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 There’s been a lot of press in the past few years about older women (meaning me and up) struggling with body image problems and eating disorders.   Headlines include: An Older Generation Falls Prey to Eating Disorders ,

Eating disorders are common in older women, study shows, and

Face Of Eating Disorders Changing: More Older Women Struggle With Disorders .

Though the articles are well-written, well-researched and in many ways validating, I couldn’t help thinking: this is no surprise.  I know women of all ages who are affected by how they view their own bodies–enough for things to cross the line into a full-blown eating disorder.   I’ve known women who have moved from their twenties into their thirties, who cannot release themselves from an adolescent standard of thinness, who struggle with infertility as a result.  I’ve known women who develop body image issues for the first time at the onset of menopause.

So … Why do Older Women Wind up with Eating Disorders? 

One reason is relapse.

Now, it’s common knowledge that teenage girls have body image problems. (Not all, and yes: we now know that boys do too, but when we think of eating disorders, we tend to think of teenage girls.  When we watch a TV show in which someone has an eating disorder, that someone is usually a teenage girl or a woman in her very early twenties.)   But you don’t just “get over” an eating disorder because you hit thirty.   Eating disorder specialists know that making the illness go away and stay away is a grueling, often lifelong process.  Therefore, it is not a surprise that many of these “older” women developing eating disorders had them when they were teens.

The psychic reverberations of eating disorders are likely to be felt when stress runs high.  I’ll use myself as an example.  While I never starve myself any more, while I never binge and purge, if I’m really struggling with my work or otherwise going through a rough patch, my positive body image is the first to go.  I can look at myself in the mirror and be perfectly content, then an hour later, after tossing outa whole chapter that just wasn’t working (though I’d been revising it for days), I can look in the same mirror again and see something completely different.  A distorted version of myself that in younger days I called huge.  I wasn’t anything like “huge” then.  I’m not now either, but it was my word for uncertainty.   I was convinced that “fixing” my weight (erasing my own hugeness) would make the rest of my life—if not perfect, manageable.

In the olden days (my tweens, teens and early twenties), it was almost as if calling myself something harsh would neutralize my anxiety.  My Punishing Self was in charge and would whip me—my body, my coursework, my dancing—into shape.  I wouldn’t feel so out of control.

At this point, I’ve been in recovery for so many years, I know what my triggers are: mostly worries about not being good enough in some area of my life.  I know how to get through the trigger situations without taking it out on my thighs, but it still happens.  Not the eating disorder itself, but the feelings of self-doubt that once evolved into one.  As a therapist, I’ve had enough training to know how to counter the negativity, to stop myself, to walk away from the mirror and get on with life.  But I can easily see why the recidivism rate is so high among eating disorder survivors.

Another Reason is Holding onto Who We Used to be.

Some of the articles describing this phenomenon mention the usual: unrealistic ideals of female beauty that become more elusive with each passing year.  One mentioned that older women should have more role models with realistic bodies.  I found that a little hard to swallow.  I don’t think at our age we’re looking at the big screen or the small screen for role models.  I also think many of us are surrounded by realistic, healthy. diverse images of female beauty: our best friends, our sisters, our neighbors—we come in all shapes and sizes and the “perfect-looking” girls we were intimidated by in high school are hard now fewer and farther between.

In any case, I just don’t think most women over forty are trying to look like (who’s hot now?) Megan Fox, or Zoe Saldana.  I don’t even think most of us are looking at Kelly Ripa or Gwyneth Paltrow,  and saying god I have to look like that.  I’d wager though, that for some of us, the image we aspire to, hold onto, compete with and, in many cases are tormented by, is that wedding photo sitting on the mantelpiece: our younger, pre-baby, pre-forty selves.  Regardless of how flawed or flawless we think we were, that image has probably evolved somewhat.  Were you known for looking a certain way?  Did you always get compliments for being tiny, buff, a voluptuous hour-glass?  That body-reputation is part of your identity.  As it ages, the changes can be unnerving.  Who am I now?  Accepting a different body image may be part of the life cycle—for some, a hard part.

Coping with Stress: Reaching for another Cookie, or—on the other hand—Refusing to Get off the Elliptical.

Being busy, holding ourselves to high standards in every area of our lives gets brutal sometimes.  Some women use food as a refuge (I’m treating myself, I don’t have time for a nap or a pedicure).  Others get carried away with dieting to “get healthy.”  Decreasing numbers on a scale can be addictive: evidence that we’re accomplishing something, getting results—no matter what else we may be struggling with.

