By Oona Hanson
“If I could get my child to eat, we wouldn’t be in this mess.”
Soon after my child received an anorexia diagnosis, I started to read compelling memoirs about families who had successfully achieved weight restoration at home. I couldn’t understand how they did it. It felt like reading science fiction.
As our child endured multiple treatment programs and various levels of care, I continued to learn as much as I could about the illness, its causes, and ways to support recovery. When we eventually found our way to Family-Based Treatment, I brought these additional resources to buttress our new approach.
There is no one-size-fits-all approach when it comes to eating disorders, of course. But if you’re struggling and could use a few more tools, perhaps some of our lessons will resonate with your family, too:
- Don’t panic if things seem worse after beginning treatment. Remember your child is not the eating disorder; rather, they are like the victim of a demon possession or alien “body snatcher.” The demonic creature will try to fight back when you challenge its hold on your loved one. Be prepared for angry, even frightening, responses from your child. Rather than being a sign of failure, these cruel and shocking outbursts are a common sign that treatment is working.
- Keep the long-term goal in mind. At every meal and snack, you have the opportunity to feed either your child or the eating disorder. This is really hard. Giving in to a request for something “safe” or allowing them to refuse food may ease their (and your) distress in the moment, but it’s usually fueling the disorder more than the recovery.
- Have a united front. If you have a spouse or co-parent, be in an alliance against the eating disorder, and ensure any other caregivers or treatment team members are on the same page. Clever and manipulative, eating disorders will find and exploit the tiniest chink in the armor. A firm, consistent, loving stance is key.
- Get support for yourself. Caring for an ill child can be grueling, physically and emotionally. Even if you can access private counseling, consider taking advantage of resources geared specifically for caregivers. Whenever possible, lean on friends, family, and your larger community.
- Explore Emotion-Focused Family Therapy (EFFT). I hate to give you another acronym to unpack, but you might be glad to add this one to your vocabulary. EFFT gives parents and other caregivers the tools to communicate with a loved one whose thoughts and emotions are controlled by their eating disorder. Validating the sufferer’s feelings does not mean you are agreeing with their irrational, self-destructive statements or colluding with their illness. Feeling heard and understood, however, helps the sick person face the daunting task before them. For weary caregivers, having some go-to “scripts” can be incredibly helpful during difficult meals.
- Use a contract. With guidance from a treatment professional and input from your child, develop a written recovery contract–and stick to it. Be sure your document contains clear expectations and lays out a realistic system of rewards and consequences.
- Don’t be afraid to go old-school. Even if your child is an older teen or young adult, you might find it useful to create a sticker chart to track progress toward small, incremental goals. Intrinsic motivation to recover tends to be very low in anorexia patients. External motivators can be incredibly helpful along the way. Having a physical chart can also alleviate some of the interpersonal tension between adult and child.
- Model an “all foods fit” approach. Everyone has different tastes and energy needs, but a child in recovery from an eating disorder cannot be fully supported if other members of the household are exhibiting dieting behaviors or other food restrictions that are not medically required. If necessary, get support for anyone else in the family who needs help healing their relationship with food.
- Remember that food is the medicine, in more ways than one. Refeeding can be physically and psychologically painful, but the only way out is through. It may be helpful to imagine a child with another medical condition that required excruciating physical therapy–or if you had to administer a foul-tasting but life-saving medicine with unpleasant side effects. If you knew the interventions were necessary to help your child go on to live a fuller life, you would acknowledge their pain and ease it as much as possible–but you wouldn’t stop the treatment.
- Learn about Health at Every Size ®. Weight stigma is everywhere, even in many eating disorder treatment settings. Examining and dismantling your family’s own unconscious bias against larger bodies can be a crucial step in fostering a healing environment for your loved one. Remember that you won’t really know an individual’s healthy weight range until they get there. And regardless of your child’s body type, living in a home free from fat phobia is health-promoting.
Every family’s needs are different, so I would never say I have the one true recipe for successful recovery. But I do know these approaches worked in our home–and helped us turn science fiction into a true story with a happy ending.