Preventing burnout, when your teen has an eating disorder

Can you prevent burnout, when you're caring for your teen with an eating disorder?

Burnout, or exhaustion, or anxiety or stress — these are terms parents use when they're not coping, now they've become a caregiver for their child with an eating disorder. But burnout is not inevitable. I'll describe ways of coping, building your resilience and preventing severe exhaustion or burnout.

'Take care of yourself' — far too vague!

If you are caring for a child or teen or partner with an eating disorder, isn't it maddening when people keep telling you to ‘take care of yourself’ so you don't get burnout? It can increase your sense of isolation. You don’t need a bubble bath, you need your loved one to be well! (And to allow you to hug them and to stop shouting at you and frightening the whole family — so many things…).

I got very low when my daughter was taken over by anorexia. From my experience of supporting many parents, I know that most of us have times we suffer hugely.

Really normal reactions

You are normal, and in good company if you catch yourself experiencing times of:

• crying all the time
• having fantasies of escape or suicide
• having fantasies of abandoning the very person you so care about
• lacking the energy to do anything that might help you

Some mothers have told me all they can do, when they're not supporting their child, is to watch the most undemanding TV series. They're a bit embarrassed, because in normal times, they might be doctors, lawyers — you get the picture.

The most loving, upright, courageous human beings have limits to how much fear or aggression or rejection or uncertainty they can bear.

Tip: get clarity on your teen's treatment

The most burnt-out parents, I find, are the ones who have the most confusion around their child’s treatment. They feel like they're watching a car crash and there's nothing they can do about it.

Your body and soul are crying out for your child to be well and thrive. So prioritise this need and seek out the information and support to make wise decisions. Knowing that you're doing the right things will energize you and help you get on with your very demanding work.

If you're not sure which treatment might be right for your child, or what your role in it should be, get started with my 'Start here' page.

Tip: what are your own needs — what matters to you?

Caring for a teen with an eating disorder is demanding and marathon-like. We’ve never been so stretched and we’re not (yet) equipped for this level of challenge.

Our suffering is a call to action, to getting major human needs met.

I'm not a fan of dishing out self-care solutions. It's better if you can put your finger on your unmet needs, so that any solutions are your solutions.

Common examples of unmet needs:

• We need rest, nutrition and movement: accept that you have physiological needs that you can't bypass for too long. When those needs are unmet, we are vulnerable to low mood, anxiety, and exhaustion. Parents often rate highly their dog walks or their cycling in nature, for example. Few talk about their alcohol consumption: what works for you?
  
• We long for a good night’s sleep (I have some tips for you here)
  
• We long for ‘me-time’, for a peaceful place where we can be restored. We are so depleted we imagine nothing less than a year’s holiday away from the family could possibly heal us. Many parents report that psychiatric medication helps at this stage (but women, check out my menopause link first).
  
• Women tend to be at the age of perimenopause or menopause. Learn more how this might be adding to your burden (there's more to it than hot flushes!) and what to ask of your doctor, on my page here.
  
• We need hope. To know that this hell will pass. To trust that life will support us, come what may.
• We are missing connection dreadfully: closeness with our child, a hug, harmony with our family, the understanding and compassion of friends.
  
• If we sense that therapists are pushing us out, failing to make use of our competences or judging us, we suffer. The converse is that when we are treated with compassion and respect and allowed to do what we’re good at, we get re-charged.
  
• We are starved of the injection of wellbeing that comes from pleasurable or stimulating activities. For some there's a longing for the work they've put on hold. Or a craving to read a book or make time for creative activities.

I invite you to review what matters to you – to your body, your mind and your soul.

Tip: be assertive about getting some of your needs met

You cannot meet all needs. But if you take care of those you can, you’ll be less depleted, more nourished — more effective and courageous.

For me, a crucial act of responsibility was to address my sense of isolation. I acknowledged that humans thrive on connection. I let go of an old attachment to self-sufficiency. With some reluctance, I made better use of friends and worked hard to find my perfect therapist.

Some of your needs can be met with practical support. If so, make requests and be specific. Humans generally like to contribute to others. There is such a thing as ‘Helper’s high’, so give your friends and family the gift of supporting you. Don’t burden others with the job of being a mind-reader. If you long for a hug more than for advice, then ask for a hug. If you want your sister to take your other children out for a fun Sunday, ask.

If you give people the genuine freedom to say ‘No’ then you gain the freedom to ask.

Saying 'No', and delegating, are skills you now really need!

Before saying 'Yes' to anything that's asked of you, ask for time to think about it. Then check in with yourself: is this a genuine, full-bodied, 'Yes'? Or is every cell in your body saying 'No'?

I speak with parents who haven't yet recognized that they're doing heroic work to support their teen out of an eating disorder. Your friends and family should be there for you, not the other way around. Let go of social obligations that you don't enjoy. Insist that family members pull their weight if there are elderly parents to care for.

Having studied Nonviolent Communication (NVC), I can tell you, it's great to be with people who can say 'No', because then you can trust their 'Yes'.

And if you can afford it, pay for the kind of help you most desire.

