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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7664
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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i have just found out that my daughter (16) has bulimia. We

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i have just found out that my daughter (16) has bulimia. We are thinking about the best treatment for her, but my immediate concern is that she competes/ trains at a very high level in martial arts, and am extremely concerned at the effects are on the body if she continues to train whilst she has this issue.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

Oddly enough, the martial arts training is most like directly related to the bulimia.

Elliott, LPCC, NCC :

I shall explain below.

Elliott, LPCC, NCC :

You never mentioned if her bulimia was the purging or on-purging type.

Customer:

Hi Elliott,

Elliott, LPCC, NCC :

Hello ! Let me give you the full criteria for bulimia from the DSM-IV diagnostic manual, the "bible" of mental health diagnoses.

Elliott, LPCC, NCC :

Diagnostic criteria for 307.51 Bulimia Nervosa


A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:


    (1) Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances (2) a sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)

B. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise.
C. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months.
D. Self-evaluation is unduly influenced by body shape and weight.
E. The disturbance does not occur exclusively during episodes of Anorexia Nervosa.
Specify type:



      Purging Type: during the current episode of Bulimia Nervosa, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas


 


    Nonpurging Type: during the current episode of Bulimia Nervosa, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas
Customer:

My daughter says it started 2 years ago with anorexia. She didn't eat at all at breakfast or lunch and ate a very healthy evening meal. She would then vomit. She lost loads of weight very quickly which we noticed. We chatted a lot and she appeared to be a lot happier and said that she'd stopped. She began to eat normally and regained all her weight approx 5kg. She has maintained the weight and looks very well/ healthy. However tonight the toilet was blocked with vomit. She says that she never stopped vomiting but began to eat more, thus maintain her weight.

Elliott, LPCC, NCC :

I see.

Elliott, LPCC, NCC :

It seems as if she has the purging type with the addition of exercise.

Elliott, LPCC, NCC :

She is very competitive?

Customer:

She is extremely competitive, represents her country, is predicted A stars for her GCSE'S and is in the Gifted and Talented top 5% of the country. She puts a lot of pressure on herself. She lacks any kind of empathy

Elliott, LPCC, NCC :

Is she a narcissist? Narcissists want to be the best and they lack empathy.

Customer:

probably

Customer:

any tears are a sign of weakness

Elliott, LPCC, NCC :

Did you know that, based on a meta-analysis (analysis of many studies), from 2% to 16% of eating disorder patients are narcissists.

Elliott, LPCC, NCC :

They are related.

Elliott, LPCC, NCC :

Narcissism is hard to treat because nobody is worthy enough to treat the narcissist

Customer:

In recent tests she was off the scale with either verbal or non verbal reasoning

Elliott, LPCC, NCC :

Her success feeds her need for "narcissistic supply", as it is called.

Elliott, LPCC, NCC :

Many narcissists are very smart. The are also extremely manipulative and are often the bet con-artists and liars.

Customer:

She's extremely smart. Doesn't suffer fools. She's upset by her lack of empathy and says she's not a nice person.

Elliott, LPCC, NCC :

You could try a couple of self-help books. She is self-aware and this is to her great benefit and credit.

Elliott, LPCC, NCC :

Here is one:

Elliott, LPCC, NCC :

and

Customer:

Funnily enough we have discussed various help , she doesn't want to talk to anyone so maybe reading is the way to go.

Elliott, LPCC, NCC :

I thought it might because most people with NPD do not want to seek help.

Elliott, LPCC, NCC :

I can recommend one more book for NPD.

Customer:

Sorry what's NPD/

Elliott, LPCC, NCC :

Narcissistic Personality Disorder. I believe that the bulimia is an outcome of it

Customer:

o.k.

Customer:

So what about the medical implications ref training for 2 1/2 hrs 3-4 times a week and competitions some weekends. This is full on training/ fighting/ fitness

Elliott, LPCC, NCC :

It is hard because all of this is totally enmeshed with her career and her goals, but it is something that can be sorted, and does not require mediatiopn

Elliott, LPCC, NCC :

medication'

Elliott, LPCC, NCC :

It DOES require a lot of psychotherapy to promote self-understanding.

Elliott, LPCC, NCC :

Empathy, alas, cannot be learned.

Customer:

Yes, I understand. My real immediate worry is the potential threat of excessive exercise on her body. I.E electrolyte imbalance etc

Elliott, LPCC, NCC :

That can only be monitored by her physician, and SHOULD be closely watched

Customer:

O.K. Thank you Elliot

Elliott, LPCC, NCC :

You are so welcome. I shall keep her in my prayers for recovery and for being a champion.

Customer:

Thank you.

Elliott, LPCC, NCC and 2 other Mental Health Specialists are ready to help you

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