Picture it: you are thirteen years old. You and your friends are hanging out in the mall, sucking down chili dogs and Cokes, standing around trying to look cool (and trying to look like you’re not trying to look cool). You laugh, you play with your hair, you admire your shoes. And then you catch sight of someone out of the corner of your eye and the scene screeches to pause: it’s your teacher. You all giggle, strangely uncomfortable, almost fascinated. Seeing your teacher outside of school – where she’s wearing jeans and holding hands with her husband and answering to her first name – is awkward. After all, don’t teachers just climb into their glass cases at four o’clock and turn into lifeless wax figures until the bell rings the next morning? They don’t have their own lives – do they?
Now fast-forward twenty years or so and imagine a similar scenario. You’re shopping in the mall, still secretly trying to look cool, in your very adult, pseudo mature way, of course. You’re hunting through a stack of sweaters on a table when you hear a familiar voice – a voice you hear often, say, once a week for about fifty minutes at a time. You look up as the voice registers in your brain as that of your therapist. She’s talking into her cell phone as she shops, and you realize she is engaged in an argument with someone. You blush. You want to escape before she sees you – to save you both the embarrassment. It doesn’t seem right, hearing your therapist duking out her own relationship strife. She shouldn’t have any relationship strife – should she?
Does your therapist having an argument with her husband or mother or child equate to the plumber with the leaky faucet, the mechanic who’s overdue for his oil change, or the out-of-shape gym teacher? Or . . . does it simply make her human?
Having spent some time “on the couch” in my thirty-three years, sorting through relationship issues, an eating disorder, and just life in general, I have been guilty of idealizing my therapists in the past. My guess is it’s a somewhat common tendency. We want to know that someone’s life actually works for them, that someone has it all together, because if they don’t, how can we hope to?
I shared this recently with my friend Allen, a clinical psychologist. “It always seemed to me that the coffee table between a therapist and me was the defining border between functional and dysfunctional, between normal and flawed.” Allen’s response was, “Well, I don’t have a coffee table in my office. “ I laughed. He went on to say, “All the good therapists start their training while dealing with their brokenness. We don't hire anyone who hasn't.”
Can that be true? If it is, the implication is profound: therapists are people, too. People with problems. People with heartaches. Flawed, imperfect, blemished people who hurt and bleed and make messes just like the rest of us.
I remember sitting in a movie theater a few years ago, seeing the romantic comedy Prime, in which Meryl Streep plays a psychotherapist who discovers that her 37-year-old client is dating her 23-year-old son. It was a charming film, and Streep did a wonderful job of portraying a professional caught in the ultimate web of conflicted interests. Around the middle plot point of the movie, Streep’s character is shown visiting her own therapist. At this scene, the audience erupted in laughter. It seemed that most people at the movie that night thought it ironic and funny for a therapist to be seeking therapy for herself. But is it?
“I am perplexed by the number of therapists who have never experienced the counseling process for themselves,” says James P. Krehbiel, Ed.S., an author and cognitive-behavioral therapist practicing in Scottsdale, Arizona. “Fortunately, many educational institutions that educate therapists mandate counseling as an aspect of their training program. In my opinion, no therapist should be licensed without having experienced the counseling process as a patient. How can a therapist identify with his clients if he has never sat in the other chair?”
In other words, a counselor who seeks counseling is wise. But can we handle that? Are we ready to let go of the impossible ideal of a perfect person on the opposite side of the Great Coffee Table? We have to be. Idealizing one’s therapist is counterproductive.
Look, life is messy. If we are engaged in the process of life – with ebbs and flows and ups and downs – there are going to be problems. There are going to be arguments. And strife. And discouragement. And maybe even depression. The flipside of these realities is that there will also be joy. And celebration. And laughter. If we are human, we will experience all of these things, both desirable and undesirable. Every one of us. Clients and therapists alike.
It is not your therapist’s job to represent some unattainable state of grace to which you should aspire. It is his or her job to come alongside of you and help you achieve the closest thing to a state of grace that we as humans can hope for: inner peace in a turbulent world full of imperfect people.
The state of human brokenness is universal. We’re all in this together.
Saturday, January 30, 2010
When Sickness is Celebrated: Exploring the 'Pro-Ana' Trend
We all know eating disorders are dangerous. We would have had to have been living under a rock for the past twenty years to have missed all the cautionary tales, tabloid headlines, and made-for-TV movies that have dramatized the dangers and trappings of such psychological illnesses as anorexia nervosa and bulimia. But a disturbing new trend has come about in the eating disorder community in recent years — and ‘community’ is, in fact, the operative word.
