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My Truth

By Judy Krasna, Executive Director

Last week, an organization that I follow on Facebook re-posted the 9 Truths. In the comments, there was pushback on Truth #2: Families are not to blame and can be the patients’ and providers’ best allies in treatment.

The commenters were angry that there was a blanket statement about not blaming parents when they felt that their own parents played a significant role in the development of their eating disorders. This hit a very personal and sensitive nerve for them, and their reaction to a statement saying that parents don’t cause eating disorders was furious.

I read their comments with dismay. First and foremost, I feel sorry for their experience. I can’t imagine what it must have been like to grow up in an abusive environment or to live with such a horrific illness like an eating disorder without a family to support them.

I can’t argue against someone else’s truth. In fact, I wouldn’t want to. I respect their truth, and I understand their desire and motivation to fight against a statement that doesn’t represent their truth.

The thing is, I also have a truth. My truth is that I think that parent blaming contributed in some way to my daughter’s death. Therefore, when I see people pushing back against a statement expressing that parents don’t cause eating disorders, I can’t just let it go.

I am not the type of person who leaves negative comments on other people’s posts. On principle, I try not to engage in drama of any kind. However, as a leader at F.E.A.S.T, and as a mother who has paid the ultimate price for parent blaming, I can’t let these comments stand without reacting to them publicly.  And so, I left a comment of my own, knowing that I was leaving myself open to a floodgate of vitriol and negativity.

We know that when it comes to eating disorders (and every other illness), early intervention and effective treatment are key factors in positive outcomes. This means that the period directly following diagnosis is critical in getting the right treatment if a person is going to have the best chance at recovery. Unfortunately, for us, my daughter received the worst possible treatment during that period, which gave her eating disorder the ability to entrench itself so deeply inside of my daughter that it proved impossible to uproot.

From day one of treatment, there was an attempt to separate us from our daughter. It wasn’t something that I could put my finger on at first, it was just a very uncomfortable feeling that her treatment team was trying to keep her away from us. This genuinely puzzled me, because we were close, and I knew that she needed our love and support while she battled against her eating disorder.

Instead of using our family as an asset, her treatment team treated us like a liability.

My daughter told me some of the things that they said about us during her sessions, trying to get her to open up about family faults that didn’t exist; she too could not understand why they were trying to drive a wedge between us. The implication, which was overt, was that there must be something wrong with our family if our daughter developed an eating disorder; and if they could not find this cause within our family, then they could not treat our daughter.

In effect, her treatment team was so obsessed with finding the root cause of my daughter’s eating disorder, which they were convinced lied within our family, that they did not actually treat her. She became sicker and sicker, and they were too busy blaming us to notice. We lost valuable time, and precious ground, to my daughter’s eating disorder. And even though later on we found much better treatment, the damage was done. It proved irreversible.

During a school holiday, we were told to bring all our kids to a “family therapy” session. We sat in the office of the director of the residential unit with our chairs in a circle facing each other and we were all asked to answer a question: “What do you think you did that could have caused Gavriella’s eating disorder?”

Subtle, right?

That experience significantly damaged my other children and kept them from getting therapy for themselves for many years. They were too traumatized by being blamed for their sister’s illness and by the association between that blame and therapy.

My husband and I were told that our daughter developed an eating disorder because we were too fat. Other parents were told that their child developed an eating disorder because they were too thin. It seems that the blame was totally indiscriminate; the therapist just wanted to get the blame in however she could. For the life of me, I can’t imagine what purpose that blame serves.

We needed to be empowered as parents, and the blame weakened us. Instead of giving us the information and the skills that we needed to help our daughter, her treatment team pulled her away from us; though they had not one shred of reasonable suspicion, they were trained that we must be guilty of causing her eating disorder, because parents cause eating disorders.

I can’t help but think about how things could have been different if we had been viewed as assets and allies in our daughter’s treatment instead of being viewed as an enemy. Would the outcome have changed if she had received treatment that was steeped in evidence and not in parent blame? At the very least, I believe that the trajectory of her eating disorder would have taken a different path.

I am adamant about the need to defend Truth #2 at all costs. Families are not to blame and can be the patients’ and providers’ best allies in treatment. Had my daughter’s original treatment team believed in this truth, she may have been given a real chance to recover, and the tragedy of her death may have been prevented. That is my truth.

