Help for Caregivers Affected by Eating Disorders

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By Danelle Spence & Lindsay Huculak

Download Resource Guide

Eating Disorder Information for Caregivers

This information seminar was created to help parents or anyone who has a child, family member or friend that’s struggling with an eating disorder.

The video will educate viewers and provide strategies to help someone with their eating disorder.

Topics covered:

What is an eating disorder?

Contributing factors of eating disorders

Early signs and markers

Early intervention strategies

Emotional and behavioural support

What to do, and what not to do

Video Transcript

Information Seminar for Caregivers Affected by Eating Disorders

Hi everyone.

I’m Danelle Spence and I’m a registered psychologist.

And I’m Lindsay Huculak.

And I’m a Canadian certified counselor.

Lindsay and I developed this information

session for caregivers affected by eating disorders.

So, we wanted to be able to help parents or anyone that has a child or a friend or

a family member that’s struggling with an eating disorder.

We wanted to provide some information,

some education, and some early intervention strategies

to help support your child if they’re suffering from an eating disorder.

So, in today’s presentation, we’re going to be going over

what is an eating disorder, discussing some of the contributing

factors of eating disorders and looking into some of the early signs and markers

that you can be watching for and helping to address early on,

since early intervention and understanding is really important for treatment success,

and then we’re going to move on into some more hands-on intangible,

emotional and behavioral support and discuss things to do and not to do.

So, it’s important to recognize that not

all of this information will be relevant to each family.

So, take the pieces that are and hopefully you’ll find some stuff in here.

That will be useful for you.

So, we’re going to start off with.

What is an eating disorder?

Listed below are some of the most common eating disorder criteria.

So, the first one there is anorexia nervosa.

You’ll commonly just hear this referred to as anorexia.

This is characterized by low weight, weed restriction, and fear of gaining weight.

So, there’s a very strong desire to be thin that’s associated with this diagnosis.

Bulimia Nervosa, or Bulimia is characterized by periods

of food restriction, which is unfolded by binge eating,

which has a recurrent compensating behavior to purge the body of the food.

So, this doesn’t always mean that there’s a period of restriction before.

So, some individuals will just eat regular

amounts of food, but they will be purging that out.

So that could be done through vomiting.

Or also laxatives or over.

Exercise disorder is characterized

by recurrent episodes of eating large quantities of food and then afterwards.

There’s no purging of this, but there is a

big experience of shame and distress and guilt afterwards.

Avoid and Restrictive food intake disorder, which is also referred to as

ARFID, involves limitations in the amount or types of food consumed.

However, unlike anorexia,

it does not involve any distress about the body size or shape or a fear of fatness.

So, this is more associated with somebody

who has had a negative experience with food.

So maybe they’ve gotten really sick after eating something and there’s a relation.

Now there or some people just have sensory issues where there are certain foods.

That really cause them to be fearful.

The eating disorder that involves an unhealthy obsession with eating healthy.

So, unlike other eating disorders, Anorexia.

Mostly revolves around the food quality, not the quantity.

You’ll also hear this just to add in clean eating, healthy eating.

I don’t eat junk food.

So, there’s a lot of rules around what type of foods are being ingested.

The last one here,

eating disorder not otherwise specified or Edna, is characterized

by displaying some of the traits of the other disorders,

but the behaviors do not fit the full criteria of any one of the conditions.

I know that was a lot of information,

but just to remind you that a lot of teens or anyone that’s struggling with an eating

disarm, not just teens because we know it’s a buried age

that do experience eating disorders, but they have and flow in between some

of these characteristics and some of these diagnoses.

So, you might be diagnosed from a medical professional

with binge eating disorder, but you might restrict during the day or

you do some sort of compensatory behavior like over exercising the following day.

So, there is some fluidity between the diagnoses.

Lindsay and I get asked all the time is why?

Like why is my child suffering from an eating disorder?

And there are so many contributing factors that are involved in eating disorders.

And it’s really hard to pinpoint just one

reason sometimes there is just one reason, like a traumatic event.

It isn’t always just one factor.

There are all of these that we’ve listed

here, but what we say often is they are biopsychosocial in nature.

And I know that’s a mouthful, but it’s basically an interaction between

things like genes and DNA and predispositions biology.

So, what’s going on in the brain?

Because there are significant chemical

imbalances that happen in eating disorders, we now know that their receptors

for serotonin and dopamine are reduced and those are the neurotransmitters

that activate happiness and contribute to the ability to self suit.

So, we know there’s the biology,

we know there’s personality traits and not just that temperament.

Some children are just more predisposed

to suffering from an eating disorder and life events and the environment.

So, the cultural influences,

the fast-paced life, the stress of school and fitting

in and of course technology and screen time is also a factor.

And the reason why we want to describe

that there isn’t just one factor that contributes is because it can maybe

help parents and families respond with less frustration.

So, knowing that this is not just a set of choices or a lack of motivation or

stubbornness, but there are many things that are impacting.

Lindsay and I always get asked why is my child struggling with food specifically?

And there are again a lot of contributing factors in this as well.

We have fear.

They are just really scared.

The underlying anxiety.

So, we know that eating disorders are comorbid with things like depression.

50% have that combined diagnosis of depression and anxiety.

It’s actually 35%.

So those are big contributing factors, and they are using food to help manage

and settle their systems because of the mood stuff and or the overthinking.

Like the third point, the negative internal dialogue.

We just know that there is a lot of overthinking that can happen.

And that inner critic that is saying

you’re not good enough or you need to do this or this.

And of course, we have the combined temperament from the last slide.

There’s perfectionism.

There’s things like cognitive inflexibility.

There’s poor coherence of what’s going on in my world.

They don’t really know how to manage things like stress and stuff

with relationships that are quite complicated sometimes for individuals.

There’s a lot of things like focusing on detail rather than the big picture.

Because we know if someone is struggling with an eating disorder,

they latch on to overthinking about something over and over and over again.

So those are some reasons why your child is struggling with food.

They’re using food to help manage all of this stuff.

Also, on our list here, we’ve got a starved brain.

So restricted eating, we know, can lead to dramatic changes in the brain.

And because of the way our brain

and bodies respond to limited nutrition, the longer someone is malnourished,

the more difficult it is to eat normally again.

So, there’s going to be actual

compositional changes to the brain that has been starved.

I know that’s a quite large list.

And you just have to look at your child

and go, okay, yes, they do have that perfectionist tendency.

We know that there’s this societal pressure that was our last point.

And so just looking at the perfect storm of things is probably why your child

is using food as a way to manage a lot of those.

That perfect storm.

So just to add on, there what we were just discussing in terms of why my child is

struggling with this is a really great quote.

Eating disorders are powerful coping mechanisms that help an individual manage

the parts of life that feel too much to bear.

Your loved one doesn’t feel threatened by it.

To the contrary, they feel threatened without it.

And just to add to that, your child likely wants the relief

of the symptoms and does not want to be struggling with an eating disorder,

but they don’t want to give up their unhealthy coping mechanism.

For them, it feels safe, it feels comforting.

And we’ve often heard that it’s like getting rid of a friend,

getting rid of a confidant, getting rid of something that just really

helps them cope with the stressors of life.

It’s really serving a purpose for them.

Next one, I get into some early signs,

some possible markers that you might notice with your children,

and we’ve broken it down into physical appearance and behaviors, food rules,

hyper, focusing on certain things and exercise specifically.

And as we go through these lists,

they’re quite detailed things to watch out for, things to notice.

