Category: Emotional Regulation Eating Disorders

Jamie feels helpless and frustrated. Her son Michael has an eating disorder and severe anxiety, and the combination is making life very hard for them. “I just want to be able to do things that other families do without thinking about it,” she says. “Like go to a restaurant or the movies without all the drama of the anxiety.”

I get it. Anxiety is stressful for everyone, and many parents feel helpless when anxiety shows up and takes over. This article will help you cope with anxiety when it shows up alongside an eating disorder.

Anxiety is a major underlying and co-occuring factor with eating disorders. And anxiety is on the rise for our tweens and teens. A study by the American College Health Association found a significant increase. Up to 62% of undergraduates reported anxiety in 2016, up from 50% in 2011. A more recent study conducted by the Health Resources and Services Administration (HRSA) found that between 2016 and 2020, the number of children ages 3-17 years diagnosed with anxiety grew by 29%.

Anxiety impacts almost every aspect of life. But anxiety is also a very treatable disorder. Things can get better! You can help by teaching your child to cope with anxiety when they have an eating disorder.

Coping tools for kids who have anxiety and an eating disorder

Anxiety disorders are hard to cope with, especially if they occur in conjunction with an eating disorder. Therapy for anxiety typically includes Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT). These treatments are designed to teach kids coping mechanisms and new thought patterns to get through anxiety.

If your child has an eating disorder, they should be receiving therapy to help them manage their anxiety. But some tools can help with short-term coping. While these tools don’t replace therapy, they can be very helpful for parents trying to cope with the stress of everyday living with anxiety and an eating disorder.

The tyranny of surprise

One of the hard things about having anxiety is that it can feel so surprising. Few people think of themselves or their kids as fragile. So we walk around expecting things to be fine. But then anxiety shows up apparently out of nowhere and surprises us. But the thing about anxiety is that it shows up reliably, usually every day. And often there are common threads before the anxiety shows up. We shouldn’t be surprised, and yet most of us are.

One idea is to start expecting anxiety to show up. This reduces the stress and anxiety about having anxiety. 

Parents can say things like “oh, here’s anxiety, I expected it, welcome anxiety!” Doing this takes some of the power away from anxiety. And it helps your child feel less vulnerable to its impact. When parents normalize and accept anxiety, it often feels less intense for everyone. 

That’s why I love using anxiety props and tools. They’re a great way to show that not only do you expect anxiety to show up, but you are also prepared for it and have your response ready to go. 

Build an anxiety toolkit 

I think it’s helpful to have some props or tools to cope with anxiety because it gives a visual and action-oriented response that shows you are not surprised or upset when anxiety appears. You can have one or two of these items available or even develop an “Emergency Anxiety Kit” with a few different options when you’re on the go. 

Talking with our kids about anxiety and discussing soothing tools that may help is important. Not every child responds similarly, so I have provided several options and ideas. Generally, we’re looking for tools that engage the senses. This helps ground the anxiety by responding neutrally when it shows up and stimulating the body’s five senses. 

Help your child find the tool or tools that help them get grounded during an anxiety episode. Here are some ideas:

1. Counting beads (touch)

Counting is very effective in soothing the mind during an anxiety episode. Many people who struggle with anxiety learn to look around and start counting items to help their brains regroup. This is a form of mindfulness. A good place to begin is with counting beads. You can get small beaded bracelets, (also called a prayer bracelet), which they can use to count silently.

The combination of touching the beads and counting can be very soothing. Your child may prefer one type of bead over another. Thus, it can help to test a few out if possible. The best part about beads is that they can be kept on the wrist or in a pocket. And it helps that they can be touched or counted without anyone knowing. 

2. Stress slime (touch)

Touching something during an anxiety episode can be very therapeutic, since anxiety often becomes trapped energy in our bodies. Slime can be a great way to provide our kids with a tactical outlet for their anxious energy. You can buy slime online. There are many types, including slime with styrofoam beads and other items that add to the tactile pleasure that slime provides.

You can also make slime using one of the hundreds of online recipes. Experiment with your child to develop different slimes. You can keep them in sealed containers or zip-top baggies so that they are always available for your child to use. 

3. Something soft (touch)

Sometimes there is nothing better than the feeling of something soft and furry when we’re stressed. This is the appeal of stuffed animals, which your child may keep in their room and stroke during stressful periods. Of course, a pet works well with that, too! Fur keychains are a popular trend right now that can be used as soothing tools without detection.

A very simple pocket-sized option to deliver softness is to go to the fabric store with your child and touch the fur and fleece fabrics. Select a few that feel best to your child, and purchase a quarter yard of each. Cut the fabric into pocket-sized squares or rectangles, and replace as often as necessary. Some children will find it soothing just to touch the fur with their fingers. Others may find it helpful to rub it on their arms or faces for soothing relief from stress.

4. Photos (sight)

When anxious, it’s easy to lose touch with our sense of place in the world. Even if plenty of people love us, anxiety can make us forget that momentarily. Kids may become flooded with fear that they will never belong and are all alone in the world. This is why photos can be grounding.

If your child has a smartphone, you can add some photos designed to remind them of the people and animals they love. Or you can print out photos to be kept in pockets or bags. 

For example, a photo of your daughter with her beloved cat can be an excellent reminder of unconditional love and acceptance. If your child has a deep affection for a cousin or extended family member, take a photo of them enjoying something together and add it to the collection. 

5. Music (sound)

Listening to music, playing an instrument, or singing can be a great tool for redirecting anxiety. You can create a playlist filled with songs to soothe anxiety so they can access music anytime anxiety strikes. Classical music is reliable in this way. Some great soothing classical music can be found on Baby Mozart-type albums.

If your child plays an instrument, you may suggest that they learn a piece by heart that they can play in times of stress. Choose something simple enough that they aren’t struggling yet challenging so that they engage their mind a little bit with the music. If your child enjoys singing, you may suggest they assign a favorite song to sing during times of anxiety. Ideally, this is a song to which they know all the words and that is inherently soothing. Lullabies and favorite childhood songs are a great choice.

6. Peppermint (taste/smell)

Studies have shown that people exposed to peppermint oil feel a sense of calm and alertness. When studying drivers, studies have shown that peppermint can reduce frustration, anxiety, and fatigue. The simplest way to get some peppermint into your child’s system is to provide them with some peppermint candies that contain real peppermint oil. They can keep the candies in their pocket and suck on them to help soothe their anxiety.

Another method is to smell peppermint oil. This can be done by adding a drop of peppermint essential oil to a cotton ball and putting it in a zip-top bag that can be kept in your child’s pocket. You can also add peppermint essential oil to slime, or you can make a small clay diffuser that your child can have available as needed.

Learning to help kids cope with anxiety and an eating disorder will help a lot with your child’s emotional regulation. And the good thing is that once you’ve learned it, it gets easier each time. Anxiety is normal – everyone has it. But we want to help our kids who have eating disorders cope with anxiety as best they can. 

Jamie saw a difference as soon as she put together her anxiety toolkit for Michael. “The biggest thing is that I felt like I knew what I was doing and was supposed to do when his anxiety showed up,” she said. “I never realized how stressed I was every time I detected anxiety. Now I feel like I know what to do. And it doesn’t work perfectly, of course, but it has helped us many times when he started to spiral and needed a little help grounding himself.”

For privacy, names and identifying details have been changed in this article.

See Our Guide to Emotions And Eating Disorders

Emotion coaching is a 5-step method developed for parents by John Gottman, PhD that can be applied to eating disorder recovery. The emotion coaching method builds emotional intelligence and creates positive, long-lasting effects for children, from toddlers to teens and young adults. It’s evidence-based, easy to learn, and regularly used by parents, educators, therapists, and caregivers in many different settings.

When parents learn the emotion coaching method, they identify how best to respond when a child is sad, angry, scared, or emotionally dysregulated and having big emotions. Once parents understand emotion coaching, they recognize that emotions, even the big, scary ones, are opportunities to build connection and emotional resilience. 

Parents also learn that emotion coaching doesn’t let the child “off the hook” when they have big emotions, but rather that the child gets to have big emotions, and the parent also gets to set clear, consistent limits on behavior.

The five steps of emotion coaching are: 

1. Be aware of your child’s emotions
2. Recognize your child’s expression of emotions as a perfect moment for intimacy and teaching
3. Listen with empathy and validate your child’s feelings
4. Help your child learn to label their emotions with words
5. Set limits and problem-solve

Emotional literacy is critical in eating disorder recovery

Often eating disorder behaviors are a way for a person to cope with difficult and uncomfortable emotions. Thus, eating disorder recovery necessarily involves learning how to feel big and uncomfortable emotions without using eating disorder behaviors. 

This is why parental emotion coaching is so helpful for recovery. You are spending far more time with your child and seeing a greater range of emotions than their therapist. Therefore, if you can help your child learn to tolerate and process difficult emotions, you can help them recover from their eating disorder. 

But tolerating and processing emotions is not something that most of us do naturally. In fact, many parents do the exact opposite. For many parents, when a child has uncomfortable emotions, the goal is to settle the emotions and move on as quickly as possible. 

Here are the three most common techniques parents use to settle emotions quickly:

• Accommodating: Your child is afraid of heights, so you avoid heights
• Authoritarian: Your child gets angry when you ask them to take out the trash, and you yell back that they are ungrateful and need just to do the job without complaint
• Reassurance/Facts: Your child doesn’t want to do something, so you provide them with facts and reassurance that it’s a good thing to do and that everything will be OK

These are just three ways that parents try to avoid emotions. Most parents who do this believe they are making the only rational choice. They believe that the rational way to handle emotions is to settle and/or avoid them. However, we know that the opposite is true. Repressed and avoided emotions tend to get bigger and more disruptive over time, not smaller. 

That’s why emotional regulation is a core element of eating disorder recovery. To recover from an eating disorder, your child must cope with big and disruptive emotions without their eating disorder behaviors. The only way to do this is to build emotional resilience, which can be achieved with emotion coaching. 

Emotion coaching when parenting a child with an eating disorder

Parents can support recovery by working with their kids’ emotions rather than denying, avoiding, or accommodating them.

1. Be aware of your child’s emotions

The first step in providing emotion coaching for a child who has an eating disorder is to recognize when your child is having emotions. This may seem obvious, but it is both essential and easy to miss. 

You need to tune into your child’s emotional state to do this. Consider these questions: 

1. Do you know when your child is angry, sad, scared, or feeling another emotion?
2. If so, how do you know? What are the signs of the different emotions your child feels? (hint: don’t focus on words alone. Emotional expression is much deeper than language, so look for physical signs like eyes, facial expression, posture, vocal tone, gestures, etc.)
3. Do you understand that often there is a presenting emotion (e.g., anger, stubbornness) that is covering a primary emotion like fear, worry, and shame?

It helps to build your emotional literacy, or ability to recognize and label emotions. There are several tools to help identify feelings: 

• Feelings wheel
• Characters emotion chart
• Plutchik’s wheel of emotions
• Vocabulary of emotions/feelings

Print out one of these tools and use it to help you recognize your child’s different emotional states. Look for opportunities to use more emotional language with your child. Show your child how often we have more than one emotion at the same time. For example, it’s normal to feel both nervous and excited at the same time. We may also have a presenting feeling like anger that’s hiding a core feeling like sadness. 

2. Recognize your child’s expression of emotion as a perfect moment for intimacy and teaching 

Most parents become alarmed and maybe defensive when a child has big emotions. But emotions are a perfectly natural and normal part of being human. There are a few different theories, but a common one developed by Paul Ekman, suggests we have six basic emotions. They are: 

• Sadness
• Happiness
• Fear
• Anger
• Surprise 
• Disgust

If you consider that there is also a state of neutral emotion, it’s safe to assume that most humans spend less time being happy than they do the many other emotions. Having a child who is not always happy is not a problem: it’s normal.

