Choice of Therapist for Diana?

Duch_Luver_4ever · December 21, 2016, 05:14:17 AM

Something I thought about a couple mornings ago when i got up was why in the early years when they (RF) knew Diana had bulimia and was having her see therapists for depression (eg, she left Balmoral early one year to see one) why didnt they have her visit the one that Sarah did to deal with her eating disorder right away?

It seems odd that it took so many years and Carolyn Bartholomew to threaten to out her to get her to see that therapist. I know Diana spoke about how doctors always rush to push pills at women with depression and such, and her speeches always sounded like it was from first hand knowledge, I know in Vancouver in '86 they wanted to push pills on her to get her ready for her evening engagement after fainting.

Might be hindsight, but seems like a lot of years could have been saved by looking at the situation and say "hey two sisters have eating disorders, albeit different ones, one saw this doctor and got better, maybe we should try this first?"

What say you all?

TLLK · December 21, 2016, 05:27:38 AM

I'm close in age to Diana and I'd not heard of eating disorders until about 1979-1980. I believe it that in the 1980's it was still a frequently misunderstood condition and unfortunately it came with the stigma that is so often associated with mental illness. I do believe that therapists were trying to get an understanding of why people would feel the need to deny themselves food (anorexia nervosa) or binge eat and then vomit it back up (bulimia). It would still take years to discover why people would have the need to control their lives with these harmful actions and to find effective and long lasting treatment. Pills are quicker and would provide an immediate effect, but without psychiatric care with counseling their effects are short term.

Perhaps because Sarah had anorexia nervosa and Diana was bulimic, no one at the time considered that the two disorders were more related than previously thought. Also I'm not sure that Diana like so many with an eating disorder (ie: CP Victoria of Sweden) was ready to admit that she needed help. I'm sorry that Carolyn Bartholomew had to resort to such a drastic step but in truth she likely saved Diana's health with that intervention.

Duch_Luver_4ever · December 21, 2016, 05:24:23 PM

Very good points @TLLK I remember Karen Carpenter's decline and death was really the first "big celebrity" that died of an eating disorder in 83, if i recall, and it would take time, and im sure even today theres lots they still dont know about it. I remember at the time how baffled the public was that some who could "have it all" as a talented musician would do that to themselves, let alone a princess.

Its true that there might have been some thought that it was a different illness, and also, like a lot of ppl, she seemed to resist getting help, as she felt bad about herself not being able to handle everything. Sadly since she was in the middle of it she didnt give herself enough credit for taking on so much that few ppl would have been able to handle all that. But she was wise enough to know she needed rest and to be looked after, and for people to understand the torment in her head. (sadly few ppl knew but millions would have helped if asked, such was the sad ironies of her life)

Hopefully, the Rf has learned from her experience and let future wives take on duties more gradually. I'm sure too, the RF probably thought they had access to the "best" doctors and such, with traditional British classism at the time, kind of like the Downton Abbey episode where they go with the better heeled doctor when one of the girls is pregnant. I know its just a show, but I just mention it to highlight my example. Also sadly doctors tend to push pills, esp to women, as they like to claim the matter is "all in their head" when really its a real illness causes by traumas in life that we have such little understanding about, even today. It interesting though that she did see therapists, that they wouldnt have gone with that option, but also she might have not felt comfortable at that time going with her own choice in doctor.

Also as well, theres an element of hindsight as well, since we know that was what did the trick, so to speak, its natural to say, well why didnt we do it sooner? But like many things in the story of Diana's life, there's a combination of elements forming a delightfully maddening portrait of grey.

I also think Carolyn also probably saved her life as well and showed her mettle as a good friend. :flower:

michelle0187 · December 22, 2016, 06:56:39 PM

Some therapists don't like to have patients that are related. The personal information one family member trusts the therapist with, can make it difficult to not it let it affect the therapy sessions with the other. Similar eating disorders don't necessarily need the same method of treatment.

Duch_Luver_4ever · December 23, 2016, 06:16:58 AM

Good points @michelle0187 I hadnt thought of that!!

TLLK · December 23, 2016, 03:35:23 PM

I know that Sarah's psychiatrist Dr. Maurice Lipsedge treated her for the bulimia, but did she have another mental health care professional that she worked with?

royalanthropologist · December 23, 2016, 08:46:39 PM

You know, I have been thinking about the Spencers and to me that family seems far more dysfunctional than the Windsors were ever accused of. Two of the girls ended up with eating disorders and the son is an exhibit in how not to treat your wife/wives. I think the entire lot should have been in therapy :lol:. At least lady Di did her fair share of therapists. I remember reading a book where they took her from doctor to doctor until one of them told her that "there is nothing wrong with you apart from your husband.

