|
Source: (consider it)
|
Thread: Anorexia
|
Kaplan Corday
Shipmate
# 16119
|
Posted
A teenaged girl in our church is suffering from quite severe anorexia.
She has been placed in hospital, is under good professional care, and is not now in physical danger, but is still very disturbed and angry.
She is very vocally abusive of her mother, but is simultaneously in spiritual despair that God has abandoned her because of her behaviour.
At the pastoral level, there is the problem of a prominent figure in the church who is into Jay Adams, and is therefore taking the line that her problem is to be dealt with by her facing up to the alleged root cause, ie her disobedient and rebellious attitude, and repenting of it.
Fortunately her parents have more sense than to let this person anywhere near her, but the mother is (understandably) upset about her daughter’s condition, and speaks about it at length to us and other friends in the church.
Any suggestions from personal experience as to how we can best pastorally support this family?
Posts: 3355 | Registered: Jan 2011
| IP: Logged
|
|
L'organist
Shipmate
# 17338
|
Posted
May I suggest that part of the reason for the girl's vocal aggression towards her mother may be because the mother is discussing her daughter publicly with people at the church?
Even if this girl is only just a teenager, at 13 she has the right to expect that personal issues - including health - are private, not bandied about by her parents, however much they protest it is well-meant.
I don't think you can pastorally support "the family" as a unit: I think you may be able to offer support to the parents but that any attempt at pastoral care for the girl herself should only be in response to a direct request from her.
There are may theories about anorexia and no doubt members of your congregation will have heard of some and may assume that one (or more) applies to this girl: any visiting with that in mind could be dangerous.
--------------------
Rara temporum felicitate ubi sentire quae velis et quae sentias dicere licet
Posts: 4950 | From: somewhere in England... | Registered: Sep 2012
| IP: Logged
|
|
Kaplan Corday
Shipmate
# 16119
|
Posted
quote:
Originally posted by L'organist:
May I suggest that part of the reason for the girl's vocal aggression towards her mother may be because the mother is discussing her daughter publicly with people at the church?
I don't think the commencement of the hostility coincided only with her mother's sharing the problem.
"Publicly" is not quite accurate, in that she is not broadcasting to the church generally.
Yes, there is a case to be made that she had no right to tell anyone else at all without her daughter's express permission, but she has.
quote:
I don't think you can pastorally support "the family" as a unit: I think you may be able to offer support to the parents but that any attempt at pastoral care for the girl herself should only be in response to a direct request from her.
Obviously, and as I said in the OP, she is under good professional care.
It is the parents who need support.
Posts: 3355 | Registered: Jan 2011
| IP: Logged
|
|
jacobsen
seeker
# 14998
|
Posted
Is this girl punishing herself and/or others? The reasons for anorexia can be so varied that it is to be hoped that the medical/psychiatric staff dealig with her will be able to unpack the reasons. But it's no surprise that anger is part of the equation.
![[Votive]](graemlins/votive.gif) for all involved.
--------------------
But God, holding a candle, looks for all who wander, all who search. - Shifra Alon
Beauty fades, dumb is forever-Judge Judy
The man who made time, made plenty.
Posts: 8040 | From: Æbleskiver country | Registered: Aug 2009
| IP: Logged
|
|
Liopleurodon
Mighty sea creature
# 4836
|
Posted
Look after the parents since they seem to want and need looking after. Offering a friendly supportive ear, help with lifts to and from the hospital, or whatever they need at the moment is the way to go. It sounds as though this girl's situation is best left with the professionals. Anorexia is a really difficult thing to offer help with at the best of times because it twists the person's perceptions of things to such an extent that virtually anything you say can be used to reinforce the disorder.
It sounds as though it's the mother who is coming to you for support, so you need to think of this in terms of how you can support the person who is asking for it, rather than the girl or the family as a whole. You can't support the family as a whole anyway because they need different things right now and it sounds like the girl is getting the most appropriate help already.
Posts: 1921 | From: Lurking under the ship | Registered: Aug 2003
| IP: Logged
|
|
L'organist
Shipmate
# 17338
|
Posted
It is very worrying to hear that the girl feels quote:
God has abandoned her because of her behaviour
Where did this idea come from? Is it something that she has picked-up from the church she and her family (and you?) attend?
Moreover, you report her as being angry - this is understandable: but you also report her as being "disturbed" - who has given this teenager the label of being disturbed?
You say the mother is not "broadcasting" her daughter's problems to the church but you know about them, you are worried that a "nouthetic counselling" zealot be kept away from her so obviously they know too.
I stand by what I say: the mother has no right to discuss her daughter's problems with people, even people at church. Sadly she has already done so but she must stop reporting any more now.
I'm glad you wish to support the parents but I think one of the best ways this can be done is to give them love but NOT listen if they start to discuss details of their daughter's treatment or diagnosis.
I have experienced something similar - not my problems but someone doing as this mother has done - and the damage to the relationship between parents and child was never repaired.
--------------------
Rara temporum felicitate ubi sentire quae velis et quae sentias dicere licet
Posts: 4950 | From: somewhere in England... | Registered: Sep 2012
| IP: Logged
|
|
quetzalcoatl
Shipmate
# 16740
|
Posted
I agree with l'organist - what I find disturbing is how this girl's problems are being, apparently, so widely discussed in a church environment. This is very irresponsible. If the girl knows about this, or suspects it, it could be quite traumatic.