And just know that one, as an example, is wearing baggy clothes.

If your child is wearing a baggy hoodie,

it doesn’t necessarily mean Holy my child is an eating disorder.

It’s just the combination of all of these things.

If you start noticing you’re like, okay, yeah.

So just know that these are some things to look out for, but they aren’t concrete.

So, we will start with physical appearance.

Physical appearance.

So, some of the physical things to be

looking out for would be obviously a fairly sudden increase or decrease

in weight attached to that sometimes may be covering up that weight loss or weight

gain with a change in how they’re clothing themselves.

So, they may be like Daniel said, starting to wear more baby clothes or not

wanting to go out as much, that sort of thing with bulimia.

So, with any type of purging behavior,

there are some noticeable behavior or physical things that come with that.

So, there’s oftentimes like swelling grounds.

Not always, but sometimes we refer to it as chipmunk cheeks as well.

So, there’s a swelling here that can occur with vomiting.

Also, in lines with bulimia would be

potentially some cuts or abrasions on the top of the fingers if they are

using their fingers to initiate that bloodshot eyes from vomiting.

So sometimes they will have precise

vessels, bad breath, or brushing their teeth a lot more than they used to.

Teeth issues.

So oftentimes dentists will notice if there’s some damage to the enamel.

So, your dentist may approach you and discuss that with you.

I’m supposed to go to some specific behaviors to watch out for as well.

So, the constant weighing of themselves.

We have clients that weigh themselves three or four times a day.

And so, getting scales out is a behavioral

thing you can do getting the scales out of the room, so they don’t do that.

Turning to food to deal with emotions.

So just noticing like, oh, I’m really overwhelmed, and they grab a bag of chips.

Or if they have no other coping mechanism

to handle emotional distress, then that is a flag.

I’m spending a lot of time in the bathroom after meals.

So just noticing showering or baths or water running to hide some purging

behavior, perhaps just finding empty laxative boxes or noticing food being

consumed faster than you would typically think.

So, you just bought that box of crackers

and then all of a sudden you go in the pantry and they’re missing things

in the garbage that you wouldn’t normally see.

Like just wrappers things like that, not eating in front of others.

So, you will notice maybe them saying I’ve already eaten or I had a big lunch or just

coming up with covers for actually eating a meal.

So those are just some of the behaviors to just be mindful of.

Now we’re going to go to just food rules

that you might start to see happening with your child.

So, some of the things that may show up

a common one would be wanting to become vegan or vegetarian.

So, lots of rules around eating things like not eating after 07:00 p.m. Or I’m not

eating carbs or I’m no longer eating sugar.

So, any hard definites in terms of what

they will or will not eat, some kind of odd behaviors with their food.

So, cutting things into very small pieces,

not allowing foods to touch, shuffling food around the table.

So, if you’re noticing that there’s not much going in but there’s a lot

of behaviors happening with the plate type thing.

Eating too rigidly, are too clean.

So, we spoke about that in terms of orthorexia.

So only eating low fat or no fat or only

eat whole foods that are not processed, that sort of thing.

Food ritual,

that kind of in line with the cutting and whatnot, but not letting food touch or

I can only eat this color of food or that sort of thing or any kind of negotiating.

So, if you hear them either making

negotiations with themselves or with you no, I can’t eat dessert today because I

didn’t get my workout in or no mum, I’m not eating your chocolate cake because

I haven’t run my ten KS or what not that sort of or.

I will eat the chocolate cake if I run ten K.

Yeah. And then we’ll get into the last one.

No, second last one.

Just hyper focusing on food nutrition, obsessing over food labels,

reading every cookbook that they can get their hands on.

So just noticing this hyper focus on weight, shape and appearance,

spending excessive amounts of brain time thinking about food.

What am I going to eat? What am I not going to eat?

We’re going to a restaurant.

Can I see the menu beforehand?

Compulsively counting calories, like looking at food labels, weighing food.

So, if you have a scale there for your

coffee beans but they’re starting to use it for I can only have so many ounces

of yogurt in the morning, which is really hyper.

Focusing on numbers on weight, just anything related to dieting,

the influencers they might have on their Instagram.

If you’re looking through their social

media use, if it’s all clean eating influencers on Snapchat or whatever kids

are using these days, then that’s just the hyper focus on weight

shape of parents that are some things to pay attention to.

And the last one is exercise.

So, what we always look at with exercise, is your child using exercise for joy,

for play, for fun, for positive reasons, or are they using exercise because it’s

eating disorder driven like Lindsay was saying?

Are they using it to negotiate with themselves?

Like I am going to be able to go to that party with my friends if I do 27

burpees before that’s random 27 burpees before school.

So just looking at exercise as how they’re using it and what purpose is it serving?

Could they stop?

If they were asked if they sprained an ankle, would they be okay?

Because they have a whole bunch of other

mechanisms to kind of calm themselves and to sue themselves.

So do they have rest days.

We know that you need one or two rest days for muscle repair in a week.

And if they are going two workouts a day,

just needing to move, needing to be physical is a flag.

Yeah.

And just paying attention to, again, some of the things that they might be doing.

So, exercising in their room at night.

So, if you’re hearing bedtime,

they said they were going to read a book and you hear the floor kind

of with jumping Jacks or whatever, it’s like, why are they doing that?

Now?

I remember the secrecy, like just to tag onto Lindsay’s mom’s onto me.

So, I’m going to pace in my room over and over again or things like that.

We might not even think of standing

instead of sitting because that’s going to use more calories or wanting to be

cold, which again, they could pick up on that.

That’s going to burn more calories or fidgeting.

So, I have one client that is constantly

moving her legs up and down and doing plyometrics or whatever it’s called.

So, she’s constantly exercising.

So, pay attention to some of these

behaviors that you might see in the odd things.

I know Lindsay laughs at this, but planking, you’re just in the middle

of watching your favorite show and they’re planking or they’re doing sit ups or

they’re like doing yoga poses and say, okay, that’s a little bit odd.

What is the purpose this is serving?

So, asking the difficult questions

and being really curious as to what some of these things are is really important.

So, some of you may have already noticed

some of these markers or these flags in your loved one,

or if you’re just starting your journey with this and you’ve now watched this

video and you’re seeing these things or paying attention to them,

you might have some reactions to these things that you’re noticing.

So, we just wanted to talk about some

really common reactions to the symptoms of an eating disorder.

And then we’re going to move into why these might not be the most helpful

and help you develop some more skills to really attend to these symptoms

in a different way that are going to be more effective in helping move.

Through the stuff, because it is very difficult stuff.

When we recognize that,

we recognize that you’re probably really scared, you’re overwhelmed.

You’re like, Holy, Holy man, how do I do this?

How do I help my child not go down?

that eating disorder route or get out of that eating disorder behavior?

So, this is Maudsley.

So, you probably have seen some resources

on what to do if your child suffers from an eating disorder.

And we love this. And its really kind of weird to have

these animal metaphors, but I’m going to put them up again.

If I know how to do that, I’ll let Lindsay begin.

Yeah. So, it’s categorized into these four

different common animal models that may come up here as reactions to symptoms.

So, the first one is the Kangaroo.

So, this is where we smother with protection.

So, we’re safeguarding everything and we’re

treating our loved ones as if they’re incapable of handling everything.

So of course, with this image here, it’s like Mama Kangaroo is putting baby

in her pouch and just protecting them from anything.

No, you can’t go to that party.

You won’t know how to handle it.

