Bulimia & Anorexia in a Wilderness Therapy Program
A wilderness program is more likely to detect bulimia than a therapeutic boarding school, psychiatric hospital, residential treatment or wilderness program. In a wilderness program, a student may not demonstrate all of their symptoms until the third or fourth week.
Students with Bulimia and Anorexia have four primary problem areas. These include:
~ Control
~ Argument and Debate
~ Secretive Behaviors
~ Guilt and Shame
~ Obsession over weight
Behavior That Will Be Encountered In The Field:
>> Hiding food.
>> Arguing over certain foods they can or cannot eat.
>> Comments that they are fat, unattractive and need to loose weight despite evidence to the contrary.
>> A pattern of drifting to the perimeter of the group or asking to leave the group to void their bladder soon after eating an adequate or large meal and then purging their meal without staff awareness.
>> A recurrent and increasing pattern over time of emotionality, low frustration tolerance, mental dullness, physical weakness or complaints of being cold that are the result of insufficient nutrition.
>> Arguments and pleas to staff or other students to keep their bulimic behavior secret and to keep information about their disorder a secrete from other staff and students.
>> Asserting that they can be trusted to not hurt themselves while minimizing and referring to the health education and increasing concerns about their health as stupid or unnecessary in their case.
>> Shame and guilt expressed in withdrawn and avoidant behavior that may appear shy, indignant or controlling, and may become defiant, argumentative or aggressive if ignored or challenged.
>> Obsessed thinking that borders on a fixation that is contradictory, illogical and irrational with regard to nutrition, food choice, purging, weight loss, the method and risks.
>> Exercising unnecessarily or in a secrete manner when others are not watching.
>> Attempts to form a close and confiding relationship with a staff person (usually a female) to enlist their aide in persuading other staff to allow their behavior to continue and to separate their Bulimic or Anorexic behavior and the impact of that behavior from all other aspects of their program.
>> Using defiance in terms of a refusal to eat, and then offering to eat in order to negotiate permission with the program and staff to continue partial starvation and purging.
>> Increasing motivation to purge when emotionally distressed, nervous or feeling out of control following limit setting, confrontation or feedback by staff or peers that interprets the student behavior in terms of manipulation, escape, or an avoidance.
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