Be a fly on the wall: coaching your child to serve their own breakfast

This post shows a practical example of getting our children with an eating disorder to let go of rigid rules and behaviours. There’s a lot of help from me on this topic in my book (Chapter 9), my Bitesize audio collection and my workshop on extinguishing fears.

I hope this page will give you ideas for how things can work out even with the kind of resistance most parents encounter. It’s not as neat as in the examples provided by researchers in the scientific literature on exposure therapy (see Chapter 9’s endnotes). There, we see people who seem well motivated to engage, to put themselves through challenging exposures and to reflect.

If you’re struggling to imagine how it is possible to take your child through a long-held fear when they won’t cooperate, here’s an opportunity to be a fly on the wall while someone else does the hard work. As always, bear in mind that we each have our own style and our situations may be quite different.

In this example, you’ll see how you can keep pushing through your child’s fear while noticing cues that things are going well.

I want to desensitise my daughter to the fear of dishing out her own portions. The process is similar to mealtime support at the refeeding stage, where the issue is fear of eating, but by now she hardly has any anorexic behaviours, we both have a lot of experience of overcoming scary things, and we have a secure, trusting relationship.

Here’s the background for this scenario. My daughter, up to this point, has relied on us to portion out her breakfast. It’s suited us to give her generous amounts so that she has enough fuel for school. Occasionally we’ve tried to get her to pour cereal into a bowl and she’s done so with much grumbling, putting small amounts in and waiting for us to ‘say when’. On the other hand she can eat freely with friends, she’s fine with sleepovers, she’s increasingly regaining independence around choice and quantities of foods. But a rigidity around breakfast remains, and that’s what I’m tackling today.

The way I understand it, she’s still bound by a rule she created a couple of years ago to feel safe: ‘I must not serve my own breakfast’. Anorexia has faded into the background but the rule is still there. Breaking it seems to be anxiety-inducing. I hope the rule will disappear once she experiences that she can safely break it.

As many other things have sorted themselves out unaided, we haven’t bothered with this issue up to now, trusting that time would do the work. But now there’s a reason to hurry things along – soon she’ll be off on a two-week school trip. It seems wise to give her more ease with serving her own breakfast.

My guiding principles are these:

• I will keep focused on the task – she will serve herself a bowl of cereal and eat it.
• I’ll break down the task in tiny steps if that proves to be necessary.
• I will give her my total, compassionate presence.
• I imagine she will need empathic support around anxiety, as well as a sense of safety, trust and dignity.
• I’ll give myself emergency self-compassion whenever I need it.

The set-up

So, it’s Saturday and my husband’s out walking the dog. He’s the one who usually deals with breakfast. (I barely manage to support a mug of tea on my chest first thing in the morning.) As my daughter heads to the sitting room, I say, ‘Sweetie, before you switch on the TV, come and help yourself to breakfast.’

She’s instantly cross. ‘You do it!’

Her aggressive refusal confirms my instinct that this is an issue I want to tackle, and I want to tackle it NOW. I like to grab opportunities when I feel ready for them. It’s my way of being brave. In hindsight, I could have considered that it’s already 9:30 a.m., that she may be hungry and that this tends to amplify her resistance. I could have left the breakfast work to another day. And I wonder if with some good communication we might have planned a progression of smaller steps together. But that’s hindsight, and we don’t have to get everything perfect.

I say, ‘No, I’d like you to do it today. I’ll help you.’ Again, in hindsight, I might have started with ‘Connect’ rather than ‘Direct’ (Chapter 13).

‘I can’t be arsed, Mum. You do it.’ She plonks herself on the sofa and switches on the TV.

I don’t argue about her language or tone of voice. She is a lovely, considerate person, and I guess that the aggression comes from fear, or, as some would say, it’s the eating-disorder voice speaking. My mission is breakfast, not manners.

‘Please switch off the TV. I’d like us to do your breakfast first.’ I sit close to her (close to the remote control too). Standing above her feels too antagonistic. I want to signal I am by her side. And I’m ready to use the remote control if she doesn’t.

‘Mum, I told you, I can’t be bothered.’ But she does switch off the TV, which I read as an excellent sign that part of her is ready to comply. It is helpful to mentally note all the things that are working, not just the difficulties.

‘Thanks, sweetie. Come into the kitchen. I’ll help you.’

‘I don’t want to do it. It’s boring.’

