By Emily Boring, author in recovery
Last April, I had the privilege of speaking to a gathering of parents—a local support group for families of children with eating disorders. I’d been invited to share my story of recovery from anorexia.
We met at the neighborhood high school, in a Spanish classroom with cheery posters (“¡Si, se puede!”) on the walls. We gathered in plastic chairs around a long table and looked around curiously, strangers united by the unspoken intimacy of shared experience. One by one, each parent described their child’s situation. A 6th-grade daughter, just home from three months in treatment. A twelve-year-old, admitted to the hospital again after relapse. A high schooler doing well, but still eating the exact same foods at every meal. A young adult, stable but nervous about the transition to college.
When it was my turn, I spoke of my diagnosis of anorexia in 2015, thousands of miles from home, during my freshman year at Yale. I described my summer of Family-Based Treatment—how, even as a college-aged adult, I needed my parents to make me eat. I recounted myriad setbacks and relapses, inner and outer progress, and my eventual arrival at full, vibrant, joyful recovery.
The parents around the table asked questions. I was blown away by their insight and specificity. Here was a father, trying to anticipate the inner workings of his daughter’s emotions. Here was a mother, torn between respect for her son’s independence and instincts to protect him from harm. Their questions were practical: meal plans and travel tips, coping mechanisms for anxiety, strategies for school and sports. And they came in the language of heart and soul. When will my daughter be happy and carefree again? Does anorexia change your personality forever? Along the way, how did you keep up hope?
In that moment, I glimpsed the full range and scope of support that recovery calls parents to provide. Eating disorders are bio-psycho-social illnesses: conditions of the body, and challenges at the level of identity and self. More than any other people, parents must recognize this dual nature and live constantly on the edge between inner and outer healing. You are the people who hold the long-term vision: the memory of who your child used to be, and the hope of who he or she can become. Yet you are also the people who understand the practical steps to get there—the supervised meals, the endless doctor’s appointments, the tears and anxiety and painstaking bites. You inhabit a paradox that many people never have the chance to discover:
There’s no hard line between biology and inner self. There’s no inner healing without nourishment of the body. But in order to persevere through physical recovery, we need vision and hope.
In other words, parents who support recovery become masters of holding contradictions. It’s this quality—the ability to honor multiple complex truths, while taking the next right step forward—that’s been on my mind in the face of COVID-19. Our current socio-cultural moment is calling all of us to hold paradoxes on every level. How can we put aside our short-term comfort in service of a larger goal to “flatten the curve”? In the face of so much fear and uncertainty, how can we wake each morning and do what must be done? How do we honor the particular nature of our own suffering—illness, economic loss, inconvenience, worry—in the face of suffering on a global and systemic scale? These are versions of the same questions my family and I asked daily throughout recovery.
I believe that families who have dealt with eating disorders are uniquely equipped to rise to the challenge of COVID-19 with courage and integrity, leaning on hard-won skills and practices.
I also know it’s hard. The challenges of recovery don’t vanish in the face of a pandemic—quite the contrary. You’re still supervising meals. You’re still working toward weight goals, re-wiring disordered habits, increasing your child’s independence. You’re doing so without vital support—in-person doctor’s appointments and therapy, weight checks and peer groups. And you’re doing all this in an environment of maximal stress and anxiety, family circumstances that both trigger old patterns and introduce new forms of challenge.
Knowing this—both the trial and invitation of COVID-19 for families in recovery—I want to share a few things. These are gestures and sketches, gleaned from my own experience: what worked and what didn’t, advice and encouragement, the way I’ve made sense of the relationship between family and illness. I share in a spirit of reassurance, gratitude, and solidarity.
Families don’t cause eating disorders. I hesitate even to write this, because putting the words on a page gives them more realness and validity than they deserve. Gone are the days when therapists blamed anorexia on overbearing mothers, when eating disorders were said to arise from family trauma that must be examined and dealt with before physical recovery.
