14year old asking for help

[shey02]

My 14 y.o. dd recently confided in her brother about being worried about her weight/shape, etc, she also told him that she had tried on a few occasions to make herself sick. She also asked that he told me, as she couldn't bring herself to do it.

We had a chat about it, it's not something that she wants to do, she feels overwhelmed by feelings of worry about her shape and looks. I looked up Body Dysmorphic Disorder and some of those things are also ringing a bell... She is extremely beautiful, but no longer sees it... it's very strange to me. Now the thing is, her BMI is underweight, we are an extremely active family, with lots of hobbies, she's very fit and in really great shape. If anything for the amount of activity she does, she needs more food and could do with carrying a few more pounds. So the thought of her purging/restricting herself is very concerning.

Obv. I am very worried. Problem is I feel for the first time in my life, I have no answers... Is it good to see a GP, for a counselling referral at this early stage. Am I jumping the gun? Any comments/advice would be greatly appreciated because I don't really know what to do right now. Thanks.

It's not too early to involve the GP. If current GP seems unfussed I would get her in front of someone else ASAP, go private if need be. She needs counselling. I would actually overstate it to the GP as much as you can without lying, because she is very vulnerable at that age and MUST talk to someone/get onto the radar so that if things suddenly go wrong, you aren't waiting weeks or months.

I know a girl who at 19 went from BMI 20 to BMI 14 within three months. If she starts to go downhill it can happen terrifyingly fast. Get her onto the waiting lists now, don't tarry.

It's wonderful that you're talking to her. You sound like a very good mother! All the best.

Thank you for your reply, I do try and we're very close, I just feel a bit out of my depth. She's such a great kid, I'm really not sure what has brought her to these feelings, so I've made the GP appt. I would not want to look back and think, why didn't I? Clearly she does need some counselling or some kind of cognitive behavioural therapy. Thank you again.

Eating disorders are often a subset of OCD type issues. I.e., large genetic component. It's not your fault or hers, or anyone's, probably. Try not to make it into a big "thing" where she must have been traumatised or something; it's just something that happens, sometimes for a biological/chemical reason and nothing more. And in therapy, she'll learn to cope with it and still thrive despite that challenge.

Apologies if you already know this...

If you know anything about OCD, you'll know that often, the "rituals" or obsession are driven by intrusive thoughts. The sufferer starts to believe that if they follow certain rituals, the intrusive thoughts will calm down. Unfortunately it becomes a cycle of ritual behaviours, because the rituals don't actually help, but the sufferer starts thinking it's because they didn't do the ritual "correctly". So they do it again and again. And never get it right -- because the thoughts never disappear. So then the self-loathing steps in, they ask themselves why they are so pathetic and useless that they can't stop the thoughts, etc. Leading to worse and worse intrusive thoughts. Terrible cycle.

The key to it all is that the sufferer needs to eventually recognise that it's the intrusive thoughts themselves that they need to learn to identify and look at rationally, and then ignore. That having the thoughts doesn't mean they're true, or something to be reacted to. So instead of trying to cope with the bad feelings and thoughts through rituals, they take a step back and refuse to engage. Eventually this starts to break the cycle, they regain a sense of mastery, and the self esteem comes back up again.

Some eating disorders are similar to this. There is a "voice" that tells the sufferer that if they just stop eating, xyz will get better, or they'll be a better person somehow, more popular, safer from harm, whatever. So replace the rituals in the above example, with not eating/restricting eating/creating complex rituals about eating, which she can never fully live up, obviously. Boom, spiral of loss of self esteem, same vicious cycle.

CBT will help your DD nip this in the bud. She'll learn to identify and deal with irrational thoughts about body image, before falling into that terrible hole of self-loathing. The earlier she gets into therapy, the better chance she'll have of gaining mastery.

She may not yet meet the full criteria required for a referral for treatment, but it is worth getting a proper assessment with the GP and community child and adolescent mental health service to see if they can or need to help at this stage.
It is really good news that she feels able to talk about it, as that is the starting point.
Two good books you could read would be getting better bit(e) by bit(e) (although that is more for adults) and, for you, Reviving Ophelia by Mary
Pipher (I think) (I read it about 15 years ago so sorry if it is not as good as I remember it being...)

But yes. A trip to the GP should be your first, next step.

Good luck. Don't blame yourself - in fact it is testimony to how good your parenting has been (and is) that she has come forward with this.

Thank you every one, I really appreciate that. The CBT thing is really making sense, the more I hear about it, I think it would really help her. And interestingly, about the OCD behaviour, throughout her childhood she has always been very, very tidy, obsessively so. She used to joke about being a bit OCD herself, ie. always having her drawers and shelves organised and her bedside cabinet top always with the same things, always the same position. If ever one was moved, she would know!

I will get those books Pabboo thanks for the recommendation.

Good luck, you can always post here for more support, I hope this proves to be something that can be quickly addressed, I wish I'd had early intervention and cbt before it got hold.

Thank you. We have the doctor's appointment for 3 days time and I discussed it with dd and she seemed okay with it.