Eating disorders are not solely about food and weight as many believe, food and weight is only the symptom of the disorder. Rather, it should be seen that the disorder is an attempt by the sufferer to assume control of some part of their life which to them seems out of control.

The domino effect for parents, spouses and family members can be extremely difficult, resulting in many confused emotions such as anger, inadequacy, helplessness and many more.
Parents, spouses and family members often feel the above emotions for many reasons.

Firstly there is the lack of knowledge about psychological eating disorders as the media portrays that the illness is primarily about food, weight and image. Secondly, there are misconceptions with regard to treatment i.e. psychotherapy, psychiatry and the use of medication in treatment and thirdly the duration of recovery. Because of this, those closest to the sufferer often tend to blame themselves for the illness and then take it upon themselves to make it better. By doing this they become self involved in the illness and therefore try to control it. 

This is because parents, spouses and family members are unable to cope emotionally and if we can fix-it then we do not have to cope with it.
This method results in creating more distress to the sufferer, it prohibits the sufferer from developing any form of emotional growth and causes the severity of the illness to increase. We have found in research time and time again that parents, spouses and family members do not look at themselves because of their own fear of recognition, but rather choose to blame the sufferer for the emotions that they are faced to deal with.

We do not believe that parents, spouses and family members are responsible for the illness, but their emotions both consciously and unconsciously certainly are a contribution and need to be addressed.  
While parents, spouses and family members have the need to address their own emotions they must also realize that their goal is not to be in control of the sufferers emotions but to rather teach the sufferer self-control. In order to address ones own emotions one must understand how emotional control works.
 
Emotional abuse and emotional control are very similar. Emotional control is often an unconscious movement while emotional abuse is done to hurt someone's feelings intentionally. They both cause severe damage to the sufferers self confidence.
Here are some examples of emotional abuse.

Look at your sister, look what she has achieved, you have dropped out of university twice. This remark makes the person feel a failure, it just adds to the low self esteem.
All your friends are as bad as you, why don't you find some decent people to hang out with. This remark tells the sufferer that she is a bad person, she is already vulnerable and believes what you have said.

I am pleased you obtained eighty nine percent in the test, what happened to the other one percent. As is, the sufferer has not achieved the percentage he/she wanted, obviously everyone would prefer ninety percent as it looks better, and all you are doing is reducing him/her to a fruit cake.

The latest addition is the cell phone or mobile phone opening sentence. 'Where are you' This is often a violation of a persons independence. This phrase is often used because the caller has the need to know the whereabouts of the person in order to satisfy his or her own needs. If the phrase is used in a sentence to meet someone, then it would be appropriate.

Emotional control is when someone's feelings are controlling another's feelings directly or indirectly. There are many examples, however we have listed a few. 

Divorced parents often use their child/children as a way of communication with one another. During the break up of a marriage or a dysfunctional marriage a parent or parents download their negative emotions on their children. The child then takes on the adult role and tries to make things better in the family.

A close family without boundaries causes emotional control. This is when the sufferer is unable to break away emotionally from the family. Even when he/she is married or lives alone, the sufferer has the need to obsessively phone his/her parent/s because if she/he does not then she/he is made to feel guilty. Comments such as 'I don't remember what you look like', 'Have you left the country', I raised you from birth and gave you everything can't you even phone me'.

Often you get a reverse situation where a parent/s or spouse obsessively phones the sufferer. This is often done because a parent/s or spouse feels insecure. We have found in our research that parent/s who have the need to control sufferers have very few friends and no social life. Their life revolves around their family.
 
When sufferers recover they become emotionally mature, make their own logical decisions and lead an independent life. Recovery is often seen as a threat to spouses and parents. Sadly we have found that some parents and spouses prefer the sufferer to remain in the illness because they are afraid that recovery will allow the the sufferer self independence and they will no longer depend on the control of their parents or spouse. 

Overprotection denies the child emotional independence and causes emotional control. 

Sadly many parents are unable to cope with their own emotions. As the child gets older they are unable to let go and allow the child emotional maturity. They rely on the child for emotional support and in so doing they diminish boundaries. Over years the adult child becomes the best friend to the parent/s. The Parent shares all their personal issues with the child and demands that the child shares all personal issues with them.

