Today we’re going to talk about a child who has returned from being in treatment for an eating disorder and is now unmotivated for recovery.
I’ll talk through what this parent can do to help her child stay on the road to recovery and discuss an important technique to help with emotional metabolism, which I think is key to full recovery from an eating disorder.
My daughter is 17. She came home from treatment three months ago. At first, she was really motivated and following her meal plan. But now she refuses to go to therapy, and she often goes all day without eating. She spends all her time in her room, never coming out. She seems completely unmotivated to stay in recovery from her eating disorder. What should we do?
Amrita, I’m so sorry to hear this. Unfortunately, this is a major challenge with eating disorder treatment. People can attend treatment and make some nice progress. They can gain weight if needed and get their behaviors under control.
But unfortunately, most people who leave treatment are still in the early stages of recovery, so the behavior you’re seeing with your daughter is not uncommon.
So let’s try to think about what you can do to support your daughter right now. While it’s very normal, being unmotivated in eating disorder recovery can get in the way of fully healing.
I would say one major goal is to get her back to eating regularly. Someone in recovery should really be eating 3 meals and 2-3 snacks every day. This applies to all types of eating disorders.
Eating disorder recovery rests on nutritional intake, so while it can feel like a lot, this step really can’t be skipped. So I’d like to know if you can adjust your schedule to eat meals and snacks with her throughout the day.
I know this can be a lot to ask, so please know that I realize it’s not always sustainable. But if there is any way at all that you or another trusted family member can eat with her 5-6 times per day for the next three months or so, that’s what I would recommend.
It’s a real challenge that eating disorder recovery requires so much of parents, but this is one of the most important steps you can take to help her. See how you can get her eating regularly, with you or someone else, every day.
A helpful approach
Now I certainly understand if you feel unmotivated to help her get through this part of eating disorder recovery. You may dread meals with her because eating is so full of drama right now. I get that, but that’s something we would really want to work on – somehow, we have to find a way for you to reconnect with her and build a safe, loving relationship.
If you have to force her to come to the table and spend 10 minutes grimly sitting together while she resists your best efforts to get her to eat, that’s just not going to work very well. You’re both going to get really tired of that, really fast. It’s just not sustainable.
Instead, I think it’s a good idea to think about your meals and snacks with her as opportunities to connect with someone who you love and want to spend time with.
Mindset is important here. And it’s important for me to say that I don’t believe parents should be abused and yelled at during meals. That’s unacceptable behavior that I put boundaries around really fast.
But if what’s happening is more about grumpiness and resistance, we can work with that.
Because remember that grumpiness and resistance are natural behaviors for anyone who is doing something that they’ve been asked to do that they don’t want to do. I think a lot of us forget that our kids should seek respect and assert their own opinions and wants. That’s a part of being a healthy human being.
Focus on mindset
I know it’s natural to focus on the food, but it’s also important to focus on your mindset and the environment you’re setting. Are you relaxed? Are you happy to see her? Are you curious about how she’s feeling? The more you can attend to the environment and keep it relaxed, the more likely she is to start eating.
And maybe, hopefully, gradually, you can start to enjoy each other and your meals together.
Back to therapy
Moving on to therapy, a lot of people who are in eating disorder recovery resist therapy. There are a lot of reasons for this. First, there could be a poor match between the therapist and your child.
Another reason people don’t like therapy is that it’s hard.
True recovery involves learning to metabolize feelings all day, every day, and that’s hard for someone who was avoiding their feelings with an eating disorder. In fact, I would say that once basic nutrition is met and a person is metabolizing the nutrition they need, the next hardest thing to do is metabolize feelings.
The eating disorder was acting as a stand-in for emotional metabolism. So to leave the eating disorder behind, your daughter needs to learn other ways to metabolize how she feels.
This is what therapy is really about – learning new ways to metabolize feelings.