We women seem to put on new hats with each passing year—between work, children, spouses and ex-spouses, caring for aging parents, commitments at our synagogues or churches, book group, cooking, laundry.  With our kids entering adolescence (or wrapping it up and fleeing the nest) we’ve got just as many variables as they do, just as many balls in the air, with menopause fast approaching (or having come, gone and left its mark).  Food is often the one area where we retain some control (who shops in your house?).

As mothers, we are responsible for feeding our families—making it taste good enough for kids and partners to gather ’round the table, but keeping it healthy enough for us all to enjoy each other for a long time to come.  As women, our bodies are changing (yet again), and like it or not, many of us feel responsible for controlling that.   Compulsive over- or undereating for stress relief is not uncommon.

Sometimes it’s Easier to Make a Teen go to the Doctor than to Seek Help Yourself.

I think teenagers are more likely to get help for disordered eating patterns primarily because they are still children and, to some degree, being looked after by parents.  Also, friends are talking about eating disorders, looking for symptoms in one another and seeking the help of adults (hopefully).  Adult women don’t necessarily have that support.  If it’s up to us, we may muddle through until something drastic happens, like collapsing on the treadmill.  That actually happened to a friend of a friend, who’d been feeling victorious about losing thirty pounds, much of which her doctor—and husband–wished she’d kept.  The important thing is for friends, sisters, cousins and partners to look out for one another, for women who suspect their own behaviors around food are changing in destructive ways to seek help: an individual therapist or a support group.

So, Your Body Changes; You’re still You.

Our bodies are inextricably connected to our identities, I don’t think there’s a way of getting around that, but it’s imperative to remember that the shape we’re in is only a small part of who we are.  As women we are all individually diverse, multi-talented, and beautiful in our own unique and ever-changing ways.

Note: this is one of several reposts from  my general blog, categorized under psychotherapy.

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Please note: For the first post on this brand new blog, I am reposting one from my original blog.  It’s the post that inspired me to create this site!

I’d been encouraging my normally chipper eleven year old daughter to consider getting a new dresser, a bigger one where we wouldn’t have to annex pajamas to a shelf in her closet.  I’d shown her some in catalogues—which she normally loves poring over.  But she declined, with a defiant no that seemed disproportionate.

“Okay,” I said.  “No big deal.”  Just a dresser, just a suggestion.  Then I took a risk and asked why she’d snapped at me, if something was wrong.  She might have snapped again; she might have denied that she’d raised her voice (it’s what I might have done at her age) but she didn’t.  Instead she confessed to being grumpy lately.

“And I don’t know why,” she said.

My first thought was: uh-oh, here they come: the new moods of early adolescence.  But maybe it was something more fundamental than that.  Maybe it had to do with some Really Big Changes coming up in our family.

First, after nearly a three year sabbatical, during which I wrote two novels, choreographed three children’s musical productions and began blogging, I am resuming my psychotherapy practice which will mean a shift in everyone’s schedule as well as some form of childcare.  My kids are used to me being there all of the time; now they’ll have to adjust to most of the time.  Second, my husband is in the middle of a job transition, which means some extra stress and uncertainty.  On a lesser and more predictable note, my son is turning nine, which to me feels like a bigger deal than eight (“eight” sounds little still; “nine” not so much).

But the biggest change of all, the one we’re talking about the most anyway, is that my daughter is starting middle school, which, in our town, begins in sixth grade.  It’s not just that she’s going to a new school, bigger and further away than her old one, where she’ll have to take the bus instead of walking or being driven by me.  It’s not just that she’s saying goodbye to many old friends who are going to different schools or “hello” to a whole new crop of kids she doesn’t know (and whose parents I don’t know).   It’s all of these things and more: the unknown.  For most people, anxiety—identified or not—is a big part of venturing into unfamiliar turf.  And, as I know from personal and professional experience: anxiety can feel just like depression.  Especially if you throw a little sleep deprivation into the mix.  (My daughter is still recovering from a week of sleep-away camp.)

For me the change is significant too.  Becoming the parent of a middle schooler is the start of some new and really big words.  Adolescence.  Independence.  Inevitably Increased Screen Presence.  On some level, I believe myself to be prepared.  As a family therapist, I specialize in adolescence; for the six years I worked at the former Montclair Counseling Center, about fifty percent of my clients were teenagers; about twenty-five percent were families and couples who’d come into therapy to talk about issues related to their kids and teens.  I felt confident translating between teens and their parents.  I gave talks on the teenager-parent power struggle.

