When Encouragement Sounds Like Criticism

I encourage parents to step up early and with urgency when a child has an eating disorder. Sometimes, for various reasons, this encouragement gets me into trouble.

How Can Positive Messages Sound Like Accusations?

The double-edged sword of encouragement is that those who didn't get that message early feel blamed for not taking action. I've heard from many parents that my encouragement sounded like criticism for their past actions. I've heard anger that I was underestimating how hard it is, how circumstances prevented them from action. More than once, I've heard that my message made a parent feel I was being condescending or uncaring.

This is not my intention. I'm trying to reach parents early in the process and influence policy-makers and clinicians who encounter and support these families. I want parents to recognize that if they are not getting this message, they should seek second opinions. This is not to criticize those who didn't, couldn't, and can't.

Eating Disorder Patients Feel Angry

I was recently dressed down by more than one presently suffering eating disorder patient who felt despair and personal affront that someone would point to a "grim" prognosis for patients whose families are unwilling or unable to be involved in eating disorder treatment. These patients believe their families are not only not helpful, they are actively toxic and their involvement could only worsen their recovery process. My message - and that of others - that parents need to step up sounded to these patients like a "death sentence" and a complete lack of confidence in their ability or chance of recovery from the eating disorder.

I don't mean to discourage anyone. In fact, I am filled with admiration and support for those who are getting treatment without the support of loving family. Your work to be well deserves more credit and more layers of assistance and support - not less. I do know people who have fully recovered after years of illness without help from their families. We need to honor that, but surely we don't want to let that happen if at all avoidable.

I'm Deeply Sorry

I deeply regret causing pain to any eating disorder sufferer or any parent. My goal is to help, not harm.

I stand by my call for parents to step up as urgently and as lovingly as possible. I do so knowing that in some circumstances it is going to fly in the face of clinical support, cause conflict within the family, expose weaknesses and faults in family members, be legally difficult, be impractical, be impossible, or be too late. I still need to get that message out there.

It is necessary to reach as many families as possible, as early as possible, with a message of urgency and engagement to save the many lives and families who CAN be saved or improved. We can not hide from the fact that every day there are young people about to be diagnosed with an eating disorder whose families need this information. These young people's parents need to know that failure to act now and act assertively decreases the chance of recovery and increases the misery of their child.

This is not to diminish the anguish and loss that currently exists. This is not to dishonor those who have been lost or their families, nor those currently fighting alone. All patients deserve all the support they can get from their families and if not relatives, then friends, neighbors, the community. Clinicians can't fight this alone with the patients: they also need society to support these patients in their homes and at every level.

All Eating Disorder Patients Need And Deserve Support

When I say that family is important, I'm not saying they are the only option or that family has to be narrowly defined as parents or blood relations. If there are no supportive family members, patients need others to step up. We all need to step up. No one should have to suffer this illness or have to pursue recovery in isolation.