One of the things that I found through my journey as a mother of a child with an eating disorder is that I don’t always have to understand. In fact, I don’t
understand most of the time. That lack of understanding doesn’t make me unqualified to help him though. Because I don’t have an eating disorder, I cannot understand what drives my son, who does have an eating disorder, to think and behave as he does. Even so, I can be helpful.
When our son first started over- exercising, his explanations made no sense to me. They still don’t and I am not even sure that they made complete sense to him. He really didn’t want to run 10 miles a day and do countless crunches, sit-ups, and push-ups after having lifted weights early in the morning. I would argue with him over and over again and give him what I thought were very logical and reasonable arguments why what he was doing was not healthy. I would ask why he couldn’t seem to grasp what I was explaining to him only to have him argue back all of the eating disorder rationalizations with the eloquence of a lawyer, but it made no sense. When my attempts at persuasion would fail, I would get angry and frustrated and say things that I thought might “snap him out of it” , scare him, or make him feel guilty, but in hindsight those things were just hurtful and they didn’t make any difference at all. He seemed to be fueled on by my explanations of how hard this was for anyone’s body to tolerate. This seemed to be a badge of honor for him. He would later admit to me that hearing how he was doing much more than the average person could tolerate would actually spur him on. It was some sort of test of how masculine he was or in some odd sense he would feel comforted to know that he could put his body through much more than the average person and be able to survive (in his case, just barely). He seemed to be constantly testing his ability to push harder and to maintain tighter control. He was never convinced that he passed the test though. There always had to be more and he viewed cutting back or slowing down to a more reasonable pace as lazy. I would call it punishing his body and he would argue that it was pushing the bar higher. I could not understand this and the truth is that I shouldn’t understand, because it is illogical and harmful.
My son didn’t believe he was fat. When he looked in the mirror he understood very clearly that he was wasting away and he even agreed that it didn’t look healthy. He could agree that he was losing muscle mass and that he had no fat stores. His backside had become so bony it was hard for him to sit down. Despite the fact that he could agree he was too thin and that this didn’t look “normal” he continued to over exercise and cut his calories. He was willing to argue with me endlessly about the benefits of exercise despite the fact that he was becoming weaker and getting sick more frequently. He would search the internet to find that one article disputing what I had said and justifying what he was telling me. He would make his case and a lot of time was spent trying to convince me that this was normal behavior.
The real problem here was that I was allowing the eating disorder to make its case. I was engaging in debate with the eating disorder and eating disorders are masters of debate. They are at the top of their game in creating confusion, chaos, excuses, and rationalizations. They turn us in endless circles that accomplish nothing but frustration and alienation from our loved ones. That is their wheelhouse, so to speak, and their batteries are charged and recharged with every debate that allows them to build their case and place everyone else in confusion and on the defensive. I could never have understood, because it wasn’t grounded in logic.
When I started learning that it was OK not to understand, I was able to deal with my son much better. Not understanding didn’t mean that my son and I had nothing to talk about. It actually meant that we had a lot more to talk about. Trying to understand what was driving him to do what he was doing was to engage in endless arguments and debates with the eating disorder. I realized that I needed to talk to my son and not his eating disorder. When I began refusing to speak with the eating disorder and would only engage that healthy part of my son that I knew was still there, things changed. That was not easy because the eating disorder was present most of the time. It meant being firm and it meant sending a clear message to the eating disorder that I would not allow it to take my son. I set limits and made it clear that I would take control and force treatment if I needed to. Most of all I made it clear to the eating disorder that I was no longer listening to its lies. That didn’t mean I wasn’t willing to listen to my son or that we couldn’t talk about his eating disorder. It meant that his eating disorder was not invited to build a case for why it was necessary or good. It also meant that I was no longer willing to treat behavior that was considered unacceptable before the eating disorder began as acceptable now. Rude, mean, and disrespectful behavior was never tolerated in my home before and they would not be tolerated or excused with the arrival of the eating disorder. The house rules that were in place for all of these years were still in place and the eating disorder was not going to alter them. The eating disorder was not going to be treated as a separate person with separate rules and standards of behavior. That was a game changer. It didn’t “cure” him, but the dynamics did change and boundaries were restored. It was a beginning. Below are some of the lessons I have learned from our experience. Once again, if hindsight was foresight!!
