How to Have the First Conversation About Your Teen's Eating Disorder
The path to wellness starts with initiating the conversation.
As a licensed therapist specializing in adolescent mental health, I understand the deep concern and fear parents experience when they suspect their teen may be struggling with an eating disorder. Addressing this delicate issue requires empathy, understanding, and a willingness to navigate through the complex emotions that arise. In this blog post, I aim to provide guidance on how to initiate the first conversation with your teenager about their eating disorder, despite the potential challenges of shame, ambivalence, and denial.
Understanding the Challenges
Before diving into the conversation, it's essential to acknowledge the hurdles you may encounter. Teens often struggle to talk with their parents about emotionally heavy topics, not necessarily because they have a difficult relationship with their parents, but because shame is present and all-consuming. They may feel embarrassed or guilty, fearing judgment or disappointment from loved ones, so any conversation about the topic may be emotionally charged.
Let’s consider this scenario to help illuminate the challenges. Imagine coming home from a stressful day at work and having a glass of wine to let off steam. Ah, relief. It helps. One glass of wine a few nights a week, turns into two glasses of wine every day, which turns into a bottle of wine over time, and so on. All of a sudden, an alcohol use disorder is forming, and you’re no longer in control. A part of you knows something is wrong and wants to talk to your partner, but you don’t know how, and there’s this icky feeling that inhibits you from doing so. That icky feeling that feels like a bottomless pit in your stomach tearing you apart, that’s shame. Shame is powerful, and it often leads us to secrecy and isolation.
Now there’s another feeling that’s also present: the part of you that doesn’t really want to change. Enter: ambivalence. The wine is helpful; it releases stress and eases your emotional reactions. A part of you doesn’t want to give it up, because then you would have to feel the stress and deal with it, but you may not know how.
And wouldn’t your family be worse off if you were stressed all the time and over-reacting? Yeah, they don’t even notice your drinking that much, and if you were yelling at them because of stress, that would be much worse. Now, another thought has popped up: denial. Somehow you convince yourself that drinking actually helps your family rather than hurts them.
These are all common emotions and thought processes that show up with eating disorders. Shame is the isolating feeling that they may be alone in their struggle, or they don’t deserve to get better, or no one cares anyway. Whatever it sounds like, shame shuts done the pursuit of help immediately and keeps them in secrecy and isolation. Ambivalence and denial are common defense mechanisms that keep them in their disorder. They may downplay their behaviors or insist that nothing is wrong, despite clear signs indicating otherwise. It’s essential to understand these challenges that might arise when talking to your teen, so that you’re prepared to handle them if they show up.
Tips for Navigating the Conversation
Choose the Right Time and Place: Find a time when you and your teen can talk privately without distractions. Create a comfortable environment where they feel safe and supported.
Approach with Compassion: Begin the conversation with empathy and understanding. Empathy is the antidote to shame. Put yourself if their shoes and reflect back what you understand their experience to be. Let your teen know that you're here to listen and support them, no matter what they're going through.
Express Concern, Not Judgment: Avoid accusatory language or making assumptions. Instead, express your concern for their well-being and explain the specific behaviors or changes you've noticed that have raised your concern. By using specific behaviors, you can cut through potential denial or ambivalence.
Use "I" Statements: Frame your concerns using "I" statements to avoid placing blame or causing defensiveness. For example, say, "I've noticed you seem to be skipping meals lately, and I'm worried about your health," rather than, "You're not eating enough, and it's concerning."
Validate Their Feelings: Let your teen know that their feelings are valid, and it's okay to feel overwhelmed or scared. Reassure them that they're not alone and that you're here to help them through whatever they’re struggling with.
Listen Actively: Give your teen the opportunity to express themselves without interruption. Listen actively, validate their feelings, and ask open-ended questions to encourage further discussion.
Offer Support and Resources: Let your teen know that help is available and that you're committed to supporting them in finding the appropriate resources for treatment. This may include therapy, nutritional counseling, medical care, or support groups.
Initiating the conversation about your teen's eating disorder is undoubtedly challenging, but it's a crucial first step toward getting them the help they need. Approach the discussion with empathy, understanding, and a commitment to supporting your teen through their journey to recovery. Remember, you're not alone in this journey, and there are resources and professionals available to help you navigate through this difficult time.
If you are seeking eating disorder treatment or mental health therapy for your adolescent, Cypress Wellness Collective can help. Cypress Wellness Collective is located in the San Francisco Bay Area where they specialize in Family Based Treatment (FBT), therapy, and nutrition counseling for teens and families going through eating disorder recovery. Call today for your free consultation to see if Cypress Wellness Collective is right for you!
Relevant Research Articles
Ali, K., Fassnacht, D. B., Farrer, L., Rieger, E., Feldhege, J., Moessner, M., & Bauer, S. (2020). What prevents young adults from seeking help? Barriers toward help-seeking for eating disorder symptomatology. International Journal of Eating Disorders, 53(6), 894–906. https://doi.org/10.1002/eat.2326
Blythin, S. P., Nicholson, H. L., Macintyre, V. G., Dickson, J. M., Fox, J. R., & Taylor, P. J. (2020). Experiences of shame and guilt in anorexia and bulimia nervosa: A systematic review. Psychology and Psychotherapy: Theory, Research and Practice, 93(1), 134–159. https://doi.org/10.1111/papt.12198
Bottera, A. R., Kambanis, P. E., & De Young, K. P. (2020). The differential associations of shame and guilt with eating disorder behaviors. Eating Behaviors, 39, 101427. https://doi.org/10.1016/j.eatbeh.2020.101427
Savage, J., Fisher, J., Birch, L. (2007). Parental Influence on Eating Behavior: Conception to Adolescence. The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, (35) 10.1111/j.1748-720X.2007.00111.x