Surfacing After Silence

Life. After.

“older” women in treatment


Old Soul form Devianart.com

Someone brought up the subject of “older” women in treatment.  But really, it’s about being plain old adult women in treatment.  By “adult women” I mean late-twenties and thirties.  When I think “older women” I think retirement age and older.  (And I do think that topic needs to be addressed, too.)

My first time in treatment for the eating disorder I was one of the oldest at age 22.  The vast majority of the population were in high school.  The same thing was true the next couple of times.  I had a couple of people around my age.  And then there was the hospitalization where I was the only one not in high school or in the first two years of college.  One day at dinner, a patient looked at me and said, “I’m 14.  You’re 28.  That’s, like, twice my age.”  My reply: That is twice your age.  While I was in treatment at Sheppard Pratt, most people were high school or college aged, with a few of us “oldies” making up the rest.  Yup.  I was nearing 30 and was considered old.

It’s awkward being this age and needing treatment for an eating disorder.  I don’t have any ill will toward any of the younger people I have met in treatment or whom I talk with online.  That’s not what this is about.  Obviously, we all need/ed help and life throws groups of people together like that.  But there are some unique challenges that adult women in treatment centers face.

A) Hopefully, at some point, generally after college, you start dealing with a very different set of day-to-day concerns and issues that may or may not affect your eating disorder but are definitely affected by your eating disorder.  Talking to your boss about needing time off is different than talking to a college professor.  Insurance is a whole different ball game.  Money is a whole different ball game.

B) Family.  Family dynamics hopefully change as you get older as well.  For some, this means adults learning how to talk to their parents as adults and not children.  For some, this now involves spouses and children.  For some, this may mean including friends in family therapy rather than family members, as I chose to do at one hospital.

C) Interests, hobbies, topics of conversation.  There’s nothing wrong with teenagers talking in their lingo and listening to the popular music of the time, but sometimes the noise and adolescent drama can grate on adults’ nerves.  And I am fully aware that adults have been part of said drama.  So maybe drama isn’t the right word.  But the adolescent energy.  As a thirty year old, it was somewhat tiring to be around–physically tiring, I mean.

D) One of the difficult things for all ages on an eating disorder unit is body image and comparison to other patients.  “How thin am I compared to her?” (“Who is sicker?”)  What makes this especially difficult for adult women is that we’re comparing ourselves to people who haven’t finished puberty, or, in some cases, haven’t really started puberty yet (Sheppard Pratt does admit pre-pubescent ages).  Logically we may know that our hips have widened to give birth and no amount of starvation can change that, and our breasts have developed and our weight distribution has changed–but emotionally it’s hard to accept these things, especially when you’re already emotionally vulnerable and when you’re surrounded by it constantly.

These are just a few issues.  I know the first time I was at Sheppard Pratt, they had groups for people over 24.  And I loved those groups, because it was a chance to talk about all of the above things.  The second time I was there, they did away with that, and a lot of the groups veered toward parental relationships, especially parental control, and rules and living at home and living in the dorms and I noticed a lot of the adults kept silent.

I’m not saying that treatment wasn’t beneficial overall.  I am saying there were challenges my age group faced that were not addressed and generally do tend to get overlooked.

Most media focuses on eating disorders among high schoolers and college students.  Which sort of makes those of us over thirty think, “gee.  I’m too old to be dealing with this.  What’s wrong with me?”  And it also prevents a great deal of women from seeking treatment: the embarrassment of having a “teenager’s illness.”  There are treatment centers who won’t take women over a certain age–usually in the mid-twenties.  I remember when I finally made THE decision to do whatever it took to get better, I really wanted to go to Mercy Ministries and I was told I was too old.  I was 27.  One of the things I appreciated about being at Radar was that they didn’t take anyone below 18.  We got to talk about “adult stuff” all we wanted.

I’m not advocating having separate treatment centers for each age group, because where do you draw specific lines?, but also because there are a lot of issues that overlap age groups.  I just think that there should be groups for the different age groups so that age appropriate discussions can take place.