With the advent of internet chat rooms in the late 1990’s came a new means for technologically-savvy sufferers to commiserate in their illnesses. And today, in the age of Twitter, Facebook, and YouTube, gone are the days when eating disorders were synonymous with isolation; conversely, those with eating disorders — especially young sufferers — now have formed a sort of sob-society online, wherein they are finding encouragement to proceed in their illnesses, often to the point of no return.
When I was a teen suffering with anorexia in the 1990’s, I gradually withdrew from my friends and family, seeking solitude as a refuge from the prying questions and intrusive concern of outsiders. As is almost always the case with these illnesses, my disorder became the most important thing in my world, and I came to a point where I would have done anything at all to protect it — even if that meant my world growing strangely small. And while I found a dysfunctional sort of comfort in the bell jar of my anorexic world, I had an undercurrent of awareness that my life had fallen away from normal. I didn’t necessarily want things to be right — but at least I knew that something was wrong.
Many of today’s young anoretics are unified in their exclusive world, and they all seem to know the secret handshake. “Pro-ana” is a modern term describing a sect of eating disorder sufferers who seek to embrace anorexia and bulimia as lifestyle choices rather than life-threatening illnesses requiring treatment.
In pro-ana circles, the illnesses are no longer referred to in clinical terms, but rather by familiar, almost friendly-sounding nicknames: “ana” for anorexia and “mia” for bulimia. The lingo also includes such neo-slang terms as “thinspiration” or “thinspo”, which is any sort of material — photos, song lyrics, books, video — that inspires sufferers to lose weight; “food porn”, which are images intended to allow a sufferer to enjoy the food vicariously by poring over the images and imagining eating the foods portrayed; and “wannarexics”, which are usually young girls (and sometimes guys) who are deemed by the group to be illegitimate posers — those seeking to pop into the chat room for diet tips and tricks who do not intend to make the disease their lifestyle, or who are not already chronic sufferers.
I spent a week lurking in these pro-ana chat rooms and groups, and was disturbed by the cameraderie that was so evident among the girls in the group. They know one another by screen names such as TinyDancer, LovelyBones, and LilStickFigure17. Their posts to one another are almost sickeningly sweet as they encourage one another one their group fasts, cleansing programs, and in their attempts to thwart the efforts of their therapists and parents or boyfriends to “make them fat.” There seems to exist a terrible “us-versus-them” mentality in the groups, wherein mental health professionals are the enemy, bent on invading their utopia.
These girls believe they can live this way. They believe that their systems are sustainable. They convince themselves — and one another — that the decision to live on, say, 250 calories per day, is a hallmark of self-control and willpower, and that those who would seek to correct their self-destructive behavior are merely jealous.
So how then do we hope to reach a generation of psychologically-fragile young women who have found comfort and community in such deadly territory? What can we offer them that their counterfeit online relationships cannot? And how do we go about doing so before it is too late?
Anorexia nervosa holds the highest mortality rate of all psychological illnesses, and is the third most common chronic illness among adolescents. A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 – 10% of anoretics die within 10 years after contracting the disease; 18-20% of anoretics will be dead after 20 years and only 30 – 40% ever fully recover. The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of all causes of death for females 15 – 24 years old.
The threat of death is real. The allure of sickness is enigmatic. The number of statistics is growing. What can we do? Have we any options? Is there an answer?
If there is any key piece to the puzzle, it is awareness. We must be aware of our teens’ online lives. They have done their homework, seeking out the forums and learning the protocol. We need to do the same. We cannot look the other way and hope the phase passes. These stakes are too high. Statistics show that early intervention affords an anoretic the greatest chance of recovery.
Got a teen or tween in your life? Sister, daughter, student, friend? Keep your eyes open. Watch for warning signs. Mentor her. Love her. Encourage her. Help her to discover her unique talents before she becomes fully convinced that starving is an art. Engage her. As much as is possible, keep her in the moment, in this three-dimensional world where people express affection without the use of emoticons. Form a support network around her (if the person is a minor, insist she see a counselor with expertise in eating disorders), so that she will not go in search of her own in a world where up is down and food is foe and illness is honor. Awareness may not equal prevention in all cases, but it is a step in the right direction, and we cannot afford to be ignorant.
Our world is changing, and if we want to make a difference, we’ve got to keep up. Mental illness, like everything else, has gone high-tech.
