This is a series of letters between the therapist, Ann Epston and Julie (aged 17), her mother, Madeline and her father, William. They were joined by siblings and a friend at one meeting. In addition, there is a consultation letter to Yvonne, a school counsellor at a New Zealand High School and Anthea (aged l6).
9 August 1999
Dear Julie, Madeline and William:
I very much appreciated meeting you all, and I hope our meetings have been as worthwhile for you as for me. Julie, you said of your family’s previous ‘therapy’, “It killed me.” Has our anti-anorexic way of working together given you a flicker of hope for renewed living?
Julie, the impression I’ve gained from our conversations is of your being “an exceptionally good sports person”, “sociable”, “a leader”, popular, academically gifted, “very determined” and a committed Christian. From what you tell me, you set high standards for yourself, and when others came to expect these of you, the idea of “letting them down” was unthinkable. This combination of circumstances rendered you a sitting duck for Perfectionism, which sneaked in oh so imperceptibly under cover of your excellence. “Good enough” was never good enough, and somewhere along the way your own sense of entitlement was eclipsed by selflessness, and as your Dad put it bluntly, you became “a doormat”.
The vampire anorexia is always on the alert for a new taste sensation in our society’s smorgasbord of young women, and what could be more appealing treat than this tall poppy, devoted to others’ wishes and needs and oblivious to her own? What could be an easier target than someone already rendered compliant by Fear and Guilt , always swift to detect and punish any hint of rebellion? Have they made you suffer even more for daring to talk with me? Have they cracked down on you for starting to explore their ways and means? Have they told you it’s wrong and wicked to entertain the idea of self-fullness? How are they trying to persuade you that “there is no alternative” to your dutiful treadmill existence?
Julie, you said of anorexia- “It’s crazy that it should happen in my life.” Had you thought that only beauty queens and model wannabes succumbed to anorexia? Does the trail of events and ideas we’ve traced render the advent of anorexia any less crazy and more comprehensible? Are we starting to make sense of seemingly unconnected phenomena? Would this be worth exploring more?
Julie, Madeline and William: beware anorexia/perfectionism’s cunning trap- “If you are going to practise anti-anorexia, you have to do it immediately and perfectly!” That’s playing by its rules. We reserve the right to choose our own pace and TO MAKE MISTAKES.
15 August 1999
Dear Julie, Madeline & William
It was good to see you all again, and especially good to hear that our anti-anorexia has indeed sparked a flicker of hope for renewed living in you, Julie. Congratulations to you all on having already started an upward spiral of happiness, with each of you saying you’re happy that the others are happier.
It came as no surprise to me to learn that this has been “a hard week for Julie”, as William put it, in which you suffered as your Mum and Dad stood firm against anorexia and set clear guidelines. Friday night’s meeting must have felt the same if not even harder, as we wrestled with difficult questions. With anorexia enlisting Guilt to dissuade you, Julie, from exploring your own needs and preferences, it must have been particularly painful to have time, energy and money spent on discussing the fine details
of gym membership and attendance. Your brief, daring venture into self-fullness (“I love gym… the thought of going makes me so happy”) was swiftly condemned by anorexia/Guilt as selfishness (“How could you expect your poor parents to pay for something as frivolous as gym membership on top of everything else???”). And the spectacle of your parents debating how to counter anorexia’s predictable attempts to undermine your self-care was the last straw; you meekly withdrew and selflessly said, “I won’t go to the gym”. But we stuck it out and reiterated the theme of “Julie is entitled to pleasure, Julie deserves to do what she wants” as an antidote to Guilt’s propaganda.
Have you thought further about William’s observation apropos of your dietitians advice to stop doing aerobics “when you get tired?” Can a person on Perfectionism’s treadmill recognise when she’s tired? Does Perfectionism ever allow fatigue to cut short its unreasonable demands? Does anorexia declare tiredness a wimp’s excuse, not grounds for deserving rest? Would setting clear boundaries, e.g. “1/2 an hour” remove a weapon from anorexia’s armory? Would such a clear guideline serve Julie’s interests or anorexia’s? Would it be helpful to evaluate the effects of whatever system you’ve chosen?
We began examining how anorexia enlists guilt to try to isolate you, Julie, from your Mum’s loving strength and wisdom. Guilt plays on the the fact that Madeline has an elderly mother who needs her support, and it uses that to enforce selflessness in you, Julie,e.g. “Why should you waste your Mum’s time and energy when she’s got so many other worries – you’re just attention-seeking!” Madeline firmly and clearly refuted Guilt’s argument: “I LIKE Julie to talk to me; we have a close relationship and TALKING ABOUT THINGS HELPS.” Madeline went on to say that these discussions are only stressful if “there isn’t a happy ending.” But as William pointed out, it isn’t always possible for each to reach resolution by bedtime. I suggested that you might further undermine guilt by making a note of unresolved matters and putting it in a special worry-proof box before you fall asleep. If solutions don’t emerge by our next meeting you may choose to bring the box’s contents along to discuss further here. (No solutions guaranteed!)
We noted some more of anorexia’s techniques of power:
– invidious comparison (“You’re not as badly off as some other girls- so why
are you in therapy?”)
