Empathic dialogue after a bust-up

Does your child act totally out of character when he or she is worried about food? Have you been screamed at, or kicked? Have you had a plate of pasta tipped onto your lap in a restaurant? Has your child run away?

After a highly charged event when your child (and perhaps yourself) have been very reactive, you could choose to initiate dialogue. The idea is to take care of yourself (because you’re hurt), your child (because he or she needs safety and understanding) and your relationship. You might also be looking for solutions or agreements so that whatever happened won’t happen again.

Eating disorders tend to make emotions run high. What can parents do after the fireworks?

My experience is that while the eating disorder is raging, this kind of conversation is near impossible. The way I understand it, our children are in such a state of turmoil that they simply don’t have the space to connect with themselves or with us. But once you’ve moved on from this stage, how can you talk with your child about her latest outburst?

In my book I offer you the main tools you can use to reconnect, based on Compassionate (or Nonviolent) Communication (NVC). Briefly, in what follows, ‘chatterbox thoughts’ are judgemental thoughts, ‘needs’ are things that matter or deep values, and self-compassion and empathy for your child are about attuning to needs.

It’s wise to prepare for this kind of conversation with some self-compassion, so that your chatterbox doesn’t end up doing all the talking. Your body language might give a lot away if you’re still hurting, and your child may not be well enough to bear it. So let’s assume you’re now reasonably grounded. The first step in your post-fireworks dialogue will be empathy for your child.

Empathy for your child

Modes-Empathy-(NVC)Your child may assume you’re cross or disappointed with her. She may need to know you’re not giving up on her and that she’s still loved and accepted.

 

 

Feelings and emotions (NVC)‘What was going on for you in the café? … Aha, yes, I thought so, you couldn’t bear the thought of eating the egg, and it was extra stressful because you thought people were watching. And now you’re embarrassed, yup [Reflecting feelings].

 

 

Need symbol (NVC)It’s not like you to do things like that [Empathising with a need for dignity and trust].’

 

Expressing your needs

Modes-Self-expression (NVC)You’ll know you’ve established connection if you see some sign of relaxation in your child. You can now move on and express yourself.

‘Nope, I’m not blaming you – I want to support you back to being well again so things like that aren’t stressful any more.’

When you express yourself, the chances are quite high that your child will hear judgement, threats or abandonment in spite of your best efforts. Here’s how you can keep checking your intentions are clear:

Need symbol (NVC) ‘I’m really worried about someone getting hurt when you kick, and I’d like us to have peace and safety within our family, because we all matter [My feelings and needs]. Hmmm, I’m worried I didn’t say that very well. Can you tell me back what you heard? [This is helpful in a difficult conversation, as chances are the other is adding a layer of interpretation onto what I’m saying]

‘You want me out of this family.’

‘Ah, thanks (for telling me what you heard). I’d like to try again, is that OK? Because I’d really like you to understand. I’m saying that I’d really like all of us all to feel safe. How’s that? Can you tell me what you heard me say now?’

Need symbol (NVC)‘You’d like for everyone to feel safe.’

‘Yup. Thank you. I want to take good care of everyone: your sisters, your dad, myself, and you. So this is what I’d like from you. No more kicking. How’s that for you?’

‘I’m not sure I can do it. I’ll try.’

‘Thank you.’

Searching for strategies

Requests - NVCNow the needs are on the table, you can go back and forth with ‘What shall we do?’

For example: ‘I want to get you used to eating out, so you become really free [Need]. And it’s normal it should be scary at first, and that was the first time in over a year. So what shall we do?’

Keep your needs and your child’s needs at the heart of the dialogue: ‘Nope, giving up on cafes isn’t a great solution, because you wouldn’t be moving towards freedom then, would you? What else might work?’

Your child might come up with something great that surprises you, but what if she isn’t able to engage much? You could make a suggestion or make a unilateral decision:

‘I think next time will be easier, but if – if – you’re feeling quite so agitated again, how about you tell me in words? I don’t mind if they’re rude words, just use words, not actions, and that way other people in the restaurant won’t even notice. How’s that sound?… OK, I’m glad you’re willing to give that a try. Let’s do that for the next meal out, and then you can tell me if anything else would help you manage more easily.’

Your child will find it a lot easier to agree to something if it’s not for ever and is up for review.

Lessons for next time

Once your child has relaxed because she’s received empathy, it’s possible for you to go into ‘education’ mode and seek to reap some learning from the event (the motto, as I explain in the book, is ‘Connect before you correct’). You might want your child to appreciate the consequences of her actions – and I really mean ‘consequences’, not ‘punishment’. This may also help you feel heard and move you away from walking on eggshells.

It’s possible that at this moment your child truly doesn’t appreciate the consequences of her actions. She may be wearing blinkers because the shame would otherwise be intolerable. Rather than dwell on ‘I’m a worthless sub-human because I kicked my mum’, she may forget the incident and resume life as normal, or even be extra loving or exuberant for a few hours[i].

