In theory.
I have an adult tap student with a long-term eating disorder and she is currrently having an episode. Read; shrinking before my eyes. She's very nice and totally enthusiastic about, and committed to, tap-dancing. Tap is her 'happy-space'. It's lovely having someone who is that committed and passionate as a student and it's generally a pleasure to teach her. When she started she was in a good weight range and she tapped really well. Now that she's in the grip of an episode, her concentration is shot to bits, her energy is low, her execution is suffering and her memory is failing her. I can't believe she does this to herself. She said once something about being able to tap better when she was a lighter weight, which is just so WRONG. Being light on your feet is not about weight, it's about energy and posture, neither of which you have if you starve yourself.
I'm finding it really difficult to position myself on this. The little I know about her illness means that I could expect the following types of behaviour, particularly when she becomes malnourished.
attention-seeking
manipulative
deceitful
lack of persepctive.
I don't want to get drawn into this. Firstly because she is essentially a client and it behoves me to keep a professional distance. And secondly, I've got 2 small people to mother and protect and I don't want to take on any more.
On the other hand, I can't stop worrying about it. Part of this is that I am completely baffled by her. Why would she do it to herself? Why is she making that choice? She appears to have supportive parents and she sees her doctor weekly and she is very upfront about it and recognises what is going on. But still she won't eat. And, look, I do know it's an illness and that there are control issues, and that there are a myriad of psychological reasons, so I don't want to sound unsympathetic. I understand these things on an intellectual level but I still don't really get it.
The other part of my worry is fear of her collapsing on my watch. If her potassium levels were to drop there is a likelihood that she could go into cardiac arrest during class and I find that prospect deeply unnerving.
I already know about myself that I am No Good In An Emergency. Some people, like for instance Fixit, stay calm and think clearly. Other people, like me, get panicky and hysterical and end up needing their faces slapped. You know Tim-I'm-A-Teapot-Brooke-Taylor from the Goodies? That's me.
When I babysit my 5-year-old diabetic nephew I am a stress-bundle. I have to restrain myself from pricking the poor kid's finger every 30 minutes. Every time he has a low sugar reading in my care I have to ring my sister. Every time she tells me calmly give him a juice. Which, you know, I actually do know to do - Bronnie always leaves me very clear instructions - but the thinking part of my brain is not functioning at full capacity. One day he had a low in the morning [gave him a juice] and by the afternoon had a high of 27 [should be under 15] and I was literally hyperventilating and skittering round in circles as I rang her. It's okay, she said, I'm almost there and I'll deal with it. Fixit meanwhile was telling me to settle down and advising that we ought to at least re-do the test, in case the reading had been caused by sticky fingers (it hadn't but it was the right suggestion).So a full-on cardiac arrest in the tap studio? Would be a Very Bad Thing.
Thoughts would be good. I'm all scattered.
Oh, goodness; I went from laughing during your first paragraph to feeling anxious for you.
ReplyDeleteAdult tap student. Hmmm. So, no parents to call and consult. There are various links out there like this one, about "how to help a friend with an eating disorder":
http://www.bucknell.edu/x7842.xml
However, I'm not sure how much this really helps in your situation. She's seeing a doctor and apparently is still in a state of denial. You can try to not contribute to the problem, but you ultimately aren't responsible for it. She's ill; she may have to reach a fairly low state before she quits being in denial.
As for you and your well-being, my suggestion is that if she continues down this path and you're seriously concerned about her collapsing during class, you "fire" her as a client. I don't know how comfortable you'd be doing that, but I at least want to put the idea out there. Really, you don't need the liability or personal trauma of seeing someone you know have a heart attack or die. You don't need the pain of watching someone go downhill, either.
In the meantime, keep the number of emergency medical services prominently posted in your studio and keep a phone at hand. Printing out a list of heart attack symptoms like this one might also be a good idea: http://www.americanheart.org/presenter.jhtml?identifier=3053
It might also be worth calling an eating disorder hotline or a professional of some ilk to get some tips for dealing with the situation without getting drawn into it more. (But what do I know? Nothing.)
Good luck!
If I was in your class, you'd have the same fears - I'm so out of shape two minutes of tapping would kill me.
ReplyDeleteShe's not your responsibility ultimately. But I can see why you'd be on tenter hooks waiting...
Tanya has some good ideas. I'd want to talk to someone to find out what to look for, in case the worst happens.
ReplyDeleteI love the Goodies btw :)
You can't help her, sorry.
