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As it is elsewhere, anorexia is a serious and growing problem in Christchurch, New Zealand, where I have been in practice as a medical herbalist since 1989. Each case is different and needs an individualised approach but there are some patterns and common ground that lead to some general recommendations given further below. Firstly however, from the clinic files, the following cases histories are shown to illustrate some individual approaches to this difficult and potentially very dangerous condition.
Andrea was 16 years old when I first met her with her parents. Every person I've met with anorexia would count as a 'tough case', it's almost always an extremely difficult condition to treat, but she immediately came to mind when I started thinking about a case history to share because she was in just such a bad way when we first met. Andrea was all bone and yellow skin. She was on a raft of powerful psycho-active medications and under constant watch from her exhausted and near-despairing parents. She'd already had two lengthy hospitalisations and a third admission was imminent if her weight did not increase above the dangerously low level it had got down to, again. The family had been referred to me by someone they knew and were coming in the hope that a different approach might help. Their specialist had told them that the window of opportunity to turn things around was rapidly shrinking and that Andrea was in danger of doing permanent organ damage. I also understood that it was only the threat of restraints and tube-feeding that had convinced her to let her parents bring her in to see me... Andrea huddled in her chair and looked out from her emaciated face with eyes that were wary, and suspicious. I suppose that, to her, I was just the next in a long line of well-meaning people who wanted to make her fat, in other words, another adversary that she would need to work out how to thwart to achieve her driving mission. No-one who has experienced a family member with bad anorexia, or who has worked with it, is in any doubt as to how serious it can be. It is a life-threatening disease with a frighteningly high mortality rate and, given the bare facts of a person who is hell-bent on starving themselves, seemingly to death, it can be utterly devastating to all those involved. To be of any help to a person with a chronic illness, you must be able to have a good connection with them and the first steps in developing that therapeutic relationship are always essential to get right. I needed to find a herbal medicine that would actually help her in a tangible way and that she would want to take, and we needed to make some kind of a start into the deep journey of healing that always requires that you attend to, and treat, the cause of what has gone wrong. There is no one right way for any of this. As mentioned earlier, there are some general recommendations below but what we used for Andrea would be completely different to another case. The next thing was to establish what she herself was struggling with the most, and I made it clear that I meant what she was struggling with the most physically. In her mind, of course, her primary struggle was that she believed she was overweight. An experienced anorexic will hide this and give the 'right answers' to people questioning them to show that they know they are underweight. But this is just an act that they can use to convince others and even themselves. Underlying the act is the reality that they still feel too fat and just want to get thinner and thinner! Moving past the thinking and psychology, I asked her about what was bothering her the most in how she felt physically from one day to the next and, like the majority of young people who have the condition badly, it was her badly dysfunctional digestive system and her profound fatigue that was giving her the most pain and suffering. Tiredness and one or more gut symptoms of pain, indigestion, constipation, bloating, nausea, almost always come with anorexia and, fortunately, these are areas in which herbal medicine typically excels. Listening to her reply, it was apparent that herbs such as Gentian and Dandelion root would be ideal allies to start with. In Andrea's case, I more than reinforced the point that the herbs could not possibly count towards being a food, I went to further lengths to explain that, by activating her digestive 'fire' that she would get more energy and that the better she was doing in this area the more she would be able to convert her food into metabolic energy instead of storing it, i.e. that this was a herb we give commonly give to people who need to lose weight! Any parents reading this, who are confused by this last point might imagine the look on Andrea's parents faces. It sounded to them (and more to the point to her) that the herbs would help her spend more energy and therefore potentially might help her to get even thinner. In other words, to do exactly the same thing as excess exercise can achieve, something nearly all anorexics have plenty of experience with too. It's not a trick. Bear with me a little while, sometimes you have to walk a mile in another person's shoes before you can understand where they are at and what they need. We got started with the following.
We make our own tinctures from organic dried herbs, so it might be important that you understand that the optimal dose range will vary with different preparations made by different companies or practitioners, The above liquid extracts were combined into a formula to make 210 mls. This will easily fit into a 200ml amber pharm round bottle and is enough to last approximately 4 weeks if taken at the maximum safe and effective dose of 4 mls twice a day, which is what we used. These herbs are some of the best in Nature to activate the digestion, any of them can be read about in more depth in the Herbal A-Z found here
Dosage, four capsules, once a day in the am. Hawthorn & Reishi are deeply nourishing herbal tonics to help with fatigue.
