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Social Support: The Cradle for Growth and Recovery with Eating Disorders
It was 1970. I learned at a young adolescent age to appreciate the value of support. I remember well my teacher, Mr. Monson, and his tall lanky frame, his worn black flood pants, his shortsleeved white shirt and black tie. I remember most his gentle kindness to a longhaired, tuned-out, and lost soul – an unlikely recipient. He said clearly, “I’ll be waiting for you after school to help you with your math.” I learned more than basic arithmetic. I learned that there are those who really care. Somehow, I wanted to be like him.
Social support is the support we receive from those around us which uplifts, assists, and gives a sense of connection and belonging. Social support involves the sharing of good times, and the giving and receiving of help through the rough times.
THE IMPORTANCE OF SOCIAL SUPPORT
Glenn and Nelsen (1989) teach us that our modern cultural trends have placed monumental stress on traditional support systems. These trends include: decreasing family interaction, fewer intergenerational associations, less family work, increasing divorce rates, increasing classroom size, and the replacement of creative family fun with chronic entertainment through television and other technologies.
Despite the external forces that decrease actual and real support and the feelings of being supported, most of us do too little to offset these trends. It will take active building and careful maintaining if we are to have support around ourselves and our loved ones.
The fast pace of our western society and the stressors of an everchanging world of technology, the economy, and the family brings with it stress and a host of stress-related problems. Basic to the ills and problems we face is the waning of family, neighborhood, community, and organizational ties and relationships. Ouchi and Jaeger (1978) refer to an increasing number of behavioral scientists who point to a “weakening of associational ties” as the basis for many of the social ills – mental illness, alcoholism, divorce, and crime. George Homans (1950) argues that without those relationships, people begin to have a variety of problems. He states:
“Now all the evidence of psychiatry . . . shows that membership in a group sustains a man, enables him to maintain his equilibrium under the ordinary shocks of life, and helps him bring up children who will in turn, be happy and resilient. If his group is shattered around him, if he leaves a group in which he was a valued member, and if, above all, he finds no new group to which he can relate himself, he will, under stress, develop disorders of thought, feelings, and behavior. . . The cycle is vicious; loss of group membership in one generation may make men less capable of group membership in the next. The civilization that, by its very process of growth, shatters small group life will leave men and women lonely and unhappy.” (pg. 457)
Social Support helps each of us to fulfill basic and critical needs. Everyone has a need to “feel a part of and to belong.” Each one of us has a basic need to feel important, wanted, needed and loved. Each of us needs the affiliation which comes from feelings of being valued and of being accepted.
SOCIAL SUPPORT BUFFERS THE EFFECTS OF STRESS
Social support is important in our lives because it lessens the consequences of physical and psychological stress. Research studies give the following examples:
- Heart attack victims who go home to even a pet are less likely to have another heart attack than those who go home to an empty house.
- Pregnant women with high stress and high support experienced complications in 37 percent of their births, while women with high stress and low support experienced complications 91 percent of the time.
- Men or women who are widowed, but have at least one confidant, are significantly less likely to die during the 24 months after the death of their spouse than those who lack such a confidant.
In the process of recovery from physical or emotional illness, addiction, and specifically eating disorders, social support is the very “cradle” in which recovery takes place. Support is equally necessary to ward against relapse, and it brings recovery into a shared experience in which love is exchanged and progress celebrated. Whatever the source – God, loved ones, friends, or self – support is a healing experience.
KINDS OF SUPPORT
In a model of social support proposed by Berrett and Cox (1983), the following main kinds of support are delineated:
- Assistance – giving or receiving aid or material goods
- Belonging – feeling that one is "a part of," and an important member of a common cause
- Emotional – encouragement, understanding, personal warmth, empathy, unconditional love
- Feedback – giving information of appraisal, comparison, validation, or constructive criticism
- Information – imparting specific knowledge, the gift of advice, suggestion, or direction
- Relief – providing fun, pleasure, distraction from the tasks of life, a "get away"
DIMENSIONS OF SUPPORT
There are three primary dimensions of support. Each one is important in the process of recovery from eating disorders and related addictive or emotional illnesses. They are as follows:
- The support we receive from others
- The support we give to others
- The support we give to ourselves
While support has three dimensions, it can also be viewed as having “two sides.” It is a process of reciprocity. Billy Graham (1993) said, “God has given us two hands – one to receive with and the other to give with.”
It is important that we all learn to ask for, and receive, help from others. It has been said that there are no people without problems, while there are both healthy and unhealthy people. Healthy people are those who admit their problems, work hard to overcome them, and have learned to ask directly for and accept help in overcoming their weaknesses. Asking for help requires humility and a willingness to learn from others. To receive support and learn requires a decrease in pride, and an increase in facing fear. Eric Hoffer (1963) described well the consequence of an unwillingness to be a true learner: “In times of change learners inherit the earth while the learned find themselves beautifully equipped to deal with a world that no longer exists.” Learn to seek support, and to learn at the feet of another.