Those kinds of things,

the rhino would be charging in with anger, irritation, or control.

So, what that would look like is just very strong.

Just eat one more. It’s so simple, why can’t you do this?

Just eat that sort of type reaction,

because parents are so lost, and they don’t know what to do.

So, this can be kind of a common reaction to that.

An ostrich parent would be the parent

that sticks their head in the sand and wants to just ignore the situation

because it’s too painful or too confusing or overwhelming to acknowledge.

A jellyfish parent is a parent who’s

really overwhelmed with their own feelings about it.

So, whether that be their own guilt or shame,

blaming themselves, all those kinds of things,

so, their emotional reactions can become kind of spilling out everywhere.

So those are common but not very helpful.

I guess it depends too, because I know as you’re listening

to this, you’re like, oh my gosh, I’m a total ostrich.

Like, I saw and noticed some things and I

never said anything because I didn’t want to make it worse.

Or you may just be feeling guilt and shame.

You shouldn’t, because it’s not about blame, ever.

But just paying attention to where you’re

gravitating to and knowing that there are sometimes for rhino as an example,

that take charge in some of the early phases of trying to get your child

to restore their weight and become healthier physically.

You may have to rhino it up and just be like, no, you’re eating this.

But we want to help you.

And that’s the next few slides to help you

become really calm, firm, loving, and connected so that you can do what you

need to for your child, even if you’re freaking out,

even if you’re really overwhelmed, even if you feel jellyfish like,

but just knowing that you want to be loving and connected

and understanding and trying to remove the eating disorder from your child,

because this is something that has taken hold of your child and it’s not your child

wanting to be, like we said at the beginning, stubborn or difficult.

So going on to the next little bit is

about why we need to build our child’s emotional competency.

So, it’s really important to understand

that in recovery they are avoiding feelings and your child is trying

to figure out, what do I do with these negative emotions that I might be having?

So, as you can see here,

an eating disorder can serve as a maladaptive way of managing unwanted

negative emotions, they may not know, what am I feeling?

What am I feeling? And what do I need to do with my feelings?

Because we know that emotions need action.

When I’m sad, I need to cry.

When I’m fearful, I need reassurance. We know this.

We know that when we build emotional competency, and we get good with our

emotions, then we don’t need a maladaptive behavior like an eating disorder.

Like, we don’t need to latch

on to overthinking about food or like, on the slide.

Starving. Numbs.

Starving is putting a lid on unwanted and undesirable emotions.

Binging actually soothes the nervous system.

Purging actually floods when a child throws up.

It’s like it’s a wave of melatonin.

That’s the sleep hormone, not melatonin.

It’s a wave of neurotransmitters. Yeah.

Like it’s blood of serotonin.

And it actually is very soothing, and it offers them a sense of relief.

So, it’s just imperative that there is

a focus on not only the behavioral ships and the refeeding and making sure

that they have that health component contributed to their recovery,

but they also need to work on the emotional component.

So, as we move into helping you guys as

parents and loved ones, develop your own emotional competency

with this stuff, this is where it links together from.

Okay, well, how do I stop being jellyfish?

How do I stop being rhino?

Is we’re going to help you guys name some of these emotional components and then

help use that knowledge to become your children’s emotion coach.

So, this next segment is just going to tell you how to actually

do that because it’s tricky, but it really actually isn’t as tricky as you think.

And we really believe that’s.

What I guess Lindsay and I really believe

in our whole heart is that we believe in parents, and we believe in parents

capacity to be that person that your child brings their emotional stuff to.

And that is really key to recovery.

So, we’ll start with, how do you be your child’s emotion coach?

So, you’ve heard us use the term emotion

coaching, and you’re probably thinking, what is that?

So here are the steps to emotion coaching.

So, one attend to the emotion.

So, what we mean by attend to the motion is

you’re going to pay attention to anything that your child is showing you,

whether that be slamming a door, whether that be rolling an eye,

whether that be minute, little flicker of a look away.

But what you’re doing is you’re noticing this thing.

So, emotions are not always big and bold.

They can be very minuscule.

And you almost have to be a Detective to look for some of these things.

But it’s really important to pay attention to it.

And by attending to it, what you’re saying is I see this.

I see that you look sad, you look confused.

You’re noticing them once you have attended to it.

So, hey, what’s up?

What was that eye roll about or how come you Slam the door there?

You’re going to label and express the emotion.

So, what we mean by labeling and expressing

it is you’re going to say something like, hey, you slammed the door there.

Seems like you’re probably pretty angry

right now, because that would be an obvious one.

So, this is not always obvious.

So, I’m making it sound very easy.

You know, a door slammed, that must be anger.

But we’re going to get it wrong sometimes.

So, you may say something like,

you look really sad if they’re showing tears or whatnot.

And they may say, I’m not sad, I’m mad and great.

Okay, now they’ve helped you out and you know what the real emotion is?

They’re feeling it’s very tricky with some

of this population because they don’t often know what they’re feeling.

Right.

So, a common thing is they are not great with their feelings.

So, they are going to miss queue things. Right.

They might be sad, but they’re showing anger or vice versa.

So just know that you’re helping be kind of a coach and a guide for this stuff.

But it’s a learning process.

It’s a co creation that’s happening there.

And it’s not, again, as simple as I’m making it sound.

And I want to remind people we have an accommodating handbook of information.

And one of the resources is Daniel Siegel.

And he always says name it to tame it.

So as Lindsay was saying, like, hey, you’re angry.

I see you’re angry. Even just that sense of, hey,

my mom is seeing me, or my dad is trying to understand me.

Even if you don’t necessarily understand

what is going on, it’s that name it to tame it.

So, labeling like the step two here, labeling and saying, I see you, I get you.

I’m trying to understand your emotional world is just really important.

But the most important I’ll let Lindsay. Yeah.

Continue.

As you see, we’ve underlined it and put important there.

So, validating the emotion.

If you take one thing away, please take this away.

Validation is a critical skill to have, not only with your loved one that’s

struggling with a mental health concern, but just any relationship.

So, validation is about putting yourself

in the other person’s shoes and understanding it from their perspective.

So, where this can be really tricky again

are they’re going to bring some feelings or emotions that don’t make sense, right?

I’m fat, I’m disgusting.

Where you see this beautiful, thin child in front of you.

So, it’s very hard to validate something that you don’t agree with and don’t see,

however, the breadth and the importance of validating it from their perspective.

So, what that would look like is something

like, I see how hard it is for you to accept yourself.

So, something like that, that’s going to capture it from their perspective.

So, validating anything they see.

I get why you’re mad right now.

I get why you’re upset that you can’t go to that party because it’s mealtime

and you need to be supervised for meals right now.

I understand that must be really hard.

So, validating.

And what we’re doing there is we’re

helping them normalize their experience and helping them recognize that their

feelings are important and they matter and they’re real.

So, they don’t need to dismiss it, hide it, wash it or not feel it.

We want these things coming up.

The next one is it’s not always possible,

but meeting the need is if you’re able to land on okay, you’re sad.

Can I give you some comfort?

Can I give you a hug?

Can I bring you some tea?

So, you meet the emotional need there.

If they’re mad, they need a boundary.

So, you’re going to meet the need of. Okay, I get it.

You need some alone time.

I’m going to come back in ten minutes and check on you.

And please know again, this is a quick summary of this stuff.

But in the handout that comes along

with this, there’s a lot of resources out there, lots of access to videos

and handouts that are really going to expand on what we’re talking about here

and helping you get more familiar with these steps.

