National Eating Disorders Association

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Evaldrynn
A little lost

My boyfriend (20) and I (21) have been together for ten months now, and about seven months ago he found out he has Bulimia Nervosa (which probably started about 4-5 years ago, if not earlier on). I'm very happy I convinced him to go to therapy, but now, after only three months of being with the program, he feels like it isn't working and at one point even told me he wanted to stop. Luckily I could convince him to keep going,because I know therapy takes time, but he isn't happy about it.

Our relationship is great and we both love each other very much, though his ED does complicate things sometimes. A few nights ago we got into an argument and he said he wanted me to worry about him less and to focus less on his eating disorder. To give you some context: I have never pushed him about anything nor demanded information; I always try to be kind, considerate, patient, and to give him space when he tells me he needs it. I don't voice my worries often, but when I do I try to talk about them as calmly as I can. The way this conversation started, however, was with me bursting out in tears because I saw him fall back into his self-destructive patterns and it hurt to see, because I care so much about him and all I want is for him to get better and to get happier. (I know that it can take a long time for him to recover but I'm committed and definitely willing to stand by his side for however long it might take). During the argument he told me that his Bulimia is part of who he is, part of his personality, and that I think therapy is some kind of miracle-working thing and that I have too many expectations of him. I just think it will help him a lot is all, and I don't expect recovery soon at all. But it hurt to hear him say that his ED is part of him, because it makes me feel like he doesn't want to change.

The therapy program only lasts for about seven or eight months I believe, which I found a little strange. Is it really possible for such a short time to help him? I do already see progress, even though he doesn't see it himself. He used to distance himself from me when he had a binge attack, but now he still allows me to come over. His mood swings are less intense (or he hides it better), he talks about his ED more easily now, and there's lots of other small things that make me so proud of him. But sometimes it feels like he is faking being happy just so I don't get suspicious or hurt, like he's putting on an act to hide his own pain.

So yeah, I'm not really sure what to do. He wants me to not worry about him, to not focus on his ED, and I'll try, but I care so deeply for him that it's hard not to get sad when he talks negatively about himself etc, and there are so many little things that are affected by his ED that it's hard not to see or notice them. I do also want to voice my thoughts and feelings, because I know that communication is important and that keeping it in only makes it worse. I want to know what's going on with him to a certain extend so I can be there for him, so I can ask him what he needs and what I can do for him, but I feel like asking about it might just frustrate him more and he doesn't tell me on his own accord.

I guess I just want to know if anyone has had similar experiences. What did you do or say? What helped and what didn't? Should I not mention his ED at all and let him figure it out with his Therapist? That seems a bit rough, but then again it doesn't feel right to 'meddle' when he doesn't want me to. On the other hand, is this a way of enabling himself more regarding his secret binges? Does this give him the space to slip back into old habits? I feel like I should be at least a little involved or informed about how he's doing so I can motivate him to keep going or support him when he's had a bad day/week, but if he says he doesn't want me to, then I shouldn't pry either, right? I'm just a little lost about it all.

Please, if you have had any similar experiences, let me know your thoughts.

BobJ48
What to do...

Hey there.

As you said, recovery can be a difficult thing, particularly when the person seems so down on themselves, and seems convinced that they may never change. It can be discouraging to hear talk like that.

" During the argument he told me that his Bulimia is part of who he is, part of his personality, and that I think therapy is some kind of miracle-working thing and that I have too many expectations of him. "

No kidding, eating disorders can put the person in a bad mood. When they are at their worst ED-type thoughts can fill their minds for really large portions of their waking hours. When a person finds their thoughts soaking in that sort of stuff pretty much all of the time, they really can begin to believe that it's what defines them, even when the truth may be otherwise.

Even so, I think you are right to be encouraged by what seems like progress. Often the person can't notice it themselves , but the fact that you can should not be discounted. Even if there may still be a long road ahead.

I think it's good that you are continuing to encourage him to stick with therapy. He may be right in thinking it's not a miracle cure, and that he's not noticing any big improvements, but at the same time, it's not nothing either. Another thing to keep in mind is that since therapy encourages people to confront issues which they may have been avoiding, the stress of that sort of confrontation really can cause people to feel like they are getting worse rather than better. It's not an uncommon feeling to have when a person first starts therapy.

Otherwise it sounds to me like your approach is a good one, even if it seems like he's not telling you that it is. I've had several people who I've supported for years, and it's only after a couple of years in that they'll stop and say Thank you. So if he's not thanking you on a regular , don't let it make you feel like somehow you aren't helping. From all you've said I think you can have faith that you are.

