Bitesize: list of contents

Introduction to Bitesize

Our story, my experience

Which eating disorders will Bitesize help with?

How about orthorexia or muscle-building compulsion?

Please only share Bitesize with family

Don't believe everything I say

Welcome: what you’ll find in Bitesize

Find your way around Bitesize

Take charge: the start

My child is too independent / too old to take our help

Should I tell my child I'm taking the lead?

Principles for a “We’re taking the lead” conversation

“We’re taking the lead”: set a time to talk

“Back off! My labs are normal!"

"I'll accept treatment if I don't have to gain weight"

Our child will not accept our help

How to be in your power right from the start

My child is 18+ and the therapist wants to promote autonomy

A full recovery: why awful statistics are out of date

On the same page: consistency between parents

“I’m eating alone – I'm eating with friends”

Who to tell?

What's the journey ahead?

Your checklist to get ready for treatment

First conversation when you suspect an eating disorder

Collaborate or take charge?

Hold up that candle of hope: your child’s full and wonderful life ahead

Alternative treatments where parents aren’t so involved

Words to tell your child you’re taking the lead

Take charge: your child's experience

Why your child will manage to eat

The hijacker holding a gun to your child’s head

Walking through hell with your child

Is your child actually hungry?

Your motto: compassionate persistence

I was desperate for my parents to feed me

Meal coaching

The fight-flight-freeze effect of malnourishment

Things we say which don’t work so well

Use direct prompts

How distraction is your friend during a meal

How to be silent at the right moment

What can I say during a meal? Demo of main tools

Direct prompts, silence, response to sarcasm: meal coaching demo

Touch, hug, spoon-feeding

Empathy, bringing out what’s on their mind

Joys to look forward to, responding to hopelessness 

"I want you to eat it" versus "You need to eat it"

 Set a time-limit for the meal?

Ask yourself, "Can I win one more bite?"

The art of ending a meal without blame

Is ‘Life Stops Until You Eat’ for you?

Lunchtime is lunchtime: even when your child is upset

My child won’t even come to the table

My child runs away from the table, into their room

“I’ll eat alone! Back off!”

Meals are not working at home – what's next?

Does your child always leave a few crumbs?

"Listen to me, not to your head"

Praise, cheerleading and giving hope

“Eat, or else”: threats, punishments, consequences, bribes and rewards

Countdown to the next mouthful

The elephant in the room: name the unsaid

Have a break or change the scene

Plan distractions for before and after the meal

Talk to the nervous system: “Trust me, I’m on your side, you’re safe”

“What can I say when my child says…?” Some mealtime scripts

Movement, stretching, breathing: to change the mood and reduce tension

Why might there be stomach and bowel pain during refeeding

What to do about stomach and bowel pain during refeeding

“I’m feeling fine and doing fine, so obviously I’m eating enough”

"You deserve this"

Should you end a meal that’s not working?

Your options after a failed meal 

If you haven’t seen the food being eaten, assume it hasn’t

The food

How many meals, how often?

How much to feed

Refeeding syndrome

What foods should I serve?

Can my child stay vegetarian/vegan?

Fear foods during refeeding

Comparing: "It’s not fair, I have to eat more than others!" Tips for responding 

My child is not gaining weight

Give me a meal plan

My child insists I eat the same amount

Why and how to take charge of exercise at the start

How to talk about limits on exercise

What kind of exercise may your child return to later?

What drives your child’s attitude to exercise?

How to coach your child towards a positive attitude to exercise

Exercise

What if my over-exercising child wants to stop but can’t?  

Why schedule rest or recovery days as you reintroduce exercise

Cautious steps as you allow more exercise 

Psychology and the Mind

Why is my child so withdrawn?

Socially isolated: what to say

Withdrawn in their room: allow or intervene?

Could your child be autistic? Autism resources help us all

What is the externalizing model? Meet the eating disorder demon

Why your child might feel misunderstood by the externalizing model

What if your child both loves and hates the eating disorder?

If you ‘hate ED’, does your child feel your love?

Should you 'attack' the eating disorder on all fronts? 

What helps you do a good job: 'Slaying the beast' or 'Walking alongside your child'?

Why isn’t my child getting psychotherapy right away?

Should my child have individual psychotherapy after weight recovery?

How to choose a psychotherapist for your child’s individual sessions

Should my child like their therapist?

If your child is self-harming

If your child is suicidal

The differences between self-harm and suicidality

Self-harm: “I’m fighting my internal bully, not myself”

A safety plan, if your child is suicidal

What if your child has ADHD? 

