As she watches Fiona slip back into the eating disorder symptoms they fought so hard against, Melissa feels hopeless. “This is the second time Fiona has gotten into recovery only to slip back into her eating disorder,” she says. “I’m tired. We’re all so tired of battling this eating disorder, and I just want recovery to stick.”
Melissa’s frustration makes sense. An eating disorder affects everyone in the family, and the primary caregiver in particular often gets burned out while facing such a difficult disorder.
When a child relapses during eating disorder recovery it can feel like a failure. Everyone worked so hard to get into recovery, and it’s hard to see it just slip away. But it may help to remember that you are not going back to where you started. You have months of experience that you didn’t have when the eating disorder first started.
When your child relapses, it’s not the same as the first time you saw the eating disorder. You are more educated and more able to respond this time around. But of course it’s hard. I know you have put so much work into your child’s recovery, and it would be so nice to feel the success of watching them walk away from the eating disorder for good.
Use these scripts:
- At the dinner table when behavior is getting out of control
- When you need to set boundaries – fast!
- After something happened so you can calmly review the triggers and events
Eating disorder recovery and relapse
I know that a relapse can feel like a failure, but let’s try thinking of it as a process rather than an event. Think of math. Throughout their school career, your child will constantly face new, more challenging math problems.
Some kids need tutoring or special help to adapt to each new module. As they become more confident with the concepts, they need less help. But then, like clockwork, they face something new and need more help again. 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.
An eating disorder diagnosis feels really different than learning algebra. But recovery also requires learning new skills. And since our kids are constantly growing and facing new situations, these skills need to flex and expand over time. They are regularly going to deal with new “modules” of recovery. And sometimes we may need to ramp up the support to learn and adapt to the new conditions.
This perspective may help you realize that what we call “relapse” is really just part of growth. It’s a sign that your child needs to flex and learn new skills. Just like you would call in a math tutor if you saw them struggling with a new math module, you may need to call in a recovery team to help them navigate a new life module.
Building and adapting skills
Unlike math (for most of us), the skills learned during eating disorder recovery are easy to get on an intellectual level. But they are challenging to implement in life. Eating disorders are exquisitely responsive to stressors, and thus, with every new stressor encountered, skills are tested.
It can be hard to incorporate recovery skills into everyday life. But relapse is not a failure – it’s a signal that help is needed to get to the next stage of recovery.
Back to the math analogy, when your child is struggling to learn a new concept, you ramp up the help available. You may help organize study time, schedule additional meetings with tutors, and brainstorm ways to master the concepts.
When your child relapses into their eating disorder, you will also need to ramp up the help available. You may need to help organize meals, schedule additional meetings with therapists, and brainstorm ways to master the concepts.
It’s not always a huge crisis, and you will be more helpful if you think about ramping up support without ramping up your stress level.
Manage stress levels
I’m not being flippant here. I recognize that it’s entirely different when your child has an eating disorder than when they’re struggling with math. But it’s important for you to adjust your mindset so that you don’t get bogged down by the stress.
Because your ability to manage relapses will make a difference. Likening relapse to learning new math concepts doesn’t mean I don’t understand how serious this is. I’m framing the problem in a way that empowers you.
This is important because people who have eating disorders are finely attuned to other people’s stress levels. If parents are stressed, kids are stressed. And stress makes getting back into recovery harder.
I’m asking you to change your mindset so that you can be concerned and active, but not stressed and overwhelmed. Stress shuts us down. Concern allows us to think strategically about a problem and mobilize plans that will help (not hurt) forward progress.
What to do when your child relapses during eating disorder recovery
1. Take care of your needs
It may seem 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 relapses back to their eating disorder, you may need to schedule some therapy or coaching 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.
2. 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 take action and ramp up support.
3. Scan the environment
Eating disorders are very sensitive to stress. Scan your child’s environment and calmly assess the stressors, new, old, and upcoming. 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.
4. Gather the troops
People who have eating disorders tend to underestimate the serious nature of their disorders, which can lead them 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 provide extra support and resources for your child. If your child lives independently, then encourage them to schedule appointments and get help.
5. 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 relapses into their eating disorder. If your sister is coming to stay for a week, 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.
When your child relapses into their eating disorder it is terrifying and overwhelming. The last thing I want you to do is feel ashamed for how hard this is. This is hard.
Melissa relaxed when she heard the math analogy. “I recognize that I’m so tightly wound up about this and that’s not helping,” she says. “Of course I get to be upset, but it’s not helping me move forward and feel better. So I’m going to work on my mindset.”
I hope Melissa will also attend to the first step, which is to take very good care of herself. Eating disorder treatment is a marathon, not a sprint. So pacing herself is going to help a lot.
Ginny Jones is on a mission to change the conversation about eating disorders and empower people to recover. She’s the founder of More-Love.org, an online resource supporting parents who have kids with eating disorders, and a Parent Coach who helps parents supercharge their kid’s eating disorder recovery.
Ginny has been researching and writing about eating disorders since 2016. She incorporates the principles of neurobiology and attachment parenting with a non-diet, Health At Every Size® approach to health and recovery.
Ginny’s most recent project is Recovery, a newsletter for deeply feeling people in recovery from diet culture, negative body image, and eating disorders.