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April 2, 2010 - Posted by | Eating Disorders, therapy | , , , , , , , , , ,

14 Comments »

  1. did you have other theme for your site?? i think your theme is too strong brighteness

    Comment by Noctis Farrel | April 2, 2010 | Reply

    • sarcasm?

      Comment by surfacingaftersilence | April 2, 2010 | Reply

  2. ugh, it’s funny you mentioned this. i always felt like i was outside of a lot of the age groups. i turned 27, so i was too young to be in the 30s+ group but definitely felt out of place in the 20s group. and the teenagers, for the most part, drove me nuts.

    Comment by jessa | April 2, 2010 | Reply

  3. Since you mentioned SP, I’ve been around the middle of the age group (being 23-24) all the times I’ve been there. Yes, it was a bit annoying when the teens talked about trivial issues – but I guess in their world, it’s big. But there were also very mature teens who I bonded with. When I go to my appointments now, the majority of people I see are around my age (25). I’ve also seen quite a few more guys.

    I think (or at least, I hope) that things are changing. People are realising that eating disorders aren’t only a problem for teenage girls. I can understand a minimum age for treatment, but a maximum isn’t fair.

    Comment by Jen | April 2, 2010 | Reply

    • I think that if you are going to be treating very young patients, then there needs to be a separate unit for them. I know at Friends, the ED team treats the young patient, but they stay on the Peds unit. At SP, I saw one young patient come in obviously needing help, but by the time I left, she was so much worse because of all the things she was learning–all the bad things. She had never heard of purging before SP, and by the time I left, she was purging after every meal. And I didn’t mind teens talking about trivial stuff, because it’s not to them. but there is a type of drama that goes on in adolescence that can be annoying. And there are always people who are more mature, yes. I still feel the best treatment I received was at SP, but I liked it more when we had three different age groups for therapy groups

      Comment by surfacingaftersilence | April 2, 2010 | Reply

  4. When I was IP, for the majority of the time, I was the youngest by quite a bit and the only one not married, and I was 21 then. I was okay with it. I feel like I fit in better with them than people my age and younger. When younger people did come in I couldn’t relate to them very well.
    I wouldn’t have liked to be seperated by age in that case.

    Comment by Andi | April 2, 2010 | Reply

  5. I can relate completely to what you have said. I was 28 when I went to SP or treatment. I was there with kids as young as 11 and adults as old as 50. Talk about an age gap. I was among the majority and though I made friends, I did not feel like my treatment was as effective as if I could h ave talked about real “adult” issues instead of just staying quiet. They did separate groups, but for the most part there was not enough of us over 24 to have a group especially since they has separated IP and PHP. Thus we got pushed into the younger groups 16 & over.

    Then when i go to IOP we were all just grouped together. So again it was a matter of not really discussing things that might have otherwise been brought up. When I was upset by my day at work, or something, it was hard to relate.

    Don’t take me wrong, I have made some really good friends of all ages, however I think some time should have been set aside for groups for each age level.

    Comment by Becca | April 2, 2010 | Reply

  6. I was 39 when I went IP for the first time. There were some ladies around the same age but we were in with the ados as well. I was able to gain a lot of insight from the younger women in relation to dealing with my daughter who was around thier age. But you are right, there is so much “different” drama when you are younger. My issues were mainly around raising a family and dealing with an abusive spouse. Also, my eating disorder had started in my late teens and progressed through my twenties and thirties. Back then nobody knew how to deal with eating disorders. Getting back to the subject at hand, I do think it would be helpful if treatment facitilites would have age specific groups. It’s hard to talk about adult stressors when the younger one’s are talking more about who said what about this person etc.