Uncomfortable emotions like sadness and anger are natural and normal. And your child needs you most when they are sad, angry, afraid, or experiencing other “negative” emotions. It’s not that your child needs to stop having the emotion. It’s that they need to have it safely, ideally with you until they learn to handle it by themselves without their eating disorder behaviors.

When your child has big emotions in your presence, it’s best if you acknowledge the emotions and see them as an opportunity to build your connection with your child. Don’t push the feelings away or avoid them, but rather to step into your role as an emotional caregiver and soothe your child’s emotions.

Soothing does not occur when you accommodate, make demands, bribe, or convince your child not to have their emotions. It takes place when you acknowledge their feelings and respond to them. Soothing can be both verbal and physical. For example, you can begin with labeling the feelings, but you can also start by reaching out to them, hugging them, and giving them gentle eye contact to let them know you are there with them in their pain.

When parents soothe their kids’ emotions, kids learn over time to soothe themselves. And this is the true growth opportunity of emotion coaching and why it’s so important in eating disorder recovery. When you coach your child, they learn to do it for themselves.

3. Listen with empathy and validate your child’s feelings 

Emotion coaching is a highly attuned, challenging task. Parents who want to emotion coach their kids through eating disorder recovery need to practice listening and validating. Here are some tips for this: 

Listening

• Make sure you are listening to understand, not listening to respond.
• Relax your desire to give solutions or convince your child of anything.
• Breathe deeply and calmly while you listen to your child. 
• Remain emotionally regulated.
• Mindfully “listen” to your child’s body language, not just their words.

Validating

• Mirror what your child said by repeating a few of their words or summarizing what you heard without judging, editorializing, problem-solving, or debating the “facts.” Say things like “It sounds like …” and “Let me know if I’m understanding how you feel, you’re …”
• Say things like “I get it” and “that makes sense.”
• Don’t discount feelings, tell them how they should feel, use logic, or try to fix anything.
• Attend to your body language: have soft eyes, a relaxed but firm posture, and an engaged and open facial expression.
• Avoid “why” questions, which will put your child on the defensive. 

You need to validate your child’s emotions, not their behaviors. There’s a big difference. For example, you don’t need to say, “I can understand why you didn’t eat today.” Instead, say, “It sounds like you felt overwhelmed by everything you had to do today (and didn’t eat).”

4. Help your child learn to label their emotions with words 

Consistently work with your child to label their emotions with words. This powerful way to integrate the mind is essential to mental health. Use the feelings tools from earlier and keep steering conversations with your child towards feelings. 

You can ask questions like: 

• Tell me more
• What was/is that like for you?
• What did that make you think? 
• How did/does that make you feel? 
• How did/does that affect you? 
• What did/does that mean to you?

When your child gives you an answer, try to pick out the feeling words or add some of your own to make sure the conversation is emotion-focused.

Most of us want to focus on “facts” and details. But with emotion coaching, you’re working to help your child identify their feelings, which will help them deal with distress without their eating disorder behaviors in the long term.

5. Set limits and problem solve 

Emotion coaching is not permissive. In other words, while you are validating and accepting all of your child’s emotions, that does not mean that all behaviors are acceptable. 

For example, your child with an eating disorder might prefer to eat alone in their room. You can validate that they prefer to do that, but in your home, you insist on eating at the table as a family. Just because your child has feelings does not mean feelings should dictate behavior. This is very important when a child is dealing with dangerous behaviors like restricting, binge eating, and purging.

You can set clear boundaries and expectations that may include things like: 

• Family meals
• Not going in the bathroom after eating
• Therapy appointments
• No swearing at people or calling people names
• Not hitting things or people

When things get hard, you can validate the feelings for why your child doesn’t want to or can’t meet the boundary but still uphold the boundary you have set. This is what parents learn to do in the highly effective and evidence-based SPACE Training. 

If your child has expressed their emotions and feels validated, you may move into problem-solving. But be careful about problem-solving, as most adolescents and young adults do not actually want you to problem-solve. Most of the time they want to express themselves and then solve their problems by themselves. 

Surprisingly, the more room you give your adolescent/young adult to solve their own problems, the more likely they will seek your advice. So hold back unless it’s specifically requested.

If you are sure that your child really wants you to problem-solve with them, here are the steps: 

1. Identify goals
   • What is the problem we are trying to fix? 

2. Think of possible solutions
   • Brainstorm – no idea is too silly or stupid to consider 
   • Write them all down 
   • Remind your adolescent/young adult of past success and how he/she handled it 

3. Evaluate proposed solutions based on family values
   • Is the solution fair? 
   • Will it work? 
   • Is it safe? 
   • How am I likely to feel? 
   • How will other people feel? 

4. Help your adolescent/young adult choose a solution if they want help doing so.

Helping your child with their emotions during eating disorder recovery can help them find healing.

See Our Guide to Emotions And Eating Disorders

Sometimes when a child has an eating disorder they get aggressive and even violent with family members. This is a deeply upsetting situation for parents. It’s especially hard if you’re already worn out from months or even years of caring for a child with an eating disorder.

The first thing to know is that getting angry, aggressive, and even physically violent are known symptoms that can accompany an eating disorder. They have been studied and observed in anorexia and bulimia. The most common symptoms are verbal and physical aggression against relatives and others who are close.

During eating disorder treatment, your child may have verbal or physical outbursts for seemingly minor things. The key is to work on understanding why they are getting so upset and to manage your own reaction to their emotional outburst. Trying to shut down violet behavior during eating disorder recovery isn’t typically effective, but managing your reactions to the behavior can defuse the situation and make things much better.

Someone with an eating disorder is living in a state of extremely high emotional dysregulation. This is a physiological state that is designed to keep us safe from predators. When it goes into overdrive, it can lead to a near-constant state of fight, flight, or freeze.

When your child is violent and aggressive in eating disorder recovery, it means they’re in a fight response. It is a signal that they are experiencing extreme fear and anxiety. It is not a sign that they have a character flaw or aren’t trying hard enough. When we soothe their physiological state, they will start to feel better and the violence will reduce.  

What happens when a child with an eating disorder gets violent

When a child gets physically violent during eating disorder recovery, parents can feel shocked, overwhelmed, and afraid. There’s so much shame and stigma around kids hurting their parents, and it’s rarely spoken about. 

Violent behavior does happen during eating disorder recovery, but it’s also something that needs to stop. There are no conditions under which a parent should accept violence. Additionally, your child’s violence is a symptom of extreme emotional distress. Living in a state of constant “fight” is not healthy. This means that ignoring it or pretending violence isn’t happening is dangerous for both your child and you.

Often it feels like the only possible responses to violence are to fight back, endure/ignore the violence, or call the police. Fighting back rarely ends well for anyone. And it can add to the shame involved for both parent and the child. And enduring or ignoring violence is unacceptable and, like fighting back, is dangerous for both the child and the parent.

The other response, calling the police, is something you may need to do at some point in the future. But most parents want to avoid that. And there are some steps between doing what you’re doing right now and calling the police.

How to prevent and handle violence during eating disorder recovery

Here are some steps you can take to help prevent and respond to violent behavior during eating disorder recovery and keep yourself and your child safe:

1. Respond to food aggression

The most common response to violent outbursts is to fight back with some form of physical or verbal wrestling about food and eating. However, when parents do this it rarely defuses the emotional tension that drove your child to their violent outburst. Fighting back is ineffective and often makes the outburst worse.

Violent outbursts are usually the result of extreme emotional disruption. And while it may feel as if it comes out of nowhere, there are usually patterns and signs that a violent outburst is coming. 

Before a violent outburst, your child will show symptoms of emotional dysregulation. These may include shifty eyes, tense body posture, pacing, or loud voice. Some kids will signal their dysregulation by swearing or name-calling.

Parents should be aware of the signs of patterns that signal a violent outburst is building and take steps to try and soothe their child’s nervous system as soon as possible. Here are some ways to avoid and/or get through aggressive and violent behavior when your child has an eating disorder:

2. Manage your own emotional dysregulation

Possibly the hardest thing to do when your child is getting aggressive and violent is to maintain your own emotional regulation. But if you are not emotionally regulated then your child will have a very hard time becoming regulated in your presence.

Work with a professional coach, therapist, or guide who can help you identify your common forms of emotional dysregulation and learn to regulate yourself with self-compassion and mindfulness.

If at any point during an aggressive confrontation you notice yourself becoming dysregulated, try to calm yourself. But if you can’t, take a break. Don’t blame your child for this by saying something like “You’re out of control so I’m leaving!” Instead, tell your child “I’m very upset right now so I’m going to take a break.” Then leave. Give yourself at least 20 minutes, which is how long it typically takes to soothe your nervous system.

Always come back to your child and talk about what happened. Leaving is not a problem, but if you leave without talking about it later, that will put your relationship at risk.

3. Label and mirror their feelings

An essential emotional regulation skill is to label and mirror your child’s feelings. This is a way of soothing your child. This is because it shows that you are attuned to them and accept their feelings as valid and real. This step alone can transform your relationship with your child. This may not work if your child is already at the point of violence. But it can be used very effectively in the moments leading up to violence and may even prevent it.

Labeling is when you name your child’s feelings. You could say something like “I can see how angry you feel right now. You’re pacing and look agitated.” This video about the concept “name it to tame it” might be helpful:

Mirroring is when you repeat about three of your child’s words back to them. For example, if your child says “you never listen to me and you’re always telling me what to do!” You could mirror back something like “it feels like I don’t listen to you.” If your child says “you can’t make me do it if I don’t want to!” You could mirror back “you don’t want to.”

When mirroring your tone of voice matters just as much, and maybe more, than the words you say. Use what Chris Voss in his book Never Split the Difference: Negotiating As If Your Life Depended On It calls the “late-night DJ voice.” Imitate the voice of a late-night DJ: slow, steady, and soothing. With this voice, you comfort both your child’s and your own nervous system. It taps into your shared neurobiology to soothe and reassure. It communicates: we can handle this.

4. Narrate what’s going on

If your child does not calm down and moves aggressively towards you, calmly narrate what is happening in a supportive and non-judgmental manner. You could say things like:

• I sense how furious you feel, but it’s not OK to push me. I’m confident we can get through this without pushing.

• I can see that you are very angry, but I will not allow you to hit me, so I’m going to leave now. I’ll come back in about 20 minutes and we can try again.

• I understand that this is making you feel very upset, and you get to feel that way, but I’m not OK with you threatening me. Let’s sit here together and I know we can get through it.

These statements do the same thing:

• Label the child’s feelings and name the inappropriate behavior

• Set a clear boundary

• Show confidence that you can handle it

Your child may not like it when you do this, but that doesn’t mean you’re doing it wrong.

Keep your narration short, simple, and factual. Don’t editorialize or debate what you’re saying with your child. Use the “late-night DJ voice” and keep your voice calm and regulated.

5. Don’t debate

One key in responding to anger is to not engage in debates with it. You will never win a debate when a person is in extreme emotional dysregulation. Most parents believe there must be a perfect verbal response to violence that will stop it. They think that other parents have figured it out and are doing better than them. But that’s simply not the case. 

Eli Lebowitz, author of Treating Childhood and Adolescent Anxiety suggests you focus not on debating but on simply getting through or getting out of the moment.

“Parents are not expected to be able to manage the disruptive situation, and instead focus on getting through it. Their only role while the child is acting in the disruptive manner is to ensure physical safety and resist being drawn into the interaction.”  – Eli Lebowitz & Haim Ober, Treating Childhood and Adolescent Anxiety

The passage continues with this advice: “remain silent, or state in a quiet way that the behavior is unacceptable. If necessary, parents should attempt to distance themselves from the child in order to minimize the potential for escalation.”

6. Follow up

Once everyone has calmed down, talk about what happened. Begin by telling your child that you know they are a good kid who was having a hard time. Tell them you are going to work with them on this because even though you know how angry they get, you know that they can handle their anger without getting violent.