Also, I get what you mean when you wonder about how much you should involve yourself. One thing to keep in mind is that he IS going to know that you are concerned, even if you don't talk about it all the time. So I don't think that you are enabling him if you aren't pressuing him - I hope you won't worry about that.

Even so, any caring partner - even in relationships that don't involve matters like this - are going to be asking how the other partner is doing. So I don't think it should be considered intrusive for you to ask. It's not prying, it's caring, you know ?

And hopefully he'll realize that too.

In any case, I know that I may not have responded to all of your questions, but I hope you'll keep origin if it seems to help ?

B.

Evaldrynn
Thank you

Hi Bob,

Thank you so much for your reply; I think it has helped me a lot, and I'm really glad to hear that my approach might be okay and helpful to him, even if he doesn't think so himself.

We called over the phone to talk about some stuff, and regarding what you said about confronting things causing stress, I think that's also why he hates those specific kinds of conversations and would rather not talk about it at all. I read up some more on other's people's posts on here and the replies below them, and also the resources posted on this site. Another thing that's really going to help me out is the 'How to take care of yourself while caring for a loved one with an eating disorder' section in the Toolkit for Parents. It reassured me that talking about my feelings and frustrations to him is okay.

'any caring partner - even in relationships that don't involve matters like this - are going to be asking how the other partner is doing', this is a good reminder for myself too, so thank you.

One think that my boyfriend brought up is that he is afraid that I will get tired and that my needs won't be met in our relationship, and though it sometimes feels that way and I sometimes worry about that too, I hope I'll be strong enough to support him all the way through. Do you have any tips for when it becomes too overwhelming?

And is there proof that a (positive/loving) relationship can be beneficial for his growth/recovery? I feel like it would help. Or is there evidence that it can make the process harder on him, because it may add to his guilt or shame? He sometimes mentions that he regrets looking for a relationship when he knew he wasn't in a right place, because he feels bad for 'putting me through this' and feels more confronted than ever. Either way I would love to read into the effects a relationship can have on someone with an ED.

Thank you for already helping me out so much.

E.

BobJ48
Dear E.

You've brought up some good questions alright. But keep this in mind : If somehow there were "perfect" approaches that we could take, there probably would be no need for this forum !

" One think that my boyfriend brought up is that he is afraid that I will get tired and that my needs won't be met in our relationship, and though it sometimes feels that way and I sometimes worry about that too, I hope I'll be strong enough to support him all the way through. Do you have any tips for when it becomes too overwhelming? "

So one other thing is that every situation is individual. Some people can put up with the sorts of helplessness they can feel, while it's really too much for others. Having said that, my feeling is that a person has to come to terms with what they reasonably can expect to do to help the situation. Sure we would like to be able to somehow "fix" the other person, but you probably know what the chances of that happening are. Still, it's not like we can't do anything. So getting to a place where we are at some kind of inner peace with what we can and can't do seems to help with the "overwhelming" part. If there *are* some sorts of things that we are allowed to do that seem helpful, I mean. That part makes a difference too.

" And is there proof that a (positive/loving) relationship can be beneficial for his growth/recovery? I feel like it would help. Or is there evidence that it can make the process harder on him, because it may add to his guilt or shame? "

Like so many things, the answer to your question is that both of these things may be true. When you hear stories from people who have recovered, often they will talk about how helpful it was, and what a difference it made to have a caring partner. Even if during their ED, they treated that partner really poorly. So yeah, I think we need to have faith that we are helping, even when our partner seems to be giving every sign that we aren't.

Can the fact that we care put pressure on the person, in ways that are upsetting to them ? I think that can be true too. One of the most common thing that you hear about is how people with EDs often start to pull away from their partners, in response to the care they exhibit. I think a lot of that has to do with…yes, they know that their partner is going to want them to recover, and that they don't have much faith that they can do it. So yeah, "caring" while a good thing, can also end up stirring things up for the person as well.

But if a person is going to be a good partner, that pretty much means that they are going to care. It's one of the duties, you know? Generally people with EDs can understand this, and while it may stir up shame or whatever, hopefully it's a reality that they can tolerate too.

Keep writing ?

Bob J.

Evaldrynn
New homework

Hi Bob,

Thank you so much for the last reply. I really have to find peace yet with the fact that I can't help a lot or that it won't be visible soon, but I'll be working on it for sure.

