Today, you’ve likely done one of the hardest things you’ll ever do in your lifetime. You have dropped your child at an eating disorder treatment center. I know that a lot of pain, anguish, and heartache have led you to these treatment center doors. First of all, there are two things you need to immediately know:
This is not your fault! You did not cause your child’s eating disorder.
You are not a failure because you had to put your loved one in a treatment center. There is no greater pain than watching your child fight a demon that cannot be seen. There is no greater challenge as a parent than fighting a monster, a terrorist holding a child captive that you can’t physically see and you don’t understand. Nothing about it makes sense. Everything is counterintuitive. That monster is an eating disorder. I understand the hell your family has likely endured before you arrived today. You are here because you’re running out of options. You may have been on this journey with your child for a few months, or many years, but you see this demon sucking the oxygen out of your child, out of you, and out of your family, and something MUST change.
As a mother who has lived this battle, I know I was a shell of my former self when I arrived at the treatment center with my child. I no longer presented as the accomplished, professional businesswoman and mother that I usually portrayed. Instead, I was an exhausted, frazzled, and desperate mother that had been battling a terrorist that had entered my home without invitation and held my child captive. This terrorist had stolen my child’s health, their mental well being, and then left our family in ruins. There were medical practitioners, neurologist, therapist, psychiatrist, physical therapist and dietitians. In fact, there were seven appointments every week. There were three snacks and three meals every single day. Each one was terrifying, and they were often violent. You may have spent months or years supporting and fighting for your child, searching for help, yet you’re loved one continues to fade before your eyes. There may have been battles with insurance companies who were refusing to cover treatment. Please show yourself some grace and recognize and remember that the parent they are seeing at admission today, although you may be a shadow of your former self, is amazing.
You are here today searching for HOPE and help. You are here because you love your child more than life itself. Understanding these 16 points may help you on the journey through treatment with your loved one:
- The key word is COMMUNICATION! COMMUNICATION! COMMUNICATION! It is imperative that the family and treatment team communicate openly, honestly and frequently. ED cannot hide in the dark! That needs to be the cardinal rule. Work together, with the treatment program, to develop a communication plan including frequency, medium, and how you should be contacted if there is an urgent, life-threatening situation. Establishing a plan in the beginning will help alleviate your concerns and fears.
- You are not alone. I understand that you may be scared. You may feel overwhelmed, frustrated, terrified, isolated, helpless and angry. Never in your wildest dreams did you think you would be admitting your child to a treatment center, battling to save your child’s life. Please know that we “get it” and we are here to support you and your child on this journey. No one should walk this journey alone!
- Be prepared for emotional phone calls from your loved one in treatment. Know that it is very probable that you will receive crying phone calls from your child during the first few days and weeks of treatment. They will beg and plead with you to let them come home. They will promise to do whatever you request…stop behaviors, eat, as long as you rescue them from treatment. They will tell you that they don’t belong there. That they’re not as sick as everyone else. That the treatment center is feeding them too much food. They are feeding them “bad” food, which is not healthy for them. They are being abused. They do not feel safe. Their roommate is scary and they’re afraid to go in their room. That is just a few examples of what you may hear. As a parent, this will be extremely difficult for you to hear. It will likely upset and terrify you. Please know that this is absolutely normal. You need to be prepared for this phone call. Do not run to rescue them from treatment. Be prepared to tell them that they are exactly where they need to be and that you love them. If you have concerns, do not address these with your child. Reach out to your child’s treatment team.
- You did not cause your loved one’s eating disorder. You are not a failure as a parent because you had to put your loved one in a treatment center. You are not to blame. Do not have any guilt if outpatient treatment did not work for you, or if you did not have the strength or ability to do it at home. If you are thinking that, please let that go. Our children can become mentally and physically compromised very quickly. So fast that we may not recognize it. You will not be judged. There is only compassion. Trust me, we have all made mistakes and learned along the way. I often wish I would have done things differently. Hindsight is 20/20. So please do not get stuck on woulda, coulda, shoulda. Instead, congratulate yourself on having the strength to bring your loved one to treatment. Hopefully today marks a new beginning for your child, your family, and you.
- You are part of the treatment equation. In fact, families can be one of the biggest assets in treatment. You have witnessed your loved one’s battle with the eating disorder. Just as the treatment center is an expert on eating disorders, you are an expert on your child. Try to help the treatment team understand your child as best as you can and provide them with as much information as possible. Please recognize that you have vital knowledge; you are an essential resource and an integral part of the team as you will likely be the one supporting them when they discharge from the treatment program. Let the treatment center guide you on how you can best support your child and the treatment team throughout this journey. Be certain to clarify with the treatment team you want to be part of the equation. Remember, no one knows your child better, loves or cares about your child more than you do!