It is important that we all learn to give support to others, that is, to extend ourselves in the benefit and positive growth of another. It is important for each of us to recognize that we have talents to offer others, and that others count on us, want to be with us, and appreciate the presence that we are in their lives. Finally, it is important that we recognize that we can and do give support. Recognize that you have something great to give – and then give it! Giving support helps the giver as much as it helps those who receive. In a study by Berrett (1987), it was found that adolescents not only have a significant need to feel supported, but that they had an equally important need to know that they were indeed supportive to others, and that they thereby “make a difference” in the life of another. in the following story: Feinberg (2003) reminds us of the unknown yet significant impact of giving of oneself.
“In a suburb of Dallas known as Richardson, a small bright-eyed gentleman named Jim Hoyt manages his own bike store. The mom and pop shop, Richardson Bike Mart, is known throughout the community as a strong sponsor of bike racers, and Hoyt maintains a personal passion to help kids get started in the sport. Keeping an eye on the street front, Jim noticed a young woman who faithfully took her son to a nearby shop for fresh donuts each week. He began talking to the woman, discovered she was a single mom, and instinctively knew she was struggling to get by. Jim took an interest in the small family and decided to give the woman a discount on a bicycle: a Schwinn Mag Scrambler. The mom accepted the offer, and through the act of a stranger, seven-year-old Lance Armstrong was introduced to the world of biking. Describing the bike, Armstrong writes, ‘It was an ugly brown with yellow wheels, but I loved it. Why does any kid love a bike? It’s liberation and independence, your first set of wheels.’”
Armstrong would go on to set an unprecedented record of winning the gruesome Tour de France multiple times, and in 1996 he established the Lance Armstrong Foundation, a charity to aid the fight against cancer.
It’s important to give support to ourselves. What if we receive support from others, yet refuse to give support to ourselves? The support we receive from others has much less chance of making a difference in our lives unless we also learn the art of “self-support.” After all is said and done, it is ourselves on whom we must depend to be a generous gatekeeper, opening wide the door to both giving and receiving. If we ultimately do not learn to support and take care of ourselves, support from others may sadly become of little consequence.
In clinical practice, we are the lucky beneficiaries of seeing support in action on a regular basis. We have seen the best and the worst in the world of support. We hope the best for those we help, as typified in the words of Sheldon B. Kopp (1972):
“One pilgrim may help another as when a blind man carries one who is lame upon his back, so that together they may make a pilgrimage that neither could make alone.”
Preparing to be released from inpatient treatment at Center for Change, a young woman shared these thoughts and feelings with a group of women – her colleagues and companions in treatment. They were fellow pilgrims. She said:
“Each of you have touched me in such a way that cannot be expressed with words. For the first time in my life, I have experienced genuine love and compassion in true friendships. I did not think it was possible for me to be loved outside of the protection, even blinding shield of my family, but each of you have filled my soul with warmth. Every hug, every smile, and even every tear have allowed me to feel your love and the connection we have with each other. I thank you from the bottom of my heart for your acceptance and genuine friendship. . . . Your support, compassion, and inspiration have changed my life, and your willingness to let me in, to be a part of your lives, and support you along your journey have filled a deep hole within my heart that once left me in emptiness. The love and genuine inspiration from all of you will always remain within my heart even as we go our separate ways.” -- Past client, 2003
RECEIVING SUPPORT: A FEW SUGGESTIONS
Receiving support best involves self-assessment or appraisal of how one is doing in receiving support, building and nurturing a support system, and accepting and “letting it in.” I offer a few guidelines:
Assess your support system by drawing it on a piece of paper. Draw yourself in the middle of the page, and draw symbols or put the initials of those in your support system in placement on the paper which best represents their closeness, and/or relationship with you. (Keele and Hammond, 1988)
Carefully look at the drawing of your support system and then ask questions like: Is my support adequate? What is missing? Whom could I ask help from right now? With whom would I like to create a better and closer relationship?
- Decide what you need to do to encircle yourself with more support.
- Take one small step towards creating that support today
- Make sure you take successive steps every day.
- Find opportunities to ask for help, and then ask often.
- Avoid the seemingly safe, subtle, and ineffective indirect requests for help (such as hoping someone will notice your needs).
- Take a risk to ask others explicitly and directly for what you need.
- Remember, when you ask and allow others to help you, you give them the gift of knowing that what they have to offer is important, valued, and appreciated.
- Train and teach your loved ones on the specifics of the kind of support you need.