I have no troubled story to tell about my family. I have two parents whose love and support are unconditional. I’ve known, from the day I was born, that they always want the best for me. I have a brother with disabilities, whose differences (autism and development delays) pose unique strains and joys. I have all these gifts and privileges, and I still got an eating disorder. I got anorexia because I have a certain set of genes, and I live in a culture where thinness is valued, and one time I fell into energy deficit and launched a biological illness that preyed on my character traits, acquired or innate. It’s as simple and complicated as that.
Perhaps there are things my family could have done to prevent anorexia from taking hold so strongly. My parents say they wish they’d caught it sooner. They feel guilty for not recognizing the signs. And perhaps some aspects of my context—the burden of my brother, the pressure for maturity, the unspoken expectation to be the “good sibling”—were kindling for the eating disorder and fuel to keep it going. Perhaps, if one or more of these things had been different, my genes would have stayed quiet, dormant and unused, instead of rising up to overwhelm me.
I’ll never know for sure, and I don’t need to. I’m not interested in a story of family and eating disorders that looks only backward, drawing simple lines of causation and blame. Just as science will never map a precise line between nature and nurture, I have no idea exactly what combination of factors, family or otherwise, laid my path. But I didn’t need to understand these things in order to move forward. My story of family and anorexia begins not by looking backward, but by looking ahead.
From the day I acknowledged my illness, my parents were a crucial part of my recovery. Their support was both symbolic and tangible, in-person and remote. When I cried myself to sleep, alone in my college dorm room, their voices on the phone were the only things that kept the darkness at bay. When I lay wide-eyed and terrified in a hospital bed, their words reassured me I would be all right. When I felt the frustration of relapse—the futile sense of being stuck, all these months later, in the same place—my parents convinced me that there’s no such thing as regression, and there must be something new to learn this time around. During that summer of Family-Based Treatment, my parents were the people who helped me rebuild my body. They re-taught me, twenty years later, how to eat.
Only in hindsight have I begun to consider the cost of their efforts. The pain of soothing my tears when they likely cried the moment they hung up the phone. The toll of pretending confident assurance when they, too, feared for my life. Mostly, the strain of holding onto so many layers of healing. The emotional whiplash of being present to all of me, body and spirit, in order to help and love.
They did it anyway. That’s what got us through. That’s the story I choose to tell.
To parents, throughout recovery, there will be truths your child isn’t ready to hear. Her right to nourishment, her care for her body, her respect for the actions you’re taking to help… All of these truths may appear absent for months or even years, meal after meal. This doesn’t mean she doesn’t know them, deep down. But because of the nature of the eating disorder, because of her own biological limits, she won’t be able to access them until her body is nourished. This isn’t her fault. She already blames herself. She needs compassion.
In her pain, she might lash out. She might yell and cry and refuse to eat what you’ve given her. She might lie, hiding her behaviors and actions, making you wonder where the trustworthy daughter you’ve always known has gone. This will be hard. You’ll wonder whether the child you had is ever coming back. You’ll fear for her future. Will she ever be able to go to college or live alone or take care of herself?
You’ll want to do all that you can to help. You’ll think you know better than she does. Many times, you probably do. Early on, you might need to make choices for her. She’ll resist, but deep down, she’ll feel relieved. Eventually, she’ll thank you.
You’ll want to do it all for her—solve all her problems and feel all her pain so she doesn’t have to. You can’t. Your role isn’t to solve everything, because eating disorders can’t be neatly “solved.” It’s her journey, and she needs space to figure this out.
I’m here to tell you: full recovery is possible. Not just some generic absence of symptoms. Not a fragile and cautious shadow of the daughter you once had. Your child will return, in all her vibrant uniqueness and energy. She’s there now, just beneath the surface. Give her the dignity of acknowledging this full self along the way.
To those recovering, throughout this journey, there will be things your parents won’t understand. This will be hard if you’re close to your parents, if they usually understand everything you’re thinking and feeling. You’ll think, “If they don’t get it, who will?”