- Eating disorders are not a choice – your child did not choose this! Please understand no one would choose this hell. No one would choose to risk his or her health or his or her ability to bear children. No one chooses to have cardiac issues, gastrointestinal issues, or blue hands and feet from poor peripheral circulation. Please know that your child did not choose this. Even a simple sickness in a person predisposed to an eating disorder combined with negative energy balance (less food eaten than energy being expended), can trigger an eating disorder. So don’t ever think that your loved one can stop this if they want. Know that they are being held captive by a terrorist. Your child needs your support, love, understanding and empathy to help set them free.
- Eating disorders are brain based biological illnesses – a complex interaction of genetic, biological, environmental and psychological factors. Often, as parents, we think our loved one should be able to stop the behaviors, or choose to eat – if they want to. Just eat. Just quit purging. Quit binging. But that’s not the reality. Your loved one’s brain is compromised, often resulting in loss of cognitive function. An inherent part of this disease is anosognosia – the inability to recognize that they are sick and need help. Often, sufferers lack insight and don’t realize the degree to which they are struggling. At this moment, your loved one may not have the ability to choose. So, you must work together, with the treatment center, to help them to choose, until they are able to choose recovery for themselves.
- It’s important for you to learn that there cannot be a crack in the window. A difficult thing to learn as a parent is how not to undermine the treatment team in front of your loved one. If you have concerns or questions, I encourage you to go directly to the treatment team without giving your child the appearance that you are aligning with them. Any perception by your child that you do not agree with the treatment team will create a crack in the treatment window and allow ED to jump through the gaping hole as a result. If your child has concerns or questions, try not jumping on the merry-go-round. Learn to tell your child that you hear and understand their concerns and that you think they should discuss such concerns with their treatment team.
- Please recognize that it is critical for the parents to present a united front. There is no denying that the eating disorder invades our lives and seeks to destroy all that is in its path. It will challenge the strongest of relationships and likely destroy the weakest. The eating disorder wants to fracture parents’ relationships with their children who suffer, and also fracture parents’ relationships with one another. It absolutely loves to divide and conquer. When parents are warring, the ED runs amok and nobody’s focused on banishing or expelling the eating disorder. That gives the eating disorder room to grow. This is exactly why the eating disorder seeks to create division between the parents and in the home. The top priority is for the parents to communicate to try to create a solid brick wall and common goal of supporting your child against the eating disorder, whether you’re still in a relationship with your spouse or not. You need to work together and support each other. Your loved one needs to hear the same message, rules, boundaries, love, empathy and support from both parents. One parent cannot be a friend (in an effort to keep the peace) while the other parent does all the heavy lifting. It is imperative that the parents are a team and join hands to support their loved one on their journey to recovery.
- Please know that your child must eat cake. No matter what the food – cake, pasta, fats, or ice cream – please know that your loved one must learn to eat them again. There are no good or bad foods. Foods do not have moral value. Yes, some foods may offer more nutritional value than others, but all foods have purpose. Some may offer more vitamins, but others may offer comfort, celebration and nurture their spirit. Nutrition is about balance. It is important for your child to eat all foods (with no restrictive diet like vegan or vegetarian) and learn all foods are good in moderation. It is very important for you, as the parents, to also adopt this mindset. You must learn to not refer to foods as good or bad, or say you were “bad” because you ate dessert. Please do not confuse your loved one by sending a mixed message. If you have questions please discuss with the treatment dietitian. Treatment is costly and limited so it is critical that the treatment team utilize this valuable time working on actual issues and feelings surrounding foods. Remember – Balance is key. Please recognize that you can be an asset and a resource while supporting your loved one on their recovery journey.
- HEALTH is THE top priority. Throughout the treatment journey it is very important that you repeatedly send the message to your child that nothing else matters. School, dance, soccer, swimming, gymnastics, college, vacations, internships or any other activities must not interfere with treatment. Learning can come later. Treatment and health are the top priority. Please do not allow the process to be rushed or think that treatment can be completed over winter or summer break. Anything that does not promote recovery or distracts them from recovery needs to be taken off the table (I don’t care if they are training for the Olympics, valedictorian of their class, or are a professional ballerina). Health is the top and only priority! This is said with love. If you do not take this approach, it is very likely you will face treatment center doors again. You and your loved one must be invested and committed. Allowing adequate time is the best chance for recovery.
- It’s important for you to learn how not to enable the eating disorder, how to tolerate their distress and how to endure feeling their pain. You will have to learn how not to rescue them. This can be extremely difficult to learn, as this journey with your loved one is emotional and demanding. If your child calls complaining about the treatment center, crying, hysterical, angry, telling you they don’t belong there, no one understands them, they are finished with treatment, they’re not sick any more, promising the world if you just let them come home… Work with your loved one’s treatment team to learn the words to say. I also encourage you, implore you, to receive outside training or therapy on how to set boundaries and how not to enable the eating disorder. You did not cause your child’s eating disorder, but you need to learn how not to contribute to it or enable it. You need solid tools. DBT (Dialectical Behavioral Therapy). You have to learn how to be loving, compassionate, with very firm boundaries, while standing in a suit of armor against the eating disorder. That takes a lot of work and a lot of practice. You will be given tools on how to navigate this while your loved one is in treatment. I know that you do not want to enable the eating disorder … you just love your child and want to see them recover. Gaining knowledge and tools to accomplish this will make the journey easier for everyone.
