By Susan Saraf

By Susan Saraf

Thursday, September 26, 2013

SpunkerFLY Woman of The Month - September

Song: Star Witness Neko Chase
With daughter Julia 

How we met:  Last July I was sitting on a return flight from San Francisco to New York and the woman next to me had that presence my whole being always seems hard wired to tune into.  I so didn’t want to do it.  I did not want to be the chatty Cathy in the next seat.  It was a long flight.  We could both end up cringing for hours.  I started telling myself Don’t you dare.  Mind your own business.  Read the book you bought.  Work on the book you’re supposed to be writing. None of it worked.  Myself couldn’t stop myself.  “Hi, are you a star?”  I asked.  I think.  If not those exact words, something very close.  She shook her head sweetly, demured, no.  “Do people ask you that?” I wondered. “Yes,” she nodded redeeming me. “Yes, they must! You have definite star energy. So, what is it? That you do?” I asked.  I sound more obnoxious in writing.  I hope. It was all a little more tempered.  I'm a smooth mo, yo.  I was so sure I was on to something.  She was so sweet, elegant and soft - yet underneath very much in charge.  A true pioneer.  A lady.  When she told me her story I was captivated.  I hope you will be too.  

I invited Judith to be a guest on the blog right as we were taking our bags out of the overhead bins, "Your information will help so many woman who read my blog, so many moms who have daughters," I said. "I have three sons, so..." (it doesn't concern me was my subtext). "Oh, no it effects boys as well," she said, sadly. "For sure."   
With daughter Senna 

Dear Judith,

Thank you so much for exchanging your information with me and agreeing to be our SpunkerFLY woman of the month.  I am so honored to feature you.  I've left the intro a real cliff-hanger so let's dive in.

1. How did you start?
I was 28 years old, putting myself through grad school and, to help pay for school, I was working as an assistant to an older grad student in the psych department.  We got to know each other well and ended up taking a share in a summer house in the Hamptons.  One day we were sitting on the beach and complaining that we had eaten too much the night before and that we felt fat (who hasn't done that at some point?!).  My friend Ellen confided in me that she had been throwing up as a way to get rid of the food (Ellen has spoken of this openly so i'm not divulging secrets here).  I was stunned because in those days (1980), no one had heard of eating and throwing up-- it was fascinating, disgusting, and riveting all at once.  Ellen had my attention!

Ellen told me she was fighting for recovery and that she had found and worked with a psychologist from Cornell University who had discovered that many other girls were binging and throwing up.  This psychologist-- Marlene Boskind White-- was the first person ever to notice this phenomenon and she termed it Bulimia-- the hunger of an ox.  Ellen had met with Marlene and found her work helpful.  Ellen proposed that we start something in New York City to address this new and potentially growing problem. We asked permission from Marlene to take her ideas into the city, she gave us the go ahead and through word of mouth, sure enough, we immediately found 5 women who were struggling with eating and vomiting.  This was a startling beginning for us.  Bulimia started as an extraordinary cultural secret, a grassroots disease that had just taken root at the end of the 1970's, seemingly out of no where, and we were finding that women actually were already struggling to make it go away.

At the time, I was finishing my Ph.D. and working at St. Vincent's Hospital as the director of the group therapy program for alcoholics.  With my experience with addictions and Ellen's experience with the disorder itself, we scrambled to come up with a weekend intensive group program to address the symptomatic behaviors.  We started the group with the 5 women we met and sent out a press release to the media (no email in those days!) saying that two NYC psychologists were starting a program to treat a stunningly new disorder, binging and vomiting.  A week later, a cable program picked us up, interviewed us and we were suddenly visible to a broad audience.
The news media of course found it fascinating that pretty girls were binging and throwing up. Once the cable show aired, there was a clamoring from other shows to pick up the story. The Today Show did a 7 minute clip of our group (with blurred pictures of the patients).  Other news shows followed as did a myriad of newspaper and magazine articles.  As a result, Ellen and I were overwhelmed with a cascade of letters and phone calls from people all over the country, many of whom were famous and visible, saying that they thought that no one else did what they did.  They wanted to know how to get help.

Ellen and I rushed to set up a Center in Manhattan to broaden our treatment reach.  We started the Bulimia Treatment Associates, hired a consortium of therapists to work with us-- and our careers took off with lightening speed.

2.  In case anyone missed it, you and Ellen started the first ever Eating Disorder clinic in NYC.  Do you ever think what if I hadn't made that choice, what would life be like if I hadn't taken the risk?

I am so incredibly grateful that I met Ellen and took the risks that I did.  I realize that had I not been financing my own way through school, I never would have been working as a research assistant and I wouldn't have met Ellen-- so this is a word of encouragement for anyone who has to work on their own to pay for school.  I can't imagine what my life would be like had it not taken the amazing turns that it did.  I feel very lucky.  But interestingly it never felt like a risk.  What we were doing was so much fun and inspiring and exciting.  Even though I worked late into the night and through weekends for years on end, it never felt as though I was working.  I think one of the most important goals with any job is to know that it's something you are passionate about doing.
3. If someone is struggling with an eating disorder--either parent or child-- what is the first step they can take to get help?  How best to approach a child?