How do I validate that when it’s nonsensical?

And how do I meet the need when I don’t really even know what is happening there?

So just please know that this is a summary.

Well, in this handout,

just to refer again, oh, my goodness, it’s a little ridiculous.

But there’s script, we put pages, I think, scripts for how to help with meals.

But then mostly with this emotion coaching, like, say this, don’t say this.

And we will get into that a bit at the end of this seminar.

But the most important thing is not to go to step five all the time.

I think we as a society want to fix and problem solve, and we like that.

We don’t want to happy with emotional dysregulation.

So, we often just jump to let’s figure out a problem.

Let’s solve this.

What can I do about this?

And we jump to step five

and we need to at times, we definitely don’t want to ignore

that our child might not have the capacity to problem solve on their own.

And we need to jump in and rhino it up.

But it’s really important to only do that if necessary.

And it’s staying in those first three

steps of attending, expressing the emotion, naming it,

and then the validation of I see you, I get you.

I understand you, even if you don’t totally understand.

I’m here with you and I’m trying

to understand and muck around in your emotional world so they don’t feel alone.

Now one of the important things here is

that if we do accidentally put the slide back up, if you accidentally jump

to number five too quickly, a concern with this is that they are not

getting the competency of developing emotional regulation skills.

So, one, two, three, and somewhat four as well for helping

model ways to meet the emotional need is helping them figure out for themselves.

Okay, I’ve got feelings.

It’s telling me something that’s valuable and important.

I need to attend to that.

My feelings matter.

Once I know what I’m feeling,

I can start to access what I might need in order to help tend to that emotion.

So, this is development of emotional regulation.

If we as parents accidentally jump to number five too quickly,

we are missing that opportunity to help them develop these really critical things.

So again, I know as a parent myself,

it is so easy, and you want to jump to number five sometimes and it’s not

always problem solving or fixing it’s things like, oh, I don’t feel that.

That’s silly.

They don’t hate you, that kind of thing. You’re not fat.

Yeah, like it’s jumping, like wanting to take their pain away.

But even if your daughter is saying, oh, I’m so fat, I’m so grotesque people can’t

stand to look at me the minute you go to but are you kidding me?

You have a cute little body.

It’s like that’s not what sad is not a feeling.

That’s not where they’re going.

That’s what they’ve latched on to.

That’s what they’re hyper focusing on.

So, pausing and going, tell me more what’s going on for you.

Like, I can see how distressed you are.

You seem really overwhelmed right now.

Help me understand because remember, the whole point of a lot of this is

that we want to render the eating disorder as we don’t want it needed.

Not needed. Yeah.

And right now, the eating disorder is soothing numbing.

It’s helping them avoid emotional content.

So, the more you muck around with their emotional stuff, then the eating disorder

will slowly it’s a lot, I know, but it will slowly go away and not be

needed as much to soothe their emotional sells.

I’m just going to put this one up. We love this.

This is Gordon Newfield, and he wrote the book hold on to your kids

and we have that in their resource list, but we cannot parent parts we do not have.

There’s lots of science that says

the nurturing, connected relationships that we have with our children have really

shown to activate really healthy brain chemistry.

So, this means that when caregivers connect in this emotionally attuned matter,

it really creates this calming effect on their nervous system.

It promotes more emotional regulation.

Kids feel seen, felt and understood.

It gives them this flood of endorphins

and neurotransmitters that would otherwise eyes be creative.

It from purging or restricting.

So, it really is important to pay attention

to the relationship you have with your child and build your competency

with emotional competency so that they can bring their emotional stuff to you do.

And that’s why therapy is really

important, not just for the child, because we often hear that like, okay,

my twelve-year-old is struggling to see her, but Lindsay and I never work

with a child in isolation, especially related to I mean,

we do sometimes, but when it was related to eating disorders,

we need to bring in parents so that you can be available to them to do this

emotion coaching stuff as well as getting them to eat.

Because back to this slide, we cannot parents hearts we do not have if

you’re trying to meal support them and make them eat breakfast because they

are underweight or in an unhealthy medical place, they’re going to be far more likely

to do this work with you as a support if they feel emotionally connected to you.

And as parents, we don’t expect or at least us as

clinicians don’t expect parents to know how to do this stuff.

Right. There’s a very emotionally avoidant

culture out there that we live in, and most of us have not been modeled or

taught how to emotionally attend to this stuff.

Right.

So, what we’re asking parents to do is very hard.

We’re asking you to be emotion coaches

when you might not have those skills developed for yourself.

So that’s where it’s really critical that you have support from a therapist as

well so that your own stuff can be processed through.

And you can figure out how to do this because how can you coach someone to do

something that you don’t even know how to do yourself?

So just we really want to reiterate

the importance always of having support for parents.

And you need a team around you to help

support and guide you and resource you so that you’re able to take on this really

big task of supporting your loved one who is suffering in this.

I know that was a lot Lindsay and I do five day,

five evening seminars on emotion coaching, but the resources in our handbook will

provide you some books to look into, to dive deeper into the emotion coaching

and the importance of emotional competency.

But now we’re going to get into some more

granular stuff of things to do, more of things to do less of.

So, the do’s and don’ts in supporting your child with an eating disorder.

So, we’re just kind of we’re going to go through this quite quickly, actually.

Yeah. And some of them

it kind of meshed together in terms of some of the emotional stuff,

but also, some of the behavioral and tangible pieces here.

So, it’s across the boards.

So, if you do is just

remembering that you want to understand what the feeling is under the words,

under the pushback or the arguing or some of the behavioral stuff.

It’s like really mucking around and what

the feelings are under that try to be as warm and loving as possible,

even if you’re super frustrated or scared or overwhelmed yourself.

Try not to blame shame or cause pain because this is not about blame.

This is not about why can’t you just do this?

Like, it’s just really important to watch your language in, especially saying things

like, you’re ruining our family or Why are you doing this to me?

It’s just because we know that guilt

and shame are really active eating disorder behavior.

So being really mindful of what you’re saying.

So do reflect, pause,

take care of yourself so that you can I know it sounds rude,

but kind of check yourself so that you can be available to your child and try

to refer to and think about the eating disorder as a separate entity.

And I know it is your child, but remember, this is your child in pain.

This is your child struggling, not being well in their emotional world.

And really illness.

Yeah, it’s a significant illness.

So, knowing that, okay, this is just my child’s suffering and this

isn’t my child being a real treat and just do offer comforting gestures.

So, rubbing her back or saying to him, I’m here for you.

So just really the comfort of just being present and offering a hug when needed.

And that reassurance.

And just also do recognize that recovery is not linear.

So, there will be setbacks.

You’ll be like, okay, we got this, we got this.

And then the next week it’ll be all falling to pieces and it’s really okay

and important for you to remember that it’s not going to be linear.

There’s going to be ebbs and flows in the treatment.

And you’ll think it’s a relapse.

I don’t even like that word.

We call them setbacks because it’s not A plus.

B equals C. There’s no.

We expect that. Yeah.

Actually. And they’re learning opportunities.

We know that’s hard to think of it like that.

And really emphasize, do emphasize success when they are

struggling, not throwing up, and they do it, you have to celebrate

that like crazy easy and just be like, oh, my God, I’m so proud of you.

You’re so strong. That was so difficult.

And you did it anyway.

So, remembering that emotion, coaching, connect, then redirect.

Right.

Connect emotionally and then offer suggestions.

So do emphasize the celebration, the positives.

