Eating Disorders and Parenting in 2015
By Joe Kelly
“Many parents feel guilty that they have played a role in their child’s eating disorder, but the evidence is irrefutable that parents are not culpable.”
– Dr. Daniel Le Grange and Dr. Sara Buckelew, UCSF Medical School Department of Psychiatry
When our children are infants, we parents have the illusion that we have enormous control over their lives. A few nights of colic or projectile vomiting should disabuse us of that notion. Nevertheless, nature (and the survival of the species) gives us enormous responsibility for nurturing, protecting, and preparing our infant children. Most of us do our imperfect (i.e., human) best to meet that responsibility.
Being human, most of us retain the urge to control our kids as they get older. As the parent of two children in their mid-30s, I can testify that this urge dies hard. But the truth is that we don’t have the control we believe—and wish—we had. And our influence diminishes steadily as our kids grow up.
What doesn’t change, however, is our parental responsibility to respond to our children and stepchildren as the unique individuals they are. Respond—not react, resent, control, dominate, or diminish.
What does this have to do with “Eating Disorders and Parenting in 2015?” Everything.
For starters, you did not cause your child to have an eating disorder.
“Let’s get that straight,” says eating disorders advocate and educator Kitty Westin. “No parent has that kind of power or control. Sure, some genetic factors appear to predispose certain people to eating disorders—but parents have no control over their DNA or their child’s DNA.”
Think of it this way: like me, my father, and my grandfather, my daughters have brown hair and long eyelashes. If I went around proclaiming that I caused these traits, and was thus responsible for my daughters’ beauty, you’d (rightly) consider me a pompous fool.
Bottom line: no parent or stepparent can control whether or not their children develop brown hair, long eyelashes, or eating disorders. Therefore, berating ourselves as somehow responsible for these complex illnesses is foolish. More important, self-flagellation and guilt are energy-wasting, unhealthy, inappropriate reactions which play right into the hands of eating disorder dynamics.
So is asking “Why does my child have an eating disorder?” Unless you’re among the handful of scientists studying eating disorder genetics, “why” leads to a dead end—and thus is the wrong question. The more useful question is “How?” How can we learn and use the tools of recovery to support our child’s healing—and retain our own sanity.
“If you’re not responsible for the illness,” Westin asks, “can you at least control its symptoms, progression, and ultimate outcome? Not really.”
“You can, however, control how you respond to your child’s eating disorder. The first step is understanding how these illnesses operate. Only then can you develop an array of strategic and influential responses which can support recovery—remembering, however, that your actions can’t force or guarantee complete recovery; you’re not that powerful.”
Your influence does matter. For example, the treatment modality known as FBT (for “family based therapy”) has been effective in reducing symptoms in adolescents with anorexia. FBT relies heavily on parents and stepparents getting their children to eat. Exerting this influence isn’t easy, as any FBT family will tell you. Our influence can’t assure every desired outcome or overcome every obstacle. But it still has enormous value.
If you haven’t done so already, go get educated about the eating disorder(s) your child has. Many treatment programs and advocacy organizations have “Eating Disorders 101” classes for family members and friends. (Those that don’t, should.)
Kitty Westin, fellow parent Carol Schirber, and I have been teaching such classes for several years. We tell family members that eating disorders are dangerous and complex problems, more prevalent than Alzheimer’s disease, autism, and schizophrenia combined. They affect females and males of all ages, races, and backgrounds. They damage the person’s psychological, physical, social, spiritual, emotional, familial, and vocational life. People can have more than one diagnosis. You can’t always assess progress or regress by how the person looks.
We also emphasize these facts:
- Eating disorders hijack families
- They continue to carry (unjustly) social stigma and shame
- No single treatment model holds all the answers for all people
- Healthy relationships are powerful medicine
- Therefore, involvement of family and friends—including men—is crucial
- Neither the disorder nor the recovery journey are logical or linear
- People do get better—they can become completely recovered
In some ways, the distress of living with someone suffering from an eating disorder parallels the experience of actually having an eating disorder. We can’t always tell when the illness rears its head, derails our thinking, or affects our behavior. It may seem like we’re living in an alternate, logic-less reality, where we have no choice but to play by the disorder’s “rules.” We may feel anger, fear, or despair over our inability to prevent the problem or protect our family from it.
All of those sensations are normal for someone who loves a person with an eating disorder. None of those sensations have to be sources of shame.
After all, we’re up against an illness which is irrational, unpredictable, cunning, baffling, powerful, stubborn, abusive, clever, devious, unfair, and unjust.
We say or do X on Monday, and get a great response. We say or do X on Tuesday, and get our heads bit off. We feel damned if we do and damned if we don’t. It’s almost as if the disorder gets a kick out of perverting our good intentions and yanking our chain.
So how can we respond to this strange and dangerous phenomenon? Chances are that you’ve already tried bargaining and/or staging a full frontal attack…without much success. Westin and I advocate a ju-jitsu-like approach. Rather than loved ones trying to head-butt the disorder’s energy into submission, they learn to deftly let it “pass to the side,” and lose its balance.
This requires five difficult things:
- Learning loving detachment.
- Recognizing our habits of reacting (rather than responding) to the disorder.
- Radical acceptance of the eating disorder.
- Learning to differentiate between our child’s eating disorder self and our child’s authentic self.
- Practicing self-care.
What does this look like in real life?
Loving detachment means sacrificing our understandable—and unhelpful—attachment to the eating disorder rules and dynamics which hijack our family. It means practicing neutral and empathic responses to the disorder’s high (and often melodramatic) stimuli. It means untangling ourselves from the belief that we can control, debate, or fix this problem. It means using the support and guidance of professionals to help our child take responsibility for her or his own recovery.
