Love, no matter what: how to support your child with compassionate communication as you treat the eating disorder

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This is a section from Chapter 14 of ‘Anorexia and other eating disorders – how to help your child eat well and be well’

Also useful: you can hear me demonstrate examples of dialogue in Bitesize:

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Has your child become hard to recognise? Do you struggle to help them as they swing between depression and aggression? Are you finding it hard to offer unconditional love? Are you confused about using rewards and punishment? In this chapter you’ll find practical tools and examples to help you navigate common issues, communicate with compassion, and rebuild connection.

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In this chapter I’ll address typical difficulties we parents face with our children when they have an eating disorder. I’ll share what helped me with my daughter, what’s worked for others, and what professionals say. I’ll write samples of dialogue. To hear more examples, listen to Bitesize, my audio collection.

You’ll get the most out of this chapter if you’ve read Chapter 13, which lays the groundwork for compassionate communication. But if you haven’t, most of what follows should still be clear and useful. As always, take what’s helpful and leave the rest.

“My feeling, with my daughter, is that each time she goes through a mood swing or a difficult time, if we handle it calmly and compassionately and she gets through it just fine, she is learning from that. It means the next time something goes wrong, she is more likely to get through it a little more easily.”

Food is medicine, and love is life

Connection with our children may well be our most powerful tool. Of course, food and time are essential – but souls need nourishment too. A parent’s love is life-giving. With our love, we soothe our children’s nervous systems. While they’re drawn to eating disorder behaviours to reduce their anxiety, we model smarter ways to deal with emotions. Because we matter deeply to our children, and because we show up for them, they’re able to face major challenges despite their fears. We make things seem safer, calmer. Our love heals their battered self-esteem, counters their self-hate and offers a promise: we will not abandon them. I find this quote from a young person in recovery especially moving, given the depth of suffering this illness can bring:

“What an amazing gift the eating disorder brought me and my family – the gift of communication, of love, of acceptance.”

Unconditional love and acceptance

Unconditional love and acceptance are among the most important tools in your toolkit. They help both you and your child. In our suffering, it’s natural to have all kinds of judgemental thoughts, and it’s easy for those to leak out and spoil our work. I’ll share some principles that helped me. I’ll be transparent about the mental twists and turns I navigated as I tried to be fully present to my daughter and offer her unconditional love.

‘Love her even when she’s down’

One afternoon, when my child was very ill, I met with a generous young woman recovering from anorexia. As we parted, I asked her, ‘What’s the one most important thing I should focus on? The one thing that will make the biggest difference to my child?’

She didn’t hesitate. ‘Love her at all times. Even when she’s down. Even when she’s at her worst.’ I still get a lump in my throat when I think of that – and everything it implies.

What is unconditional love and acceptance?

Unconditional love means loving our children regardless of what they do or don’t do. It’s love, no matter what. It’s about them mattering to us. Letting them know they are wanted, special, significant, valued, appreciated, missed, and enjoyed.

I thrive on unconditional love – and I’m a grown-up. I want my child to be nourished by that too.

Family-based treatment puts love into action.[i] Even the best residential units can’t provide that.

My child is more important than what she does. My relationship with her matters more than any achievement or behaviour. Or to put it another way: I’m her mum!

Here’s how I saw it when times were hard: it’s easy to show love when all is sweetness and light. But I believe she needs it most when her behaviour is out of order. These are the moments when she has no resources to draw on, when her only tools are those of fight, flight or freeze. If she had better ways of getting what matters to her, she wouldn’t be in such a state. In fact, many times she’s done a great job of achieving her aims peacefully. But right now, she is lost. I’m the person she needs to turn to. I’m her anchor, her rock. I will not add to her stress, uncertainty or self-loathing by criticising her. Because of the state she’s in, she’ll be expecting me to judge her, so I’ll take extra care to show her my uncritical acceptance.

But what about her behaviour? If she has my love, will she think it’s OK to behave without consideration for me?

Connect before you Direct (I did a YouTube on that). I’ll address the behaviour later, if needed. But first I’ll take care of our connection.

Parents often struggle to believe that love and acceptance work better than rewards, punishments or forceful authority. They think the only alternative is permissiveness – and who wants to raise a spoiled brat? Some parents become masters of unconditional love and are delighted by how well compassionate persistence works. Still, they may see it as a temporary, abnormal parenting style – only suitable for eating disorder situations. I disagree. Nonviolent Communicationprinciples were developed for all human beings. You don’t need an eating disorder to thrive on connection and mutual respect.

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How to be effective

You don’t have to walk on eggshells

We parents know what it’s like to walk on eggshells. Eating disorders can bring unpredictable, explosive reactions in our children. They accuse us of ‘saying the wrong things’ and then escalate their restricting, bingeing or purging behaviours. So we tiptoe around them.

What if she doesn’t want to tidy her room, or clean her hamster’s cage, or stop hitting her sister? What if she storms off when Grandma’s expecting a birthday visit? It’s hard enough navigating meals six times a day – what about all the ordinary situations in between? Should we show her who’s the boss and make demands? Or should we say yes to everything, because she’s already lost so much autonomy around food and health?