– guilt-tripping (“You don’t deserve having money spent on your
Why is anorexia so keen to stop you coming to therapy? Why does anorexia hate everything that’s good for you? Why does anorexia try to make money the bottom line? Why does it try to reduce the mystery of parental love to dollars and cents?
August 23rd, 1999
Dear Julie, Madeline and William:
I was sorry not to see you on Friday, William, but hope this letter and talking with Julie and Madeline will catch you up on our meeting. Do you feel doubly betrayed by anorexia’s assault on your father-daughter relationship? Was anorexia smirking with satisfaction when your anger and frustration boiled over onto Julie? What would anorexia have to gain if it succeeded in driving a wedge between you and Julie? What can you do to repair any damage suffered? How can anti-anorexia help ensure that in future anorexia cops the blame for the wrongs it commits?
This must have been a great week for anorexia. It must have felt smugly triumphant that, thanks to its predations, Julie was unable to enter the cross-country race you used to win. And what pleasure for anorexia to see you sidelined instead of playing netball against the staff! You said you felt “sad” at these two major losses, Julie, and agreed too with my question that you also felt a spark of anger. Is it not outrageous that a champion athlete should be stripped of her health, her strength, her energy, her enthusiasm, her stamina, her ability to participate, her joy in the workings of her body?
I want to fan that spark of anger until it becomes a bonfire of righteous rage that burns anorexia to ashes! For the unfairness of your deprivations and suffering is an outrage that is intolerable to anyone with a sense of justice. Is it intolerable that anorexia torments you by making you “sick and fearful” at even the thought of the food you so desperately need and hunger for? Is it despicable that anorexia teams up with Guilt and Perfectionism to demand dazzling exam marks of a starving student, with the obscene rationale that you got high marks before “when you were eating heaps less”? Julie, anorexia will try to fool you with its lies that “you’re just having a bad day. Things aren’t really bad enough to make a fuss about…just shut up and get on with it”. But Madeline and I saw the depths of your misery and we will never be silenced from speaking the truth, that YOU DON’T DESERVE THIS AGONY. You deserve happiness and freedom from torment.
And – no doubt to anorexia’s fury – you dared to create in this living hell a few moments of happiness on Wednesday when you went to aerobics with a friend. What strength did you draw upon to do so, Julie? How did you manage to remind yourself you were entitled to enjoyment? Did you succeed in working out for pure pleasure, or did anorexia turn it into torturecize? Did anorexia demand its pound of flesh in sadistic retaliation? Did Perfectionism set the rules? Did they try to argue – “You used to work out harder/longer when you were eating heaps less, so you have to surpass yourself now?” How did you stand up to their insidious attempts to take over?
We talked about William and Madeline’s plan to visit England in the next holidays – what a great example of self-fullness. And Julie agreed, with deep reluctance, that a backup team of friends and family should be invited to meet and get into anti-anorexic practice. Julie, without this support, you would be at the mercy of anorexia’s potentially lethal assaults. And William and Madeline would not have a moment’s peace of mind.
Julie, you cringed at the thought of prevailing upon other people’s time and energy, protesting that you “never had to depend on anyone before”, that you’ve always “managed by myself”. Julie, how might these ideals of rugged “go-it-alone’ independence provide encouragement to anorexia and its mates Guilt and Perfectionism? Why do they get roused to a fury when we discuss ideals of interdependence, mutuality, reciprocity and self-fullness?
I look forward to seeing you and guests at 5.30pm Friday.
Yours with hope,
Sept. 1st, 1999
Dear Julie, Madeline, William, Susan (older sister), Andrew (older brother) and Jen (closest girl-friend):
It was great to meet with you all and experience first-hand the loving determination you all bring to our anti-anorexic campaign. Julie, did Susan and Andrew and Jen’s truth – “We want to be here with you!” – speak louder than anorexia’s lies, e.g. ‘Everyone’s too busy to waste time on your petty concerns?’ Did their sincerity get through to your heart? Has anorexia tried to convince you they didn’t mean it? If it makes you doubt their words or motives, could you ask them if anorexia is telling the truth or telling lies about them?
We talked about what a support team needs to know and do to be on Julie’s side, and Madeline shared her knowledge with us. Emphasis was placed on:
- the need for constant reassurance, particularly that Julie is entitled to
- expression of her feelings, needs and wishes
- pleasurable exercise
- supporting Julie means respectfully endorsing her but NOT pitying her or treating her as ‘fragile.’
We agreed that an inspiring family motto might be -EVERYONE DESERVES HAPPINESS – and several budding artists offered their services in rendering this strikingly visible!
We also agreed to start listing anorexia’s lies (e.g.’ they aren’t having lunch so you don’t need to’) and contrasting them with truths (e.g. ‘everyone needs food’; ‘Julie needs and deserves nourishment’).
Remember: opposing anorexia means opposing its allies: guilt and perfectionism. How can we help Julie stand firm against guilt? Against Perfectionism? What do we encourage in their stead?
I look forward to another meeting at your convenience.
