An adult patient I recently worked with (who made an incredible journey of recovery after over 5 years of being unwell with disordered eating) recently took time out to write an open letter to parents whose children are currently engaged in family based treatment. Joanne felt compelled to write this letter after what she frequently observed taking place in our waiting room as families were leaving their FBT meetings.
Dear Parent,
This will be the fight of your life, to save your life - your child.
When I lived with an eating disorder, I lived for nothing but the eating disorder. In doing so, I developed two versions of myself, Joanne, the girl I truly was, the girl who was sensitive, kind, loved her mother unconditionally and savored time spent with her. Then there was Joanne the eating disorder. This is the Joanne who lied about eating and how much she had ate, the Joanne who threw out food, stole food, purged. This was the Joanne who told her mother that she hated her, that she wasn’t sick and that she didn’t need help. The Joanne that manipulated my mum into thinking I would be ok, by convincing her that I wanted to eat but I just wanted to be ‘healthy,’ when in actual fact my body was screaming out for nourishment. As my eating disorder became too obvious for me to disclose, Joanne, the eating disorder told my mum that as my parent she could never understand and that it was her fault that I had developed a distorted perception of myself.
I obviously can’t speak for every eating disorder case out there, but when your child says they will eat but ‘only healthy foods’ you should hear alarm bells. The fact that they are set on limiting their diet to healthy foods alone proves just how trapped they have become by an eating disorder. Furthermore, it’s almost guaranteed that their idea of a ‘healthy’ diet and portion size is extremely unrealistic and dangerous. I got to the point where I would watch my mother cut up vegetables and throw a raging tantrum the moment I thought she was cooking too many. “Why would you do that!” I would scream as if she had just told my worst enemy my biggest secret. Sometimes I would work myself up into such a state that I would then refuse to eat, as if my mother’s actions had given me a reason not to, when all I was actually doing is giving into the eating disorder. Instead of taking responsibility for why I did not want to eat, I was trying to shift the blame onto my mother and her actions. I remember feeling torn in these situations. On one hand, I remember realizing how irrational I was being, but on the other hand, hating my mother for being so insensitive to my perceived needs.
So I want to make this point. Even during the most trying times, try to recognize that your child is living through two versions of themselves, the personality they were born with, and the personality of an eating disorder. Try to separate them in your mind so that you don’t take the mean things say to you and their often-extreme behaviors to heart. When you take what they say to you in the heat of the moment to heart it will lead you to do one of two things. You will either fight back aggressively about the surface level issue eg: preparing too much food and your child, the eating disorder, will resent you and rebel, leaving you at a dead end. Or you will give into your child and let them take control of their diet. Both of these actions will only keep your child trapped in this ongoing battle of disordered eating.
So what do you do? In terms of their physical needs, remain firm with your child and their diet, which should incorporate a wide cross section of food. This is something my own mother struggled to do for a very long time, to the detriment of my health. She would hate to see me upset so she would give in to my demands for low calorie meals and allow me to over exercise. She would allow me to avoid going out for dinner and if I did attend a dinner she would order my food with no dressing or cooked with no oil. She did this because she loved me and was trying not to make my life easier during an obvious time of uncertainty. She just wanted me to eat anything. But what she was actually doing was loving me to death. Like my own brain, she was also feeding into the eating disorder, further distorting my view of normality, and adding momentum to my world which had become a constant merry go round of fear frustration, restriction, binging and purging. Looking back, what I wished my mum had done is to kick me out of the kitchen and prepare good nutritious meals. When I questioned her about it, she should have her explained to me why I needed to eat it and why the portion size she had given me was realistic compared to my bird sized beliefs. Easier said than done, right? When my mum did start doing this I was convinced she had turned her back on me, that she didn’t love me anymore. I would freak out in attempt to manipulate her into allowing me to eat what I wanted to.
Looking back now the biggest thing I learnt from my relationship with my eating disorder and with my mum is the power I parent can have in reshaping a child’s perception of their illness. In a nutshell, I will ask of you one thing - when your child freaks about certain foods or portion sizes don’t freak out back at them. Realize this is the eating disordered side of their personality coming out and see it as an opportunity to talk your child about their beliefs and attitudes towards food, an opportunity to gain some insight into what’s driving them to behave this way. When I first realized my mother was really listening to me and trying her best to understand, I gradually became honest with her and started to acknowledge my own irrational behavior. I believe I could do this because I wasn’t scared that she was going to try and change me overnight, or make me do something I didn’t want to do, I was comforted by the fact that she was trying to help release me from a prison I was well aware I may never be free from without her help. Yes we had some very heated moments, I threw food, I screamed, I called her names. But the more she didn’t fight back with anger, but with concern and love, the more I began to give in and as I gave in I shared more, and as I shared more I realized how sick I truly was.