In Chapter 13 I introduced you to the principles of making requests. Now let’s explore a few more details that might be especially helpful with your child.

Teenage rudeness or eating disorder?

Parents tie themselves in knots trying to work out whether a rude behaviour is driven by the eating disorder or simply teenage defiance. Their assumption may be: if it’s ‘just teenage behaviour’, then the child is being deliberately obnoxious and needs ‘consequences’ (punishment). Otherwise, parents fear they’ll be condoning the behaviour, becoming doormats – and there’ll be no end to the rudeness.

But if they believe the behaviour stems from the eating disorder, they appreciate how well a compassionate, non-blaming, non-punitive approach works. They also understand it’s unfair to punish their child for something which is not his fault.

Take the example of a teen screaming obscenities because he’s run out of clean school shirts. The parents freeze, unsure how to respond. Is this an eating disorder issue – because he saw his weight yesterday and breakfast includes a fear food? If so, they have the skills to say, ‘Use polite language! Now tell me – this is not like you. What’s up? What is it that makes this feel so serious?’

But if they think their son is being a pesky teen, they might go for: ‘Don’t you dare speak to your mother like that! Your outing with your friends is cancelled!’

I propose letting go of these distinctions. Use your wonderful compassionate communication skills for everything. You know how well they work, even in the toughest mealtime situations. If they can get your child to eat, they can also get him to empty the dishwasher and to find a pleasing alternative to the F-word.

What tipped our child’s nervous system into a state of threat? Often, we don’t know. Difficult meals and constant eating disorder thoughts are hard – but so is dreading an essay, or being shamed by a teacher for forgetting homework.

There’s an added difficulty when our children are depressed or suicidal. Punishments (like cancelling friends) are hardly going to lift their mood.

Yes, being compassionate can feel counter-intuitive when you’re at the receiving end of appalling behaviour. It’s unfamiliar for parents to step out of a well-worn groove and choose peace over war. We tend to rely on our higher status to make our kids polite. But when your child is being disrespectful, consider that his nervous system has detected a threat, putting him in fight-flight-freeze. He’s not in choice.  Otherwise, why wouldn’t he choose pleasant things like harmony, connection, growth, and happiness? When he’s dysregulated, it’s especially important – and especially challenging – for you to create the connection he so needs in order to return to his own gorgeous, wonderful self.

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De-escalating violence

With de-escalation, you start strong to match your child’s intensity, then gradually model a quieter, kinder tone of voice. You’re juggling several things at once: giving yourself self-compassion, listening and responding to your child with compassion, making clear requests to stop aggressive behaviours, and lowering the emotional temperature with your body language and tone of voice. The sooner you can get grounded, the more likely your child will begin to calm. De-escalation can time, during which your child may leap from one accusation to another. It might start with ‘You’re a control freak! Everyone else can use social media’ then shift to, ‘You gave me too much pasta at lunch!’ and then, ‘You never listen to me!’ This is usually not the time to justify yourself or to correct. Instead, look for responses that validate each emotion as it surfaces (as explained in Chapter 13).

For instance, you might respond to the social media complaint with, ‘Sure, I can well imagine how you’d like more freedom because we’re already deciding your food, and because you have friends who are given that kind of freedom.’ A few minutes later, when you’re accused of never listening, you might say, ‘Oh, that’s terrible! I really want to listen and understand. Tell me more. And it will help if you speak in a lower tone of voice. Can you do that?’

This can be a real feat of endurance for us parents. When you feel lost, remember the simple template, ‘I’m sorry, and I love you,’ as well as the power of silent empathy. This will save you from trying to fix problems in a hurry – usually badly. You may need to keep breathing and offering yourself compassion at every step, to stretch your patience a little further – just enough for the next rung on the ladder. Eventually, you’ll see a sign that your child is reconnecting  with herself and with you: a sigh, a relaxation, a shift in tone, or even tears. Now, you can offer a hug, suggest a break, move towards problem-solving, or offer explanations.

Some time after this demanding exchange, you may need to find someone to offer you compassion for what you’ve been through. If you want to be in top form for your child’s sake and your own, this belongs in the ‘essentials’ category, not luxuries. Your child may need more support too, as they may feel ashamed of how they treated you. So consider having a conversation later in the day to mend the relationship and to problem-solve how to avoid such fireworks in the future. More on this mending process later..

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'Am I fat? How to respond

It’s very normal, with most of the eating disorders, that our children have a distorted, anxious view of their body shape. Or they attach a disproportionate importance to it, as though their life depended on it. They seek reassurance and promises from us. Over the next few pages, I offer a range of responses. You’ll talk differently when your child is malnourished and delusional, compared to when they’re able to self-reflect and show kindness toward themselves.