Yesterday he got new homework, and when I asked him if it was very different from what he had had before, he explained that he has to put the aspects of his life into a pie chart in a way that shows how important things are to him. He continued to say that appearance and weight would be a pacman figure inside that pie chart, and that everything else - work, school, family, friends, me - fit inside the leftover bit inside that pacmans mouth. That hurt me quite deeply, knowing that things like that are more important to him than his family or me, but I reminded myself that it is not how he wants it to be and that he doesn't really have a choice right now. It did make me feel a bit unimportant, and it's giving me all kinds of nasty thoughts I don't want to have. Thoughts like: would it even matter to him if I left, then? Will I be one of the lowest priorities in his life as long as he is recovering from his ED, which could possibly have no end? But I feel so selfish thinking those kinds of things. I mean yes, I would love to be a higher priority in his life, as he is quite a high priority in mine, but again: I know he can't help it and I know I shouldn't compare him to myself or compare our relationship to other relationships. It just hurts and I don't want it to hurt, and I don't want my pain to hurt him in turn.

Another very selfish thought I had was that I wished we could both just be normal, mentally healthy people in a normal, healthy relationship. When I am with him everything feels so right, but when I've not seen him in a few days all kinds of doubts start to creep up on me and I begin to wonder if it isn't better for my own mental health to leave. I am going to see a psychologist in February, however, so I'm really hoping that it helps me stay okay and all that, but I wonder if I can talk about all these things to her since I'm going there for a whole other thing altogether.

I also feel like I can't support him in the way he needs me to. Every time I want to listen and offer support that way it brings me to tears hearing what he says, and I feel like that always turns the conversation around to me. I wish I could be strong enough to calmly listen to him telling about his struggles and his rough days.

Thank you so much for listening, though. I don't have many other people I can talk to about this, and I sometimes just feel like I'm rambling without knowing what the point is in saying all of this other than just getting it off my chest and having someone listen and respond. I guess it's helping me keep hope, which sometimes feels so, so far away.

E.

BobJ48
Dear E.

Hey there E.

About his new homework, you wrote :

"He continued to say that appearance and weight would be a pacman figure inside that pie chart, and that everything else - work, school, family, friends, me - fit inside the leftover bit inside that pacmans mouth."

So here's the thing. When people are really rolling with their EDs, this really is how it can be -Thoughts about weight and appearance start being all they can think about. It really can be one of the defining symptoms. Folks kind of allow it to be, because hey, they are trying to drop weight, but as time passes they can begin to become distressed and alarmed when it begins to dawn on them that this really is what fills their head pretty much all of the time. You really do hear people start to go "Oh no" when they realize how much of the rest of their life, and things that they used to enjoy, has been squeezed out of their minds, and displaced by these ED thoughts. It can be alarming to the point where they truly do start wishing for recovery.

So it's possible that the point of this homework is to move him closer to that point, by helping him realize just how much of his mind has been colonized by all of this. I mean it's possible that at first he'll see this as a reflection of his strength and dedication to losing and looking better, but it's also possible that it's moving him closer to that "Uh oh" moment too. If I had to guess, I'd say that that's the point of this homework.

"When I am with him everything feels so right, but when I've not seen him in a few days all kinds of doubts start to creep up on me and I begin to wonder if it isn't better for my own mental health to leave. "

Yes, you'll have to see how you feel about that, because as much as we love someone, we really do have a duty to look out for our own mental state too. One other thing to think about is what makes us feel worse, and what makes us feel better. Our mood and feelings of hopelessness really can take a nosedive if it seems like the person isn't giving us anything positive to support. In contrast, we can feel better and less helpless if they do seem to giving us things to support. I know this pie-chart doesn't seem to be offering up anything positive to you, but I'd give it some time, and see what effect it has on his outlook.

The down-side can be that once they do realize the sort of trouble they are in, their mood can begin to sink. And in response to that, their ED symptoms can begin to get worse too. So be prepared for the worse-before-better possibility. This really can be one of the stages in this, but it doesn't necessarily mean that the person is moving backwards.

In any case, good on you for getting your appointment in Feb. I'm not sure what your original reason for going was, but this situation seems pretty important to me, and as you said, being able to keep your feet under you is going to be important, so I think it's perfectly OK to let this be a topic when you see her.

And yes, it is good to just vent sometimes, so I hope you'll keep writing if it seem to help.

Bob J.

Evaldrynn
Hi Bob,

Hi Bob,

Thanks once again for the quick reply. Things are going well now, though I won't be able to see him much, but we talked about some of the things that were on my mind and some that were on his.

One thing I'm still a bit wary about is the reoccuring painful and heavy cramping in his leg, which is one of the reasons he has difficulty sleeping most nights. I think I saw something like that on the list of symptoms that need medical attention. We already went to his general practitioner about half a year ago for it, but he didn't think it was anything and just gave him some stretching exercises to do before going to bed. My boyfriend's psychologist also knows about the cramps but doesn't think it's anything important either. I guess I don't have to worry about it then? But if it's on your list of symptoms that need medical attention, there's a reason for that, right? Perhaps it's just a coincidence, I don't know. Do you think it's something or?