Duch_Luver_4ever · December 24, 2016, 05:58:01 AM

Yes, that was what the doctor @TLLK mentioned said to her about her situation, and that in 6months she'd be a different person, and not soon after that was the showdown with C&C and the b-day party at Annabelle Elliot's.

Yes, she did see other mental health care professionals, such as susie orback(sp) in later years, and of course in early years the palace had a variety of doctors she saw, too tired to google them all.

IDK about a dysfunction match between both families, both are chock full of them, the Windsors have had the benefit of having courtiers and government working to try and keep their secrets to stay in their favor. True that pretty much Jane is the only one that came out of it relatively unscathed at the beginning, although I think the strain of being married to Robert Fellows and being Diana's sister from the late 80s to the end was hard on her. Her hair is grey and you can see the strain on her face, albeit, she still looks the closest to Diana and my template to what she might look like now.

Sarah being the oldest got to see the worst of the divorce close up, she used to play her records loud to drown out the arguments, she had alcohol problems as well. Jane being kind of in the middle might have been more insulated or on a more even keel, she seemed the most steady. Diana and Charles being the youngest, had the fewest tools for dealing with it. Also they both were haunted by the fact that neither of them might have been born had their older brother John, survived dying shortly after birth.

Divorce being a rarity for the nobility at that time, they got exposed to strains that other noble families didnt have maybe, or at least as out in the open as that, most families at that level had problems, but stuck it out for the estate, etc.

But then the Windsors have Charles with all his baggage of temper and insecurities, cowed by his parents, constantly needing reassurance, PP reduced him to tears the day before the funeral for Mountbatten to make sure he would cry on the day at dinner. Anne being more the son PP wished he had and the first to hit the divorce button, Andrew a layabout (Diana lamented his constant TV watching and golfing) whos known for his questionable business and trade dealings and air miles and being pals with Jeffrey Epstein(oh yeah, forgot Charles was buddies with Jimmy Saville), and Edward, rumors of "fabulousness" have dogged him for years, he went from dropping out of the marines, to his royal knockout press fiasco, then his media company getting him in a row with Charles over covering Will at college, they have their share of messed up stuff too.

Throw in Margaret, HM and PP and its a full deck of dysfunction.

But I believe the Spencers were once called "difficult people" and "good haters" and if you watch the Secrets of Althorp or read about the family history, there were enough clues that what happened could have been forseen. But I think the RF was either indifferent or overconfident, and as desperate to get Charles married off as Diana was to find a prince charming that wouldnt divorce her, and iceberg met titantic, so sad.....

amabel · March 11, 2017, 11:57:17 AM

Quote from: TLLK on December 21, 2016, 05:27:38 AM
I'm close in age to Diana and I'd not heard of eating disorders until about 1979-1980. I believe it that in the 1980's it was still a frequently misunderstood condition and unfortunately it came with the stigma that is so often associated with mental illness. I do believe that therapists were trying to get an understanding of why people would feel the need to deny themselves food (anorexia nervosa) or binge eat and then vomit it back up (bulimia). It would still take years to discover why people would have the need to control their lives with these harmful actions and to find effective and long lasting treatment. Pills are quicker and would provide an immediate effect, but without psychiatric care with counseling their effects are short term.

Yes its true that eating disorders weren't well known and at the time Di joined the RF, there were problaboly very few specialists in that field. Charles didn't like Diana being put on Valium but she was anxiouis depressed and nervous and that was the standard treatment. But she herself refused to admit she ahd a problem for a long time. Its no good, even if she had been referred to a specialist in eating disorders, for her famaly or Charles to tell a therapist, "Diana's making herself voimit" because Diana would just deny it and refuse to cooperate.

sandy · March 11, 2017, 12:02:41 PM

I think eating disorders were well known. Karen Carpenter's story was in the media and a tragedy. Charles had some doctors put DIana on valium but SHE gave it up after she found she was pregnant. Diana did not have a "problem" until she got involved with Charles. Her friends and employers found her happy and healthy. Stress brought on the bulimia and she was stressed. Charles put down Diana's bulimia and was no saint. Diana's bulimia did ease up after she and Charles became estranged ca. 1986. The royals did not "understand" why Diana got morning sickness. Charles got Diana the wrong sort of help so he was pretty useless. Charles also caused much of the anxiety for obvious reasons.

