Several other mothers also described painful sibling and marital relationships as further fallout from having an eating disordered and/or mentally ill, addicted son or daughter. Elaine said that her daughter Jill’s eating disorder created a huge rift in the family: “Her brother told her she was stupid, that it was stupid,” and refused to attend any family therapy sessions after the first one. Elaine’s husband left it for her to handle: “Daddy was the good cop. We would argue at night, and he would say he wasn’t going to do this anymore, but by the next morning I knew somebody had to, so I would.”

And it wasn’t easy. Elaine said that Jill would leave school at 10:30 if she knew she had an 11:00 appointment at the Nutrition Clinic. “I would always find her, put her in the car, and take her kicking and screaming,” and added, “My anger got me through.” Jill’s nutritionist told Elaine to “handle the teenager, and I’ll handle the eating disorder.” But Elaine asked, “How do you separate the two?” This was a frequent dilemma we all faced as parents: where does normal teenage rebelliousness end and the disease begin?

Elaine also didn’t relate to the stereotypes of mothers as “Type A” and “super dominant” in the books she read, which only added to her frustration. When she sought therapy for herself, she learned to find inner peace and was told that it wasn’t her fault or something she could control. “I never went through thinking I was a terrible Mom.”

Her advice to other parents was to, “Go with your own convictions,” and to change therapists until you find one who is helpful. Finally, echoing what many others said, “It made me stronger—like I could handle anything.”

When Elaine and I spoke, Jill had been married in the past year and was teaching elementary school. She had had some minor relapses, such as losing twenty pounds before her wedding, but seemed to be holding her own and not letting the eating disorder regain the power it once had.

Another mother, Susan, whose then twenty-year-old son Tom was severely bi-polar and drug and alcohol addicted, said that her husband, like Elaine’s, laid the situation in her lap. He told Susan he believed Tom should be permanently hospitalized so they could go on with their lives, which she has been reluctant to do. “We still love each other, but this is ruining our marriage,” she said. What kept them together was not wanting to break the family apart more than Tom’s addiction and disease already had.

At the time we met, Susan had just learned that Tom had not been following the guidelines for being outpatient since his discharge a month before from the hospital where he was being treated for drug and alcohol addiction and mental illness. Her voice cracked and she started crying as she described telling Tom: “You either do what the professionals say, or I’m cutting you out of my life!”

Susan was exhausted. While Tom was in the hospital for two weeks she had driven nearly two hours each way to see him daily because he was so anxious and asked her to come. Before that, she would bring him his medicine several times a day because she knew he wouldn’t take it on his own. She was still shedding the belief that she, as Mother, was all-powerful and therefore responsible for keeping Tom alive. She said she knew it wasn’t her fault, especially with a family history of mental illness, alcoholism, and drug abuse on both sides. “But I can’t get rid of the regrets.”

Tom had been evicted from his last apartment because he allowed drug dealers to stay there. Now the doctors were recommending a 28-day program, which Tom was vehemently protesting. Besides the stress of making decisions about Tom’s care against his will and without her husband’s support, Susan noted that her daughter Beth, seventeen at the time, “has lived through Hell. She’s watched Tom try to kill me and try to kill himself and even assault others.”

Despite the trauma of seeing these behaviors in her brother, Beth would attempt to protect Tom from being tormented by fellow students and try to calm his outbursts at school. Even though Beth was angry with her brother, Susan said that Beth, “knows that in the end, when my husband and I are no longer around, she will probably have to take care of Tom.”

Setting that limit with Tom was the hardest thing Susan had ever done: “But I mean it, because I know if I don’t do something he’s going to die. “ Susan now believed that if she continued to rescue Tom as she repeatedly had, she wasn’t helping him. “He had to make the choice whether he wanted to be part of my life anymore (by following the rules of his hospital discharge plan). “I love my son more than anything. I couldn’t love him more, and I would never love him less. But he is taking a toll on my life that I don’t know if I’ll ever get back. And I want to be around to watch him get older, and for my daughter to go to college and get married. I want to be here for that.”

Susan would swim to shore on her own remaining strength. Valuing her own life may be the best motivation for Tom to survive the powerful undertow of his addiction and mental illness was still in question.