I’ve had countless kids tell me they felt a certain way or were acting a certain way—and didn’t know why.  Actually, my favorite part about being a therapist is tracking feelings.  I don’t know why I’m angry; I don’t know what’s making me sad.  Even in the case where moods are truly biological or chemical in origin, there are always triggers: losses, moves or other life events that contribute (which is why therapy is always recommended along with medication!).  It’s so normal, so common to be grumpy, grouchy, sad or however you manifest stress when things are in flux.  Day to day snapping at people, nightly bouts of tears, feelings of emptiness and I-don’t-know-why listlessness—when you trace them back, it’s not surprising to find something concrete that you didn’t think bothered you all that much.

I remember when I was nineteen, on a leave from college, about to move to the Midwest for the first time to join a mid-sized ballet company.  I was excited about living in an apartment of my own for the first time, not a dorm, paying my own rent, my own utilities, groceries, such as they’d be.  The best part was that dancing with a real ballet company had been my dream for as long as I could remember; now it was coming true.  I’d have my own pointe shoe order, an amazing repertoire to learn, not to mention a paycheck—a real pay check.  But why was I feeling down?  Why these unexpected crying jags at night?  The therapist I saw at the time made her usual quizzical-sympathetic face (a face I swore never to make once I became a therapist, right up there with the phrase how did that make you feel?) as she wondered aloud whether I was having some feelings about leaving home for the first time?

“Absolutely not,” I said.  “I can’t wait to leave.  Besides, it’s not the first time; I’ve been in college (one hour’s drive away) for over a year.”    And then I began to cry anew.

Well how about that?  Maybe I did have some feelings about leaving, about dancing full-time, about living in Ohio … about all the wild and crazy new-ness, the fear that maybe I wouldn’t be able to handle it all.

Most people I know, clients as well as friends and family, suppress fears and worries to a degree, just to get through the day.  But it builds.  It can makes you sad or angry if you don’t explore what’s going on and sort it out.  You take it out on others, if not yourself.

When it comes to transitions, most people have plenty of fears and worries, even if the transition is something they’re thrilled about on some level.  A move to a new house, a new job, a new baby, a new school.  All can be hugely exciting; all can increase anxiety, bring on or exacerbate depression.   In a few weeks, my daughter will have a new school, new classes, a new bus, and new peers.  A Hogwarts-like house system, a specialized arts program, an audition for the school play the second week of school.  Going from a tiny school where every teacher knows and loves her, to an enormous school where no one knows her.  Going from being the oldest in the school to the youngest.  Lots and lots of changes.  Possibly enough to make anyone grumpy.   My therapist training had given me the skills to talk about this with kids.  But those were other people’s kids.  They were in my professional realm, not my personal one.  This was my own daughter.  Since I’m her mother, I am—by status, by role, and by virtue of the fact that I make her do things like make her bed and write thank-you notes—really annoying, which cuts down on the credibility I might have had with a tween client her age.   I had to choose my words and tread more carefully, wanting to be supportive, hoping to get her talking but not wanting to sound too therapist-y.

“Summer is ending,” I said, trying to sound neutral.  A cricket outside chortled its agreement.  “Think you might be feeling a little sad about that?”

“Maybe,” she said.

“And …” a deep breath, “middle school is coming up soon.  Any feelings about starting middle school?”

She assured me it wasn’t that.  “I can’t wait for middle school to start.”

But we talked a little more.  There were some details, she admitted, a few small ones, she might be wondering about.  Like the bus, like being in a House with the friends she’s got from elementary school.  Like some other stuff she hadn’t realized were on her mind.  We talked about the worries that she said weren’t really worries until her excitement about going to this big new place really took over.  Soon she was gushing about the cool things she’d heard from friends with older siblings who went there.  I’ve found this with clients too: when you’ve got mixed feelings about a transition: both thrills and doubts, you can only really enjoy the thrills once you’ve unpacked the doubts.   My daughter had moved on to the thrills, happily speculating about the future.  But I felt like I had to get in my therapeutic mama moment:

“It’s so normal,” I said.  “To worry about things even when you’re happy about them.  And sometimes, worries you don’t talk about can make you sad without knowing why.”  I was saying it after the fact; it might have been moot anyway at this point, but I said it.

“Hmm.”  She said, pretending to think it over, though really I think she was patronizing me.  She rolled over and went to sleep.  But I know she heard me.  And maybe next time the “grumpies” set in, we’ll have a good place to start.

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