Intervention needed for family trying to help anorexic daughter

(It has been more than) eight years since we have moved here to help our (other) daughter and husband with their son. We have had to balance that joy with the daily grief of watching our other once-beautiful daughter fight off the horrible effects of anorexia/bulimia. We have begged her husband to get her help. Her other siblings have come to Las Vegas and have called her to try to keep some relationship if at all possible.

The husband refused to get her the help when she was strong enough to perhaps at least survive without the damage I cannot even describe. I am 76 years old; my daughter looks to be 88 or so, and she is 39. My daughter would scare any child if seen in public. In your practice have you ever seen what this extreme malnutrition can do to a body? She was 5 feet 9 inches, and now she is shrinking more each time we are able to see her. During this time she has cut off friendships and family. Isn’t it strange that the husband appears to go along with this and blames her parents?

No matter what we tried, no one would listen to us. Doctors and medical hospitals and nursing homes will not communicate with us as parents. As a mother, I find it so difficult to give up. But over the past six months, our relationship has become so damaged again that I can’t physically handle it and take care of a toddler and a husband recovering from cancer. Having lost a daughter, I am well aware of the grief the loss of her will involve, but I have been able somehow to put that aside for now so that I can do what is expected of me as a person. I would go to the ends of the earth for my daughter, but who would take care of my responsibilities if I give in to the emotions that I cannot help but feel when I speak with her or see her from time to time? — D.A., Las Vegas

Anorexia is dangerous and in some cases deadly. Patients who seek treatment have effective outcomes in most cases, but getting these patients to seek treatment isn’t easy. The behavior works very much like drug addiction in that it’s ultimately isolating and tends to estrange social and familial bonds.

And speaking of the addiction metaphor, you describe her husband as somehow woven into the disease as the spouse of an addict often is. He participates in this problem by doing nothing. Worse than doing nothing, actually; he muddles and distracts possibilities of aid by blaming you and your husband! The last part makes me very curious, especially when you say that over the last six months your relationship with your daughter has been “damaged again.” What are the themes or history of her antagonism with you? Is it just you? Or is your daughter equally conflicted with her father? You suggest that her relationships with her siblings also are strained.

I’m not setting up an argument that you and your husband are responsible for her eating disorder, because you’re not responsible. I’m trying to inventory what I call “The Pathology Machine” — the way a patient sets up beliefs, ideas, a worldview, etc., then weaves all that into family-of-origin, family and social relationships.

Regardless, perhaps another thing your daughter has in common with a serious drug addict is that she needs a formal intervention. I remind you that family interventions are first and foremost something valuable we do for ourselves — not for the patient! In a world where none of us ultimately has the power, by mere force of love, to save people from self-destruction, we sometimes choose a course that can at the very least provide us with the comfort that, whatever the outcome, we did not do nothing.

You might consider a familial and even psychiatric intervention. The first step would be for you and your husband to make an appointment with a specialist in this field to identify options and begin to decide upon a strategy.

You cannot choose health for your daughter. But you can decide not to participate in, normalize or wink at her self-destruction.

Steven Kalas is a behavioral health consultant and counselor at Las Vegas Psychiatry and the author of “Human Matters: Wise and Witty Counsel on Relationships, Parenting, Grief and Doing the Right Thing” (Stephens Press). His columns also appear on Sundays in the Las Vegas Review-Journal. Contact him at 227-4165 or skalas@reviewjournal.com.