Friday, October 2, 2015

The Language of Healing: For parents to care for and support their child who suffers from an eating disorder and self-injury.

By Amy M. Klimek, MA, LPC
Trigger warning/Stress warning: Triggers can be unique, inconsistent and unpredictable. Content in this article may be “triggering.” Content warning: self-harm, suicideThe information contained in this website is for general information purposes only. In no event is Gurze/Salucore liable for any loss or damage, including without limitations, indirect or direct or consequential loss or damage, or any loss or damage whatsoever arising from the use of this website. Use of the information posted is at your own risk.

Language of Self-Injury and ED

Self-injury and eating disorder scars tell a story, a personal history of the conflict both internally and externally on the body. This story is different from one person to the next with the one constant being, the struggle is real.
Those who suffer from inflicting pain by means of cutting or restricting, struggle with a marked inability to verbalize and process emotions. Inescapably, their bodies are used in avoidance to experience their emotions. Reaching for a part of themselves that is missing, at times they do not fully understand how to navigate their own experiences. The behaviors can be a means to disconnect from emotions due to a lack of internal resources to deal with feelings mindfully and with neutrality.
Self-injury is the result of self-inflicted pain to oneself, without suicidal intent. There is a parallel between those who struggle with self-injury and those who suffer from an eating disorder—both use the behaviors of cutting, burning, and picking – restricting, binging, or purging to control distress. These behaviors are identified as coping skills to alleviate a person’s emotional and mental suffering.
As it may be difficult to align these behaviors as a means of coping, they are in fact the person’s only resource to regulate intense feelings. Whether the behaviors are aggressive or passive, the person’s struggle needs attention and support in order to cease these destructive, at times deadly behaviors; this applies to both self- injury and eating disorders. For healing to occur, the child who is suffering and the parents must discover a new language, a new source of coping both in body and in words.
To put this in perspective, in an article written for the American Foundation for Suicide Prevention, Dr. Cynthia Bulk, Ph.D. shared, “Not all eating disorders are the same when it comes to deliberate self-harm. Individuals with bulimia behaviors who reported they had experienced more deliberate self-harm episodes were more likely to engage in violent deliberate self-harm behaviors and these destructive behaviors tended to fluctuate with their weight.”
Dr. Bulik also reported that individuals with anorexia, the restricting type, had the lowest risk of self-harm episodes while those with history of both anorexia and bulimia were at the highest risk. The relationship between the two behaviors, eating disorder and self-injury, indicates an undeniable need to support the person who is suffering.
The objective is not supporting the notion of “more” or “fewer” serious self-destructive acts. Any acts of self harm including eating disorders, addictions, and all forms of self-mutilation are “significant “ when they sustain feelings of guilt and shame, cause distress in relationships, create defensives, or encourage lying as well as foster emotional, physical, and psychological pain.  -Excerpt from “Letting Go of Self-Destructive Behaviors” by Lisa Ferentz

Language of Support

Support can be reached for both parties when viewed through the same lens. Enabling the individual to express a whole self so that authenticity and connection to others can emerge is the best means to achieve this support.
It is incredibly overwhelming, frustrating, and discouraging for a parent to stay calm while watching a child engage in these terrifying behaviors. It may appear that the correct approach is to “STOP” the behavior, make the child disengage from the cutting, restricting, burning, or purging; regrettably, this is not the right answer. Rather, it is honoring the child’s experience as described by the child without assumptions or historical perceptions about the struggle and behaviors.
Creating a supportive environment is not safeguarding the physical environment by removing all the sharp objects or binge foods in the hope that your child will not engage in the behaviors. The pull of the struggle is strong; the child will find ways to engage in behaviors if he/she does not feel safe internally.
This is not to say you should ignore the physical environment. There are ways to alter the surroundings without trying to create a fragile environment for the child.
It may be helpful in early recovery to not have certain foods in the house or sharp objects in sight. Your child may ask for specific support such as bathroom monitoring or reassurance that he/she is following the meal plan. Your child may ask you to remove objects that he/she might be enticed to use again if available. Both you and your child will learn how to acclimate to this new environment with the help of therapy and support.
Remember, you are the parent, not the police. Watching your child’s every move may appear as if you only care about stopping the behaviors and not about the suffering itself. The “policing” of behaviors can place a barrier between you and your child, and is exhausting for both.
While it is impossible to safeguard your child’s experience, you can validate it. Validation does not mean that you completely agree with your child or the reasons of their experience; rather, it is hearing and honoring what your child is saying either with words or in body language.
Validation is inherently nonjudgmental. Be curious with your child; invite him or her to describe the experience. At times, words are inadequate and the unspoken words can speak louder through the language of the body.