This brings me to my next, more important point – consistent communication. Talk to your child, in a calm collected way. Realize that their relationship with food is the secondary issue, the result of some other psychological battle that they have been carrying, perhaps for many years. I can’t stress enough the importance of communication. Even if they don’t realize it at the time, and maintain that they have nothing to say, expressing what is troubling them out loud will have some powerful positive impacts on this disease. Simply acknowledging it exists, and that things aren’t right, is a step towards recovery and overcoming it once and for all.
The single most important thing that kept me on track during my recovery, particularly when I felt down and defeated, was positive reinforcement. I will explain what I mean. I have read that when a person develops an eating disorder their brain stops maturing. Regardless of the science behind this, I wholeheartedly believe this is true. I became like a child in all aspects of my behavior, my temper and my ability to look after myself. I was a 20-odd year old, living in the adult world with a 14 year olds brain. When I avoided eating or felt I lost weight, the eating disorder rewarded me a feeling of positivity, a sense of value and wellbeing. When I ate, I automatically felt less worthy as a person, more irritable and irrational. Overtime this control that the eating disorder had on me developed into a deep anger and confusion that lived with me even during the times when I was feeling ok about my body image. No matter how much I wanted to get better I couldn’t turn this mental pattern around.
Like a child, the eating disorder makes you demand attention, either the attention of yourself by liking what you see or the attention of others saying that you look good, thin, beautiful - perfect. As you are probably aware, many with eating disorders are driven by the pursuit of perfection so hearing complements about their appearance or even concern that they are looking too thin will only spur the eating disorder on. One thing that my mother helped me to do was to redefine what I believed to be positive reinforcement. Each time I ate my mum would focus on what I had consumed which I may have found challenging, instead of focusing on something which I hadn’t managed to eat. She rewarded me with praise and it made me feel good during instances when I whole-heartedly believed I had done wrong by myself. The more praise I received the more stopped devaluing myself every time I ate and starting believing that nourishing myself was right. The more I took on this belief the more power I was stealing back from the eating disorder. I also want to highlight the importance of having a very supportive group of professionals around your child. The knowledge and insight I gained from my psychologist and dietician, and their positive reinforcement also served to drown out the demands of the eating disorder and enable me to develop new values and attitudes towards food and the amazingly positive impact it can have on your quality of life.
You see, recovery is about a mindset, yes physical aspects like eating, regaining wait and reincorporating a varied diet in your child’s life are essential, but these changes are secondary elements in the recovery process. These changes cannot be sustained unless you child is willing and able to alter their mindset and develop a new relationship with food. So as parents you need to reach out and hold onto any glimmer of hope, which shows you your child, is willing to change. Foster what's ever that is, like anything the more energy you put into something the more it will improve, take over, becomes second nature, their life - your life.
I know you feel lost. But just believe in your child. They are stronger than they seem. Do not make them feel like a lost cause and really support each step they take no matter how big or small. Appreciate dolly steps – it took your child a long time to develop this illness so it may take even longer to overcome. Each move forward counts towards becoming fully recovered. Love your child, hate the disease. You’re not battling your child, you’re battling an illness. Like any illness, do your best to keep your child on side with you so you can tackle it together. You may want recovery to happen quickly but it wont, and just because it wont please do not think you are a failure.
Upon writing this letter I asked my own mother what the biggest piece of advice she could give another parent enduring what we have gone through together. The first words which came out her mouth was “Get help before they turn 18.” We failed to do this and after I turned 18 my mother couldn’t provide me with any professional help without my consent. Because it took me so long to truly acknowledge that I needed support my battle continued well into my early adult life. I then found myself having to juggle my professional career and a disease, which had increasingly made me incapable of operating in an adult world. Help your child turn their life around before it becomes their only life and before it’s solely up to them. Provide strength and guidance with love, not resentment or anger, it’s not their fault they have developed this truly soul-destroying disease.
You have one of the toughest roles having to witness your child grapple with an eating disorder, but take comfort in knowing that you truly have the most power in helping them find themselves again.