Dosage, four capsules, once a day in the evening or before bed. These are two of the best herbs to help achieve a deep and restful sleep. Something that also, of course, can go a long way to restore energy and wellbeing. The first step in the healing journey comes from Nature. We come to a point where we are unable to fix ourselves and then these ancient allies, the herbs, can help us to get well. The next step is the 'work'. It is what the patient does to help themselves. Underlying all the old ways of healing is an understanding that living organisms have the ability to self-repair, unless something is getting in the way. The 'work' is usually doing something to remove the obstacles that are getting in the way of that innate, self-healing intelligence. Anorexia is such a hard problem because the roots of it go so deep into the psyche. Dysmorphia, the altered body-image whereby a person sees themselves as still too fat when they are literally skeletal thin, is not something you can wish away by giving someone a good talking to. You have to go deeper, and you have to take it one step at a time. For Andrea, the beginning step was to stop focusing on the problem and to switch gears for a while. For several years it had consumed every conversation with her family every day. She had been to numerous therapists, child psychologists, psychiatrists, support groups, social workers and so forth. I understood the looming threat of hospitals and force-feeding but I also recognised that she wasn't there yet, we still had at least some time and, rather than be that next person in line with an answer for her anorexia, I said I wanted to put it aside for a while and help her to explore something more interesting. Young people hate to be bored, and she truly was bored of it! We talked about what else she could focus her attention on, what might be something that she would actually enjoy (which turned out to be a small list of quite normal things for a teenage girl) and then I asked everyone in the room to take a fortnight's holiday from anorexia. Hard advice for the parents, no doubt, who were in fear that they simply had to watch her like hawks every meal time whilst monitoring exactly how much exercise she did (in other words to perform the same function as the hospital without the benefit of only an 8 hour shift just so many times a week) But they did it, to their credit, and we met again a fortnight later. Andrea had not gained any weight, but she had not lost any either, and previously she had been steadily going downhill. She hated the taste of the liquid herbs, as I told her she would, but she was taking them anyway and grudgingly acknowledged that her gut was less sore, less bloated, less constipated. I don't know if she would have given much more away, but her parents, who again both came to the 2nd visit, said that she had been far nicer to live with, that she had even been making some jokes and that they had caught a few smiles... We had crossed the first and what is often the hardest hurdle. Making a start, establishing some trust, letting Nature help. My notes show that I saw Andrea 15 times in total. To put that in perspective, most of the people I meet with only need to come back just one or two times after their first visit. To be a good enough herbalist, you also need to be able to be a dietician, an exercise coach and a counsellor. After a few visits, it was just Andrea in the room. We had a lot of deep conversations about a lot of stuff. Spirituality, sexuality, life, death, love, the world... I'm not going to go into detail here, like I said, every case is different. I do want to make it clear that you aren't trying to guide a person towards your own way, it's nothing like that, you are simply trying to help them find theirs. I haven't yet met the person with anorexia who didn't have a deep, sensitive and suffering soul underneath all that crazy dieting, and exercising, They also have an extraordinary depth of sheer, bloody-minded will-power and, whilst Andrea's case is like others I've worked with, I fully recognise that the approach I'm describing is not at all the right way for everyone. However, I do see that, for a lot of bad health conditions, people can end up making things worse by excessively focusing on the condition rather than meeting the person where they are. The cure for most diseases is in Nature, in the self-correcting intelligent life -force inside a person, and sometimes you must remember to work with that power or you just end up giving more energy to the disease... Andrea used the liquid herbs for a few months and the capsules quite a lot longer. We last met when she was 18 and finally, at long last, was in a committed, physically intimate relationship with a boy who was about as crazy and mixed up as she was. Getting into some kind of, at least half-way, decent relationship with another human being is about the best cure I know for this dread disease. Once the power of love gets into the picture, and I don't just mean sexual love, though that is not separate from it, but that another person can love and accept them, warts and all, is when that 'mortido' (the opposite force to the libido) can start to take a rest and get into some kind of reasonable perspective. Andrea looked amazing the last time we met. Her whole life was still in front of her. I haven't seen her for years but there is a bond there and I know she will reach out if things get bad again. I believe she is better now, and I hope never have to see her again unless it is just for some herbs to help have a healthy pregnancy or some-such. People can and do 'grow out' of anorexia. Life is long, it has its suffering, but people can get better from just about anything if they survive and don't give up hope.