Violence must be named clearly and in a detailed but non-emotional manner. Avoid pointing fingers, blaming, or criticizing. Think of yourself as a dispassionate reporter. State what you observed during the violent episode. 

Don’t ask questions like “What were you thinking?” or say things like “How dare you!” Because these will shut the conversation down or escalate another outburst. They will not be useful in preventing future violence. Maintain your own emotional regulation.

Talk through what you did in response to their outburst, and why. For example, if you narrated what was going on, tell them you did that because it’s important to name feelings and behaviors. If you left the room, tell them you needed to do that because violence is not acceptable.

If you did something that you regret, like wrestle with them verbally or physically, take responsibility for that and apologize for it without defending yourself. “When you approached me with your fist raised, I pushed you away. I’m sorry for doing that, as I have no intention of wrestling with you.” Or “When you called me that name, I cursed at you. I’m sorry for doing that, as I have no intention of swearing at you.”

You will likely need to follow all of these steps consistently a few times before you see a change in behavior.  

If violence continues: write a letter

A written letter is a way to make clear your beliefs and what you intend to do in response to violence. It is a way to formally escalate your attempt to solve this problem and make it clear to your child that you take it seriously.

Lebowitz suggests printing this letter and giving it to your child, then reading it aloud. He also says that even if your child’s response is to put their fingers in their ears and rip the letter into pieces, it has still sent a meaningful signal to your child that you are serious about ending the violence. 

The goals of the letter are to clearly define the specific problem of physical violence and say exactly what will happen in response. This makes clear exactly what is happening and escalates the situation in your child’s mind.

One of the biggest problems with physical violence and intimidation is that families don’t talk about it. This letter states clearly what the behavior is and how the parents are going to respond from now on. 

There is a very important thing that the letter does not do. It does not tell the child what they need to do differently. This is strategic and by design. Lebowitz says that the parents need to take responsibility for what the parent will do and how they will respond, but they should not tell the child what they should do, as this will be perceived as criticism and blaming, no matter how carefully done.

If violence continues: bring in supporters

If your child continues to physically threaten and attack you, then it’s time to enlist help from your community. This may feel like an extreme response, but it’s much less extreme and often more effective than calling the police. 

This is based on the strength of our social and community relationships. We are social beings, and the thought of someone outside the family witnessing the child’s violence can help end unacceptable patterns of violence. When done with support and love, bringing in supporters can make a huge difference.

“The role of supporters is not to shame children or embarrass them but rather to rally round the children, giving them the message ‘We all care about you, believe in you, and are going to help you.’” – Eli Lebowitz & Haim Ober, Treating Childhood and Adolescent Anxiety

Make a list of people in your family and community who might be able to help you. You are looking for people who have high levels of compassion and a good relationship with your child. Possible options include grandparents, uncles, aunts, friends and family, sports coaches, teachers, school psychologists, guidance counselors, your child’s eating disorder treatment team, and others. 

Lebowitz suggests a list of 5-10 supporters, at least some of whom are in your physical community. Then reach out to them and explain the reason for your request.

Telling your child about supporters

Once you have contacted your supporters, tell your child what you have done. You can say something like “August, your violent behavior has been escalating, so we have decided to get some community support. We have contacted [list the names] and told them about what’s going on. They’re going to contact you in the next few days, and we will also tell them each time you get violent with us.”

Your child will not like that you have told outsiders about their violent behavior. Be unwavering in your belief that this is the best approach, as your next option is calling the police, which is really a last resort. Don’t debate why you did this, who you chose, or whether it’s a terrible idea. Stay firm in your conviction that this is the right thing to do.

“Any objection on the part of the child to this step should be met with a simple statement: ‘When you act in a violent way, we will not keep that a secret.’ Parents should adamantly avoid any further discussion of this point.” – Eli Lebowitz & Haim Ober, Treating Childhood and Adolescent Anxiety

When things get violent during eating disorder recovery

This article is designed to give you ideas about how to handle violent and aggressive behavior during eating disorder recovery. If your child is struggling with emotions in eating disorder recovery, then I encourage you to seek professional coaching and support for yourself as you navigate this difficult situation. You will likely need it, and you definitely deserve support. You will also be more effective if you have someone who can help you weather this storm.

See Our Guide to Emotions And Eating Disorders

A child who has an eating disorder will benefit from emotional regulation skills, and parents can help by learning co-regulation techniques. When we co-regulate with our kids, they learn to do it for themselves. In fact, we are in the best possible position to improve our kids’ capacity for emotional regulation.

Often when we learn a child has an eating disorder all our attention goes to the child’s disordered behaviors. We focus on feeding them and getting them to therapy. This is important, necessary, and makes a lot of sense. 

But when we focus exclusively on behaviors we may miss the cause of the behaviors. And emotional dysregulation and disengagement are often at the heart of eating disorders. This is why emotional regulation is key to lasting recovery.

What is emotional regulation?

All of us have a nervous system that is attuned to internal and external threats. When it perceives a threat, it triggers our amygdala and raises cortisol levels and the flight, fight, or freeze response. A highly-sensitive person has a more reactive threat response, meaning they find themselves frequently dysregulated (over-reactive) or disengaged (under-active).

People who are frequently in a dysregulated state typically have symptoms of anxiety, while those in the disengaged state have symptoms of depression. Either way, the body diverts attention from the digestive process, focusing instead on seeking safety. Thus, appetite tends to be low and it is very hard to eat and digest food. Many people with eating disorders struggle with emotional regulation.

Parental co-regulation

Children are not born with emotional regulation skills. They learn them through a process called co-regulation.

Parental co-regulation is when a parent’s nervous system regulates the child’s nervous system. With practice, the child gradually learns to regulate their own nervous system without the aid of their parent. This is something we know based on recent developments in neuroscience, which is teaching us how children’s emotional systems develop. 

When there isn’t enough co-regulation in the parent-child relationship, our kids don’t develop a healthy self-regulation system. We often see signs of this through kids’ negative behavior.

Benefits of co-regulation:

• More balanced and calm state of mind
• Able to cope with worry and regulate thoughts and emotions
• Ability to think more clearly and make decisions
• Increased ability to respond rather than react
• Process worry, stress, and anxiety in a healthy way
• Emotional balance
• Relationship balance
• Self-awareness
• Social awareness

Adults can learn emotional regulation when they are older, but it is much harder and takes a lot of time and effort. A child/teen, on the other hand, can learn emotional regulation through co-regulation with a parent much faster due to the neurobiology of the emotional regulation system. A parent who co-regulates with their child, especially when there is an eating disorder, can make a huge impact on the child’s lifetime mental health.

Understanding attunement

Co-regulation begins with parental attunement. This is when a parent tunes into how a child is feeling – the feelings that lie beneath the behavior we’re observing – and responds in a way that will bring the child into an emotionally-regulated state. Attunement is something that we’re designed to do for our children, and it’s something our kids need us to do to build a healthy self-regulation system.

Attunement begins with tuning in to how your child is feeling. Your first trigger that there’s a feeling to pay attention to is that you might notice you are getting irritated or frustrated with them. That’s typically a good sign that your child is having feelings and needs you to tune in and help them regulate their emotional system. 

Once you notice a behavior that bothers you and therefore indicates hard feelings, take a deep, calming breath and look at your child. Think about what they might be feeling, and try to sense it with your body. 

We have a vagus nerve that is automatically attuned to our child’s distress. The vagus nerve winds throughout our brain, face, neck, and trunk. “Gut feelings” are actually the vagus nerve sending feedback to your stomach and intestines. Vagus nerve feedback is powerful and embodied, and it’s one of the best ways we can become attuned to our child’s emotional needs.

Being attuned to your child takes practice, but it’s something you can learn. 

Childhood emotional regulation

Behavior is often seen as something we need to fix or get rid of. But when we shift our thinking to recognize that behavior holds critical clues, we can decode our kids’ emotional state and respond appropriately. Our kids’ negative, annoying, and dangerous behavior, including eating disorder behavior, tells us they need this from us. 

This approach is a critical shift from thinking our kids’ behavior is something that needs to be overcome, fixed, shut down, or controlled. Instead, we want to learn to translate behavior and use co-regulation to help them learn self-regulation. 

Often we get frustrated with our kids’ irritating behaviors. We all wish our kids would self-regulate their emotions better. But emotional regulation is a learned skill, and our own irritation is our signal that we need to tune in and help them with co-regulation. 

No matter how convenient it would be, we don’t improve nervous system regulation with cognitive skill-building. Rather, we improve nervous system self-regulation through co-regulation.

Windows of tolerance

One helpful way to visualize this is to consider our kids as having different emotional “windows.” I created a visual way of seeing these three windows, or emotional states: dysregulated, co-regulated, and disengaged. You can get a copy in my free eBook. This illustration is based on materials provided by Mona Delahooke. It interprets the “Window of Tolerance” concept developed by Dr. Daniel J. Siegel, a leader in neuroscience research particularly as it relates to the parenting relationship. I also integrated concepts from the work of Dr. Stephen Porges.

The behaviors and feelings are scientifically validated. However, the information for “eating disorder behaviors” is based on my professional observations, research, and lived experience. Please use this information as guidance, not fact. Every eating disorder is unique.

A child who has an eating disorder will likely have periods of emotional regulation. That is to be expected. However, the eating disorder behaviors are unlikely to be a problem while the child is in a regulated state, which is why I put “N/A” in that column. Eating disorder behaviors are most often triggered by emotional dysregulation and/or disengagement.

Co-regulating with your child through recovery

A child’s eating disorder recovery will go through many stages. The main thing to keep in mind is that when a child increases their emotional regulation, their eating disorder behaviors will almost always decrease. 

This rarely happens all at once, but rather in stages. And the goal is not to achieve a state of constant emotional regulation. Instead, we just want to shift the balance and have more periods of regulation than periods of dysregulation and disengagement. This is normal and healthy human emotional functioning.

I’ve come up with a model: Emotional Stages of Eating Disorder Recovery based on my research, observations, and lived experience. 

The key here is that parents can play an integral role in eating disorder recovery by focusing on co-regulating with their child, which will build the child’s ability to self-regulate and therefore not seek eating disorder behaviors as a coping mechanism.

How to co-regulate with your child

So how does a parent co-regulate with a child who has an eating disorder? Remember that the first step is to be attuned to your child’s emotional state. Keep in mind that often your first signal that your child needs co-regulation is that you’ll feel irritated or upset with them. Use that signal to determine where your child falls: are they dysregulated or disengaged? Once you know that, you can start to intuit the feelings they are experiencing.

Once you are tuned into your child’s emotional state, you can begin co-regulating by: 

• Making gentle, non-threatening eye contact
• Using a soothing vocal tone
• Saying kind words of understanding and validation
• Touching them gently and respectfully
• Breathing deeply to keep your nervous system regulated
• Using compassionate self-talk to keep yourself centered

The most important part of co-regulation is to keep your nervous system centered and confident. What you feel is more important than what you do or say.

Remember that you can always come back and talk about the problematic behavior that tipped you off to your child’s need for co-regulation. But you cannot have useful conversations about behavior while your child is in a state of dysregulation or disengagement.

Activities you can do together

The steps above are the most important part of co-regulation. But sometimes it will help to move into activity. Be thoughtful here and make sure activity is called for. Adjust your activity and expectations based on the level of dysregulation or disengagement. It’s unlikely that you will want to use the same activity all the time. These are a few go-to activities that can help your nervous system get in touch with theirs if they are resisting connection:

• Art: color, paint, or doodle
• Play: play a simple and non-competitive game from childhood
• Stretch: do some gentle stretches
• Exercise: go for a walk or run
• Pets: talk about your pets and/or pet your pets
• Eat/Drink: make a cup of tea or a piece of toast to share
• Go outside: look up at the sky, look at trees or grass
• Read: read a book out loud in a calm voice. You could choose something from childhood that holds good memories
• Light a scented candle: smell is a powerful and underutilized way to soothe and calm the nervous system
• Listen to music together

While you do these activities, don’t worry about what you say. Worry about how you feel. The goal is to stay in your child’s presence so that your calm, confident emotional state will automatically transmit to their dysregulated or disengaged nervous system.