TLLK · March 12, 2017, 12:22:34 AM

Quote from: amabel on March 11, 2017, 11:57:17 AM
Quote from: TLLK on December 21, 2016, 05:27:38 AM
I'm close in age to Diana and I'd not heard of eating disorders until about 1979-1980. I believe it that in the 1980's it was still a frequently misunderstood condition and unfortunately it came with the stigma that is so often associated with mental illness. I do believe that therapists were trying to get an understanding of why people would feel the need to deny themselves food (anorexia nervosa) or binge eat and then vomit it back up (bulimia). It would still take years to discover why people would have the need to control their lives with these harmful actions and to find effective and long lasting treatment. Pills are quicker and would provide an immediate effect, but without psychiatric care with counseling their effects are short term.

Yes its true that eating disorders weren't well known and at the time Di joined the RF, there were problaboly very few specialists in that field. Charles didn't like Diana being put on Valium but she was anxiouis depressed and nervous and that was the standard treatment. But she herself refused to admit she ahd a problem for a long time. Its no good, even if she had been referred to a specialist in eating disorders, for her famaly or Charles to tell a therapist, "Diana's making herself voimit" because Diana would just deny it and refuse to cooperate.

Unfortunately treatment is unlikely to be successful until the patient is ready to admit that they need assistance. Fortunately there was a psychiatrist who was finally able to help her with her eating disorder.

sandy · March 12, 2017, 12:39:28 AM

I found it odd that Charles of all people (who knew about Sarah Spencer's anorexia and that she was treated by Dr. Lipsedge) did not recommend Dr. Lipsedge to treat Diana. Instead he found doctors that gave her valium which was useless Eventually, Diana did see Dr. Lipsedge with successful results.

Curryong · March 12, 2017, 12:58:05 AM

Charles may have heard from Sarah herself while they were dating that she had been successfully treated for an eating disorder. However he might not have remembered the name of the doctor who treated her by the time Diana's food issues became known to him.

I'm wondering more as to why Sarah didn't remind her sister that she she had suffered from the same sort of condition and who had successfully treated her. To me that seems more natural than her husband searching his memory, always being conscious that news of any treatment could get out to the media.

TLLK · March 12, 2017, 01:26:22 AM

Quote
I'm wondering more as to why Sarah didn't remind her sister that she she had suffered from the same sort of condition and who had successfully treated her

I'd never thought about it that way. You're right @Curryong Sarah would have been the best source of information on it and where to seek treatment.

Double post auto-merged: March 12, 2017, 07:25:01 AM

Quote from: sandy on March 12, 2017, 12:39:28 AM
I found it odd that Charles of all people (who knew about Sarah Spencer's anorexia and that she was treated by Dr. Lipsedge) did not recommend Dr. Lipsedge to treat Diana. Instead he found doctors that gave her valium which was useless Eventually, Diana did see Dr. Lipsedge with successful results.

While both had an eating disorder, they each had a different one. Sarah had anorexia nervosa while Diana was a bulimic. I have to agree with @Curryong that it wasn't likely that Charles would have recalled which psychiatrist Sarah had seen when she was being treated. Fortunately Diana was able to recover from her eating disorder as we sadly know that not everyone survives.

Double post auto-merged: March 12, 2017, 07:28:48 AM

Differences Between Anorexia and Bulimia

The main criteria differences involve weight, as an anorexic must technically be classified as underweight. Another factor is in anorexia there is typically the loss of the woman's menstrual cycle. Generally the anorexic does not engage in regular binging and purging sessions.

Characteristically, those with bulimia nervosa feel more shame and out of control with their behaviors, as the anorexic meticulously controls their intake naive to the notion that it, in fact, controls him/her. For this reason, the bulimic is more likely to admit to having a problem, as they do not feel they are in control of their behavior. The anorexic is more likely to believe they are in control of their eating and much less likely to admit t that a problem even exists.

Both anorexics and bulimics have an overpowering sense of self that is determined by their weight and their perceptions of it. They both place all their achievements and successes as the result of their body, and for this reason are often depressed as they feel they are consistently failing to achieve what they consider to be the perfect body.