Despite what they say they don’t hate you, and your support through this disease will bring you closer together. As, the saying goes, love can conquer all.
Good luck, stay strong and kind regards,
Joanne
Dear Parent,
This will be the fight of your life, to save your life - your child.
When I lived with an eating disorder, I lived for nothing but the eating disorder. In doing so, I developed two versions of myself, Joanne, the girl I truly was, the girl who was sensitive, kind, loved her mother unconditionally and savored time spent with her. Then there was Joanne the eating disorder. This is the Joanne who lied about eating and how much she had ate, the Joanne who threw out food, stole food, purged. This was the Joanne who told her mother that she hated her, that she wasn’t sick and that she didn’t need help. The Joanne that manipulated my mum into thinking I would be ok, by convincing her that I wanted to eat but I just wanted to be ‘healthy,’ when in actual fact my body was screaming out for nourishment. As my eating disorder became too obvious for me to disclose, Joanne, the eating disorder told my mum that as my parent she could never understand and that it was her fault that I had developed a distorted perception of myself.
I obviously can’t speak for every eating disorder case out there, but when your child says they will eat but ‘only healthy foods’ you should hear alarm bells. The fact that they are set on limiting their diet to healthy foods alone proves just how trapped they have become by an eating disorder. Furthermore, it’s almost guaranteed that their idea of a ‘healthy’ diet and portion size is extremely unrealistic and dangerous. I got to the point where I would watch my mother cut up vegetables and throw a raging tantrum the moment I thought she was cooking too many. “Why would you do that!” I would scream as if she had just told my worst enemy my biggest secret. Sometimes I would work myself up into such a state that I would then refuse to eat, as if my mother’s actions had given me a reason not to, when all I was actually doing is giving into the eating disorder. Instead of taking responsibility for why I did not want to eat, I was trying to shift the blame onto my mother and her actions. I remember feeling torn in these situations. On one hand, I remember realizing how irrational I was being, but on the other hand, hating my mother for being so insensitive to my perceived needs.
So I want to make this point. Even during the most trying times, try to recognize that your child is living through two versions of themselves, the personality they were born with, and the personality of an eating disorder. Try to separate them in your mind so that you don’t take the mean things say to you and their often-extreme behaviors to heart. When you take what they say to you in the heat of the moment to heart it will lead you to do one of two things. You will either fight back aggressively about the surface level issue eg: preparing too much food and your child, the eating disorder, will resent you and rebel, leaving you at a dead end. Or you will give into your child and let them take control of their diet. Both of these actions will only keep your child trapped in this ongoing battle of disordered eating.
So what do you do? In terms of their physical needs, remain firm with your child and their diet, which should incorporate a wide cross section of food. This is something my own mother struggled to do for a very long time, to the detriment of my health. She would hate to see me upset so she would give in to my demands for low calorie meals and allow me to over exercise. She would allow me to avoid going out for dinner and if I did attend a dinner she would order my food with no dressing or cooked with no oil. She did this because she loved me and was trying not to make my life easier during an obvious time of uncertainty. She just wanted me to eat anything. But what she was actually doing was loving me to death. Like my own brain, she was also feeding into the eating disorder, further distorting my view of normality, and adding momentum to my world which had become a constant merry go round of fear frustration, restriction, binging and purging. Looking back, what I wished my mum had done is to kick me out of the kitchen and prepare good nutritious meals. When I questioned her about it, she should have her explained to me why I needed to eat it and why the portion size she had given me was realistic compared to my bird sized beliefs. Easier said than done, right? When my mum did start doing this I was convinced she had turned her back on me, that she didn’t love me anymore. I would freak out in attempt to manipulate her into allowing me to eat what I wanted to.
Looking back now the biggest thing I learnt from my relationship with my eating disorder and with my mum is the power I parent can have in reshaping a child’s perception of their illness. In a nutshell, I will ask of you one thing - when your child freaks about certain foods or portion sizes don’t freak out back at them. Realize this is the eating disordered side of their personality coming out and see it as an opportunity to talk your child about their beliefs and attitudes towards food, an opportunity to gain some insight into what’s driving them to behave this way. When I first realized my mother was really listening to me and trying her best to understand, I gradually became honest with her and started to acknowledge my own irrational behavior. I believe I could do this because I wasn’t scared that she was going to try and change me overnight, or make me do something I didn’t want to do, I was comforted by the fact that she was trying to help release me from a prison I was well aware I may never be free from without her help. Yes we had some very heated moments, I threw food, I screamed, I called her names. But the more she didn’t fight back with anger, but with concern and love, the more I began to give in and as I gave in I shared more, and as I shared more I realized how sick I truly was.
