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The 4 A's of Healthy Relationships

Topic: Eating DisordersBy Marty Lerner, Ph.D.Published Recently added

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One of the more challenging aspects of recovery from an eating disorder is learning to “navigate” through our relationships with family, friends, and co-workers. One certainty that exists for people regarding their ongoing relationships prior to entering recovery is that no relationship will “stay the same” once they begin and maintain their recovery from an eating disorder. It’s not unusual for people who care about us to want our eating disorder to end but are not necessarily prepared for the other changes that usual follow. These can include becoming more independent, and therefore less dependent on those who took on responsibilities for us, gaining a “voice” in decision making when we may have been inclined to let others make decisions for us, and setting new boundaries and limits on how people are treating us. These may be a few of the more obvious changes but there are many subtle “shifts” in our personalities as we emerge from the ashes of self-hate and isolation. Sometimes in a family system or social network we can find that “any act of independence (e.g. independent thinking) can be looked upon as an act of betrayal” and experience resistance to some of these changes as we begin to become our real selves. In effect, it’s important to anticipate that many of our relationships will go through “growing pains” with the result being either a permanent parting of the ways or a temporary parting with a coming back together with a newly defined relationship(s). Either way, our relationships will be stressed and tested in the short run but, in the long run, more healthy and satisfying.

Although no one is really the ultimate authority or expert on relationships, I would offer some suggested guidelines as to what elements need to exist for a relationship to be reasonably “healthy”… I like to refer to these as “the 4 A’s” The 4 A’s are the following criteria to be tested: 1. Attraction, 2. Affluence, 3. Availability, and 4. Appropriateness. Attraction refers to either the physical and/or personality aspects of a person. What is it that makes us attracted to this person, their character, their personality, their appearance, etc. Affluence not only refers to their “wealth” but, more importantly, their ability to be self supporting or self sufficient. Being affluent has to do with wanting to be with someone rather than “needing” to be with someone. Availability is about being both physically present as well as emotionally present. Someone who is physically there but emotionally distant is not an example of someone who is available. People who are “active” with an addiction or eating disorder tend to be “unavailable” compared to people who are in recovery. Appropriateness is about exhibiting acceptable behaviors in the context of any situation. What may be appropriate behavior or language in the locker room may not be appropriate for the dinner table, etc. Being appropriate is about exercising sound social judgment. In asking yourself if someone is appropriate you might consider whether you are proud to be with this person in all circumstances (e.g. with family, friends, co-workers).

When examining our existing relationships, we might consider whether the person or persons who are important to us exhibit these 4 A’s. If not, which are missing? Whether we would like to admit it or not, most relationships that fall short of any one of these elements are likely to not work well for us. Sometimes we find that the problem exists with someone in our family, perhaps a parent. In such instances we are bound to experience the stress involved with “re-formulating” and redefining the relationship from our end. Key to this remains our accepting that we are not likely to change others as much as we have the power to change ourselves. This brings us to the concluding point, namely that it is no so much about finding a person who has the 4 A’s but rather becoming the 4 A’s ourselves. Recovering from an eating disorder is the beginning.

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About the Author

Dr. Lerner is the founder and executive director of the Milestones in Recovery Eating Disorders Program located in Cooper City, Florida. A graduate of Nova Southeaste
University, Dr. Lerner is a licensed and board certified clinical psychologist who has specialized in the treatment of eating disorders since 1980. He has appeared on numerous national television and radio programs that include The NPR Report, 20/20, Discovery Health, and ABC’s Nightline as well authored several publications related to eating disorders in the professional literature, national magazines, and newspapers including USA Today, The Wall Street journal, New York Times, Miami Herald, Orlando and Hollywood Sun Sentinels. An active member of the professional community here in South Florida since finishing his training, Dr. Lerner makes his home in Davie with his wife Michele and daughters Janelle and Danielle and their dog, Reggie.

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