It is no secret that Eating Disorders have the highest mortality rate of any mental illness. According to the National Eating Disorder Information Centre (NEDIC) website, a 2002 study showed that 10 per cent of individuals with Anorexia Nervosa will die within 10 years of the onset of the disorder.
Most people assume that this death rate has to do with all the physical ramifications of being extremely malnourished. However, suicide is actually the second cause of death among people with Eating Disorders, after cardiac arrest.
Sara L. was diagnosed with Anorexia when she was 14 years old and says that she has suffered with suicidal thoughts for as long as she has had her Eating Disorder. She says she first thought about suicide when she was feeling abandoned and alone in the hospital. As she got older, she found that her suicidal ideations became much more prevalent in response to an intense feeling of hopelessness about her Eating Disorder. “I was feeling like a huge burden and really stuck; like this was never going to get better,” she says. “And if it was never going to get better, I didn’t want to live that way.”
Sara attempted to take her own life on three separate occasions. She says a lot of what lead her to act on plans to end her life had to do with that intense sense hopelessness and feeling of being a burden on those around her. She also says the fact that her brain and body were severely malnourished played a role in exacerbating her depression and made ending her life seem like the only option.
Sara acknowledges the fact that it can be extremely difficult to help someone who is having suicidal thoughts. She says that even though she expressed how constant her suicidal ideations were, it was really hard for her support system to know when those thoughts were turning into an attempt to go through with ending her life. “There was a lot of secrecy when it came to actually going forward with that,” she says. “That was just the point that I was at and I wasn’t willing to accept help from anyone.”
Sara now has some distance from her suicide attempts and works in the mental health field. She says that while suicidality is hard to address, there are some warning signs and things that caregivers can do to help support and protect their loved ones. She says some of the most common things to watch out for are low mood, withdrawal, isolation and verbalization that they’re tired of dealing with their mental illness, are feeling hopeless or that life is pointless and meaningless.
Keep the dialogue open
Sara says it is very important to keep the dialogue open with the person who may be suffering with suicidal ideation. “Suicidal thoughts wax and wane and as long as that conversation is ongoing, they’re going to catch people when they are more willing to open up,” she says.
What helped for her is having someone who she knew she could talk to about her suicidal thoughts, without judgement. She found comfort in the fact that, when she was willing, she could reach out to her sister for support and know that she would listen, without telling her that she shouldn’t feel the way she was feeling. “I could even just say it out loud and have her offer suggestions as to what to do in that time, knowing that she would only offer empathy and not get mad at me for having those thoughts,” she says.
Don’t assume you understand
Sara also says she always advises people not to say they understand what the sufferer is going through. “You really absolutely have no idea what it is like for that person, regardless of whether you have experienced suicidal thoughts before,” she says. “When I hear that it’s very invalidating.”
Make sure they know you want to support them
In Sara’s experience it is also important to meet the person where they are at, while also telling them that you are there to help them get to a better place. “Having people, even if it becomes a broken record, tell you that you are not a burden,” she says. “Because that’s the trick of the mind where your depression or suicidal thoughts tell you that people would be better off without you when actually that is not the case.”
If you have a plan – wait
Sara says that if she could give any advice to someone having suicidal thoughts or making a plan to end their life it would be to postpone their actions and reach out if they can. “Those thoughts wax and wane and in 12 hours you might feel differently,” she says.
Suicide is not an easy thing to address and it is often veiled in a lot of secrecy. Whether you are someone suffering with suicidal ideation or a caregiver, don’t be afraid to reach out for help. Counsellors at Crisis Services Canada are available 24 hours a day at 1-833-456-4566. Links to suicide crisis hotlines can also be found on the Open Counselling (https://www.opencounseling.com/hotlines-ca) and Teen Health and Wellness (https://teenhealthandwellness.com/static/hotlines) websites.
How to support a loved one who is struggling with suicideHilary Thomson2020-09-10T06:46:51-04:00
Today is International Youth Day and NIED would like to acknowledge all the teens and young adults in Canada who are struggling with mental illness. You are not alone.
Eating Disorders are mental illnesses that often (but not always) show up in adolescence. Although Eating Disorders can affect people of all ages, genders, races, and socioeconomic backgrounds, many often report pre-occupations with weight and shape starting around puberty. This is usually while they are still in school and living at home with their parents, who may not know what to do if their child is showing signs of an Eating Disorder.