Compassion: for all those unmet needs

Many of your needs genuinely cannot be met at present, so you might think it’s pointless and painful to give them your attention. Most of us have got through our earlier lives by gritting our teeth and ‘getting on with it’. And yes, it's OK to 'stretch'. But this strategy tends to break down when we encounter the marathon challenge of an eating disorder. We need an upskill.

A more sustainable response is to greet unmet needs with compassion from yourself (self-compassion) or from someone else.

Kindness is a huge human need. When we feel loved, understood, accepted, we get energized. Compassion activates the parasympathetic nervous system (or ‘care and repair’) which stops the production of stress hormones and releases feel-good, protective chemicals.

Compassion moves you from the fight-flight-freeze state to a state where you can be effective, loving, intelligent, hopeful, courageous and where you may even flourish.

Self-compassion: the ultimate coping tool for unmet needs

Ideally you will receive compassion from others and benefit from human connection. In addition, learn self-compassion, so that you can process your emotions fast, any time of day, before they grow and overwhelm you. I give you a lot more guidance on self-compassion here and in Chapter 13 of my book and in my Bitesize audios.

If you’d like to be guided and to experience the self-compassion process, try the guided compassion meditations that I created for parents (and which I used on myself when I wanted to return to my wise self). They start with self-compassion and move on to compassion for your child.

Become an expert on resilience

There are many, many more coping tools to help you prevent burnout and to nurture your wellbeing. I gathered the most powerful tips for you in Chapter 15 of my book, and in my Bitesize audios. And I sometimes do an online workshop just on that topic.

Tools include

• managing your thoughts and beliefs
• mindfulness
• acceptance of reality
• trust
• gratitude
• connecting with the body
• use of imagery / visualisation
• skillful responses to fearful thoughts, shame and guilt
• connecting with others
• ways to communicate more effectively
• connecting with the bigger picture
• permission to be well

When you have NO TIME!

At the start of this post, I scorned the 'have a bubble bath' advice. I shouldn't have. Emotions reside in the body. Kind touch, warm water and pleasant scents give direct messages of safety to the nervous system.

But maybe you're at a stage of your teen's treatment where you have zero time for yourself. You cannot go for a massage, you cannot take that damn bubble bath.

So attend to small pleasures. Smell the rose on your table. Stroke the dog. Feel the air on your skin. Each time you're bringing down the cortisol, the adrenaline. You're refilling your cup. It's do-able, and it's worth doing.

Permission to enjoy any opportunity for wellbeing

Even while your child is unwell and sadness is a given, you can have multiple moments of wellbeing and joy. Every stimulus that brings a smile to your face tops you up emotionally and physiologically.

Does being joyful at this time sounds selfish or insensitive? I invite you to think bigger. Your wellbeing reassures your child: you’re a stable force they can count on. They can also feel less guilty about ‘what they are doing to you’. And you are modelling powerful life-skills which are not widely taught.

You might think of yourself as a lighthouse, sending out light, guiding boats safely to shore. Even while you suffer, nurture your own life force, your capacity to radiate wellness, love and hope. For most of us, wellbeing – especially in tough times – comes from connection. Connection with humans, animals, nature, beauty and those unnameable things that are bigger than us.

Protect yourself from PTSD

Some parents report that after many years of supporting a child with an eating disorder, they're now suffering from Post-Traumatic Stress Disorder (PTSD). This is heart-breaking. I point you to help for PTSD here. It's treatable. Prevention is, of course, far more desirable, and I hope this page will lead you to truly effective self-care.

More resources

In Chapter 13 of my book, I guide you through self-compassion and related tools in more depth. I devote Chapter 15 to tools for your own wellbeing. And if you prefer listening to reading, there's plenty in my searchable Bitesize audio collection.

If you don't have my book or Bitesize, read my page on self-compassion here, where I guide you on the why and how.

My free guided compassion meditations are here. (and I included a couple of them in my Bitesize audios. The longest one takes you step by step through self-compassion, followed by compassion for your child. One version allows you to fall asleep. There are short ones too — I used one of those for myself before meals.

There are wonderful resources from others that I list on 'Help with compassion, self-compassion and sleep'

Find out how to treat PTSD on my page: Three routes out of post-traumatic stress disorder (PTSD)

My YouTube, 'The hero's journey': to give you heart when you're feeling very low, when it feels like rock bottom

This might resonate with you: How we lose the very friends who should be supporting us (it’s not about you!)

A truly gorgeous and inspiring piece on that lighthouse metaphor: 'Stoking the fires of joy' by David Spangler

A powerful short piece from a parent: 'Taking care of my daughter by taking care of me'. The author, David Dunn, has been running a support group Men of F.E.A.S.T. for fathers within the very wonderful F.E.A.S.T. parent organisation:

Peer support groups can be a major part of how we avoid burnout. I point you to some (and warn you of possible pitfalls) here.

Nonviolent Communication (NVC) is an approach I've found really wonderful to get to appreciate human NEEDS and learn to work out my 'Yes' and my 'No'… and express it. Also to communicate with compassion and respect. More here.