ReplyDeleteHow old is she ?
If she's past her 20's, she's firmly entrenched and there's no going back, despite any help she may be seeking. She's probably been self-harming for 20years already. Too long.
Shit like this, and people that won't help themselves is why I walked out on my Psychology degree in my final year. Doing actual sessions made me realise most people don't want to help themselves, they just want to whine and woe. Promises are hollow, advice isn't taken, re-lapses common. Deceit, common.
Lies - common.
I'm very cynical, but man, i've been on both sides, and it aint pretty.
I'm all for tough love.
Tell her you can't have her in your class any more until she starts respecting herself. Tell her hard-up that the fear of her dying on your floor freaks you out.
Put the ball in her court. Tell her you're worried about her energy levels and lack of stamina. Tell her she's letting down the team. Just tell her the truth, and don't pussyfoot.
Just do it.
Umm...
ReplyDeleteA CPR intensive.
Not very helpful, am I?
I find this stuff as hard to deal with as you do. I want to drag them off to a 3rd world country by their hair, and put a cholera patient in their face and say "you want hard? This. Is hard."
Though of course I do no such thing.
So I'm totally the wrong person to be asking.
I think I agree with h&b - or maybe because I am just scared of her after reading the comment!!!!!!!She is right though she has to move in the direction of trying to help herself...although it is easy for us to judge isn't it? if your concern for her is causing you anxiety you may have to just tell the truth - be honest with her - you cannot teach her objectively and you are worried about her dropping dead in your class and that is too much for you.
ReplyDeleteMay the force be with you!
Oh stomper, I've got nothing useful to add, just lots of sympathy for your situation. How stressful for you.
ReplyDeleteHaving suffered from an eating disorder for over 10 years (although I've been relatively healthy for the last 10 years) I find it helps to remember that this is a mental illness - she has no control over what she is doing because she is mentally ill. I know that it is very hard for someone to understand if they haven't experienced it themselves but what she is feeling is very real etc. and she is probably unable to control what she does.
ReplyDeleteI agree with others that you can refuse to teach her because of your concerns about her health (maybe it will be a wake up call?) but ultimately she needs to help herself - which means going further and deeper - perhaps with a therapist rather than a doctor.
I also think that you could get support (in SA for example there is an eating disorder association that provides suppport for sufferers and for people who are impacted by the illness because they know or love someone with the condition).
Good luck & hugs
Em xx
Eugh, scattered sounds like a good word for it to me.
ReplyDeleteFor what it's worth... anorexia is a mental disorder. I was VERY encouraged when you wrote she's seeing a counsellor and has a supportive family and 'knows' where she's at. That is all good.
But you are right. You have people you have not choice but to worry about and take care of. There is a very legitimate concern on your part regarding her health and possible situations or issues occuring while she's under your tutelage.
Is it possible for you to talk to her counsellor for some tips and strategies for you?
Speaking as someone with a propensity to go brain crazy and an impressive history of my own eating disorders (although never at the thin edge of the wedge... so to speak) keeping things 'normal' and having activities etc that keep you in the community, rather than drifting off its periphery is very very important.
That or you could tell her about this blogger you know, who had a new boss with no managerial skills, no leadership ability and a really odd personality, who if that wasn't a big enough load for one person to bear, also had a really really large arse. And that she recently took up tap dancing and was apparently incredibly light-of-foot.
I am also quite the fan of tough love and could quite have easily written the comment mirroring h&b's. For what it's worth.
ReplyDeleteBut then, every time I have a depressive episode, I say, "I'm never going to let myself get to this place ever again." But I guess that is the sinister reality of mental illness.
In a practical sense: Do you have some sort of health information or disclaimer on your enrollment form? Or a policy about dance classes and illness? I know that your concerns are not with the legalities of dealing with an ill person, but maybe that could help. You could use the policy to support you when you let her know that you cannot be responsible for her collapse.
ReplyDeleteIn a supportive sense: this is very tough to deal with. You are not responsible for her decisions, but you don't want to have a crisis on your conscience.
Where mental illness is concerned, rationality is out the window, so don't even try and ask why? You can only know if you've been there and it's not a nice place.
ReplyDeleteSince she is aware of her illness and is open about it, I would suggest you ask her to provide a medical certificate saying she is OK to exercise, and/or that she is welcome to rejoin when she is on top of things again.
You can't save the world. The best you can hope for is not to be too near someone in the throes of self-destruction when they turn into a mushroom cloud.
ReplyDeleteAMHIK.