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Early days: your child is genuinely suffering

Let’s start with the early period, when the eating disorder is strong, your child is malnourished and very anxious. You see a person who’s irrationally terrified of being fat, and of any weight increase. Meltdowns are common after they’ve been weighed or when they dress in front of a mirror (some parents choose to cover those). They ask obsessively, ‘Am I fat? Will this make me fat?’ They howl, ‘I’ve gained too much weight! I’m so fat! I feel fat! All you want is to make me fat!’ They demand numbers. They fear that all we’ll ever want is endless gain: ‘What’s the weight target? How many more kilos?’ Their complaints are so far from our reality that we can get irritated and dismissive: ‘Fat isn’t a feeling! Get a grip!’ What may be more helpful is to start with empathy for what they are genuinely experiencing. They’re getting distorted signals from their nervous system. Their body genuinely feels wrong (this is called interoception). Their senses signal, ‘You’re huge, you’re in danger’.

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‘It’s not useful to talk about it’

If logic is useless, how can you answer your child’s incessant questions? One option is to refuse to engage: ‘I’m sorry sweetheart, remember we’ve found it’s not helpful to talk about this.’ This option could appeal to you if your child tends to distort your meaning and if every response you give fuels more distress and questions.

“ED will NEVER hear that the way they look is OK or ‘normal’. Never. This is something I am still learning. ED constantly wants to engage me in the discussion of ‘I'm fat’ or ‘My stomach is huge!’ Just for grins, one day, I had her and I stand side by side and lift our shirts. I said, ‘Which stomach is bigger?’ Answer: Hers! Now, you must all know that I am objectively MUCH larger than her. But still the voice in her head says something very different. That was the day I stopped having those conversations. Now, I either ignore the comment, or simply say, ‘We're not discussing that.’”

Expect your child to try to keep you talking: ‘You’re not saying I’m not fat, so that means I really am fat!’

Remember ‘Connect before you Direct?’ I recommend that before you shut down the fat talk, you go for connection – even if it’s just a few words of kindness and regret. Otherwise our children can feel invalidated, unseen, like an object, like we don’t care.  I’m especially not a fan of the ‘externalising’ response you might see on parent support groups: ‘That’s an eating disorder question. I don’t talk to the eating disorder.’

Connection, followed by redirection, could sound like, ‘I’m guessing you’re wanting reassurance, because this topic is going round and round in your mind. If you remember, we’ve found it’s not useful to discuss weight, so let’s look at some kitten YouTubes.’ Or, ‘I’m sorry, darling. I’m guessing you’re tense about all this, and you desperately want reassurance… and we know that talking about it won’t give you that. Best to go for distraction. Would you teach me to fold a paper bird?’ After that, when the fat questions keep recurring, we can give a shorter reply, ‘Remember, sweetheart, we’re not discussing that because it’s not helpful.’

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When can you encourage an acceptance of body diversity?

I mentioned earlier how ‘No, you’re not fat’ is a temporary Band-Aid. While it may make meals work, it could also reinforce your child’s belief that fatness is bad. This isn’t just an eating disorder issue. When any child asks, ‘Am I fat?’ thousands of parents around the world instinctively respond with, ‘No, of course not’ or ‘No, you’re beautiful.’ To grasp why this is problematic, consider the parallel between ‘fatphobia’ and homophobia: imagine your child asked, ‘Am I gay?’

Look, you’re the expert on your child. Is this a good time to engage in conversations on body acceptance, diversity, social justice, Health At Every Size, and the fat-liberation movement – bearing in mind that most of us adults are still on our own learning journey? Is it realistic to expect your child to embrace body diversity, if an ‘extra’ grape still feels unbearable?

They may agree that their best friend is fat and wonderful, but right now, they’re in agony about how their body feels: ‘It’s different for me. I have to be thin. Am I fat? How much more weight do I have to gain?’ But the happy day will come when you’ll feel you can explore these topics. I’ll share some tips for that now.

[End of extracts from the chapter]

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In this chapter:

• Food is medicine, and love is life
• Unconditional love and acceptance
• Judgemental thoughts: my story
• She loves you, even when she loves you not
• What to do with your child’s anger
• Is your child’s anger better out than in?
• Is your own anger better out than in?
• It’s not about you (even when she’s mad at you)
• Punishment, sanctions, consequences and ultimatums
• Rewards and incentives can backfire
• How to be effective
• Dealing with aggression
• ‘Am I fat?’ How to respond
• Hysterics, panic attacks and extreme anguish
• Comfort and reassurance: what works and what doesn’t
• Nurturing your child's wellbeing
• Personality traits that help and hinder
• The power of your relationship
• Sick, mad, bad? What's the story about your child?
• Mending, apologising, and regrets
• Influencers and reading materials for your child: take care

More help on this website:

* Next  chapter: How to build up your own resilience and wellbeing *

* How to overcome weight bias and fat phobia *

* Could a parent’s rage at ‘ED’ slow down progress? *

* Empathic and effective dialogue with your child: example after food is binned in school *

* I posed as a teen with an eating disorder. Here’s how AI responded. *

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