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Face-to-Face with EDs: An Interview with Holly Grishkat

by angelique on January 17th, 2008

This week’s Breaking the Mirror interview series ”Face-to-Face with EDs” is pleased to introduce readers to Holly Grishkat (pictured at right), Clinical Psychologist and Site Director of The Renfrew Center, Radnor, Pennsylvania.

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Breaking the Mirror (BtM):  How did you become interested in helping those with eating disorders? 

Holly Grishkat (HG):  Eating disorders are one area of mental health that is not typically included, to any great depth, in the academic training of a psychologist. 

After graduate school, I worked at a mental health center providing treatment to patients with a variety of disorders, eating disorders being one of them.  Through experience and supervision, I came to realize the tremendous impact an eating disorder can have on a person’s health, interpersonal relations, and emotional well-being. 

It also became clear that there weren’t many providers in the community that really knew anything about eating disorders.  It was around this time that I accepted a position with The Renfrew Center as a Team Leader in the Residential Treatment program and began an intensive study of the eating disorder world.

BtM:  There are many mature persons with eating disorders…how is life different for an eating disordered 50- year old than an eating disordered 15 year old?  What are the long-term ramifications of having an active (or mostly active) eating disorder for many decades?

HG:  Well, it is different and it is not.  The symptoms are pretty much the same at age 15 and 50.  Both populations binge, purge and restrict.  What are different are the issues, problems and needs that underlie the eating disorder. 

For instance, at 15 years old, most teens are worried about school, peers, boyfriends, dating, and so forth.  A 50 year old is well past these concerns in her life, for the most part. 

At 50, the stressors that women have to deal with are much different and include things like: divorce, step-parenting, death of parents, caring for aging parents, changes in health, mortality, and so on.

A second difference is women at age 50 coping with an eating disorder also must cope with the normal effects of ageing on the body. 

At 50, we are sagging and wrinkling.  We are getting grey hair and there are changes in skin tone.   Given that body image is a huge issue with eating disorders, you might say that the 50 year olds now have to deal with a double whammy – their body image distortions associated with the eating disorder, and also their body image in relation to the normal aging process.

A third major difference is physical/medical condition.  At 15 a girl/boy is usually just starting out on the eating disorder journey and may only have been engaging in symptoms a short time.  A woman at age 50 is likely to have had eating issues since she was at least 15 years old.  That means she may have been using symptoms to some degree, over the course of 35 years. 

Eating disorders can wreak havoc on a body and at age 50 women are now facing serious dental problems, osteoporosis, major gastrointestinal problems, and heart problems as a result of years and years of damage to their body.

BtM:  Do you see older men with eating disorders, or are your patients mainly older women?

HG:  At this time, The Renfrew Center only offers individual therapy, nutrition and psychiatry services for women. I don’t think we have seen enough men yet to make an accurate statement about men in treatment. 

In my 3 years of working at the outpatient site in Philadelphia, we’ve seen approximately 10 men–the youngest being in his 20s and the oldest in his 50s.  The few we have seen have come to us with a variety of eating disorders so it is difficult to comment on trends.

I think we still live in a culture that is very much focused on body image and demands that women (of any age) live up to society’s expectations of what a woman should look like.  The pressures on men are much less, but that is slowly changing.

BtM:  What are the most common reasons that drive lifelong anorexics and bulimics to come to Renfrew for help?

HG:  Many midlife women who come to Renfrew come because they are burned out.  They have been fighting this disorder for a long time and mentally and physically they just cannot do it any more.

Another reason is because mid-lifers now have children about the age they may have started their own eating disorder and they are afraid they will pass this on to their children. 

Eating disorders wreak havoc on relationships as well.  They may come because of a loss of yet another relationship.I think a big thing that drives midlife women to seek treatment is that it is now considered acceptable. 

They are getting “permission” from eating disorders centers like The Renfrew Center, to come into treatment.  They are hearing that it is okay to seek treatment at any age and that there are now places that offer special programming for women thirty and older. When they first began their eating disorder journey, treatment may not have been an option, either because it didn’t exist or because of the stigma associated with eating disorders at the time. 

For many years eating disorders have been an “illness of the young” so as these women grew older and continued with their symptoms, treatment probably felt further and further from their grasp. 

The Renfrew Center in Philadelphia and at the Radnor site offer programming for women in midlife who are coping with an eating disorder.

BtM:  What recovery methods work best for a person who has had an active eating disorder for half (or a higher percentage) of his/her life?

HG:  It will take patience and devotion to recovery and immense compassion for Self. 

After living with an eating disorder for many years, it almost becomes a part of who that person is; perhaps part of their personality.  That’s a tough thing to change and involves seeking to know who you are without the eating disorder. 

I will say that the thirty and older women that we see come into treatment are determined and apply themselves to recovery more so than the younger patients tend to do.  So even though it may be a more difficult road, their devotion to recovery helps them to stay on track and do the work they need to do for success in recovery.

With regard to specific methods?… I think women thirty and older need a space they can call their own.  They need to be able to have the space and time to devote to the stressors specific to their age group and find healthier coping skills, while still working, being a mother, and a wife. 

There are many, many methods of treatment out there and you need to find the right therapist and approach that works best for you.  Some times that takes some hunting, but it is worth it.

BtM:  What do you wish every older person with an eating disorder knew?

HG:  It’s not too late.  Even at 30, 40, and 50, there is hope for recovery.  We have seen women in treatment at The Renfrew Center in their 70s learning to take care of themselves and getting better!  It is no longer a disease of the youth but rather a disorder that can affect anyone regardless of age or gender.  It is acceptable to reach out and ask for help, because help is out there!

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I cannot thank Holly and the Renfrew Center enough for sharing her expertise with us. 

If you or a loved one is ready to explore treatment options, I urge you to connect with the compassionate, knowledgeable staff at The Renfrew Center, 1-800-RENFREW.

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