I am an eating disorder specialist that also has a passion for marriage and family therapy. I never thought that was weird until other professionals started asking “How does a family therapist get involved in Eating Disorder work?”
My answer is, very naturally. I have a strong desire to treat people who struggle in this way and I also know it is an incredibly difficult road for families and partners to walk. One of the hardest things for a loved one is feeling like they are going to do and say something that is wrong. My answer is usually, you probably will say something wrong. Have compassion. Just like your loved one can’t do recovery perfectly, you won’t be able to do support perfectly.
With that being said, I would like to offer some tips and wisdom to help you understand eating disorders better:
Do: Realize that Recovery is a long process filled with setbacks, challenges, and positive strides. We always say in the recovery world “Progress, Not Perfection.”
Don’t: Criticize, threaten, or shame your loved one for where they are in this journey. Shame is never a powerful motivator for change.
Do: Speak up if you feel like your loved one is harming themselves or their recovery. Ask them how they would like you to address concerns about their recovery.
Don’t: Ignore harmful behaviors and pretend that everything will be okay.
Do: Work on your own language around food and your body.
Don’t: Body shame yourself or others, diet, meal skip, or talk about food in black and white terms (healthy vs. unhealthy, good vs. bad). Your loved one will encounter this enough on a daily basis they don’t need you to engage in this type of behavior too.
Do: Talk about how amazing your friend or family member is. How strong they have been and how hard you know the process is.
Don’t: Compliment their appearance. “You look great!” Can often be heard as “you have gained weight…” or “you have lost weight and that is a good thing.” Also be aware that saying “I think you are recovered” or “doing a good job” can sometimes be interpreted as you wanting them to hurry up and be better. Often, clients take this as a signal that you can’t support them if they relapse or engage in behaviors again. This only leads to shame and secrecy. Secrets will keep you sick.
Do: Let them know you fully support them in their recovery and will be there for them no matter what. Also, let them know that you will help them find the best and most appropriate care for them.
Don’t: Talk about the cost of treatment in front of them. Many of my clients have refused treatment or tried to rush through (by engaging in harmful behaviors) so that they won’t be a “burden” on their loved ones. One significant aspect of eating disorders is that these clients tend to have a harder than average time asking for support and care. When they feel shame about finances this becomes recovery sabbotaging. You wouldn’t make your loved one feel bad about the cost of treatment for a medical disease, know that your child isn’t choosing this anymore than they would chose a life threatening medical disease.
Do: Plan activities and resume living life without fear of what “might” or “could” happen. Make sure these activities do not revolve around weight loss and they have been cleared by your loved ones treatment team.
Don’t: Keep your child away from friends and activities that they find meaning in, unless they are directly sabotaging recovery. If your child loves to attend church, it’s important that they still retain some life outside of the eating disorder. Don’t center the family schedule around the eating disorder, if you always went to the movies on Friday nights- keep doing that and have your loved one talk to their treatment team about any difficult thoughts and feelings that might come up.
Do: Realize that the Eating Disorder is not a choice, but recovery is. This helps place the power in your loved ones hands and it helps normalize the eating disorder. I often say “I know you didn’t chose this sickness but I think it is brave that you are waking up each day and choosing recovery.”
Don’t: Blame your loved one for having an eating disorder, try to manipulate them out of the eating disorder, or accuse them of faking it because they may not “look sick” or they “seem fine.” Eating disorders don’t have a specific look (despite what Hollywood may portray) and some of my clients that engage in the most harmful behaviors have “normal looking” bodies or are even at a higher weight. Binging and purging is still harmful no mater what size body you have. Restricting calorie intake is still starving your body of needed energy and nutrients, even if you are in a larger body. You can’t trick or talk your loved one out of his or her eating disorder, efforts to do so will only lead to shame.
Do: Emotionally support your loved one through meals. Let them know that it is hard and that you are there to listen to them and hear them out. Realize that meal times, shopping for clothing, or other activities are unbelievably difficult for your loved one.
Don’t: Scream, yell, or punish your child. Don’t tell them to “just eat.” They would if they could. I promise. I know you are scared, and fear is a powerful motivator, but this type of behavior is not helpful. Also, don’t try to fix their problem by giving them advice – they need your support more than they need words of wisdom.
Do: Get your own help. I can’t tell you how many support people are resistant to going to their own therapy. Sometimes it is a financial issue and sometimes they just feel like they will be blamed for the problem. There are great resources for affordable counseling.If your therapist has an understanding of eating disorders they will know that this is not your fault. Practice self care and self compassion, this is the best thing you can model to your struggling loved one.
Don’t: Blame yourself and spend all of your time and energy trying to figure out what caused this.
Do: Realize that your loved one and their eating disorder are not the same person. A lot of the work of therapy is helping clients realize this. You are not angry with your child, you are angry with an Eating Disorder.
Don’t: Beat yourself up for being imperfect, again modeling self compassion is exactly what your loved one needs to see.
Do: Realize that 100% recovery is possible. Yep. You heard that. 100%! Your loved one won’t have to deal with an eating disorder forever. Sometimes it may seem like forever, and to be sure eating disorder recovery can take a long time but it is possible to be recovered!
Don’t: Give up! You have got this, Your loved one is so very fortunate to have you caring for them. This is hard stuff, look for support groups and people who have been down this road.