In this story we take a look at parent coaching for an adult child who has anorexia. We meet Lee, mom to Olivia, who was diagnosed with Anorexia Nervosa at age 13. Lee can’t sleep, and refuses to speak with Olivia until she gets treatment for her eating disorder. But Olivia is 26 years old, and cannot be forced into treatment. Their relationship is suffering, and this dynamic is making things worse, not better. Lee needs help.
The background story
Lee’s daughter Olivia was first diagnosed with anorexia nervosa at age 13. Lee and her husband sought treatment as soon as they could, and Olivia was hospitalized and then underwent residential treatment. The entire family sighed in relief when Olivia returned home, supposedly in recovery from her eating disorder.
But it wasn’t that simple. Olivia still struggled to eat and hid her low weight from her parents by wearing baggy clothing and avoiding them. “We just hoped things would get better,” Lee said.
Olivia left for college and seemed underweight. Her family was concerned, but she refused treatment. After college, Olivia left the U.S. for China, where she got a job and seemed to appreciate being far away from her concerned parents.
Parenting a young adult in eating disorder recovery
Today Olivia is 26 years old and has returned home from China. She seems very thin, and Lee is deeply concerned about her daughter’s health. “I worry every minute of every day,” she says. “I just need her to get over this, realize how beautiful she is, and move on with her life.”
Olivia insists that the problem is that she has digestive problems. She completely refuses that her eating disorder is problematic or even exists. But many visits with gastrointestinal specialists have cleared her of any medical diagnosis. Lee feels like she is watching her daughter waste away, and she feels powerless to help her.
“Mom, why do you treat me like I’m a problem?” says Olivia. “You never appreciate who I am. I’m successful, I’m smart, but all you can do is obsess about my weight and eating.”
Olivia says that the eating disorder treatment center was a traumatic experience for her as a person of color and absolutely refuses to enter another treatment center. Parents who have adult children with anorexia have a much harder time enforcing the structure and support or insisting upon treatment. Sometimes the only path forward is to build a relationship of trust and support into which the adult child may seek recovery on their own.
So while Lee can continue to worry and complain about Olivia’s weight and eating, she is only driving her daughter further away from her. Thus, Lee’s task as a parent – the only thing she can do to help her daughter get healthy – is to focus on their relationship.
The parent-child relationship
So I asked for some more information about Lee and Olivia’s relationship. As with many mother-daughter relationships, there’s a long history of Mom seeking a relationship and feeling rejected. When Olivia was hospitalized, Lee was terrified that she would die. Her father and brother both died when Lee was young, and she has residual trauma about those events.
She became obsessed with watching Olivia constantly for signs of the eating disorder. She prepared elaborate meals and watched Olivia eat anxiously.
All of this makes perfect sense, but the trouble is that Olivia felt resentful and resistant to her mother’s pressure. She pulled away. The more she pulled away, the more insistent Lee became. When we started talking, Lee had decided that she would not speak with Olivia until she enrolled herself in residential treatment for her eating disorder. Since Olivia refused, they had not spoken in weeks. Lee was beside herself.
“You try to control my life too much,” says Olivia. “You are trying to push me into a treatment center, but you are not understanding me.”
Lee can’t sleep. She went to the doctor because the stress is becoming too much for her. She can’t do anything but think about Olivia’s weight. “I can’t be nice to her,” Lee says. “If I do that, she’ll think I approve of the eating disorder.”
Parent coaching for an adult child who has anorexia
Together we explored the mother-child relationship and I helped Lee understand more about anorexia, parenting, and separating what she can do from what she cannot control. Importantly, Lee can build her relationship with Olivia, but she cannot control her weight or eating.
Once this was clear, we came up with strategies for improving the parent-child relationship. Lee began reaching out to Olivia without focusing on her weight and eating habits. We practiced releasing her fear before and during encounters with Olivia.
Olivia had desperately missed her mother. While she was reticent at first, she gradually accepted her mother’s love and care when it came without strings. Coaching helped Lee and Olivia build a loving, supportive relationship. It is within relationships like these that children heal from eating disorders.
What we worked on in parent coaching for an adult child who has anorexia:
- There are many paths to eating disorder recovery. People can recover outside of eating disorder treatment centers.
- Lee’s insistence that Olivia enter a treatment center was interfering with their relationship and was not improving Olivia’s condition.
- Lee cannot control Olivia’s weight and eating, but she can improve their mother-child relationship. By focusing on what she can do, Lee made strides toward reconnecting with her daughter and increasing her parental influence.
- Parents can make a tremendous impact by building a safe, loving family relationship for children at any age. This relationship may become the platform upon which recovery occurs.