A resource guide for parents of a child with an eating disorder (PDF)

A resource guide for parents of a child with an eating disorder. Written by parents with lived experience. Parents Survive to Thrive Guide An agency of the Provincial Health Services Authority  ta b l e o f c o n t e n t s acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 disclaimer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 chapter 1: WhAt to do if you’re concerned . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 What signs, symptoms, and characteristics could i be looking for? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 how do i talk to my child about my concerns? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 What can i do when everyone is telling me my child is okay, when i know they are struggling with an eating disorder? . . . . . 8 Who could i talk to, to address my concerns? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 chapter 2: diAgnosis of An eAting disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10 is my child’s diagnosis my fault? if not, how is it not my fault? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 is it okay to talk about my child’s diagnosis with others? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11 What can i do if my child doesn’t think anything is wrong? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 What are some coping mechanisms i can use for myself? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 chapter 3: MAnAging eAting disorder behAviours . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 What are some reasons it is difficult for my child to eat? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 What can i do to make it easier for my child to eat? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 how can i keep my child from bingeing and/or purging? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 how can i keep my child from over-exercising? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 What is externalizing the eating disorder? is it helpful? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 What can i do if my child doesn’t want to recover? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 chapter 4: relApse/MAintAining recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 What can i do to maintain my child’s health and stability? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 What can i do if i start to see signs of relapse? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Are we back at the beginning if my child has relapsed? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Will recovery ever come? Will my child be struggling like this forever? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 chapter 5: recovery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28 how can i help my child manage the symptoms of discomfort with eating again? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 What can i do to support my child in having a positive body image? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 how can i ensure the whole family is supporting my child in the recovery process? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30 What are some hurdles that can come up doing recovery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 how can i help my child see the value of recovery? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 how do i know if my child is recovered? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 chapter 6: scenArios And situAtions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 What are some tips for managing holiday times and vacations? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34 What are some ways to make it easier to shop for my child’s new clothes? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 how can i handle people making comments about my child’s appearance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36 how can i properly provide structure and meal support for my child when the family is always at work/busy? . . . . . . . . . 36 What can i do if i have disagreements with my partner? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 What can i do to manage conflict in the family as a result of the eating disorder? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 how can i make the transition back to school or home easier? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 how can i improve my relationship with my child while fighting the eating disorder? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40 how can i maintain a positive relationship with my other kids? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 chapter 7: MessAges of hope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 What i’m most proud of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 general inspirational messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 pA r e n t s s u r v i v e t o t h r i v e g u i d e 1  Ac k now l e dg m e n ts bc children’s hospital has developed a resource to provide parents with tools, tips, advice, and strategies on how to navigate the challenges of having a child with body image and eating issues. the uniqueness of this resource is that it has been written by parents with firsthand experience having a child who has experienced an eating disorder. We would like to express our gratitude for the more than 150 responses we received from parents who shared helpful strategies in managing their child’s recovery. thank you, to everyone who contributed – your strength, insight, advice, and encouragement are inspiring and invaluable. Project Coordinator amy pezzente Eating Disorders Peer Support Worker and Provincial Eating Disorders Awareness Campaign Coordinator Kelty Mental Health Resource Centre Contributors and Reviewers kiera bailey Project Manager, Health Literacy BC Children’s Hospital tom bauslaugh youth & Family Clinical Resource Educator, Provincial Specialized Eating Disorders Program for Children and Adolescents BC Children’s Hospital barbara beach Registered Psychologist, Provincial