by Laura Collins Lyster-Mensh, F.E.A.S.T. Executive Director
One of F.E.A.S.T.’s earlier Executive Directors, Belinda Caldwell, made a very wise observation recently about the difference between the kind of “support” that parents look for when it comes to eating disorders compared with other kinds of caregiving:
“in ED we are looking to be very active and skilled whereas the focus for the others is more on self care and support.”
This was a lightbulb moment for me. I mean: I knew it –I do it all day — but I hadn’t quite parsed it that way and it matters.
It matters when treatment providers think that a parent’s needs and role are about feeling better and being cared about. If that’s all we really need, then a provider is going to expect us to be satisfied with a warm greeting and expect us to be grateful to be reminded to take care of ourselves. I’ve seen first hand how hurt providers can be when that is not received warmly. Their intentions are good, I know.
But if what we as parents are expecting is to be actively involved and to be taught skills and given coaching then it is going to be a jarring mismatch to be asked to wait outside or “let the professionals do it.” Treatment that focuses on the patient on their own without the family is not skills-building for the parents and siblings. Treatment that limits the family to self-care without active engagement for all family members may seem compassionate but it is more often deeply disappointing and even frightening.
This difference between “active and skilled” and “self-care and support” may indeed be the tectonic shift from the older ways of approaching eating disorders to the more modern approaches.
The old model looked at parents as needing to be fixed. The newer model sees parent skills and knowledge as powerful elements of treatment.
The old model looked at parent distress as a distraction. The newer model frames parent distress as normal and inclusion on the treatment team and skills building as a solution.
The old model looked at self-care as for the parents. The newer model looks at self-care for the parents as part of building the resources and success of the patient’s treatment. It assumes patients are in good care and that the family is well-resourced — because parents cannot pursue self-care when our house is on fire and our children are in harm’s way.
The old model saw the patient as the focus of treatment. The newer model sees the patient as part of a family and a community.
The old model told parents to wait outside for news. The newer model never had us leave the building.
I’m reframing the way I look at literature and services for parents, and deeply grateful for Belinda’s phrasing and insight.