She Secretly Struggles with Bulimia & Alcohol

peepsandklucks has a high-functioning daughter who secretly struggles with bulimia and alcohol. As her daughter is looking for help with a loan to buy a home, mom wonders about striking a deal: treatment in exchange for co-signing…

"My 24-year-old daughter struggles with Bulimia and alcohol, both of which she denies. I realize that shame makes it hard to admit either issue to your own parents so we have both, separately and gently, discussed our love for her and our desire to help her, but she continues to deny that she needs help. I even got a little desperate and started emailing her info and leaving helpful information lying around the house (which only ended up in the garbage). Finally she sent an email that said, "STOP." I did. Maybe she feels that her issues are not so bad that she can't handle them – like a smoker who says, "I can quit any time, but not now because I enjoy smoking." Or that the alternative is worse (getting fat or anxiety in public). Or maybe it is just the shame of admitting she has these problems. Her older brother is a Radiologist and her younger brother is also studying to become a doctor. That could be a lot of pressure on a middle child.

Kim no longer lives at home. On the outside, everything looks great – she has a full time job, a stable boyfriend and shares a nice apartment on a golf course with a childhood girlfriend. But her addictions still haunt her and I have much less influence now that she has moved out. In a way, it is also a relief. Her addictions and the stress they cause me are not in my face everyday and I can actually pretend all is well. That's the way my husband wants to live. But I have been praying and waiting for an opportunity to help her. And I think the opportunity has arrived, but I need advice.

Kim wants to purchase a house. Her life-long dream has been to remodel homes (she may have grown up on too much HGTV). The market here in San Antonio is very strong, but she has no credit to get a loan. Therefore, we could go in with her and put the down payment on the house. We would all be on the mortgage, but she would be responsible for the payments (which would also help build her credit). And yes, she IS financially responsible. She graduated college and holds a job with medical insurance. We have no doubts that she would be able to manage the payments.

My question is, can I tell her that for us to help her with the house, she would need to get counseling. And to verify that she is sticking to counseling, she needs give permission for the doctor(s) and/or therapist(s) to discuss her situation with us (add us to the HIPAA form). My hope is that getting her life-long dream of a house is enough incentive to confront her addictions. Or am I, once again, being too optimistic and pushy. (We absolutely will not help her purchase a house without confirmation that she is working on recovery)

Kim has already walked away from multiple car accidents, of which three vehicles were completely totaled. Luckily, she has never gotten a DUI (probably because she never looks drunk – and the flask of vodka in her purse is very discrete). I fear that either she, or the driver of the other vehicle, will not walk away from the next one.

Please advise."
 

Welcome to the site. Your daughter is drinking alcohol in ways that don’t seem to affect her job or friends. She has, however, totaled three cars and you worry about the next time this happens. She is also bulimic. 

Bulimia and drinking is a growing problem in young women. Combined, the two can accelerate the harm caused by purging.

You are asking whether helping her purchase a home might be sufficiently rewarding that she would agree to treatment.

Before addressing the purchase of a home, I wonder if you have provided her also with treatment options for eating disorders? She could be more willing to address the bulimia than the drinking to start. Leaving treatment information lying around is a good idea. Perhaps you put it all together in one document and provide it to her in a moment when she is more willing to listen. Learning Module 8 talks about these moments, and how to orchestrate a planned talk. 

Should that planned talk include an offer to help with the house purchase? CRAFT suggests rewards as positive reinforcements for non-use. The reward should be easy for you to give, and easy for you to take away. Co-signing and help with a down-payment are not easy to take back. 

Your daughter can say all the right things now to convince you to help purchase the home, but down the road continue to use, struggle with bulimia and refuse to seek help. 

You are unwilling to help with the purchase of the home if she doesn’t seek help. 

I wonder if your daughter would be willing to complete a program and agree to follow its aftercare plan BEFORE you sit down and sign papers. 

This idea is less a reward as CRAFT suggests, but a straight up deal between you. Your daughter would get treatment, skills, and education about her eating problem and the drinking; she would be much more aware going forward of what she is doing. You would have given her insight, to the degree she is willing to listen, and provided her with a way out, should she start using and purging again. She would know about treatment and self-help, where to go. In AA, they say you will be messing up here drinking because when she uses in the future, she will have a belly full of booze and a head filled with AA.

There is a difference between someone who is legitimately unaware of the effects and dangers of what they are doing, who doesn’t have, or has not experienced, behaviors of healthy living….and someone who has. When and if they go back to problem drinking and bulimic purging, they are doing it with the knowledge of the mechanism inside them that fuels this, and of the solutions available to them when they lapse. 

Your daughter needs both the drinking and bulimia addressed in an integrated way. Would you be willing to co-sign and help with the down-payment AND pay (possibly, depending on insurance) for a quality long-term dual diagnosis program? It doesn’t need to be inpatient necessarily but may have to be in the case of bulimia (I know less about evidence-based programs for bulimia). Your daughter follows the program and the aftercare for 6 months or so, then you sit down and sign papers. 

You may not have a totally recovered daughter at the end of this but you will have moved her to the next stage of recovery: an informed young woman who has experienced a pause in the progression towards a more chronic situation. 

Your daughter has aspirations, she sounds creative and capable. This is the moment for her to make a choice as to how she wants to live. It’s an intersection of sorts…you are willing to help if she is willing to experience living a healthy lifestyle for 6 months. What she does afterwards is up to her. You will still love her and be there to help, regardless. 

You are looking to provide her with a huge step up towards her goals…the goals however are stunted if she continues to lead a secret and self-harming double life. The moment is now. Suggest to her that you as her parents are willing to make this deal. She can go back to her old life afterwards, and she will now have a house. You are aware of this possibility. You are providing her a critical piece of education by striking this deal. She has to expose herself to another way of life through the program (don’t say "treatment" anymore, sounds like she has a knee jerk reaction to the word)…that is what you ask in exchange for helping her obtain the house. 

BTW: she will probably see problems doing this with her job. She will need to ask for a health leave of absence. Yes, it is that serious.