The trick to maintain connection throughout is to keep your needs and her needs at the centre of these discussions.

For instance, ‘When you ran away because you were so terribly upset, I saw you crossing a busy road without looking. You could get killed or disabled in the blink of an eyelid. Let’s look at what else you could do when you’re in that state, so you can stay safe.’

Or, ‘When you said you wouldn’t get in the car it meant you didn’t get to practice sitting, and that doesn’t get you any closer to your goal of making it to Gran’s birthday get-together next month. What would work for you better next time?’

Throughout this section I’ve given you examples with quite a few words, in the hope it demonstrates the role of various principles. Now, let go of my words and let go of doing anything ‘right’. Trust that if you are self-connected and in touch with needs, the words that come out of your mouth will do a fine job.

So for instance, let’s say my child is lying in bed peacefully and I’m about to kiss her goodnight. I might say, ‘Darling, today in the café, when you tipped your pasta onto my lap, that wasn’t great, right?’ I don’t see the point of spelling out the obvious: ‘Please don’t do that again because I really want some dignity in my life.’ It might not be necessary to repeat something she already knows: ‘If you feel like that again, will you please try and use words instead?’ I can see in her eyes that we’re on the same page.

 


[i] Bon Dobbs’s description of this sudden mood change among people suffering from Borderline Personality Disorder matches some of the descriptions I’ve heard of people with anorexia. http://www.anythingtostopthepain.com

8 Replies to “Empathic dialogue after a bust-up”

  1. Thank you so much for this. This is exactly what we need after doing maudsley based practice for 7 months which was what we needed to get stability we are now in a relatively stable (Ok the boat often rocks violently!) place but moving to phase 2 is such a bitch that we really really can do with these specific skills with actual example of conversations like ” giving up on cafes is not a great solution” these are just the practical tips that I need that I feel a lot of books don’t address as they are so concerned with getting the kids away from deaths door but as we have discovered that is just a first step. We are nominally weight restored but the state is so so so stuck that I often wonder and this hard work of getting back to independent eating seems like a huge ocean with very few guiding principles to help us navigate, so this book is very timely and I will be buying a physical and e copy as soon as its published.

  2. Lebza, I’m really pleased if this is helping give you specifics. I know it’s what I needed to at the time. I’d love to hear how you get on. I also suggest you show your FBT therapist this site if you haven’t already done so. That way you might get more from the partnership. (Plus, I would love therapists to point families to the resources here.)

  3. Dear Eva,
    I came close to a big bust up with my daughter this morning, following the sort of behaviour that I simply would not countenance if she weren’t ill, but I’ve just re-read this chapter and you’ve reassured me that I love her despite everything, and that I can deal with this. Thank you for your wonderful book – I really think it might save my sanity!

    1. Wow. You’re back in touch with your love and your strength. I am so very glad. You’ve made my day by letting me know. Sending warm wishes to you, your daughter and family.

  4. Hello,
    My sister showed me your page a couple of days ago and I’m reading it in detail. My daughter is 10 and her eating has been getting worse for a year. Now she seems fully entrenched, crying for hours after small meals, very low esteem and loosing weight rapidly.
    Your site is helping me to be clear on what approach to take whilst feeling so all over the place.
    Her referral to further support is just coming through.
    Thank you,

    1. Thanks for letting me know. I’ll be so glad if this book, and the therapy to come, help you help your little girl and if you get to find some peace of mind too.

  5. Eva, your site has provided some very useful and practical guidance. My daughter’s therapist is incredibly cold and at times has provided conflicting advice. This is not only unhelpful but also very confusing. My daughter is holding back so much in her sessions. She does not trust or feel comfortable with her therapist. Please could you provide some advice on how I can request an alternative therapist. The relationship and chemistry is simply not there.

    1. Hi Sahara, I’m glad there’s practical guidance for you here. Have you seen my chapter on therapists http://anorexiafamily.com/therapists-treatments-anorexia/ ?
      How you request an alternative therapist would depend on the country and system you’re in. Here in the UK, within the NHS, I reckon I would first ask the therapist him/herself, then their boss (the clinical director maybe), then if that failed, go up the tree to the head of the Trust.
      The next question is whether it’s the therapy that’s the issue, rather than the therapist.
      For a child, FBT is the best therapy to go for, yet it’s unlikely the child will like the therapist because the therapist will make eating a priority. And it’s fine if the child holds back – it’s not a talking psychotherapy . There, the question is more whether you the parents feel well supported so you can support your child.
      If your child is a young adult or an adult, if it’s CBT-E therapy and parents are not involved much, then it does matter that there is a relationship as that is part of the treatment, so it would be a perfectly valid request to change or revisit how things are going.
      If it’s another kind of therapy then there’s probably no research to show the chances of it working even if your child loved the therapist and opened up, so you have many more questions to ask. I hope this gets you a step further along the road?

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