Enlightened Parents Become Empowered Eating Disorder Recovery Advocates
By Abigail Natenshon, MALCSW, GCFP

The parent's voice "All your life you love something. Because you love it, you take care of it. You know what you need to do to make it whatever it is. You know how to provide for it, change it, feed it, care for it. You know how to fix what has gone wrong. Then, something like this comes and you can't fix it no matter how hard you try. She doesn't feel she needs fixing or changing. And I can't fix it. So I feel frustrated, helpless, angry, guilty. I can't do anything about it when she feels so unhappy with herself that she hurts herself, or she takes laxatives. I can't stop it. Because I can't be there 24 hours a day, 7 days a week, wherever she is. I don't know how to help her."

After 37 years of a psychotherapeutic practice specializing in the treatment of eating disorders, I make it my business to come cheek to jowl with parents of child patients as soon, and as often as possible, as a diagnostic and treatment priority, for information gathering, knowledge sharing and the assurance of an efficient recovery for the child. What has stood out most significantly for me is that in cases where a child's past therapies have not resulted in successful outcomes, their parents were invariably, under-utilized as resources, unprepared, frightened and clueless about the disease, their child, and what it takes to heal, having been excluded from treatment and recovery process. Eating disorders are family diseases. Parents and families are the warp and weft of the fabric of a child's life, the holding environment and context for the process of emotional and physical development from childhood into young adulthood.

Too frequently, health professionals consider intervening parents to be interfering parents, admonishing parents for honesty and openness in communication, for commenting on the child's eating behaviors, for expressing concerns or wanting to become involved in the recovery process. Too many health professionals still subscribe to the myth that parents are to be seen and not heard, that their involvement represents an attempt to sabotage their child's budding autonomy. Parents are typically instructed to look the other way in an attempt not to notice this "elephant under the chair."

In the face of eating disorder treatment, the child's health professionals need to prepare parents to prepare themselves to prepare their children for the recovery challenges facing them. Parents need to be prepared to identify problems-in-the-making and seek their resolution, to seek out and find the best professional care, to persevere side by side with the child in support of a typically convoluted and frustrating recovery process, to realize their own potential as treatment allies and child advocates, team collaborators and mentors, perceptive and keen observers, cooks and bottle washers, role models and teachers… pivotal figures in the recovery of the child that takes place within the context of daily living, 24/7. By default, parents are the most potent diagnosticians of a disease that rarely shows up in the doctor's office but more readily presents at home… in bedrooms, bathrooms and kitchens. In my extensive experience with eating disorder treatment, I have found parents to be willing, loving, well-intentioned, supportive, capable, and ready to resume the role in their child's life that has been stolen from them by a tyrannical disorder.

Food and eating are primal elements, attached to early nurture, comfort, parenting and trust, to genetics, biology and personality. Food and eating become a metaphor for the child's expression of beliefs and feelings, perceptions, self-esteem, self-determination m and an early means of communication for the youngster who is reluctant or incapable of communicating in any other way. Despite the pernicious messages of the media or peers in a society preoccupied with thinness, positive influences of home and parents will prevail, essentially preventing, immunizing, or "eating disorder proofing" the child. Nature abhors a vacuum; by raising healthy eaters with enough identity and self-esteem to nourish and care for themselves, and with the capacity to face life and resolve problems effectively, parents effectively bypass or eliminate the need for the likes of an eating disorder in the child's emotional repertoire.

When brought up to speed on the recovery journey and kept there, parents become MVP's in the treatment team and in healing. Parent advocacy can be counted on to carry the recovery ball through the good and tough times. With recovery, children invariably contend that they have gotten their personality back, and parents contend that they have gotten their child back. It is simply not enough for parents to love their child. They must be prepared by the child's treatment professionals to put that love into action….to seek action, to seek change, to seek their child's health…. and not to stop till they are there.