In our book Surviving an Eating Disorder: Strategies for Family and Friends (Siegel, Brisman and Weinshel, Harper Collins, 3rd edition), we spell out step by step what to do if someone you care about is in trouble with food.

First, find a time that is calm to talk.  Let the person know what you are concerned about-- be really specific (i.e., "I saw signs of vomit in the toilet" or " you've lost a lot of weight lately and you seem worried about how you look"  or "you seem so sad lately"). Don't be blaming or angry!!  Just be factual.  Let the person know how it affects you-- maybe you are worried, maybe it is hard to talk together lately, maybe you feel you should help and you don't know what to do.  And then have a step that you'd like the person to take.  This may as gentle as just wanting to talk about it as a first step-- or you may be so worried that you want a professional to evaluate whether a problem exists. Be clear, unemotional and suggest a step that is possible to do (ie don't suggest seeing a professional if you are not prepared to set this up or go with the person the first time).

With younger kids, keep to this same format.  If you are worried that someone is eating too much, you might want to focus on health or mood instead of weight.  It's okay to tell kids that you worry that they are not eating healthfully or that they seem preoccupied with what they will eat or what they weigh. Don't ever say that you think they have gained weight or are fat-- that's just too embarrassing and shame filled.  Your child will block you out and not hear what you have to say.

In this kind of situation, be prepared to both be supportive but also set limits.  So you might want to tell your daughter or son that it's okay to have one or two desserts/snacks a day and that they can choose when the snacks will be eaten-- but that will be the limit because otherwise it's not healthy.  If you get into too deep of a tangle with your son or daughter over food, maybe it's time to get a third party in there (a therapist, nutritionist?) to broaden the discussion.  This should not be a battle but a slow moving direction toward health in which the child chooses one step he or she is able to take .

4.  Do eating disorders predominantly effect young girls?

Eating disorders can effect ANYONE-- including young boys and men.  What is important to know is that the best chance for recovery is early intervention.  If you know someone who you suspect is in trouble with food-- or if you are worried about yourself-- make sure you don't turn the other way thinking it will get better or that you are making too big a deal of it.  If you have any questions, speak with a professional about how to proceed.

5.  I noticed my middle guy, (who was always being teased that he was chubby by his older brother) at 2 years old pushing a biscuit away after I said to my husband, "these are nothing but fat" I didn't mean he or I shouldn't eat it, I was actually taking a bite, celebrating it, I guess! But I couldn't believe that he heard it and reacted by restricting himself at such an early age. I became conscious of my words around food at that moment (I'm not sure how long it lasted! But I try).  How young do you see eating disorders start in children? How do parents views of their own bodies and attitudes toward food contribute? 

We're unfortunately seeing kids as young as 8 or 9 in treatment with full blown eating disorders.  This was unheard of years ago but there is such a focus on being thin in our culture-- and these young kids are so media-savvy-- the messages travel fast.
Kids pick up tones and messages about food and weight at home too.  But parents don't create eating disorders.  The current thinking is that kids become eating disordered as a result of a complex combination of genetics, psychology and the culture.  We've seen kids with the most eating disordered parents who are fine around food.  And we've seen a lot of eating disordered kids who come from families where their parents were healthy but not overly concerned about food and weight. 
That being said, given the epidemic of eating problems in our culture, as parents it is a good idea to notice "fat talk" in the house and to be aware of the messages one is giving kids about their self-worth.  A parent's job is to set the stage for strong self worth and self-esteem so that the child can fight the messages of the culture.  Notice at home how many comments are made about bodies versus intellect or creativity.  Notice what compliments are given-- are they mostly directly at how one looks or how one acts?  And what about feelings?  Kids who develop eating disorders have a hard time knowing or regulating their feelings.  What can you do as a parent to help your child learn to sooth one's self, to express complicated feelings, to have a voice in the family about one's own needs and desires?    
We're in a food and fat obsessed culture.  Every parent is going to make a comment about food, looks and weight somehow. Helping a child know one's internal world, not just the outside appearance and actions, and helping  that child give voice to his or her own thoughts and feelings  is one of the best things a parent can do to help set the stage for a healthy kid.

Judith,  I cannot thank you enough for your thoughtful and thought provoking interview.  Thank you for helping so many people and families and souls in your lifetime.  And for flying Jetblue! You are a blessing.  You are FLY! 

Love, Susan 

If you or someone you know is struggling with an eating disorder and would like to contact Dr. Brisman or just send her fan mail, her information is below.   

Judith Brisman, Ph.D.
Founding Director
Eating Disorder Resource Center
330 W. 58th St.  Suite 206
NY, NY  10019


Judith Brisman said...

Susan-- YOU are the SUPERWOMAN-- raising your tribe of sons, reaching out to woman with inspiration and support-- AND being so engaging, uplifting, funny (and yes beautiful!) that you broke through my airplane mode reserve. Thank you for being so daring-- you made an otherwise uneventful and routine trip home from SF ever memorable! Thank you for the opportunity to share my story. I hope this can be of help in some way... Judith

Francesca said...

Great post! And I completely agree that Judith definitely has star quality. I have always thought that—so funny! Such great energy and so dedicated in her field. Thanks for hosting her on your blog and sharing this information with your community.
~ Francesca