Friday, October 2, 2015

For the Parents of Jewish Orthodox Children with Eating Disorders

By Devorah Levinson
In speaking with and guiding Orthodox Jewish families about Eating Disorders over the years, I have noticed many commonly asked questions and concerns. Orthodox families are connected by their culture and I have found that regardless of where they are located their fears and need for support are strongly similar. I would like to share my experiences with Jewish Orthodox parents of children with an eating disorder.  Before I do so, let me explain a little bit about Relief Resources, who we are and what I do. 
I am a referral specialist and Director of the Eating Disorder Division at Relief Resources. Relief Resources is a nonprofit mental health referral organization that caters to the needs of the Orthodox Jewish community. We research mental health issues and provide information on the illnesses. We research clinicians, mental health facilities and treatment options. In addition, we promote cultural sensitivity amongst clinicians and treatment facilities. Most importantly we explain treatment options and give referrals.
The referral process is so important. As anyone who’s been in therapy before will know, mental health is not a one size fits all approach. In addition family dynamics and resources vary and treatments are updated and enhanced. 
The need for these resources is great; however, there has been much speculation in regards to mental health issues, and eating disorders in particular in the Jewish Community. It is difficult to know whether eating disorders are on the rise and if members of the orthodox community have more or less mental health issues. It is also challenging to get answers to such questions as there is no singular group to poll amongst Orthodox Jews. There is also tremendous secrecy and embarrassment in admission of the illness, and often there is failure to even recognize the disorder.
The Relief record keeping system has been tracking mental health needs and numbers since its inception in 2001. Each case is recorded and verified for duplication. Our confidential service has to date recorded over 65,000 cases. Currently, we receive over 650 new calls a month. Of those numbers approximately 3% are Eating Disorders, or about 19 new eating disorder cases a month. (see graph #1) 
So what contributes to this rise? Is it because with time there is more awareness of mental health issues and, therefore, more people reaching out for help? Are there more societal challenges and pressures? Is it because of issues with technology and the internet? Does cause really even matter? For myself, I would say it’s not relevant if mental illness is on the rise in our community or not. The only fact I can be sure of is that people have it and we must make it our mission to get them to appropriate care. 
The best ways to get the community to appropriate care is to educate them about early warning signs. We give appropriate referrals and encourage people to stay in treatment. We support them if necessary during the process and even advise or assist with insurance navigation wherever possible. 
The majority of my work is with adolescent Eating Disorder patients and their families. (see graph # 2) As an additional proof that mental health referrals aren’t a one size fits all approach, treatment for adolescents with eating disorders is very different than adults. This then brings us back to this article’s initial goal of sharing information with the Jewish Orthodox parents of children with an eating disorder.
You are not alone. Just because your neighbors might not be talking about it doesn’t mean that they don’t also struggle with mental health issues. Understand that other families are struggling with this just like you are. There is help and you will get it. Don’t let that feeling of isolation discourage you. 
No, you didn’t cause this. While there are many factors that can contribute to an eating disorder, they are biologically based illnesses. Research continues to show that parents do not cause eating disorders. Eating disorders don’t discriminate, having a larger family or smaller family doesn’t seem to make any difference. Don’t let feelings of guilt discourage you. 
Yes, your daughter can get better and can be happily married one day. That is why we want to act now. We need to get her to the best care and aggressively follow the treatment. The quicker the illness is recognized and dealt with the better chances of full recovery. Don’t let concerns for the future discourage you. 
Shidduchim,” the Orthodox method of finding a spouse, does not cause eating disorders. Beauty has always been important to someone who is looking for a wife. Years ago it was the heavier woman who was desirable. It is not a problem with our system of dating; it is rather proof that the thin ideal is so ubiquitous. Even in more sheltered societies like that of Orthodox Jews, being thin has now become the goal. Don’t let misinformation discourage you. 
Eating disorders are NOT a spiritual illness. They need proper medical and therapeutic care to get better. Rabbi’s and religious leaders are an integral part of our lives but eating disorders are serious illnesses that need the treatment of trained licensed clinicians.  Don’t let well-meaning community members discourage you.
Orthodox Jews do not need Orthodox treatment centers. Eating disorders are life threatening conditions. We need and deserve the best care possible. Cultural issues can be navigated but good care can’t be compromised. Look for the best treatment recommended and then we can work through religious concerns. If this was cancer we wouldn’t hesitate to go anywhere and do anything appropriate. Let’s treat eating disorders the same. Don’t let religious fears discourage you. 
As Orthodox Jews we need to be encouraged to focus on our unique strengths as a community to combat this serious illness. 
Graph #1
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Data from Relief Resources Database (August 2015)
Graph # 2

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