I’m so proud of you.

You did that.

Now can you eat the next part?

So just remembering, we will get into more

details on the meal support and scripts, but just celebrate the small success.

So, the don’ts, the don’ts would be.

So, we want to encourage emotional expressions.

But of course, we don’t want to tolerate any sort of abuse.

Right. So, if they’re really angry or protesting

or whatnot, it’s again, making space for that feeling.

But knowing that there’s also a line

of you can’t throw a plate at my head or you can’t call me the F word or whatnot.

I recognize this is really hard for you

and very frustrating, but I’m not going to tolerate you treating me that way.

Don’t do most of the talking.

So really, this is a time

in your family’s life where it’s really about increasing your capacity to listen

really wholeheartedly and less knowledge here, listening more.

Don’t set unrealistic goals for yourself or for your loved ones.

So, something like gaining £5 in a week,

that’s really unrealistic or even for the family of like,

we’re going to beat this thing within three months and then life is going

to take off again and we’ll be able to go to Hawaii as planned, blah, blah, blah.

So don’t set unrealistic goals because dependent on the severity of where your

loved one is showing up in, this can be a very long journey and

that it’s not helpful for them or for you to have these goals that may not be met

on time because there’s no timeline on how this is going to go.

This is really important.

Don’t always go to the silver lining place.

So, what we mean by that is, don’t worry,

kiddo, you’ll get this next time and you’ll

figure this out or everything’s going to be just fine.

I know you can do this.

I know you can get through this.

You’re strong, you’re brave or always

being the light of joy and being Pollyanna of like, it’s okay.

I know this sucks, but we’re good.

Our level get us through that kind of thing.

We have to go into some of these dark places you need.

Disorders are dark and deep, and they bring up a lot of really nasty stuff.

Nasty like existential kind of self worth stuff.

So, we have to be able to go into those places with our children and explore.

It so dependent on where you’re at in your

journey and the severity of your loved one who is struggling.

It may be recommended to you,

whether that be through your doctor or maybe you’ve enlisted a dietician already

and we will talk more about dietitian support in a bit.

But you may be tasked with really taking

over responsibility of meals in the early stages of treatment and recovery.

So, this slide is in relation to if you are taking that responsibility over.

So, what we suggest is really looking

at a very structured approach in the beginning.

So, what we want to do is eliminate any of these high stress moments where,

oh gosh, I don’t have a snack prepared for you, I got to pull something together

and your loved one is getting increasingly anxious as that’s happening.

So, we want a lot of structured around

the planning, the preparation, deciding what that is.

Day of so structure, structure, structure.

Timing is really important in the beginning.

So again, we’ll talk about this with dietitian when we move into that.

But really the recommendation, depending again on severity,

is often three meals and three snacks a day if you’re needing to gain weight.

So, looking at how that’s going to work

for your family, where is the best likelihood of success?

Those sorts of things stick to grocery lists, don’t check ingredients.

So simple.

Keep it as simple as you can.

This is my food plan.

These are the things that we need.

Don’t go off the list.

We talk about introducing fierce foods early on.

So, what we mean by that is if your loved one is absolutely against all sugars,

I will not eat any sugary food, any desserts.

You don’t want to let that go on too long. I’m an ex-teacher.

So, I think of scaffolding,

like starting really slow and going, okay, right now I need to own this.

I need to take this on and take control of this.

But then as treatment, things get a little bit better and they’re

like, okay, now you can come with me to the grocery store because you can help.

But don’t obviously look at labels, don’t look at calories.

Just remind you of is in this handbook

that’s accommodating this video is a whole bunch of scripts on how to do the emotion

coaching, how to talk about emotions and redirect and help with meal support.

But some of them are I can see this is overwhelming for you.

I’m here to help.

It sounds like you have a lot of fear right now.

Can you tell me about it so that I know?

that’s what a lot of parents need is like, okay, I get it.

But just give me what do I actually say?

And then even we got some more specifics around meal support here.

So, it depends.

I know some of your loved ones may not they might be living on their own.

So, you can’t be available to do this, meal support.

Some of you, they won’t even let you help with meal support.

But we just wanted to put this in there too, because it’s really important.

Especially at the early phases of an eating disorder.

They need structure and routine around getting the nutrition into their bodies.

So, what we have discovered, what does work is the first two.

So, using direct eating prompts and being

that firm, strong, warm, if you can do the combo of that.

But being really direct and saying things

like, you have to eat all your eggs, you got to eat this.

You’re eating this and this is what you need.

This is what you need.

This is what I know because I know how to do this.

I’m the expert here, even if it feels like

you’re not the expert, just being direct and just I’ve got this.

I’ve got you. I’m capable because remember,

they’re scared and they know if you’re scared, then they’re scared.

And that perpetuates an eating disorder.

So direct eating prompts are super helpful.

The next one using physical prompts.

It’s kind of ridiculous.

But handing them the food, eat this, pushing the plate in front of them like

we’re eating breakfast, we’re sitting as a family.

We are eating breakfast and putting a plate right in front of them.

That direct firmness is really important, especially in meal support.

Things that don’t work are the other four.

So, offering choice, promoting autonomy and nondirected eating prompts.

So, saying things like, why don’t you eat just a little bit more pasta.

Or could you or could you have one more? Yeah.

Do you want another one? Yeah.

Okay.

Do you think it would be okay if you could eat breakfast today?

Which one would you like?

Would you like this one or this one?

So, you’re really taking control, especially at the beginning stages.

So being really direct and not offering

them options because that’s just super overwhelming as well for them.

So, they need to see that you have control of this.

And oftentimes what Lindsay and I’ve discovered is that it is really like

meal prep and meal sitting and eating a meal is really overwhelming for a lot.

So, distraction can be quite helpful.

So not talking about an eating disorder

related topic necessarily but having the TV on or playing a board game.

And we would never really promote multitasking at meals.

Yeah. But for an eating disorder,

it can be really helpful to put on a video or their favorite show just to distract

themselves from the discomfort and the pain that they might be feeling.

Yeah.

And this would be again in the early phases of refeeding and whatnot.

So, as you progress through that, then you would look at removing some

of those distractions and being more mindful of how we’re eating.

But again, we’re really targeting kind

of those early places where we know it’s really, really difficult.

So, whatever you can do to help them get

that in and then some things, even some behavioral things afterwards.

I know lots of families speak about going and laying down afterwards

and having like a nice warm hot water bottle or something on the tummy.

Just because people do experience a lot

of discomfort afterwards if they’re used to not having much food at all.

And now they’re tasked with eating regular

meals, three meals, three snacks, their bodies literally will be uncomfortable.

So going for a gentle walk as a family afterwards or letting them lay down while

you clean up anything that we can do to help support these.

Tough places,

the next little bit of the presentation is going to feel a little bit one off.

So, we’re going to be talking about dietitian support and medical support.

But the one additional piece

of body image concerns your child may say, I don’t like how I fit in my clothes or

when I look in the mirror, I feel fat, or I look.

Fat and I hate my body. Yeah.

And a lot of parents will say, what do we say?

Like, do we go shopping and buy clothes that will fit better?

The thing we want you to understand is

that this is the last thing to often settle in and to improve.

So, it often goes from tolerating we want your child to begin to tolerate their

body, and then it will go to accepting their body and then feeling good about

their body and then eventually loving their body.

But it is often the last thing to feel good about.

So just paying attention to that and not

arguing like, oh, you got a beautiful little body,

or don’t worry, we’ll go shopping and we’ll get you some new pants.