The boundaries sound in a mess here; but it's difficult to suggest any remedy at a distance. Perhaps allow the professionals to treat the girl in total privacy and confidentiality?
--------------------
I can't talk to you today; I talked to two people yesterday.
Posts: 9878 | From: UK | Registered: Oct 2011
| IP: Logged
|
|
Doc Tor
Deepest Red
# 9748
|
Posted
quote:
Originally posted by L'organist:
I stand by what I say: the mother has no right to discuss her daughter's problems with people, even people at church. Sadly she has already done so but she must stop reporting any more now.
I couldn't disagree more.
A child with anorexia (or autism or Downs or OCD or Crones or a whole host of other conditions) affects the whole family. They are not, per se, the daughter's problems. They are the mother's problems, the father's problems, the siblings' problems. If other family members don't reach outside the family, individually or collectively, for help and support, it can get really very messy.
--------------------
Forward the New Republic
Posts: 9131 | From: Ultima Thule | Registered: Jul 2005
| IP: Logged
|
|
L'organist
Shipmate
# 17338
|
Posted
Doc Tor
I'm not saying that the parents, siblings, won't be affected by the illness afflicting this daughter but its one thing for the mother to discuss her own feelings, that's fine, but she shouldn't be reporting back on things she's either being told by the hospitalised daughter or (worse) by the daughter's doctors.
--------------------
Rara temporum felicitate ubi sentire quae velis et quae sentias dicere licet
Posts: 4950 | From: somewhere in England... | Registered: Sep 2012
| IP: Logged
|
|
Avila
Shipmate
# 15541
|
Posted
A key part of supporting will be getting a buffer between them and the walking pastoral disaster of the church person you mention.
That may mean vocally opposing their ideas which may seep into others as news creeps through the congregation (which it will). Those who don't understand may be open to a range of ideas, and if they are a prominent person does that add weight to their opinions.
The family may be alert to avoid them but don't want their ideas creeping in a back door.
Being there for them without any answers, but with them in the pain and chaos is all you can do, and I suspect it is also the best thing.
The hostility and anger is possibly a symptom of the inner chaos that is also the trigger for the anorexia - she is having professional support to follow that up, so not for others to try and be armchair psychologists.
Prayers for the family and for you and others caring for them and being there,
--------------------
http://aweebleswonderings.blogspot.com/
Posts: 1305 | From: west midlands | Registered: Mar 2010
| IP: Logged
|
|
Adeodatus
Shipmate
# 4992
|
Posted
quote:
Originally posted by Doc Tor:
quote:
Originally posted by L'organist:
I stand by what I say: the mother has no right to discuss her daughter's problems with people, even people at church. Sadly she has already done so but she must stop reporting any more now.
I couldn't disagree more.
A child with anorexia (or autism or Downs or OCD or Crones or a whole host of other conditions) affects the whole family. They are not, per se, the daughter's problems. They are the mother's problems, the father's problems, the siblings' problems. If other family members don't reach outside the family, individually or collectively, for help and support, it can get really very messy.
As someone working in healthcare, I disagree, Doc Tor. Anyone's illness is their own business, and no-one else's, unless the person with the illness chooses to make it so.
This is an especially important principle in cases where the person's illness may relate to a feeling of not having any control over their own life. A feeling of lack of control can make them subconsciously retreat to something they do have control, over, such as eating (or not), and so become a contributory factor in the illness.
To then have the illness gossipped about, and also be on the receiving end of a barrage of unwanted, unprofessional and often unkind advice, is only going to make things much, much worse. What this person and her family need is good ongoing professional help, and for congregation and friends, however well meaning, to mind their own business.
--------------------
"What is broken, repair with gold."
Posts: 9779 | From: Manchester | Registered: Sep 2003
| IP: Logged
|
|
quetzalcoatl
Shipmate
# 16740
|
Posted
I often found in situations like this that the parents themselves need professional help. It sounds here, for instance, as if the boundaries are all over the place, but you can't solve that by just chatting to people in church.
--------------------
I can't talk to you today; I talked to two people yesterday.
Posts: 9878 | From: UK | Registered: Oct 2011
| IP: Logged
|
|
Evensong
Shipmate
# 14696
|
Posted
quote:
Originally posted by Kaplan Corday:
Any suggestions from personal experience as to how we can best pastorally support this family?
Get them involved in the professional counseling.
--------------------
a theological scrapbook
Posts: 9481 | From: Australia | Registered: Apr 2009
| IP: Logged
|
|
cliffdweller
Shipmate
# 13338
|
Posted
quote:
Originally posted by Adeodatus:
quote:
Originally posted by Doc Tor:
quote:
Originally posted by L'organist:
I stand by what I say: the mother has no right to discuss her daughter's problems with people, even people at church. Sadly she has already done so but she must stop reporting any more now.
I couldn't disagree more.
A child with anorexia (or autism or Downs or OCD or Crones or a whole host of other conditions) affects the whole family. They are not, per se, the daughter's problems. They are the mother's problems, the father's problems, the siblings' problems. If other family members don't reach outside the family, individually or collectively, for help and support, it can get really very messy.