With the advent of internet chat rooms in the late 1990’s came a new means for technologically-savvy sufferers to commiserate in their illnesses. And today, in the age of Twitter, Facebook, and YouTube, gone are the days when eating disorders were synonymous with isolation; conversely, those with eating disorders — especially young sufferers — now have formed a sort of sob-society online, wherein they are finding encouragement to proceed in their illnesses, often to the point of no return.
When I was a teen suffering with anorexia in the 1990’s, I gradually withdrew from my friends and family, seeking solitude as a refuge from the prying questions and intrusive concern of outsiders. As is almost always the case with these illnesses, my disorder became the most important thing in my world, and I came to a point where I would have done anything at all to protect it — even if that meant my world growing strangely small. And while I found a dysfunctional sort of comfort in the bell jar of my anorexic world, I had an undercurrent of awareness that my life had fallen away from normal. I didn’t necessarily want things to be right — but at least I knew that something was wrong.
Many of today’s young anoretics are unified in their exclusive world, and they all seem to know the secret handshake. “Pro-ana” is a modern term describing a sect of eating disorder sufferers who seek to embrace anorexia and bulimia as lifestyle choices rather than life-threatening illnesses requiring treatment.
In pro-ana circles, the illnesses are no longer referred to in clinical terms, but rather by familiar, almost friendly-sounding nicknames: “ana” for anorexia and “mia” for bulimia. The lingo also includes such neo-slang terms as “thinspiration” or “thinspo”, which is any sort of material — photos, song lyrics, books, video — that inspires sufferers to lose weight; “food porn”, which are images intended to allow a sufferer to enjoy the food vicariously by poring over the images and imagining eating the foods portrayed; and “wannarexics”, which are usually young girls (and sometimes guys) who are deemed by the group to be illegitimate posers — those seeking to pop into the chat room for diet tips and tricks who do not intend to make the disease their lifestyle, or who are not already chronic sufferers.
I spent a week lurking in these pro-ana chat rooms and groups, and was disturbed by the cameraderie that was so evident among the girls in the group. They know one another by screen names such as TinyDancer, LovelyBones, and LilStickFigure17. Their posts to one another are almost sickeningly sweet as they encourage one another one their group fasts, cleansing programs, and in their attempts to thwart the efforts of their therapists and parents or boyfriends to “make them fat.” There seems to exist a terrible “us-versus-them” mentality in the groups, wherein mental health professionals are the enemy, bent on invading their utopia.
These girls believe they can live this way. They believe that their systems are sustainable. They convince themselves — and one another — that the decision to live on, say, 250 calories per day, is a hallmark of self-control and willpower, and that those who would seek to correct their self-destructive behavior are merely jealous.
So how then do we hope to reach a generation of psychologically-fragile young women who have found comfort and community in such deadly territory? What can we offer them that their counterfeit online relationships cannot? And how do we go about doing so before it is too late?
Anorexia nervosa holds the highest mortality rate of all psychological illnesses, and is the third most common chronic illness among adolescents. A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 – 10% of anoretics die within 10 years after contracting the disease; 18-20% of anoretics will be dead after 20 years and only 30 – 40% ever fully recover. The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of all causes of death for females 15 – 24 years old.
The threat of death is real. The allure of sickness is enigmatic. The number of statistics is growing. What can we do? Have we any options? Is there an answer?
If there is any key piece to the puzzle, it is awareness. We must be aware of our teens’ online lives. They have done their homework, seeking out the forums and learning the protocol. We need to do the same. We cannot look the other way and hope the phase passes. These stakes are too high. Statistics show that early intervention affords an anoretic the greatest chance of recovery.
Got a teen or tween in your life? Sister, daughter, student, friend? Keep your eyes open. Watch for warning signs. Mentor her. Love her. Encourage her. Help her to discover her unique talents before she becomes fully convinced that starving is an art. Engage her. As much as is possible, keep her in the moment, in this three-dimensional world where people express affection without the use of emoticons. Form a support network around her (if the person is a minor, insist she see a counselor with expertise in eating disorders), so that she will not go in search of her own in a world where up is down and food is foe and illness is honor. Awareness may not equal prevention in all cases, but it is a step in the right direction, and we cannot afford to be ignorant.
Our world is changing, and if we want to make a difference, we’ve got to keep up. Mental illness, like everything else, has gone high-tech.
Thursday, January 21, 2010
Picking Up Where We Left Off
Last weekend was amazing. My son and I flew (or rather, were flown) to Boston to be with a dear friend of mine, Nancy, as she made a public profession of her Christian faith through the act of baptism. It was a very special, emotionally-electric reunion for my friend and I, having not seen one another in 13 years. We met under unconventional circumstances, and both of our lives have done 180-degree turnarounds in the past decade or so, and so this reunion was interesting, finding us both in completely different modes than when we'd last been together.