I first met Haydee when she was 14 and she had only recently been officially diagnosed with 'anorexia'. She'd had no hospital visits, no drugs, and not much previous therapy before we met. Her mother had been a patient of the clinic long ago for a quite serious health problem, so I was contacted reasonably early in the piece to see if I could be of any help. Haydee's case demonstrates a quite different approach and, as anyone will understand, anorexia has a wide spectrum of severity. Haydee wasn't in imminent danger, not yet anyway. No-one was threatening putting her into restraints, but something was clearly quite wrong and we needed to understand how her 'biography had become her biology' to work out what. Like many children in Christchurch, Haydee had been badly affected by the earthquakes of 2011. The catastrophic big shakes were traumatising enough, but the more than 10,000 aftershocks over the coming couple of years put many children and adults into a continual 'fight or flight' mode and gave rise to a lot of anxiety in our community. Some open questioning showed that Haydee, from a young age, had begun developing strategies to help her to feel safer. There is nothing inherently wrong with that but, instead of needing them less, as time went on her list of how things needed to be done and where things needed to be etc. got longer and harder to fulfil rather than shorter and easier. Eventually Haydee worked out that it was much harder to control the world around her than it was to control what she ate and how much she ran. One of the insidious things about anorexia is that, at least in the beginning, it can look like a person is just trying to be healthier. They reject junk foods and get interested in healthy eating, they get into a fitness routine that most people, naturally enough, think is great and only want to support. Hormones surely must play a big part in it too, at least for some. 2 years earlier, when she was 12, Haydee had started getting her period and her running and dieting had started up soon after. By the time we met, she had not had a period for over 6 months. We began with the following herbs
This formula makes 50mls, note that we make our own tinctures from dried organic herbs, so the best dose may vary with different preparations, but typically I use between 1 ml, which is about 20 drops and 2mls or approximately 40 drops. Each time I have seen someone who needs these herbs, I give them a dose then and there to see how they respond and to see if they need 1 ml (most people) or 2 mls (some people), and then I teach them how to take 3 deep breaths with a certain breathing technique called 7-11, more about that shortly. So long as the person can feel a subtle but characteristic 'scratchy' or 'slightly numb' sensation in the back of their throat followed by a subtle but characteristic 'warmth' in their chest then we know that the therapeutic threshold of the herbs has been achieved. If you watch someone who has had a dose of these herbs you will almost always see how, within about a minute, they get more colour in their face, their breathing deepens, their shoulders drop a little and they start to visibly relax. People's faces soften, and they often begin to smile. It is also very interesting to be gently holding the pulse before, during and after a dose. If you do this, then you can feel how the effective dose always slows, opens and relaxes the heart-beat; this is partly how I determine whether they just need 1 ml or more. Taking a bigger dose than the amount the person can palpably feel or obviously reacts to does not seem to work any better and may, in fact, be less helpful in the long run. That last point may sound counter-intuitive, but these are not mind-altering drugs, they are physical relaxants and you want to work with the body, not over it. People are told to use this formula as freely and frequently as they wish, and I warmly encourage them to use the herbs a lot, especially at first when they need to get out of a bad state. It is completely ok to use it multiple times a day and it has never been seen to do any kind of harm no matter how much a person uses it. The 7-11 breathing technique is described in detail along with other information about treating anxiety here Like Andrea, it was critical that we made a positive start with some medicine that she would palpably be able to feel working right away and this formula, along with the breathing, always helps people to relax. Further to that there was a lot of work to unwind the great ball of tangled string that was Haydee's nervous system. Again, like it seems with nearly all the people I have met with anorexia, there was a highly aware, conscious, sensitive mind beneath the craziness of the condition. I am certain that it is essential to make a personal connection with that underlying being for there to be a successful outcome of any kind of treatment plan. Haydee wasn't advised to de-emphasise the focus on her eating like Andrea was, but she needed to channel her nervous energy into something else and we had to be ready to evolve that over time. Facing fear is a big subject, and a complex one. If this is an area that resonates for you then, rather than try to compress that complexity into a nutshell that won't do it justice, I will invite you to read my thoughts in more detail in the section on emotional healing that begins here I saw Haydee 6 times over about a year and a half. Her eating and exercising balanced out reasonably easily and we didn't need a herbal hormonal treatment as her periods came back by themselves. She got very into making herbal teas and especially liked using the Relaxing tea (more about that here) but most of our work was in the counselling sphere. I think that the biggest turning point for her was when she realised that channelling her nervous energy into sports and school work made her really good at them! This was all several years ago at the time of writing, and partly what made me think of her case is that I have seen her mother recently, who tells me that she is now in a leadership position in her school and is already talking about doing training for a very serious career choice. Her mother still worries about her too much, as do good mothers all over the world. Would Haydee be a happier or a healthier person if she was a less intense or driven person? Perhaps, but it would be a dull world if at least some of us didn't push their limits and it's fair to say that she isn't self-destructing any more. Certainly, that intense energy is a lot better going out than it was being pushed in...