As someone working in healthcare, I disagree, Doc Tor. Anyone's illness is their own business, and no-one else's, unless the person with the illness chooses to make it so.
This is an especially important principle in cases where the person's illness may relate to a feeling of not having any control over their own life. A feeling of lack of control can make them subconsciously retreat to something they do have control, over, such as eating (or not), and so become a contributory factor in the illness.
To then have the illness gossipped about, and also be on the receiving end of a barrage of unwanted, unprofessional and often unkind advice, is only going to make things much, much worse. What this person and her family need is good ongoing professional help, and for congregation and friends, however well meaning, to mind their own business.
The issues re boundaries and control are apt and worth noting. However, I can't imagine how anyone working in health care could not recognize that a child (even an adult child's) serious illness DOES impact every member of the family, particularly the parents. While the suggestion of professional family counseling is a good one, these parents are asking for pastoral care as well. They need the love and support of their faith community. (And, as noted above, they need protection against congregants who may insinuate themselves into the situation offering a false hope through a dangerous quack therapy.) Your all-or-nothing approach fails to recognize that providing effective spiritual care for these parents will improve the entire system and help everyone grow stronger.
Which is not to deny that there aren't serious boundary issues going on here, especially given the nature of the illness. It's a messy situation-- as families always are. It won't be an easy dance to navigate. But, as noted above, they have asked for help-- and that's a good sign. Their pastor and church friends should respond on that basis-- by listening and praying for them without engaging in long conversations speculating on the meaning, cause, or cure of the daughter's illness. Mostly the parents are asking for someone to walk alongside them., with no words necessary. That's what we do as a church.
--------------------
"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
| IP: Logged
|
|
Doc Tor
Deepest Red
# 9748
|
Posted
quote:
Originally posted by L'organist:
Doc Tor
I'm not saying that the parents, siblings, won't be affected by the illness afflicting this daughter but its one thing for the mother to discuss her own feelings, that's fine, but she shouldn't be reporting back on things she's either being told by the hospitalised daughter or (worse) by the daughter's doctors.
"I'm sorry that the doctors have told you your daughter is dying, but should you really be discussing that with me?"
As cliffdweller said, the boundaries are messy, but not supporting the parents in their grief, pain, and yes, guilt?
Harsh. Really harsh. And frankly, not what we signed up for. No, the entire congo don't need to know every jot and tittle, but the pastoral team can, and prayers, assuming you believe them efficacious, should be given both in public and private.
--------------------
Forward the New Republic
Posts: 9131 | From: Ultima Thule | Registered: Jul 2005
| IP: Logged
|
|
|
|
quetzalcoatl
Shipmate
# 16740
|
Posted
It depends on whether the parents are talking about their own feelings and so on, or are disclosing stuff about the daughter's feelings, symptoms, treatment, and so on. The latter could be quite disastrous, and represents a bad breach of boundaries.
In fact, eating disorders, as others have commented, often represent problems with control, choice, boundaries, and so on, so any such boundary fuck-up by the parents will not help their daughter at all. But it's impossible to judge at third hand.
--------------------
I can't talk to you today; I talked to two people yesterday.
Posts: 9878 | From: UK | Registered: Oct 2011
| IP: Logged
|
|
Gwai
Shipmate
# 11076
|
Posted
quote:
Originally posted by quetzalcoatl:
It depends on whether the parents are talking about their own feelings and so on, or are disclosing stuff about the daughter's feelings, symptoms, treatment, and so on. The latter could be quite disastrous, and represents a bad breach of boundaries.
Well, it sounds like they clearly are doing #1. I am thinking that Doc Tor was pointing out that the parents will need support and will need to talk about their own problems. I was suggesting that sort of intro would help them talk about their own problems instead of their daughters'. If the parents have anger and pain, they almost certainly do need to express them, but I agree that this sort of situation will make the girl feel gossiped about, and will likely cause more problems than it helps.
--------------------
A master of men was the Goodly Fere,
A mate of the wind and sea.
If they think they ha’ slain our Goodly Fere
They are fools eternally.
Posts: 11914 | From: Chicago | Registered: Feb 2006
| IP: Logged
|
|
quetzalcoatl
Shipmate
# 16740
|
Posted
I was just remembering working with adolescents in therapy, and it's amazing how many parents want to phone up and get the info on their kid, or even want to sit in on the session, or have some other kind of control. I suppose this a natural reaction in some ways, but the adolescent needs some kind of autonomy here, and needs the boundaries to be preserved. Thus to chat to the parent about their child would be a betrayal of the latter, except in emergencies and extreme situations, e.g. suicide attempts, wishes to kill someone, and so on.
--------------------
I can't talk to you today; I talked to two people yesterday.
Posts: 9878 | From: UK | Registered: Oct 2011
| IP: Logged
|
|
no prophet's flag is set so...
Proceed to see sea
# 15560
|
Posted
Anorexia Nervosa is a psychological and physical disorder. It's complicated. There's something going on about body image, control of emotions, control of body, relationships, other things. The professionals need to figure out what the best set of interventions are.
I think the pastoral care required is to do something about the person in the church with the unhelpful ideas. Like asking them to not promote these ideas in this case. It is tremendously difficult. I personally had to tell someone in our church that "we do not follow your line of thinking on this, it does not work for us, we disagree, please do not push this on us, and stop calling". It was the well meaning prayer team chair on the telephone to us.
