Merryl Bear M.Ed. (Psych)
Parents and partners of an individual with an eating problem often find themselves confused and scared as they cope with the knowledge that a loved one is in pain, and may question their role in the development of the problem and recovery process.
Different demands will be made on family members when the individual with the eating disorder is living at home, compared to those families where the affected individual is living independently. However, there will be some common principles in coping with the situation, and with the individual with an eating disorder.
Other NEDIC articles have addressed how to support adolescents with eating problems and looked at both the stages of change and how to guide youth through them into recovery (see What is Helping? Youth & Recovery). This article looks at some of the strategies that family members and partners of an affected individual can use to better understand the complexity of their own situations and to manage their lives in a healthy manner during the recovery process.
A basic requirement to coping during this difficult time is to recognize that eating disorders do not develop because of one traumatic event or situation. They develop out of a complex interaction between events, circumstances and the individual’s personality and coping style. This means that you are not to blame for your family member’s eating disorder. The individual struggling with the eating disorder is also not to blame for “getting sick.” By not apportioning blame to oneself and other family members for the problem, it is easier to mobilize energy to deal with the current situation.
One of the most valuable assets that you can create for yourself is to know your enemy: and it is neither the affected family member, nor any other person. The enemy is the eating disorder. Lack of understanding of the condition from which your loved one suffers may cause you to make poor decisions in handling the situation. It is highly recommended that you educate yourself about eating disorders. You and your family are going to be addressing the physical and psychological consequences of this problem for a while: Eating disorders do not develop overnight, nor are they resolved overnight. Knowing some of the factors which contribute to developing, maintaining and perpetuating an eating disorder can be helpful in making decisions on how to cope with the specific situations you will face.
Although blaming and feeling guilt around your family member’s food and weight issues are not helpful, an opportunity to be more self-reflective can open up. The standard manner in which you communicate, treat yourself and others may be examined and improved. This can lead to clearer communication and less tension between family members. Coping with the difficulties you experience with your family member can be enhanced through reflecting that the person is not doing any of this to hurt or inconvenience you, but as an unconventional and unproductive coping strategy for herself or himself. The distress that the affected individual is experiencing is significant, regardless of how much she or he may deny it. Reflecting on the impact of larger cultural influences and messages on issues such as appearance in general, food, weight and shape in particular and values of masculinity and femininity may be useful. It can help in understanding your own attitudes and biases as well as those of the family member who has an eating disorder.
It is vital to understand that it is not possible or appropriate for you to make decisions for the adult suffering from an eating disorder. The individual has to take responsibility for choosing recovery and what path that will take. Although you can provide support and encouragement, recovery and the form that it takes is a choice that the affected person has to make.
Understanding eating disorders and your response to the affected individual and her or his behaviour can be enhanced through meeting with others in a similar situation. There are many self-help and support groups for family and friends of an individual with an eating disorder. Take advantage of them: you can benefit from the knowledge and strategies of others. These groups also provide support and comfort to many.
In addition to a support group, it may be helpful to seek family, marital or individual therapy or counselling. It is common for families and couples to experience increased difficulties while one member is struggling with an eating disorder. Counselling can provide one with increased insight into strengths and weaknesses in relationships. It can also give one additional healthy strategies with which to deal with everyday life and relationships.
Living with, or emotionally supporting someone with an eating disorder can be time consuming and draining. Take time out—ensure that you have appropriate avenues of self-care, and use them. This may take the form of regular outings with friends, time set aside for pursuing an interest or hobby, or simply taking time each day to relax with a book or another pleasurable pursuit.
Maintaining a healthy lifestyle is fundamental to your own quality of life. It is important to engage in normal healthy eating patterns, and to engage in on-going, pleasurable physical activity. This will boost energy and mood and, in a social context, can contribute further to quality of life. It may feel strange to engage in eating regular meals and pleasurable snacks when a family member is struggling with these issues. However, it is important not to punish yourself for her or his suffering by not eating well or nourishing yourself, physically and emotionally. In fact, in this and other areas, you may be a healthy role model for the person struggling to find a healthy balance.
One of our major sources of affirmation and pleasure is our social contact with others. When we become depressed or overburdened, we tend to withdraw from social events. It is precisely at times when we require a bit of a boost that we need to maintain our friendships. Meeting with people for whom we have a great deal of affection, and with whom we have things in common other than a troubled relative, can boost our sense of well-being. Socializing and discussing subjects of interest other than food and weight preoccupation can be rejuvenating. Having time out with friends and colleagues does not detract from the support you can provide for your loved one. On the contrary, it can help you to keep things in perspective and to re-energize you for the demands of coping with an individual with an eating disorder.
Sometimes the individual with an eating disorder asks that their partners and family members keep it secret. This may infringe on your ability to receive appropriate personal support. One way of dealing with this is to be circumspect with regard to whom you confide in, and to let the person with the eating disorder know whom you have told.
Boundaries and responsibilities can become blurred when we live with someone with an eating disorder. It is natural to want to do everything possible to help the individual. It seems natural to want to try to take some pressure off one’s loved one, and to take on tasks that they don’t want to or appear unable to do. On the other hand, fear of angering or being punished by the affected individual may motivate taking on her or his responsibilities. It is important to be clear about each family member’s role and responsibilities. Don’t take on the responsibilities of the affected family member—let them do for themselves: it encourages a sense of efficacy, independence and personal responsibility which all contribute to increased self-esteem. Also develop boundaries and expectations around the way in which the affected individual behaves within the relationship and the home, e.g.: the individual may find grocery shopping too stressful, and do the laundry in exchange.
Although it may seem all-consuming, don’t make the eating disorder as large as life: it should not control your life or dominate the relationship that you have with either the individual with the eating disorder, or be the centre of your relationship with other family members. By ensuring that you take responsibility for your own life and actions, and establishing good boundaries around your relationship with the individual experiencing the eating disorder, it is easier to maintain a healthy equilibrium during this stressful time. It is by living the principles of a healthy, engaged lifestyle that you can best assist your family member.
Survival Strategies for Families
- Educate yourself about eating disorders.
- Realize there is no quick and easy solution.
- Recognize that no one is to blame for the eating disorder.
- Attend support groups to learn helpful strategies.
- Encourage the affected family member to get appropriate help.
- Go on with your life: don’t let the eating disorder dominate.
- Show compassion and support.
- Engage in healthy social outings, hobbies and self-pleasuring activities.
- Eat well and have adequate physical activity to maximize health and energy.
- Express honest love through physical and verbal affection for the affected individual.
- Value your family member so that she or he can learn to value her/himself.
- Acknowledge that an eating disorder is difficult to give up, and allow the person to set their own pace.
- Encourage your family member to make decisions and take responsibility.
- Create other focuses for engagement than food and weight issues.
- Don’t expect yourself or your family member to be perfect.
- Communicate directly with your family member about specific concerns.
- Take time to nurture yourself.
- Maintain a positive attitude.
Some Suggested Reading
Treasure, J., Smith, G., & Crane, A. (2007). Skills-based Learning for Caring for a Loved One with an Eating Disorder: The New Maudsley Model. East Sussex: Routledge.
Treasure, J. & Alexander, J., 2013. Anorexia Nervosa: A Recovery Guide for Sufferers, Families and Friends. Washington, DC: Taylor & Francis.
© NEDIC 2001; reviewed and updated 2015 www.nedic.ca