I am really angry. My parents are accusing me of having an eating disorder, which I do not have. Now they say I can’t go away to college unless I gain 20 pounds! Twenty pounds! I think I will lose my mind if I cannot get away from their incessant nagging.

I have researched anorexia on the web. People who have it look emaciated and simultaneously believe they are fat. I am neither skeletal nor fat! I am slim, like the rest of my friends, nothing more, nothing less. What they may not understand is that I am constantly hungry, which is my response to stress, just like other people get headaches or stomach pains. If I were to eat whatever I wanted to eat, or whenever my parents were “at me” about eating, I would look like a blimp.

I thought maybe if I wrote to you, you would post something to show my parents that they are wrong. Frankly, they are the messed up ones, wanting their own daughter to look unattractive, especially to boys. As usual, they are trying to control me. It is infuriating. Can you please settle this?

Dr. J replies:

I can certainly hear how angry you are at your parents.
It would be helpful to try to separate out several issues that seem intertwined at present.

Eating problems are extremely prevalent in this culture, especially in young women, although some men have them as well. You may not meet the most stringent technical definition of anorexia, so you are correct about refuting that diagnosis. However, eating disorders exist on a spectrum, ranging from intrusive preoccupations with food and dieting, to serious, even life-threatening caloric restriction. Body image disturbances accompany anorexia as well. Other eating disorders, again on a spectrum of disturbance, involve binge eating, eccentric eating behaviors and bulimia ( cycles of binging and vomiting).

Even though you may not meet all the criteria for anorexia, at least not at present, you still fall someplace along the spectrum of eating disordered behavior. Some of the feelings and issues you describe are commonly part of the picture. I am struck by your feeling of horror at the thought of gaining weight, and I suspect that you are reacting to the injunction to gain weight, as much as to the number of pounds your parents suggest. I gather that as this moment you are experiencing your family as intrusive and manipulative, so food has become a way in which each side struggles for power and control.

I have no way of determining whether you are slim in a normal way, or slim in a distorted way, as you do not mention your height and weight. However, it is not my place to establish that, but if you distrust your parent’s assessment, perhaps another caring adult would have an opinion on this. Your family doctor or the school guidance department might be helpful consultants. Be aware that distortions in body image are present in most disordered eating syndromes, and but also occur without disordered eating in other syndromes. For example, men who are losing hair may feel they are already bald, or attractive people may feel ugly.

While you are clearly astute in assessing that your anxiety triggers hunger, you may also be hungry because you are restricting your food intake unnecessarily. I wonder about other aspects of your life style, ranging from skipping meals, or eating in unhealthy ways, to compulsive exercise or sleep deprivation.

Successful weight regulation is complex and involves eating adequate protein as well as eating in patterns that do not inadvertantly trigger the body into “starvation mode”, thus reducing the amount of calories that can be consumed without weight gain. All calories are not created equal in the sense that different foods eaten at different points in the day may be more or less likely to be “burned off” as opposed to “stored” as fat. There are as yet poorly understood genetic predispositions to weight gain. Finally, hormones as well as certain medications can also effect metabolism.

You and your parents are in a power struggle, a power struggle you can always win if you ignore the cost of your victory. If you view eating as a surrender to them, then of course you will resist eating. It is helpful that you know yourself well enough to know that hunger is your response to anxiety, but it is unclear what conflicts are producing that anxiety. People are anxious for both conscious and unconscious reasons. It sounds like your fear of losing control of your appetite, which may be a magical way of controlling something
else, such as your anger, may be leading you to compensate by maintaining too tight a control. I would wonder if you could figure out some some capacity for moderation without rigidity. Occasional “indulgences” might even reduce your chronic hunger. Sometimes simply reminding yourself that your body is trying to alert you, via hunger, to some other source of concern can make a difference. It is a subtle but important shift to value your body as kind of radar giving you helpful information, as opposed to an enemy you must defeat.

My husband and I have 2 daughters. The first one we conceived together, but after several years of trying for our second, we adopted a beautiful newborn girl. Fast forward to the present. Our oldest daughter has been “a force of nature”, just a very outgoing intense personality, gratifying but also a handful, pushing and testing us at every turn. But she’s a great girl, a good student, has friends and self-confidence. Her life is going well and we have no specific worries about her.

We were advised by the adoption agency to tell our second daughter that she was adopted early on… we told her when she was 7. I have often wondered if we should have waited. As she grew up she never seemed as secure as our other daughter. She was quiet and shy, almost “too good”. She also has asked us if we would ever put her up for adoption if she was “bad” or got bad grades in school. A heartbreaking question.

Now she is finishing high school and has a boyfriend… they are very involved. Most days they go to his house after school and have sex. This boy comes from a very dysfunctional family, and has few ambitions for himself. While I don’t like to be judgmental, I can’t help but feel the relationship is very unequal, and based on her insecurities about herself.

