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TherapistJen
TherapistJen, LCSW, CPC
Category: Mental Health
Satisfied Customers: 2813
Experience:  Licensed Clinical Social Worker.
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My seventeen-year-old sister suffers from an eating disorder,

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My seventeen-year-old sister suffers from an eating disorder, and we have just discovered that she has been cutting herself. Our father survived a heart attack in the fall of 2009, and that event was a wake-up call to our family to better attend to our health. My parents, my youngest sister (of two younger sisters) and I were all significantly overweight. We made a commitment to eat healthier, exercise more regularly, and in general live a healthier lifestyle. We all lost weight, but in the autumn of 2010, when my youngest sister was sixteen, we began to notice that was perhaps overdoing it. We didn't want to admit to ourselves how unwell she had become, so we talked to her a few times and took her word for it that she was okay. As the autumn continued, she lost more and more weight, and we noticed that she ate very little and exercised obsessively. She often complained of headaches, slept irregularly, and became moody and withdrawn. One evening in late November we all sat down as a family and talked, and she eventually admitted that she had been hiding some very dark thought patterns and beliefs, and that she had been acting on them. She had been deliberately eating very little, drinking very little, and exercising far more than would be healthy even for a person with adequate nutrition. A physician confirmed that my sister was at a dangerously low weight (just over ninety pounds) and that she was experiencing serious and potentially dangerous physical conditions as a result of her eating disorder. My mother kept my sister close for the next few months, and prepared all of her food for all meals, and watched that she ate it. By the spring, she had gained weight and was nearing a healthy weight. He mental state seemed slightly improved, but not much. Left to her own devices, she would not eat. If my mother told her to prepare food and eat, she would do so. She would eat a small amount of the food she had prepared and then stop, and then after further prompting from my mother she would finish her food. Things went on this way for a few months before we began to notice a gnat problem in our home. Gnats swarmed around our kitchen and bathroom sinks and around garbage cans and wastebaskets. We began to notice old food in the trash, and worse, what seemed to be vomit. We asked my sister about this until she admitted that she had been purging. My mother had initially been reluctant to get my sister professional help for fear of the label of mental illness and the accompanying social stigmas, but she now turned to counseling. My mother is deeply religious and so sought mental health professionals who had a Christian philosophy and who approached their profession from a Christian perspective. My sister began keeping a weekly appointment with a Christian counselor from a counseling practice in a nearby city. I do not know the level of accreditation of the counselor, nor do I know whether or not the Christian perspective of the counselor negatively impacted the quality of care she provided. I know that the service seemed reputable from what little I know of it. My sister talked to the counselor for one hour each week, but did not seem to improve very much in her outlook. After fourteen weeks of appointments, my mother felt that the counseling was not sufficiently effective to be continued. My sister had learned some techniques for gauging the rationality of her own thought, and for attempting to prevent herself from thinking in unhealthy ways, but her unhealthy behavior persisted and she openly told my mother that while she was aware that she was not thinking in normal, healthy ways, she was not ready to take steps to get better. The counseling was discontinued and we decided that we would approach her disorder as a family, offering support and positive encouragement when we could, and promoting healthy eating habits in any way possible. My sister seemed to get better, if very gradually. She has now achieved marginal independence. She takes classes at a nearby community college for dual high school and college credit, and packs and eats her own meals. She has maintained a healthy weight and we have not found evidence of purging in months. Unfortunately, things again seem to be getting worse. Lately she has relapsed into irregular sleeping patterns and sometimes spends long periods of time locked in the bathroom. A few nights ago she awoke my mother in the middle of the night because she was very concerned that she was fat. She has begun to eat strangely again. For example, she recently ate an entire box of cracker chips over the course of several hours while she worked on her homework, but did not eat again for the rest of the day. Today on a shopping excursion, my mother discovered cut wounds on my sister's arms. We are all very worried. What can be done to help my sister out of the darkness of her thoughts, and how can we help her to live a normal and happy life?

CoachJenK :

Hi. Welcome. I am a Licensed Master Social Worker with more than 20 years experience working with individuals and families on a variety of issues.

CoachJenK :

I am so very glad to answer your question. I ave worked with people with eating disorders for many years. Your sister is in the midst of a very serious eating disorder with many associated features such as the purging and now the cutting.


 

CoachJenK :

Eating disorders can often occur after a diet or a lifestyle change as you report happened when you Dad had a heart attack.


 

CoachJenK :

the stress from your Dad having a heart attack could have been the precipitant to the disorder


 

Customer:

Hi. Thank you for responding. I would appreciate your insight about all of this.


 

CoachJenK :

I believe that the counseling did not help because it was not enough


 

Customer:

I think you are probably right.


 

Customer:

I believe she needs more intensive treatment.


 

CoachJenK :

eating disorders and one of her magnitude cannot really be treated by one hour a week.


 

CoachJenK :

She would benefit better from a stay at a place that specializes in the treatment of eating disorders.


 

CoachJenK :

yes you are correct.


 

CoachJenK :

where do you live?


 

Customer:

Shiloh, Ohio.


 

CoachJenK :

with it being this entrenched I am not of the belief that outpatient will help very much.


 

Customer:

The nearest cities of notable size are Ashland, Mansfield and Norwalk.


