Reactions of Carers to Eating Disorders
There are many possible ways carers respond to their loved ones who have developed an eating disorder. In their book Skills-based Learning for Caring for a Loved One with an Eating Disorder, Janet Treasure, Grainne Smith and Anna Crane (2007) developed animal metaphors to illustrate common behaviors and emotional responses that carers can get drawn into when caring for someone with an eating disorder. Loved ones may find themselves providing care that is characterized predominantly by one of these animal metaphors, while others may provide care characterized by several of the animal metaphors depending on the situation.
Kangaroo Care
Kangaroo care draws you in to protect the person with the eating disorder. You will find yourself accommodating the demands of the person of the disorder and protecting your loved one from any upsets. A downside of this is that the person with the eating disorder won't learn how to take on the challenges of life and gain independence. She or he can become trapped in the role of infant like a baby kangaroo enveloped in Mom's pouch. The message is that the world is threatening and it is the carer's job to prevent harm.
Solution: Step back a little. Let your loved ones fight for their own health and find out what they can do for themselves.
Rhinoceros Care
Because you are stressed, frustrated and exhausted you may adopt too much control and take over too much direction. Tempers may erupt and attempts may be made to change the eating disorder behavior by "charging" with arguments. You may think the eating disorder will understand and respond to logic. This does not work. The eating disorder is usually not rational. The more coercion that is applied, the more frustrated the carer becomes. The person with the eating disorder will likely respond to arguments and battles with hackles up and defenses mounted. Or she or he might obey out of fear of upsetting you but have developed no real "muscles" to keep the eating disorder in check.
Solution: Recognize that eating disorder beliefs are rigid and tightly protected. To avoid building resentments, let go of coercion and trying to force a change. Try the dolphin approach. Step back and calm down. You can say you don't agree with the behavior of the eating disorder and at the same time respectfully agree to differ.
The dolphin response
Rather than falling into the extremes of the Rhinoceros or Kangaroo, try modeling a dolphin. This way you can nudge the person with the eating disorder to safety instead of trying to force her or him to give up the safety of the eating disorder. Dolphins coach and gently persuade. They may swim ahead or alongside. When the person with the eating disorder is making progress the dolphin may simply swim behind.
Emotions of carers
The emotions of carers can be overwhelming and difficult to handle. Here are some animal metaphors developed by Janet Treasure, Grainne Smith and Anna Crane to describe different emotional responses of carers to eating disorders (Treasure et al, 2007, Skills-based Learning for Caring for a Loved One with an Eating Disorder. London and New York: Routledge.)
The ostrich
Sometimes family and friends take the "ostrich approach" when dealing with the eating disorder. In the midst of distress there may be temptation to ignore or underestimate the impact of the eating disorder on the person with the eating disorder and on involved carers. Carers taking the ostrich approach may find themselves disconnecting. They may avoid going home or otherwise dealing directly with the problems created by the eating disorder. Families may feel ashamed and secretive. They may isolate and not reach out for help. They may blame the person with the eating disorder and say, "It is your problem, not mine."
Solution: It is best to work to reduce avoidance and escapism. Eating disorders are family affairs. They affect friends and everyone who cares. Eating disorders are diseases of disconnection. To reduce isolation and loneliness, work to increase connection and communication. Reach out to help and support.
The jellyfish
Sometimes family, friends and carers experience an overwhelming intensity of emotions. They become too sensitive about the eating disorder. They feel like a jelly fish because they are "engulfed" in their emotions and feel helpless and adrift. For parents, this can come from self-blame for the eating disorder. There may be a great deal of self-criticism related to mistaken beliefs that poor parenting has caused the eating disorder.
Solution: Learn to harness anxiety and manage emotions. This takes time and patience. Carers often need their own support to prevent burn-out and exhaustion.
The St. Bernard dog
Carers who are St. Bernards find themselves in an optimal position. Carers are often overwhelmed at first. However, with time they can adopt the calm and steady nature of the St. Bernard. When this happens, they become warm, caring, consistent, available, and nurturing. It is hard but parents and carers can learn to respond in an even, consistent, loving fashion even though the situation may be dangerous and frightening. A loyal and helpful St. Bernard seeks the lost loved one with the eating disorder. He is a good listener and provides empathy for the struggling person with an eating disorder.
