Offering Wellness as an
Option: Preparing What to
Say
The script below is an
excerpt taken from When
Your Child Has an Eating
Disorder: A Step-by-Step
Workbook for Parents and
Other Caregivers
(Natenshon, pgs. 83-85)
Beginning the Dialogue with
Your Child
Mentally rehearsing a confrontation
with your child can help you
get ready to intervene by
mapping out major points and
goals for your dialogue. You
may want to anticipate
making active listening
responses, recognizing and
responding to resistance,
and offering effective
rebuttals. The following
section is a sample script,
or discussion outline, for a
parent who sees symptoms of
an eating disorder in her
child that the child is
refusing to acknowledge. It
incorporates many of the
ideas discussed in this
chapter. Think about
which aspects of the script
might work for you. If some
parts of the discussion feel
less comfortable to you than
others, try to understand
why. You may use the script
as a model for preparing
your own outline of what you
might say and how you might
respond to your child’s
predictable display of
resistance.
Sample Script for an
Intervention
PARENT:
I’m concerned about you.
Here is what I’ve observed
[describes his or her
observations]. My hunch is
that you may be needing some
help now. What’s your take
on this?
CHILD:
There’s nothing wrong [or,
You’re imagining it,
exaggerating; or, It’s
really none of your
business; or, If there’s
ever anything to be
concerned about, I’ll let
you know].
PARENT:
I understand what you think,
but it would be helpful for
me to know more about how
you’ve arrived at this
conclusion. Because we see
things differently, and
because this might possibly
be a matter of your health,
maybe a professional should
help us determine what, if
anything, might be going on
here.
CHILD:
I’m not going to see anyone.
I don’t want to, and I don’t
need to [or, I can fix
things myself whenever I
choose].
PARENT:
It’s only natural to feel
reluctant to investigate a
situation that scares you or
makes you feel out of
control. A lot of people who
don’t understand eating
disorders think all kinds of
scary things about them,
like once you have a
disorder you’ve got it “for
life” or that you have to be
“psycho” to have an eating
disorder or to go into
therapy. You know that these
notions aren’t true, don’t
you?
CHILD:
Of course. I also know
there’s nothing wrong with
me. I’m just trying to keep
my weight down so I can look
good. All I want to do is
lose ten pounds.
PARENT:
What is so confusing about
eating disorders is that
they appear to be about food
and weight, but they are
actually devices that help
people solve problems, cope
with anxiety, and take
control—not only of food,
but of life. The odds are
that if you are out of
control with food and
frightened about gaining
weight, you are probably
feeling out of control and
fearful about other things
in life as well. Eating
disorders reflect how a
person thinks, acts, and
feels in general. By the
way, have you thought about
why you feel you must engage
in such extreme behaviors in
order to lose weight? And
are you absolutely certain
that you’d be content to
stop losing weight once you
lost the initial ten pounds?
CHILD:
OK, so let’s say I have a
problem and I went for help.
What if things didn’t get
better for me even then?
PARENT:
It’s understandable that you
might be concerned about
that, because eating
disorder recovery can be a
real challenge and can take
time. But you’re up to it,
and I’m behind you. You’ve
done a lot of tough things
in your life—you’ll do this
one, too. The changes you
will need to make won’t
require you to totally
revamp who you are; they
will simply be a matter of
fine-tuning some of the
strengths and resources that
you already have in place.
CHILD:
What if I have to leave
college [or, school]?
PARENT:
There’s a good chance that
you could work on your
recovery while in school,
through various supports on
campus. If the problem is
too intense for you to stay
at school, it will make
sense for you to take a
semester off, because
there’s not a lot of
learning that can go on
anyway when all you can
think about is food.
CHILD:
I’m not ready to get help
now. I’ll take care of this
next week. Just give me a
little time.
PARENT:
Do you believe that waiting
will help the situation go
away? Initially, an eating
disorder helps a person feel
better, but the longer the
disease goes on, the greater
the damage it does to the
body and the harder it is to
fix. If you’d like to try to
make a few changes on your
own for a week or so and
then see what happens,
that’s OK with me. But let’s
plan to talk about it again
in a week’s time to see how
things are going.
CHILD:
I promise, I can do this
myself. I don’t need
anybody’s help.
PARENT:
If you had diabetes and
needed insulin, I’d be
responsible, as your parent,
to make sure you got the
medical attention you
needed. This situation
leaves me no choice either.
Why not take the week you
are looking for, and let’s
say that if you haven’t been
able to make sufficient
changes in that time, then
I’ll step in at that point
to find help for you. That’s
the deal. I will offer you a
hand temporarily, just until
you are free to take control
of things on your own again.
So, what do you think?
CHILD:
I guess that sounds fair. I
just wish I could be good
enough the way I am.
PARENT:
You are certainly good
enough. My intention is to
help you stay that way.
Achieving an open exchange
is the most important goal
as you begin to dialogue
with your child. Don’t
expect results immediately,
but remain focused,
confident that you are doing
what needs to be done, and
persistent.
Getting Started
By now, you have the
essential information you
need to confront your child.
Think of an appropriate time
to bring up the necessary
conversation with your
child, or resolve to take
advantage of the next
opportunity that presents
itself. Decide whether you
want to be with or without
your partner when you talk
with your child. If the two
of you are to do this
together, determine the
things you and your partner
should discuss prior to the
dialogue with your child. Be
sure that you are
both of the same mind and
that your child does not
feel ambushed.
Psychotherapist Abigail H. Natenshon has specialized in the treatment of eating disorders with individuals, families, and groups for the past 35 years. She is the author of When Your Child Has An Eating Disorder, A Step-by-Step Workbook For Parents And Other Caregivers, Jossey-Bass, 1999. Based on hundreds of successful outcomes, this book shepherds concerned parents step-by-step through the processes of eating disorder recognition, confronting the child, finding the most effective treatment for patient and family, and evaluating and insuring a timely recovery. A guide to eating disorder prevention, this book is useful to parents, health professionals and school personnel alike in countering the pervasive epidemic of unhealthy eating and body image concerns, and destructive media and peer influences. Her work can be reviewed further at www.empoweredparents.com, www.empoweredkidZ.com,
www.treatingeatingdisorders.com.