On her 18th birthday, she came home with her boyfriend’s name tattooed on her arm. SUPER conspicuous! My husband and I are shocked. I don’t understand why people get tattoos at all. A tattoo is irreversible! I am furious. I find it stupid and repulsive. My husband doesn’t like it but he says it is now “her life”. She is an adult in the eyes of the law. So…what is an appropriate response?

Dr. J replies,

My role is not to suggest anything specific to do, but rather some things to consider. Your daughter is struggling with what is and is not reversible in life. Her birth mother gave her up for adoption, and wonders if you and your spouse would ever do the same. While she may fear this, she may simultaneously have a fantasy that if you did give her up, she would get a better family, or certainly a different family. It is hard to be an adopted child when your sister is a biological child. It must also be hard for her to feel you love her as much as you love your biological daughter. Another common fantasy for adopted children is some hypothetical situation where her biological mother would reclaim her.

For an adopted child, aware that nothing can be taken for granted, even being raised by one’s own mother, the separation and individuation of growing up can be extremely threatening. Her boyfriend offers her love and support at a time of great vulnerability. Perhaps she senses your desire for her to leave home, not to be rid of her, but just to reclaim your adult life with your spouse.

Tatoos have become much more common although many parents find them distasteful and upsetting. The motivation to have them is very specific to each person, and more than one factor is usually at play. I can make only some speculations about your daughter.
She probably knows you will disapprove and hence she is experimenting with giving up her “good girl” persona. Yet she is still fears losing your love, so she waited until she was legally of age and you have less grounds to object. Tattoos are a means of proclaiming self and bodily ownership. Again there is a compromise in her decision; she gets a conspicuous and permanent tattoo, yet her boyfriend is about to be left behind, so the timing also is an acknowledgment that their relationship is transient. His name provides continuity with her past and a reminder that there is love to be found in other places besides home.

Returning to the theme of reversibility, it would not surprise me to learn that your daughter also knows there are procedures which can remove tattoos., that even these permanent emblems can disappear. Also, some provocative behavior from her is overdue: it is a sign she is growing stronger…it just surprises you because of her past docility. Reassure her that you will always be there to come home to, even she leaves for college, or “hooks up” with someone not to your liking.

Dr. J replies:

I think it would be helpful to think about whether you see your partner as collaborative or combative in general. If you usually function as a team and the situation with the dishes is an exception, you have two choices. Gracefully accept his version of clean, or do the dishes yourself. All relationships have hidden inequities, and, ironically each partner may feel he or she does just a bit more of the “work”. It is probably more important to keep your relationship intact than have him do the dishes. Role differentiation has been around a lot longer than role equality. No arrangement guarantees harmony.

My daughter is 15. We fight incessantly. My husband says I need to be the adult, but I get so enraged that I explode. This happens at least once a day and it is creating havoc in our household. Our son, who is 18, and college-bound, stays at his friend’s house because he hates the screaming. I feel like a failure as a mother. My husband, daughter and son all seem united “against me”. I feel that no one in the family respects me. Do you have any suggestions? I feel very discouraged.

Dr. J replies,

Fortunately, adolescence does not last forever. In the meantime, it seems that your daughter has split you and your husband, and he is being critical at a time when you desperately need his support. However, you have given your daughter the power to regulate your self-esteem, more power than is good for either of you. She is not your peer.
Your self esteem cannot rest on her approval. You will feel better about yourself when you get your own temper under control. Then you can feel like an adult with a steamy teen.

If your daughter has her own room, I suggest that the moment she begins to insult or demean you, you quietly yet firmly tell her to go to her room. Terminate any conversation in which there is obvious “attitude”. Tell her you are willing to talk when her tone is appropriate. This approach is amazing effective if you are unerringly consistent and speak from a place of clarity, not turmoil.

Another technique, which seems simplistic, may also be helpful. Walk away or even briefly leave the house…until you are back in control. Don’t hesitate to say you need time to reflect before you respond to a demand. As much as you and your daughter struggle, remember that she needs a mother, and wants you to be able to survive her attacks intact.

As for your son, the screaming may or may not be why he leaves home. He is at an age where he needs to separate.The tension provides a pretext in which he can experiment with leaving and returning.

Lastly, arrange to talk with other mothers, perhaps the mothers of your daughter’s friends. You are likely to hear some similar stories. This may shore up your shaky self-esteem.

Dr. J replies:

The fact that you realize it bothers you out of proportion to the real life event is a step in the right direction. Holidays always have special meanings, and it sounds like you feel entitled to have a wonderful meal on that particular day. But I wonder if the focus on the quality of the food is to compensate for something missing in the quality of the whole family being together. There are few relationships more inherently ambivalent than those between a woman and her mother-in-law. It is a relationship that easily lends itself to power struggles and loyalty concerns. I think that it would be helpful to think about whether your resentment has other deeper sources. And be glad that most of the time you get to control the quality of what you eat in a way that you can’t on this one day.