Therapy for anorexia: Parents

Dear Parents 

There’s something you need to know about therapy for anorexia. It isn’t a walk in the park, for you or for your child. If it was, it won’t work.

The cognitions of a starving brain are faulty and we must not collude with them.

The moods and emotions of a starving body are turbulent - anxiety, depression and mood swings are inevitable. We must not allow them, or the avoidance of them, to dictate the journey. This means that emotions will fluctuate even during session which is sometimes worrying for parents and hard to bear. But emotions can often be an indicator that real treatment leading to change is happening.

Different professionals may say different things, unfortunately. The most appropriate intervention is that which includes your instincts and experience of what your child best responds to and a combination of professional advice. But don’t be surprised if some professionals you encounter seem clueless about Anorexia and don’t hang on their every word.

It is very unusual for both parents to approach this in the same way, which can sometimes be helpful as it means you can take it in turns to be good cop/bad cop. And cops you will have to be, tough love includes compassion still and a firm consistent approach is the way.

Life as you know it needs to stop for a while. Holidays are no longer the priority, nor are fancy restaurants or even work. Your child must weight restore as a priority. The best chance your child has of recovery is within the first six months.

Counselling often doesn’t work for anorexia because the individual bathes in the glory of actually being able to talk about their obsessions, ie body image. Anorexia requires a specific intervention (CBT or a psychological intervention/treatment) which challenges distorted cognitions, obsessive ritualistic behaviours, restrictive eating behaviours, etc. 

Anti-depressants may prove helpful if your child is particularly stuck, but a big part of why they are low or anxious is because they are starving. Perhaps the best anti-depressants are taken with a knife and fork.

And yes, your child, who has always been honest to the core, may well be lying. The very nature of anorexia is a deceitful one. A starving brain and body is fearful, desperately trying to reach equilibrium to survive. This is temporary and does not reflect your child’s personality, but does need acknowledging. Every one of my recovered anorexia patients has told me afterwards that they needed to hear the truth no matter how hard it was at the time, and that people who were easily fooled were not helpful. 

I hope this is helpful. Your journey is an extremely difficult one and won’t be helped by ruminating on what you did or didn’t do to bring about Anorexia in your child. If there is something relevant, and let's face it - us parents cannot get everything right, this can be explored once your child is weight restored. Your energies, for now, are best well spent on helping them to exit the dangerous self-perpetuating state of starvation.