Collateral Damage

There was a time when I would have said that an eating disorder affected primarily the person with the actual eating disorder.  I was not ignorant of the fact that families and friends were sure to be impacted, but I truly underestimated how much so.  As a mom, I have to say that I did not anticipate the impact that my son’s  eating disorder would have on his brothers and sisters.  I wish I had had hindsight as foresight in this instance.

During the time that our son’s illness was progressing, things in our home changed rapidly.  He was truly a different person to deal with.  He was sullen, irritable, completely focused upon acting on his symptoms, and not engaged with the family much at all.  My other children quickly started filling the role of spies.  They were quietly, and sometimes not so quietly, observing their brother’s behavior and reporting back to me.  They would let me know that he fed his breakfast to the dog, that he was lifting weights or running an extra mile while I was at the store.  They were the ones that pointed out that he was wearing shorts or sweat pants under his jeans in order to hide his weight loss.

I was complicit in this.  I would not directly encourage them to “tattle” on their brother, but I was certainly all ears when they did.  I would ask them if they had seen their brother eating, observed his behavior when I was out, or knew where he was if he wasn’t home.  I didn’t intend to make them my spies, but that was exactly what was happening.

They were young and confused.  Having to go from the role of being the younger siblings to literally “my brother’s keeper” was a very difficult and unfair role for them.  It changed the entire dynamic of our family.  The kids argued.  Our son didn’t respond to the “tattling”, or their concern, very well.  He would berate them and very nasty exchanges occurred.  His next two youngest siblings were very protective of me and would yell at him for causing worry.  They would also yell at him for the damage he was doing to his body and things would deteriorate into a shouting match very quickly.

It really wasn’t until our son came out of the hospital and recovery began that I realized the extent of the collateral damage.  My youngest daughter was haunted by the images of her brother’s anorexic body and very frightened that she would lose control and the same thing would happen to her.  My youngest son was confused and almost afraid to see his brother.  My oldest daughter probably interacted with him the most when he was sick and she was very traumatized by the things that were said and the panic of nearly losing her brother.  His next youngest brother took over the chores and work that our son was supposed to be doing when he was sick.  After our son returned home from the hospital it was hard for him to be relegated back to younger brother and take the second seat again.

All of my other children were casualties in their own way.  They had lost their brother.  They very nearly lost him physically, but they did definitely lose him emotionally.  They grieved the loss of the relationship they had with their big brother.  It wasn’t damaged forever, but it definitely was damaged and would take time to repair.

The damage that most surprised me most was their anger at losing their mother.  It would be wonderful to believe that I sailed through this experience with the grace and poise of June Cleaver, but the truth is that I made a lot of mistakes.  My children grieved the loss of me almost as much as the loss of their brother.  They felt slighted and unimportant.   They saw me preoccupied and anxious almost all of the time.  That left very little for them.  It took time and, in a way, we were all in recovery and things did get better.  I have learned a lot along the way though.  Below are some suggestions for helping siblings through the struggles of an eating disorder.

Keep Communication Open:  Allow your other children to talk about what they are observing.  Give them room to vent their feelings, frustrations, and fears.

Don’t put them in the role of spy:  As parents we don’t deliberately put our children in these roles, it just seems to happen.  Don’t foster that role with your other children.  Encourage them to talk to you when they see something of concern, but be clear that it is not their job to watch their sibling and report his/her behavior.  Leave the door open that they are free to tell you whatever they would like to tell you, but there is no obligation to “spy” and that they are not “tattling” if they do choose to tell you something that they observed.

Remind you children that they did not cause their brother or sister’s illness:  Children often engage in magical thinking, especially younger ones.  They can believe that their “bad” behavior or thoughts caused something bad to happen to someone that they love.  They might believe that because they didn’t report on an eating disorder behavior that they witnessed, they somehow allowed their brother/sister to get worse.  Talk about this with your other children.  They often won’t bring it, but many times they are thinking it.  Let them know that nothing that they did or didn’t do caused this to happen or made it worse.  Let them know that what they think or do doesn’t have the power to cause an eating disorder.

Give your other children some of your best time:  By this I mean that it is easy to get so caught up in your own worry and concern for the child that isn’t well, the other children get you at the end of the day when you are tired and stressed.  This isn’t easy by any means because you are probably always tired and stressed while going through this.  Perhaps a family game night, or just some time reading together or watching TV together.  Maybe even just talking, but talking about things not related to the eating disorder.  Talk about their day, or something that is important to them.  Let them pick the topic, but just spend some time together that doesn’t involve eating disorder talk.

 Talk to your child with the eating disorder about your expectations regarding his/her siblings:  It is OK to talk to your child about not venting anger inappropriately at his siblings.  Let him/her know that you do not want eating disorder symptoms legitimized to siblings.  Talk openly about expectations that siblings are not to be asked to keep secrets from mom and dad.   Be clear what your rules and expectations are and enforce them. Set very clear boundaries.

Make sure that siblings know you have a plan:  Children need to feel that mom and dad know what to do.  They need the security that someone is in charge and everything isn’t going to fall apart around them.  You might feel like everything is falling apart (I know I did) but developing a plan and letting the other children know that you have one is important.  That plan might be working with a treatment team that is already in place or it might mean a plan to consult a professional or join a support group.  Just knowing that there is help in place or available and how things are going to proceed is helpful to other children.

Let siblings be involved in recovery:  Often this is encouraged by treatment providers.  If not, children can be involved in positive ways by simple things like talking with their brother/sister about a subject they like (not eating), or playing a game, or going shopping together.  They can help just by treating their sibling no differently than they did before the eating disorder.  Keeping them in the loop regarding progress is often helpful.  It can be scary for children to feel left out.  They often recognize when secrets are being kept and their imaginations can run away with them. How much to tell, of course, depends on their age and your personal circumstances.

Find a Family Therapist:  Sometimes the anger, fear, and hurt are too overwhelming and seem too much to handle alone.  In this case a family therapist can be very helpful.  Finding someone who specializes in eating disorders can be very helpful, but not required. is a good resource and can point you in the direction of therapists and treatment providers.  Sometimes an individual therapist may be helpful for a sibling who is really struggling.

Join a support group:  There are many support groups available for siblings and family members.  Some of them are specific to teenagers or younger siblings and some are specific to parents and other adults.  There is a variety.  The resource provided above also provides lists of support groups.  Your local department of Health and Mental Hygiene can also help.  Often your family doctor or pediatrician has information or can access this information for you as well.  School counselors are another good resource.

There is good news.  Even if damage has been done, it can be fixed.  Probably one of the most important lessons I learned during my journey is how valuable early intervention is.  The sooner you jump in and request an evaluation, treatment, or support for the rest of the family, the better the outcome and the less the collateral damage.



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