Be careful of the talk trap

Avoid getting stuck in the trap of thinking that co-regulation relies on talking about feelings. It does not. Your child cannot have useful, meaningful conversations with you when they are dysregulated or disengaged. Therefore, while soothing talk may be helpful, trying to talk about the behavior or even the feelings may not be helpful and can even get in the way. Focus on feeling calm and being with your child and rely on your senses rather than words. 

If your child wants to talk, validate what they say and help them clarify their feelings and thoughts. But avoid debating, offering advice, or providing guidance when you see signs of dysregulation or disengagement.

You can have longer and more meaningful conversations once they are regulated, which means they are showing signs of being calm and confident. But trying to do this when they are not emotionally regulated can backfire.

How we can do this better

As parents, our nervous system is constantly communicating with our kids’ nervous systems. This is why attending to our own emotional health will help our kids feel better. 

In fact, there are several validated interventions in which only parents are treated for childhood emotional disorders. In these cases, therapists never work directly with the child, but instead, teach the parent emotional regulation skills. And they work just as well if not better than direct intervention with the child. 

How to strengthen your emotional regulation as an adult:

• Work with a therapist/coach to discover and address your own dysregulation and disconnection patterns
• Practice meditation
• Learn self-compassion 
• Nourish your body with food you love
• Move your body joyfully
• Get outdoors every day
• Learn self-acceptance
• Find a hobby or something you do enthusiastically just because you enjoy it
• Build/deepen your friendships and relationships with others

Supporting our kids’ eating disorder recovery

Parents can make a significant difference in kids’ recovery from eating disorders. And while feeding your child and getting them to therapy are important, your emotional growth can also make a big difference. 

Learning emotional regulation for your child with an eating disorder may be the difference-maker you’ve been looking for! You can download my eBook: Emotional Regulation Skills for Parents Who Have Kids With Eating Disorders. In this eBook you’ll learn how to recognize the different emotional states and how to respond, plus powerful worksheets to help you get started.

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This article is informed by the work of Stephen Porges, Daniel Siegel, and Mona Delahooke

See Our Guide to Emotions And Eating Disorders

A common part of eating disorder recovery is learning to feel feelings. This may seem like a strange task, but it may be the most important thing we need to do to achieve full recovery.

People who have an eating disorder typically become disconnected from their feelings. Rather than process feelings, someone with an eating disorder turns to food and exercise behaviors and an obsession with weight as a coping mechanism.

When we’re healthy, we recognize feelings and metabolize them as they arise. Mental health means that when feelings arise we don’t ignore, avoid, or use a coping behavior to distract ourselves from them. But in our culture many people are “feeling-phobic.” Most of us are desperate to avoid the negative feelings that are a part of being human.

What is your family’s emotional coping style?

If you have a child who has an eating disorder, then it’s time to evaluate your family’s emotional coping style. Take a moment and think about:

• Do we try to avoid negative feelings?
• Have we tried to cheer up or distract our kids from negative feelings?
• When a child gets upset, do we either get angry or shut down because it’s too hard for us?

These three behaviors are really common parenting practices. And they are also harmful, because they show our kids that their feelings are unsafe and dangerous. Feelings like anger, despair, loneliness, sadness, and betrayal are natural and normal parts of being human. And even though our intentions are good when we try to get our kids back to being happy, we’re accidentally creating a problem.

Rather than trying to get our kids “back to happy,” parents need to instead help kids feel all types of feelings without shame or fear.

Feeling feelings – the good and the bad

The goal for mental health is to feel both the good and bad feelings. This can be scary, since most of us were raised to fear bad emotions, and of course we have tried to shield our kids from bad feelings.

Some feelings that parents tend to welcome and encourage include:

• Happiness
• Joy
• Pleasure
• Gratefulness
• Contentment
• Delight

Some feelings that parents tend to try to shut down and move past as quickly as possible include:

• Fear
• Anger
• Loneliness
• Despair
• Guilt

How do we try to move past these emotions? Here are some ways:

Fear	Don’t be afraid! You’ll be all right.
Anger	Stop yelling! You need to calm down.
Loneliness	Don’t be sad. Just call someone. Didn’t you have a good time with Dante last time you played with him?
Despair	Oh, it’s not so bad! Things will get better, I promise.
Guilt	You need to stop thinking about it and just fix it.

All of these responses feel perfectly normal in today’s parenting culture. However, they all do one thing: discount the child’s feelings, which are real. Even if you don’t agree with or like the feeling, the fact is that it exists, and denying it only creates side effects.

When parents try to skip negative feelings, we accidentally create conditions in which our children are afraid of feeling negative feelings. The message they receive when we try to move past their feelings too quickly is that negative feelings are dangerous and bad and should be avoided at all costs.

Yet feelings live in our bodies and are a sign of health. Our bodies were designed to feel a broad range of emotions, including negative ones. Having bad feelings isn’t a sign that something’s wrong. It’s a sign that our minds and bodies are behaving exactly as they should.

It is adaptive to feel negative feelings sometimes. It is maladaptive to try and avoid negative feelings.

Healing from an eating disorder

When our children are in the healing process from an eating disorder, they need to learn how to process their negative feelings. We tend to think the most important milestones in eating disorder recovery are a reduction in weight obsession and eating/exercise behaviors. But in fact the most important milestone in eating disorder recovery may be learning to feel feelings.

Eating disorders are a way to cope with feelings. So while lots of people can resist the temptation to use their eating disorder behaviors for a while, if they haven’t learned to feel their feelings, it’s likely they will return to their eating disorder when things get stressful (and they will).

Learning to feel feelings can be a painful process. When we first start to have negative feelings without the benefit of our coping mechanisms, we can feel deeply afraid and get triggered to act out our eating disorder or other destructive coping behavior.

This is why eating disorder recovery is so painful. It looks like the problem is food, exercise, and weight. But the real problem is feelings.

How to feel feelings

The first step in feeling feelings is noticing how often we have them. Most of us are so automatically averse to feeling negative feelings that it can take some time to notice them. Please remember that this is about practice, not perfection.

The best way to help your child navigate eating disorder recovery is to start practicing feeling feelings as a family. Bookmark or print out this simple guide and work together to help each other feel feelings, especially the negative ones.

This may sound like you’re all going to be incredibly depressed all the time. But I assure you that, just like clouds in the sky, negative feelings, when felt openly and freely, pass. As you get better at this practice, you will notice that even the most intense negative feelings can usually be fully felt and metabolized in fewer than five minutes. I’m not saying that in order to encourage you to use a stopwatch, but I’m just letting you know that it gets easier with practice.

Here are the steps to feeling feelings:

1. Notice

First, you have to recognize that you’re having a feeling. Sometimes this is the hardest part!

I’m having a feeling.

2. Locate

Find out where in your body you can feel the feeling. Our emotions live in our bodies, so it’s important not to try and turn a feeling into a thought. Feelings are much more than thoughts!

My head is pounding.
It feels hard to breathe.
My eyes are scrunching up.

3. Name

Give the feeling a name. Use the “Feelings Wheel” to help identify which one feels most likely. Try to go beyond the basics: angry, sad, and afraid. Stretch your emotional vocabulary to incorporate lots of feeling words.

I’m feeling lonely and hopeless, and I feel scared that I feel this way.

4. Accept

Accept the feeling. Tell it that it’s welcome to exist. Validate its existence.

I feel so alone right now.
This totally sucks for me.
I hate this.

5. Talk

Talk about the feeling and remind yourself that while the feeling is valid, it will pass. A feeling is important, but it’s also not a fact.

Self-Talk: Feeling bad feelings is so hard for me. I struggle to accept these sorts of feelings in myself. I feel scared when I feel these feelings.

With a Loved One: Feeling bad feelings can be scary. It makes sense that you struggle to accept all of your feelings. I’m so sorry you’re having these hard feelings, and I’m here for you.

6. Touch

Because feelings live in the body, it helps to touch or be touched with love and acceptance. In this way you are acknowledging the embodiment of the feeling.

Alone: I can soothe myself by touching my own skin lovingly – on my arm, my leg, my face. My touch transmits my love and acceptance physically to myself.

With a Loved One: I will soothe you by touching your skin lovingly in a place that you agree is comfortable and safe for you. With my touch, I’m transmitting my love and acceptance physically to you.

7. Sit

Give the feeling time to exist. Don’t rush it away or try to force it into gratefulness or happiness. This process will get easier the more completely you accept the negative feeling and validate it.

Alone: I’m going to sit here for a while and feel this feeling. I’m going to keep talking to myself and touching my skin to remember that I’m here, and I’m safe, and this feeling will pass.

With a Loved One: I’m going to sit here for as long as you feel this feeling. There’s nothing more important. Nothing else I need to do. I’m going to keep talking to you and touching your skin to remind you that I’m here, and you’re safe.

I hope this helps you help your whole family build emotional resilience and the ability to feel all feelings. I know first-hand how hard it is to practice this, but I can also attest to the incredible healing power of feeling feelings and emotions in eating disorder recovery. This takes patience. It is not easy. But it is well worth it.

See Our Guide to Emotions And Eating Disorders

Parents who teach their kids who have eating disorders self-care can make a huge impact on their lifetime health and wellness. Kids who have eating disorders often struggle with poor self-care habits. Parents are critical when it comes to developing healthy self-care practices that will last a lifetime.

What is self-care?

Self-care is a way for someone to recognize and respond to their personal needs. It’s unfortunate that this is something to be learned, but our culture is actually anti-self-care. Many of us are actively taught to be selfless and care for others before caring for ourselves. Putting ourselves first and caring for our own needs can be a revolutionary act in our society.

A lot of the things you read about self-care focus on things like bubble baths, massages, and glasses of wine. But true self-care is a daily practice of tuning into who you are and what you truly need.

Why is self-care important for kids with eating disorders?

We are currently facing terrifying increases in suicide, self-harm, eating disorders, substance abuse, and mental conditions such as anxiety and depression. Our children are entering a society that is clearly emotionally compromised.

This is a huge public health crisis. There are many societal and structural changes that need to take place to make our culture safer for our kids. But for now, as parents, we simply need to do our very best to help our kids be resilient against the mental health challenges they face.

One of the recognized methods for protecting children from mental health issues is to develop self-care routines that promote health and well-being. Self-care is essential if we want our kids to thrive despite increasing rates of poor mental health in our society.

How do we learn self-care?

Self-care begins with the word “self,” but it’s not something that needs to be developed alone. Human beings are finely attuned to social groups, particularly their parents. As a result, loving oneself often requires a sense of being loved in critical relationships. This is why self-care is often best when learned in partnership with a loving parent.

People can strive to learn to love themselves as adults. But it’s far easier if children are taught by their parents that they are deeply loved and accepted as children. It’s also helpful if parents show their kids some effective methods of self-care rather than just expecting them to develop it for themselves. When parents teach self-care to kids, it is easier for them to tap into self-love and personal caregiving any time they are struggling emotionally.

Feeling loved is the first pillar of self-care

Self-care is about loving ourselves. But because we are social animals, loving ourselves often begins with feeling loved by our parents. Almost all parents do love their children deeply and want only what’s best for them. But it’s surprisingly common for adult children to report that they did not feel loved by their parents. As a result, they have a hard time tapping into an innate sense of worthiness and acceptance, which is a foundation of self-care.

Parents can teach self-care to kids by helping them feel deeply loved. Parents need to give love in a way that children recognize at the moment. Giving love to our children will give them a lifetime of self-care techniques and improved health and happiness for life.