- Progress, not perfection, needs to be the goal. As a parent who navigated this journey with their child I also thought that I wanted everything to go perfectly in treatment. I would quickly learn that the more things that went wrong during treatment, the stronger my child would be after treatment. It is important that they be faced with obstacles and challenges in treatment so that they learn how to navigate hurdles in real life. If everything goes perfectly in treatment, when they are faced with challenges on the outside world they are not going to have the tools and experience necessary to face those obstacles head-on. The challenges will highlight where they need more support and what type of support. This is so important.
- Don’t be afraid to speak. It’s important for you to learn to use your voice to support your loved one. I clearly remember the eating disorder did not want to hear my voice. Almost every time I spoke I would have the wrath and venom of the eating disorder directed at me. Because of that, I started walking on “eggshells”. Every time I was around my loved one my tongue became paralyzed. I was afraid to express my concerns for fear it would escalate to World War III. I did not want to upset my child or the status quo. I finally came to learn that “ED grows in the dark”. When we shine the light on the eating disorder it cannot survive. Honesty and transparency is what opens the door for ED to exit. Not being afraid. This is one of the hardest things as caregivers – because we are exhausted, weary, we start to question our role, or we wonder if we are overstepping boundaries or squashing our child’s independence. But, in actuality, when we don’t walk on eggshells we are shining a bright and harmful light on the terrorist, the eating disorder. A nice by-product of this is that we are modeling for our loved ones how to have the necessary conversations and how to express and meet our own needs. Learn to be the light!
- There is not a magic cure. It is important to understand that treatment is a journey and will have many twists and turns in the road. There is NOT a magic cure or pill. An eating disorder will likely not disappear in a few weeks or months of residential treatment and/or PHP. It is important for your expectations to be managed early. I know this is extremely hard to hear, especially after everything you and your family have been through before you arrived. But it is important for you to know that your loved one will likely not be that one in a million for who this is just a little blip, where they will receive treatment and get right back to their life, like nothing ever happened. It may take years for your loved one to recover from their eating disorder with lapses and relapses along the way. I want to help you understand that even after weight restoration the journey can be lengthy – that the goal is restoration of physical and mental state. Often, the most difficult part of the journey is when your child returns home, to the environment where the eating disorder existed. Please understand that they will not return home magically cured. Although it pains me to tell you this, you need to know this. No matter how much you love your child, you cannot rescue them from ED. No matter what you do, no matter how hard you try, recovery will take as long as it takes. I want you to know that every step in this journey is critical and helps get to the end result. I also want you to believe that full recovery is possible. I encourage you to hold on to hope while having realistic expectations.
- Self-care is critical! This journey is going to be hard and possibly long. You must keep your oxygen mask firmly planted so that you have the strength to help your loved one – if you don’t put your own oxygen mask on, you cannot put it on your child! Whether this includes walks, coffee breaks, knitting, painting, lunch with a friend, reading a book for 30 minutes, spa day, whatever brings you joy and allows you to breathe you must do on a regular basis (please see enclosed self-care information). If you are not well, you cannot help your child. I implore you to do what is necessary to keep your oxygen mask on. Your child is safe in the treatment center. Please take this time to restore and replenish yourselves. Another important piece of the self-care is that we must role model this for our loved ones. If we don’t demonstrate self-care, how can we expect our loved ones to do self-care?!
Please know that you are amazing! You are doing everything possible to help your loved one. Know that you are not going to be perfect in this battle. And you don’t want to be perfect. We are role modeling for our children that no-one is perfect. Do not ever hesitate to share that with them. Tell them you’re not perfect. That this is a new journey for you too. So, as you walk this journey with your loved one, recognize and understand that a diagnosis of an eating disorder is no different from being diagnosed with cancer; it needs to evoke empathy, compassion, love and understanding from you. Reassure your child that you are standing there next to them, supporting them, loving them, and willing to do whatever is necessary to save their life.
My hope is that you will receive the suggestions above the way they were intended – to provide insight and help, manage your expectations, and share with you my experiences. My goal is to help make this journey a little less arduous and to educate you and your family. When we know better, we do better.
The ultimate goal is for your loved one to recover from their eating disorder and live a healthy and happy life. The only way to make that happens is to have a cohesive treatment team and to work together with them. By doing that, you are helping your loved one to reach a point where they are stronger, healthier, more nourished, and where they have the cognitive ability to find their recovery path using the therapeutic skills learned during treatment. The key to making this happen is open and honest communication. Develop a solid plan together. Please recognize your loved one’s team wants to work with you, not against you. You are better and stronger together!
As you are walking this journey with your child, know that there is a light at the end of the tunnel. That there is hope. Full recovery is absolutely possible. Remember you are an important piece of the equation. The more you learn and built on a solid framework, the stronger the foundation upon which your child can build recovery. Your child loves you and needs you standing by their side, supporting them, as they take steps into recovery.
Cherie Monarch | A mom who walked this journey