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Interventions and Eating Disorders: A Resource for Families

By Monica M. Bracht

Mention the word "intervention" and what comes to mind? Family members or concerned others, with or without professional assistance, trying to get help for the alcoholic or addict. We don't usually think of using an intervention when it comes to those suffering with an eating disorder.

This association with alcoholism does have a historical base. Dr. Vernon Johnson developed the modern process of intervention, a Minnesota minister, who developed the process through working with alcoholics in his congregation. Current media attention furthers the association with alcoholism with the advent of the A&E Network's celebrated cable television show of the same name, "The Soprano's" now infamous if unrealistic mob family "intervention," and Dr. Phil's prime time introduction to the method. This focus notwithstanding, interventions, as we know, have always had a much broader use in the mental health field. They are employed continually, if less formally, by professionals and family members as they intercede on another's behalf in almost any attempt to influence behavior changes or prevent negative consequences.

The association of formal interventions with alcohol and drug addiction, however, has made many professionals and families alike uncertain about using this method with eating disorders. This reluctance is due in part to perceived, as well as real, differences between eating disorders and other addictions, and to a lack of agreement in the field as to whether eating disorders can, or should, be considered "addictions." It is interesting to note that the most current and comprehensive research shows a genetic link or base for both addictions and eating disorders along with a growing recognition of both disorders as "brain diseases," not unlike depression or Parkinson's disease. (http://www.wpic.pitt.edu/research/pfanbn/pinvestigators.html#)

An intervention is often seen as an event where individuals confront the "addicted individual" with the negative consequences of his/her actions, and as an eating disorder treatment professional recently said to me, "It's not as if they (the anorexic or bulimic) has just smashed up the car." I think we can all agree, however, on a few simple facts related to eating disorders:

  • The suffering of individuals and their families is equally as excruciating
  • Anorexia kills. It has the highest mortality rate of all mental illnesses including depression.
  • Obesity, often the result of binge eating disorder, has reached epidemic levels in this country
  • Bulimia comes with a laundry list of medical complications.

Eating disorders are characterized as persistent patterns of dysfunctional eating and dieting behavior. Associated with serious emotional, physical and social distress, eating disorders negatively impact an individual's quality of life, self image, relationships, financial and employment status. Eating disorders can exhaust and finally bankrupt parents and family members as the eating disorder sufferer retreats from job or school, alienating friends he or she uses all of his or her energy and resources to manage the disorder.

Independent of the field's decision whether to categorize eating disorders as an addiction, the similarities in how both addictions and eating disorders affect individuals and their families is too striking to ignore. Rather than wasting time debating the issue, we in the field should work to make families and therapists more aware of, and comfortable with, a tried and true method for motivating behavior change and helping families. Interventions work for the eating disorder sufferer.

Why intervene? Very simple. No one deserves to get sicker before they can get better. Intervention services are one of the best ways to motivate someone to accept help when they are unable or unwilling to ask for it themselves.

Families with a loved one suffering from an eating disorder may have tried various approaches and made many unsuccessful attempts to help. They may feel helpless, hopeless or afraid and not know where to turn. When a professional therapist or interventionist trained in working with eating disorders partners with a family there should be two goals in mind.

A) The first goal is to get the individual suffering with an eating disorder into treatment.
B) The second goal is to move the family out of crisis and to help them set healthy boundaries for themselves.

A clinician, in collaboration with family members, implements a confidential and respectful plan to interrupt the negative physical and emotional spiral of the eating disorder. Through education, assessment, and action planning an immediate attempt is made to move the identified individual into a clinically appropriate level of care. When families are willing to hold a mirror up to their loved one that reflects not only the negative toll of the disorder on the individual, but also the very real and terrible toll on each member of the family, this represents the larger sense in which "confrontation" works in interventions.

"The goal of the intervention," says Dr. Johnson, is for the identified individual to "see and accept enough reality" to accept his/her need for help (1980, p. 57). When family members are willing to present reality to their loved one and willing to change their own relationship to the eating disorder, the emotional impact and power of that act (interventions are rarely dry-eyed events) can move the individual to make a decision in his or her own best interest. If the intervention is not immediately successful the clinician will work with the family and individual over time to motivate him/her toward greater acceptance of the need for help.

Will doing an intervention make matters worse? No. Doing nothing makes matters worse.

  • Eating disorders are not a "phase."
  • Eating disorder sufferers rarely get better without help.
  • Eating disorders have serious psychological and medical complications that can be life threatening.
  • Eating disorders are not a failure of will or behavior nor are "parents to blame."
  • The earlier eating disorders are diagnosed and treated the better the outcome.
  • Eating disorders are real and treatable medical illnesses. If left untreated they can progress - becoming chronic and even fatal.

Is now the time to intervene? Ask yourself how much worse things will have to get before you are willing to act? Intervention is a direct call to action for all involved. Intervention combined with treatment is the best solution.

Johnson, V.E. (1980). I'll quit tomorrow. New York: Harper & Row.
A collaborative study of the genetics of anorexia nervosa and bulimia nervosa. Available from the Collaborative Group's web site.

Monica M. Bracht, M.A., LADAC is a licensed alcohol and drug counselor currently working on her MSW degree. She is the Southwest Regional Director for Addiction Intervention Resources, Inc., A national intervention, education, and consulting company based in St. Paul, MN. For more information on Eating Disorders and Interventions visit intervene.com or contact Monica directly at monica@addictionintervention.com

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