And that's the crux I think, the person with the unhelpful ideas is well meaning, but off base. But the person (and her family) in the most vulnerable position must be the priority. So someone's feelings will possibly be hurt, and that's what may be required, plus appropriate pastoral care about this. (Perhaps something to do with obedience, since this person already understands that idea? )
--------------------
Out of this nettle, danger, we pluck this flower, safety.
\_(ツ)_/
Posts: 11498 | From: Treaty 6 territory in the nonexistant Province of Buffalo, Canada ↄ⃝' | Registered: Mar 2010
| IP: Logged
|
|
Ethne Alba
Shipmate
# 5804
|
Posted
istm that one type of pastoral support for any family in a situation like this is to offer to help the normal things continue to happen.
In the middle of a situation that is distinctly abnormal, values can get skewed and individuals rapidly forget who we are and what we like doing. Other people's needs/ wants/ desires get pushed down (like we are helping anyone by becoming 'less than' or doing without.....)
Things like: having someone to go clothes shopping with....going out for coffee....having a trip out to a cinema....arranging and then going for a walk....going fishing (or swishing).....Christmas shopping, it can be great fun with others....ordering cards....bonfire night....processing the summer holiday snaps into a book is good fun, but even more fun with a friend.....going to the hairdressers...or the beach...having our ears pierced or our nails done....
The friendship things.
( but caution: no one who wants to go fishing for information or is a gossip need step up)
It's not all about the person who is ill. We tend to loose ourselves. The best pastoral care that i ever recieved enabled me to find myself again. And the Very best pastoral care (for the entire family) was a gift of ten sessions with a art therapist...for me. Kindness X 100.
i would have thought that everyone reading this thread will pray that your church finds creative and sensitive ways of providing the right care, in the right way, for the right individuals and at the right time.
Posts: 3126 | Registered: Apr 2004
| IP: Logged
|
|
cliffdweller
Shipmate
# 13338
|
Posted
quote:
Originally posted by Gwai:
quote:
Originally posted by quetzalcoatl:
It depends on whether the parents are talking about their own feelings and so on, or are disclosing stuff about the daughter's feelings, symptoms, treatment, and so on. The latter could be quite disastrous, and represents a bad breach of boundaries.
Well, it sounds like they clearly are doing #1. I am thinking that Doc Tor was pointing out that the parents will need support and will need to talk about their own problems. I was suggesting that sort of intro would help them talk about their own problems instead of their daughters'. If the parents have anger and pain, they almost certainly do need to express them, but I agree that this sort of situation will make the girl feel gossiped about, and will likely cause more problems than it helps.
I don't know if it's "clearly" but it is probable. Because the people who are going this haven't read the text books or DSM and don't know all the rules re: what they can/ can't talk about, what is/ is not appropriate boundaries (although if they do go to family therapy they may learn some of this). They just know that their child is hurting, and so they are hurting, and they are reaching out to the people who love them, who care for them, for help. And they want to talk-- because for many of us, that's how we process stuff like this. They need to talk, not so much for someone to give them answers (that's what the mental health professionals are for) but simply because it is good, it brings healing, it helps us to feel not so alone. (And, btw, the opposite suggestion-- that they shouldn't tell anyone-- is what breeds the idea that mental illness is shameful and needs to be kept hidden).
So we need to be gentle with them. We can gently help them find those boundaries, without shutting them down and making them feel shamed and alone. One way we do that is to allow them to speak freely, but then respond only to the parts that are appropriate and ignore the things that are "outside the boundaries". Or by redirecting at times where the sharing takes place (e.g. in a more private setting).
Again, it's a delicate balance to care for everyone's needs here-- the daughter's and the parent's-- but ultimately caring for either one is caring for the other, because it's a whole family system. There aren't a lot of hard and fast rules, but in general silencing people seems like shaming to me, and overall not particularly helpful.
--------------------
"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
| IP: Logged
|
|
quetzalcoatl
Shipmate
# 16740
|
Posted
That's fine, cliffdweller, but the OP describes a girl who is 'very disturbed and angry' and who is vocally abusing her mother.
I think it's fine to support the parents, but what does this girl need? My own view is that she might need firm boundaries, and that she is the one who decides whether or not her feelings, her illness, her treatment, are discussed anywhere. Those things belong to her, no-one else, and the danger is that they are handed over to others, without her permission.
Adolescents are very sensitive to stuff like this, and those with eating disorders, often intensely.
The danger is that her autonomy is eroded in some way.
[ 21. October 2013, 18:05: Message edited by: quetzalcoatl ]
--------------------
I can't talk to you today; I talked to two people yesterday.
Posts: 9878 | From: UK | Registered: Oct 2011
| IP: Logged
|
|
Pyx_e
Quixotic Tilter
# 57
|
Posted
mmmmmmmm I would be very careful about boundaries. In my tiny book anorexia is a family illness exhibited by one member. So every conversation is confidential to everyone else.
Plus keep the nutter away, plus strong direction against gossip, plus asking for prayer for whole family.
Freaks me out, anorexia, too complex, too hard. Lord have mercy.
--------------------
It is better to be Kind than right.