Specialized Eating Disorders Program for Children and Adolescents BC Children’s Hospital 2 pA r e n t s s u r v i v e t o t h r i v e g u i d e  a c k n o w l e d g m e n t s ( c o n t i n u e d ) connie coniglio Provincial Executive Director, Children and Women’s Mental Health and Substance Use Programs BC Children’s Hospital karen dixon Family Therapist, Provincial Specialized Eating Disorders Program for Children and Adolescents BC Children’s Hospital charlene king Project Manager, Health Literacy BC Children’s Hospital kimberley korf-uzan Project Manager, Health Literacy BC Children’s Hospital mary mccracken Parent in Residence Institute of Families for Child and Youth Mental Health karina o’brien Registered Psychologist, Provincial Specialized Eating Disorders Program for Children and Adolescents BC Children’s Hospital kathy tremayne Program Director, Provincial Specialized Eating Disorders Program for Children & Adolescents BC Children’s Hospital Disclaimer the parent resource guide (the “guide”) is intended to provide information as an aid to parents of children struggling with eating disorders, and to help in the development of healthy strategies to overcome these disorders. the guide was written by parents of children who have struggled with an eating disorder, and contains suggestions on how to reduce disordered eating behaviours. the guide is not intended as a substitute for the advice of an appropriate health care professional, and no person may rely upon any information contained in the guide for any reason whatsoever. if professional advice is required, the services of a competent and qualified professional should be sought. decision- making in a specific context remains the responsibility of attending professionals. nothing contained in the guide should in any way be construed as being either official or unofficial policy of british columbia Mental health society branch, children’s & Women health centre of british columbia branch or provincial health services Authority (together the “societies”). the societies assume no responsibility or liability arising from any error in or omission of information or from the use of any information, link, contact, opinion or advice provided in the guide. pA r e n t s s u r v i v e t o t h r i v e g u i d e 3  I n t ro d uctI o n “You CAN do this. As Winston Churchill said, ‘you’re walking through hell – KEEP GOING!’” the often long and difficult process of recovering from an eating disorder can drain a parent or caregiver of both physical and emotional energy. it is common to feel helpless, confused, frustrated and exhausted at times. Whether your child has been newly diagnosed with an eating disorder, or has been struggling for some time, this guide can help. it was created to offer parents ideas, advice, tips, tools, and helpful strategies from other parents and caregivers who have been through the recovery process with their own child. the guide is consistent with a family- centered approach, and we hope that the experience of others can help you provide your child with the support they need. by creating this guide, our goal is to empower parents and caregivers to play an active role in their child’s recovery, and to also support them in addressing and overcoming common feelings of despair and hopelessness. We hope by reading the words of other families who have walked in your shoes, you will gain some insight, understanding, and – most importantly – the awareness that you are not alone. 4 pA r e n t s s u r v i v e t o t h r i v e g u i d e  chA pt e r 1: W h At t o d o i f y o u ’ r e c o n c e r n e d What signs, symptoms, and characteristics could I be looking for? “It is so subtle, often hard to notice. If you think something is not right; follow your instincts, seek help.” it is not easy to watch your child do damage to their health - especially when the solution appears, at least on the outside, to be simple. eating disorders are not simple. they are not only about food or weight. so what can you do when you suspect that your child may have an eating disorder? Knowing the first steps to take and how to approach the situation can make a huge difference. people with eating disorders display a wide range of symptoms. some signs can be more obvious than others: dramatic weight loss, a refusal to eat, retreating to the bathroom for long periods after meals. there are also more subtle signs that are often overlooked. here are some signs and symptoms that parents have suggested you could look for. personality traits • Wants to be perfect at everything • obsessions with routine physical changes • More hair on body or losing head hair • rapid weight fluctuations • brittle nails pA r e n t s s u r v i v e t o t h r i v e g u i d e 5  What signs, symptoms, and characteristics could I be looking for? (continued) “If your child’s friends reach out (to their parents or guidance counsellor) expressing concern about your child, you must take that very seriously. Friends can often be the first to know there is a problem.” c h a p t e r 1 : W h At t o d o i f y o u ’ r e c o n c e r n e d ( c o n t i n u e d ) • Always being cold • loss of period • puffy face • glassy eyes • bad breath • Wearing baggy clothes more often behaviours • counting calories and having difficulty eating food without knowing the calories and/or ingredients • sudden interest in wanting to shop for groceries or feed other members of the family; always keen to bake for others • Always watching cooking television shows, reading recipes, diet books, food magazines, etc. • disappearing to the bathroom during meals • constant thoughts of being fat and/or ugly; spending an excessive amount of time in front of mirrors • Avoidance of everything: life, leisure activities, friends, food, and family • difficulty concentrating, dressing, and focusing • early morning jogs before anyone wakes up and/or immediately exercising after meals • cutting marks on arms or legs or in hidden places on their body 6 pA r e n t s s u r v i v e t o t h r i v e g u i d e  c h a p t e r 1 : W h At t o d o i f y o u ’ r e c o n c e r n e d ( c o n t i n u e d ) “Instead of something like, ‘I know you are purging and it’s going to hurt you,’ try, ‘I can see that you are having struggles right now, and you seem sad and distant.’” “Be honest. Let your child know you have some concerns and address what is bothering you. Be open and willing to listen and not judge.” have open dialogue • Approach your child with concern and without judgement. try not to blame or make accusations. recognize the effects of the eating disorder on your child and not just their actions. • try to maintain an open and ongoing dialogue with your child. this is a life- threatening disease, so we have to make that part of the conversation. • try: “i am noticing you are not yourself, having mood swings, always cold. i can feel something is bothering you. is there anything you want to share with me? Know that i am here for you always. i love you no matter what you are going through. help me to understand what you’re going through.” • do not comment on weight or appearance! And be careful not to tell them to “just eat.” instead, reinforce that you are there for them no matter what, that they seem to be struggling with some feelings around food and eating or body image, and get permission to discuss it. • emphasize how important any effort towards wellness is, and acknowledge all positive efforts, no matter how small. be direct and firm • try saying to your child, “hey, i’m a bit worried about you. you aren’t doing fun things very much anymore, and you’re being a bit weird about food. let’s go to the doctor.” • Approach the topic firmly but lovingly. understand that your child will almost certainly deny that there’s a problem. schedule an appointment with a doctor immediately. • use factual information such as “i have noticed that you do not seem to be eating foods you used to like, or as much food as typical.” “you seem to want to be away from the family, low in mood.” “i am concerned about your health.” • negotiation and compromise are counter-productive. talking with your child about your concerns can result in circular arguments, because those struggling with eating disorders typically don’t perceive that they are ill or have a problem with eating. • think about how you would talk to your child if they showed symptoms of a different disease like the flu, or something even more serious. then use that same tone of concern to express that you believe your child is ill and needs medical attention right away. prepare yourself • Manage your own emotions. be honest, calm, consistent and loving. try to avoid becoming emotional and angry. • research as much as you can by reading books that promote family as part of the solution and learn about what to say, what not to say, and most importantly, when to say nothing. How do I talk to my child about my concerns? pA r e n t s s u r v i v e t o t h r i v e g u i d e 7  c h a p t e r 1 : W h At t o d o i f y o u ’ r e c o n c e r n e d ( c o n t i n u e d ) What can I do when everyone is telling me that my child is okay, when I know they are struggling with an eating disorder? As a parent, you have intuitive feelings and knowledge about your child. you know your child better than anyone else. so what can you do when others think you are overreacting? follow your instincts • find the evidence to convince the doctors that there is a problem and your child needs treatment. no one, absolutely no one else matters but your child. • trust your intuition. if you suspect something is wrong, it almost certainly is. i’ve never known a parent to worry without some cause for concern. • let the other people know you have concerns that are real and not going away. no one can advocate better than a parent for their child. look for support • seek the help of eating disorder-knowledgeable and experienced clinicians, parents, and caregivers. • Join a parent support group either in person or online...many times parents who have been there before are the best source of information and support. • read some authoritative books and see your family doctor for a base weight, height, blood pressure and heart rate. don’t give up! educate your friends and family • explain that eating disorders are a mental health problem and you can’t see what is going on inside a person’s mind. it’s not always what a person looks like. • educate your family and friends so they become part of your support team; if they can’t be helpful, then limit your time with them - you are in a fight for your child’s life - they are not dying - your child is. • tell them that you’ve been doing some research and that in fact, there is a problem. be helpful by offering the articles/books you’ve researched to validate your concerns. • Keep in mind that most people do not understand eating disorders. some people even still believe that parents can cause eating disorders, which is entirely untrue, so you must try to thank them for their concern but ignore their bad advice. “Believe in yourself and don’t give up.” To family and friends: “I’m their parent and something is definitely wrong. But of course, we are seeking medical advice.” To medical professionals: “Can you do some blood work please? I have been raising my child for x amount of years and I know something is wrong.” Don’t give up!” 8 pA r e n t s s u r v i v e t o t h r i v e g u i d e  Who could I talk to, to address my concerns? if you are concerned that your child is struggling with an eating disorder, it is important to seek support sooner rather than later. the longer a person is struggling with an eating disorder, the longer it will take to recover. Who could you talk to about these concerns? it is important to seek out health care professionals that are specifically trained to work with children and youth. below are some ideas that parents shared with us. professionals • your primary care doctor can be the first line of defense. then look into options like therapists or eating disorders programs. • family doctor, trusted counsellor, psychologist, psychiatrist, social worker - make sure any professional you talk to has some experience with eating disorders - if they don’t, they just don’t get it - move on and find someone else. • do not rest until you’ve talked to every expert you can find. search the web and make phone calls to those experts who seem to speak to you over the internet. family members • parents are encouraged to talk with one another and develop a plan together for establishing responsibility for supervising every meal and snack. educators • school teachers, guidance counsellors, principal of the school - anyone at the school who is an educator i found to be extremely helpful. peers • become involved in a parent support group both offline and online if possible. • use resources like nied.ca and nedic.ca to find support networks. investigate support groups for parents/friends/family members so you can share experiences. • get involved with the forums at feAst-ed.org (Atdt.org) and listen to the parents there. c h a p t e r 1 : W h At t o d o i f y o u ’ r e c o n c e r n e d ( c o n t i n u e d ) “ Talk to everyone who will listen. Hiding, secrecy and avoidance perpetuate the illness.” “Do not waste time with professionals who are not well versed in eating disorders.” “One of the first persons I discussed my concerns with was my significant other. Together we created a united front against the eating disorder.” pA r e n t s s u r v i v e t o t h r i v e g u i d e 9  chA pt e r 2 d i A g n o s i s o f A n e At i n g d i s o r d e r Is my child’s diagnosis my fault? If not, how is it not my fault? “Don’t let anyone tell you it’s your fault!” When your child has been diagnosed with an eating disorder, it is natural to feel frightened. remember that although it may not always be easy, recovery is possible. Many of the parents who contributed to this guide have a child who has recovered from their eating disorder, and your child can get there too. an eating disorder is a complex mental health disorder • it is not your fault because it is a biologically-based brain disorder that requires a perfect storm of genetic predisposition, temperament, environment, and so on. it could be kicked off by weight loss through diet, illness, huge growth spurt, etc. it really doesn’t come down to you. And if you can’t get past that, tell yourself that you will read, learn and tolerate everything that you can and that you Will get your child better no matter what you think started it. pick yourself up and soldier on. no point looking for answers, you need to move forward. • it is out of your control or ability to give your child an eating disorder. • sometimes i think my own body image comments taught my child negative thinking patterns about themselves, but an eating disorder is much more complicated than just one factor. My child says that it’s like a math equation: a(genetics) + b(cultural messages) + c(peer group) + d(family stress)+e(body issues) = an eating disorder. 1 0 pA r e n t s s u r v i v e t o t h r i v e g u i d e  Is it okay to talk about my child’s diagnosis with others? “I believe it is a personal decision on what to tell and to whom.” blame interferes with action toward recovery • no family is perfect, and some experience problems. but many children come out of those families without eating disorders. blaming is pointless. the real issue is to get the child help now. steer clear of therapy that suggests that the family dynamic is to blame. • it is very important for parents not to feel guilty, because while parental behaviour cannot cause the disease, parental behaviour is a big part of the most successful treatment. so get help and educate yourself; you didn’t cause the disease but you can help your child to full recovery! guilt and anger are not constructive for moving forward. • parents are an essential part of recovery; not the fault, not the problem. eating disorders affect the entire family. Keeping the eating disorder a secret may lead to more stress, particularly if you need the support from others. before you open up about your child’s eating disorder, think through your child’s feelings, your reasons for telling someone else about it, and what you expect of them. challenge stigma • talking about eating disorders will take away the stigma and encourage others to get their children treated. • it’s good to help others understand that eating disorders aren’t a choice, they are an illness. • secrets fuel the eating disorder. secrets fuel stigma. • telling others might make them less likely to trigger your child by saying something improper, such as about their appearance. involve your child • it could be up to your child to decide who to tell and when. of course, feel free to discuss this with your personal therapist or doctor, but not with your friends and extended family unless your child gives you permission. it’s an issue of respect. • i am honest and open when people ask how my child is doing. but before this, i had made sure they were okay with me letting others know. • depends on your level of comfort and your child’s comfort. • your parental instincts will enable you to know who to trust with your child’s personal information. c h a p t e r 2 : d i A g n o s i s o f A n e At i n g d i s o r d e r Is my child’s diagnosis my fault? If not, how is it not my fault? (continued) “You wouldn’t blame yourself if your child was diabetic, so it isn’t your fault your child has an eating disorder.” pA r e n t s s u r v i v e t o t h r i v e g u i d e 1 1  “This is tricky. Your child won’t want you to tell others, and there are situations in which it’s best not to broadcast it. But you need some sort of support. Choose a few close friends who you can trust.” c h a p t e r 2 : d i A g n o s i s o f A n e At i n g d i s o r d e r Is it okay to talk about my child’s diagnosis with others? (continued) core support • i had one person that i talked to about it all the time, who helped me through the hard times. i found it difficult to keep to myself. • find a core few that you can talk with, and get support from parents who are going through what you are going through. come prepared • it is so important to start the conversation and help others understand. understanding what is helpful and what is destructive is critical. generally