Don’t build your case: Don’t spend large amounts of time defending your position. Be firm that this behavior is harmful and leave it there. Don’t be put on the defensive.
Don’t allow the eating disorder to make an endless case for its behavior: By this I mean that it isn’t helpful to let your child/loved one go on and on about why this behavior isn’t harmful, problematic, or is under control. The goal isn’t for you to begin to be convinced of these unhealthy and illogical arguments. Engaging in counter-arguments isn’t likely to be received at that point. Be sympathetic and acknowledge how much he/she is suffering and how much you love them and want to help, but be clear that you don’t agree with these solutions.
Set Limits: Along the lines of #2, limits are important for everyone else in the family as well as the person with the eating disorder. Everyone is impacted by a family member with an eating disorder. Set a limit that debating the merits of the eating disorder isn’t going to be allowed. That doesn’t just include parents, but it includes debating with siblings as well. Be gentle, but firm about this. Let them know that you are not willing to debate with the unhealthy voice, but that you are willing to talk with that healthy voice that wants to get better. There generally is a healthy voice that does want to get better or is at least ambivalent. Try to ally yourself with that voice. Sometimes that can mean just letting him/her know that you are willing to wait until that healthy voice is ready to talk with you.
Do not make excuses for unacceptable behavior: Behavior that would not have been tolerated before the eating disorder should not be tolerated now. Make it clear that you understand how much suffering this is causing, but disrespectful and unkind behavior will not be tolerated. The house rules have not changed and it is expected that all of them will continue to be observed.
Be open to talking about feelings: While not allowing unproductive debating, make sure that doesn’t stray into not listening at all. Make sure that there is room to express feelings and frustrations surrounding the eating disorder. That goes for everyone living in the home. Make sure that you make it clear that you are available to listen to feelings, concerns, frustrations, etc. Often in the expression of those feelings lies that healthy voice. It is often a way of saying I don’t want to live like this, or maybe that he/she feels stuck. Ally yourself with that voice.
It’s OK to say you don’t understand: It’s OK to tell your child/loved one that you don’t understand what is driving them to do the things that they do. Make it clear that what you can understand is that they are suffering. Sometimes it is much more appreciated to hear that, while you don’t understand, you can see how difficult and distressing this is for them. Ask for suggestions of what you might do to support them. It might lead your loved one to help engage you in treatment by telling you what is helpful and what isn’t helpful to them. Be careful, though, not to let this stray into defense of eating disorder behavior.
Walk away when things get heated: I don’t mean walk off in a huff, but simply say that the conversation is getting charged and isn’t productive, so it is time to put it aside and revisit it later. Very little is gained when you are yelling at each other. The eating disorder gets its head and loves turning up the heat. If possible, cut it off before tempers are lost.
Be willing to make it clear that you will intervene if you have to: This is one that I wish I had said and done much sooner than I did. Making it clear that you don’t agree with the eating disorder behavior and will intervene if it becomes dangerous is OK. You are also setting a limit and a boundary. You are making it clear that if the eating disorder behavior becomes a serious threat to your loved one’s health, you will intervene and force treatment. Eating disorders can be life threatening and it is Ok to say so and to make it clear that you won’t let things get to that point. Sometimes, that is reassuring. With a child under 18, you can intervene much sooner.
Call your treatment providers: Call your child/family member’s treatment team, if you have one, and are sensing a return to the old eating disorder arguments and fear a setback. Your treatment team is most qualified with regard to how to deal with your individual circumstances because they know your family member and your family. If you don’t have treatment providers, contact your local department of Mental Health and Hygiene or The National Eating Disorders Association www.nationaleatingdisorders.org. They can help you find providers and are also a wealth of information and education. Another very good place to begin is with your family doctor.
It is hard to watch your child/loved one suffer and sometimes very hard to set limits when they are hurting so badly. You are not being unkind or unloving. Remembering that I was fighting the eating disorder and not my child made it easier, but certainly not easy.