You aren’t alone. There’s nothing wrong with you. If someone hasn’t had an eating disorder, it’s simply impossible for their body and mind to know what it’s like. You can try your best to help them. There are podcasts and Ted Talks and books that describe how it feels to have anorexia. But your parents don’t need to fully “get” what you’re going through in order to support you. Understanding isn’t a requisite to empathy. As you get older, there will be other times when you and your parents don’t see eye to eye. This is a trial run for both of you, an exercise in independence.
Your parents’ lack of understanding may come out as frustration. It may appear as anger, worry, or micro-managing. I hope you can see the deeper feelings beneath your parent’s reactions: helplessness, desire for your wellbeing, concern, fear, and love. My guess is you already know this. You’re compassionate and sensitive and mature.
You probably want to make your parents proud. You feel guilty for causing them worry, for costing them money, for taking their attention from their own lives or your siblings. To the extent that this guilt helps you stay motivated to recover, use it. But if it’s not serving you, if it’s making you feel ashamed and paralyzed, then let the guilt fall away. What you’re doing right now (eating and challenging disordered thoughts and slowly persevering through anxiety) is a full-time job. Respect the desires of your parents, but also pay attention to what you feel and what you need. It’s not your job to manage their expectations and take on all of their feelings.
Ask yourself: are you doing your best, courageously and whole-heartedly, today? This is all that anyone can ask for. These challenges are growing pains—steps toward your healthy, self-sustained, resilient self, which is really all your parents want for you.
To both parents and those recovering: allow yourself to imagine full recovery. What does it look like? How does it feel? What behaviors and symptoms are missing? What new traits and freedoms are present?
Make lists—one for each of you—and compare them. The specific goals might be different. Parents, try to listen to your child’s visions. Maybe you hope they’ll ask for ice cream every day like they used to, but for now their version of victory would be frozen yogurt once a week. Children, let your parent’s vision help you imagine a freedom that the eating disorder can’t quite let you grasp.
Be open to compromise. Focus on shared themes, not differences. Get on the same page, and stick to these goals. At each turn, ask yourselves: how will this action help us move toward what we both desire? Be patient. Be kind.
I asked my mom recently what she’d tell a parent of someone beginning recovery. Be ready for a marathon, she said. No one can prepare you, at the outset, for just how long this journey will be. Along the way, give yourself the grace of separation. Don’t try to weather every up and down, every moment of darkness, alongside your daughter. It’s her journey. You can travel alongside her, but if you try to hold all her pain, there won’t be enough of you left to support her. You’ll learn a hard lesson: you can’t stake your happiness and wellbeing on how well (or not) your child is doing. You’ll emerge with independence: a definition of closeness that transcends the need for shared experience. A mature and resilient kind of love.
Her answer reminded me of another lesson—a lesson that all of us, in this time of COVID-19, are being forced to realize. Our well-being in the present can’t depend on the certainty of the future. Our optimism can’t require that we see a clear route to personal or global repair. It’s a matter of survival, really. We can spend all of this quarantine feeling miserable, desperate, waiting for the future to relieve the fear of the here-and-now. Or we can realize that peace and optimism are qualities of the present. They’re available before we reach resolution, before we even believe there’s resolution to be had.
There’s a quote by Sloan Wilson on our refrigerator, printed on a small strip of paper.
“The hardest part of raising children is teaching them to ride bicycles… a shaky child on a bicycle for the first time needs both support and freedom. The realization that this is what the child will always need can hit hard.”
Beneath it, there’s a picture of me, clad in pink shorts and ladybug-spotted helmet, proudly perched on my bike the day I learned to ride. My parents stand beside me.
Bio: Emily Boring is a writer and scientist from Corvallis, Oregon. A graduate of Yale University, she currently studies marine ecology at Oregon State. Since recovering from anorexia nervosa during college, she has become an active speaker, writer, and one-on-one mentor. Her writing has appeared on Recovery Warriors and The Mighty. She’s passionate about the science of eating disorders: How can recent advances in genetics and neuroscience remove stigma and open up space for narratives of the inner self? You can reach her at [email protected].