Love is not as much a feeling as an action. And how parents show love is how kids learn to love themselves.

How parents can teach self-care to kids

You already love your child. That goes without saying. But how do you let them know they are loved? Are you able to tap into methods of showing more love to them when emotions are challenging? Parents can teach self-care to kids by showing them more love in the most difficult situations.

We teach our kids self-care by showing them we love them. We can’t assume our kids know we love them. Feeling love for our kids is not enough. Driving carpool, making three meals a day, and keeping a roof over their head is not the same as showing love, it’s the tactical work of being a parent.

Instead, we must show our kids we love them. Our love actions are how they learn self-care practices that will keep them healthy for life.

6 ways parents can show kids love

A parent’s demonstrated love actions build a powerful foundation for self-care and self-love. These six ways to show love will help you raise a child who knows how to care for themselves when you are not available. Your acts of love will guide their self-care practices for life.

1. Allow all feelings

Our society promotes toxic positivity. This damages our kids because they learn to repress their emotions, which is not healthy. Healthy emotional regulation requires that kids repeatedly feel negative emotions like anger, sadness, and fear when they are with their parents. And, over time, they learn that feelings are nothing to be scared about.

⭐ As your child recovers from their eating disorder, feeling their feelings is an essential part of self-care. They can only take care of their emotional needs if they are able to accept their emotional landscape.

2. Feed them fearlessly

Eating is a critical part of self-care. And yet our society promotes denying hunger and ignoring cravings. This damages our kids because appetite is an essential part of being human. Ignore societal messages that tell you to fear food and restrict what your child eats. This will support disordered eating and an unhealthy relationship with food. Help your child tune into their hunger, appetite, and satiety. Teach them that there is nothing wrong with emotional eating. It’s just a part of being human.

⭐ As your child recovers from their eating disorder, eating fearlessly is an essential part of self-care. They can tune into their natural appetite and hunger cues and respond with love and kindness.

3. Tuck them into bed

In our go-go-go society, sleep is often neglected. But in fact, our kids need a tremendous amount of sleep to maintain basic health. Sleep affects mental and physical health. While your child is in recovery from their eating disorder they may need even more sleep than is normally recommended. The biggest impediments to sleep are phones, laptops, Netflix, and homework. Help your child establish a sleep hygiene routine. Yes, this will be hard. They will not like it. But sleep hygiene is an essential part of health and self-care.

⭐ In the short term, your child will need your help making sleep happen. But over time, they will learn the benefits of good sleep for themselves and make it part of their self-care.

4. Touch them

Humans are social animals. Look at any images of mammals with their babies and you’ll notice how often they touch each other. We have much longer childhoods than other mammals, but the need for touch remains strong while our kids are living with us. If your child is not in the habit of being touched by you, then move very slowly. Touch their hand, shoulder, or some other area of their body lightly and briefly. Build up until you are intentionally giving them a little bit of touch every day. If your child already loves to be touched, then give them at least one 20-second hug every day.

⭐ When your child grows up, they will learn to give themselves gentle touch and seek it from loved ones. This can be an essential part of self-care.

5. Move together

You know how when your baby was crying it often helped to walk around the house holding them? Or perhaps they calmed down in the car? So many parents hold their infants against their bodies in chest carriers, which is deeply comforting. Movement is a powerful soothing activity, and it can defuse tension and anxiety. When your child is emotionally triggered, see if you can take a walk together or go for a drive together. When tensions are high at home and you’re having a hard time communicating, movement can often help to literally shake things up a little bit.

⭐ When you do this with your child you show them that sometimes the best self-care is a little bit of movement or a change of scenery. Sometimes moving the body can help offload tension and create a calmer emotional state.

A daily practice

Emotions and eating disorders show up every day, so self-care is a daily practice; it’s more like brushing your teeth than taking a vacation. Many articles suggest big gestures are needed to take care of yourself. And those are great sometimes. But the best and easiest self-care is small actions often. When parents care for their kids like this, kids learn to tune into what they need and develop good self-care habits.

See Our Guide to Emotions And Eating Disorders

Having anxiety about food and eating shows up in many eating disorders, especially anorexia and orthorexia. If your child has an eating disorder, it’s very likely they are struggling with a lot of anxiety around food and eating. It’s really frustrating to watch a child refuse to eat and have complete meltdowns over meals.

This is advanced parenting, but you can learn skills to help your child learn to soothe their food and eating anxiety. This is a great way to support your child at home while they undergo therapy for their eating disorder. If you learn how to manage your child’s food and eating anxiety, you can help them recover from their eating disorder.

1. Check your own anxiety about food and eating

It’s important to start with yourself. This is because while we live in a highly individualistic society that emphasizes individual agency, humans are designed to attune with each other. Parents are our first attunement partners, and how they feel deeply impacts how we feel.

It’s completely normal if you feel anxious when your child gets anxious. In fact, it would be a little strange if you didn’t! But this is where we have to build new emotional regulation skills and learn to stay calm inside of ourselves even as our child escalates into anxiety.

This is not easy. You understandably want to get your child to eat. But the fact is that you will be unable to meaningfully help them without first soothing your own anxiety.

Here’s the hard thing about anxiety: your child knows when you feel anxious. They feel it on a subconscious level, and they have felt it since your first held them and every day since. Your emotional security is crucial to their survival. Any unresolved anxiety can make them feel insecure and anxious.

It takes effort to learn to regulate your anxiety, but you can do it! And when you invest in your own anxiety management skills, your child will benefit.

2. Food and eating anxiety is not breaking news

One of the most important concepts to internalize about your child’s anxiety about food and eating is that it’s not breaking news. You have probably noticed that it pops up repeatedly. Whether it’s every meal or just certain meals, the fact is that your child feels anxious about eating.

Most of us naturally jump in to try and soothe the anxiety with words and questions. This makes a lot of sense, and perhaps it worked when your child was younger. But if your child is feeling consistently anxious about food and refusing to eat, then you are in a new stage of anxiety management, and your old methods don’t work anymore.

Parents must stop responding to anxiety as if it is breaking news that must be interviewed, reported on, and discussed at length as front page headlines. Instead, it’s more like the weather in Los Angeles. It may vary a little bit, and sometimes we have significant weather events, but it’s rare. Most of the time, native Los Angeleans don’t check the weather because we pretty much know what’s coming tomorrow, next week, and even next month. It’s almost never breaking news.

Here’s a scenario:

Lulu’s daughter Amy is very anxious about mealtimes. Every time she puts a plate down, Amy starts to shake and cry. She physically shrinks away from the food. Lulu asks her what’s wrong, and she cries more. “I reassure her that the food is healthy, safe, and tasty, and that she has liked it before, and she screams at me,” says Lulu. “Her palms are sweaty and she’s shaking. I keep asking her questions and trying to convince her that it’s safe, but it’s not working, and she’s pretty much not eating at this point.”

Here’s another way it could go:

Amy is very anxious about mealtimes. Lulu knows this. So before it’s time to eat, they talk a little bit about the fact that it’s time to eat and acknowledge that anxiety often shows up for meals. “Then we’ll take a walk together or do some yoga poses, or I’ll just sit quietly with her,” says Lulu. “I work to connect with her and let her know that I know anxiety is coming and that it’s OK. We don’t make a big deal out of the reasons for her anxiety, we just assume it’s going to show up. After doing this for a while, we’re noticing that she’s coming to the table less stressed. I’m definitely less stressed, too!”

Parents who anticipate anxiety feel less stressed about it when it shows up. Since kids feel parents’ anxiety, this is a big deal. Remember that kids don’t want to be anxious, and they can sense that it’s upsetting for you, which is scary for them. So when you respond like it’s breaking news, they panic even more. When you normalize it and expect the anxiety, it’s not quite so scary.

3. Right channel, volume too high

The problem is not that your child is afraid. The problem is that their brain is over-reacting to fear.

One way to think of anxiety is that our child is on the right channel, but the volume is too high. What they are thinking about makes sense. It’s true that the food might taste bad. It’s true that they might feel worried about eating too much. They may be worried about getting fat or eating something unhealthy.

Whatever fears they have make sense to them right now. The problem is that the volume is up way too high. Instead of having a thought and moving on like a healthy brain would, their anxious amygdala blows up and overreacts.

This video provides a great overview of how this works:

Sounds familiar …

You might recognize this response in yourself. As soon as you sit down and you can tell that your child doesn’t want to eat, your amygdala immediately jumps to the fear that they are going to die if they don’t eat. Of course you are worried, and you have every reason to be.

At the same time, missing a single meal is not the end of the world. Both things are true: you are afraid, and this single meal your child is refusing right now is not a life-or-death situation. (If a single meal is life-threatening, then stop reading and take your child to the Emergency Room!)

What I am saying is that the channel is right – the fear makes sense, but the volume is way too loud.

Calm the amygdala

High-volume anxiety means our amygdala is freaking out. Once our amygdala freaks out, it’s impossible to be rational and effective. Until we calm our amygdala down, we’re not going to believe that our child is safe, and we’re not going to be able to help our child eat.

Likewise, until our child’s amygdala calms down and stops shouting, they’re not going to be able to eat.

Don’t try to talk your child out of their anxiety and into eating until you sense that the volume is lower and their amygdala is calmer. When you try to reason at high volume, it’s like screaming into a speaker blasting Iron Maiden. Nobody can hear you. No matter how perfect your words are, you won’t accomplish anything. You will, however, get exhausted and hoarse.

Your job is not to convince your child that they’re on the wrong channel. Your job is to help them lower the volume of their amygdala so they can figure that out for themselves how to eat.

4. Say less, be more

Most of us respond to anxiety by using language and words. We desperately want to help our child feel better and eat a healthy meal. So we try to use our words to convince them to eat. We think that if we say just the right thing, it will fix the problem. But remember that until their amygdala lowers its volume, we will not succeed. The amygdala does not respond to language. It responds to feelings.

We are hard-wired from birth to respond to our parents’ internal state of mind. We are highly attuned to our parents’ feelings. That means that what’s going on emotionally for you matters to your child more than anything you say.

Don’t get into debates about the value of the meal, the number of calories, and whether it is healthy or not. Don’t get sucked into discussions of how much is enough, how their stomach feels right now, or anything else. You don’t want to get into an argument about what’s on the plate or the fact that there is a plate. You will never win a debate with an amygdala.

So what do you do instead?

You need to find a calm place inside of yourself to accept the anxiety your child is in. If you can find a way to believe that their anxiety will not kill them (or you!) and that it will pass like clouds in the sky, they will pick up on your emotional state and their amygdala will calm down.

Think of yourself as a solid boulder in the ocean of your child’s emotions. No matter how hard it storms, you stay steady. Trust that your child will get through their anxiety and that they will be OK.

Sit with them while they rage and storm. Be a calm and loving presence in the face of their anxiety. Let them know that you care, but that you will not get into arguments about the value of food and eating. You know they are anxious right now, and you are going to sit with them through the anxiety.

What to say

Here are some things you can say when they start to try and engage you in a debate:

• That may be true, but right now we’re just going to sit here so that your amygdala can settle down.
• I hear what you’re saying, and I know you’re feeling very anxious. For now, we’re just going to sit here together and wait for our amygdalae to chill out.
• I understand that you’re afraid, so let’s just accept that right now. I’m all right with all your feelings.
• I know that when you yell at me, it means you’re feeling anxious. It’s OK – I’m still here and I’m not going anywhere.

Your calm, loving presence will help calm their amygdala. Your refusal to engage in debate and steady belief that food is good and healthy will help them know that you expect them to eat. You don’t have to tell them that you want them to eat – they know what you want. Don’t engage with the anxiety, and instead let them feel it like a passing storm.

This takes practice and self-compassion. Be kind to yourself!