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  1. Laura Collins Lyster-Mensh

    The legacy of blaming parents for their children’s mental illnesses has a long history but the victims are not the parents, it’s the ill person and their siblings. Cutting off and undermining parents of a vulnerable and suffering young person has always struck me as bizarre and cruel. It almost seems like the perfect tool OF the eating disorder, except in this case it is often, still, carried out by unrealizing professionals. Yet there is hope, too: the many professionals I have known who have in their own careers turned this on its head and seen the parents and extended family as allies to and indeed key to the recovery team’s work. I have heard over and over the regret by treatment providers who found that they were more effective in their own work when they changed their view of the family. I have also heard their regret and even apologies. We must all apologize for being part of that, to you, Judy, and all families who have not been given a chance at those pivotal first encounters with treatment. We must apologize and take action until this is no longer the case: we know better.

    • Judy Krasna

      Thanks, Laura. I agree that there is hope. I know that there are many fantastic treatment providers who have changed their views on parental inclusion and on the role of the family and I know that the newer generation of providers have been trained somewhat differently. As to your point that the victim of parent blaming is the ill person, you are absolutely correct. This is what motivates me to advocate for parental inclusion in treatment and to make every effort to obliterate parent bias.

      • Dawne Badrock

        Thank you Judy for your courage to endure the vitriol and negativity. I appreciate their truth, as you do, but it needs to be said that family based therapy works very well.
        My daughter’s life is testament to that. She is now coming up to her 2 year anniversary of diagnosis. To think two years ago we were in the life and death struggle with anorexia. I marvel at her today, a strong, healthy 15 year old traversing normal teen issues. She still has her times when self harm is her coping method but it’s much less severe and as her psychiatrist said, she won’t die from a flesh wound but she will from not eating.
        My husband, especially me, were enveloped into her care by all the professionals involved. They literally taught me what to do and how to do it. They picked me up and put me on my feet when the guilt and terror of her diagnosis floored me. I cannot say how grateful I am that we experienced this model of care. My heart breaks for what you and your family had to endure on top of the sheer agony of watching your child disappear into someone else. Bless you for your determination to keep the message going. ❤️❤️

        • Judy Krasna

          Dawne, it makes me so happy to know that your daughter is doing well and that you received such great care!!

        • Tricia

          Dawne I am happy for you that FBT worked for your daughter.
          However, I think it is important to realise that not every child with an eating disorder will respond to FBT – which is the case with our daughter. We have had to fight to get the right treatment for her and are still in the midst of this awful battle. The professionals are finally realising that our daughter’s case is not a textbook case. Here’s hoping that, months after battling, our daughter will finally get the correct treatment plan to help her recover from this terrible mental illness.
          Judy – I am so sorry for your loss. Thank you for sharing your very sad story.
          I too felt the need to share mine because we are the ones who know our children inside out, so if you think the treatment you are receiving isn’t working – fight to get the right treatment for your beautiful baby ❤️

      • Gia Marson

        While our field has evolved, this parent-blaming trope was not beyond a mistake. It is devastating to hear about your experience and know it may have inadvertently contributed to your daughter’s death as well as the negative impact on your other children. There is no excuse for this error. All families and humans are imperfect but that is not what leads anyone to develop an eating disorder. As a psychologist in this field for more than two decades, I have witnessed the evolution and am extremely grateful to align with the power, love, and knowledge of families in helping children return to health. Your family deserved better. Thank you for this post. I hope you will remain a strong voice for families and clinicians who have not embraced a non-blaming approach.

  2. Gretchen

    I am so sorry this happened to your family. I agree that the family is the ill person’s best ally. We also experienced the wedge trying to be driven between us and our son. Fortunately, I had already found FEAST before that occurred so I felt confident in looking for other treatment options.
    Thank you for being brave and standing up for what you know is right.

  3. Oona Hanson

    Oh, Judy. Thank you for sharing this part of your story. And, again, I’m so sorry for your loss.

    I agree with Laura that, in some way, it’s not just cultural myths and stereotypes about EDs (especially regarding mothers’s roles) but also eating disorders themselves that work in insidious ways to try to keep their sufferers ill and distanced from the ones who most want to help.

  4. Tracey C

    Thank you for continuing to be the ‘voice of the parent’ to help families you will never get to meet.
    I cannot imagine how much worse our nightmare would have been had we been blamed as parents. It was unbearable enough without that to contend with too, yet that’s others truth (sadly).
    It’s because of parents like you that families starting this journey have the chance of positive outcomes. Thank you and much love to your family.

