Introduction
This book started five years ago when my then fourteen-year-old daughter, Phoebe, was alternately throwing up in her school bathroom and starving herself at home. Somehow, at what seemed like warp speed, Phoebe went from being happy to being miserable. From not worrying about her weight to insisting on having two scales in her bathroom and memorizing the calorie count of every morsel of food. From not worrying about how she looked to freezing like a deer in the headlights in front of the nearest mirror and asking, "Do I look particularly fat today?" Day after day after day.
We took Phoebe to a therapist who suggested she draw pictures of rainbows. I went to a therapist who said, "She's such a beautiful girl. How can she have an eating disorder?" My husband and I talked to a psychopharmacologist who said it was probably all biochemical. "Oh, she's just having a hard time adjusting to a new town...to a new school...to adolescence...to two parents who are never home," said her school guidance counselor, hastily adding, "but two parents who love her very much."
Phoebe went to an eating disorder clinic where they gave her a healthful diet and told her all about the food pyramid. "Complex people have complex problems," suggested her pediatrician. "Just look at all the depression that runs in our family," my sister-in-law theorized. "It's all those Sylvia Plath books and Anne Sexton poems she's wallowing in," warned her teacher. And this dubiously positive pronouncement was offered by my mother: "Well, she certainly eats a lot for a girl with anorexia."
Phoebe was in crisis. I was in crisis. Our family was in crisis. And while her eating disorders slowly got better (with time, with family therapy, with counseling, with revelations), her body image issues remained. Phoebe, always precocious, might have been first on her block to obsess about her looks, but soon most of her friends had their own problems, too. And I gradually realized that most of America is caught up with body image issues. There's an absolute epidemic today of beautiful, accomplished adolescent girls who are convinced that they're fat and ugly, who believe that looks are everything and that their looks don't measure up to some impossible ideal. They are matched by loving and well-meaning mothers who feel blindsided, helpless, clueless, terrified, and guilty (sometimes all at once) and who invariably have their own unresolved body image issues.
Always a problem solver (instant when possible), when the problems became overwhelming, I read everything. I talked to every smart person I could find. I got conflicting opinions, outdated information, misinformation, suggestions that might have been helpful if Phoebe were ten. I read books written in some sort of academic shrink-y language I couldn't understand, breezy magazine articles that both minimized and oversimplified complex subjects, overwrought books with only worst-case scenarios. I saw TV shows on body image topics that sensationalized everything. I found bits and pieces of what sounded like good advice on the Internet but didn't know how reliable the sources were.
Oddly enough, it was when I read Mary Pipher's brilliantly insightful Reviving Ophelia that I felt the most helpless. While this was the one book that helped me get an overview and explained the magnitude of the problem, after I finished it, I still didn't have a clue about what to do with Phoebe. How was I to respond to her saying, "Will you look at how gross my stomach is?" when her stomach was as flat as a washboard? How was I to answer "What's wrong with my knees?" when there was nothing wrong with her knees? And when no matter what I said, she came back with, "Well, you have to say that, you're my mother."
Where was the book to help mothers like me who need to address body image problems, not just understand them? Where could mothers go for practical advice and straightforward strategies? Where could mothers get answers to the universal mother questions: "But what do I do now?" "What do I say to her?" "How do I get through to her?"
With all due modesty, I have to say there is no one less qualified on her own to write a body image book than I am. What I do have is a lot more painful experience than I would like to. And the right questions. Lots of them. Why does a beautiful, seemingly happy young girl feel so unbeautiful? Why does my daughter hate her body? Why is she so preoccupied with it? Why does she seem to hate parts of her body ("I hate my feet," "I hate my hips," "I hate my butt")? Why does she think she's fat when she wears a size two? Why is her self-esteem based on the circumference of her thighs? If she's smart enough to learn AP Physics and Honors Calculus, why can't she learn to love herself? Are we too close or not close enough? How do I know? Am I too concerned? And if I'm feeling this helpless and powerless, how can I get help from a husband who seems helpless, powerless, and clueless? Are other girls suffering the way my daughter is? Is every other mother sleeping soundly at night?
How can I help my daughter when I don't understand her and she won't talk to me? Why doesn't she take my advice? Is it a phase? Will she outgrow it? What does it mean? Who can I blame for her problems? Barbie, Kate Moss, Jenny Craig, the cute varsity football captain she's got a crush on, myself? Is it a question of blame at all? Do I even have the power to make my daughter's problems better or worse?
After I had all the right questions, I looked for someone with answers. Through some karmic miracle (maybe I had suffered enough in this lifetime) I found Phyllis Cohen, a New York psychotherapist specializing in adolescents, who after thirty years of practice, of teaching and writing and lecturing and listening, knows how serious and pervasive body image issues are. Phyllis's practice often includes mothers as well as adolescents, so she understands these issues from both vantage points. She knows that what is crucial to achieving success is the ongoing emotional education of both mothers and daughters. And no one is a better teacher than Phyllis.