5. Celebrate successful anxiety resolution

Remember that anxiety is not breaking news. That means that getting through one meal does not mean the next one will be easy. It just means that the next meal is very likely to have anxiety as well. Try to never be surprised by anxiety.

It takes patience, time, and compassion to resolve anxiety, but it helps to have hope. This is why celebrating successful anxiety resolution can help. It reminds everyone that this is a process that you are all learning.

The goal is not to never experience anxiety, but rather to endure anxiety without actually dying (which is what anxiety feels like). Anxiety always resolves.

Journal ideas

Get a journal or a calendar, and take a few minutes together to write a quick recap of anxiety events. For example:

• I sat down at the table, and I thought I was going to die. Seriously, my anxiety was HUGE. Mom and Dad sat with me. I started to feel a little better.
• Dad called me to dinner and I fell down on the floor and refused to get up. I was so MAD. Mom sat with me on the floor. It took a while, but it passed. And it really wasn’t comfortable on the floor 😉
• Mom served mac and cheese and I felt so ANGRY. I cried and yelled and told her that she was so mean. Mom put the plate down in the kitchen and sat with me while I calmed down. Then we tried again and the mac and cheese was actually pretty good.

Notice that we’re allowing the child to talk about the anxiety and how it felt. Anxiety is big and scary. It’s terrifying and enormous. People go to the emergency room for anxiety symptoms because it is so hard to endure.

But like a huge thunderstorm, anxiety never lasts forever. So let your child acknowledge the pain of having anxiety as well as recognize that as big as it gets, it always passes. If it’s possible to add some humor in the retelling, that may help lighten the mood and laugh a little together.

Frequently Asked Questions

Q: But isn’t this catering to the anxiety?

A: This is catering to your child’s biological need to be in a state of homeostasis in order to eat. I know that most of us were raised in environments when feeling feelings wasn’t allowed, but when you have a child who has an eating disorder you simply must recognize that emotional literacy is your number one goal to support their recovery. Trying to shut down anxiety, ignore it, or treat it as if it’s bad is only going to hurt recovery.

Q: This is so much work! Will I have to do this every single time we eat?

A: I know it’s so much work, and I’m so sorry that you have to experience food and eating anxiety. It’s very stressful. Luckily, you can learn to regulate your own emotions, which will reduce stress for everyone. And your child is in therapy, so they’re learning emotional regulation skills, too. Over time and with proper treatment, you will be better-regulated, your child’s anxiety will reduce, the eating disorder will recede, and you will not have to put so much effort into every meal. But for now, yeah. It’s a lot of work.

Q: That’s all fine, but what if they still don’t eat?

A: This is a question that you have to work on with your child’s treatment team. The point of this article is to help parents who have kids who are eating sometimes, but feel tremendous anxiety around food and eating. If your child is truly not eating and is deep in their anorexia behaviors and medically unstable, then they need a higher level of care. This article is not intended to replace any professional care – it’s only intended to help make mealtimes less stressful, which is good for everyone’s appetite.

A final note

Emotions and eating disorders are linked, and having a child with anxiety is scary and frustrating. A child who is anxious about food is at high risk of having their anxiety create a major health problem. You are right to be scared.

But please know that anxiety is the most treatable mental disorder. There is tremendous hope for your child. While the eating disorder is multi-layered, food and eating anxiety often lie at the heart of it. Helping your child navigate anxiety is possibly the single most important skill you can learn right now.

See Our Guide to Emotions And Eating Disorders

Are you looking for ways to help your child recover from an eating disorder? If so, learning compassion is a great way to support eating disorder recovery. Compassion for your child or loved one, and compassion for yourself will go a long way to helping everyone during the recovery process.

1. Giving compassion to your child in eating disorder recovery

Compassion for someone who is in eating disorder recovery looks like this:

I see you

This is a deep, deep need in all human beings, but it is especially important for a child to feel seen by her parents. She needs to be seen for who she is on the inside, not how she looks or behaves on the outside.

You are loved

You may think that your kids know this, but there is no limit to their need for love from you. It is a deep, driving force. Give them extreme love with words and actions.

I hear you

It can be hard to listen to a child who has disordered thoughts about her body and food. You want to fix them and make them go away. But just listen and acknowledge her thoughts and they will begin to loosen their hold on her mind.

I accept you

Unconditional love is when we are able to leave our judgement behind and love the person for who they are on the inside, regardless of their behavior. This doesn’t mean you have to like their behavior, but you will always love them.

Your feelings are valid

The trouble with feelings is that we become afraid that acknowledging them will make them permanent and intractable. But they aren’t. Feelings are real, and they should be free to come and go like clouds across a blue sky. Let your child talk about the clouds without fear or judgement.

I can handle this

A deep fear for anyone with a mental illness is that they will ruin all of their relationships and lose all love. As a parent, it is so important that you reassure your child that you can handle whatever happens with her, and that you will do your best to support and love her no matter what happens.

Why compassion helps with eating disorder recovery

Many people suffering from eating disorders feel compelled to repeat a self-destructive behavior despite evidence that it is harmful. Eating disorders can baffle people. They wonder “why can’t you just eat healthy?” But they are more complex than just food and weight.

Eating disorders are behavioral addictions that soothe and calm someone who feels anxious and out of control. Most people who have eating disorders also feel a sense of low self-worth. They seek to bolster their self-worth through food and exercise behaviors. They believe they will be more worthy when they achieve a certain weight.

Having compassion for a person who has an eating disorder means understanding that food and weight are just the tip of the iceberg. Compassion means that we understand that our child needs more than just food and eating advice. They need our affection, attention, and unconditional love.

The compassion mindset flips your thinking about the disorder from “this has to stop!” to “how can I support her towards change?”

Your child may need a team of professionals to recover. But compassion is something that you can give her for free, day in and day out. Practicing compassion will pay dividends for everyone in your family and your life.

2. Compassion for yourself when your child is in eating disorder recovery

Parents who have children who have eating disorders frequently suffer from compassion fatigue. They are exhausted by the care required to help their child heal.

Between doctors’ appointments, therapy appointments, and family therapy, you may be overwhelmed. But the answer to this is not to stop doing things or do less. The answer is often to give yourself compassion fo how hard this is.

Self-compassion is an incredible skill that most of us need to learn. It means that instead of trying to ignore our feelings, we allow them. You may have been raised to keep on a happy face. It’s possible your parents asked you to repress your negative emotions to keep the family peace. But emotional repression is unhealthy for everyone.

Instead, learn to give yourself compassion for all of your feelings, especially the negative ones.

The principles of self-compassion

Self Kindness

When we make a mistake or fail in some way, we often use harsh, critical internal language – “You’re so stupid and lazy, I’m ashamed of you!” We would be unlikely to say such things to a close friend, or even a stranger for that matter. With self-kindness, we are supportive and understanding toward ourselves. Our inner dialogues are gentle and encouraging rather than harsh and belittling. This means that instead of continually punishing ourselves for not being good enough, we kindly acknowledge that we’re doing the best we can. Similarly, when external life circumstances are challenging and difficult to bear, we soothe and nurture ourselves.

Common Humanity

The sense of common humanity recognizes that everyone fails, makes mistakes, and gets it wrong sometimes. We do not always get what we want and are often disappointed – either in ourselves or in our life circumstances. This is part of the human experience, a basic fact of life shared with everyone else on the planet. With self-compassion, we take the stance of a compassionate “other” toward ourselves, allowing us to take a broader perspective on our selves and our lives. By remembering the shared human experience, we feel less isolated when we are in pain. Self-compassion recognizes that we all suffer.

Mindfulness

When we are mindful, we are experientially open to the reality of the present moment without judgment, avoidance, or repression. We must be willing to turn toward and experience our painful thoughts and emotions in order to embrace ourselves with compassion. While it might seem that our pain is blindingly obvious, many people do not acknowledge how much pain they’re in, especially when that pain stems from their own inner self-critic. Or when confronted with life challenges, people often get so lost in problem-solving mode that they do not pause to consider how hard it is in the moment. We recognize our thoughts and feelings in real-time.

Compassion will help all of you

Emotions and eating disorders are linked. Compassion is the key to navigating eating disorder recovery at home. While your child goes through treatment, every person in your family can benefit from more compassion.

Learn to give your child more compassion as they go through recovery. But don’t forget to give yourself compassion, too!

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The “principles of compassion” are adapted from Self-Compassion: The Proven Power of Being Kind to Yourself, by Kristin D. Neff 

See Our Guide to Emotions And Eating Disorders

Emotional repression can be considered a gateway to eating disorders. Parents who are interested in preventing and healing eating disorders can help their kids feel their feelings.

For the first time in history, our kids are more actively stressed than we (their parents) are. Our kids are living with high levels of anxiety and fear. They worry about everything from their bodies to their grades. Their performance, their social standing, politics and climate change … just about everything can be worried about.

Our kids are living with levels of high anxiety, and it’s hurting them. It’s hurting their ability to feel good about themselves, and it’s hurting their life prospects. It’s also terrible for their health.

Cortisol, the stress hormone, is highly correlated with every major disease. A lifetime of stress and anxiety can wreak havoc on our kids’ long term health. Most of us worry about whether they are getting enough fruits and vegetables. But the anxiety that runs in the background of their minds is actually determining their future health. While we worry about their weight, it is their anxiety that will actually impact their longevity and health.

One of the greatest sources of chronic stress is repressed emotions. This is because repressing emotions takes far more energy than feeling and fully processing emotions the first time they come around.

When we repress our emotions, we are kept in a never-ending process of keeping them repressed. Think of it this way: it takes a lot more energy to swim while trying to keep a beach ball submerged underwater. It’s much easier to simply allowing the beach ball to float alongside us as we swim.

How most parents respond to negative emotions

Most of us were raised to repress and downplay our emotions. We did this especially with negative emotions like anger, fear, and hurt. If we are female, we were taught by well-meaning parents, teachers, peers, and religious leaders that girls should be sweet, kind, and easygoing. We were taught in ways explicit and implicit that being loud, angry, and fearful is unattractive. And we learned that being attractive is essential to being a good girl. If we are male, we were taught that being sad and afraid is unacceptable.

As a result of this thorough training, most of us unconsciously train our own children in the same way. When she cries, we wipe her tears and tell her everything is fine. We shush her and tell her to quiet down and come back when she can control herself. When she tells us she is afraid, we dismiss her fears as irrational and tell her there’s nothing to worry about.

Almost none of us know that what we can and should actually do is allow our children to have all of their emotions, feelings and anxieties. What almost none of us know how to do is accept our kids’ emotions gracefully and without fear.

It’s not just parents – our society hates emotions

It should be said that most of us are not great at processing emotions. This is through no fault of our own – it’s hard to feel feelings when you have been taught to repress them your whole life.

But even if a parent is an excellent emotional processor who fully accepts their child’s emotions, our kids still live in a society that discourages negative emotions.

Even if we do everything to the best of our ability, our society will still teach our kids to play a closely defined gender role when it comes to emotions. Those who rebel and refuse to meet the standards of emotional repression are often ostracized and bullied.

Emotional repression and eating disorders

It’s no surprise, nor is it debatable that human beings of any gender are born with the ability and the freedom to fully express and process their emotions. It’s also not a secret that over time, because they are driven to pursue parental and societal love and acceptance, our kids learn to feel guilt and shame every time they feel a negative emotion. They learn to believe that negative emotions much be repressed because they are “not allowed” or “not appropriate.”

This is a very bad thing, because emotions are physical as much as mental. They never fail to exist – they only go underground, where, trapped, they wreak havoc on our bodies and minds.

Think of the beach ball that you’re trying to keep underwater. It takes tremendous energy to keep it down, and inevitably, every once in a while it explodes out of the water, and then we must scramble to get it back down again. The process is exhausting and endless, because no matter how hard we try, the ball will never stay underwater peacefully. It will fight for freedom.