speaking, people do not understand eating disorders; there is blame directed at the individual and the family, and this is not appropriate, helpful or beneficial. these are difficult conversations. if someone does not understand or is negative or non-supportive, they may cause more harm than good. • be prepared for them to not understand the full horror of living with an eating disorder in the house. you will lose friends and gain new friends in this journey. • the treatment for eating disorders will require you to talk with other adults who will be supervising your child at mealtimes, to make sure everyone is on the same page. 1 2 pA r e n t s s u r v i v e t o t h r i v e g u i d e  c h a p t e r 2 : d i A g n o s i s o f A n e At i n g d i s o r d e r What can I do if my child doesn’t think anything is wrong? especially during the early stages of an eating disorder, it is common for the person who is struggling to deny that there is anything wrong. denial of the issue can be a symptom of the eating disorder. in many cases it takes a lot of time before a person is ready and able to face the eating disorder and acknowledge it, so parents may have to be the driving force in seeking support. take charge • it does not matter. you are the parent. you have to be in charge. Would you ignore it if it was cancer? no. • seek out treatment anyway, as your child will not have any comprehension or understanding that they are sick. their brain is starved and will not be able to process thoughts that let them recognize or understand that they are sick. • if your child was anything like mine, then they will think you are being annoying and invasive. they will be secretive, lie and deceive; it is the disease. eating disorders are insidious and extremely difficult to deal with. by the time you realize something is not right, the disease is firmly entrenched; you have no time to lose. seek treatment and do your research as soon as you suspect something. focus on health • if your child is an adult, be supportive in healthy living and setting a good example for your child. provide resources for counselling or encourage them to attend a support group. • try to show your child the things they used to love to do, but now feel too sick to enjoy them anymore. remind them of how nice it would be to find joy in these things again. • Keep trying to show your child that their behaviour is unhealthy and unsafe. don’t ignore their behaviour. Keep talking even if they don’t want to listen - but try to be gentle and careful with your words, not judgmental or critical. be loving, understanding, and compassionate. • remember that they don’t want to live in this hell, but they are trapped by it. you need to help your child get free. Keep focusing on your child’s health and well-being. Keep asking how they feel, and offer empathy, not pity. “My child’s acknowledgment of a problem is not a necessity for treatment.” “Know that this is a natural part of the disease. Don’t take your child’s denial as a measure of health. It’s just a symptom of the disease.” pA r e n t s s u r v i v e t o t h r i v e g u i d e 1 3  What are some coping mechanisms I can use for myself? it is common for parents to feel a range of emotions through this journey, starting with their child’s diagnosis, and throughout. guilt, frustration and blame are just a few emotions that are common for parents of a child with an eating disorder. remembering to have self-compassion is extremely important. here are some coping mechanisms that other parents have found helpful in managing their feelings about their child’s illness and recovery process. acceptance • it is a hard thing to cope with. but what i learned is that everyone has their own problems, and it’s ok if your family isn’t perfect. • it is hard because society makes it seem like eating disorders are the family’s fault, which is not true. you do start to think, “where did we go wrong?”, but when you get past that, it becomes easier and you can focus better on your child’s illness. • take a lot of deep breaths and you will shed a lot of tears in the process, but that’s ok, it’s all worth it. • it is tough. probably the toughest thing i’ve ever dealt with. you can do it. • recognize that it’s a process and a journey, so try to keep calm and take things day by day. it is all-consuming. self-care • Make sure you take time for yourself. time to vent your frustrations and clear your thoughts. for myself, i found a counsellor and went for regular massages. understand that you’ll likely be experiencing some post- traumatic stress. • try to remain healthy for yourself and don’t let the issue consume your life. this will only cause shame and guilt for the child. • try journaling daily. getting those feelings out allows you to cope with all the stuff that comes with a child with an eating disorder. • We all have to accept things we cannot change. find a project that will give you some joy and make lifestyle adjustments to promote your child’s recovery and give you the time to care for them and yourself. • do emotional work on yourself so that your feelings don’t transfer to your child. it is horrible to watch your child suffer, i know. support • seek support from other parents/caregivers that have been through it. i think you have to adjust to a “new normal.” things might not be the same as they were, but a new way of living together is possible. • try to enlist at least one other adult to help with the regime and be sure that all immediate family members know how to best support your child. “I try never to let my guard completely down or to secretly jump for joy. I try to just take each day as it comes and continue to reflect on how things are for them, how things are for the family, and what pressures are coming up, so that I am as prepared as I can be to support my child if they experience difficulties.” c h a p t e r 2 : d i A g n o s i s o f A n e At i n g d i s o r d e r “ Find people who are going through the same situation and lean on them. Go into this with your eyes wide open – it will take a long time.” 1 4 pA r e n t s s u r v i v e t o t h r i v e g u i d e