Our shared goal was to write a book of fundamental lessons and advice, a book so practical, it wouldn't just be read, it would be used -- as a guide, a compass, and a road map. We two speak with one voice for mothers of daughters from thirteen to nineteen, to help you help your daughter with the staggering number of body image issues that come up on her radar screen from the moment she wakes up in the morning to the time she goes to bed at night. From looks to weight to glossy retouched magazine perfection to cosmetic surgery to disordered eating to eating disorders to mothers on diets to health clubs to makeup to depression to cutting to suicide to cyber relationships to sex to bare midriffs to bikinis to body piercing to MTV to numbers on the scale to SAT scores.
When we told people we were writing a book about body image issues, they frequently responded, "Oh, a book about eating disorders." Body image issues seem to have become synonymous with anorexia, bulimia, bingeing, starving, overeating, obesity -- the highly visible area of eating disorders. But body image is a much broader idea. It is linked to self-image, self-esteem, and self-confidence. It is the sense you have of yourself as a person. And once you see that body image is a much larger issue, you can begin to understand it in a larger and more accurate context.
The first question to be answered in this book is why so many body image problems exist in the first place. Many mothers correctly perceive that the passage from childhood to adulthood is a lot more complex for their daughters than it was for them. The pressure on adolescent girls is more intense; their choices are less clear; their reactions are more extreme. Today getting from twelve to twenty in one sane, self-confident piece is a challenge up there with scaling Mount Everest. The real difficulty lies in the fact that the teenage years are when these girls are defining themselves as individuals. These days most of that definition begins, and sometimes ends, with how they look. Who they are feels more about what's outside and less about what's inside, because they invest so much of their sense of self in their bodies.
So real problems exist; you're not imagining them. The next question is, how is your daughter likely to deal with these problems? She'll express her unhappiness through something that has to do with her body. Or (does this sound familiar?) she'll take it out on you.
So here the two of you are, often at loggerheads -- sometimes friendly and comfortable with each other, but more often skirmishing. You know how important it is to have a relationship with your daughter; the problem is, you just can't figure out how to relate. You want to talk to her about her school, her life, her friends, and her feelings. But if she wants to talk to you at all, she wants to talk about her hips (too big), her hair (too wavy), her thighs (too fat), her eyes (too whatever). Somehow all you have in common is the fact that you can't talk to each other. And if you ever swore to yourself that you would never behave toward your daughter the way your mother behaved toward you, this is probably the point where you find yourself doing exactly that. And with no more success than your mother had.
A first piece of advice: Do not despair. Do not give up. Do not think it's too late to make it better or do it differently. Know that in the course of helping your daughter develop a healthy body image, you will experience as many highs as lows, as much laughter as tears. Have faith that you and your daughter can have a mutually satisfying relationship and that you can effect positive changes. Why? Because you and your daughter love each other. You need each other and you both need a relationship that works. It may feel as though the girl you once loved is gone, along with all the familiar ties that connected the two of you, but be reassured. The mother-daughter bond that was formed when your daughter was an infant is still strong. No matter how deeply it may be buried under all the conflicts that have grown between you, the connection is still there and always will be, and you can find it when you start to look for it. Once you recover that bond, you will be able to do two vital things: start listening to your daughter and start learning from her. At the same time, this connection will help your daughter start to learn more about you as a person and to listen to what you have to say. This genuine mutual communication is the basis for a loving, supportive relationship.
To even begin to take a first positive step, you need to stop feeling guilty about everything. Stop blaming either your daughter or yourself for every argument that results from your daughter's hating her body, from your saying something critical to her, from her saying something mean to you. And no matter how many times she tells you that you don't do anything right, no matter how mean-spirited or verbally abusive she is, do not come away concluding, "She's right, I can't do or say anything right. She's impossible to understand. She hates me. I give up." You are doing lots of things right, and you'll do more. So don't devalue yourself.
For your daughter, it's all about testing. She's testing limits, she's testing reality, she's testing your love, she's testing your acceptance or rejection of who she is, and she's testing body boundaries. While she's being hysterical, hateful, and horrible, you need to be firm. As the grown-up in the relationship, it's your job to set boundaries. While you're setting limits about her body, remember that it's her body, not yours. If she's doing something risky (like having promiscuous sex, abusing drugs, bingeing and purging, or yo-yo dieting), then you must intervene. Otherwise, respect her boundaries.
To help make all of this less abstract, throughout the book we'll give you what you need: steps, strategies, suggestions, and templates.
Basically, your job is to figure out what isn't working and why, to find ways to better understand and connect with your daughter. Ours is to give you the tools to do this. If we do our job and you do yours, we'll reach our shared goal: your daughter will have a positive body image. You'll have your life back.
Two disclaimers: Phoebe (inspiration and intelligent reader) points out that, in her opinion, this book occasionally reads like one of those public television nature shows, where the announcer intones, "The young female is apt to be skittish, if not dangerous. She stays close to her pack and resists any attempt to lure her out of the bush." We ask any girl who reads the book to understand that we don't mean to talk about her as if she were a young gazelle or zebra.
The other disclaimer is that Phoebe (expert critic and stickler for accuracy) also points out that although we're not adolescent girls ourselves, we presume to speak for them and to know everything they're thinking and saying. We feel strongly that we have captured both the spirit and the essence of these girls without misrepresenting them, but the nature of a book like this is to universalize, generalize, and make some assumptions. We do presume smart readers. If you and your daughter (and Phoebe) don't take it totally literally, this book will make more sense.
Copyright © 2003 by Stephanie Pierson and Phyllis Cohen