 

Customer:

What kinds of facilities are available in Ohio?


 

CoachJenK :

I am looking right now...but my thoughts are inpatient fist and then transitioning to an intensive outpatient program. I understand the stigma that your parents think comes with this but eating disorders are quite common but very deadly


 

Customer:

How should we transition her to inpatient care? Is it possible to do so without completely disrupting her life and all of the things she is invested in?


 

CoachJenK :

if her symptoms are very sever now then the symptoms alone will disrupt her life. Getting her into inpatient care will be what is necessary for her to live a productive life.


 

Customer:

I see. How long will she be in inpatient care? What is the typical approach of that kind of care?


 

Customer:

Will we be able to see her while she is in treatment?


 

CoachJenK :

Here is one that i would start with getting some information from. http://www.river-centre.org/


 

CoachJenK :

in a residential treatment facility they will work with her on all facets of the illness...physical, emotional, nutritional, etc.


 

Customer:

Thanks, XXXXX XXXXX into it.


 

CoachJenK :

yes you will be encouraged to attend family meetings. She will not be locked away...these are open and therapeutic environments where she will have therapy, medical therapy, family therapy and ore so that she can undrstand the underlying cause to these symptoms.


 

CoachJenK :

eating disorders are very hard to recover from on their own as each time new stressors appear one can revert back to the symptoms as a coping mechanism.


 

Customer:

That makes sense.


 

CoachJenK :

The goal for her treatment is to know what the reasons are, how she is feeling at any given moment and not let food, weight or cutting relieve her of any of these feelings.


 

CoachJenK :

eating disorders have nothing to do with food.


 

Customer:

My father was diagnosed with kidney cancer just over six months after his heart attack. He survived it, but he has just been diagnosed with bladder cancer. I think these have contributed to her relapses.


 

CoachJenK :

absolutely and I am sorry to hear about your Dad. It seems to me that she is under much stress arounf this and her fear of losing him keeps coming at her over and over


 

Customer:

Her disorder is about feelings of control, is that right? She needs to feel in control of her life, so she resorts to this kind of thing?


 

CoachJenK :

the preoccupation around food and weight is a way to avoid any other pain that she is experiencing. The cutting is a relief as it is real physical pain to focus on rather than the emotional.


 

CoachJenK :

with the right support and outlet for her feelings she could do well. I have seen many that recover, but it does take work and the proper treatment.


 

CoachJenK :

that is the answer that all of the lay person literature likes to focus on....she is feeling so out of control and so scared of feelings that this focus on the food and weight avoids having to deal with the rest of it.


 

CoachJenK :

connecting her back to her feelings is the goal so that she doesnt use the eating disorder as a way to feel.


 

CoachJenK :

sounds simple...but it takes a long time. her fears and worries are deep.


 

Customer:

Is she suicidal? Is it possible for her to recover from this and to live a healthy and normal and happy life?


 

CoachJenK :

not a starchy hospital but rather a very healing environment that has the specialty of treating eating disorders.


 

CoachJenK :

some sya that an eating disorder is a slow suicide.


 

CoachJenK :

I think when you take a look at the River Centre you will be comforted by what you see.


 

CoachJenK :

It is possible for her to get better but with the right treatment as I am suggesting.


 

CoachJenK :

I have worked in many places both inpatient and out with people suffering from eating disorders and I have seen many do quite well.


 

Customer:

I will do what I can to make sure that she gets the treatment she needs. I think the facility you have recommended seems very promising.


 

CoachJenK :

I am hoping the family can move past feeling the stigma so that she can get the help that she desperately needs.


 

Customer:

I think my mother is beginning to be more open to getting her the help she needs.


 

CoachJenK :

Eating disorders are deadly and she has shown you that she cannot do it alone or in the way she has had treatment already.


 

CoachJenK :

the whole family needs to be on board and support her.


 

CoachJenK :

wonderful. you can come to me anytime by requesting me. I am glad she is coming around.


 

Customer:

I do not share her convictions, but my mother is very religious. When she is afraid or when she does not understand, she turns to God. She believes that God can help my sister to heal, and wants to find a counselor or facility that shares this view.


 

Customer:

I think my sister's mental health is the priority.


 

CoachJenK :

I agree with you and also understand your mom's fears.


 

Customer:

I hope that my mother's fanaticism does not cause her to neglect my sister's care.


 

CoachJenK :

I hope so too as this disorder is deadly if not properly treated.


 

Customer:

Thank you for your help. You have offered some valuable advice and I appreciate your time.


 

CoachJenK :

It is my pleasure. I hope you Dad does okay and your sister. Please come to me if you need more help. you will have a copy of this chat when you complete the rating and I hope I have earned a rating of EXCELLENT service.


 

Customer:

You have more than earned that rating. Thank you.


 

CoachJenK :

Thanks for taking the time to say that and to click on the rating tab. I am here if you need.


 

Customer:

Thank you again for your help. Good evening.


 

TherapistJen and other Mental Health Specialists are ready to help you
Hi Craig,
Just wanted to check back in with you to see how you are doing and how your sister is doing. I am hoping you have been able to contact the River Centre. Please let me know if I can help you any further.
Jen

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