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The Trauma of Having a Child With an Eating Disorder

By Dr. Theresa Fassihi, PhD, FAED, CEDS

What is a trauma?  An OpEd in the New York Times on Saturday, February 4, raises the question, “If Everything is trauma, is anything?”  The author expresses concern that the term “Trauma” is being used too loosely to describe any “disagreement or hardship.”

In my work as a therapist, I have found that the common understanding of trauma is usually too narrow, limited to war, violence, rape, extreme danger.  I know this because when I ask my new patients if they have had trauma, most people initially say they haven’t.  It is only after we have discussed what it means that they recognize that they have had traumatic experiences.

This holds true for parents of patients with eating disorders.  They are usually unaware that having a child with an eating disorder is traumatic.  

The Substance Abuse and Mental Health Services Administration (SAMHSA) describes individual trauma as resulting from “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.”  This definition is known as the three E’s – Event, Experience and Effect.  Let’s look at the three E’s of an eating disorder’s impact on parents:

Event – eating disorders are life-threatening illnesses. They are physically and emotionally harmful and dangerous.

Experience – although their children may not be able to recognize the illness, most parents can and are overwhelmed with fear and helplessness. The only thing scarier to a parent than having their own life in danger is having their child’s life in danger. 

Effect – parents often exhibit extreme emotions when they bring their children to treatment.  They are anxious, frantic, fearful, or angry at their child and treatment providers, or avoidant of the issue, in denial.  These responses are consistent with the automatic fear responses of Fight, Flight or Freeze.  

One wise clinician once said that the eating disorder puts a magnifying glass on our vulnerabilities.  Whatever difficulties we may have with coping are intensified by the trauma of having a loved one with an eating disorder.  

It is helpful to recognize that the responses families are having to the illness are NORMAL responses to an abnormally difficult situation.

Fortunately, the most effective treatment we have for eating disorders, Family Based Treatment or FBT, can also be effective in healing parents’ trauma.  As parents learn to nourish their child back to health, they regain their confidence that they can make a difference and use support to get through the challenges.  

One thing we are learning, though, is that before we can teach skills for addressing the eating disorder, we need to address parents’ trauma.  A common symptom of trauma is self-blame and shame, and parents often blame themselves for their child’s illness or for not recognizing it sooner.  Not too long ago, the medical field was also blaming parents.

Addressing parents’ self-blame and fear is the first step to helping them support their child’s recovery, so that instead of feeling “afraid and alone,” parents can feel empowered and supported by their treatment team and the FEAST community.  

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  1. Katie Maki

    This is spot on. This is an incredibly traumatic experience. Our brains get suffocated by fight or flight chemistry. We spend months to years not sleeping well, in constant worry, and often isolated within our own homes and minds. I myself have had ten years of trauma. First with my daughter and ED, the fallout, then my son and SAs and clinical depression. Followed by the pandemic and being a front line family. This past year I have really felt the effects of constant traumas. It is very difficult to heal and take care of yourself when you don’t even know who you are anymore other than a caregiver you kids trying to actively die.

  2. KAZ

    Yes i can so relate to this not only after my d (and the entire family) battling her AN for past 5 years, I myself dx and treatment for cancer the last 18 months then my son drug addiction to deal with
    I really don’t know how we continue to get up and function each day but we do
    What other choice is there
    Thankful for the online support offered from FEAST x

  3. Erika

    All three of my daughters had severe eating disorders. When the middle daughter was hospitalized, I had a breakdown and had to go into a PHP program for depression and anxiety. Eating disorders have scarred our whole family. My girls still have ED struggles as adults. My advice is to get help for the family asap because everyone is affected and hurting.

  4. Mikki Lawrence

    We’re a family that has been on this horrible journey for almost 3 years! My D17 is currently on a rapid downward spiral. It’s, most certainly, affecting all of us. I believe especially my beautiful fighter and myself. Nothing about our lives are easy or our “normal “. This disease is devastating

  5. Bea R.

    Reading the comments didn’t not make me feel better about situation with my son, but made me feel connected, I am not alone. My 14 yours old son has been having different issues since he was 4, so it has been over 10 years now. I feel often I don’t have any more patience in me left to deal with it. I am a single mom. My son has been diagnosed with Anorexia 18 months ago, we are still not at goal weight. Eating should be simple, so difficult to understand.

  6. Karen Kalasy

    My 14 year old Daughter has Anorexia..for the past year. The Pandemic didn’t help! My husband and I brought her home yesterday afternoon 3 weeks on a children’s ward. Only for refeeding program no mental health help. She is under the EDT. I can’t read or think straight feeling like I’m spaced out not with it and exhausted.

  7. Misty

    After 15 rounds of the inpatient/residential/PHP cycle with my “treatment resistant” (now adult) daughter who has Anorexia, and a couple cycles of the same for her twin with anxiety/depression, I am a shell of a person. I don’t have anything left to give. I don’t even have anything left to keep at this point. I genuinely don’t know if I can survive another year of this.

  8. Tina Whelan

    I’m so sorry to hear. It’s really devastating. I’m a mother also supporting mg daughter with AN. We just have to do what it takes to get them better.

  9. Shelley

    Our experience has been that if FBT is not successful, it is anything but therapeutic for traumatized parents. In fact, the failed attempts we have had over multiple years to nourish our child back to health have made the trauma worse. We have tried lots of things, but no program or method really focuses on helping parents cope with these strong emotions. The one ‘family session’ a week at the many places our daughter has been serves double and triple duty as an update session, logistical meeting and in there is time for maybe a few therapeutic moments. I have found that mostly, parents are on their own. Trying to explain the situation to a personal therapist who doesn’t know my child or what it is like to live day in and day out with a child with a severe ED is equally unhelpful. Sorry to be a downer, but let me know if you know something I haven’t heard about.

    • Judy Krasna

      FEAST is actually developing a program designed to teach these critical coping skills to parents–it will include other types of skills as well. We hope to have it released by early summer.

  10. Mrs C

    I’ve been diagnosed with PTSD. I was wondering if anyone was writing about the trauma families experience. My son’s ED happened during Covid isolation and the only thing worse than his ED was not being able to find care….and when I did find care they wouldn’t accept the insurance. It’s the scariest experience I’ve ever had and I survived a terrorist attack in London. God help these parents…employers need to be aware with parents who deal with these issues and provide them with support

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