Restoring Family Relationships after Eating Disorder Treatment

Contributor: Amber Allen LMFT, is currently a Licensed Marriage and Family Therapist and Program Director at Shoreline Center for Eating Disorder Treatment. She is also a Certified Family Wellness Instructor that facilitates the Multi-Family Groups held monthly as part of treatment.

Eating Disorders affect families. That is the reality. It is not just the client that goes through a barrage of emotions as they navigate the disorder, but the families as well. The following article is my letter to both families and clients as you seek to restore your relationships after eating disorder treatment.

This is based upon my experience as a Licensed Marriage and Family Therapist who has worked in a facility based eating disorder treatment setting for the last seven years. My letter is to simply provide families with additional support as you seek to heal and restore from the eating disorder.

Families:

Yes it is OK to say to yourselves “I don’t know how to even begin to get back to the trust that was lost with the eating disorder”. Most likely at some point you may have received the brunt end of the challenging emotions that your loved one was experiencing at the height of the disorder.

These emotions may have included:

• Anger
• Resentment
• Isolation
• Manipulation
• Denial
• Depression
• Anxiety

In fact, you may still be on the receiving end of these emotions even after discharge. Recognize that it may be this way for a while as your loved one continues to get nutritionally stabilized (consistent meal plan compliance and stabilization/maintenance of food intake for any eating disorder).

Stabilization Is Needed First

Your loved one cannot be in a position to communicate effectively with you until that stabilization and maintenance has occurred. After that stabilization of eating patterns occurs, the real family work can develop. It is important to recognize that your loved one still needs patience from you as they continue to learn how to communicate their emotions in a healthy way.

You yourself may still experience some overwhelming fear, resentment, frustration, and overall sadness in reflecting on how much the eating disorder has done damage to the family.

To support you, it’s pertinent for you to communicate with your loved one (it may feel safer in family therapy) how they can work to re-build that trust which may have been lost in the throes of the eating disorder.

Continuing Individual Therapy

I would also support you in continuing in your own therapy if you haven’t already done so, so that you get to express uncensored what you are struggling with as your loved ones transitions back into the family. Research to see if there are any support groups in your local community that specifically cater to parents/families of those whom suffer from eating disorders.

Try not to minimize your own emotions and know that there are resources out there to also support you in how to continue to heal. Recognize that your loved one may not be “the same”; because with recovery comes change in your loved ones’ overall identity.

He/she is still working through who they are without the eating disorder and how they can manage the possible depression, anxiety, trauma, perfectionism, anger/resentment towards family dynamics etc. It will feel harder before it feels easier. Just remember that ongoing willingness and openness to the process through time is what will get you to the healing.

Clients

After discharge from treatment, know that it is normal to experience a mixture of emotions also.

You may experience questions within yourself including,

• “Can I really do this on my own?”
• “Will my family expect me to never mess up?”
• “I have so many people whom are depending on me being better….what if I blow it?”
• “My family and my treatment team have invested so much time, energy, financial strain, and turmoil”
• “I already feel ashamed and embarrassed for the impact my eating disorder has made thus far”

This is normal and OK to feel! Recognize that your major priority is for your continued health and in routinely seeing outpatient providers i.e. Therapist, Dietician, support groups, family therapy as needed, etc.

Patience towards Your Family

It is so important for you to also have patience towards your family as they navigate who you are now vs when you were in your eating disorder. Just as you would like for them to have patience with you in this process of restoring the family, they need patience from you too.

Be open and honest as best you can about ongoing struggles, urges, depression, anxiety, etc. Your family is having to adjust and figure out the balance between being a loved one and not having to also be the professional (that’s the outpatient team’s role).

Continue to advocate for consistent family meals to support the continuance of commitment to meal plan (accepting also that your family may not be eating the exact same foods as your meal plan) to support overall connection.

Spending Time Together

Spend some time together non-food related. Assume that at some points your family may not always “say the right thing” as you may need in the moment. This does not mean that they are not caring or trying; rather struggling to figure out what not only feels comfortable for you for them to say but what they actually feel comfortable saying themselves.

Your family is not your therapy team (that’s what the professionals are there for). They are your family. Use your voice and set boundaries when needed. They cannot read your mind based on facial expressions, body language, etc. If you need to express something, use your voice; or if that feels too scary, use written letters or family sessions as a safe space.

To Both Parties:

Healing the family after discharge can look like a wave of the ocean. There will be moments in healing that you feel pretty good i.e. “My son/daughter is following his/her meal plan, we’re communicating with each other, and are utilizing each of our own professional support team as we go”.

This could be considered as the wave going up and in mid-point. The wave also however can come crashing downwards, in which “Oops I said the wrong thing my loved one is upset”, “We aren’t communicating at all, I think that the eating disorder is getting stronger again just when we thought it’s getting better”.

Know that that crashing or downward wave will still rise up again. It ebbs and flows, at times intense, at others very slow and fluid. The good news is as long as there is a willingness on both ends to ride the wave; this process is not in vain.

As a family you are and will become stronger as a unit, little by little, one moment at a time. Healing within the family is gradual upon discharge. There is no time limit or constraint. Become OK with not having to know the exact future, but whatever the future holds, you’re in it together.