It’s not about that necessarily.

It’s just what can you do to support them

as they are being overwhelmed or not comfortable in their bodies?

So, some of those things are to remove scales.

If you have

a lot of individuals will weigh themselves in the morning and then that will set

the tone for their nutritional intake throughout the day.

So not even having a scale available to activate that need and that compulsion

mirrors paying attention to the body checking and how much time they’re

spending in front of the mirror and pulling their body apart.

Like, oh, I hate this, I hate this, I hate this.

And so just really having them be aware and conscious of how much body checking

they’re doing, having a gratitude Journal and writing down things that they like

about their bodies and how their bodies are used to move them up a mountain,

how they have strong arms to help them play volleyball.

And so, looking at the positives that their

body provide, rather than just hyper focusing on what it looks like and.

What it appears like, another important thing is to be really

cognizant of what kind of influences they’re having.

So, if your child is willing and hopefully you’re able to encourage this.

But going on their social media threads or

streams or whatever it’s called and seeing what kind of influencers that they are

following, helping them be kind of critical,

critical viewers of what they’re taking in and helping them maybe cleanse out some

of these followers that aren’t going to be helpful if they’re doing a lot

of comparing and a lot of Why don’t I look like this?

It’s like, why don’t we take that off there for now?

Or even social media cleanse.

Another thing as well that we really want

to put the importance on here is our own relationships with our bodies.

So as parents or aunts or loved ones, whatnot watching how we discuss.

Our. Bodies and oh, I can’t fit into a bikini

this season, or I’ve got to lay off on this until I can get back

into my skinny jeans or what kind of stuff that we’re encouraging there.

Because of course,

that’s going to be modeling sense to them of value and importance on bodies.

So really checking ourselves in that area.

And even if you don’t think you’re doing it, they pick a lot of girls or guys will

pick up on the atmosphere and the environment.

And if you’re not feeling good about you,

then they’ll be like, okay, well, that’s something I have to focus on as well.

So just be mindful of that stuff.

So, we’re going to move into treatment options here.

So, it’s really important that you do look

into what’s available in your provinces here.

So, what I’m discussing is in relation to Calgary, Alberta,

and this will look a little different depending on where you are.

So here are the options that at least in Calgary we have.

We have private care,

hospital day treatment program inpatient hospitalization and residential treatment

centers, which we actually don’t have here, but we will speak to them.

So private care is really important that you have a team of skilled

professionals that are collaborating together.

So, we always suggest having a dietitian and a physician and then obviously

a therapist and a therapist for your loved one.

And that might be the same therapist that you’re working together with as

a family or you may have your own that’s collaborating again.

So, we really want that team approach.

We want dietitians to be familiar with eating disorder clients.

So really setting out who’s capable of doing those things.

We will talk a little bit more about the physician in the next one there.

But ensuring that your physician has

a good understanding of this population and if not, they’re referring out

to someone who does the hospital day treatment program is

something that’s available to both under 18 and over 18.

They’re in different places, but this would be sort of structure

of like 07:00 A.m. To 07:00 P.m. Where all meals are being supervised and there is

an element of therapeutic support, some group stuff, that sort of thing.

During the day, they do come home at night,

but they are getting all their meals supervised monitored.

So, it’s really helpful in terms of weight restoration inpatient hospitalization

would be when someone is really medically unstable.

So, they need to be fed through an IV,

they need to be monitored 24/7 type thing for their vitals.

And whatnot often what happens is you’ll move from the inpatient and once you’re

stabilized, they would Segway you into the hospital day treatment program.

And then the last thing that we speak

about here is residential treatment centers.

So again, in Calgary, we don’t have any of those available,

but in other provinces in Canada, they do have some options for that.

And we make note of that in the resource booklet at the end.

Yes.

And of course, the States, they have a bunch of them available.

However, that does come at a really high cost.

So just things to consider in terms of treatment.

I think there’s a lot of things happening behind the scenes to get some day

treatment programs in Alberta, so that’s a positive.

So, in regard to medical support, there are a lot of physicians that feel

they are not qualified or have the expertise in eating disorders.

So, we know that in Calgary specifically,

that the eating disorder program will support and offer lab works and lab work

requisitions and stuff to consult with a doctor if needed,

if your family physician just feels like they’re in over their heads.

But the one thing we really want to remind parents is you have to go in with your

doctor with telling them specifically the changes you’ve noticed in your child

because it is that early identification that’s super critical in recovery.

So going in and going, I’m noticing this,

I’m really worried, be confident, be specific in what you’re seeing

and ensure that you’re taken seriously and not have someone say, oh,

it’s just a phase or, oh, well, teenagers make me seem like physician care,

but just making sure that you’re like, hey, listen, I’m really noticing this.

And being the expert of your child, when you walk in there, your doctor,

especially if you have a long-standing relationship with your family,

can potentially compare earlier weights that they’ve had on there as they were

developing and then compare it with the new weight to see how their

growth is and then can figure out how to support based on that.

And then just to segue into the next specifics of the medical tests that your

doctor should and could perform if they felt like it was appropriate is just

making sure that their height and their weight is being measured.

And a BMI less than 19 is a concern, depending though.

So, it’s very specific to your child.

But you may have to book with your doctor weekly and then getting blood work taken,

making sure levels are appropriate, electrolytes, potassium, iron.

And if your child is purging more than two

times a week, you might want to be going in every week as well.

And then, of course, heart rate and blood pressure.

So those orthostatic vital signs,

standing, sitting, blood pressure and just getting the whole battery complete so

that you are making sure that they’re medically not compromised.

And depending, your doctor may want

to refer them to one of the treatments plans that Lindsay was speaking to.

It can be really helpful to enlist

a dietitian to come in to support you and your child.

They can become the expert in all thing’s food related.

There’s a couple of different benefits to this, but one of them being they become

kind of the food police and you can delegate, we’re doing this because

the dietician told us this is what we need to do.

So, pulling in a dietician to help create

food plans, helping you understand what’s going to be the best nutrition guide

to get your child through what stage they’re in, those sorts of things.

Well, I just want to add to that,

like having a dietitian explain why we need carbs and what they do for our

bodies, why we need a protein and what they do for our bodies.

And it’s that education that a lot

of children that we find they really appreciate it.

They go, okay, I have to have good fats.

I can’t have a fat free diet.

And the reason for it is because it helps

with my brain health and my ability to focus.

And so having a dietitian explain the science of food and nutrition,

we have found to be extremely helpful in the treatment plan.

Yeah.

And help debunk a lot of those food myths and help them really challenge

that from a very knowledgeable and scientific approach.

Exactly. And then to create a plan of

getting to that intuitive place, but with the structure of the support

and the education and the three meals and the three snacks,

as we have mentioned before, so that they build their confidence so

that they can become an intuitive and mindful eater.

Like that last point.

And then if they are feeling really competent

in how they’re nurturing their bodies, then they feel a lot more competence

and competency in other things like body image and just that sense of control

and that sense of self efficacy and inner resourcing that is just good for overall

confidence that we want for all of our children.

Someone is struggling.

Depending on the age of your child,

you may need to enlist the support of the school,

mostly because of appointments and they may have to miss school,

and then they get behind and then that adds more stress and then

that activates more disordered eating behavior.

So, enlisting someone in the school to know what’s going on,

whether that be a counselor or an assistant principal or a teacher

that you trust just to inform them that this is what’s going on and having

a safe place for your child to go if needed.