The lack of healthy boundaries continues even when the child is married, without even realizing the effect it has on their partner. They know no better and believe it is ok to share everything that goes on at home, interfere in the marriage. When confronted they deny what they are doing.

Often you hear the remark " I have a good relationship with my daughter she tells me everything." The good relationship may be one that is extremely unhealthy with no boundaries. If the daughter does not share and satisfy the needs of a parent then guilt is used as a weapon.

The sufferer often feels that it is his/her responsibility to protect a parent that is emotionally insecure and in so doing takes on the adult role. This is often done to avoid guilt which is one of the most difficult emotions for anyone to deal with.
  
People often feel low or withdrawn at some stage of their life and need their space. We find that often a parent or spouse pressurizes the sufferer into telling them what is wrong. This is done because the parent or spouse has little or no coping skills to deal with the emotions of a close family member.

Parents and spouses often overprotect the sufferer because of their own insecurity. This causes emotional control.
Emotional Control prohibits the development of coping tools and strategies and does not allow an environment for recovery.

Question yourself, do you feel you have the need to control your child or spouse to satisfy you own emotional needs. If your answer is yes then seek help from a professional. Even if your answer is no, re-evaluate your answer as we have seen so many cases where emotional control exists in families and is being denied.
 
To overcome emotional control you would have to allow the sufferer to deal with his/her emotions by allowing self respect. Teaching self control is often done by setting examples of being in control of oneself.      
When parents, spouses and family members are not part of the sufferers life during the eating disorder recovery they can then also become part of the problem.

Parents, family members and spouses need to remain in a presence in the sufferers life by spending time together, by listening actively and making an effort to understand the illness, lending their wisdom, judgment and values in a new healthy way and allowing sufferers to make their own decisions even if you think it may be a wrong decision. (Age appropriate) They have the need to learn about the illness, by reading books, attending family support group meetings and often seek their own counselor or psychologist.

Psychologists, psychiatrists and treating clinicians often tell sufferers that they come from an emotionally controlled environment or dysfunctional family which is seen by any clinician as an obstacle towards recovery. When you treat a sufferer of an eating disorder you are in fact treating the family, something that no individual therapist is able to achieve. 

Part of unconditional recovery is gaining the sufferers trust and in doing so the therapist may not violate confidentiality between client and therapist. Because of this, it is advisable that the therapist should not communicate with either parents, spouses or family members without the consent or presence of his/her client. The therapists prime objective is to assist the sufferer towards his/her recovery. Should a psychologist break the privacy between therapist and client then there is a chance that the sufferer will no longer trust the therapist, which then will effect recovery.

All communication by parents and spouses with the treating therapist must take place in the presence of the sufferer and with the permission of the sufferer regardless of his/her age. It is also not ethical for a treating clinician to involve himself/herself in the treatment of any member of the family that is associated with the sufferer.

If parents and spouses can understand the necessity for this, then perhaps one can alleviate the anger towards the therapist. Often anger is formed because parents or spouses are unable to approach or communicate with the therapist regarding their loved one in obtaining a suitable answer that meets their own needs. 

It is important to understand that we are each personally responsible for our own feelings and if the therapist does not respond then we must respect the wishes of the therapist and accept his/her ethics. 

  
Psychologists often suggest (Age appropriate) that it would be in the interest for the person with the disorder to leave home. Parents and spouses often take exception to this type of suggestion. We believe that it is grossly misunderstood and needs to be corrected in its right content. There are many factors for this approach, but do realize that they are all in the interest of the person suffering from the disorder and ultimately their recovery. 

This suggestion may cause many negative emotions within the family, such as anger towards the therapist and guilt that many have failed as parents. Some see this, as a form of rejection, alienation and blame.

However it is important to realize that this suggestion is aimed at allowing the sufferer to break emotional ties with his/her family, something he/she desperately needs to achieve in order to begin the long road towards recovery. For reasons beyond the sufferers control he/she may not be able to achieve this in the present environment. 
Be careful! as those that sufferer from the disorder often use this opportunity to turn parents or spouses against the psychologist.  Perhaps an ideal way of eliminating therapy.

As children get older and they mature, one must realize that the quality of connection between child and parent must change. Part of change is allowing the sufferer to develop his/her own coping strategies. These strategies are developed by allowing the sufferer to be in control of his/her own decisions, allowing him/her to make mistakes, correcting those mistakes in a way that allows the sufferer to take personal responsibility for them. Condemning mistakes is an act of destruction with devastating consequences not only for a child but also for a adult. 

