Tips for managing the stressors of a child’s eating disorder while also supporting their recovery
Having a child who is struggling with an eating disorder is not only scary and overwhelming for parents, but it also disrupts their family system. Parents need to receive support during their child’s treatment to manage the fear and self-blame surrounding their child’s diagnosis, so they can feel capable of engaging in their child’s treatment and recovery.
One of the most important factors in helping parents feel capable of engaging in their child’s recovery is a sense of self-efficacy. Self-efficacy is gained when parents learn skills for how to support their child’s recovery best. Self-efficacy is maintained when they have their own support system and ways to care for themselves while their child is recovering.
An Eating Disorder’s Impact on the Family
When a child is diagnosed with an eating disorder, parents are faced with the stress of adapting to the illness. The adaptation stage is not easy and comes with many emotions, such as fear, anxiety, guilt, anger, or denial. The intensity of these negative emotions makes it challenging for parents to accept the reality of the illness and the treatment necessary for their child, and family, to overcome it.
It makes sense for parents to experience distress over their child’s illness. After all an eating disorder disrupts the family in many ways, including:
Changes Your Relationship with Your Child. When parents of children with eating disorders were interviewed, they reported a negative change in their relationship with their child since the onset of the illness. Parents reported increased anger and resentment, frustrations with the perceived manipulative behaviors of their child, and fear of upsetting their child if they went against the eating disorder.
Increased Conflict in Marital Relationships. Married parents of children with eating disorders reported increased tension, stress, and conflict. The changes in the marital relationship were reportedly due to the limited time they were able to spend together, differing views on the severity of their child’s illness, or differing approaches to their child’s treatment plan.
Less Space for Leisure Activities. Parents of children with eating disorders don’t have extra time for things they once enjoyed. Parents may no longer be able to see friends, engage in hobbies, or have time to themselves.
Changes to the Family’s Routine. Treatment for an eating disorder typically involves a multidisciplinary team of professionals, which can be very time-consuming. Parents have to fit into the weekly schedule their child’s doctor visits, therapy appointments, and dietitian meetings. In addition, for children whose eating disorders are more severe or unable to be managed at home, parents have to manage hospital or treatment center visits while their child receives inpatient or residential care.
Financial Stress. Eating disorder recovery can be a long process filled with appointments and specialized care. Families report increased financial stress while their child is trying to recover. The increased financial burden can cause marital conflict and parental despair due to the added strain on the family system.
Sense of Isolation. Parents report feeling isolated and misunderstood by their friends and extended family as a lack of awareness of the true nature of eating disorders often leads people to offer advice that feels dismissive and invalidating. Many parents also reported frustration with doctors who overlooked or dismissed their child’s condition, which then led to delayed intervention and a lack of initial resources.
Parent Involvement in Their Child’s Recovery
Research has proven positive outcomes in eating disorder treatment when parents and caregivers are involved. However, when parents don’t feel equipped to support their child’s recovery, they may believe they are incapable of being a part of the treatment process, and, in turn, appear unmotivated to participate. Two primary reasons parents feel ill-equipped to support their child’s recovery are fear and self-blame.
Self-Blame
Self-blame is one of the intense emotions parents commonly experience when their child is diagnosed with an eating disorder. Research has shown that eating disorders happen due to a mix of contributing factors and that parents aren’t to blame. Still, parents tend to blame themselves for causing the illness or for not seeking help soon enough. Self-blame can lead parents to become resentful of their child’s illness, turn defensive and refuse treatment for their child due to shame, become reactive toward healthcare professionals on their child’s treatment team, or disengage with their child’s treatment process.
Fear
The second most common intense emotion for parents to struggle with is fear. Fear arises for a multitude of reasons, such as worries about the physical and mental consequences of their child’s eating disorder or fears associated with the emotional crisis that they anticipate happening when they push forward with treatment goals. Fear can lead to parents becoming paralyzed and losing their parental instincts for how to support their child. As a result, parents may deny the severity of their child’s eating disorder and instead enable the disorder so as not to cause their child any more suffering.
Enabling the Eating Disorder
Both self-blame and fear cause parents to lose their caregiving instincts, forget any knowledge or learned parenting skills, and become paralyzed regarding how to help. These intense emotions often cause parents to resist implementing suggested treatment goals and, instead, allow the eating disorder to take control of the family dynamic. This is called enabling the eating disorder.