So, teachers may need to be informed, having that point person at the school

to be available if your child just needs to sit and eat lunch possibly,

and or is feeling quite overwhelmed that they have a place they can go

and there might be some learning accommodations that might be needed.

You would have to obviously talk to your

school counselor or an administrator to see what accommodations could be

created for your child, whether that be exempting them from exams

or offering some extensions on deadlines or a quiet place to write a test if

they’re feeling a lot of anxiety and overwhelmed.

So, checking in with your schools and not

trying to do this in isolation because we need a team of people to support,

especially if you’re really enmeshed in some eating disorder behavior.

Yes.

And Dell had touched on this here, but in terms of some meal support as well.

So, I know I’ve had clients before that had to have their snacks during a time where

they’re in a class that they’re not allowed to be eating.

So, they worked with the teacher.

This is hush hush.

So, the teacher helped them kind of figure

out a way to always excuse themselves to go down to the office and take

the attendance so that they could quickly have their snack there.

And other kids wouldn’t know what was

going on if they didn’t want other people to be involved at that point.

And we often get asked if medication would help the treatment plan.

And we say, yes, it can.

But there also isn’t any specific

medication that can cure an eating disorder.

Some can help with symptoms, and it can perhaps treat some cooccurring

disorders because as we mentioned at the beginning, there can be a higher

level of anxiety and depression diagnoses as well.

So, a medication that can help support

that would then help support the eating disorder.

We also know that nutritional support is

really important at the beginning phases of an eating disorder.

So, food is the medicine.

However,

SSRI So, a selective serotonin reuptake inhibitor, specifically have shown

to improve some of the disturbances that come along with an eating disorder.

It helps with some bulimia and binge eating.

There are more studies related to that,

but it’s something to explore with your doctor and see if that is something

that could help while you’re doing the nutritional support as well.

So, what do you do if your child thinks nothing is wrong?

Malnutrition can impair the brain self perception.

So, a person with an eating disorder may

not be able to recognize that they even have an illness.

With teens and children, it’s really important that the caregiver

take on that responsibility to bring their loved ones to the appointments and get

help and appointments really shouldn’t be optional at this point.

It’s just the impairment and judgment that we see.

We often get clients that are mandated or forced to come,

and we are okay with that because we have to get them in the office,

get them saying that there are some costs and benefits, and that sounds awful.

But the benefits of an eating disorder are that it’s trying to take care of them

and they’re using their eating disorder to settle and soothe their emotional selves.

So, bringing them in, helping them understand where this is

coming from and the costs and the things that they are losing or that are hindered

in the world, how we work with clients right

at the beginning, if they feel like they are being forced or mandated

for counseling, at least getting them in the door and saying, you got to go.

And oftentimes we are doing a lot more of the work at the forefront of sessions,

but it’s just really important to know that their judgment is hindered.

So, if they don’t feel like anything’s

wrong, then you just have to be the one to say, yes, I’m concerned about this.

We’re going it’s your responsibility as

a parent to take care of their emotional needs.

There. This would be a really great place

to weave in Some of that emotional support and coaching that we’ve been discussing

previously, as this would be an opportunity for you

to be that very loving, warm, but firm parent who’s saying, I know this is hard.

I know you’re scared.

I know you might not want to go talk to somebody, and we’re going.

I’m worried about you.

There’s something going on, and we need help, and that’s my job.

So that minimizing the negotiations.

You are the parents.

I know this is tough, but we’re going.

And so that connects and redirect stuff that we keep repeating.

This final slide here is really important.

So, it’s about modeling self care and healthy relationships.

During this really tough time in your family, you may need a lot of.

Support, and that not only

from the professionals, but also from your family members,

your partner, a friend, your own personal counselor.

But it’s really important that you’re not falling to pieces in front of your child.

You just don’t want your child to feel

like, oh, I’m messing up my family or look what I’m doing to my dad.

You really want to be able to take your

emotional frustration, anger, fear to someone that can help you process this.

So, the better you are,

the better you are feeling about where you are emotionally and confidence wise.

Although I know there’s going to be a lack

of confidence in figuring out, what do I do?

I’m at this weird stage, I’m not sure,

but you have to take that insurance to someone other than your

child, and it is okay to say to your child, you know what?

This is new for me, too.

I’m not sure because you want to also show

your child that you’re human and you’re in this together.

That’s the essence.

You can’t force your child to get better.

You can only support them during the recovery.

And so just saying, I’m here, we’ll figure this out.

I don’t know what we’re doing,

but I’m strong and I’m capable, so they just really need your strength.

So, bring in your people and ask for help.

Personally, we just want to end with the fact we have this handbook.

We might even.

Shown it a few times that this will be alongside the video.

We’ll have access to this resource, and.

That resource has videos, YouTube, I guess YouTube videos,

some books to read, articles, websites, podcasts, A whole page full of.

Resources so that you can expand on any

of these areas that we’ve touched on because even though it probably felt

overwhelming, this is just kind of a summary of some of the work.

So please refer to the resources for more in-depth material, and we wish you well.

Thank you. Thank you.

 

Information Seminar for Caregivers Affected by Eating Disorders

 

Hi everyone.

 

I’m Danelle Spence and I’m a registered psychologist.

 

And I’m Lindsay Huculak.

 

And I’m a Canadian certified counselor.

 

Lindsay and I developed this information

 

session for caregivers affected by eating disorders.

 

So, we wanted to be able to help parents or anyone that has a child or a friend or

 

a family member that’s struggling with an eating disorder.

 

We wanted to provide some information,

 

some education, and some early intervention strategies

 

to help support your child if they’re suffering from an eating disorder.

 

So, in today’s presentation, we’re going to be going over

 

what is an eating disorder, discussing some of the contributing

 

factors of eating disorders and looking into some of the early signs and markers

 

that you can be watching for and helping to address early on,

 

since early intervention and understanding is really important for treatment success,

 

and then we’re going to move on into some more hands-on intangible,

 

emotional and behavioral support and discuss things to do and not to do.

 

So, it’s important to recognize that not

 

all of this information will be relevant to each family.

 

So, take the pieces that are and hopefully you’ll find some stuff in here.

 

That will be useful for you.

 

So, we’re going to start off with.

 

What is an eating disorder?

 

Listed below are some of the most common eating disorder criteria.

 

So, the first one there is anorexia nervosa.

 

You’ll commonly just hear this referred to as anorexia.

 

This is characterized by low weight, weed restriction, and fear of gaining weight.

 

So, there’s a very strong desire to be thin that’s associated with this diagnosis.

 

Bulimia Nervosa, or Bulimia is characterized by periods

 

of food restriction, which is unfolded by binge eating,

 

which has a recurrent compensating behavior to purge the body of the food.

 

So, this doesn’t always mean that there’s a period of restriction before.

 

So, some individuals will just eat regular

 

amounts of food, but they will be purging that out.

 

So that could be done through vomiting.

 

Or also laxatives or over.

 

Exercise disorder is characterized

 

by recurrent episodes of eating large quantities of food and then afterwards.

 

There’s no purging of this, but there is a

 

big experience of shame and distress and guilt afterwards.

 

Avoid and Restrictive food intake disorder, which is also referred to as

 

ARFID, involves limitations in the amount or types of food consumed.

 

However, unlike anorexia,

 

it does not involve any distress about the body size or shape or a fear of fatness.

 

So, this is more associated with somebody

 

who has had a negative experience with food.

 

So maybe they’ve gotten really sick after eating something and there’s a relation.

