Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More
Most families and friends react with alarm when it becomes apparent that their loved one has an eating disorder such as Anorexia or Bulimia. The immediate reaction is to order the individual to start eating and regain lost weight. As part of this, parents often believe that the symptoms are designed to punish them. What they eventually discover is that the eating disorder has nothing to do with them and that they will not respond to being ordered to eat more. In effect, parents, siblings and friends soon discover that they are on a rocky road with this disorder and that the journey is filled with fear, frustration, despair and utter helplessness in dealing with their son or daughter who has this problem. One way to reduce frustration, if not fear, is to understand that their are certain things that should not be. Let’s take a look at the do’s and don’ts of living with an eating disordered family member.
Mostly, parents are rational, intelligent and reasonable beings who approach their Anorectic child with both carefully planned logic and a list of facts about nutrition and health. What they soon discover is that their child is also armed with facts and logic in complete opposition to what they prepared. Indeed, those people who have fallen victim to Anorexia and Bulimia gather voluminous amounts of information about calories and nutrition. That is why parents are shocked by their child’s unflinching and unrealistic information about healthy eating. Parents are shocked by the amazing number of facts that their sons or daughters have about each and every food category, it’s fat content and caloric value. Knowing this information, the anorectic restricts what they eat with a masterful precision that is as amazing as it is awful. The bottom line to this is that logic and reasoning do not work.
Many parents fall back on love and anguish in an effort to get their child back to a normal eating pattern. We are all familiar with this type of approach: “If you loved me you would eat,”, or, “Don’t you know what this is doing to your father, mother or both?” or, “How could you do this to me?” None of this works. People with eating disorders already feel guilty, anxious and worried about everyone else. Adding more of these emotions does not move them away from Anorexia. In fact, as a result of this strategy, everyone ends up feeling angry and resentful. Besides, individuals with Anorexia deny limiting what they eat. They will state that they ate everything and that they are stuffed. The fact that their is food left on the plate means nothing. Because they are in denial they, in a delusional way, see an empty plate. Any argument to the contrary will result in conflict and more frustration. When frutration levels reach their peak, some parents resort to angry outbursts in hope of bullying their child into eating better. This is doomed to failure.
The fact is that eating disorders are not really about weight, parents or about getting attention. Rather, they are about feeling in control if their lives even though it’s a failed way to gain control. Underlying all the eating disorders are powerful underlying emotions that are not understood by loved ones nor by the patient.
To better understand a person with Anorexia or Bulimia, it’s necessary to understand the language of this disorder in order to avoid pitfalls. In other words, what may seem like a compliment by parents is felt like the opposite to an Anorectic. For example, “You look really good” gets translated into, “Uh Oh, I’ve gained weight.” In other words, no compliment will go unpunished.
Parents’ attempt to point out how skinny their child looks will be met with complete denial. It goes something like this: “I looked in the mirror this morning and I see how much weight I’ve gained.” Though this may be baffling to the parents, it is truly what the Anorectic sees.
An important rule for parents to follow is to avoid saying anything about appearance. No matter how well intentioned a comment may be it will be met with hostility. Arguing about the facts like the clothes are too loose, the sweater is too big and etc. will be rejected with complete denials. These young people are smart and use their intelligence to completely undermine their own health.
So, what can parents do?
It is vitally important to get their child into the doctor’s office and have a weight taken. With that clear evidence, the youngster needs to be referred for treatment of eating disorders. This might begin with a psychologist who specializes in this area and most doctors will have a list of such people. However, it is more likely that the child and family will be referred to an outpatient treatment center for eating disorder. There, a team consisting of a psychiatrist, medical doctor, psychologist, nutrition specialist and social worker will be referred to the case. Part of the work will directed to helping parents and siblings learn how to both avoid problems and help their loved one recover. In essence, they must learn to say nothing about eating and appearance. Most outpatient programs have group therapy for patient and family.
If you know someone with an eating disorder do not hesitate to get help. This can be a deadly disorder that must not be dismissed.
Your comments and questions are encouraged.
Allan N. Schwartz, PhD