‘The way you’re saying it, I’m guessing you’ve got a bit of anxiety around this, right?’ This is me empathising with her feelings.

‘No, just can’t be arsed.’

‘OK. Either way I think you’ll manage to do it fine. I’d like to see you have a little practice at it because of your school trip.’ It’s the truth, and it may help motivate her. She is extremely keen on the school trip.

‘Oh, honestly!’ Grumbling, she comes into the kitchen. Another sign that she is ready to do a lot more than it would first appear. My guess is that the authentic part of her wants to succeed, but she’s fighting me to appease the last whimpers of the bullying eating-disorder voice. So I’m thinking that she needs me to keep going, to leave her no get-out clause.

In the kitchen

She grabs a box of cereal and shakes cornflakes wildly into the bowl I’ve placed in front of her. In the past she’s always gone for tiny portions. Today she fills three-quarters of the bowl and tops it with porridge oats. The dish is overflowing now, to a ridiculous degree. She glares at me. I am very aware that this is a massive challenge for her, and that she may be scared or wanting to save face. Because this is my interpretation of her behaviour, her defiant manner washes over me. I notice that I’m surprisingly not stressed, but I am vigilant to how best to steer this.

I say, ‘OK, there’s a bit too much in there, so put some of the oats back in the jar, and that will be you done.’ I am body-swerving her provocation by remaining matter-of-fact. I have never had to tell her to reduce her portions before and am quite enjoying the chance to show that I am not on a mission to get her to eat to excess.

With some degree of violence, she pours the surplus oats back in the jar and scowls at me.

I say, ‘OK, there’s a bit of a mess here, but I know this is a challenge for you, so for this time, that’s OK with me. You’ve still got a bit more than you need.’ If she’d been very upset or aggressive, I probably wouldn’t have mentioned the mess, because she might latch on to that as something else to argue about. On the other hand, my instinct at this moment is to remind her of my preference for polite behaviour.

She scoops oats out of her bowl, a little more gently this time. Again, positive feedback for me that she is actually OK, and quite capable of continuing.

Next step: the milk

I hand her the carton of milk: ‘OK, so now you need to pour milk over your cereal and also pour some milk in this glass.’ I’m giving her step-by-step instructions to make it easier for her. She is used to us portioning the milk in a small jug. The only time I ever saw her pour milk directly from the carton was when she was with friends.

She crosses her arms. ‘You do it.’

‘Sweetie,’ I say, ‘I’d like you to do it. You’ll need to do it when you’re on your school trip.’

‘They’ll serve me. I won’t need to do it myself.’ Yet she knows that breakfast on her trip will be self-service.

‘They’ll serve you lunch and dinner, but not breakfast. Go on, pour some milk onto your cereal.’ I’m trying to keep the discussion short and focus on action.

Anxiety on the rise

She blurts out, ‘I don’t even want to go on the school trip.’

A wave of sadness washes over me. Anorexia is such a killjoy. I’m grateful it’s mostly out of her life now. Her statement is so obviously driven by fear, so out of tune with her desires, that I choose to gloss over it. If I argued, she’d only argue back and get more entrenched and we’d have a pointless discussion. I trust that the instant she’s succeeded with her breakfast, she’ll be back on her phone discussing the excitement of the trip with her friends.

I say, ‘Go on, pour some milk.’

‘Nah, I can’t be bothered anyway.’

‘Sweetie, I’m guessing you’ve got some anxiety right now, hmm?’

I use the expression ‘right now’ a lot, because I want to place feelings where they belong, in the present. While we are scared, it feels like the agony will never pass, and that adds to our anxiety. Also, I usually say ‘You’ve got some anxiety’ rather than ‘You are anxious’ to move her towards being an observer of her emotions and away from being helplessly entangled with them (some call this distancing ‘defusion’). I’m keeping my manner calm and soothing. If she was in a more intense state of fear or frustration, I might mirror that with a more robust expression of empathy, to convey that I ‘get’ it.

I say, ‘I’m sorry some anxiety’s come up. I can see it’s hard for you.’

There’s a pause, and she blinks, and I take it as a cue she’s feeling a tiny bit more understood, more supported, and that this is enough for us to continue. ‘Connect before you Direct’. At present this level of feedback is all I have to work on.

‘Even with anxiety, you can pour your milk. And then let’s make sure there’s something fun for you on TV.’