Dr. Shari Mayman has been working in the field of Eating Disorders for 15 years. She started her career as psychologist in the Children Hospital of Eastern Ontario (CHEO) Eating Disorder program where she worked with many children and teenagers struggling with Eating Disorders and their families. At CHEO parents were heavily involved in their children’s care, as the program used a family-based approach. Dr. Mayman says that family-based therapy is an approach that is proven to work well, but it didn’t have a strong enough focus on the multitude of emotions that come up during the recovery process, both for the patient and their caregivers.
About ten years ago two psychologists, Dr. Adele Lafrance and Dr. Joanne Dolhanty, filled that gap with the creation of Emotion Focused Family Therapy (EFFT), a modality on which Dr. Mayman’s current practice, at Anchor Psychological Services in Ottawa, is focused. It was created to support parents of children of any age support their loved ones in recovery (both emotionally and practically), and to address “emotional blocks” that may be getting in the way of a them providing this support. Dr. Mayman says these “emotional blocks” are normal and expected, and often show up in the form of guilt, with parents wondering what they did to cause their child’s Eating Disorder. “Shame and self blame often come up,” Dr. Mayman says. “If you think you are the problem, then it is hard to be part of the solution.”
EFFT is focused on breaking down that self blame, as well as other emotions such as fear, anger, resentment, and grief, and giving caregivers the tools they need to support their own and their child’s emotional needs. Through a process called emotion coaching, parents and caregivers are taught how to coach their children through difficult feelings, which are often at the crux of the Eating Disorder. “Emotional avoidance is central to all mental health issues,” Dr. Mayman says. “Restricting, bingeing, purging and over-exercising are all emotion-numbing strategies.” EFFT also focuses on teaching caregivers strategies to facilitate symptom reduction, and to deal with the intense emotions that arise when symptoms are reduced or eliminated.
Another impactful component to EFFT is the repairing of any relational injuries, both past and present. This is not to place blame, but to create the trust that is needed in order for parents to effectively support their child through the recovery process. “Caregivers have this tremendous healing power when they have compassion and empowerment holding them up,” Dr. Mayman says. “Then they are also more ready to repair things that need to be repaired.”
By instilling parents with the confidence and tools they need to support their children, they are more likely to help them make change in a way that is sustainable and effective for everyone. Dr. Mayman says their goal is to have parents and caregivers acting like a Saint Bernard, with sensitivity for their child’s struggles; but also a steady and assured response to emotional stress. “It’s focused on empowering caregivers and giving them the ability to act as healing agent.”
Dr. Mayman wants to stress that the tools that are the foundation of EFFT are learned, and no parent should feel badly about not having the knowledge to heal their child’s Eating Disorder in their back pocket. This is why Dr. Mayman and her partner at Anchor Psychological Services, Dr. Katherine Henderson, offer workshops for parents three to four times a year, to help teach the EFFT skills in an immersive setting. Even though their practice is based in Ottawa, Dr. Mayman says there are EFFT practitioners all over Canada.
While EFFT is fairly new on the scene in the treatment of Eating Disorders it has spread like wildfire in treatment spaces across the country because of its effectiveness. For more information about EFFT or to find a practitioner in your area visit. www.efftinternational.org.
Emotion Focused Family Therapy (EFFT), and how it can really help you and your struggling teenHilary Thomson2020-08-12T12:40:56-04:00
It is not easy to support someone with an Eating Disorder.
Kirk Mason was the partner of Michelle Stewart, the former head of communications for the B.C. Ministry of Health, who suffered from a devastating Eating Disorder for 32 years before it eventually claimed her life in 2014.
Mason met Stewart when she was in her mid 30s and had already been living with an Eating Disorder for 17 years. It wasn’t until they had been living together for four months that Michelle sat him down one day and told him about her history. “She said I completely understand if you don’t want to be with me, if you want to walk away from this,” Mason remembers.
But Mason didn’t want to walk away. He started educating himself about Eating Disorders and how to support Stewart as best he could. He even started going to a support group in Victoria for caregivers of people with Eating Disorders. He says it was shocking for many people in the group, who were parents of teens with Eating Disorders, to hear the story about a grown woman who was still struggling with her Eating Disorder after so many years.
Mason supported Stewart through many emergency room visits and a short stay in an inpatient treatment program but nothing seemed to be able to shake the illness that was deeply ingrained in her life. Mason says Stewart was very good at making it seem like everything was going well. “Everyone thought she was quite normal,” Mason remembers. He says her position at the Ministry of Health was sometimes difficult for her because she had to address files of people with Eating Disorders while keeping her own secret alive. “Cases of people with anorexia and bulimia would be put right on her desk,” Mason says. “There were some really tough times for her.”