Double post auto-merged: March 12, 2017, 07:30:14 AM

Anorexia and Bulimia

royalanthropologist · March 12, 2017, 08:37:47 AM

I wonder why both girls had eating disorders. Was it something hereditary or was there a common stressor in their lives?

amabel · March 12, 2017, 09:40:16 AM

Quote from: Curryong on March 12, 2017, 12:58:05 AM
Charles may have heard from Sarah herself while they were dating that she had been successfully treated for an eating disorder. However he might not have remembered the name of the doctor who treated her by the time Diana's food issues became known to him.

I'm wondering more as to why Sarah didn't remind her sister that she she had suffered from the same sort of condition and who had successfully treated her. To me that seems more natural than her husband searching his memory, always being conscious that news of any treatment could get out to the media.

Diana suffered from bulimia, which IS different from anorexia. Charles knew that Sarah had something wrong iwht her but she may not have told him about the treatemten or who treated her. Sarah said to a journalist later that "we'd like to talk to Diana about her losing weight " but it does not seem very clear if "they" (I presume she meant her family) did talk ot her. Its possible that she too thought of Di's illness as being different ot her own, and not necessarily treatable by the same doctor.
Diana was eating, and vomitign, whch is differnet to not eating at all. SOME bulimics dnt lose so much weight, so they can conceal the illness.
Anyway it doesn't relaly matter if other people got Diana to a doctor, she at the time clearly wasn't ready to talk about her illness and to seek advice. A therapist can't do anything if a patient is not willing to admit they have a problem. Diana clearly thought she was concealing the illness and didn't realise how much weight she had lost or that it was increasingly obvious to people around her that she was very thin and that she was disappearing after her meals to be sick.
Later, one of her friends Colthurst a doctor said "It was obvious what she was doing but you couldn't say anything ot her because she was so very vulnerable."

Curryong · March 12, 2017, 10:15:33 AM

^ Perhaps the common stressor was the horrendous separation and divorce of Johnnie and Frances Spencer. It has been said that the older girls coped with it all better than their younger siblings, but you do wonder. Jane appears to have been virtually unaffected but perhaps she just had a more phlegmatic nature than her sisters. Sarah seems to have been quite an emotional and volatile girl and it is notable that she drank when she was at boarding school and was expelled for it. Perhaps she just acted out in a different way to Diana. Mind you, family background may have come into play. The Spencers were aristos with a wild side and there were depression issues in the Shand/Work family.

sandy · March 12, 2017, 11:33:19 AM

Quote from: amabel on March 12, 2017, 09:40:16 AM
Quote from: Curryong on March 12, 2017, 12:58:05 AM
Charles may have heard from Sarah herself while they were dating that she had been successfully treated for an eating disorder. However he might not have remembered the name of the doctor who treated her by the time Diana's food issues became known to him.

I'm wondering more as to why Sarah didn't remind her sister that she she had suffered from the same sort of condition and who had successfully treated her. To me that seems more natural than her husband searching his memory, always being conscious that news of any treatment could get out to the media.
Diana suffered from bulimia, which IS different from anorexia. Charles knew that Sarah had something wrong iwht her but she may not have told him about the treatemten or who treated her. Sarah said to a journalist later that "we'd like to talk to Diana about her losing weight " but it does not seem very clear if "they" (I presume she meant her family) did talk ot her. Its possible that she too thought of Di's illness as being different ot her own, and not necessarily treatable by the same doctor.
Diana was eating, and vomitign, whch is differnet to not eating at all. SOME bulimics dnt lose so much weight, so they can conceal the illness.
Anyway it doesn't relaly matter if other people got Diana to a doctor, she at the time clearly wasn't ready to talk about her illness and to seek advice. A therapist can't do anything if a patient is not willing to admit they have a problem. Diana clearly thought she was concealing the illness and didn't realise how much weight she had lost or that it was increasingly obvious to people around her that she was very thin and that she was disappearing after her meals to be sick.
Later, one of her friends Colthurst a doctor said "It was obvious what she was doing but you couldn't say anything ot her because she was so very vulnerable."

They are both eating disorders. Lipsedge was able to treat both Sarah and Diana.

Diana's bones were sticking out she did show that she had an eating disorder especially ca.late 1982

amabel · March 12, 2017, 12:41:13 PM

Quote from: Curryong on March 12, 2017, 10:15:33 AM
^ Perhaps the common stressor was the horrendous separation and divorce of Johnnie and Frances Spencer. It has been said that the older girls coped with it all better than their younger siblings, but you do wonder. Jane appears to have been virtually unaffected but perhaps she just had a more phlegmatic nature than her sisters.