Emotional repression is the perfect gateway for eating disorders. Keeping our emotions underground becomes easier if we find ways to numb and disconnect from our emotions. One of the best ways to do this is through coping mechanisms like eating disorders, self-harm, and addiction.

Eating disorders feel good

Something few parents who have kids who have eating disorders realize is that eating disorders feel good!

Eating disorders may look dangerous, but the person who has an eating disorder finds them to be an effective way to find peace from the emotional turmoil that is always roiling beneath the surface. Eating disorders are the way some people manage live in a world that requires us to repress our emotions.

Even if they know intellectually that eating disorders are unhealthy, and even if they feel shame over them because they believe they are “stupid” or “disgusting,” a person’s eating disorder still makes them feel better in the short-term. Eating disorders may look like monsters, but they feel like the ultimate caregiver.

The path to healing from an eating disorder

Emotional repression can contribute to eating disorders. This is why the path to healing from an eating disorder is an emotional one. Most people who have eating disorders must relearn what it means to feel emotions. They have hidden and repressed them for so long that they must slowly, gradually, rebuild our connection with their emotions.

The path to full emotional health requires us to actually feel. Sometimes for the first time in years or even decades. Feeling for the first time after an eating disorder is excruciating. Many people reach for their eating disorder behaviors again and again. Not because they want to. But because of the terror of facing their negative emotions without their preferred numbing agent.

When we have repressed our emotions and used our eating disorders to avoid feeling feelings, recovery means feeling again. And this unleashes physical sensations of panic similar to what we would feel if we were being chased by a tiger. I am not exaggerating. It’s really, really scary. Feeling feelings after an eating disorder is terrifying. But it is necessary in order to heal.

Over time, it gets easier. Once we learn to feel our emotions in a healthy, regular way, we no longer need to numb them away. We start to realize that trying to keep the beach ball underwater was an unnecessary use of our time, energy, and intellect. When we start swimming alongside the beach ball, we free up space, and the eating disorder is no longer necessary.

How parents can help

Parents can help their children recover from an eating disorder by first learning to better process their own emotions. Emotional regulation is something few of us learned in childhood, and almost all parents need more of it. Also, our kids develop healthy emotional regulation when they first co-regulate with their parents’ calm, confident nervous system.

The best and fastest way to do this is to work with a qualified therapist or coach. They can help you learn to regulate yourself and co-regulate with your child.

Next, parents can help their kids recover by accepting and allowing their kids to experience all emotions in eating disorder recovery. Learn emotional first aid. When your kids’ fear, anxiety, anger, and other negative emotions arise, let them. Don’t try to stop them. Be there, as steady as a rock. Allow your child’s emotions to surround you without fear of being swept away. It’s exhausting to do this work for your child. And it takes practice, but there is nobody who can do it better than you. It is, quite possibly, the greatest gift any of us can give to our children.

See Our Guide to Emotions And Eating Disorders

When your child is upset, sad, anxious, depressed, or any other negative feeling, it’s perfectly natural to think about food as a way to make them feel better. Who hasn’t thought about offering ice cream, a favorite meal, or a visit to Starbucks as a cure for the blues?

Most of us have used food as a form of soothing and nurturing when our kids are down and celebrating or rewarding them when they are up. There’s a good reason for this: food is the first way we nurture and respond to our child’s needs, but we need to be careful to not become over-reliant on food as a way to show our kids we love them.

Think back: the very first time your child was upset, you used food to soothe them (with either a bottle or breast). That’s exactly how the parent-child bond begins. There is nothing wrong with the instinct to soothe our kids with nourishing food. But this natural instinct can go awry if food becomes the primary way that we soothe and recognize our children.

What kids really need

Our children are deeply feeling individuals. They look to us, their parents, as a source of emotional regulation as well as a source of nourishment, nurturing, and love. While it’s OK to incorporate food into a soothing or celebratory experience, we should never mistake food as a substitute for our thoughtful attention.

What our kids really need is our undivided, nonjudgemental attention.

What our kids really need is our unwavering acceptance of them as whole, worthy human beings whom we love deeply and consistently.

To meet their needs, we need to approach them with love, compassion, and kindness. Most of the time they do not need us to give them anything more, with the exception of kind words such as:

• You are awesome
• I’m so proud of you
• I like being with you
• I want to know more about you
• I like spending time with you
• I want to care for you
• I want to keep you safe
• I love you
• I hear you
• I’m here for you

How to give our kids what they need

Giving our kids ice cream when they’ve done something we approve of or chocolate when they’re down is not the same as giving them what they need emotionally. To meet our kids’ emotional needs, we must spend time with them and give them our full attention. Here is how we can do this:

1. Remove distractions: turn off the TV, put your phone on airplane mode, and move away from your computer and other devices. This should be required for any parent-child relationship. It is very hurtful to your child when you look at texts or are otherwise distracted when you are interacting with them. This goes both way – your kid should do the same.

2. Pay attention to non-verbal cues: watch your child’s body language, their tone of voice, and other non-verbal cues to really understand what’s going on. Most kids will not answer direct questions about why they are upset, but if we watch them carefully we can intuitively understand how they are feeling and what they need from us.

3. Mirror them: match your child’s posture, expressions, nonverbal cues, language, and other mannerisms to let them know you are on the same plane as them. Mirroring a person is a form of deep connection because it makes the person feel safe on a subconscious level.

4. Reflect back: rather than asking a lot of questions, which can be overwhelming, reflect what you hear them say. So if they say “I hate Mary – she was so mean to me today!” Instead of saying something like “you need to stop caring so much about what other people think about you,” say “it sounds like Mary wasn’t very nice to you.” This tiny difference makes a huge impact and helps your child feel heard rather than controlled.

5. Show interest: encourage the moment to last longer by showing interest in whatever your child is telling you. We show interest by making eye contact and using our faces to show that we are listening. Raising our eyebrows, squeezing our eyes shut, and saying things like “oooooh!” and “ugh!” can show our child that we are really listening and will help them open up and say more.

6. Don’t interrupt: give your child the floor. Don’t interrupt their story or commentary even if you feel you have something really valuable to contribute or think you really need to ask a question to understand what’s going on. If it’s worth saying, then it can wait. Allow your child to vent, rage, or lament for as long as they need to without interrupting them. Wait for a break in their conversation, and then look for a sign that they want to hear something from you.

7. Don’t give advice: 90% of the time our responses should be reflective rather than directive. Avoid telling them what to do or how to handle a situation unless they specifically ask for your opinion. Most of the time, our kids are very capable of solving their own problems, but they need us to give them a safe place to process their various feelings. Ideally, wait for your child to ask your advice before you try to give any.

How we treat kids becomes how they treat themselves

The way we treat our children will become their inner conscience and the voice they use inside their heads when things go wrong. This is why we have to think carefully about how we respond to difficult emotional states like fear, anger, sadness, and more.

Our voices become the voices in our kids’ heads.

Responding to our children with unconditional acceptance, listening, and kind words will teach our child to respond to their own needs with the same compassion.

For example, when our college student gets a low grade on a test, they may respond by eating an entire carton of ice cream, or they may respond by processing their feelings of fear and shame and then meet with the professor to learn about how they can do better next time.

When our adult child gets reprimanded at work, they may respond by eating an XL pizza and drinking a bottle of wine while watching Netflix, or they may go out for pizza with a trusted friend and talk about their work experience and troubleshoot the situation.

Which would you prefer for your grown child?

Helping kids build emotional toolboxes

There is nothing wrong with using food as part of a soothing ritual. Food is inherently soothing to humans, and emotions and eating disorders are linked. So what we want to think about is that our child has an emotional toolbox that they will use to soothe their negative emotional states.

If the only tool in their toolbox is food, they are missing out on many other self-soothing techniques.

The way we parent makes a huge impact on our child’s emotional toolbox. We want to provide them with compassion and acceptance and model thoughtful listening. This will help them avoid becoming overly-reliant on a single tool like food or other forms of consumption like alcohol, drugs, self-harm, shopping, gambling, sex, etc.

See Our Guide to Emotions And Eating Disorders

Have you noticed that your child has become emotionally withdrawn? Are they spending less time with you, and not sharing their life with you? When a child is emotionally withdrawn, it is often a sign that their parents need to learn some new parenting skills. Emotional withdrawal in the parent-child relationship can be a red flag for eating disorders and other dangerous behaviors.

The most powerful emotional shield our children utilize when they are suffering is emotional withdrawal. They may withdraw slowly or abruptly. The overall goal of the withdrawal is to protect themselves from perceived danger in their relationship with us, their parents.

How does a child emotionally withdraw?

A child can become emotionally withdrawn using many different barriers, including:

• Physical isolation (e.g. always in a different room, behind a closed door, etc.)
• Emotional isolation (not sharing emotional intimacy with family members)
• Over-committing to outside interests such as friends, activities, and school
• Angry outbursts, verbal attacks, and abuse
• Stonewalling and being uncommunicative
• Sarcasm, eye rolling, slammed doors, etc.
• Crying
• Hiding behind electronic screens (e.g. social media, gaming, etc.)
• Saying “I’m fine” when it’s obvious they are not fine

Withdrawal is a very common tactic used by children who are experiencing emotional disruption. This includes when they have or are developing an eating disorder. A child who is protected by withdrawal is less likely to be “caught.” Thus the eating disorder is at lower risk of exposure.

Why withdraw?

Withdrawal is an emotional tactic used by people who are afraid they will not get their needs met in their most important relationships. Rather than confronting this fear, they shut down and pull away from the people who love them. Emotional withdrawal is the execution of the thought “I’ll dump you before you can dump me.” The person who is withdrawing desperately wants connection. But they are deeply convinced that the person from whom they are withdrawing is unable to love them completely as-is. They may be afraid that:

• If you knew the real me (all of me), you wouldn’t love me
• You don’t really love me
• You don’t understand or respect me

It is important for parents to understand this. Typically when a child withdraws, the parent experiences the withdrawal as a rejection. But in fact withdrawal is a desperate cry for attention.

Many times when our kids withdraw from a relationship with us, we feel the sting of rejection. We think things like:

• My child doesn’t respect me
• My child doesn’t need me anymore
• If my child wanted me around, they would treat me differently
• I can’t do anything right with my child
• My child gets everything they need from their friends

Unfortunately, this causes us to withdraw from our kids, which creates a self-perpetuating loop

• The child is afraid their parent won’t understand, so they withdraw.
• The parent feels rejected, so they withdraw or begin clinging.
• The child feels justified in believing their parent can’t understand them or meet their needs.

The result is that the child and parent both end up feeling unloved, hurt, abandoned, and uncared for. It’s deeply painful for both sides.

When withdrawal gets dangerous

There is a difference between healthy independence and emotional withdrawal. Our children seek healthy independence by gradually doing more and more on their own without seeking our prior opinion or approval. Healthy independent children do not feel ashamed of what they are doing and are not avoiding talking to their parents about these activities. In most cases, healthy independent children will share their explorations into independence in at least general terms with their parents.

When a child is withdrawing, they often have a sense of shame and sneaking while doing things outside of their parent’s view. This is especially true of a child who is exploring eating disorder behaviors, self-harm behaviors, drug and alcohol use, shoplifting, and promiscuous sexual activity.

They feel uneasy while doing these things because they believe that their parents would not approve or could not understand. These activities provide short-term relief for their suffering. And the only way they can see to continue pursuing is to erect a wall between themselves and their parents.

Not all kids who withdraw are doing the dangerous things listed above. But withdrawal from the family is a requirement for most people who engage in these behaviors. This is why withdrawal should be taken very seriously.

Reconnecting after withdrawal

Emotional withdrawal erodes the trust and security that underlies a healthy relationship. Our children require a connection with us in order to feel safe and secure as independent individuals. All kids long to feel loved, cared about, respected, and valued by their parents. When a child withdraws, it is usually a sign that they need their parents to learn some new parenting skills. 

