Dear Kay,

Thank you for the picture. What beautiful people. For reasons of privacy, legal permissions, etc. I doubt if I could post the picture with your writings. But I wish I could. Your sister and your children are so very lovely. And their beauty is part of the problem in this culture. Even with all the eating disorder awareness and distorted body image publicity moving through our society, it is still difficult for most people to believe or understand that a person can look this good according to current standards of beauty and be in danger of losing her life from an eating disorder.

You wrote: "If you have any unique suggestions as to how we can get Janet help, please let me know. ?... She's an adult and she needs to make the change. I just don't know if I can live with the consequences."

Here's my attempt to respond. You are exhausted from doing everything you possibly can for Janet. Your request is for help for Janet. You write about time, money, energy, heartache, rescue missions all directed at Janet.

But... you and your family are suffering terribly. I'm especially concerned with your sentence, " I just don't know if I can live with the consequences." Not only are there people in your life who love you and whom you love, but you also have young children. You have a five year old who is worried about Aunt Janet dying. Must he also worry about his mother dying?

I invite you to make a major energy direction shift. Tough love sounds like it's behaving harshly to the sick person. But really, it's behaving with love, care and practical day-to-day wisdom as you actively honor and cherish what you honor and cherish.

If you put your own mental, spiritual and physical well being first, you will find that you get more sleep, find more reason to smile, have more positive experiences to share with your children, build health and confidence in yourself and those near to you. The tough love part emerges when your sister discovers that you are putting your energy into health and not her illness.

The aspect of this that confuses people is the issue of support. You want to support your sister. You do not want to support her illness. How to be clear on the difference can be a great challenge. You can offer her love, friendship, normal sharing of activities, and encouragement in terms of health promoting activities. She needs to be responsible for the consequences of her actions, especially the actions that come from acting out her illness.

I also suggest that you explore the possibility of attending al-anon meetings. There you will find people working to create healthy lives despite loving a person with a self-destructive behavior pattern. The meetings can be very helpful for people who love someone with a serious eating disorder. And, of course, you completely qualify because Janet's problems include drinking alcohol to excess.

You say that Janet doesn't remember certain events in her life. Perhaps this is due to alcoholic blackouts or some kind of chemical disruption in her system. But it also could relate to a form of a dissociative illness. Has she been tested for such an illness?

The DES test is a simple pen and paper instrument that can give an indication of whether dissociative experiences are part of her complex diagnosis.

You can go to the website: http://www.issd.org/ The International Society for the Study of Dissociation. Under "online resource for the public" you'll see a number of resources that may be helpful including "treatment guidelines" and useful links.

Also, The Sidran Institute, http://www.sidran.org/ concerns itself with traumatic stress education and advocacy and may have some useful information for you and your sister. Actually Sidran was created by a woman whose sister suffers from a serious and debilitating traumatic stress disorder.

That's all I can think of from this distance, Kay. You may have heard all this before. If you haven't and I've been intrusive with my remarks, please forgive me and let my comments go. If you have heard this before and are open to these thoughts, then my comments may help reinforce what you are already considering.

About posting your letter:

Do you want to keep all the names as they are? If we use your real name then we are also revealing the identity of your sister and other family members. Do you want that? I think the power of your letter will remain unchanged if you use different names, but the choice is yours.

If we include your e-mail, you will get letters. I have no doubt about that. Do you want that correspondence?

My personal suggestion is that you do not leave contact information. You are under enough stress, and the letters can be triggering.

Best wishes, Kay. And yes, people do die from illnesses similar to what your sister is experiencing. But please remember, people also find recovery and live.

Peace, peace, peace

Joanna

Dear Joanna,

Thank you so much for your help. Your words have given me strength, hope, and next steps. The time you took to respond to me way out here in Illinois shows that you are indeed an incredible person.

Yes, you can post my letter and my e-mail. Please change the names.

Sincerely,

Kay

presented with author's permission by Joanna Poppink, M.F.T.

Names of family members and eating disorder treatment programs have been changed to protect and respect the privacy of family members.

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