As a parent, you have been there for your child through thick and thin, and have always had your child's best interests at heart. If your child has always been a great kid, and now is diagnosed with anorexia nervosa and in an eating disorder program, you're probably just about going crazy trying to figure out what's going on inside your child's head, or what you did wrong as a parent.
Often the therapists or social workers involved in your child's case will make you feel like you've failed as a parent, or perhaps your expectations are too high. They may tell you this is a desperate cry for attention, and that perhaps you've been working too much and not spending enough time with your son or daughter. They may find some troubling detail in your child's artwork that suggests you really need to change your parenting methods.
My wife and I have been through all that and I never quite understood how many of these theories and conclusions could possibly apply to our child. It seemed like almost every passion our daughter had was misconstrued as an obsession. I recall one encounter with a therapist who said to me, "your daughter thinks of you and your wife more as a brother and sister than as parents. You need to be more of a father figure to her!" This conclusion was arrived at after spending only a few minutes with my daughter and only about five minutes with me.
All of us have shortcomings as parents and each child is unique. Some people who are terrible parents end up having kids who turn out great, some great parents have kids that turn out terrible. That's life. It is important not to blame yourself if your child has an eating disorder. You must realize that many of the assumptions therapists make about family dynamics are based on speculative theories that may have no bearing on what is happening in your family.
Typically, therapists start with the assumption that there is some family dynamic that is causing your child's disordered eating. This belief will determine how they interpret your child's behavior and even your behavior. Almost any type of stress in the family situation (death of a family member, changing schools, moving, divorce, working long hours, etc.) will be seen as a causal factor. They will also look for evidence of obsessive compulsive tendencies, so just about anything your child is passionate about may be misconstrued as disordered behavior (hobbies, sports, music, etc.). And, just about anything you are passionate about may be viewed as contributing to the problem.
Because these beliefs about eating disorders are so wide spread, even your friends may think there is something you should change in your family or in your parenting style. Friends would tell us that maybe we shouldn't insist on our daughter taking piano lessons, or that I needed to work less and spend more time with her. The type of magazines we read or television shows we watched may be a factor. It seemed everyone, with the best of intentions had an idea how we could improve as parents.
Family therapy and attending a support group may be beneficial for some, but it may also make you feel like you are part of the problem. You'll find many parents who've attended these meetings admitting "yes, we expected too much of our daughter", or "we were too controlling", or "my husband was too domineering". Some may become so indoctrinated through these groups that they will begin to sound just like therapists themselves. I have met many parents who have swallowed these speculative theories hook, line, and sinker, and who eagerly share these new beliefs with the same fervor as a religious zealot.
You as a parent should remain skeptical of these theories, because there is a significant probabliity that at the root of your child's eating disorder there lies some physiological problem that makes it very difficult to maintain a healthy body weight. If you ask most parents with an anorexic child, most will admit that the child does complain of stomach pain, bloating, nausea, early satiety, though many have been told that these symptoms are just from not eating enough. Some therapists will tell you that complaints of stomach pain are just ploys to avoid eating. I recall a visit with a pediatrician at one of Canada's top hospitals who after a quick five-minute assessment of our daughter, said it was important not to take these complaints of stomach pain seriously, since "anorexics will do anything to avoid eating and trying to starve themselves to death". This was even after an ultrasound had confirmed the presence of gallstones and a flat-plate x-ray had shown the colon to be fully impacted with stool. He added that "months of psychotherapy can be wasted when parents heed these complaints and start to pursue a second opinion or more medical testing".
You can see that there are some very dangerous beliefs entrenched in the medical community. If a physician does not listen to the patient, he loses one of the best diagnostic tools he has. Doctors must not dismiss complaints of abdominal pain, and should make every effort to request diagnostic tests to determine the problem.
Until the proper diagnostic tests are performed, you will never know if a chronic digestive disorder is the root cause of your child's appetite loss. You may think that your child is purposely refusing to eat, and that they seem obsessed with losing weight. If your situation is like ours was, mealtimes can become a "war zone", where most of the meal is spent arguing with your child trying to get them to eat. They may push their food around their plate, try to hide their food, or eat it then vomit it up later. Their constant activity and exercising may drive you crazy. This seemingly bizarre behavior however, is very likely caused by some digestive disorder that is making it very difficult for your child to eat. Your child may be totally unaware that there is anything wrong with them, for they may have adapted to the chronic condition over many months or years.
It is imperative that you request the proper diagnostic tests to determine if your child has a chronic illness (see medical tests). Of course, of utmost importance is the health of your child, and this may necessitate hospitalization for force feeding if malnutrition is advanced. This should be determined by your physician. In some cases, nutritonal counselling and cognitive behavioral therapy may be effective, but if your child has a serious digestive tract disorder, they will be in serious trouble.
The one thing I regret about our daughter's case is that I trusted the experts for too long. I should have insisted on extensive diagnostic testing right away. In the end, I had to make the arrangements for the medical tests to be done, against almost every doctor's advice. And even after these tests confirmed gallbladder disease, every doctor said this couldn't possibly cause anorexia. They were all wrong. In the end, we had to travel 3,000 miles to find a surgeon who agreed with me.
Our story has a happy ending. Our daughter is well and has regained all the weight she lost during her ordeal. She is healthy, happy, and living a full, rewarding life. We almost lost her because we trusted the experts. My heart goes out to those families whose stories did not end happily. I hope that this website may play a part in acheiving more happy endings.