Mason says he sometimes wishes he had been more upfront with Stewart about her Eating Disorder. He says he always avoided her triggers and they never got into arguments about her illness. “I became complacent,” he says. “I wish I had been more communicative with her, more involved.”
That being said Mason stayed by her side, a constant support through her diagnosis with end stage renal disease and eventual death. He says it was important to him to remain committed to Stewart and show her kindness, compassion and understanding both in her illness and end of life. “It’s something I never thought I would experience but I am glad I did because it opened my eyes,” Mason says.
Stewart’s older sister Karen Flello also played a key role in supporting her throughout her long battle with her Eating Disorder. Flello remembers Stewart first exhibiting signs of an Eating Disorder at 16 in the 1980s when very few healthcare professionals knew how to treat the illness. “We were given a lot of bad advice,” she remembers. “It completely ignored the root causes and biological connections.”
There is not doubt that supporting her sister through over three decades of an Eating Disorder was hard for Flello. All she ever wanted was for her to see how smart, loved and worthy she was. Flello said she had to realize that she was not to blame for not being able to heal her sister’s Eating Disorder. All she could do was focus her energy on being there for her when her illness would let her accept help. “It’s no different than if the person has a physical illness that you can’t cure,” she says.
Flello says if she could give any advice to people supporting a loved one through an Eating Disorder it would be to educate yourself, talk as openly about it as possible and encourage them to seek treatment early. She also says it is extremely important to set boundaries and make sure you are creating your own practice of mindful self compassion. “Whenever things got bad I went to counselling,” she says. “I needed to know how to cope.”
Mason agrees that educating yourself as a caregiver is key to being able to adequately support someone with an Eating Disorder. The desire to be thin is just scratching the surface when it comes to these complex illnesses. Mason says every part of Stewart knew that what she was doing was dangerous and that it would most likely eventually claim her life. “For her it was all about control,” he says.
Mason also encourages caregivers to seek support for themselves. Whether that be through a support group, individual counselling or family and friends. This is something that Stewart herself talked about in her blog, where she documented the end of her life. “Remember and acknowledge your own need for a helping hand and don’t be afraid to reach out,” she wrote in a post on December 5, 2013. “You will lead by the example of your own willingness to acknowledge there is no prize for suffering alone.”
“Lead by example” – How to support someone with an Eating DisorderHilary Thomson2020-07-13T15:19:52-04:00
Firstly, let me introduce myself. My name is Hilary Thomson and I am a journalist and writer based in Kemptville, Ontario. I was diagnosed with anorexia when I was 16 and the past 15 years has been a whirlwind of hospital admissions and treatment attempts. I have been in steady recovery now for three years and while I don’t consider myself fully recovered; I am definitely on my way.
So, what am I doing here? Having struggled with my mental and physical health for so long I am passionate about raising awareness for Eating Disorders and helping others on their recovery journey. I have known about NIED ever since they launched in 2012 and always felt that one day I wanted to get involved. I started out on NIED’s education committee, helping to organize symposiums, but I soon got the opportunity to get involved with their communications team. My training is in journalism, so it felt like a perfect fit.
I am so excited to have this platform to further NIED’s mission to provide access to educational, informational, and recovery-oriented resources related to the treatment and prevention of eating disorders in Canada. The goal of this blog is to provide engaging and well-researched content geared towards people with Eating Disorders, their caregivers and healthcare professionals. It will include everything from useful recovery tips to interviews with people with Eating Disorders from diverse backgrounds, knowledgeable Eating Disorder treatment professionals and advocates. The goal is to represent the reality of Eating Disorders and treatment in Canada and provide a platform for insightful perspectives and conversations.
NIED is thrilled to be launching this blog on World Eating Disorders Action Day, an initiative that unites activists across the globe to expand global awareness of Eating Disorders. There are roughly 1 million people struggling with Eating Disorders in Canada alone right now, many of whom are suffering silently and without proper support or treatment. Eating Disorders thrive in isolation and the more people speak out about their experience the more likely we are to see change. On this day of action we are asking you to consider telling your story. If you are not sure how we have prepared a document which outlines how to tell your story responsibly, without putting you or anyone else at risk. You can download the pdf here.
We would love to see this blog morph and grow into something that is driven by our community. We want this to be a welcoming and informative space for anyone looking for support in their own recovery or help in supporting a loved one or patient/client. We are extremely interested in hearing what you would like to see. Is there a topic you want us to cover? A person you would like to see interviewed? Do you want a platform to help tell your own story? We would love to help.
Contact us here and let us know what you think. What do you think is missing from the Eating Disorder recovery space?