-J.
Dear SG, can I commend you on such a thoughtful and thought provoking post. The human condition, particularly in its contemporary form, raises some things that just fall into the dilemma category - ah, sweet mystery of life! In what you describe everything seems to be being handled by your client and her family in the best and most intelligent way - but these things, of themselves, do not effect a cure. You have had some marvellous suggestions made in the comments to consider. There is one other thing to consider in this matter and this is you. And what is the one factor in this situation you have control over? You. Could I suggest - but you may already do this - that you sit quietly regularly (but particularly before your client's class)to let your thoughts deal with themselves in this regard. The first and best thing for you is to keep your inner peace and equilibrium in all the aspects of this matter. This is how you can be of most value to yourselves and to others. This is what is an aid to clear thinking in a crisis. We may not all be as naturally gifted in this regard as Fixit but we can make some efforts of our own to move in that direction. I don't think she should be cast away or out of the class too readily. You do need to maintain your professionalism - to do otherwise would be foolish and can bring other ramifications. So I think she should only be asked to leave your class on the same basis as any other person might be: disruption, ignoring your instruction etc. I can't recall that you mentioned how long she has been in your class -but you might have. You see, one thing we human beings have difficulty with is time. We are impatient and do not have an expansive attitude to time, its effects, what it does. You have seen this client is good times and now in bad times. A good time might be imminent if we have the patience to wait and welcome it. On the other hand, it can be thwarted by our own impatience and restlessness. So, in a nutshell, my recommendations are personal peace; professionalism; and patience.
ReplyDeleteSome really good advice here.
ReplyDeleteBut I am with H & B.
It sounds like you are seeing the disorder rather than the person. This is not helping anybody. It would be upsetting if she collapsed in your studio but it could be worse if she did so when no one was areound. If it were to happen, you would call the paramedics just as you would for anyone else who had a problem. I think that I would try to treat her as a person and ignore the condition unless she is unable to dance.
ReplyDeleteeeek, I dunno, don't ask me!
ReplyDeleteBut H&B's advice sounded good!
I think...
Truthfully (and I too don't want to come across as unsympathetic but I am thinking "tough love" here) you are within your rights to ask her to not be a part of your class until she is well. She is actually putting you in an awkward position. As a caring instructor you do have a responsibility for the safety of your clients. She is putting the entire class in a scarry situation. What about an intervention?
ReplyDeleteI have to agree with some of the previous commenters: it's a mental disorder and there's really nothing you can do to 'help' in this case.
ReplyDeleteIf having her in your class is starting to seriously concern you, however, you might have to sit her down and gently explain to her that her presence is too 'disruptive' or too much of a concern for you to let her continue at the moment.
It's a hard position to be in... I wish you luck in dealing with it.
Hey Sis
ReplyDeleteMy wicked stepdaughter is also in the grips of an eating disorder, not to mention her drug and alcohol disorder, and resultant mood disorder, and she is naturally clinically depressed! Of course, she is a complete pain in the neck. A lot of it is self inflicted, but some of it she can't help, because of past stuff we've talked about. But the bottom line is that NOTHING will improve for her until she makes that decision to help herself (if she were reading this, I would say "for fuck's sake, when are you going to finally book into the clinic you've been referred too, in order to fix your life (not to mention ours too!", which of course, she currently won't do - even though the private health insurance I've maintained her on will PAY for the whole bloody thing!). It's very difficult, and v. stressful, and no wonder you feel like a bloody teapot. I am assured these disorders are valid mental illnesses, but until the sufferer admits they need to help themselves, there is nothing you can do. So you need to make a decision either to (1) not have her in your class if that's what will preserve your sanity, which you need for your own family (which is what I had to do with affore-mentioned WSD, I have just detached), or like others have said, (2) be as prepared as you can for a medical ememgency, which would basically involve phoning the 000 and letting THEM instruct you on what to do.
By the way, I turned into a bit of a teapot (well, actually after I'd calmly dealt with the wickedly low hypo) last night, when Heath's sugars fell so low last night I'm sure he almost passed out. 1.2 - holy fuck. After dinner/bath, he lost all function and rationality and I did actually worry he was going to collapse on me.
You do fine with Heath(even if you accidently phone me with a teapot question 1.5 minutes before the cup field is going to jump! I thought he'd gone unconscious on you when I saw it was your number!!!), and are always a huge source of wisdom and common sense!
love
Sis
Crap.
ReplyDeleteH&B is on the money.
But golly, I feel for you.