E.

BobJ48
Leg cramping.

As the old saying goes, none of us here are doctors, and it's unethical to etc etc.

Having said that, yes, people with EDs will often report cramping. Again, don't quote me, but my sense is that it has to do with electrolyte imbalance which is a notorious issue with bulimia. I'm surprised that the doctor did not recommend some kind of supplement to help deal with this. People sometimes drink those sports drinks, to keep their potassium levels ( K+ ) up. Not to put too fine a point on it, but a person's heart is a muscle as well, and a lot of the mortality from bulimia stems from heart issues.

If it were me, I'd want to see him get some blood tests - testing for electrolyte levels is really common for people with bulimia. If a person's K+ levels are low, often they'll get an IV drip to help bring their levels back up, to where hopefully they can be maintained by supplements.

Again, I'm not a doctor, but this is the procedure that you hear about a lot of people having to go through. At the least, he should be having his blood levels checked, a harmless procedure that pretty much anyone with knowledge of EDs would recoment.

Evaldrynn
Hi again

It's been a while and things have been going well! He's been getting ill quite often recently and I guess it's because of his lowered resistance against viruses and such, but it's always gone within a week so I'm not too worried. He's postponing getting his blood tested since he doesn't like the idea but I'll gently remind him to make an appointment every now and then.

The only thing that bothers me a little is something he said a while ago:
"I'm just not in the right situation to work on really getting better right now. I try but it doesn't work; once we live together I won't get the chance to binge so that will help me get rid of it much quicker."

I don't really think it's a good reason, it sounds more like an excuse and I wonder if there will ever be a good time to battle his bulimia. It also feels like quite the responsibility to me, since only me being home in that situation will keep him from binging,but I'm sure I can't always be home even when we live together.
I haven't had the courage to tell him about my doubts yet but I really want to ask him to keep trying. I could use a second perspective, though. Is there logic to his reason and does it really work like that - that if you dont get the chance to binge, it will get better much more easily? Or is it an excuse to not try as hard?

Thanks in advance,

E.

BobJ48
Dear E.

Good to hear from you again.

"I'm just not in the right situation to work on really getting better right now. "
Really, people with EDs do say this a lot, so it really is a pretty common sentiment. On the one hand they wish they were better, but for whatever reason it doesn't feel like the right emotional time for them to work at it. Which could be from stress (EDs are a coping method) of some sort, or some other current emotional issue.

"..once we live together I won't get the chance to binge so that will help me get rid of it much quicker."

One thing about this statement : It's not often you hear people with EDs be optimistic like this. Instead they'll often fret and worry about how things are going to work out for them once they move in with their partner. Mostly about how they'll be able to hide their behaviors and such, So the idea that he sees some ED-related positives to the two of you being together…that's not always what you hear from people in this sort of situation. It's possible that he'll still have just the same problems of course, but the fact that he was able to put it this way - in a way that includes you - is notable.

" Is there logic to his reason and does it really work like that - that if you dont get the chance to binge, it will get better much more easily? Or is it an excuse to not try as hard? "

It could be an excuse I suppose - putting things off until some set of circumstances that hasn't happened yet. Like you said, sometimes the "right time" is never ever right now. But he could also be earnest about this.

If you read about what makes people finally want to stop, the answers are all over the place. But sometimes people will mention how having a partner has helped them. Like how they don't want to be a disappointment to them. Sure, it would be great if they simply wanted to recover for themselves, but it can also be a "whatever works" thing, when it comes to the idea of motivation.

" It also feels like quite the responsibility to me…"
Yep, I can totally understand that. So one thing that might help when the time comes, is to ask him to be specific about the ways that he hopes you can help him. "Just…everything' - like you said, that's too vague for anyone to be comfortable with. So encourage him to be specific, not just about you, but what he sees as his responsibilities too. With the addendum that he also gets to mess up now and then.

Anyhow, just some thoughts. I hope things are going OK for you guys otherwise, because the "otherwise" is important too.

Evaldrynn
Strange feeling of dread

Hi Bob! Thank you for your reply. The otherwise is definitely going okay and we're having lots of good times together! And it's good to hear that the hope he has for the future is a positive sign, I'm really glad he thinks that way then. I mentioned my doubts on the 'not the right time to change/fight' argument and he told me he's definitely still very much trying right now, so that was also a relief.

