Coping with Eating Distress in the Family
- If someone in a family develops an Eating Distress (ED), it is time to listen, not to blame.
- Neither the sufferer nor the family can be blamed or criticised for developing an ED.
- Families need to learn about the ED in order to be a positive support.
- A family’s involvement can speed up the process of recovery greatly.
- Friends and family members are often the forgotten victims of ED. It is often difficult for the carer to know what to do for the person or for themselves.
- Work with ED Families is a slow process that involves a lot of education, communication and patience.
The term ‘family’ describes ‘a unique cluster of people who enjoy a special relationship by reason of love, marriage, procreation, and mutual dependence.’ The family plays a primary role in how we develop as a person and how we see ourselves in relation to other people. The family acts as a ‘mini -society’ with its own governing system, politics, economics, culture and beliefs. Our experiences with how we operate in this first structure influences how we operate out in the world because the family is vital to helping to develop belief systems and values. However, this does not mean that the family is responsible for all developmental problems that may emerge in a person’s life.
There are no Typical ED Families. The presence of an ED in a family does NOT mean that the family or its members are dysfunctional! Over the years, families have been studied and re-studied to determine the causes of ED. However, there is nothing conclusive to say that dysfunctional families breed ED. Many sufferers come from loving families without trauma or upset.
There is no perfect family, parent, sibling or environment. The only conclusive absolute that links sufferers is their sensitivity. The negativity of the sufferers’ condition is similar, yet the sufferers and their families and environments are all unique and individual. Work with the family is firstly educational. The key to successful recovery is improve their knowledge of the condition.
Many family members enter treatment with shame, guilt and fear. In the practitioner’s first session with the family, it is necessary to address the fears, shame and guilt. Fear of the ED, and shame and guilt for causing it all get in the way of helping to get rid of it!! Fear usually effects boundaries and rules. Parents are afraid to set rules and/or boundaries for fear that the sufferer will react poorly. Therefore, they become too flexible or too rigid.
The most important thing to impart on carers is to help them to let go of trying to change their loved one’s behaviour. The family member needs to come to terms with understanding that they have power only over their own behaviour. Not understanding this can set the family on a dangerous course. If we only concentrate on controlling the eating behaviour, the Eating Distress gets worse. Stressing that carers need to care for themselves just as much as they do for the sufferer is a difficult concept for most family members. And, when they understand in theory, it is often difficult to put into practice.
A Study of Heablon and Andersen (1981) examined 73 consecutive ED families, more than 2/3 showed not the slightest sign of imbalance or unhealthy functioning. Family issues need to be addressed through evaluation and treatment.
- burdens of guilt
- Anger and exhaustion.
Family Involvement in Recovery
It is important for family members to express concerns, fears and observations, but in a loving and non-judgemental manner, even if this is not received very well. Remind them over and over not to give up!
Denial is often the first stage of the illness for the sufferer. However, it is also very present in the family. Many family members do not want to hear that recovery takes time and needs the family members to change. Thus, there are many families that do not want to be involved in the treatment process.
However, it is necessary that family and friends are at least seen as trying to reach out to a suffering loved one in order to facilitate the person getting help and support during recovery. Often the fact that family members make appointments to learn about the condition is a relief to sufferers. On the surface, many ED clients express resistance to allowing their family members and or carers’ involvement. Family members must show their willingness by making appointments taking a stand.
Family members often think that they are doing the right thing when they ask how the sufferer is feeling, or getting on in therapy? It takes a long time before the sufferer knows the answer to these questions. Therefore, these direct questions asking how they are doing can overwhelm them and make them feel mis-understood. It is up to the practitioner to explain this to families and sufferers. The practitioner takes the responsibility from the client to explain the condition.