Is anorexia a need for control?

A healthy weight

Regular periods: a poor criterion for weight recovery

Overview: how full weight recovery is essential

Weight is more like shoe size than hair style

Start on weight gain NOW. Worry about targets later.

Previously ‘overweight’? Weight gain is still the early priority

The need for body fat, not just muscle

How announcing a weight goal might be positive

Poor mental state: need more weight or more time?

Overshoot: extra weight might be essential for healing

'My kid is/was overweight: is the target to regain it all?'

How to use a growth chart as part of predicting recovery weight

Is that weight target a gift to the eating disorder?

What does BMI or 100% weight-for-height mean?

How announcing a weight goal might create problems

Should your child be weighed during the refeeding phase?

Open or blind weighing?

How to weigh blind, and what to say

The work after weight-restoration

Why we need to expose our children to their fears 

How to talk with your child about exposure work

Exposure to fears: small, gradual steps or dive in?

Small steps make challenges manageable and safe

Techniques for fear foods in small steps

Eating out: an example of exposure work

Is a particular fear food just too hard?

Should I compensate for a fear food that failed?

Make a list of everything that is not yet normal 

Exposure work to bring back normal foods and behaviours

When to do exposure and desensitisation work?

Exposure: freedom from fear of the fear

Exposure: don’t allow compensations 

Will things not get better naturally, without exposure work? 

Exposure: Repeat soon, with variations  

Is your child motivated to expand their range? 

Exposure: forewarn or surprise?

Soothing your child while exposing to a fear

Independence (Phase 2 tasks)

Don’t rush or skip Phase 2

When does Phase 2 start?

When does Phase 2 end and Phase 3 begin? 

How will your child become independent and not slip back?  

Coach your child to serve themselves 

Intuitive eating versus rule-based eating

Is your child ready for intuitive eating?

Welcome hiccups as an opportunity to practice 

The extra care needed when weight-restored

Parents deal with uncertainty: 'I hate phase 2' 

My child got worse with more autonomy, and we can’t go back

Do you disagree with the clinician how fast to go with Phase 2?

Is it OK to keep my child in Phase 1 a lot longer?

Should my child still get weighed during Phase 2?

Should we continue weighing after complete recovery?

Handing back independence: what is Phase 2?

List the competencies required for independence

Compassionate Communication

Why kindness works better than explanations

“I’m sorry, and I love you”: the simplest formula to connect and soothe

Silent empathy: a surprisingly powerful tool

Offer hugs and touch

A recipe for compassionate communication

Words to express kindness and non-judgement

'Yes' words to show you are listening

Words to guess deeper about feelings and needs

Use question marks to avoid “You have no idea how I feel"

Signs of a shift to a more relaxed state

Give your kindness and reassurance

Logic, education and explanations

Action: making suggestions and requests, problem-solving

Continuum of requests: from Choice to No Choice

Ask for what you want: a recipe for framing a request

Getting past a ‘No’

Words to validate feelings and needs

'Connect before you Direct' (part 1) Why and how?

'Connect before you Direct' (part 2) Examples

'Connect before you Direct' (part 3) Special situations

Compassionate Communication – More help

Get your ‘But’ out of the way!

Your child's 'Why' question is rarely a question

What deep needs does your child want you to really hear?

Open questions that bring up deeper needs

Keep tracking and validating what matters to your child

Difficult conversation: meet obstacles with empathy

"We’ll try it and then review"

Can you share your feelings with your child?

What to tell your child when they see you crying?

Had a fallout? Become skilled at repairing the relationship

How to repair the relationship after you messed up – the main steps

After you screwed up: words of connection

How to repair the relationship: problem-solving

A repairing conversation when your child behaved poorly

Compassionate Communication – Troubleshooting

How to respond to “You’re so patronizing!”

Can I motivate my child by telling them how ill they are?

Why does my child reject my empathy? The invulnerable fortress

Why does my child reject my empathy? Unworthy of love

‘You’re disrespecting me!’ Help your child let you in

How to de-escalate a meltdown

Empathy after your child's meltdown

"Get out of my room!"

You don’t understand how hard it is

Hostility from your child? Empathy for YOU 

Hostility and aggression: set your limits 

Aggression: what you can do when a behaviour exceeds your limit 

Receiving unacceptable behaviour: how to not be a doormat 

How the nervous system drives a state of fear, or a state of safety

Why you should become expert at calming

How to tell when your child is in fight, flight or freeze

What makes the nervous system class something as a threat?