    Comment by Cathy | April 3, 2010 | Reply

  7. Lex, I think this was a great topic for a post, and so needed. I think age is a huge thing that needs to be addressed for women with eating disorders. One of the thing I really APPRECIATED at Selah House WAS the variety in age. I was the youngest at 18 (the minimum age), and did appreciate that they set a minimum age–it meant that the women there WANTED to get better since they weren’t pushed into treatment by their parents. I was also with women in their 30’s and one who was in her late 50’s, and I’m so thankful all of them were there. I can’t guarantee they felt the same way about me, haha, but I truly learned so much from them, their life experiences, and wisdom.
    One of the things that really frustrates me about Mercy Ministries is the situation you were put in, and you are NOT the only one I have known who has been turned away for being “too old”, when they are barely 30.
    I can see the benefit of separating ages because of ALL the points you listed-I was 18 in treatment and don’t think I could have dealt with 14 year olds, so I can’t even imagine the new challenges that come as more time goes on! And I definitely think people can benefit from age specific groups. I do also think that people of all ages can really learn from each other, too.
    Again, so glad you wrote about this 🙂

    Comment by Mindy | April 3, 2010 | Reply

  8. I am glad you brought this point up, I am turning 24 in a couple months and I rmeber the first reactions my fiance gave me when I confessed my ED to him. He at first acted like I never told him at all, he didn’t think someone like me an adult would suffer from eating disorders. Now he is so loving and understanding, he is a huge savior for me. But I don’t have a vast network of friends, much less anyone with an ED, so being able to read stories like this are a HUGE help. Just knowing i’m not alone.

    I never sought treatment at a facility, and I think that is partly because I won’t never have the strength to admitt myself. But moreso the fact that I never looked sick. I am more the binge/purge type of ED, so I am skinny, but not shockingly thin enough for people to suspect anything. Its interesting that you can be terribly torn up inside mentally, b/p 2-3 times a day but if you look normal no one even notices. Its actually terrible… But at least I know I’m not alone, thank all of you for telling your story.

    Comment by mylifemywishfulthinking | April 4, 2010 | Reply

  9. I can relate to a lot of this. I’m 27; was 25 when I started this round of outpatient treatment. My treatment center only treats late adolescents and up, so I find that every group that I participate in has people my age and older in it (and sometimes younger people too), which is a REALLY nice change of pace from former treatment. I don’t mind having a mixed group, but in the past it has made me feel very much like an outsider or like I “should” be over my e.d. when I’ve been the oldest in the group. And then, yes, just the difference in day-to-day life is huge!

    I think the hardest thing for me, is being a full-fledged adult, being in a Ph.D. program for god’s sake, and still having times where I need my RD to call me at home because I’ve suddenly lost the ability to figure out how to feed myself, or needing to email my therapist in between sessions because I’m feeling an emotion and don’t know what to do. It sounds silly, but there it is. One thing that I really appreciate is that my treatment team has helped me understand that my brain just works differently and my circumstances are different – it’s not that I’m immature, stupid, etc. Also, they never make me feel incompetent or “weird’ that I’m 27 and need help with these seemingly “basic” tasks, and that really helps!

    Comment by Sayhealth | April 5, 2010 | Reply

  10. Great information! I’ve been looking for something like this for a while now. Thanks!

    Comment by emt training | April 11, 2010 | Reply

  11. I think that this is a very interesting topic. I went IP for the first and only time six years ago, when I was 17. I was in a unit that had women and men of all ages- some who were in their teens as I was, one girl who was either 11 or twelve, several women in their twenties, and then there were a few in their forties and fifties.

    While I had a hard time relating to the women in their forties and fifties, it was quite a wake-up call to be in treatment with them. Most of them developed their eating disorders when they were my age and I was able to see first-hand what my life would be like if I didn’t take charge of my recovery. I was forced to confront the realization that I would most likely be in and out of facilities, living what I refer to as a “half-life” – only being half there when the other half of you is consumed with eating disorder thoughts and behaviors.

    I truly realized that you don’t just grow out of an eating disorder, you have to WORK your way out. To this day I credit those women for saving my life, even if only as a living example of everything I never wanted to become.

    Today I consider myself to be fully recovered, and when I picture my future, it (thankfully) has nothing to do with treatment facilities.

    Comment by Rachel | April 12, 2010 | Reply

  12. quite a bit late on this one, but just wanted to put my vote in for “DON’T FORGET ABOUT THE OLD LADIES!” I mean that in the most affectionate of terms, since, of course, i AM an old lady:)

    Comment by slzu | May 12, 2010 | Reply


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