Most sufferers are vulnerable and seem to allow parents, spouses or even friends to control and influence their thinking processes. Both of these methods prohibit the development of healthy coping strategies to deal with their own emotional feelings. Most that suffer from the disorder fear accepting personal responsibility because they fear making mistakes. In time they will learn that accepting personal responsibility for mistakes contributes towards emotional growth which results in emotional maturity. 

 
Our research has shown that many parents and spouses have themselves developed unhealthy coping strategies during childhood. We have often found severe anxiety in either both or one of the parents, a low self image and very often a form of perfectionism. The perfectionism often camouflages the first two and causes outsiders to think how well parents and spouses are in control of their own lives. 

Sexual abuse is the second highest contributor to Psychological Eating Disorders and we believe this is as a result of the sufferers vulnerability in not being able to say no. Many parents or spouses were victims of alcohol or sexual abuse in their own families. Sadly many sufferers are victims of alcohol and sexual abuse. As they become parents they themselves form a protection barrier and unconsciously overprotect their children. Sufferers often feel they deserve the sexual abuse.

Many questions have been raised by parents and spouses in support group meetings over the past years. One being how do we create an environment for change. It would be very difficult to answer this question without knowing the family dynamics of each individual family. However creating an environment for recovery means changing your own way of thinking.

You must realize that we are each responsible for your own way of thinking as well as the emotion that we choose. No matter what the sufferer says and does you are responsible for the way you react. If you choose to get angry, you will respond with anger, then again if you choose to get anxious you will respond with anxiety. If you choose to reply in a healthy confident manor you will then only achieve your objective.

How does one respond in a healthy way? Easy, you make it your business to learn as much as you can about the illness, attend family support group meetings, read books and literature and if necessary see a professional. In time you will make those changes that are necessary to create a climate for recovery.

Remember! by you changing your own way of thinking your can become a model of excellence to others. How long does this take? Years of learning, understanding and realizing that although you are a parent or spouse you will continue to learn and accept that learning is a ongoing process which leads to change. Apologizing, for something you said or did is also a way of earning respect.

It would be unfair to claim that you know everything about the disorder as you have never been through the emotional pain that the sufferers face day to day. Acknowledge the pain that the sufferer experiences both throughout the illness and recovery and also encourage the sufferer to remain in treatment. Encouragement is not telling the sufferer to remain in treatment but rather to allow the sufferer to make the decision to remain in treatment.

A suggestion would be. 'It is so sad that you wish to quit treatment but then that is your decision.' By using this phrase or something similar you are respecting the sufferers choice, you are showing that you do not necessarily agree with the decision, which allows the sufferer to reconsider. 

If you become anxious and try to convince the sufferer to remain in treatment, partly because this may alleviate your own anxiety then you will not achieve your objective, in fact you may achieve the opposite. Besides medical issues related to the disorder allow the sufferer to make his/her own decisions. 

Trust is also an important issue, and it is suggested that you respect the sufferers confidentiality if asked to. Honesty is also an important ingredient in creating an environment for recovery. If a parent or spouse says or does something that is incorrect remember to apologize, by doing this you are showing the sufferer that one can apologize and not necessary feel guilt.

We are all human and we make mistakes from which we learn by acceptance. Not only will you create trust but earn respect. Covering mistakes creates mistrust, and can take weeks to months to correct. Never demand respect-parents, spouses or family members must earn respect. If your child or spouse has made a mistake do not pressurize him/her to apologize, rather try to understand that sufferers have a extremely low self esteem and making mistakes is seen by the sufferer as being extremely negative, they sadly regard themselves as a total failure.

Try to analyze your own feelings and fears, communicate them to the sufferer without making the sufferer feel guilty, and remember that you are responsible for your own thoughts and feelings. Use the word 'I' e.g. "I am feeling so anxious that something may happen to you." If you use the word 'You' then it would sound like this. "You are making me so anxious thinking that something could happen to you" The later remark imposes extreme guilt on the sufferer and you can well imagine a negative response.

