Anorexia: True Story in a Sister's Words

by Kay (pseudonym) presented with author's permission
by Joanna Poppink, M.F.T.

(Only names have been changed to protect the privacy of family members) Followed by author's correspondence with Joanna Poppink, L.M.F.T.

Dear Joanna,

I am writing in the hopes of saving my sister Janet. Janet has always been one of my best friends, and my other sister Wilma and I are certain Janet will die if she doesn't t get help.

Janet is 36 years old and has been suffering from Anorexia Nervosa since the age of 16. She has been in an out of treatment and hospitals over the years. It has been about one year since her last 5-month stay at XX (a well known eating disorder treatment center). Since her release last April, she has had 4 hospitalizations and three seizures all caused by her eating disorder.

Janet insists on living in her studio apartment in the city while most of the family is in the suburbs. She comes out to the suburbs often, but despite our efforts to keep her to stay with us she insists on going back to her apartment, and has even called cabs to take her back home.

She can no longer drive because of her seizures and has been on disability for the last year and a half. Janet is also an alcoholic and often turns to binge drinking to escape her problems. On one occasion we picked her up at an El stop bombed drunk. She does not remember the incident.

Janet admits that she drinks to escape her depression. It s a non-ending cycle and I m convinced she will die soon if something drastic doesn't change.

Janet is the middle daughter of three girls. Wilma is 37, and I am 33. In everyone's eyes, Janet is an outgoing person with a bubbly personality. Janet was the lead in many plays in high school. She was an honor student in high school with practically a perfect straight A report card. She was the 2nd runner up in our town beauty pageant at the age of 20.

Janet is a people pleaser. She would do anything to help a friend, relative or stranger. She just can t seem to help herself.

I believe God has saved her time and time again. All of her seizures occurred when she was either around family, or in public. They could just as well have happened while she was alone in her apartment, which is where she spends most of her time these days. When we picked her up, drunk, at the El stop, we found her because she called dad from a payphone. She doesn't remember the incident or the phone call.

My five year old son Chris and Janet have a special bond. Janet lived with us for the first few years of Chris's life. Chris knows Janet is sick because she doesn't t eat. He recently overheard my cries and conversation with my husband in which I stated that I didn't want Janet to die. He pretty much went hysterical crying, "I don t want Auntie Janety to die."

How do you explain Anorexia to a 5 year old? Janet has often said that she doesn't t want to live, but is going on for her nieces and nephew.

Janet loves children. Her first job out of college was teaching preschoolers at a Montessori school. Janet has told me, "The kids love me for me." If only she could love herself the same way.

She has had several bad relationships over the years. The most recent one was with a married lawyer who was getting divorced. This scum was at my house on Thanksgiving a couple of years ago and even held my baby daughter, which now makes me sick to my stomach. He used Janet for very selfish reasons and then Janet found out that his wife was pregnant again. This put Janet over the edge and back in the hospital. Still though, he tracked her down in the hospital and continued to call her.

Because Janet is so sick and has no self-esteem, she immediately got her hopes up and started the relationship back up. Once she was out of the hospital; the relationship resumed and consisted only of lunchtime visits to her apartment for sex. He is now out of the picture because we told his wife.

I have every crazy story you can imagine about the abnormal behavior of a severe anorexic. These memories go back at least 15 years. Janet and I lived together right after I got out of college. This was after her first in-patient stay at a treatment center in Illinois. Janet has specific foods that are okay for her to eat. This list consists of vegetables, diet soda, a morning bagel if you are feeling thin that day, pickles, olives, and pretzels.

She has shared with me every thought that goes through her mind. Nothing I could say helped her. She usually denied that she still had a problem. I've even gone as far as going through the garbage even after it was outside in the trash can to prove to Janet that her anorexia/bulimia was no secret. I found wrappers of all the food she ate during a binge.

We had fights on a regular basis that would end up in tears and hugs. Tough love has never been my expertise. She was staying at our house recently and I asked her to try a little chicken breast on her salad. She did put it on and ate it, but later threw it up. She admitted to me that she threw it up, and broke down in tears saying she had to do it because she ate a lot at mom and dad's the last weekend and gained a few pounds and was freaking out about it.

She also told me in tears that she couldn't t be alone. Sure enough, two days later she demanded going back to her apartment. Her cycle now is to eat when she's visiting us out in the suburbs, and then she starves for 3-5 days.