Language of Healing

As you are acquiring a new perspective regarding what you can do, how you can care for and support your child, you will gain an understanding of the function of the behaviors.
Your role is to facilitate change. This starts with change within you. Both you and your child will need to acquire new language as well as a new set of tools to respond to the thoughts and feelings that are creating distress. You will not always have the right answers or the ideal approach. You are not supposed to; you are a parent, not a trained clinician. The simple hope is you will find another way to react, responding differently each time.
Supporting your child is having trust in the process. Through the process, you will find new ways to speak and listen to your child, along with new ways to experience your own feelings about the behaviors. Communication should be without condemnation or judgment. It is the language of acceptance towards the present moment.
Both parties will be called upon to exercise collaborative communicating and empathic listening, which are necessary in the therapeutic relationship. The practice of transparency in relationship to healing implies open communication and vulnerability. This is working towards surrendering the familiar response of escaping from the experience. Building present moment resilience honors the emotions, it is to be mindful of the judgements that show up, and not attach oneself to that experience. This creates more opportunity to heal and recover.
Recovery does not occur all at once. You are not intended to learn all new skills immediately, since it takes practice and patience to respond to emotions. Being patient is not synonymous with doing nothing. This is a journey, a path towards healing, self-reflection, and individuality. This journey requires cultivating an attitude of willingness to change a lifestyle that once compromised the authenticity of the self.
Throughout the journey you may question yourself.  Do so mindfully, with care, kindness, and curiosity, knowing that the two of you are learning and growing together.
About the Author -
Amy M. Klimek, MA. LPC, Eating Disorder Program Coordinator Timberline Knolls Residential Treatment Center, Lemont, Ill.
Amy has worked in the behavioral health field for five years. She received a Bachelor of Science Degree in Sociology from the University of Illinois in 2006. She subsequently earned a Master’s Degree in Counseling, specializing in both community and school counseling from Lewis University in 2010.
Amy is the Eating Disorder Program Coordinator at Timberline Knolls Residential Treatment Center in Lemont, Ill. In this position, she supervises the Eating Disorder Specialists Team, offers support through training to other staff, and provides education on eating disorders to the community. As a clinical professional counselor she works individually with residents and families to educate and support the healing process of recovery.  Amy is a member of The International Association of Eating Disorders Professionals Foundation.
Amy is currently completing a 200 hour yoga certification training to facilitate mind and body connection in the healing process of recovery. The certification will contribute to her work with residents in the expressive therapy component of the Timberline program. Through yoga, she hopes to create balance in the mind and body through movement, breathing, and meditation.
Resources -
American Foundation for Suicide Prevention (Aspg.org)
Article written Dr. Cynthia Bulk, PHD “Not all eating disorders are the same when it comes to deliberate self-harm”
Letting Go of Self-Destructive Behaviors: A Workbook of Hope and Healing 1st Edition written by Lisa Ferentz (2015) Letting Go of Self-Destructive Behaviors offers inspiring, hopeful, creative resources for the millions of male and female adolescents and adults who struggle with eating disorders, addictions, any form of self-mutilation.

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