EATING DISORDERS: PRACTICAL TIPS ON HOW TO INTERVENE

Plan your strategy: Think about who should approach your daughter. The mother alone? The father? Both? Whatever your plan, be sure you present a strong, unified front.

Get your facts straight: Be sure your daughter does indeed have an eating disorder, and isn’t just spending too much time in the bathroom combing her hair. If you have doubts, bring them up in a nonjudgmental way. Keep at it until you are satisfied that your daughter is not endangering herself.

Know the problem: Bone up on the subject. Become as well informed as your daughter is.

Know the solution: Find out about treatment facilities in your area and meet with caregivers. If you don’t like their approach, keep hunting. A list of resources appears on page 216.

Choose your words: Think about what you will say. Rehearse it. Imagine the conversation and prepare answers to any objections.

Set the stage: Decide when and where to confront her. Don’t act on impulse. Wait for a moment of calm, a time free from distractions-not, for example, ten minutes before Thanksgiving dinner.

Plunge in: Once you’ve made your plan, stick to it. Every day you delay, the disorder gets worse.

Show your concern: Make it clear how you feel. Tell your daughter you love her but are concerned. Tell her she needs help, and why. If she says, “There’s no problem,” you can say, “I don’t accept that. I’m worried, and I just can’t look the other way when I see that you are hurting yourself.”

Make “I” contact: Focus on how the problem affects you personally. Say, “I notice that you spend a lot of money on food,” or, “I’ve heard you vomiting after dinner, and I feel very concerned.” Show her how you feel. Doing so, rather than telling your daughter that she is “weak” or “bad,” can reduce her tendency to be defensive.

State the goal: Your goal is to get help; stay focused on this goal. Tell her, “I have looked into it and I know help is available. If you’ll see an expert, I’ll do everything I can to support you.” No matter how carefully you word it, however, an anorexic child will probably think you just want to make her fat. Reassure her that the goal is to overcome her fear of fatness and help her cope with difficult feelings.

Don’t criticize: Avoid commenting on her appearance. You may think you are making helpful statements, but she may take them as criticisms. For example, when you say, “You’re looking healthier,” she may interpret your remark as, “You’re getting fatter.”

Listen!: Listening is hard work. Your feelings may be so strong that you have to resist the temptation to interrupt or make judgments.

Acknowledge her fears: For her, gaining weight may be scarier than dying. She may be terrified of being cooped up in a hospital or of being force-fed. Don’t say, “There’s nothing to be afraid of.” Better to say, “I understand how you feel. A counselor can help you conquer those fears.” Denying her feelings is something she does too much of already.

Be realistic: Treatment won’t necessarily cure the disorder. It can teach other ways to think and behave. “Cure” comes as the patient applies those methods over time in different situations. Also, some anorexics fantasize that they can eliminate symptoms without restoring weight. Not true.

Keep plugging: You may not succeed at first. Be patient. Don’t let the subject drop. If you keep at it, you add to your chances for success. Sometimes the danger to your daughter may warrant taking increasingly serious steps. Cut off her allowance; ground her; keep her home from school. If this doesn’t work, you may find it helpful to get professional guidance to develop another strategy.

Stop “enabling”: If you’re not helping your daughter, then you are enabling her to get worse. Shift the responsibility to her. If she binges, she must replace that food. Make her pay for it, too. If she makes a mess of the bathroom, she must clean it up.

Make yourself available: Make sure she knows you are there to help. Open the lines of communication-not just about her disorder, but about anything that concerns her. Tell her, “I know you’re going through a hard time, I’m here for you, I want to help.” Of course, families who aren’t very supportive can’t change overnight. They may need therapy themselves. But it’s worth the effort.