  
Power struggles achieve nothing in fact they cause further distress to yourself and the sufferer. Realize that you as the parent or spouse should remain in control and if necessary end any abusive discussions by saying, "I do not wish to continue with this discussion until we both have cooled down." Realize that this method of approach allows for a cooling period enabling you both to reconsider your method of approach.

You will need to confront the issue at a later stage in a calm manor. All issues need to be addressed and must not be ignored. Do not neglect the needs of the sufferer even as illogical as it may seem to you, remember it is logical to the sufferer.

Manipulation is something that is part of the sufferers profile. Children often try to manipulate their parents, however there is a degree of manipulation and we have found that sufferers from obsessive compulsive disorders have a higher degree of manipulation than others. In order to create an environment for recovery both parents and even spouses must be consistent when making decisions. If this is achieved then the degree of manipulation becomes less. 

Never make promises that you are unable to fulfill. Do not threaten the sufferer with something that is beyond your control. We have found that parents of most sufferers have little or no consistency within their own relationship. 

 
Sufferers often develop behavioral disorders that result from many negative emotional feelings that are being contained and not being expressed. During childhood children are taught to express feelings both negative and positive by verbalizing them to their parents. Sadly some children were unable to get a response from their parents that met with their needs, often the reason being that some parents responded by telling their child how he/she should think rather than allowing the child to think for his/her self. If a child is taught life skills at an early age then he/she will develop healthy coping strategies for later life. 

If the child or adult is unable to communicate with a parent or parents then emotions are redirected towards themselves in a negative manor. This often causes passive anger.
Sadly they often believe that they are not up to the parent or parents expectations and they begin to seek self recognition by unhealthy methods. Perfectionism and academic achievement artificially lift the low self esteem, creating a false feeling of acceptance and recognition.

Sadly sufferers are often seen as the perfect role model child always pleasing everyone excluding themselves, constantly receiving recognition throughout for their perfect behavior or perfect achievements. They do not realize that directing negative emotions towards themselves causes self destruction. They believe that they are worthless and deserve the pain that they are constantly feeling.

Time and time again we see how sufferers protect their families and refuse to acknowledge or accept that they are the victims of a dysfunctional environment. 
Those that suffer from Anorexia and Bulimia often develop behavioral disorders whereby the sufferer is constantly in conflict situations with his/her parents or spouse. Every situation is blown apart with negative feelings of anger. The reason for this is that the sufferer has not developed healthy coping strategies to deal with anger and guilt. He/she believes that they are not loved by their parents, family, friends or spouse, and in order to get recognition they resort to screaming, yelling and temper tantrums even if that causes negative recognition, it is still recognition.

We have found this behavior in many adolescence, teenagers and adult sufferers. 
There is often resistance to giving up the illness. As illogical as it may sound, this is normal to the sufferers way of thinking. The illness has been responsible for making the sufferer feel better about him/her self and allowed the sufferer some control in certain aspects of his/her life.

This article is not about who is to blame nor who is responsible, it is about taking personal responsibility, learning to look at oneself with an objective view point and making positive changes to ones own way of thinking. 
Those parents and spouses that make changes to themselves, set limits and boundaries, who listen, who communicate, who actively CARE ABOUT the sufferers illness and present a united front as partners, against the illness and in favor of the health and the success of their child or spouse - have the potential to become a powerfully positive influence on recovery.

Those parents and spouses who CARE FOR the sufferer illness become caretakers, creating their own self destruction.
Creating an environment for recovery takes time, understanding and patience. There are many factors in family dynamics that need to be addressed. When change does take place there is no guarantee of immediate transformation, in fact things may become worse before they get better. It is important to understand that the changes you are making are for your own benefit. It should be your aim to become a better person or partner. If you believe that you are forced into making changes you will not succeed in creating a climate for recovery nor will you become enriched. 

A Message to Parents.

You taught me all the cities in the world but
I don't know how to survive the streets in my own city.
You taught me all the minerals that are in the earth but
I don't know what to do to prevent my world's destruction
You taught me how to speak and write in several languages but
I don't know how to say what I feel in my heart.
You taught me all about the reproduction of animals but
I don't know how to prevent pregnancy
You taught me how to solve my mathematical problems but
I still can't solve my own emotional problems
Yes, you taught me many facts - and I thank you - I am quite clever now - but
Why is that I feel I know nothing?
Why do I feel that that when I leave school I have to learn to 
cope with my life?
Anon.