This is how I see empathy working at mealtimes: acknowledge the feelings, be by your child’s side, and press for action. The feelings are unpleasant but shouldn’t render her helpless. ‘Feel the fear and do it anyway’.

She bursts into tears. ‘I have anxiety because of you!’

Her anxiety is more likely to be caused by the task than by me (the mantra is, ‘It’s not about you’) so I let the comment pass. Otherwise we’ll be discussing my failings for the next hour instead of getting on with breakfast. Responding to accusations won’t help: I need to tune into what really matters to her.I am confident that so far, everything has gone very well. Anxiety was to be expected and is a lot lighter than in the early days of refeeding. The tears, to me, are a sign that she’s let go of her belligerence and is a bit more attuned to her desires and ambivalence. Sometimes tears are part of the process, sometimes they’re not. I’m sorry for her but I’m not at all worried.

I say, ‘This will be easier next time, sweetie. Right now it’s hard, and it’s also manageable. Pour the milk, my darling. And then you can enjoy some TV. I recorded Would I Lie to You yesterday.’

I’m talking about the TV to try and get her to focus on how soon her ordeal will be over and to imagine something pleasurable. At the same time I take care that this doesn’t deflect from direct prompts to keep the momentum going.

She frowns at me. I say, in a mock serious way, ‘It’s a particularly hilarious one this week.’

I’m testing the waters, wondering whether I can help her shake off some of her anxiety with some laughter. But I’m not confident I can be genuinely funny right now or that she is ready to be amused.

Note that I am not telling her that TV is conditional on success. She knows she can watch TV either way. And in any case, there is no ‘if’, as in ‘if you manage to serve your breakfast’. We are doing very well, and so it’s ‘when’. We have done wonders with refeeding without threats or punishments, and there’s certainly no need for them today.

She gets cross: ‘I don’t care about TV!’

OK, I don’t think she’s up for lightening the mood right now. She may be hearing it as an attempt to jolly her along, a lack of empathy. Or perhaps anything I say will provoke a reaction, because she is on high alert right now. Who knows? No harm done in trying, though.

Spilling milk, then the banana challenge

She grabs the milk carton and fills her bowl to the brim, letting it spill over onto the kitchen counter. Then she pours a decent amount into her glass. I’m not worried about the spillage or the aggression. Helping herself to milk at breakfast time is an important new step and that’s what matters.

I say, ‘The amount in the glass is good. There’s too much in the bowl, so pour some out into this cup here.’

Again, she makes a mess, and I say, ‘I’m not going to ask you to clean up this time, because I know this is tricky for you. Now I’ll just wipe the edges of your bowl clean and you can go watch TV. But first, would you chop half this banana onto this plate?’

I don’t praise her for managing to put cereal and milk in the bowl, because in her case (and our children vary in this respect), even a matter-of-fact ‘well done’ can anger her in the heat of the moment.

Asking her to chop the banana is a bit risky. I’d rather end this session with the thrill of success than a feeling of failure, as success would surely help in a Pavlovian sort of way. But I tell myself that if she manages the banana, she’ll have accomplished serving herself her entire breakfast, which may be even more affirming. As I debate this internally I check my body language so she won’t guess I am hesitating. Well, I tell myself, the worst that can happen is that she’ll refuse, and then I’ll add it to tomorrow’s task.

She protests, ‘I hate banana! Why do I get banana every day, why can’t I have something else? Give me something else!’

I let this pass. I know she’s eaten hundreds of bananas without a problem. Discussing it would be a distraction. Note that she hasn’t stormed off, she hasn’t said she’s not eating anything, that she even has the knife in her hand – this is all positive feedback. (OK, having your furious teen wielding a knife isn’t that generally positive, but you know what I mean.)

‘On you go, darling. And then you’re all done.’

Tears

She bursts into tears and sobs her little heart out. I wait a little, then I murmur, ‘Can I give you a cuddle?’

She doesn’t answer, so I put my arm round her. Two years ago, there was no way I could touch her when she was upset. Even now, when she’s in this state, it’s hard to tell. She won’t actually say yes. All I can do is watch out for a small sign or touch her hand, and when she doesn’t push me off, I wrap my arm around her shoulders.

