By Dana Magee, RD
For those suffering from an eating disorder remember:
“You alone can do it, but you can’t do it alone.”
What is meal support?
Meal support is not taking on the role of the food police, or the enforcer. It is the modeling of healthy food behaviors, being there with your loved one, the calmness and compassion at meal times that has the true value. See below for some amazing tips from the New Maudsley Approach: Skills-based Learning for Caring for a Loved One with an Eating Disorder book. If someone in your life is affected by an eating disorder (ED) I highly recommend reading this book. It is an invaluable resource!
Loved ones: Remember this is not easy.
Have compassion for yourself, learn, ask for help, forgive yourself if you wish you reacted differently. To illustrate the roles family members may take I will use the model from the Skills-based Learning for Caring for a Loved One with an Eating Disorder animal analogies. As stated in the book it is natural, typical and instinctive to a concerned and frightened family member or friend to take on one of the following roles:
|You see your loved one struggling, it hurts your heart to see them in pain and you try to protect them from that pain and keep them safe as if you have them in your pouch.
The challenge with protecting your loved one from any stress or discomfort is that they do not learn to do this for themselves. It traps them in the infant role, and can exhaust you in the caregiver role.
|You see your loved one in pain and you are present there with them. Their eating disorder is their life preserver and you are helping them to understand they can swim on their own, when they are ready.
The benefit is that you are there to gently nudge in the direction of recovery, lead the way and model healthy behaviors, swim alongside with encouragement and even swim behind them when they taking strides in recovery.
|In response to the family members pain you want to FIX it as soon as possible. Likened to charging at the ED with logic.
The challenge is that ED’s do not make logical sense. This is exhausting and met with the defense of the eating disorder to preserve itself and actually strengthens ED.
How can I be a dolphin for my loved one?
CALM, COMMUNICATION, COMPASSION, COOPERATION, CONSISTENCY, COACHING
Points to Remember:
- Understand that the ED is serving some benefit to your loved one. The ED will use secrecy, manipulation, and decite to keep in power. This is not your loved one, but a result of the illness. Prepare that you may be met with defenses when the ED is threatened. The ED provides something of use to your loved one that might be intertwined with their sense of well being, power, control, uniqueness or comfort..
- Eating disorders come in all shapes and sizes.
- Do not participate in discussions of food, calories, body shape or weight in regards to your loved one, yourself, those you know, or even strangers and celebrities. Instead comment on their confidence, their smile, their happiness, their hard work etc.
- Remember that eating disorders are not just about the food-the food is linked with identity, emotions, beliefs and/or values attached. When you see your loved one struggling with an ED behavior try not to get soley focused on the food, instead ask how they are feeling and how you can help support them.
Only your loved one can decide when to change.
- Family members and friends may have trouble tolerating the distress in their loved one and can “bury their head in the sand” like an ostrich when faced witnessing difficult behaviors or having hard conversations. This can inadvertently invalidate their loved ones emotional pain and discount their thoughts and feelings.
- One of the personality traits common to those suffering with an ED is to be over- analytical. They can easily get consumed by the details, rather than being able to see the big picture. Their ability to focus on one thing without distraction makes them inflexible and rigid. By adding flexibility to other areas of their life it will in turn help them make progress on flexibility with food.
- Remember it is not a simple switch. There are many steps on the road to doing something different.
- Care for yourself. Feed yourself regularly, take breaks, plan to have other family members support at different meals to prevent burning out. This will also model self care for your loved one and allow them time on their own to build confidence.
Guidelines at meals:
- Eating with a family member, they also have a balanced plate with normalized portions, and can model pacing. Meals typically last about 30 minutes.
- Sitting at the table.
- Eating on a schedule (allowing for some flexibility).
- No discussion of food at the table.
- Gentle prompting, “I notice you are struggling, I am here with you.”
- Meal time distractions.
- Expect as the goal that your loved one complete at least 75% of their meal.
- Remember you cannot force your loved one to eat. You cannot bully or bargain with them to eat. You will get sucked in a trap by the ED. What you can do sit there with them, distract them, sit with them if feeling overly full or uncomfortable after the meal.
- Do not lock up foods- this sends the message to the eating disorder that these foods are unsafe and gives them more power. We want to help your family member feel safe around these foods.
After the meal:
- It may be helpful to your loved one to distract them after the meal. Often the ED is on full blast with blame, guilt and shame stirring and it may help to get their mind off of it.
- If you have any concerns about the meal ask your loved one about it after the meal away from the table. In a quiet place without distractions ask questions, calmly express your concerns and talk about what you observed
- If the discussion gets heated try to stay calm. Remember there two parts in front of you, your loved one and the eating disorder. If you get frustrated at the process take a break; it is the ED that you are fighting with, not your loved one.
- Think about yourself like a fly on the wall here suggestion of how to guide the conversation with decreased room for battle with the ED from the Maudsley Skill Based Learning book:
- “I am concerned about…”
- “I see you think…”
- “Please can you talk to me about…
- “I think you feel…”
- “I have noticed that…”
- Confirm you understand what they are expressing, “Sounds like this might be the way you see things…? Have I got that right?”
Do not get stuck in reassurance traps.
- People with ED have high anxiety and look to loved ones for reassurance. Unfortunately this will only provide temporary relief and anxiety will soon return. The reassurance will inhibit your loved one from learning that they can master fear and doubt on their own. You can remind your loved one that you are ther for them and that this will pass and not last forever.
Take a break; here are some ways to healthfully end a discussion from the Mausdley method Skill Based Learning book:
- “I don’t think this is a good time to discuss the matter. Let’s talk about it later when we are both calm.”
- “We have both said what we think, now i am going to…”
- “My emotions are too intense to think clearly at the moment. Let’s come back to it later.”
Guidelines for Communication
- One person speaks at a time
- Don’t try to offer a simple solution
- Don’t try to bargain with logic or use threats
- Do not lecture, allow your loved one to do the talking
- Keep calm, compassionate, respectful
- Focus on the positive
Supporting loved ones is key to recovery. I am more than happy to answer any questions you may have about how to be offer support. Please feel free to email me at email@example.com or use the resources on our website empoweredeating.com