Helping Your Family Help You

A Few Ways to Speak to Your Family About Supporting You After Graduating from Residential Eating Disorder Treatment

If you’re reading this, you’ve probably gone through a residential eating disorder program – or are close to someone who has. If it’s the former, we hope you can use some of these ideas to help your family and friends better support your recovery. If it’s the latter, we hope you can gain a greater idea of how to provide that support.

Eating disorders aren’t like catching the flu; you don’t just go to the hospital and walk out “cured.” You or your loved one will likely take advantage of a “step-down” program like a Partial Hospitalization Program (PHP) or Intensive Outpatient Program (IOP), or another form of day treatment. You’ll almost certainly take part in alumni groups, in person or (more recently) online. These programs are great, and professional help furthers your recovery, but they can’t provide the 24/7 support you experienced in residential treatment.

That’s where your family and closest friends can step in.

Talking about mental health disorders isn’t easy in any circumstances. Even common mental health disorders like depression are often anathema. The stigma society places on mental health makes talking to family or close friends about it a rare occurrence, and they may not be completely prepared to support you. Especially after spending time in residential eating disorder treatment, you might be used to a world in which recovery from eating disorders is the sole focus of everyone around you.

To help them help you, there are certain ground rules and expectations you can set. By helping them understand some of the things you learned in treatment, and how they can act and talk to you in a recovery context, you can make your bonds with them even closer, and they can feel secure they are helping you recover successfully.

Setting Ground Rules and Helping Them Give You Support

The first thing to do when asking your loved ones for support after graduating from a residential eating disorder treatment program is to understand where they’re coming from. Even if they do participate in family therapy provided by the treatment center or a family therapist (and they should, as we discuss later), your closest loved ones haven’t been living in that milieu for 30 days or more. They probably won’t fully understand why certain topics are triggering or come across as judgmental.

You can, however, help them understand these triggering topics or microaggressions. By setting up a few ground rules and asking them to try and abide by them, you can help them support you in a way that works for all parties.

1. Let them know about your trigger words

These terms are different for everyone who has an eating disorder, depending on the type of disorder they have, their unique disordered eating patterns, and attitudes about body image. However, you know your triggers better than anybody. You may ask them to respect that certain terms and topics are triggering to you and as you to avoid discussing them.

For example, if your loved one is engaged in a diet or is counting calories, and you’ve recovered from anorexia nervosa, the discussion or food restriction might spur on disordered thoughts and maybe behaviors in you. Simply asking them to avoid discussing that topic in front of you can go a long way towards helping you reacclimate to your daily life without putting you at further risk for relapse.

Other things you can ask them to avoid discussing are specific weight figures, i.e. “I lost XX pounds!” or, “My doctor says the ideal BMI is XXX.” People who haven’t experienced an eating disorder don’t know how powerful those kinds of discussion can be – how they can become compulsions to use disordered behaviors.

2. Ask them to remove certain items from the house

Just as certain topics of discussion can trigger disordered thoughts and feelings, so can certain objects and items associated with disordered eating. So, in the same sense, you might ask your family member to avoid talking about specific weight figures, you might also ask them to remove all scales from the house. Someone working to overcome a compulsion to control weight can easily be triggered by a device that tells them their weight.

Other things to remove might include those that affect body image and self-esteem, such as fashion magazines or other images of “skinny” people. If you had a binging-type disorder, you might ask them not to keep the kinds of food you ate during binge eating episodes in the house. These are just examples, of course. Your specific triggers were likely identified while you were in residential eating disorder treatment, or you already know them. Just make sure your family knows them too.

3. Help them understand how to support without pressure

Your family might think that spending time in residential works as a magical “cure” for bulimia nervosa, anorexia nervosa, ARFID, or other types of eating disorders. They might not understand why you’re still anxious at mealtimes, of what a challenge it can be to simply be there. In the worst cases, they may ask you something like “Why aren’t you eating?” or “Just eat a little more, ok?”

It’s important to remember in situations like this that your loved one isn’t trying to hurt or trigger you. They just don’t know how intrusive comments about a person’s eating habits can be. That being said, if you feel yourself craving disordered eating behaviors, you should establish a baseline where you can initiate a conversation about it. Saying something like “I’ve been struggling with my eating disorder lately, can I talk to you about it?” and having them listen can be a great boon, and they may be able to help you decide if you need to engage with a professional therapist again.

4. Convince them to go to family eating disorder therapy with you

Even before you enter a residential program, you’ll want to research what the treatment facility has to offer. Thinking ahead to your post-graduation life, you’ll want to have your family involved, right? For that reason, you’ll want to pick a residential eating disorder treatment center that has family programming included in the treatment plan.

For the family that wants to respectfully support their loved one in eating disorder recovery, there is no better resource than family programs. Normally, there will be sessions with the person in treatment, but also sessions that only include the family and the therapists. These programs help the family members understand their loved one’s disorder, and what they can do to help foster a full recovery.

It may be difficult to get some members of the family to open up in therapy, but because of the extended nature of eating disorder aftercare as well as the role of the family in shared eating, it’s essential. Convince them that they’ll learn a lot ad it would mean everything to you if they participated.

5. Thank them and make sure they feel appreciated

Your family and friends love you and definitely want to make sure you know they’d do anything they can to protect and support you. Make sure they know their efforts are appreciated. It’s a small thing, but so important to communicate your thanks and appreciation.

If you’ve ever done emotional labor for a friend or family member, you know that it’s rewarding but sometimes exhausting. It can feel thankless. Your recovery from an eating disorder is important to them, but it’s not necessarily the only thing in their life. You can help them keep supporting you by letting them know that it means a lot to you.

When they lend a caring ear, or change their routines to accommodate your recovery needs, a simple hug and “thank you” can remind both parties why you love each other so much.

6. Communicate how you’re doing

First and foremost, your family is not your therapist or vice versa. You’ve got to set boundaries about how much discussion of your emotions and eating disorder is appropriate and comfortable for you and your loved ones. However, plenty of non-confrontational, non-judgmental communication is also key to a complete recovery.

In pursuing this interest, make sure you let your family know how you’re coming along in your recovery, good or bad. If you’re feeling you are making progress and your disordered behaviors are a thing of the past, tell them! They’ll be very happy to hear it and validated in their support. And if you’re struggling, they can help lend you a sympathetic ear and help you escalate to a higher level of care. Either way, respectful communication is a key to continuing your recovery.

Pick an Eating Disorder Treatment Center That Keeps Your Family In the Loop

As we mentioned, most quality eating disorder treatment centers have some sort of family programming as part of their treatment methodologies. While that’s not the only component of treatment to consider (you’ll want a facility that can help you with your medical and psychiatric needs, and you may want gender-affirming care or specialized treatment for adolescents, for example), it is an important component.

After taking the location, financial consideration, amenities, and other important deciding factors into account, make sure you ask the eating disorder treatment facility about their family involvement programs. The admissions specialists will be happy to tell you about the programs and help you coordinate admissions and payment.

Your recovery can be a source of pride for your family. Don’t wait to get help if you’re struggling with an eating disorder – reach out and get started today.