March 5, 2009
Doc talk
What's eating our kids?
By Dr Brian Yeo
Looking at the bright, pretty young executive in front of me, it was hard to comprehend why she regarded herself as a failure and an unattractive woman.
Every one to two days, Selena would go to the toilet and vomit in order to stay slim. She had become so used to this routine that she would binge on food that would be easier to throw up, choosing ice cream, bread and cookies.
Her habit had become so practised that she did not even have to stick her finger in her throat to induce the vomiting. It became automatic.
At home, she hid all this from her parents by kneeling next to the toilet bowl when she threw up, so that the surrounding area was not messed up. She then sprayed air freshener copiously in the bathroom.
There are many young people like Selena who, to the outside world, seem to have everything going for them: Good school, successful career, supportive parents and boyfriends.
However, beyond their stock answer that they do this to look slim and attractive, I invariably find another reason for their compulsive actions when I delve deeper.
Young people like Selena feel that they have lost control over their lives. Sadly, they believe that it is only through binge eating and the subsequent vomiting that they can achieve control over their weight - and hence their lives.
I have found that this need to have control over one's life runs as a persistent thread through the mindsets of almost all my young patients. In our hectic-paced world, many find things moving ahead of them and they do not seem to be able to dictate the direction and pace of their lives.
Thus, to escape from their helpless situation, some inflict cuts on themselves, some escape into another realm by playing computer games, yet others take recreational drugs.
Clueless parents are aghast at such actions, harking back to their own youth when life was hasher. In their eyes, today's youngsters have a much more comfortable life. So, they scold and punish them and deny them access to computer games.
Many would lecture their children and then arrange for more tuition time to try and divert their attention towards academic work, which can create a vicious circle.
Yet we keep missing the core issue behind their angst and frustration - a loss of control in their lives - when we keep focusing instead on their grades, their friends, their vomiting, their gaming or their self-wounding.
Behind the sullen or nonchalant demeanour, our youths still yearn for the approval of parents, even if this is not overtly expressed.
Parents should try and set aside regular time, say, over meals, to talk to them or even just be with them. Such moments may present opportunities for them to open up.
The first step for the caregivers is to be aware of the situation while trying not to pre-judge them.
Even when we are unsure of what to do and the situation becomes a crisis, all is not lost. Despite their rage, resentment and feelings of being misunderstood, these young people usually still realise that parents do care.
Even children placed by parents in compulsory counselling in programmes such as Beyond Parental Control do come around.
With the many changes in the education system and the proliferation of private education, there are many more opportunities for all our youths to reach their goals, unlike the limited standard education paths that we had in our school days a few decades ago.
Life is full of twists and turns. Parents may sometimes just have to hang in there and just be there if their children are not yet ready to listen. People do change, just as we do, although some just take longer. There is always hope.
Dr Brian Yeo is a consultant psychiatrist in private practice and adjunct associate professor in the department of psychological medicine at the Yong Loo Lin School of Medicine, National University of Singapore. He is also a certified master substance abuse counsellor and is currently the Singapore Medical Association representative to the Board of Management, Singapore Anti-Narcotics Association.
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