someone needs your advice

Hey guys, so someone wrote to me and said that she’d like to get advice from the people who comment on this blog, because they are so thoughtful and smart. I usually don’t do this sort of thing, but I wanted to share her question with you all. If you have a moment and some insight, I know she’d love to get your response. Thank you!

After months of secretly cutting, my husband’s young teen niece attempted suicide over the weekend and we are all reeling with how to reach her (and her younger sister). It is coming out that it is a case of severe bulimia and body dysmorphic disorder, and she has been admitted to the hospital for seven days of intensive counseling and rest.

My husband and I feel prepared to offer her our support, as we both have backgrounds with counseling and mental health, but we are concerned with the state of her immediate family and extended family, who regard mental health issues as voo-doo, the result of being “weak-minded” (their words). The niece’s immediate family has a history of alcohol abuse, while the extended family has a history of emotional and physical abuse (none of which is acknowledged by the patriarch, so no one has sought counseling except my husband). However, none of these issues are rated severe enough for the state to interfere or take the children away.

We also don’t know how much we can or should help in regards to our physical distance from the family and burgeoning estrangement from each of its members. My husband and I have been working on establishing boundaries and creating distance for a few years now, kind of a “save yourself!” mentality, but of course we cannot apply this to our under-age nieces who are suffering!

What can we do? How much is too much or how much is too little? Our plan is to offer emotional support however we can, but to aim to be role models from afar for the nieces and to keep the lines of communication open, but I would love to hear if anyone has a similar story or what to expect from a professional therapist/social worker’s opinion. 

And of course, let’s all take a moment for our hearts to break about the little string-bean of an athlete who hates herself and her body for not being attractive enough. Agh!

21 Comments »

Kate on September 13th 2012 in Uncategorized

21 Responses to “someone needs your advice”

  1. Melanie responded on 13 Sep 2012 at 12:32 pm #

    First of all, I am really sorry that someone you love is going through this. It is a really hard situation to be in for sure.

    I think you are on the right track with just offering as much support as you can, and letting her know you are there for her if she needs anything.

    As for the rest of the family, the distancing with the troubled adults is the best thing you can do. Nothing you say or do will help them. They need to want to make that change on their own. I know this because I spent many years battling drugs and alcohol. Nothing anyone said or did made any difference until a really horrible life event woke me up to what I was doing.

    I will keep your family, and especially your husband’s niece, in my positive thoughts. I hope she can get the help she needs and come out of this as unscathed as possible.

  2. Kristina responded on 13 Sep 2012 at 12:43 pm #

    I have a 15 yr old niece who went through the same thing this summer. Cutting herself, bullying other girls in her school, then having a breakdown and swallowed some pills and ended up in in-patient psych. Her family dynamic is strained; there are 6 children total in the house and each child does not get the individual/emotional support they all need because the parents, in my opinion, can be quite lazy in parenting and verbally abusive. Although there has been talk of taking her out of the family household and having her live with her grandma or another relative, I think the best approach us distant family members have is to offer OUR support to the family and our niece as much as we can. We visit her as often as we can and always offer our emotional support. There are 3 girls and 3 boys in the house and my husband and I take the 3 girls out as a group, and we always take each girl out individually as well so they know they are each uniqually appreciated. I was a teen that was a cutter and I still suffer from BDD. Looking back at myself during my teen-cutting years, I would want someone to just spend time with me, talk with me about my issues, and just tell me they love me. Taking her out of her usual environment and doing an activity that is different can help; going on a hike, go watch a play or movie that she likes, even taking her out to buy some ice cream and have girl-talk. Make a routine out of it. It will help her to know that there are other adults around her that she can count on when in crisis.

  3. Lola responded on 13 Sep 2012 at 12:51 pm #

    I highly, highly reccomend taking this problem to Captain Awkward (http://captainawkward.com/). You will find great advice and scripts for talking with your family.

  4. A. responded on 13 Sep 2012 at 12:52 pm #

    So sorry to hear about your niece. It must be hard to watch someone so young go through something so awful!

    I felt compelled to respond to your post because I have been through something similar to what your niece is going through. I am a survivor of rape and a couple other bad situations which, I’m sure, would’ve become rape if circumstances hadn’t interfered (someone walking in the room, etc.) I have received little to no support from my immediate family. I won’t go into details here but let’s just say my mom is the definition of a victim blamer, and one of my sisters is sadly following in her footsteps. It quickly became evident to me that I was not going to be able to rely on my immediate family (with whom I am otherwise very close) for support on this issue. I had to essentially build my own support system , which includes people such as a couple of close friends, a therapist, a doctor, etc.