Posts: 9778 | From: The Dark Tower | Registered: May 2001
| IP: Logged
|
|
Zoey
Broken idealist
# 11152
|
Posted
Weird thread this. I'm pretty sure my parents will have told people at their church and asked for prayer when I was in psychiatric hospital (a number of years ago). But they can't have told people at their church about my thoughts, feelings and difficulties, because I wasn't discussing those with them. My relationship with my parents is not a good one, at times I have been extremely angry indeed with them and this has been noted by professionals as a (causal / exacerbating) factor in my mental-health difficulties. But in my case, and I suspect in many similar cases, talking to people at church about the fact their child is experiencing mental-health problems comes way, way down the list of reasons why a child considers their mother and father to be shite parents.
(Additionally, I think "disturbed and angry" has been a fairly apt description of my mental state at times in my life. But people who matter realise that (1) this is not necessarily an entirely bad thing and (2) my parents being shite at meeting the needs I had as a child played a fairly large part in this coming to be the case.)
--------------------
Pay no mind, I'm doing fine, I'm breathing on my own.
Posts: 3095 | From: the penultimate stop? | Registered: Mar 2006
| IP: Logged
|
|
|
|
Zoey
Broken idealist
# 11152
|
Posted
True. The way I handled my parents being shite at meeting my emotional needs was to stop telling them very much at all about myself. I guess as a result I'm finding it difficult to understand why the patient in the OP would still be telling her parents about issues like a sense of spiritual betrayal if there is a long-standing problem with her parents not respecting her privacy and autonomy. But, yes, I take your point. (And it comes back to the issue other people have raised, which is the difference between parents saying "I'm struggling to support my daughter who's in hospital with anorexia" and "I'm struggling to support my daughter who is having deeply personal problems a, b and c, resulting in her telling me x, y, z intimate pieces of information [which she clearly wouldn't have wanted me to pass on to you]".) Hey ho.
--------------------
Pay no mind, I'm doing fine, I'm breathing on my own.
Posts: 3095 | From: the penultimate stop? | Registered: Mar 2006
| IP: Logged
|
|
quetzalcoatl
Shipmate
# 16740
|
Posted
Zoey
That's a good summary.
I suppose the phrase 'at length' was a bit of a warning bell for me, but it's true that the mother may be talking at length about her own stuff, and not her daughter's stuff.
Anorexia is so deadly, I think the highest mortality rate of any mental illness, I think maybe 15-20%. What a living hell for everyone.
--------------------
I can't talk to you today; I talked to two people yesterday.
Posts: 9878 | From: UK | Registered: Oct 2011
| IP: Logged
|
|
cliffdweller
Shipmate
# 13338
|
Posted
I suspect the mother is talking at length just because she needs to talk. It doesn't matter so much (to her) what she says-- she just needs to share this awful burden. She may very well be crossing all sorts of boundaries because she just doesn't know any better-- none of us do, until you find yourself in that particular hell. So again, some gentle direction may be helpful but we should try not to act like this is a mental health professional who knows all the rules and is breaking confidentiality. This is a mom, crying out for help, perhaps clumsily, perhaps making all sorts of mistakes, but crying out for help nonetheless. Responding to the underlying need while trying to provide some gentle boundaries is an act of kindness that will benefit much IMHO.
--------------------
"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
| IP: Logged
|
|
quetzalcoatl
Shipmate
# 16740
|
Posted
Again, cliffdweller, that sounds fine. I am curious as to who knows about 'gentle direction', and 'gentle boundaries', and is able to act accordingly? Perhaps you have trained counsellors.
I would say simply, if the mother is freaking out, she should get professional help.
--------------------
I can't talk to you today; I talked to two people yesterday.
Posts: 9878 | From: UK | Registered: Oct 2011
| IP: Logged
|
|
Porridge
Shipmate
# 15405
|
Posted
I'm fortunate that on my caseload I only have to deal with schizophrenia, borderline personalities, garden-variety dementia, pedophilia, explosive disorder, depression and the like.
But I want to second what Pyx_e said. This is a family disorder, with a single identified patient. Great care must be taken lest the "sides" in the family start lining up "allies" to carry on their struggles for them. Ideally, family therapy is called for.
One of my staffers has anorexia, currently more-or-less under control (though she's gone off the rails occasionally, and I've had to put her on leave not only for her own safety but for our clients'). I've lost count of the supervision hours spent dragging her back from her own issues to discussing what's going on with the clients in our care.
I'll be honest: she terrifies me. Her nutritional and exercise habits scare me, her judgment and coordination and perceptions scare me when she begins to lose her grip, and, well, she scares me.
I hope all concerned in this situation tread very carefully and softly.
[ 21. October 2013, 23:47: Message edited by: Porridge ]
--------------------
Spiggott: Everything I've ever told you is a lie, including that.
Moon: Including what?
Spiggott: That everything I've ever told you is a lie.
Moon: That's not true!
Posts: 3925 | From: Upper right corner | Registered: Jan 2010
| IP: Logged
|
|
cliffdweller
Shipmate
# 13338
|
Posted
quote:
Originally posted by quetzalcoatl:
Again, cliffdweller, that sounds fine. I am curious as to who knows about 'gentle direction', and 'gentle boundaries', and is able to act accordingly? Perhaps you have trained counsellors.