  5. Alli Spotts-De Lazzer

    Thank you for this courageous, heart-breaking post. As a therapist, I get 1-2 hours a week with a client/patient/person–and the rest of the team similar. Of the 168 hours in a week, that still leaves a lot of hours that the person afflicted by the eating disorder might be alone AND those who love that person might also feel alone and helpless. In addition to the team, I want whoever is willing to learn and help to be involved–parents, a partner/spouse, sibling(s), roommates, etc. Besides, I find that secrecy and isolation seem to empower the ED. The more people who know and can respond in an attuned way, the less it can hide. Just my two cents. I do think treatment is changing, but it might still be long road. AND the vocabulary/messaging needs to be probably be pristine and so ultra clear… Judy, my heart hurts for what happened to your whole family. What an AWFUL way for this field to acquire you as an advocate.

  6. Sarah Wells

    Dear Judy,

    It is devastating to hear of the story of blame inflicted on your family and ultimate death of your daughter due to anorexia nervosa. As a clinician, I am appalled at the history we have (and may continue to have in some clinical settings) where blame has been placed on the family due to a young person developing an eating disorder. This history has been so very harmful to the patient, the family and the treatment provided by the health system.

    The passionate and diverse debate around the people who have had difficult and traumatising experiences with their families whilst experiencing such a devastating illness has to be held alongside the very important progress we have made in ensuring that parents feel supported, not blamed for the illness in their young person and an integral part of the treatment team. I was always taught if the family thank you, I haven’t done my job well enough – because families really should feel they did the hard work I as a clinician walked alongside and gave tools as needed to help them and the young person.

    How can we hold this truth and the essential progress made in not blaming families; whilst also acknowledging the truths of those who sadly this wasn’t the case?

    • Judy Krasna

      I think the answer is to treat this as you would any other bias. Blanket statements rarely, if at all, apply 100%. But at times, not making these blanket statements do tremendous harm. So you start with the premise that the bias is unfounded, unjust, and unproductive, and that it does harm. Some people affected by eating disorders have dysfunctional, even abusive families. I am not denying that. But if the premise is that all families are inherently guilty by virtue of the fact that their child has an ED, and treatment is guided by this insidious and false premise, then the person with the ED, the person who clinicians are trying to help, is going to pay the price. So instead, you go with the premise that most parents are loving and solid, and they want to help their child recover. They are no more to blame for their child’s ED than they would be if their child developed cancer or an autoimmune disease. They are experts on their child, and they can offer valuable insight. That makes them natural partners in treatment. If you come across families in your practice who are not loving and solid, and whose inclusion in treatment would be detrimental, then you adjust your treatment accordingly. I would hope that people who have had difficult and traumatizing experiences with their families would be able to recognize that there are parents out there like me, and like the thousands of families in our FEAST community, who are not like their parents. I would hope that just as I am willing to make space for their truth and to respect their experiences, they would be willing to make space for mine.

  7. Sarah

    “Experts” used to believe that poor parenting caused schizophrenia, refrigerator mothers caused autism. We now know this is not correct and has zero evidence for. I hope that soon it’s also realised that parents do not cause eating disorders.

  8. Michelle Haneberg

    This is one of the most powerful pieces on this topic that I have ever read. Thank you for speaking for all of us who have been blamed and our children who have been victimized by ego and ignorance.

  9. Katie Makj

    When my daughter was diagnosed with anorexia at ten, the first questions out of everyone’s mouths were “ Was she molested? Raped? What happened to her?” There just had to be a “ reason” she got anorexia. The reason was she decided to stop eating junk food and exercise more because school told her that there were too many fat kids in their anti- obesity brain washing madness. And the negative energy balance that ensued caused her genes to turn on. That simple. Of course all cases are unique, but ultimately if parents caused EDs, then most of the population would have one. We are surrounded by diet culture etc.

    I’m so sorry you lost your child. I cannot imagine that pain. Thank you for speaking up.

  10. Natalie

    What a brave and beautiful post. I am so grateful that F.E.A.S.T exists. This is the organization that saved my daughter’s life. I am so sorry, Judy, for all that you and your family have been put through. It is unfair, it is not what it should have been, but it is. You are the perfect person to be at the head of this organization today, and all you have done since being appointed is the best evidence of this. Thank you, from all of us parents!!!