I think that all of them except Jane (it seems) were affected by the unpleasant divorce and I tink then later by JOhnny Spencer's remarriage. (ad the way he shut himself away after his wife left him).
I think it hit Charles and Diana worst as the 2 youngest who felt very much left alone when their mother left them. Botht of them had problems. Charles has been criticised as being a bully and had 2 failed marriages. Diana had one failed marriage and a lot of emotional problems. But Sarah too was affected... she drank at school and was nearly expelled. and I think that eating disorders, like alcoholism can often run in a family.
Someone has said (I forget who) that perhaps Sarah after her anorexia, made a sensible choice of a quiet life with a gentleman farmer, and didn't try for anyting more glamourous.. and that that's what a girl with her emotional problems needed, a quiet steady husband wtih a quiet country life...who would look after her. Diana reached for a grand marriage, and also of course hoped that she had made a marriage that could not end in divorce.. but the pressures of public life, and a difficult marriage brought out her problems and she became ill.

sandy · March 12, 2017, 02:03:16 PM

Diana did not have a "lot" of emotional problems. She was reportedly happy and healthy by her friends and employers pre marriage. She was brought into a situation of great stress and managed to work to control the bulimia. I think Charles, her husband had and has many hangups and unfair expectations of what he wanted in the marriage. Sarah did want a glamorous marriage to the Duke of Westminster and he dropped her. Had things worked out with them, I think she would have said yes in a heartbeat to his proposal. Charles "reached" for Diana since she was aristo, fertile, pretty and had no past. He was turned down by other ladies. Diana wanted a marriage. As she told Settelen, she said to Camilla in their confrontation "I want my husband." That about sums up her expectations.

TLLK · March 13, 2017, 12:02:44 AM

Quote from: Curryong on March 12, 2017, 10:15:33 AM
^ Perhaps the common stressor was the horrendous separation and divorce of Johnnie and Frances Spencer. It has been said that the older girls coped with it all better than their younger siblings, but you do wonder. Jane appears to have been virtually unaffected but perhaps she just had a more phlegmatic nature than her sisters. Sarah seems to have been quite an emotional and volatile girl and it is notable that she drank when she was at boarding school and was expelled for it. Perhaps she just acted out in a different way to Diana. Mind you, family background may have come into play. The Spencers were aristos with a wild side and there were depression issues in the Shand/Work family.

I have to agree @Curryong.

amabel · March 28, 2017, 07:20:31 PM

Quote from: royalanthropologist on December 23, 2016, 08:46:39 PM
You :. At least lady Di did her fair share of therapists. I remember reading a book where they took her from doctor to doctor until one of them told her that "there is nothing wrong with you apart from your husband.

WHO took her from doctor to doctor? And what doctor said this?? I've never heard it. And it does not make sense. Eating disorders are complex illnesses and not likely to sprng from one cause. Diana clearly had problems before she met Charles but I think if she had had a quiet life, they might have lain dormant.

sandy · March 28, 2017, 09:25:15 PM

Diana did not have the eating disorder before she got engaged to Charles. Her employers and friends attest to this. THe stress was brought on after the engagement.

TLLK · March 28, 2017, 10:44:56 PM

Quote from: amabel on March 28, 2017, 07:20:31 PM
Quote from: royalanthropologist on December 23, 2016, 08:46:39 PM
You :. At least lady Di did her fair share of therapists. I remember reading a book where they took her from doctor to doctor until one of them told her that "there is nothing wrong with you apart from your husband.
WHO took her from doctor to doctor? And what doctor said this?? I've never heard it. And it does not make sense. Eating disorders are complex illnesses and not likely to sprng from one cause. Diana clearly had problems before she met Charles but I think if she had had a quiet life, they might have lain dormant.

Hard to say because even everyday life concerns could trigger one ie: Loss of control due to job loss or a sick family member. With Sarah also having an eating disorder it is likely that one of her siblings could have a genetic predisposition to them.

Curryong · March 28, 2017, 11:00:20 PM

There may not have been a genetic component to Sarah and Diana's illnesses, but I believe there was a family history on both sides of depression and other disorders. Frances grew up a very independent minded person but it was made clear to her and her sister that they must make good marriages and pressure was put on them from their mid teens by their mother Ruth to do so. Both Frances and her sister had a couple of marriages end in divorce and, like her brother, I believe Frances suffered from depression. In her case at low points in her life she dulled the pain with alcohol.