I would say simply, if the mother is freaking out, she should get professional help.
Referrals to mental health professionals are part of good pastoral care, but don't replace the spiritual care that is offered by the pastor, as well as the care provided by other trusted congregants, deacons, etc. So, yes, hopefully you can point her to a trained counselor-- one who will address these boundary issues, among other things. But the pastor doesn't just pass a congregant off to an MFT and be done w/ it. I see the two roles (clinical counseling and pastoral care) as quite different, but complementary, and proceeding concurrently.
[ 22. October 2013, 01:38: Message edited by: cliffdweller ]
--------------------
"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
| IP: Logged
|
|
Kaplan Corday
Shipmate
# 16119
|
Posted
Thanks for all the comments.
They have stimulated my thinking even if they have not provided definitive answers.
The girl and her parents and siblings are being counseled by health professionals as a family unit, and whether the mother was not told by them to respect confidentiality, or was told but ignored them, I don’t know.
I think that one of the problems is that a good church is both a family and not a family.
If a kid does not turn up for a number of Sundays, naturally his/her parents and siblings are going to be asked by friends, “Where’s…?”, and it is difficult to just respond cryptically, “Health issues”, or, “Mind your own business and respect our privacy”.
The mother’s response, rightly or wrongly, was that it was natural to share such a matter with her Christian friends (though not with the church at large).
Then there are differences in personality.
If it were my daughter, my instinctive reaction would be to say as little as possible, put up a wall, and resent any attempts by other church members to become involved, however well-meaning, as “meddling” by “busybodies”.
However, other people (such as the mother) just as instinctively demand, welcome and embrace interest and concern, and are hurt if it is not offered.
Then there is the question of confidentiality as regards other sorts of health challenges.
For example, a mother would probably be less likely to be judged if she shared details of her child’s recovery, physically and emotionally, from cancer, or a traffic accident, but strictly speaking the confidentiality issues are just as relevant in those cases as in the case of anorexia.
Perhaps, as someone pointed out upthread, anything involving psychological challenges is still regarded as more “shameful” than straightforward physical problems.
At this point ISTM that the best strategy would be to let the mother talk; avoid responding with any prying or curiosity (ie don’t encourage her to cross boundaries); don’t share with others any information she reveals; offer love, prayer and practical support; and don’t attempt any DIY amateur analysis and counseling which could interfere with the therapy being conducted by those who know what they’re doing.
Posts: 3355 | Registered: Jan 2011
| IP: Logged
|
|
Huia
Shipmate
# 3473
|
Posted
Kaplan, I am concerned about this thread . I know several Shipmates, especially clergy, have been outed by people who recognise who they are in real life. If I were this mother and even more so if I were her daughter I would feel both angry and betrayed that my life was being discussed in this way.
I may be overidentifying as I had serious issues with hating my mother as a teenager, and I do understand your concern, however I feel uncomfortable.
Huia
--------------------
Charity gives food from the table, Justice gives a place at the table.
Posts: 10382 | From: Te Wai Pounamu | Registered: Oct 2002
| IP: Logged
|
|
Erroneous Monk
Shipmate
# 10858
|
Posted
quote:
Originally posted by Kaplan Corday:
Any suggestions from personal experience as to how we can best pastorally support this family?
You can't help. Please try not to do any harm.
Erroneous Monk - sister of anorexic
--------------------
And I shot a man in Tesco, just to watch him die.
Posts: 2950 | From: I cannot tell you, for you are not a friar | Registered: Jan 2006
| IP: Logged
|
|
the giant cheeseburger
Shipmate
# 10942
|
Posted
quote:
Originally posted by Erroneous Monk:
quote:
Originally posted by Kaplan Corday:
Any suggestions from personal experience as to how we can best pastorally support this family?
You can't help. Please try not to do any harm.
Erroneous Monk - sister of anorexic
+1
I would have phrased it as "you can help - by staying out of the way of those who actually know what they're doing."
--------------------
If I give a homeopathy advocate a really huge punch in the face, can the injury be cured by giving them another really small punch in the face?
Posts: 4834 | From: Adelaide, South Australia. | Registered: Jan 2006
| IP: Logged
|
|
Badger Lady
Shipmate
# 13453
|
Posted
I've thought long and hard about whether and how to respond to this thread.
I was anorexic in my late teens and early twenties. I received hospital treatment. To do this I took a year out of university and returned to my parent's home. My mother was an active church goer. I started going to the same church (long story but essentially I only became a Christian during my illness).
When I was ill my mother would talk to other people about it. She is one of those folk who need to share.
At the time I hated it.
However, with hindsight, I can see:
(1) Anorexia is a very visible mental illness. If someone is ill enough to be hospitalised it will be obvious to all they are seriously underweight. Even if my mother hadn't told people they would have known.
(2) Anorexia is a fucking bitch. For the sufferer but also for their loved ones. It is deadly, frustrating and terrifying. I think support for family, both professional and pastoral is key. My mum needed not just the (limited) professional counselling provided by the family therapist but also just friends.
As for the family in your situation, Kaplan, I think it is crucial to keep away/dilute the influence of the negative person and to counter their ignorance with some facts.
The one thing I would add to the many other comments is it might be worth thinking about what will happen when (if) the girl returns to church from hospital. Not just those who are obviously damaging but, many well meaning comments (don't you look well ) are not great to someone in a fragile state of recovery.