Her body is so messed up. Among many of her problems is severe osteoporosis. Recent test showed her bones to be as frail as those of a 98 year-old woman. She had to have all her teeth drilled down to just nubs, and have caps put on all of her them because her teeth deteriorated so much due to vomiting. Her blond hair was once healthy. Now, it is thin and sparse.

She started in therapy after her release from the hospital last April at WW, a well-known eating disorder center here. I tried to get her there for the past ten years! I was very hopeful. That didn't last because it required her to go in for weigh-ins and stick to certain commitments.

Janet's story is that she didn't t like the therapist. She said that therapist blamed everything on family issues. Janet simply couldn't stick to the expectations of the program. Janet somehow got her way out of that one.

Janet has been seeing a therapist off and on for several years who does not specialize in anorexia. She says, "He makes me feel better." She s very encouraged by the fact that he recently started reading up on anorexia to learn more about it! Wow, after years of seeing her, he's now reading up on it! Shouldn't we feel so good?

God forbid my parents would ever get cancer, I m sure Janet would just love it if we sent them to a doctor who started reading up on it. She doesn't listen to me when we say that she needs to be going to someone who understands her problem. Making her feel good is indeed a good thing, but a doctor needs to help you make progress toward recovery and this therapist is not doing that.

But I think Janet sees his concern for her, and she sees that he really likes her which is what Janet longs for in any relationship. It s all part of anorexia. She is a people pleaser but continues to damage herself.

Joanna, my parents are at a loss of what to do. My retired father has spent $110,000 of his savings from Janet's most recent stay in the hospital last year. He has hired a lawyer to fight the insurance companies denial of the claims.

Anorexia is NOT just a mental disease I have no doubt Janet would be dead if she didn't t get into that hospital. She would have died because her body stopped working. Isn't that physical? The 200 pages of documentation from doctors, hospitals, and therapists verify this.

We cannot afford for her to go back into in-patient treatment. Her Cobra ends in June. She is applying for social security, but if she doesn't get it, any more hospitalizations will be devastating for my parents. My mother works mostly so they have health insurance. I know what a terrible position it is to have to put money into consideration to save a life, but it's reality.

My dad can t get out of his mind one of her recent seizure episodes where she was laying on the ground and fighting the paramedics in complete hysteria screaming, "Dad, I don't want to die."

I bought Janet the new book by Tracy Gold entitled Room to Grow- An Appetite for Life. Janet read it and is convinced that Tracy went through everything she is! When asking her how Tracey got through it, Janet replied, "She met her husband." Janet doesn't realize this needs to come from within her.

I want to continue my efforts in finding her more help.

Sincerely,

Kay

Dear Kay,

Your letter is moving and heartbreaking. I admire your stamina and dedication as you attempt to help your sister and your family. Your question, how do you explain anorexia to a five year old? lingers in my soul.

I wish you every success in finding the quality treatment your sister needs and the support you and your family need. Please take care of yourself.

Best wishes and peace, peace, peace

Joanna

Dear Kay,

Your letter describing your sister's situation is a most valuable description of what agony anorexia can bring to the individual suffering from the illness and the entire family.

I think many people would benefit from hearing this story. Would you be willing to have your letter be posted on my website?

Please let me know. You can be as public or as anonymous as you wish. I believe your story needs to be told and you tell it clearly and well. Truth, pain and love pour from every sentence.

Best wishes and peace, peace, peace.

Joanna

Dear Joanna,

Yes, Joanna, you can post my letter. The comfort of knowing that it could help someone makes me feel better. I do not care if my email address is attached.

I appreciate your response, and on behalf of everyone you have helped and are helping right now, THANK YOU. I truly believe that 5-10 years from now, the horrors of Anorexia will be much better known and treatment will be accessible and covered by insurance for in-patient treatment for the necessary period of time it takes to help a person. In the meantime, I'm afraid my sister will become a statistic.

If you have any unique suggestions as to how we can get Janet help, please let me know. I know that our distance disables our ability to become a client of yours. I know it really takes the right therapy and commitment of the patient to beat the disease. Janet has lived with this so long, I just don't see her making the change in her lifestyle. It's horrible for me to say that, but it's how I feel. She needs to be forced, and that goes against a lot of the recommendations of doctors for someone with anorexia. She's an adult and she needs to make the change. I just don't know if I can live with the consequences.

Thank you again for your quick response. God bless you.

Attached is a picture of my beautiful sister and my two great kids who adore her more than candy or life itself.

Sincerely,

Kay

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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