The teenage years typically bring on the developmental milestones of separation and autonomy, which many parents know, lead to power struggles. As parents, we feel the need to protect our children from harm, but when dealing with daughters, that sense can be and usually is heightened. And when a child suffers from an eating disorder it brings tremendous worry and concern to the table, which is why it’s even more important to keep an open line of communication between parents and teens.
Maintaining open, respectful and authentic communication may be a challenge, and power struggles can be especially difficult and frightening for families who have a daughter suffering from an eating disorder. The teenage years are often synonymous with bringing on rebellious behavior from teens, but when compounding that with an eating disorder, these behaviors may escalate more rapidly than you are prepared to handle, and have far more dangerous consequences than the typical teenage rebellion.
Following are some important points to remember when dealing with a child with an eating disorder:
- know how to separate through love and respect
- understand why
- verbalize feelings
- keep anxiety in check
- seek help from professionals
- focus on the food
- punish for not eating
- lose faith
- send mixed messages
- keep it to yourself
Separation and autonomy are inevitable and necessary tasks of adolescence. Supporting healthy separation of a child with an eating disorder is a key in recovery. Internally handling issues and problems for a teen with an eating disorder is necessary; i.e. making sure she receives medical, nutritional and psychological care and learning about eating disorders is an essential way for families to remain involved. However parents need to also respect that teens need to figure out life in their own head as part of the separation process i.e. “I am not like my mom or dad. I have my own way of being,” yet when teens express these issues through the language of an eating disorder, it can become a very unhealthy and self-destructive form of communication. The goal in recovery is for patients and families to learn to verbally communicate their feelings and needs as separate people. Some families do not have any ability to define and articulate how they feel. Helping these families learn a language of emotions is a key for recovery and healing.
There are many reasons why an eating disorder develops in teenagers. One reason is that eating disorders serve as a way to express feelings and behaviors that can’t necessarily be verbalized. Most people with eating disorders have a difficult time experiencing and expressing emotions. Symptoms are a behavioral way to express what cannot, or is not, being expressed emotionally. So, a typical child who is angry at a parent may slam the door, sulk, avoid contact, or not follow through on household chores. A child with an eating disorder might choose to vomit or not eat. Children with an eating disorder have an increased difficulty in working out these tasks and expressing their feelings, especially anger. Understand that the eating disorder is not a willful act, but one of helplessness and pain. Their attempt is ultimately not to thwart you, but to hurt themselves.
Teens with an eating disorder need your voice of understanding, sensible limit setting and compromise. Point out when you see your child using their symptoms as a weapon, and ask whether they can share in words what they are feeling. Do not make her feel guilty about what she is experiencing; rather show her that you are there for continuous support.
A parent’s anxiety is likely to be understandably escalated during the course of their child’s illness. Keeping your anxiety in check will help with rational thinking in your responses, particularly when your child’s behavior is provocative and scary.
Be mindful of sending mixed messages about body images both through words and actions. Don’t place an emphasis on diet foods or leave around magazines with distorted images of women. And while commenting on another person’s overall appearance may not seem like a big deal to someone without an eating disorder, someone dealing with the demons of an eating disorder are hypersensitive to these types of comments.
Talking about what they are or are not eating is typically not helpful, especially in the older adolescent, and often provokes the power struggle. Instead, focus on the mealtime and eating as a cohesive family. Communicate about things other than food at the table.
It is easier to have consequences for the power struggle that ensues when a child won’t take out the garbage. It is painfully sensitive and scary to have consequences for the child who chooses not to eat as a way to express her dissatisfaction or wish for autonomy. Dealing with these types of behaviors isn’t easy, but is integral to the well-being of your daughter and your family. A good family therapist can help you learn where and how to set appropriate limits and boundaries during types of power struggles where your child’s behavior is self-destructive or puts them at medical risk.
Don’t give up! As a parent, you have a tremendous role in helping establish your daughter’s self-esteem. With every step forward, there will be steps backward. Don’t get discouraged, and don’t let these setbacks discourage your child. Keep focusing on the ultimate goal at hand.
It may seem counter-intuitive not to praise the student for asking a question, but the goal is to create a more intrinsic motivation for students to ask. If you praise Joey, instead of his question, he’ll ask questions just to hear you praise him. By praising the question, students will be more inclined to think through that question for the sake of the question.
Empathy transcends sympathy. Sympathizing with those who are suffering often carries connotations of pity. Those with eating disorders do not want to be pitied and are likely tired of hearing how to eat, think or feel. What your child needs to know is that you respect her enough to see these individual experiences as valuable; that you can resonate with them; and that they make sense to you even if you can’t fully understand or experience them.
It’s important to confront your attitudes and behaviors toward your child, because in some cases these feelings predated the eating disorder and may have contributed to your child’s negative self-perception. Attitudes and behaviors may emerge in response to the overwhelming despair and hopelessness that accompanies watching a loved one starving herself, and sometimes family dynamics over a long period of time (job stress, marital discord, substance abuse by a parent) have had an influential and lasting effect on a child predisposed to developing an eating disorder.
On the surface it may look like a teenager is controlling eating habits in a desire to be thin, but in reality dangerous behaviors are a response to deeper emotional pain, depression, anxiety and other interpersonal issues. If you notice your child exhibiting any of these behaviors, it’s important to reach out to trained professionals early on.
The sooner signs and symptoms of eating disorders are noticed, the sooner they can be addressed and treated by someone licensed to do so. What causes an eating disorder to emerge and the steps to recovery are a different process for everyone, but awareness and early intervention are critical for every treatment approach.