If you sense that your child is withdrawing, take some time to think critically about the withdrawal patterns. Consider and write down:

• What behaviors am I noticing that suggest my child is withdrawing from me?
• How do I know that this is withdrawal and not healthy independence?
• How is my child most often relating to me, and how is it different from 6 months ago?
• Has anything changed in our family lately that may explain the withdrawal?
• Has anything changed in my child’s life lately that may explain the withdrawal?
• How am I responding to my child’s withdrawal? Am I doing things like crying, walking away, yelling, etc.?
• How does my child’s withdrawal make me feel?
• Are there times when my child is more open to me? When is my child least open to me? What patterns are there in the withdrawal behavior?
• What are we fighting about most? OR What is the “elephant in the room” that we are avoiding?

Getting help when a child emotionally withdraws

When a child is emotionally withdrawn, parents struggle. Everything is harder. If possible, find a therapist, counselor, coach, friend, or partner who can help. You need to talk and process your feelings about your child’s emotional withdrawal.

Your feelings are valid and important. Your feelings need space and you need to heal. Look especially closely at your reactive emotions to your child’s withdrawal. It hurts. Be there for yourself and care for your deep, vulnerable, primary emotions that are being hurt by your child’s withdrawal.

Process all of this with another adult before you address it with your child. The best way for you to help your child is to recognize that withdrawal is not a rejection of you, but an invitation to find another way of relating to your child. This situation requires you to tap into your parent side instead of your childlike, reactionary side. Your child needs you to be strong and stable for them.

What your child needs to hear

Your child needs to hear things like:

• I value your opinion
• I respect you
• I am willing to talk about hard things with you
• I care about you
• I’m not going to get critical like I have been in the past
• I’m going to stay right here. I’m not going to leave you like I have been doing when things get hard
• I’m going to hang in here and fight for our relationship
• I’m going to interrupt our pattern of withdrawal from each other

It may take a while for this to work. You are trying to break a pattern to which you have both become accustomed. It’s scary to get vulnerable after withdrawal. As parents, we need to keep showing up in a soft yet strong way. We need to continually show our child that we are fighting for our relationship with them. We have to prove – with anti-withdrawal behavior – that we are committed to them no matter what they say or do. Over time, we can replace the withdrawal cycle with supportive, loving, and nurturing parenting.

Getting help with withdrawal

It is often very difficult and sometimes impossible for a parent to reconnect with a withdrawn child without help. Don’t hesitate to seek professional support from a therapist, counselor, or coach. You should definitely seek professional help in the following cases:

• Your child refuses to engage with you and keeps you at arm’s length.
• You learn your child was or is currently engaging in dangerous behaviors. This may include an eating disorder, drug and alcohol use, shoplifting, self-harm, etc.
• You suspect your child was or may be engaging in dangerous behaviors. These may include an eating disorder, drug and alcohol use, shoplifting, self-harm, etc.
• You are unable to engage with your child without yelling, crying, shutting down and/or leaving during difficult conversations.
• After engaging with your child, you feel like you acted like a child.

An emotionally withdrawn child is harder to parent and harder to love. Emotions are linked to eating disorders, so emotional withdrawal can be considered both a risk factor and a symptom.

See Our Guide to Emotions And Eating Disorders

Panic attacks and anxiety attacks are common during eating disorder recovery. A panic attack is described as more “bottom up” behavior, meaning it arrives suddenly and apparently without forethought, coming up through the body to the mind. An anxiety attack is a “top down” behavior,” meaning it typically arrives following a period of mental rumination and perseveration. 

Either way, they tend to have similar symptoms, all of which are associated with the nervous system’s response to fear: fight, flight, or freeze.

Symptoms of anxiety attacks

1. Chest pain: Your child may feel chest pain, heart palpitations, and an accelerated heart rate. Some people describe it as pressure on their chest, fluttering in their chest, stabbing pain in their chest, etc.

2. Sweating, trembling & shaking: Your child may sweat, tremble and shake during an anxiety attack. This may or may not be visible.

3. Nausea: Your child may feel nauseated as their blood rushes out of their digestive system to their limbs in preparation for running away or defending themselves against a predator.

4. A sense of choking, shortness of breath & smothering: Your child may feel their airways are constricted, which can increase anxiety because a lack of air is a panic-inducing experience. 

5. Dizziness and Fainting: Your child’s senses may become overwhelmed with fear, which can overwhelm their sense of balance and even lead to a complete freeze or shut down. 

6. Fear of dying: Your child’s symptoms will most likely feel like death is imminent, which adds to the panic. They may demand that you call 911. 

7. Racing thoughts: Your child’s mind will be trying to solve the situation by throwing up thousands of thoughts, which adds to the feeling of overwhelm.

What anxiety attacks feel like in eating disorder recovery

The experience of having an anxiety attack is extremely terrifying. Never hesitate to take your child to the ER or call 911 if you believe your child may be in danger. Paramedics and ER doctors see anxiety attacks regularly, and will be able to identify whether there is something life-threatening going on vs. anxiety symptoms.

Unfortunately, some professionals are not very thoughtful when presenting the diagnosis of an anxiety attack, which can lead to shame and increased anxiety. A doctor’s diagnosis that “it’s just anxiety” can make your child feel as if they have wasted everyone’s time and are pathetic and needy. This, of course, just increases anxiety. Reassure your child that there’s no shame in having a panic attack. Lots of people have them. And tell them that now that you know the symptoms, you’ll be able to respond differently in the future. 

Panic attacks are common. At some point in our lifetimes, nearly 30 percent of us will be hit by a wave of anxiety so intense that it includes some combination of nausea, dizziness, numbness, tingling, a feeling of detachment from reality, chills, sweating, and, as already noted, fear that one is losing control or dying.”

Under Pressure: Confronting the Epidemic of Stress and Anxiety in Girls

What to know about anxiety attacks

Here are some more things parents should know about anxiety attack symptoms:

1. Timing: Panic attacks typically build in severity over the course of about 10 minutes or less. Those 10 minutes can be incredibly scary, but symptoms will subside gradually after they reach a peak.

2. Acknowledge how your child feels, and accept how bad it feels. It’s all right to say to your child that they may be having a panic attack. Say this in a calm, confident, accepting tone, and your child may find relief in having a name for their experience. Allow the anxiety symptoms to arise under your care and acceptance. Help your child name the symptoms, and write them down if that seems to help your child recognize that their feelings are real and valid. 

3. Don’t ask questions about why the anxiety is happening – many times your child doesn’t actually know the cause until long after the event, and sometimes it’s never quite clear. Asking questions tends to create more anxiety. When your child is in a state of panic they are not capable of that level of evaluation. Keep it simple and soothing.

4. Calm them, but not by saying “calm down.” Telling someone who is having a panic attack to calm down can make the symptoms worse. Your child wants to calm down, but they need to sense that it is safe to calm down first. Regulate your own nervous system, which is always communicating with your child’s nervous system. Breathe calmly, keep your posture relaxed, and keep your eyes soft and gentle. If this is hard for you, start practicing mindfulness, which will help you achieve this level of calm faster. 

5. Reassure them that you are here for them. During panic attacks, your child may feel deeply ashamed of bringing anyone around us “down” with them. They may experience feelings of worthlessness, helplessness, and hopelessness. And, importantly, they may feel a deep fear of abandonment. Let your child know that you are in no rush and they can take all the time they need to recover. Say things like “this is exactly where I want to be,” and “I am here for you as long as you need me” to help them understand your unconditional positive regard in the face of a debilitating anxiety attack.

6. Tools may help your child recover from an anxiety attack. For example, some people find aromatherapy, a cold compress, a heavy blanket, a glass of cold water, or meditative music helpful. Some people find it helpful to listen to guided meditation, classical music, or yoga nidra podcasts during an anxiety attack.

Once you know your child has anxiety attacks in eating disorder recovery, keep these tools on hand so you can pull them out as needed. For example, if smelling something helps, carry a small bottle of essential oils at all times. If listening to yoga nidra helps, then download a favorite podcast on both your own and your child’s phone. Be aware that these tools may work sometimes and not others. Try not to get frustrated or take it personally if a tool doesn’t work – just try something else, or just stay calm, attentive, and present for a while.

7. Medication may help your child recover faster, and may be the route recommended by their care team. If your child’s doctor has prescribed medication to reduce the symptoms of anxiety, then keep them available in various places around your home and other locations so that you have medication ready to go when necessary.

After an anxiety attack

Once the anxiety attack seems to be coming to completion, your child may need to take a nap or at least rest for a while. Anxiety attacks are physically and emotionally exhausting, so don’t rush off to do something right away. If you have plans or are supposed to be somewhere, try to delay your arrival by at least an hour to provide time for recovery. 

When your child appears to be fully recovered, set an appointment with a care provider to talk about the anxiety attack. Anxiety attacks can seriously impact your child’s eating disorder behaviors, so take every attack seriously and talk to your child’s treatment team so they know about it and can recommend a course of action.

Finally, check in with your child periodically about their anxiety levels. Keep in mind that emotions and eating disorders are linked, so more panic attacks may mean more triggers for eating disorders. Especially in the days following an anxiety attack, your child may have residual symptoms. Make it safe for your child to talk to you about their symptoms of anxiety in a nonjudgmental manner.

See Our Guide to Emotions And Eating Disorders

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It can be incredibly difficult to watch a loved one who has a mental health condition like depression, anxiety, or an eating disorder. Mental health conditions make it hard for your loved one to experience life. No matter how much you love the person, your love alone will not help them recover. The person you love will probably need some professional help from a trained therapist. But that doesn’t mean you can’t help! Emotions and eating disorders go together, so helping your child feel feelings is important. We came up with a video to help parents understand some ways they can help kids who are struggling with mental health conditions.

When you love someone, it’s usually easy to have a good time together. But when someone you love has a mental health condition, it can be hard to figure out what to do.

It’s hard because, to you, the world is the same, but for the person who is hurting, nothing feels good anymore. You want to help, but you can’t figure out what to do. It’s easy to feel hurt by the person who is hurting. This is not fair at all. But you can help make things better.

Here is a metaphor to help explain how you can help.

The person you love is enjoying life and having a great time. There is a small puddle of sadness in her life, but it’s not a big deal. Then, one day, she falls into her puddle of sadness. Her puddle of sadness grows, and now she can’t get out.

A boat comes along to help her. She gets in the boat, and now she’s out of the water. But the puddle has grown into a lake, and the boat keeps her stuck in the middle.

You come along and see your loved one in the middle of the lake. You ask how you can help, but she can’t hear you. You realize that this situation is pretty bad.

But you are enthusiastic and optimistic. You try to jump in and carry her out of the lake. But this is her lake, and you can’t pull her out of it.

You feel confused and frustrated, but you keep trying. You bring her tools to paddle out of the lake, but she can’t reach them. You’re starting to panic a little, but you keep trying. You try more things, but nothing seems to help. You feel stuck and worried.

Then you talk to someone who gives you a good idea. You start to collect materials to build a small dock out into the lake. You build the dock out of patience, acceptance, understanding, empathy, and validation. Then you sit down on the end of the dock, put out your hand, and wait.

When she talks, you listen without trying to fix anything. You encourage her to talk about her feelings. And you stay there even when she can’t answer

When she feels ready, you stay right there. When she feels afraid, you validate her fears. You show her that you can tolerate her fear, and you are not going anywhere.

As she gets closer, you stay right there because you believe she can do this. And then, when she makes it onto the edge of the dock, you stay with her still. You give her empathy and acceptance.

The lake starts to shrink.

You stay there with her.

And then, one day, she feels better! The lake is back to being a little puddle, and she is outside of the puddle. Your support allowed her to find her own way out.

And now she is stronger than ever.

See Our Guide to Emotions And Eating Disorders