7 September 1999
Dear Julie, Madeline, William & Allies:
I was inspired by memories of our meetings when I met last night with a 13 year old and her parents. This innocent has stepped into anorexia’s trap, baited with dizzying promises of attractiveness, success and control and she has no inkling of the hideous price in anguish that will be exacted from her. Julie, my knowledge of your suffering has fuelled a most righteous anger and determination to save this child from years of the same torture.
Julie, what horror and agonies anorexia inflicts upon you, the back lashing for daring to defy its rule of unmitigated suffering. But no matter how anorexia/guilt/fear hate you for refusing to submit to exam pressures, for accepting your Dad & Mum’s invitation to accompany them on their overseas adventure (whoops, sorry, “Geography field excursion”), for actually enjoying food and relaxing at mealtimes, your bravery of spirit shines through.
It is so inspiring that no matter how battered, you remain steadfastly unbroken. This was evident in your “little glimpses of feeling good”; expressing humour in the face of anorexia; smiling; praying with friends; resting at the hospital and openly acknowledging your need for, and entitledness to, rest; eating a little chicken with the words, “Why shouldn’t I?”; enjoying and eating the last helping of fruit.
Of course this amazing series of tiny triumphs is anathema to anorexia, and it will be flailing around, trying to seize every weapon available to drive you back into its prison. But I truly believe you have turned the tide, and slowly inch by inch, you are reclaiming the pleasures of life to which you are so richly entitled.
Do you think that question, “Why shouldn’t I?” is a powerful refutation of anorexia’s presumption that it can dictate to you? Have you applied it to other rights, e.g. Why shouldn’t I smile/rest/spend school holidays with my parents?’ Why shouldn’t I go to England?’ (After all, anorexia, even rats fly first-class!)
Julie, Madeline and William, congratulations on making mealtimes into special family times, TV – free zones where you can relax together with conversation, fires and flowers. Does this create a sense of the sacredness of everyday life, do you think?
Your hug meant a lot to me, Julie – I could really feel your strength and determination. Let’s meet again before long.
F.O.A. (Fuck Off Anorexia)
Solitary ebony koru
You stand alone
Your tears etch a moku
In a placid sky
Kia Kaha ebony
Your frond stands tall
Amongst the suffocating
Fingers of ivy
grasping at your tears
Kia Kaha Koru
carve your strong story
like a moku
in our lives
by Julie, 15 Sept.99
21st September 1999
Dear Julie, Madeline and William:
I hope you are having a wonderful holiday in the far North of England. Although perfectionism has tried to make me write you a separate letter, I am quite certain that a copy of the one I sent Yvonne(school counsellor) and Anthea at Otago Girl’s High School (after reading it over the phone to Madeline) will stand as a true record of some of your family’s remarkable achievements against anorexia. I hope you’ll send a copy as usual to your general practitioner, with my regards. I look forward to hearing from you when you’ve recovered from jet-lag.
Julie, your purple bouquet is still lovely and has attracted lots of compliments. Thank you for that and for the unspoken but understood message it conveyed.
I shared your poem “FOA’ with David and we were both moved by the powerful language and imagery. All the more so as we have been marvelling this spring how some tree-fern logs (used as edging to borders in a courtyard garden we created) have refused to die. With their roots and crowns cut off, felled and laid horizontally they have sprung into new life, glorious fern branches unfolding in radiant determination. The garden is so much richer for their powerful affirmation of life. And we both said: Better ‘FOA’; than ‘DOA(Dead on Arrival).
Sept. 21st 1999
Dear Yvonne and Anthea:
Last week, I met with J. and her mother, who have recently turned the tide against anorexia. J. was most distressed to hear that Anthea had been captured by anorexia, but – said it felt “very soon and a bit scary to actually write down” details of her own struggles. Perfectionism might once have required J. to set her own wishes aside and attend immediately and at length to your fax, but she has recently begun listening to her own needs and preferences. Thus she chose not to reply, but has given me permission to tell you of some of her anti-anorexic practices.
- she and her teacher Mum took a fortnight off school to engage in pleasures
- strolling on the beach in the sun,
- pleasurable exercise (with Mum guarding lest anorexia turn it into torturecize),
- befriending a kuni-kuni pig as an ally in the art of pleasurable eating!
- took a ferry ride for fun,
- told friends J was recuperating and needed a break”. Thus they leave messages of encouragement, but J. is practising “self-fullness” and not replying , the way selflessness would have once forced her to.
- reading a novel, her first for 1999!
- saying “what do I really want?
- planting a fern, symbolic of growth,
- adopting as a family motto -‘Everyone deserves happiness’,
- learning that hunger invites anorexia to get louder; so avoiding hunger by snacking between meals,
- smiling, laughing, even joking at anorexia’s expense,
- using strong and disrespectful language against anorexia.
J. said her biggest achievement AND challenge was/is “getting familiar with entitlement” e.g. saying -“I deserve happiness/rest/food. . . .”
J’s mother added her wisdom:” “Bad days make you stronger in your opposition. Steel yourself to be more determined to get on top of it. Out of bad days, the good days are better – because you’re really determined to make them better. NEVER NEVER give up on hope”.
J. and her Mum and I hope that their ideas will help your escape mission.