    The reason I tell you all this is that it sounds like your niece is in a similar situation, where her immediate family won’t be able to offer much help and may even inhibit her healing with their belief that mental health issues are “voodoo.” She is going to need an outside support system, and that’s where you and your husband come in. At the very least, I would suggest that you call or e-mail her to just check in and see how things are going. There may be days where you are the only one offering compassion and a sympathetic ear. Not knowing your niece, I can’t say whether or not she’ll open up to you, but even knowing that you care will be a huge help to her. Because of your physical distance, it may also be a good idea to help her find a support system in her own area, such as close friends, teachers, school counselor, etc.

    One of the biggest factors in these situations is the sense of loneliness — I’m going through this, I think about it all the time, but no one else is going through it and I have no one to talk to. It’s completely isolating. So knowing that you’re thinking of her will hopefully help her feel less lonely & isolated. Thank you for your willingness to step up and support your niece through this difficult time. I know she will appreciate it, even if she isn’t able to talk about what’s going on at first.

  5. Kimmy Sue Ruby Lou responded on 13 Sep 2012 at 1:15 pm #

    My heart so completely goes out to you on this. My youngest daughter began cutting herself at age 10 and at one point even carved the word “fat” on her stomach. She is now 18, driving, working and getting ready to go to college. Every day is a challenge, but ongoing therapy and open communication has made a difference. Bottom line, it really isn’t about body image so much…but the body is something you can control when you don’t have control over anything else. Overcoming this form of self-loathing and pain has everything to do with discovering one’s personal power. She obviously feels “powerless” and no damned wonder. Feel free to contact me personally, because I have dealt with this as a mother for 8 years now. NOTE: it all began with a very nasty divorce and a very controlling and verbally (sometimes physically) abusive father. She can overcome this, but it won’t be easy and she will need all the “adult” help she can get. I will send my personal info to Kate and she can share with you!

  6. Lisa F responded on 13 Sep 2012 at 1:24 pm #

    I would recommend keeping in touch with your niece regularly so that she knows that there are other ways of living and that there are safe adults out there who support her.

    I would also recommend giving her the phone number of the National Suicide Prevention Lifeline, which is 800-273-TALK. It’s a free, confidential 24/7 crisis line that your niece can use any time she feels like she needs help immediately, needs to talk to someone outside of her family and is there any time of day or night (which even the most loving aunt and uncle may not be).

    When your niece is an adult, she will look back and be so grateful that her aunt and uncle were there for her.

  7. lik_11 responded on 13 Sep 2012 at 1:34 pm #

    As a former cutter and someone who has suffered crippling depression- I had an aunt who lived several hundred miles away from me. On her own volition, she would send me little care packages every couple of months. Sometimes there were homemade cookies, or stationary, craft projects. Nothing was too expensive, but she constantly showed me that she cared about me. Every note told me that she was thinking about me and loved me, but never pressured me to talk about it with her. Out of everything that anyone has ever done for me- hers meant the most. The quiet, supportive love that she provided was one of the most meaningful things in my whole life- and I still respect her so much for taking it upon herself to give to me.

  8. Loren responded on 13 Sep 2012 at 1:35 pm #

    I also immediately thought of Captain Awkward (http://captainawkward.com/) when I read this letter.

    I know that family affairs can get kind of messy and don’t want to encourage arguing or meddling in their lives. But is there a way you can get her out of thier house and spend more time with her? Do you live nearby? Do have children she can baby sit, or yard work or house work you can pay her to help you with? And art class you can sign up for together? This would get her out of the house, and get you and your husband (trained professionals?) a little more face time with her.
    Even without professional training you might have some luck, I know it is very hard for teenagers to open up to their parents.

    If her parents are refusing to pay for therapy, encourage her to talk to her school counselor who might have more power and better resources for changing their minds, or providing her alternatives.

    Also even if you do not believe she is in an abusive situation, please make sure she has a list of phone numbers for suicide and abuse hotlines. Write them down and hand them to her, send her an email or a link online.
    There is a list of some here.
    http://captainawkward.com/2012/09/11/san-francisco-meetup-and-admin-notes/

  9. Alex responded on 13 Sep 2012 at 1:57 pm #

    I think there are no shoulds or proper protocol, you need to dive in and risk losing family to save this kiddo. If the family wants you out you will need to know that you have done everything that you can to help her…sounds like she could use a break from her family, those are harsh words…could she come and stay with you? check out http://www.freeyouremotions.com…she is an amazing practitioner and can refer your niece to someone closer to her. This technique (it is alternative medicine for sure!) has changed me so dramatically in such a positive way, stripping away all old baggage and letting me shine in a way that I didn’t know was possible. It is worth exploring.
    Try to find a way to get this to her without her folk’s intervention.

