Don’t beat up your child (or yourself) for failing in spite of therapy

Anyone who engages with psychotherapy is showing courage and willingness to make changes and take risks. The greater the changes, the more we’re likely to stumble and fail for a while. It takes time to use new tools. It takes time for brains to form new connections. I make a plea to all families to be patient with the process and to resist criticising and lecturing every time the person having therapy fails to apply it. ‘Stop shouting and do your bloody CBT!’ isn’t going to work.

You yourself may be trying to apply some of what you’ve read here. I would hate your spouse to try to shame you because time and again, you get triggered and do the opposite of what you’ve been hoping to achieve. I spent many months coming to grips with Compassionate Communication (or 'Nonviolent Communication') and I’m grateful my husband didn’t comment every time I fell flat on my face.

Your child may be learning techniques to manage his anger. He may have worksheets to fill in. If he fails, it’s not his failure. It might mean he needs more time, practice and support with the tools. As a parent said:

“If your kid is getting skills based therapy, reminding them ‘It sounds like you could use some skills right now’ is a great idea. Helping or coaching them through using their favorite distraction, opposites, challenging the assumption, whatever, is a good way to get out of the distress of the moment while working towards your ultimate goal of them being able to do it themselves. I must say, I think that most of our ED kids have a tough tough time getting started, but wind up being really impressive people on the other side of it all once they come through.”

Bear in mind that psychotherapy and worksheets may not be what your child needs right now. Many types of therapy are totally inappropriate while his brain is malnourished. As I explain in my book, psychotherapy is not the first line of treatment for an eating disorder in a child or adolescent. Remember also that your child's cup of empathy needs to be very full before he has access to his internal resources. Our children need to know some level of safety is assured before they will put aside their usual protective mechanisms — and that's quite sensible. If it’s hard for us adults, think what a huge ask it is from a kid with a brain that’s not only adolescent, but affected by an eating disorder.