- Reach out and be a friend. That will bring friends into your life.
- Keep at it, and be patient, since it takes time and effort to nurture and develop good relationships.
GIVING SUPPORT TO OTHERS: A FEW SUGGESTIONS
Giving support and being a good support to others also requires self-appraisal, taking the risk of involvement and loving others, and developing a lifestyle of sharing and helping others along the path of life. I suggest a few ideas:
- Write down ten people who are most positively impacted by your support, friendship, helping hand, or love.
- Write down some of the talents, gifts, emotional support, and information which you share with others.
- Write down the names of three people you would like to give help or support to now or in the near future.
- Choose one person and take a supportive step today – a phone call, a letter sent, a kind act, a smile, an expression of gratitude or encouragement.
- Choose to take similar steps everyday.
- Choose someone with whom you would like to become closer or more emotionally intimate. Let them know of your hopes in that relationship, and begin to share with them and serve them.
- Remember, good friends accept you as you are, and great friends accept you as you are and then push you to become better. Have the courage to be a great friend.
- Spend your time giving love rather than trying to get it. As David Wilcox (1999) wrote, "The only love that lasts a lifetime is the love you give away."
GIVING YOURSELF SUPPORT: A FEW SUGGESTIONS
Finally, what about being one’s own best support? What would that look like? What would our lives be like if we truly became our own best friend, teacher, coach, mom and dad, and our own best advocate? Confidence and peace can replace that gnawing feeling of emptiness. I offer a few suggestions:
- Take responsibility for your own recovery. There are no magic wands. You must do the work.
- Quit worrying so much about who you can trust, and worry more about whether you can trust yourself to take good care of you. Then earn your own trust the hard way, by making and keeping promises to yourself.
- Dare to dream again, to have hope, to tell yourself and others the truth about what you want and hope for.
- Work hard on the most important priorities each day so that your dreams might come true over time.
- Have a voice, let it be expressed and heard, and respect and keep boundaries of self- respect in relationships.
- After mistakes, avoid self-judgment and punishment. Simply ponder the lessons, make corrections, and move on.
- Learn to recognize and acknowledge your goodness, the good intentions of your heart, and your gifts and talents. If you can't see them – look harder.
- Don't travel the path alone - invite others to come along with you.
- Be wise enough to make your spirituality the hub of the wheel in your life. Whether you believe in God, a higher power, nature, or the striving for a refined personal character – whatever it is, kneel often at that alter of belief as opposed to self-neglect.
- Treat yourself as if your importance, value, and worth are grand and immeasurable. That "as if," IS true. If you persist, the thoughts and feelings will eventually follow in a very real and genuine way.
In conclusion, someone with much wisdom pointed out: “As you open your hand in order to ‘let go’– you are in that moment open for something new.” So it is with support. It can seem scary to become vulnerable enough to receive support, and scary to give your gift, fearing it will be rejected or believing that what you have to give is not good. It takes courage to let go of the old beliefs: “I should be able to do it myself.” “Asking for help is weak.” “I don’t deserve help anyway.” Even if that “letting go” is for but a moment, it gives way to something new.
That “something new” for each of us can be a new sense of commitment to let love in, to freely give, and to advocate for oneself. That cradle of support holds us up, lifts our spirits, and provides calm during rougher times. May we, each one, have the wisdom, the courage, and the blessing to seek and share support.
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Berrett, M.E. & Cox, V. Social Support Assessment, Unpublished Manuscript, (1983)
Cochran, Michelle, Letter of Hope, (2003)
Feinberg, M. & Rockwell, N., Simple Acts of Faith, Harvest House Publishers, Eugene, OR, (2003)
Glenn, Stephen H. and Nelsen, Jane, Raising Self Reliant Children in a Self Indulgent World, Pri ma Publishing & Communications, Rocklin, C.A., (1989)
Graham, Billy, in Simple Acts of Faith, by Margaret Feinberg and Norman Rockwell, Harvest House Publishers, Eugene. OR, (2003)
Hoffer, Eric, The True Believer, Harper & Row Publishers, New York, N.Y. (1951)
Homans, G.C. The Human Group, Harcourt, Brace, and Company, New York, (1950)
Keele, Reba L., & Hammond, S, Support Systems: To Give and Receive, BYU Today, February, (1988)
Kopp, Sheldon, If You Meet The Buddha On The Hill, Kill Him: The Pilgrimage of Psychotherapy Patients, Science and Behavior Books, Palo Alto, CA ,(1972)
Ouchi, W. G., & Jaeger, F. M., Type Z Organization: Stability in the Midst of Mobility. Academy of Management Review, 3(2), 305-314.
Wicox, David., David Wilcox Underneath, Music CD, Vangaurd Records, Santa Monica, CA, (1999)