  10. Kelly responded on 13 Sep 2012 at 2:04 pm #

    I will be praying for your neice and your family. My advice would echo what the other ladies have said, with the additional thought that each of us is unique and precious to God. Your neice would benefit from knowing that fact, and knowing that He loves her unconditionally. I sense that i will get a lot of flack for saying that, but those truths have helped me through some very dark times.

  11. Call Me Jo responded on 13 Sep 2012 at 4:08 pm #

    The fact that you are keeping a distance from this family may actually play a helpful role when making a meaningful connection with your nieces. Rather than play up the mental health aspect of your role, I would suggest using the internet (email, chat, etc.) as a way to form a stronger connection with the girls, allowing them to vent to someone who understands their family situation but who will clearly not disclose what is said to the other adults in their lives. Teenagers are often looking for a confidant, and if you can play that role, your positive influence (and yes, even your mental health background) will surely be able to help your nieces. Also, at the appropriate time, it wouldn’t hurt to mention how much you respect Beyonce, J-lo or Christina, all women who are curvy, own it, and have become more powerful because of it. Christina is an especially good example, because she’s gained a lot of weight over the years, faced criticism in the media for it, and doesn’t care…and is obviously gorgeous and more famous than ever.

  12. Bethany responded on 13 Sep 2012 at 4:26 pm #

    First of all, I’m so sorry you’re going through this. My heart goes out to your family.

    I was just like your niece. And my father, who I was sent to live with, also did not “believe” in mental illness. He certainly didn’t want to discuss it and believed that I did the things I did (which included self harm) for attention, period.

    So I lived in a house with a man who thought I was creating this elaborate illusion just for fun and games. It was hurtful. I don’t think he realized that, I think he thought he was just expressing his opinion. So, my first advice to your niece’s immediate family would be: Just because you’ve never felt or experienced something doesn’t mean that it isn’t real. And that opinions can be hurtful and damaging. They can only make things worse by expressing disbelief in her condition and issues.

    I felt very abandoned when I was going through those troublesome times. I was lonely. I felt like baggage that no one wanted to embrace or come near, lest I infect them with my sadness and cause chaos in their lives. I think the best thing you can do is establish contact with her and let her know, in no uncertain or wishy washy terms, that you care so so much. No judgement, no lengthy lectures or advice, just, “We’re here, we care, we love you and we have faith in your ability to recover from this.” Send her a care package, send her a book or a funny card. Just open the door and then leave it open. Not so wide that she ends up sleeping on your couch, but wide enough that if she ever needs someone to talk to and tell her it’s going to be ok, that she’ll know yours is a number she can call.

    Good luck.

  13. Christina McPants responded on 13 Sep 2012 at 4:52 pm #

    Oh my. First, I just want to give all three of you a hug. It sounds like this poor girl is not going to get the support she needs from her family and it sounds like you’re equipped to offer it. So, offer to be an escape for her – phone calls, have her over for weekends away if you can, that sort of thing.

  14. morgaine responded on 13 Sep 2012 at 5:10 pm #

    “Bottom line, it really isn’t about body image so much…but the body is something you can control when you don’t have control over anything else.”

    Absolutely this. Let her steer the conversation; offer her support on body image issues if that’s where she initially takes it. But after a while, help her go deeper. As a former bulimic, I’ve seen a lot of people make this mistake: focusing too intently on the body stuff and ignoring what’s behind it. No amount of “but you’re so beautiful!” will soothe the underlying turmoil.

  15. Katie responded on 13 Sep 2012 at 9:08 pm #

    I agree with all those who have mentioned “letting her steer the conversation,” etc. It seems she seeks a desire for control in her life. As much as you can, allow her to lead; affirm for her that she is in control of her future, don’t say things like “we think you need…” but instead things like “we love you and know you’re strong, you know best what you need, just let us know what that might be.”

    I’m sure you’re familiar with Erikson’s Psychosocial Stages (easily Google-able), I really like to re-read those when searching for guidance on working with young people. Helps to break down her history through the life stages and understand what she may need in terms of ego development.

    Then, also, if you haven’t already, find out exactly what your state’s laws are in regards to her rights, and what kind of rights does your husband have since she is his daughter?

