering is a reaction to resisting the fear, anger, sadness, and frustration that I can't do anything to ensure her recovery."

That reaction is very human as well, I think. And that as a caring and emotional person, somehow we're *not* supposed to find ourselves up against feelings like this ? How human would we be if we didn't experience these feelings ?

Part of being able to deal with all this is realizing our limitations - what we can and cannot really hope to accomplish. And then coming to the realization that "support" really does have some value and meaning for the other person. Even if it may not count as "doing", I mean.

But you've probably heard me say this before - If we are going to support someone, they really do need to give us something to support. Sometimes they will consciously give us something, while other times it's almost like we need to use a magnifying glass in order to locate the positive bits.

So yes, the taking of small risks. And "dare to be imperfect" you know ?

These are some of those positive things.

Bob J.