Calming skills: avoid reasoning

Calming skills: watch your body language

Prepare and coach calming tools assertively

Calming skills: rate the distress level on a scale of 0 to 10

De-escalating violence, punching cushions and other stressbusters

Breathing techniques for calming and times of panic

Movement that helps bring calm

Calming skills: hugs and touch

Be present for your anxious or 'clingy' child

Calming skills: engage the physical senses

Calming skills: cold water, ice cubes and elastic bands

Use music to shift your child’s anxious state

Connect with empathy to bring calm

Apps, audiobooks and meditation types to help with calm and sleep

Medication to reduce anxiety

Tapping (EFT) or EMDR self-help to bring calm

A quiet corner for your child to find calm

Calming skills

"You're not fat" doesn't reassure

Why "You're not fat" is only a temporary band-aid

I'm so fat!

"I'm fat": Refuse to engage

Attitude to body shape: what you are aiming at

How to talk about wellbeing instead of engaging in fat talk

“I’m fat!” How empathy can get your child unstuck

"I'm fat": examples of open questions for empathy

"I'm fat": how to talk about needs to fit in and be safe from fat-bullying

“I’m fat”: conflicting internal and external messages

Responding to “I’m fat” distress as they gain weight

“I was happy when I was thin – I wasted all that effort!”

Conversations for a better attitude to body shape

"I'm fat!" Opportunity for education on body acceptance

“I’m getting fat so fast! It will never stop!”

Gentler words to talk about weight gain

Weight gain will reduce the fear of fat

Your child’s fear of fat as a phobia

"The weight that you never should have lost"

School

Perfectionism and academic ambitions: how to steer your child

What to do about school and exam stress?

Meals in school: what level of support to set up?

Supervising school meals: how to talk with your child

My child wants to study the hardest topic in university

Your wellbeing and inner strength

You are normal

What to do with unhelpful thoughts – the Chatterbox

Why does your child reject you and hate you?

Coping with your child’s rejection

The best psychological tools for these extraordinary times

Self-care to avoid burnout and model wellbeing

Hold off from problem-solving while you’re upset

Your body needs care too

Is this thought true? Is it useful?

Chatterbox thoughts as signposts to compassion

How to do self-compassion (Part 1): Generate kindness through your body

How to do self-compassion (Part 2): how to deal with thoughts

How to do self-compassion (Part 3): Wishes for yourself and for the wider world

Should you meditate?

Notice you’re OK in this present instant 

Emotions pass like a wave

Can you manage one more minute?

Accept reality

Accept the things you cannot change and change the things you can

"Accept and let go": let go of what?

Trust and go with the flow?

Imagery to sustain you and expand your perspective

Every hero gets a helper. Who is yours?

How much should you tell your friends and family?

How to do emergency self-compassion

You’re good enough

Feeling 5 percent better

Give yourself permission to escape

Notice and soak in the small joys

Women, you’re probably in perimenopause or menopause

Family teamwork

When parents disagree with each other

How to get my partner to do more

What's going on for the siblings?

How much can a distressed parent share with the siblings? 

Hospital

Why will they eat in hospital and not at home?

Will my child be fed by tube in hospital?

Tasks at home after weight-restoration in hospital

Is inpatient treatment a terrible thing?

What kind of inpatient or hospital care is there?

Is your child distressed or distant while inpatient?

Why your child might  be scared of coming home from hospital

My child plans to lose the weight gained in hospital, on their return home

How to make the transition from home to hospital work

Home from hospital? Who’s making the decisions?

Make sure the hospital involves you

Before early discharge: a progress-continuation plan 

 Expect wobbles and lapses, prevent relapse

Relapse prevention plan: lifestyle habits to remain in green zone

Relapse prevention plan: orange and red higher risk zones

Is my child ready to leave home (for college, university)?

How can I prepare my child to leave home?

Guardrails and college contracts when your child leaves home

How can I talk about relapse prevention and safety plans for leaving home? 

Prepare your child to be cool with money

Prepare your child for loving relationships, intimacy and sex 

Will I forever have to be vigilant about relapse?

Is my child inevitably going to relapse?

Full recovery and relapse prevention

Empathy for you if you’re facing relapse

My child might be relapsing: Wait? Discuss?

It’s a relapse – what should I do??

8-minute guided compassion meditation

27-minute guided compassion meditation – sleep version

Guided meditations