I want to briefly mention something about constitutions. I'm 99% certain that Andrea was an EB, an 'Elephant-Butterfly' and I'm reasonably sure that Haydee was a Tiger. However, you can usually only be definite about someone's constitution when they are fully grown and, as most people with anorexia are met when they are still teenagers, there's usually an element of doubt. In any case, this is not an essential area, just potentially a very helpful one, because this ancient way of understanding our differences, according to how we are naturally either hotter or cooler, and at the same time dryer or damper, can underpin an approach to what kinds of foods, herbs etc, will best help the person. Therefore if you, or someone you care for, are having troubles in this area, you may find it useful to learn more about the general subject of the constitutions starting here, and then perhaps try to work out which constitution you or they are by going here
After getting a sense of whether a person is naturally cooler or hotter, dryer or damper, another level of knowledge that can do much to develop a personal approach is to look into the healing cycle. This can give insight into what needs to be done to treat the cause and help healing happen naturally. There are four stages in the cycle; cleansing, activation, nourishment and rest, more about the cycle of healing here
Anorexia is like a nervous breakdown that happens in the flesh. It is a catastrophic crisis of identity. It is a confusing and frequently terrifying condition, and yet reacting to it with more fear only seems to make it worse in the long run. Unfortunately, the mainstream approach to anorexia does seem, for the large part, based on fear with the consequence of trying to control the person... There is a place for everything, and perhaps this is the exact intervention that some people need, however it also clearly doesn't serve many young people at all well... This was touched on in the beginning under 'finding a good herbalist', now I want to open it out to 'find a good anyone!'. Anorexia is just not a condition that a family should be trying to deal with without support. It's too hard and it's too potentially dangerous. In actual fact, I don't think it matters so much whether the person who is sought out for help works with the old ways of herbs etc, or whether they are in mainstream medicine. What does matter is that they take an interest, that they get involved, that they are ready to have a conversation about the 'why', and that they are ready and willing to give some guidance to address those deeper causes when its needed. I don't know what your personal circumstances are, and as it says at the bottom of all my articles, I strictly cannot treat or advise someone without first meeting them in person. But if I could talk with you I would ask questions such as, 'how are the mental health services in your area? How is your relationship with your general practitioner? Have you been to any therapists who have experience with anorexia and how do you feel about them and what they are doing? I don't think herbalism has the answer for anorexia. Nor do I think drugs, or psychiatry, or any other system or set of methods has the answer. However, what is consistent, is that any practitioner, from any field, who can establish a good therapeutic relationship with the person who is suffering from anorexia has the best chance to see them through to the other side of it. That said, I have to believe that a holistic approach is the most likely to help such a complex condition as anorexia because, if they are well trained and have embraced the principles and philosophy of the old ways of working with the whole person, the holistic practitioner they can have a conversation about diet just as easily as they can about matters of the heart or mind, and anorexia crosses all those borders.
Andrea's case above talked about why this is so important. It is a mistake to only focus on food; what's being eaten, how much is being eaten. The way the body processes and absorbs the food is just as important as what foods, and how much foods, are being eaten. Taking steps to improve digestion has been seen to bring about a foundational shift in the relationship to food. When the gut is working well, food doesn't sit there causing bloating and distension. When the 'fire' of digestion is burning better, then the person always feels better in themselves. Their badly damaged relationship to food has a much better chance of healing if they actually feel good after eating! Gentian can be a core strategy to get that fire burning, and again, detailed notes on how it works and how to take it and how it works are found here But no one herb is right for everyone and an equally valid approach could be to use those herbs that excel at soothing an acidic, painful gut. If the primary symptoms of indigestion involve things like reflux, or some other form of 'rising indigestion' then three of the best of all herbs to help this are Fennel, Catnip and Licorice root. The method to use these herbs, perhaps alongside a tea of Chamomile, Caraway and again Fennel, is written up in a separate article here Lastly, one of the most difficult digestive issues that can come up for a person with anorexia is constipation. Not eating, or eating so little that the body loses significant amounts of weight, tends to send a very strong message into the gut - namely 'don't let go! Alternately, or alongside, the person with anorexia may well have used large amounts of laxatives as part of their condition. This may have created an imbalance and/or a dependency that will need careful treatment to correct. In any case, a thoughtful, individualised approach is often needed... more here
With its full name anorexia nervosa, no-one is in any doubt that the nerves are the driving force behind the condition. People tend to focus nearly entirely on the psychological aspect of the nervous system but what tends to be less well understood is just how much physicality builds up behind any kind of chronic condition involving the nerves. Remember, the healing process is a journey where you take one step at a time. If the best way to help the nervous system is to treat excess anxiety, then there are a number of practical, effective strategies that are seen to consistently help written up here If poor sleep is the driving issue behind excess nervous tension, then study the article on insomnia here If an underlying depression is the biggest issue that needs help, then the best of what I know to help is written up in detail here Never give up. People can get better from just about anything with time and care. Anorexia is no different
Please understand that I cannot personally advise you without seeing you in my clinic. |
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