This brings me to my next, more important point – consistent communication. Talk to your child, in a calm collected way. Realize that their relationship with food is the secondary issue, the result of some other psychological battle that they have been carrying, perhaps for many years. I can’t stress enough the importance of communication. Even if they don’t realize it at the time, and maintain that they have nothing to say, expressing what is troubling them out loud will have some powerful positive impacts on this disease. Simply acknowledging it exists, and that things aren’t right, is a step towards recovery and overcoming it once and for all.
The single most important thing that kept me on track during my recovery, particularly when I felt down and defeated, was positive reinforcement. I will explain what I mean. I have read that when a person develops an eating disorder their brain stops maturing. Regardless of the science behind this, I wholeheartedly believe this is true. I became like a child in all aspects of my behavior, my temper and my ability to look after myself. I was a 20-odd year old, living in the adult world with a 14 year olds brain. When I avoided eating or felt I lost weight, the eating disorder rewarded me a feeling of positivity, a sense of value and wellbeing. When I ate, I automatically felt less worthy as a person, more irritable and irrational. Overtime this control that the eating disorder had on me developed into a deep anger and confusion that lived with me even during the times when I was feeling ok about my body image. No matter how much I wanted to get better I couldn’t turn this mental pattern around.
Like a child, the eating disorder makes you demand attention, either the attention of yourself by liking what you see or the attention of others saying that you look good, thin, beautiful - perfect. As you are probably aware, many with eating disorders are driven by the pursuit of perfection so hearing complements about their appearance or even concern that they are looking too thin will only spur the eating disorder on. One thing that my mother helped me to do was to redefine what I believed to be positive reinforcement. Each time I ate my mum would focus on what I had consumed which I may have found challenging, instead of focusing on something which I hadn’t managed to eat. She rewarded me with praise and it made me feel good during instances when I whole-heartedly believed I had done wrong by myself. The more praise I received the more stopped devaluing myself every time I ate and starting believing that nourishing myself was right. The more I took on this belief the more power I was stealing back from the eating disorder. I also want to highlight the importance of having a very supportive group of professionals around your child. The knowledge and insight I gained from my psychologist and dietician, and their positive reinforcement also served to drown out the demands of the eating disorder and enable me to develop new values and attitudes towards food and the amazingly positive impact it can have on your quality of life.
You see, recovery is about a mindset, yes physical aspects like eating, regaining wait and reincorporating a varied diet in your child’s life are essential, but these changes are secondary elements in the recovery process. These changes cannot be sustained unless you child is willing and able to alter their mindset and develop a new relationship with food. So as parents you need to reach out and hold onto any glimmer of hope, which shows you your child, is willing to change. Foster what's ever that is, like anything the more energy you put into something the more it will improve, take over, becomes second nature, their life - your life.
I know you feel lost. But just believe in your child. They are stronger than they seem. Do not make them feel like a lost cause and really support each step they take no matter how big or small. Appreciate dolly steps – it took your child a long time to develop this illness so it may take even longer to overcome. Each move forward counts towards becoming fully recovered. Love your child, hate the disease. You’re not battling your child, you’re battling an illness. Like any illness, do your best to keep your child on side with you so you can tackle it together. You may want recovery to happen quickly but it wont, and just because it wont please do not think you are a failure.
Upon writing this letter I asked my own mother what the biggest piece of advice she could give another parent enduring what we have gone through together. The first words which came out her mouth was “Get help before they turn 18.” We failed to do this and after I turned 18 my mother couldn’t provide me with any professional help without my consent. Because it took me so long to truly acknowledge that I needed support my battle continued well into my early adult life. I then found myself having to juggle my professional career and a disease, which had increasingly made me incapable of operating in an adult world. Help your child turn their life around before it becomes their only life and before it’s solely up to them. Provide strength and guidance with love, not resentment or anger, it’s not their fault they have developed this truly soul-destroying disease.
You have one of the toughest roles having to witness your child grapple with an eating disorder, but take comfort in knowing that you truly have the most power in helping them find themselves again.
Despite what they say they don’t hate you, and your support through this disease will bring you closer together. As, the saying goes, love can conquer all.
Good luck, stay strong and kind regards,
Joanne
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