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What to do when your child relapses (again) during eating disorder recovery

A lot of parents understandably want their child to recover as quickly as possible from their eating disorder. Full recovery suggests to us that we have done our jobs as parents “correctly” and can now relax with a healthy child.

Unfortunately, many parents find themselves frustrated because their child’s eating disorder keeps coming back. Just as you’re celebrating a few months of abstinence, you see signs of the eating disorder behaviors again.

This can feel like a failure or at least a devastating event. But it’s important to know that relapse does not signal failure – just more work. This may feel overwhelming after all the work you have already put into your child’s recovery, but take away the confounding nature of an eating disorder and compare this to any other challenge your child has.

Learning new skills

If your child struggles with math, you may recognize the need for tutoring and special help. Each time a new module begins, your child needs more tutoring. Once the skills are mastered, you can scale back. This likely continues in a cycle throughout your child’s education. You don’t take this personally, but instead just keep a list of excellent tutors and learn to recognize the signals that your child needs help.

Without the strangeness of the eating disorder diagnosis, you can see that helping your child learn new skills and overcome challenges is just a part of parenting. It’s not a reflection of any failure on your part – or your child’s part. It’s not your child’s attempt to “get attention” or maintain a “status” as someone with an eating disorder. You would never think that if your child were struggling with math. So don’t think it when they struggle with an eating disorder.

The skills we gain during eating disorder recovery are easy to learn on an intellectual level, but they are challenging to implement in our lives. It is well known that our eating disorders are exquisitely responsive to stressors, and thus, with every new stressor we encounter, we must test our new skills. It can be exhausting to work on these new skills, and sometimes we slip back into our eating disorder behaviors, which are largely unconscious and serve the purpose of taking our stress underground where we don’t have to deal with it.

Time to integrate

It takes time for us to gain the confidence and subconscious memory to handle stress without our eating disorders. A relapse is not a failure, it is just a sign that we need to reinforce alternate behaviors and thinking patterns to handle the stressors in our lives.

Back to the math analogy, when your child is struggling to learn a new concept, you will ramp up the help available. You may help organize study time, schedule additional meetings with tutors, and help brainstorm ways to master the concepts.

When your child has an eating disorder relapse, you just need to ramp up the help available. You may need to help organize meals, schedule additional meetings with therapists, and help brainstorm ways to master the concepts.

That’s all. It doesn’t need to be a huge crisis, and you will be more helpful if you think about ramping up her support and not ramping up your stress level.

Be concerned, not stressed

Most people who have eating disorders are finely attuned to the stress levels at home and in the world. If our parents are stressed, especially if they are stressed about us, we are stressed. And stress directly leads to relapse.

Of course you are concerned. But concern is different from stress, which is a chemical response in our bodies that makes us feel powerless and renders us unable to make the thoughtful changes necessary to support a child who has an eating disorder. Concern allows us to think strategically about the problem and mobilize plans that will help (not hurt) forward progress.

Find the resources you need to be concerned, but not stressed.

What to do when your child has a relapse

When your child has an eating disorder relapse, consider these steps to handle it:

1. Center yourself. Think of the math analogy. What would you do if this were any other type of challenge in your child’s life? Take away the stigma and automatic thoughts you have about your child’s future mental health, and center yourself on the knowledge that you do not have power over the eating disorder, but you do have the power to make some environmental changes that can be very helpful to your child’s recovery.

2. Scan the environment. Eating disorders are very sensitive to stress. Scan your child’s environment and calmly assess the stressors, new, old, and upcoming, that exist. Stressors are not always bad – sometimes they are positive and exciting. Starting a new job, making new friends, and going on a long-anticipated vacation can all be stressors. Even though they are positive in nature, they are still stressful. Help your child identify the stressors that may have contributed to relapse. None of us can live without stress, but during recovery we need to learn to anticipate, manage and process stress in healthy ways.

3. Gather the troops. People who have eating disorders tend to underestimate the serious nature of their disorders, which can lead us to deny help when offered. Parents can be incredibly helpful by finding ways to gather supportive resources even when  children say they are fine. If your child lives at home, then ramp up therapy and find time in your schedule to provide extra support and resources to your child. If your child lives independently, then encourage them to schedule appointments and get help.

4. Reduce stressors. Consider what you can do to take stressors off your child’s plate. Family events, social events, and vacations may need to be put on hold if your child is in an eating disorder relapse. If your sister is coming to stay for a week, and your child is in a relapse, you may need to change the plans. This doesn’t feel fair, but it may be necessary for your child’s recovery. It’s not that you need to stop life from happening, but when there are optional events on the calendar, you should consider your child’s health first and foremost. Think about how it would be if your child had cancer and was undergoing radiation treatment. You would change plans in that situation, right? In many cases, we need to think of invisible illnesses like eating disorders in terms of diseases like cancer in order to give them the appropriate level of seriousness.

5. Take care of your needs. It may sound as if you are supposed to drop everything in exchange for your child’s needs, but actually, it’s more important than ever that you find ways to take care of your needs. If your child is in an eating disorder relapse, you may need to schedule some therapy for yourself. You may need time alone, walking, reading, or meditating. You may need to get away with your best friend or spouse – for lunch, dinner, or even a weekend away. Your own self-care is just as important as the care you give your child because we can’t pour from an empty cup, and we can’t help our child if we are emotionally depleted.

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