This is a section from Chapter 7 of ‘Anorexia and other eating disorders – how to help your child eat well and be well’
It can seem impossible to get your son or daughter to eat when they’re suffering from anorexia or another restrictive eating disorder. Yet refeeding is essential in the early days of treatment. In this chapter I give you all the tips I’ve learned from experience, from our therapists and from other parents. I’ll use a bungee-jumping analogy to illustrate the principles. Later, I’ll offer some examples using practical scenarios of refeeding and of exposure to scary (fear) foods.
In the early days, most of us find it impossible to get our children to eat. We desperately hunt for treatment, and when we find it we’re brought round full circle: we, the parents, are the people at the centre of our child’s recovery. We need to learn how to get our kids to eat.
The tools I’m about to offer you got my child from eating practically nothing, to eating what she needed. They saw her through a whole list of foods she couldn’t previously eat, and freed her up to enjoy other people’s cooking and meals in cafés. These tools deal with fear and irrationality, so they’re relevant to many of the challenges of anorexia and related eating disorders, including the drive to exercise, or to engage in obsessive-compulsive behaviours.
Some of what I suggest may not be for you, and that’s fine. We’re all different. Different situations, different resources.
And now, prepare yourself. I’m going to invite you on a bungee jump. I hope you are suitably terrified!
Actually I have no intention of raising your stress levels and I’m going to take very good care of you. The aim of this thought experiment is to help you empathise with your child, so that when you’re in the middle of a meal the tools come to you instinctively and you don’t have to go and consult a book.
The great bungee-jump: a thought experiment
Your child’s resistance is driven by fear
One day I realised that just about every mealtime obstacle my daughter threw at us was driven by fear. This changed everything. Her behaviour might have looked like contempt, or stupidity, or rudeness, or defiance, but the eating-disorders specialist coaching us suggested that the underlying emotion was fear. How can food be frightening? It’s not of course, but if you have a brain disorder, you don’t think the way others do.
“Before, we knew she was having rages and tantrums, however, on the multi-family therapy week we have all learned together that it is fear and anxiety.”
When we presented our daughter with a plate of pasta, she refused because she was scared. When we asked her to drink a glass of milk in a café or at home, she refused, despite having been able to drink milk in the hospital, because in this new situation she was scared. When we asked her to sit for a car journey, she was in turmoil because she was scared.
Knowing this meant that none of her abuse pushed my buttons any more. I stopped telling myself that she wasn’t trying enough, or that she was being awkward or inconsistent. Instead I felt deep compassion. My only concern became wanting to know how I could ease her fear enough for her to manage the next step. And I recognised the parallels with my own challenges to support my daughter even when I was scared.
My new understanding also meant that there was no point in lecturing her about her rudeness while she was in this state. She was a kind and considerate person normally, and I trusted that her unwelcome behaviours would disappear along with her fear. Which they did.
Fear is a horrible emotion. So horrible that often we fear fear, and will do anything to avoid situations we know induce fear. When we feel fear, we assume that we are in danger. Think of public speaking. Many people fear it more than anything, and yet where is the danger? Even the fear we feel as we prepare to give our speech is not dangerous. Feel the fear and do it anyway, as Susan Jeffers says in her best-selling self-help book. Eat.
Ready for the bungee jump?
To help us support our children to eat even though they are frightened, let’s think what it would be like to take a bungee jump. I don’t know about you, but I have never even considered taking a bungee jump. Way too scary. Are you telling me I have to take a jump? Arghhh!
And to take the analogy further, let’s say that I’m supposed to jump not just once but several times a day for the rest of my life.
Perhaps that’s what eating feels like to our kids right now.
So, how could a friend support me to jump?
[End of the extract]
More in this chapter of the book:
- Planning the challenge
- Logic doesn’t work
- Education: the dinner table is not a lecture hall
- Conversation topics: pick with care
- Distraction: a firm favourite
- Reassurance: suprisingly not reassuring
- Trust me, I’m an expert
- Shock tactics: short-lived gains, high costs
- Shouting, intimidating, blaming: counterproductive
- Threats, punishment, and ‘consequences’: unnecessary
- Rewards and bribes: handle with care
- Incentives: a nudge in the right direction
- Visualisation: access to inner resources
- Praise: complex and risky
- ‘It’s your medicine’: worth a go
- Damage limitation: blame something other than your kid
- Make a graceful exit
- Containment: stay close
- Humour: the best relaxant
- Feelings: a good start
- Empathy: powerful when focused on the task
- Selective hearing, body-swerving and translation skills
- Mirroring: model calm confidence
- Defusing fear: remove the fear of fear
- Notice indicators of progress
- Wait a few minutes
- How long should you persist?
- Focus on the current step in the present moment
- Let your kid save face and maintain some dignity
- All singing from the same hymn sheet
- Teamwork: relay each other
- Giving uncritical acceptance
- Putting it all together
- Video and audio resources
More on how to get your child to eat, or what your options are if your child isn’t eating everything required, on this page, listing all video and audio resources.
Next chapter: See the tools in action: mealtime scenarios