  11. JD Ouellette

    VIP writing—a Very Important Post. I am so sorry your family experienced this, and it so clearly did not support recovery.

    It’s hard to see how entrenched this parent blame is in the ED community. My own daughter has spoken and written about her conviction that the path of her anorexia aligns with a negative energy balance trigger, and that it is through FBT renourishment (against her will) that she was able to get to a place where she could begin to absorb psycho-education on her illness and do skills-building therapy and engage in temperamental insight that she got well in a relatively short period of time. Both clinicians and others who have had EDs have told her, and me, that she’s simply not willing to see how her family actually was a cause, and that it’s not possible that she and I both agree that she was a happy, healthy kid from a close, well-functioning family both before and after her illness. Meanwhile, she lost very little of her life to anorexia and is an adult living her best life, free of any eating disorder. I am grateful for the way UC San Diego educated and treated us and wish everyone could access treatment that is forward-thinking and neurobiologically informed.

  12. Laura H

    Judy, you write with a truth and a love that cuts clean through. As parents too many of us have had to carry the burden of blame alongside the devastation of a life-threatening diagnosis in our child at a time when we needed clear direction and an abundance of support. This illness more than any other requires us as parents to be empowered and knowledgeable, and fast. Too often when we reach out for medical support, our children receive non-evidence based care which is often undermining of our role and ability as caregivers to help guide our child to recovery. With the scientific evidence currently available this is completely unacceptable, especially for an illness with such a high mortality rate. Although our child is on the road to a strong recovery thanks in part to the information and support from F.E.A.S.T., the path was a harrowing one and could have gone wrong on more occasions than I care to think of. F.E.A.S.T. and the families it supports are truly blessed to have such a strong and clear advocate at the helm. Thank you for speaking your truth.

  13. May

    I suffered with anorexia and bulimia as a teen and fully recovered as a young adult after being lucky enough to find a excellent therapist who was herself recovered from bulimia. I am in my mid 40s now and thankfully have had a happy and fulfilling life. I feel for parents and their children who struggle with these disorders.

    The uncomfortable truth is my family’s dysfunction did – without question – play a critical and essential role in the development of my eating disorder at age 14. My view is that it is harmful to blindly repeat the mantra that “parents do not cause eating disorders.” To not even be able to entertain the possibility of family dysfunction/dynamics being relevant, absolving parents in all cases of responsibility, is simply turning a blind eye. It makes recovery much harder, and it minimizes root causes and underlying trauma. Eating disorders are related to emotions, trauma and attachment injuries. I feel as adults we need to have a much richer conversation – parents need to hear a different message that just FBT orthodoxy and I pray it changes.

    • Judy Krasna

      I wrote about my own truth. You have yours, and I thank you for sharing it. What I am speaking about in my own case is blanket parent blame and the assumption that all parents cause eating disorders. When this is the case, parents are pushed away and unable to participate in their child’s treatment or to serve as a support. For my own daughter, this was a huge detriment.

      There are horrible cases of parent dysfunction and of abuse, and I can certainly see how that could contribute to the development of an eating disorder and how those parents’ involvement in treatment may not be productive. I am not denying that. But in my own experience, through my involvement at FEAST and with the thousands of families who we help, I have found that way more often than not, the families of people with eating disorders are functional, caring, and willing to do anything to help their child. Families are not perfect. We all have our flaws. There needs to be space in treatment for parents to be guided on how to change the environment if it triggers or negatively impacts their child’s eating disorder. I have seen at times that parents do the wrong things due to ignorance; and when properly informed and educated, they can change their behaviors to benefit their person with an eating disorder.

      We each have our truths and we can all learn from each other through these conversations. As a side point, FEAST does not subscribe to “FBT orthodoxy” as you put it. FBT is an evidence based treatment with proven efficacy. I think that to a large degree, it is due to the fact that families make excellent partners in treatment. In some cases, FBT, or parental involvement in treatment, is not advisable.

      When you start with the premise that parents are always part of the problem, then you come to the conclusion that parents can never be part of the solution. This was my own experience, and I think that the attitudes in early treatment sowed seeds that couldn’t be undone, and that ultimately that played a part in my daughter’s death.

      Every person with an eating disorder deserves the best possible chance at recovery. Blindly and indiscriminately blaming parents will not achieve this.

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