For all I know, she is feeling not only scared but stupid and desperate. She knows a banana shouldn’t be frightening. She may also be feeling guilty or ashamed of her behaviour towards me. Perhaps she is filled with hopelessness. She’s probably not heard her eating-disorder voice for a long time, and this is an unwelcome blast from the past. Maybe she wonders if she’ll ever be free.

I want her to know I’m by her side and that in no way am I blaming her for anything. I am very aware that what she’s doing is heroic. It calls for courage and mastery, and I love how she’s managing it. We applaud intrepid explorers who brave the highest peaks and the deepest oceans, but it’s nothing compared to what people do when they defy an eating disorder demand or break an OCD rule. I feel totally confident that her sobs are utterly normal in this context, and not at all a sign of danger or failure.

She cries some more, and I give her some time, hugging her. When the crying subsides, I say, ‘I’m sorry it’s hard. It’s a bugger, isn’t it?’ (my style of empathy often involves swearing). ‘It’s going to be way easier next time; you know that, don’t you? So, the banana, and then that’s you all done.’ Again, empathy, quickly followed by action.

As she starts chopping the banana, my husband comes in from walking the dog. My daughter tries to hide her tears, but I don’t want her to be ashamed of crying. I explain in a warm but matter-of-fact way that she’s busy doing her own breakfast, and we’re nearly there and she’s doing fine.

She bursts out: ‘Mum’s making me anxious. She’s rubbish!’

Time for another body swerve on my part. I say, ‘OK, you’re nearly there. Just finish chopping the banana.’

The finale

She chops and I say, ‘That’s you! Enjoy your TV!’ Again, I avoid even a simple ‘Well done!’

As she carries her bowl to the living room, she says to my husband, ‘I hate banana. Why do you give me banana every morning?’

Wisely, he doesn’t respond. She wasn’t waiting for an answer anyway; she just needed to vent. We leave her in peace for a while, as our instinct is she needs to do a bit of face-saving to recover her dignity. And it might be a little easier for her if we’re not watching. A while back we had to support and supervise her breakfast, but these days she can be relied on to eat more or less alone in front of the TV, while we busy ourselves and take the odd peak through the open door.

For a few minutes, she watches TV without touching her food and I wonder if she’s going to need my input, but then she starts eating. I join her when she’s nearly done, and we watch a bit of the show together. Everything is back to normal. She is relaxed, chatty and close to me again. The rest of the day is delightful.

Debrief

I don’t discuss the breakfast work with my daughter: my experience is that analysis leads nowhere. And I don’t need an apology from her about the mess in the kitchen. We both know that she’s not really like that.

I do discuss the events with my husband. There’s an old feeling of shame or inadequacy in me that’s just resurfaced. After all, he walked into the house on a perfectly ordinary day and was faced with an unexpected bit of drama and my daughter blurting out, ‘Mum makes me anxious.’ It turns out my husband is delighted with what’s been achieved. I’m grateful that we’re a team. (Dear reader, if things are not so smooth in your household, take heart: couples do often struggle, and the children still recover.)

Consolidation

On each of the following days, my husband or I ask her to do her own breakfast again, and she doesn’t show any resistance or anxiety. Each day she asks for less feedback, needs less guidance. On the third day she even asks on her way downstairs, ‘Shall I do my own breakfast?’

We make each day a little different, as we’re not sure what will be on offer during the school trip. One day there’s a croissant as well as cereal, another day there’s brioche, and I have plans for pancakes, waffles or eggs. I also plan to buy different-sized bowls, then forget about it because she appears free and relaxed.

Ideally, we would get her to generalise to other situations by doing this conditioning in different places, with different people present. Some sleepovers are coming up, and I may ask her friends’ parents for some feedback.

The school trip will give her the challenge of a new environment, but also the fun of being with others, which is usually helpful. Either way, her stress will be much lower as a result of desensitisation at home.

The end

The following breakfasts are a breeze. The school trip is a total success. Were breakfasts ever an issue? It’s become hard to imagine. This particular chapter seems well and truly finished. Years later, all my daughter recalls about this episode is that I was making a fuss over nothing.

I hope this scenario gives you a vision of how exposure can work, even though your situation may be different in many ways.

To recap, the skills involve remaining focused on the task, moving forward in spite of fear, tracking and judging how fast to go at any moment, and maintaining a compassionate presence.

For more on this topic

• Chapter 9 of my book: Free you son or daughter of fears and rules with exposure
• Many Bitesize audios
• My workshop for parents