As many of you know, I lost my brother recently. One month and twelve days ago, to be more exact. Why, exactly, we don't know. In general, we do know. Mental illness. Specifically, an untreated anxiety disorder and a raging food addiction. As a result of his death, I'm undergoing therapy myself. I don't have a mental health disorder to my knowledge, but I've got plenty of unresolved issues rooted in growing up in a family with an addict - in addition to all of the normal bereavement you'd expect.
So, my present to me for 2009 is a great therapist, and my New Year's resolution for 2009 is to get my shit worked out. This brings up three major issues. First, the benefit we could all have from a great therapist. Second, the freaking COST of a great therapist and our system's inadequacy at helping us afford it. Third, the prevalence of food addictions and our society's lack of recognition of them (and the achievable recovery from them, if you know someone afflicted).
First of all, let's talk about cost. Right now I'm paying $150 per week to see an excellent psychologist. She's got a PhD, she's a specialist in exactly my circumstance (adults losing siblings), and I love her. Yet, she's out of network. That's like the kiss of death. Out of network. I looked up who is IN network and found a bunch of psychiatrists (drug dealers, as my brother calls them), social workers, and MFTs - marriage & family therapists. Nobody who specializes in bereavement, much less adults losing siblings.
What does that mean? I could throw away a $20 copay per week and risk not getting the help I need by seeing somebody in network, or I can go to the doctor I want who is out of network and I can pay. Now, it's not like I'll have to pay every penny. Oh no. My terrific insurance plan will gladly cover about half of the cost, AFTER I meet the $2000 deductible. That means that a year of weekly sessions will run me about $5000. Thanks, American health care system.
But I'm lucky. I can afford this. I don't enjoy paying for it. I could easily travel across Europe for several months on less money than I am spending on therapy. But I consider this to be of utmost importance, so I'll do it. Now, how many people are there out there who are equally or MORE in need of therapy than me, who just plain old couldn't afford it even if they wanted to? There are people out there who have to choose between heat, food, and prescription drugs... mental health is not even an option.
There is one thing I knew while my brother was alive, and I have since confirmed that I was right in reading up on food addictions: My brother was not weak, bad, or stupid for eating too much. He was a victim. If you, or someone you know, has an eating problem - whether they binge, binge and purge, or starve themselves - they are not weak, bad, or stupid either.
My brother knew damn well that being fat was unhealthy, and that you get fat by eating too much (and too much of the wrong foods) and by sitting around on your butt. He knew that you get thin by exercising and eating moderate amounts of the right foods. And what's more - he WANTED to be a healthy weight. He wanted DESPERATELY to be a healthy weight. So why on earth would a person who knows better eat themselves to death? (Note: There are other circumstances that probably affected his death, like a prescription drug he was abusing, but no doubt his obesity and thus his eating played a role).
My brother was a victim. He had an illness. His brain reacted to certain foods (sugars, refined carbohydrates, and fats) as drugs. When my brother felt pain or sadness, those foods made him feel better. To some extent that happens to all people, like to some extent we all may have fun getting drunk on alcohol. But we're not all alcoholics just because we drink sometimes - that only happens to some of us. And we're not all food addicts even though we can feel good from food, but that's what happened to my brother.
A book I'm reading now - one that I recommend highly - called Anatomy of a Food Addiction by Anne Katherine - relates my brother's eating to Maslow's hierarchy of needs. Maslow ranks our needs as follows:
- Body needs - air, water, food, temperature
- Safety and protection from harm
- Status, approval, love, acceptance, belonging
- Competence, adequacy, security, self-esteem
- Curiosity, to know and understand
- Order, structure, system
- Self-actualization, exploration, newness, values, artistic expression, self-fulfillment, meaning
As Anne Katherine puts it "I can't remember that I want to be slimmer when I'm hanging on for deal life." Another good one liner from her is: "You don't decorate the house while the wind is smashing the windows."
Food rescued us in two important ways. It provided escape from fear, loneliness, misery, danger, and feeling trapped, taking us to a place where we felt warmth and belonging. Food made us secure and fulfilled. There are always new foods and new treats, new concoctions to buy or make, new flavors. Food gave us newness and exploration. We learned to substitute food for many of Maslow's ranked needs. We learned avoidance and substitution. - p.74
With my brother, I feel like we focused far too much on his weight. It was never the weight. It was the food - the drug. (There's a reason they call it Overeaters Anonymous, not Fatties Anonymous, or Obese People's Anonymous!) And it was a problem that underlied even that. His anxiety, depression, loneliness, shame, and his inability to meet his own basic (emotional) needs or even recognize that his emotional needs weren't being met! You can take away all of those foods that messed with his brain chemistry but if you don't fix the underlying problem, you end up with the equivalent of a dry drunk.
If you do suspect you - or somebody you know - has a food addiction, I strongly recommend this book.
What I found when I started reading about food addiction is that many of our shared early childhood experiences that led to his food addiction also impacted me. I just never developed a food addiction. I took those same influences and went in another direction.
The fact of the matter is that each of our parents were flawed. Some were flawed more than others, of course. If a parent beats or molests a child, they are far more flawed than any parent who was just doing the best they could and failed at the inhuman goal of perfection. So, in that context, my parents are flawed. I'm not angry or blaming them - it's just a fact of life.
As a child, you observe VERY well, but you don't necessarily interpret very well. You notice everything, but you don't say to yourself "My mom and dad love me very much, and they are doing the best they can. The truth is that THEIR parents didn't do a perfect job either, and they just aren't equipped to do a perfect job with me!" Nope, that's not the message you take. You come up with other explanations like "I'm bad," or "I'm not lovable." And then you come up with coping mechanisms - which in my brother's case took the form of addiction and proved lethal.
In this sense, I would characterize my problems as run-of-the-mill. That doesn't diminish the fact that they ARE problems and it's important to me to fix them... it's just an acknowledgment that imperfection is part of the human condition, and we could probably all benefit from a good therapist.
I suppose the point of writing this is to encourage anyone who can afford it, who has the courage to go do it, to find a great therapist and make yourself as healthy as you possibly can. It's not a political goal but it IS kind of the sense that Gandhi tells us to be the change we want to see in the world! And also - let's fix our system so that we can ALL afford a great therapist via universal single payor health care... this in/out of network bullshit MAKES ME MAD!