    Best of luck; she is lucky to have you guys involved.
    -social worker

  16. Claire Allison responded on 14 Sep 2012 at 2:57 am #

    I agree with the commenter who suggested sending little care packages. Letters are good too. I was going through a rough patch in my depression once an called my best friend’s house, who lived in another province, and her mother answered and I ended up talking to her instead. The next day she sent me flowers with a card I have to this day. It really did change how I felt to know I was loved by someone, anyone. This girl needs love, and little tokens of it (cards, flowers, etc) are the best way for her to have a physical reminder that she is valued and would be missed in this world.

  17. Emily responded on 14 Sep 2012 at 10:12 am #

    I grew up in an environment like your niece. There is not much you can do, unfortunately. Her parents are creating a burden that she will have to deal with long into adulthood, as I am now. I have PTSD from the abuse I endured and my parents’ addictions that crippled them and left me to suffer on my own. This is now, as I said, my burden that I have to deal with daily. Just let her know that you care about her. That is really all you can do. It might help, it might not (various family members attempted to reach out to me at different points, and some I wanted to help me, some I didn’t want to). Do everything you can to let her know that her situation is not her fault. Be there for her whenever she decides she might need you. Let her stay with you if she wants to. If she’s like me, she will need refuge eventually from an abusive relationship or two or three. Best of luck to her.

  18. Anon responded on 15 Sep 2012 at 7:56 am #

    Your niece does need your support, and for you to just be really normal with her and show you’re there for her with a lot of consistent contact. Hang out a lot. Can she stay with you even for a weekend?
    I went through a period of cutting myself violently at the age of 14 and am only feeling comfortable talking about it now or even addressing it with myself at almost thirty. Regardless of how I feel about it now, the fact my forearms are sliced up is a constant reminder now as a professional woman of where I’ve come from – with a terrible and unsupportive, incompetent parenting structure and an unstable home, I had no support I trusted. I had an aunt and uncle I loved to stay with but they had their own business troubles at that time so were not emotionally available, and it was a lonely time.
    Looking back, it’s really obvious that like an eating disorder it’s an attempt at control when as a powerless child – which she is – you have no control over your surroundings and something in her environment she’s unhappy with.
    Just be there for her, and make sure she knows it. Don’t even talk about it or freak out. She’ll feel weird. Just be there. She’s lucky to have your concern.
    And she’ll be fine, she’s not psycho – just overwhelmed.

  19. mercury responded on 16 Sep 2012 at 5:45 am #

    I just want to endorse the suggestions already given, to just make simple gestures of contact that don’t necessarily involve big confrontations (which won’t work with such a large group with a toxic dynamic).

    I like others posting here had a messy family situation with severe anxiety, self-harm & decades of recovery as a result. The things which stick in my mind are the tiniest things- just a single message of support from a teacher, a brief postive, friendly comment from the friend of parents, things which made me feel a tiny bit more warm on the inside to counteract the chilling effects of family emotional nastiness.

    So my message would be don’t underestimate the power of small things to have an impact, you might want to give counselling but given the situation described, that might be difficult to do or even suggest.

    So just try to help her feel not totally alone – it may not seem to have much effect but it may be doing something underneath. Support her to seek out help if her family won’t do it – she may need to get stronger to do this but she needs the encouragement, as it may not even enter her mind as something that’s possible or justifiable given the family denial mentality. Small encouragements, little suggestions, keep it positive and not conditional. I wish all of you the very best.

  20. K responded on 16 Sep 2012 at 4:19 pm #

    I cut myself as a teenager and also had issues with food. No one knew. I had a lot of conflict with my mom and my dad was pretty passive. Even today (I don’t talk with my mom) but I need to call my dad if I want to talk – my mom doesn’t really try to have a relationship with me anymore and my dad won’t really do anything if he doesn’t hear from me in a while.

    I say this because I think *not* being passive is something you can do to help. Contact your niece and ask her what she’s up to. Send her a link to an article or song or funny video (about anything relevant that she’d like – not connected to these issues) and say I thought of you. Care packages are sweet too. I don’t think the commenter who received cookies mentioned having issues with food, but as someone who did have issues with – receiving a box full of sweets is the last thing I want.

    I think with a teenager you can also help her with the practicalities of getting out of that environment for college – or something. Obviously it doesn’t mean you have to pay for that, or to push her if she doesn’t want to – but I know I could have benefitted from advice on applications, financial aid forms and deadlines and so on.

    I would be careful with taking on her issues and trying to help her with them beyond listening and finding resources.

    I wish you the best. It’s nice that you want to help.

  21. Kate responded on 20 Sep 2012 at 1:14 pm #

    Thank you all so so much for these amazing responses. The asker is very appreciative and touched!