Examples of how the eating disorder can take control of the family are as follows:
Changing how food is prepared. (i.e. allowing your child to watch you cook, allowing your child to make their own meal, or cooking a different meal for your child)
Avoiding or modifying routines. (i.e. rearranging plans to let your child spend more time at the gym or moving up or back mealtimes)
Engaging in reassurance seeking. (i.e. engaging in conversations with your child about whether clothes make them look fat)
Accommodating meal rituals. (i.e. what tableware is used, how fast or slow food is eaten, or where food is eaten)
Increasing Parent’s Self-Efficiency
Parents are a crucial asset in their child’s treatment process, but to get them to feel capable of engaging in treatment goals the impact of their intense emotions associated with their child’s illness must be decreased.
The way to reduce self-blame and fear in parents is to improve their sense of self-efficiency. Improving self-efficiency minimizes distress, anxiety, and the sense of burden their child’s eating disorder may create. One of the primary ways to build self-efficiency in parents is by acquiring the skills necessary to navigate their child’s recovery. Examples of these skills are as follows:
Education
When parents are educated about eating disorders, they gain necessary knowledge about the illness their child is suffering from, such as clinical features, physical complications, and emotional impacts. In addition, they can learn about the causes of eating disorders, and how many factors interact to cause the development of the illness. Learning these facts can help alleviate parental blame that they were the cause of their child’s disorder.
Communication skills
Anxiety, confusion, and fear are decreased when parents learn communication tools for effectively encouraging their child to engage in recovery-focused behaviors. Emotion coaching and recovery coaching are two skills influenced by motivational interviewing techniques that walk parents through how to effectively support their child in times of distress. These techniques are outlined in this article, Supporting a Child with an Eating Disorder, which is a great starting point for parents wishing to learn more.
Get Support
Having a child who is struggling with an eating disorder can cause a whole range of emotional challenges. Parents don’t want to be unsupportive of their child’s recovery, but sometimes they become paralyzed by their grief, overwhelm, and anxiety. These intense emotions can contribute to large reactions toward their child, which further familial conflict and promote the maintenance of the disorder.
For parents to feel capable of showing up for their children, they may benefit from having emotional support outside of their child’s treatment team. Emotional support can come in many forms. Two examples would be joining a support group or finding an individual therapist, both of which are resources offered by Hilltop Behavioral Health.
Maintaining Self-Efficacy
Maintaining self-efficacy in parents is just as important as increasing it. The maintenance of a parent’s sense of capability comes from practicing the skills necessary to support their child and intentionally receiving their own mental health support.
Practice Your Communication Skills
Practice. Practice. Practice.
It is one thing for parents to learn the tools helpful in supporting their child’s recovery, such as emotion and recovery coaching, but these skills must be put into practice for parents to feel their effects. The more parents follow the steps of these coaching techniques, the more capable they will feel of navigating moments of intense distress in their child.
Schedule Time for Parents to Care for Themselves
Supporting a child who is recovering from an eating disorder is time-consuming. There is no getting around that. Recovery comes with many appointments and changes to a family’s prior routine. However, it is important for parents to still be recharged and cared for amid their child’s crisis. The time parents have to do things for themselves may look different while their child is recovering, but even 15 minutes of intentional space for self-care can make a difference.
Do Things with Your Family Away from Food
Food is a huge part of life experiences, which means eating disorders can impact so many family events. Holidays, vacations, birthdays, or simply going to a restaurant are all events that can feel hijacked by a child’s eating disorder. It can be beneficial to schedule a family outing that doesn’t involve food to give parents and their children time to be together without the added strain of managing a meal.
Use Your Support System
Parents are deeply emotionally impacted when their child is recovering from an eating disorder, and, therefore, require a support system of their own to lean on. Even having one or two people that parents can call for support can lessen feelings of isolation. A parent’s support system can also help out with the other siblings when the recovering child needs to be taken to doctors and therapist appointments.
Final Thoughts
If you’re a parent of a child struggling with food or body image, feel free to reach out to Hilltop Behavioral Health. Our team of experts can answer questions and get you set up with support. Remember, you don’t have to do this alone.
Research
Gilbert, A. A., Shaw, S. M., & Notar, M. K. (2000). The impact of eating disorders on family relationships. Eating disorders, 8(4), 331–345. https://doi.org/10.1080/10640260008251240
Stillar, A., Strahan, E., Nash, P., Files, N., Scarborough, J., Mayman, S., . . . Lafrance Robinson, A. (2016). The influence of carer fear and self-blame when supporting a loved one with an eating disorder. Eating Disorders, 24(2), 173-185
Strahan, E. J., Stillar, A., Files, N., Nash, P., Scarborough, J., Connors, L., … & Orr, E. Lafrance, A. (2017). Increasing parental self-efficacy with Emotion-Focused Family Therapy for eating disorders: a process model. Person-Centered & Experiential Psychotherapies, 16(3), 256-269