Posts: 340 | From: London | Registered: Feb 2008
| IP: Logged
|
|
cliffdweller
Shipmate
# 13338
|
Posted
quote:
Originally posted by the giant cheeseburger:
quote:
Originally posted by Erroneous Monk:
quote:
Originally posted by Kaplan Corday:
Any suggestions from personal experience as to how we can best pastorally support this family?
You can't help. Please try not to do any harm.
Erroneous Monk - sister of anorexic
+1
I would have phrased it as "you can help - by staying out of the way of those who actually know what they're doing."
Obviously I'm biased, but I resent the implication that pastoral care is "of no help". I would agree that pastors masquerading as mental health professionals is of no help (or worse than no help). I believe each has a distinct role to play in caring for the entire person-- or family, in this case. Pastors should take care not to overstep their role and their training/expertise by offering advice about diagnosis, cause, treatment, etc. But they do have a significant and important role to play in providing ongoing spiritual care to those involved, especially when it is being directly requested.
--------------------
"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
| IP: Logged
|
|
Curiosity killed ...
Ship's Mug
# 11770
|
Posted
quote:
Originally posted by the giant cheeseburger:
quote:
Originally posted by Erroneous Monk:
quote:
Originally posted by Kaplan Corday:
Any suggestions from personal experience as to how we can best pastorally support this family?
You can't help. Please try not to do any harm.
Erroneous Monk - sister of anorexic
+1
I would have phrased it as "you can help - by staying out of the way of those who actually know what they're doing."
+ 2 - another sister of an anorexic checking in.
And Pyx_e put his finger on it by describing anorexia as an individual's expression of a family illness. That sister became anorexic. My other sister and I found our own ways to self-abuse to deal with the control freakery of our parents.
I have got sucked into another situation when a friend was getting professional advice to deal with her self-harm and underlying problems. And she was leaning on a group of us to bolster her against the advice she didn't want to hear. The kindest thing I did was to pull my support so she had to rely on the professionals. But she didn't see it that way.
Anorexia is always complicated and often a family issue. How do you know that the help the family is asking for from the church is support not to deal with that which the professionals are trying to get them to face?
--------------------
Mugs - Keep the Ship afloat
Posts: 13794 | From: outiside the outer ring road | Registered: Aug 2006
| IP: Logged
|
|
cliffdweller
Shipmate
# 13338
|
Posted
quote:
Originally posted by Curiosity killed ...:
I have got sucked into another situation when a friend was getting professional advice to deal with her self-harm and underlying problems. And she was leaning on a group of us to bolster her against the advice she didn't want to hear. The kindest thing I did was to pull my support so she had to rely on the professionals. But she didn't see it that way.
Anorexia is always complicated and often a family issue. How do you know that the help the family is asking for from the church is support not to deal with that which the professionals are trying to get them to face?
They may very well be. But that doesn't mean your only options are to give them exactly what they're asking for or bugging off and doing nothing. Again, if pastors are clear about their role and not trying to supplant mental health professionals, the fact that the family may make inappropriate requests is not a problem-- you can still respond with appropriate spiritual care/support, without allowing yourself to be triangled into the actual treatment.
I appreciate Badger Lady's post above, which I think sketches out the holistic needs of family and "identified patient" much better than I can.
[ 23. October 2013, 17:50: Message edited by: cliffdweller ]
--------------------
"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
| IP: Logged
|
|
quetzalcoatl
Shipmate
# 16740
|
Posted
Curiosity killed ... wrote:
I have got sucked into another situation when a friend was getting professional advice to deal with her self-harm and underlying problems. And she was leaning on a group of us to bolster her against the advice she didn't want to hear. The kindest thing I did was to pull my support so she had to rely on the professionals. But she didn't see it that way.
Anorexia is always complicated and often a family issue. How do you know that the help the family is asking for from the church is support not to deal with that which the professionals are trying to get them to face?
Very good points. This happens from time to time in therapy, whereby the client enlists the support of friends or family to work against the therapy. Of course, the therapist can explicitly point this out.
"My sister says that I've been much more depressed since I started seeing you."
"Yes, well, therapy can make you depressed."
"My sister says that I'm losing weight as well."
"Perhaps your sister would prefer you not to do therapy?"
"My sister says that your fees are way too high."
I'm not suggesting that this is happening in this case.
--------------------
I can't talk to you today; I talked to two people yesterday.
Posts: 9878 | From: UK | Registered: Oct 2011
| IP: Logged
|
|
Doublethink.
Ship's Foolwise Unperson
# 1984
|
Posted
There is an argument for someone with a recognised role in the church - e.g. A deacon or the vicar or whomever - to discuss with mother if they would like some support and if so whether they may liaise withe treating team, to agree the most helpful way to do this and boundaries.
It maybe the treating team may say, ok jhere is a contact number for any concerns and can we take yours. Please keep the conversation private, and that would be it. The key would be carer support from one person vs stuff being disseminated through the congregation.
--------------------
All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
| IP: Logged
|
|
Kaplan Corday
Shipmate
# 16119
|
Posted
quote:
Originally posted by Huia:
Kaplan, I am concerned about this thread . I know several Shipmates, especially clergy, have been outed by people who recognise who they are in real life. If I were this mother and even more so if I were her daughter I would feel both angry and betrayed that my life was being discussed in this way.