Recognizing our reaction habits means shifting focus away from our child’s behavior, and attending to our own behavior. This seems counter-intuitive to many parents and stepparents. As one father told me: “My child is in danger! Don’t I need to focus on her before anything else?” Well, eating and related disorders are rich in paradox, and this is no exception. Paradoxically, the most effective way for us to challenge and disrupt the eating disorder is to develop our own habits of radical acceptance, loving detachment, self-care, etc. Remember: we do not control our children, or the symptomatic behaviors that their illness generates. We can, however, control our own behavior—including our responses to the disorder’s conduct.
Radical acceptance means that we stop denying, avoiding, or being ashamed of our child’s eating disorder. Instead, in conversations with our child, the rest of our family, and others, we matter-of-factly, calmly, and compassionately name the disorder as a problem. We refuse to blame our child or anyone else for her or his eating disorder. We acknowledge that the eating disorder performs some function for our child. We commit to the belief that, with appropriate care, our child can recover by developing alternative ways to meet her or his very human needs.
It’s not easy to differentiate between our child’s eating disorder self and our child’s authentic self. Nevertheless, there are noticeable differences. “People who have recovered from an eating disorder often speak of a battle or conflict between their ‘ED self’ and their genuine or true self,” Westin says. “They assert that recovery depended on giving voice and embodiment to the authentic self—even while the ‘ED self’ fought to continue its roar and rigid rules.” In the midst of an eating disorder, we parents and stepparents may have more awareness of our child’s authentic self than she or he does. We can leverage that awareness and shine our attention and care like a growth light to gently strengthen the flower of our child’s true self. In other words, keep treating your child like a person who is more than the disorder.
Self-care is not self-indulgent, self-centered or selfish. Instead, it is essential human nourishment fed by simple, rejuvenating activities like taking a walk, dining out with a friend, meditating, reading, shooting hoops—and engaging in fellowship with other people who have loved ones with eating disorders. By stepping away from a chaotic and manipulative situation, we gain perspective to see that we have a life outside of the eating disorder vortex. Self-care clears our head, releases emotional tension, and strengthens our connections with other loved ones and friends. Yes, self-care means temporarily removing ourselves from the person with the eating disorder, but (paradoxically) this is a good thing.
The eating disorder works hard to pull parents, stepparents, and other loved ones into its distorted way of perceiving and reacting to the world. It thrives on drawing us into arguments, arguments we simply can’t win. It loves having us rise to the bait of reacting in kind to its melodramatically intense behavior.
Our challenge—and our hope—lies in responding rather than reacting. It lies in supporting our children, rather than (futilely) attempting to control them. It lies in our faith that—even when the battle against the eating disorder seems most intense—our child can recover fully.
Father, eating disorders advocate, and blogger Don Blackwell uses the metaphors of boxing to describe our parental responsibility during our child’s eating disorder battle. He writes:
“I know how scary it can be to stare into the ‘eyes’ of an adversary that’s hell-bent on destroying a loved one. I know the desire to flee or at least look the other way in the hope that the onslaught will miraculously stop on its own.
“But I also know this: When your loved one is laying on the canvas in the middle of the ring; when they are exhausted; when they are battered and bruised and every fiber of their being is telling them (screaming at them!) not to get back up; to just let themselves be “counted out;” whether they do or don’t may well depend on what and who they see when they look over to their corner.”
We can be in our child’s corner with calm words and actions which keep our focus where it belongs. Through our own healthy self-nurturance, we can demonstrate to our child that one’s authentic self it is worth fighting for.
About the author –
Joe Kelly is a father, grandfather, writer, editor, and educator living in Oakland, California. The author of six books on fathering, he’s been an eating disorders activist for 15 years and served on the Eating Disorders Coalition’s board of directors. Kelly provides mental health professionals with evidence-based methods for mobilizing and utilizing a client’s male loved ones. He also coaches family members of people with eating disorders and/or addiction. Learn more at www.joekelly.org.
I disagree with Mr. Kelly’s contention that the child must “take responsibility for her own recovery” and that anorexia “performs some function in the child.” In FBT, the parents, not the child, take responsibility for the recovery by re-feeding the kid and re-establishing normal patterns of eating. The anorexia is viewed as an illness, not something that “performs some function.” Anorexia robs the sufferer of the ability to think rationally, and therefore the parents need to step in and take control of the sufferer’s eating behavior.
In FBT, the parents, not the sufferer, are responsible for making sure the child gains weight and re-establishes normal patterns of eating. Therefore, I don’t understand Joe’s comment that the support and guidance of professionals is used to “help the child take responsibility for her own recovery.”
Also, I don’t agree with Joe that anorexia nervosa “performs some function in the child.” Anorexia is an illness. It doesn’t perform a function.
Almost. A is a year into recovery..so proud of my daughter’s accomplishments.
This is a great article!
BUT – unless you have had a child as I have that has suffered with an eating disorder, you wouldn’t appreciate just how hard FBT can be.
15 years ago, my son had anorexia became skeletal and spent six months at a psychiatric hospital. Thankfully, he has made a recovery although he still has peculiar attitudes to certain foods. No amount of family encouragement worked and we had very little support to turn to at that time.
In the UK, we have a great treatment centre called Breathe Therapies. Breathe advocate a holistic approach to eating disorder treatment based on proven research. I wish they and others like them had been around 15 years ago!
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