He did mention another thing though, but I'm not sure if it could be related to his bulimia. Most nights he keeps waking up with an intense feeling of dread, like something bad is going to happen. I know you're not a doctor,but I wonder if it's a common symptom or not. He's definitely having trouble sleeping at night, whereas during the day he could lie down at any given moment and sleep.

I look forward to your reply

E.

BobJ48
Back to you, E.

" I mentioned my doubts on the 'not the right time to change/fight' argument and he told me he's definitely still very much trying right now, so that was also a relief. "

No kidding, that is a good sign. People with EDs often find it very difficult to keep fighting, or to maintain any sort of optimism regarding recovery, so the fact that he's still working at that really does count as a positive sign. Even if he is still involved in ED behaviors.

"He did mention another thing though, but I'm not sure if it could be related to his bulimia. Most nights he keeps waking up with an intense feeling of dread, like something bad is going to happen...I wonder if it's a common symptom or not."

I'm not sure that it's a common symptom, but we can all be prey to free-floating anxiety sometimes. Like we may not consciously know what exactly the issue is…but at the same time, part of our brain seems to know.

And really, it could have to do with ED stuff. Because even in recovery, people still can be plagued with urges, and the sorts of doubts and premonitions as to what that might mean. Like what if his efforts amount to nothing ? His marriage could go to hell, and he could be stuck alone in this ED place forever. There's no way to really tell and…well…I'm sure you know how things like that can go. There's no real way tell what the outcome could be, so our worries start running away with us.

So I think it's fair to say things like this to him - " I know you still worry about what the future might bring." You never know, just hearing something true and something simple like that from you might make more of difference than it might seem ?

Bob J.

Evaldrynn
Things are going really well

Hi Bob, thank you for your previous reply!
Things have been going really well despite his trouble sleeping, and I think I'm noticing a growth in his confidence regarding his body and showing it to me without even thinking much about it. Sometimes I wonder if it's only on days where he hasn't eaten much and has excercised a lot but I haven't been able to confirm it, so for now I'm going to assume it's good progress! I also wonder at times if I should compliment his body at all? On some forum posts I've read that it might help him feel better about his body, on other forum posts people mentioned it might convince him that he needs to stay as thin as he already is and keep worrying about his weight. I have told him my love for him definitely wouldn't change if he gained weight, only that him losing weight will make me worry more - and he seems to accept my compliments, so I guess it's not that big of a deal. Of course I also compliment him on lots and lots of other stuff and not just his body, so I'm hoping that it helps him get more confidence too. He"s always so hard on himself when it comes to performing at university though... Even when he gets 70 - 80% on assignments he mentions his group members must've done the most, or his professor must have low standards. Even when he gets great marks on exams he doesn't believe it's because of his own intelligence and perserverance. I really hope that sentiment falls away when he graduates, but I can see how it could affect him in a job too. He doesn't accept my compliments about his intelligence fully yet either, it feel like. But! It used to be worse. He used to come home and bang his head against a wall saying how he was an idiot and all that, so I'm glad he's come so far already.

So yeah, I'm glad it has been going so well! I'll keep you updated; it's nice to write things out.

E.

BobJ48
To you again, E.

" He's always so hard on himself when it comes to…"

Oh brother, the "Good Enough" thing. This seems to be a universal issue with pretty much everyone who has eating disorders. You name the area of endeavor, and they are just not good enough…yet, that is. But perhaps some time in the future, if they only keep pushing forward with ( insert ED behavior here ). And hopefully in ways that are clearly measurable in numbers, or some other black and white way of assessing things.

So yeah, moving into an emotional area where one can assess themselves in a more gentle and spiritual ( <—or whatever your preferred term is here ) way really does count as progress I think. And it does seem like you are seeing some of that, so yay !

" I also wonder at times if I should compliment his body at all? On some forum posts I've read that it might help him feel better about his body, on other forum posts people mentioned it might convince him that he needs to stay as thin as he already is and keep worrying about his weight."

This is just me of course, but I'd stay away from weight or body comments if it were me. People with EDs really can become fixated on then nature of their bodies as their primary means of personal assessment, so I'm not a fan of anything which might seem to support or encourage that. Plus, if the person is really deep into their ED, there's nothing you can say that's going to help. If you say they've gained weight and look better, what you really mean is that they look fat. If you say they look thinner, you are just saying that to try and make them feel better, when what you really mean is that you think they look fat. Perhaps he's no longer that way with such sorts of comments, but even so, I'd steer away from body related comments if it were me. You probably know for you own self how easily problematic such comments can be.

But yes, any signs of healthy internal self esteem that doesn't seem to primarily rely on numbers…that really is wonderful to hear about, and it does sound like you are starting to hear a little of that. :-)

Bob J.

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