So keep working with her and keep trying to find a therapist with whom she respects and feels safe. The fact is that without ongoing therapy, it’s very hard to hold onto eating disorder recovery because it’s just too tempting to use the eating disorder again when bad feelings pop up, which they inevitably will.
Now, here’s how you can help with this at home.
Just like dental hygiene, emotional hygiene is the daily effort of taking care of our mental health by noticing, labeling, and processing feelings.
Let me walk you through an example.
Let’s say that you’re sitting down for the fourth time in a day to eat. You may notice that you’re having some feelings, and the giveaway is that you’re snapping at her. Now label some of the feelings: I’m feeling irritable and snappy, and if I’m honest, I also feel a bit resentful that I have to do this all the time.
Now that’s great! You just noticed and labeled your feelings!
There is no shame in feeling feelings like this. We all have feelings, good and bad, all day. And the worst thing to do is ignore them or squash them down. When we do that, we’re almost guaranteed to have them leak out in a destructive way. Instead, we want to metabolize all the feelings, good and bad, without judgment.
So let’s talk about the third step – metabolism.
Maybe you have done that mindfulness exercise where you chew a raisin really, really slowly and notice each bite? That part – the chewing – is like noticing and labeling feelings. It happens in your head.
But now imagine that you swallow the raisin and feel it go into your stomach. We want to imagine how the raisin feels in your body – below your head.
When we want to metabolize feelings, we start by noticing there’s a feeling, then labeling the feeling. This happens in your head.
But then go deeper. Focus on how the feelings feel in your body. Do you feel tension, heat, or coldness anywhere? Zero in on where and how you feel your feelings in your body. The mistake most of us make is keeping feelings up in our minds, never letting them metabolize through our bodies.
It’s sort of like chewing food but never swallowing it. You’ll have some really serious side effects if you keep digestion limited to your head.
So feel the feelings in your body, and let them exist.
Do this a few times, and you’ll start to notice that they move around and fluctuate. And another thing: they always move on. No feeling is ever permanent. That’s just not how they work.
So I’d like you to practice this by yourself. Practice noticing, labeling, and metabolizing feelings. And then, when you feel like you’re getting a bit better at it, try talking to your daughter about it.
Start small – by helping her notice a feeling. “Hey, I notice you’re a bit snappy right now.” And if she seems even slightly open to saying more, try helping her to label possible feelings.
Like, maybe you’re feeling a bit run down after this long day, and maybe you’re irritated that I asked you to unload the dishwasher. In this way, you’re helping your daughter start to notice and label her feelings.
Stay there for a bit, just make it safe for her to have these feelings in your presence. Some advice I have is that you shouldn’t try to change or debate these feelings.
Just let them exist.
So if you’re talking about the dishwasher, don’t say “it only takes 5 minutes!” or “you know that’s your responsibility!” I know how tempting that is, but when we do that, we aren’t making it safe for our kids to feel their feelings.
We’re trying to get them to move on from their feelings. And this is super-important because we want to be a safe place where our kids can feel their feelings without feeling defensive.
When our kids feel safe feeling their feelings, then they don’t need their eating disorder to process them. Of course, we can’t do this all by ourselves – they have to also do their work with their therapist.
Keep it up
I have seen stunning turnarounds when parents implement this one practice. The simple act of allowing and labeling feelings without an argument can transform a child’s life. And it can really help when someone is unmotivated during eating disorder recovery.
Once your child gets more comfortable with sharing feelings with you, you might even ask some questions that will help her metabolize those feelings. For example, “how does anger feel in your body? Does it show up hot, tight, tingly, or slippery?”
And then leave space for her to think about it and possibly even feel it.
I believe this is one of the most important things a parent can do when they have a child who has an eating disorder. And I’ve seen the transformative results. It really works!
Amrita, I know this is a difficult, challenging time for you.
I hope you can reach out for some support from your child’s therapist to help with the eating and therapy issues. And I wish you all the best as you keep traveling the path of recovery together.
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