I may be overidentifying as I had serious issues with hating my mother as a teenager, and I do understand your concern, however I feel uncomfortable.
Huia
I understand your concern, and agree that it is theoretically remotely possible, but would still maintain that it is highly unlikely.
Posts: 3355 | Registered: Jan 2011
| IP: Logged
|
|
Kaplan Corday
Shipmate
# 16119
|
Posted
quote:
Originally posted by the giant cheeseburger:
quote:
Originally posted by Erroneous Monk:
quote:
Originally posted by Kaplan Corday:
Any suggestions from personal experience as to how we can best pastorally support this family?
You can't help. Please try not to do any harm.
Erroneous Monk - sister of anorexic
+1
I would have phrased it as "you can help - by staying out of the way of those who actually know what they're doing."
That is effectively what I decided,as I indicated upthread.
Posts: 3355 | Registered: Jan 2011
| IP: Logged
|
|
Kaplan Corday
Shipmate
# 16119
|
Posted
quote:
Originally posted by Badger Lady:
Anorexia is a very visible mental illness. If someone is ill enough to be hospitalised it will be obvious to all they are seriously underweight. Even if my mother hadn't told people they would have known.
Another young woman in the church also struggles with anorexia and is on the worship team, which means that she is up on the platform in front of the congregation each week.
Her anorexia is common knowledge, and (apparently) she does not mind that.
Whether she was forced into that position by people who talked about her without her permission, forcing her to adapt to a situation where she had lost any hope of privacy, or whether she genuinely didn’t see it as a boundaries problem and broadcast the information herself, I don’t know, and it is none of my business.
The reason the other case mentioned in the OP came to my notice was because of the girl’s mother’s unsolicited approach to us.
It is not a subject in which I have any particular interest or expertise, but it did reveal some difficult ways in which pastoral and therapeutic issues can clash and interact.
Posts: 3355 | Registered: Jan 2011
| IP: Logged
|
|
mdijon
Shipmate
# 8520
|
Posted
quote:
Originally posted by Curiosity killed ...:
And Pyx_e put his finger on it by describing anorexia as an individual's expression of a family illness.
I think one should say that is sometimes the case, but certainly not always. Psychiatric illness may result from unhealthy family dynamics, but it would be wrong to label all families as dysfunctional because one member suffered with anorexia. Human psychology is not so mechanistic that output A consistently implies input B.
--------------------
mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
| IP: Logged
|
|
Curiosity killed ...
Ship's Mug
# 11770
|
Posted
mdijon - I would agree that not everyone's anorexia is a family issue - but for many teenagers it is. I've come across adult bulimics with similar issues outwith their family. But ... the scenario as depicted here sounds as if this one is a family issue.
--------------------
Mugs - Keep the Ship afloat
Posts: 13794 | From: outiside the outer ring road | Registered: Aug 2006
| IP: Logged
|
|
lilBuddha
Shipmate
# 14333
|
Posted
quote:
Originally posted by Kaplan Corday:
The mother’s response, rightly or wrongly, was that it was natural to share such a matter with her Christian friends (though not with the church at large).
Three may keep a secret if two of them are dead.
quote:
Originally posted by mdijon:
quote:
Originally posted by Curiosity killed ...:
And Pyx_e put his finger on it by describing anorexia as an individual's expression of a family illness.
I think one should say that is sometimes the case, but certainly not always. Psychiatric illness may result from unhealthy family dynamics, but it would be wrong to label all families as dysfunctional because one member suffered with anorexia. Human psychology is not so mechanistic that output A consistently implies input B.
I agree. However, I do not see how sharing the daughter's problems with the church helps the daughter at all. I see sharing beyond the pastor as extremely unhelpful to the girl.
--------------------
I put on my rockin' shoes in the morning
Hallellou, hallellou
Posts: 17627 | From: the round earth's imagined corners | Registered: Dec 2008
| IP: Logged
|
|
mdijon
Shipmate
# 8520
|
Posted
I don't see that as a however - that's simply a different statement which I'd also agree with.
It seems to me a pastor and/or church needs to draw careful boundaries, as many above have indicated already.
I think a skilled pastor would see their role as supporting a mother in distress who came to them, not as giving her advice on managing her daughter's anorexia, but perhaps where appropriate giving the mother advice about how to handle her own response to her daughter and her illness and being someone she can talk to about what is happening to her.
--------------------
mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
| IP: Logged
|
|
Doc Tor
Deepest Red
# 9748
|
Posted
quote:
Originally posted by Curiosity killed ...:
mdijon - I would agree that not everyone's anorexia is a family issue - but for many teenagers it is. I've come across adult bulimics with similar issues outwith their family. But ... the scenario as depicted here sounds as if this one is a family issue.
Philip Larkin aside, there is no clinical evidence that parents cause anorexia. Or rather, if they do, they are not the sole cause and there are some very complicated psychological and chemical relationships at play.
Saying "it's the parents" over the internet likely means you're wrong.
--------------------
Forward the New Republic
Posts: 9131 | From: Ultima Thule | Registered: Jul 2005
| IP: Logged
|
|
|
Printer-friendly view