And yet, there was no awkwardness. No pretense. No need to get used to one another again. We fell into one another's arms at the airport, got some giggles out of our system, and then seemed to pick up our friendship right where we'd left off, with a flippant "So, anyway . . . "
It was very cool. Our connection seemed to transcend the time that's passed. It was as though we'd been together even while we'd been apart. And it made me think about Jesus.
I have this idea of what my arrival in Heaven will be like. I don't believe I'll have to stand in line at the pearly gates with my "Admit One" pass, waiting for Peter to stamp my hand. My Bible tells me that "to be absent from the body is to be present with the Lord" -- in other words, my last breath here will be my first breath there. And somehow I get the feeling that when I fall at Jesus' feet, it will be a bit like when I fell into Nancy's arms -- as if we'd been together all the time we'd been apart.
Now, I know I'm stretching things a bit; seeing an old friend surely cannot begin to compare to seeing the savior of my soul face-to-face for the very first time. Don't get me wrong; I am in no way trying to minimize or humanize the unfathomable magnitude of that moment. I'm only trying to wrap my mind around something in the here and now that might help me to glimpse just a wee bit of what I'll feel when the most blessed reunion of all takes place.
I'd held Nancy in my heart all those years, and so being in the same room with her didn't feel new or weird or forgotten. It felt only natural. And that's how I believe it will be when I am in the same room (as it were, since God is not or never has been confined by time or space) as my Lord. It will be amazing. Stunning. It will feel too good to be true. And yet, it will be only natural. As if it were the plan all along.
Our relationships on Earth are meant to be a model of our relationship to God. God Himself is relational -- before there was an "us" there was a Him, and even then He was not alone. God said, "Let Us make man in Our image" -- speaking to the other members of the Trinity. Relationship was at work, even before there were people with whom to relate. Is it any wonder God places such value on the importance of relationships?
I left Boston a very grateful girl. Grateful for friendship and common ground and heart connections. Grateful to know that I am loved by one who knows me on a heart level, and in whose presence I could be myself from the very moment I stepped off the plane.
It's only a teeny, one-dimensional thumbnail picture of what that other Great Reunion promises, but I am grateful for the foretaste of what I cannot otherwise begin to imagine.
And yet, there was no awkwardness. No pretense. No need to get used to one another again. We fell into one another's arms at the airport, got some giggles out of our system, and then seemed to pick up our friendship right where we'd left off, with a flippant "So, anyway . . . "
It was very cool. Our connection seemed to transcend the time that's passed. It was as though we'd been together even while we'd been apart. And it made me think about Jesus.
I have this idea of what my arrival in Heaven will be like. I don't believe I'll have to stand in line at the pearly gates with my "Admit One" pass, waiting for Peter to stamp my hand. My Bible tells me that "to be absent from the body is to be present with the Lord" -- in other words, my last breath here will be my first breath there. And somehow I get the feeling that when I fall at Jesus' feet, it will be a bit like when I fell into Nancy's arms -- as if we'd been together all the time we'd been apart.
Now, I know I'm stretching things a bit; seeing an old friend surely cannot begin to compare to seeing the savior of my soul face-to-face for the very first time. Don't get me wrong; I am in no way trying to minimize or humanize the unfathomable magnitude of that moment. I'm only trying to wrap my mind around something in the here and now that might help me to glimpse just a wee bit of what I'll feel when the most blessed reunion of all takes place.
I'd held Nancy in my heart all those years, and so being in the same room with her didn't feel new or weird or forgotten. It felt only natural. And that's how I believe it will be when I am in the same room (as it were, since God is not or never has been confined by time or space) as my Lord. It will be amazing. Stunning. It will feel too good to be true. And yet, it will be only natural. As if it were the plan all along.
Our relationships on Earth are meant to be a model of our relationship to God. God Himself is relational -- before there was an "us" there was a Him, and even then He was not alone. God said, "Let Us make man in Our image" -- speaking to the other members of the Trinity. Relationship was at work, even before there were people with whom to relate. Is it any wonder God places such value on the importance of relationships?
I left Boston a very grateful girl. Grateful for friendship and common ground and heart connections. Grateful to know that I am loved by one who knows me on a heart level, and in whose presence I could be myself from the very moment I stepped off the plane.
It's only a teeny, one-dimensional thumbnail picture of what that other Great Reunion promises, but I am grateful for the foretaste of what I cannot otherwise begin to imagine.
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