 

Now there or some people just have sensory issues where there are certain foods.

 

That really cause them to be fearful.

 

The eating disorder that involves an unhealthy obsession with eating healthy.

 

So, unlike other eating disorders, Anorexia.

 

Mostly revolves around the food quality, not the quantity.

 

You’ll also hear this just to add in clean eating, healthy eating.

 

I don’t eat junk food.

 

So, there’s a lot of rules around what type of foods are being ingested.

 

The last one here,

 

eating disorder not otherwise specified or Edna, is characterized

 

by displaying some of the traits of the other disorders,

 

but the behaviors do not fit the full criteria of any one of the conditions.

 

I know that was a lot of information,

 

but just to remind you that a lot of teens or anyone that’s struggling with an eating

 

disarm, not just teens because we know it’s a buried age

 

that do experience eating disorders, but they have and flow in between some

 

of these characteristics and some of these diagnoses.

 

So, you might be diagnosed from a medical professional

 

with binge eating disorder, but you might restrict during the day or

 

you do some sort of compensatory behavior like over exercising the following day.

 

So, there is some fluidity between the diagnoses.

 

Lindsay and I get asked all the time is why?

 

Like why is my child suffering from an eating disorder?

 

And there are so many contributing factors that are involved in eating disorders.

 

And it’s really hard to pinpoint just one

 

reason sometimes there is just one reason, like a traumatic event.

 

It isn’t always just one factor.

 

There are all of these that we’ve listed

 

here, but what we say often is they are biopsychosocial in nature.

 

And I know that’s a mouthful, but it’s basically an interaction between

 

things like genes and DNA and predispositions biology.

 

So, what’s going on in the brain?

 

Because there are significant chemical

 

imbalances that happen in eating disorders, we now know that their receptors

 

for serotonin and dopamine are reduced and those are the neurotransmitters

 

that activate happiness and contribute to the ability to self suit.

 

So, we know there’s the biology,

 

we know there’s personality traits and not just that temperament.

 

Some children are just more predisposed

 

to suffering from an eating disorder and life events and the environment.

 

So, the cultural influences,

 

the fast-paced life, the stress of school and fitting

 

in and of course technology and screen time is also a factor.

 

And the reason why we want to describe

 

that there isn’t just one factor that contributes is because it can maybe

 

help parents and families respond with less frustration.

 

So, knowing that this is not just a set of choices or a lack of motivation or

 

stubbornness, but there are many things that are impacting.

 

Lindsay and I always get asked why is my child struggling with food specifically?

 

And there are again a lot of contributing factors in this as well.

 

We have fear.

 

They are just really scared.

 

The underlying anxiety.

 

So, we know that eating disorders are comorbid with things like depression.

 

50% have that combined diagnosis of depression and anxiety.

 

It’s actually 35%.

 

So those are big contributing factors, and they are using food to help manage

 

and settle their systems because of the mood stuff and or the overthinking.

 

Like the third point, the negative internal dialogue.

 

We just know that there is a lot of overthinking that can happen.

 

And that inner critic that is saying

 

you’re not good enough or you need to do this or this.

 

And of course, we have the combined temperament from the last slide.

 

There’s perfectionism.

 

There’s things like cognitive inflexibility.

 

There’s poor coherence of what’s going on in my world.

 

They don’t really know how to manage things like stress and stuff

 

with relationships that are quite complicated sometimes for individuals.

 

There’s a lot of things like focusing on detail rather than the big picture.

 

Because we know if someone is struggling with an eating disorder,

 

they latch on to overthinking about something over and over and over again.

 

So those are some reasons why your child is struggling with food.

 

They’re using food to help manage all of this stuff.

 

Also, on our list here, we’ve got a starved brain.

 

So restricted eating, we know, can lead to dramatic changes in the brain.

 

And because of the way our brain

 

and bodies respond to limited nutrition, the longer someone is malnourished,

 

the more difficult it is to eat normally again.

 

So, there’s going to be actual

 

compositional changes to the brain that has been starved.

 

I know that’s a quite large list.

 

And you just have to look at your child

 

and go, okay, yes, they do have that perfectionist tendency.

 

We know that there’s this societal pressure that was our last point.

 

And so just looking at the perfect storm of things is probably why your child

 

is using food as a way to manage a lot of those.

 

That perfect storm.

 

So just to add on, there what we were just discussing in terms of why my child is

 

struggling with this is a really great quote.

 

Eating disorders are powerful coping mechanisms that help an individual manage

 

the parts of life that feel too much to bear.

 

Your loved one doesn’t feel threatened by it.

 

To the contrary, they feel threatened without it.

 

And just to add to that, your child likely wants the relief

 

of the symptoms and does not want to be struggling with an eating disorder,

 

but they don’t want to give up their unhealthy coping mechanism.

 

For them, it feels safe, it feels comforting.

 

And we’ve often heard that it’s like getting rid of a friend,

 

getting rid of a confidant, getting rid of something that just really

 

helps them cope with the stressors of life.

 

It’s really serving a purpose for them.

 

Next one, I get into some early signs,

 

some possible markers that you might notice with your children,

 

and we’ve broken it down into physical appearance and behaviors, food rules,

 

hyper, focusing on certain things and exercise specifically.

 

And as we go through these lists,

 

they’re quite detailed things to watch out for, things to notice.

 

And just know that one, as an example, is wearing baggy clothes.

 

If your child is wearing a baggy hoodie,

 

it doesn’t necessarily mean Holy my child is an eating disorder.

 

It’s just the combination of all of these things.

 

If you start noticing you’re like, okay, yeah.

 

So just know that these are some things to look out for, but they aren’t concrete.

 

So, we will start with physical appearance.

 

Physical appearance.

 

So, some of the physical things to be

 

looking out for would be obviously a fairly sudden increase or decrease

 

in weight attached to that sometimes may be covering up that weight loss or weight

 

gain with a change in how they’re clothing themselves.

 

So, they may be like Daniel said, starting to wear more baby clothes or not

 

wanting to go out as much, that sort of thing with bulimia.

 

So, with any type of purging behavior,

 

there are some noticeable behavior or physical things that come with that.

 

So, there’s oftentimes like swelling grounds.

 

Not always, but sometimes we refer to it as chipmunk cheeks as well.

 

So, there’s a swelling here that can occur with vomiting.

 

Also, in lines with bulimia would be

 

potentially some cuts or abrasions on the top of the fingers if they are

 

using their fingers to initiate that bloodshot eyes from vomiting.

 

So sometimes they will have precise

 

vessels, bad breath, or brushing their teeth a lot more than they used to.

 

Teeth issues.

 

So oftentimes dentists will notice if there’s some damage to the enamel.

 

So, your dentist may approach you and discuss that with you.

 

I’m supposed to go to some specific behaviors to watch out for as well.

 

So, the constant weighing of themselves.

 

We have clients that weigh themselves three or four times a day.

 

And so, getting scales out is a behavioral

 

thing you can do getting the scales out of the room, so they don’t do that.

 

Turning to food to deal with emotions.

 

So just noticing like, oh, I’m really overwhelmed, and they grab a bag of chips.

 

Or if they have no other coping mechanism

 

to handle emotional distress, then that is a flag.

 

I’m spending a lot of time in the bathroom after meals.

 

So just noticing showering or baths or water running to hide some purging

 

behavior, perhaps just finding empty laxative boxes or noticing food being

 

consumed faster than you would typically think.

 

So, you just bought that box of crackers

 

and then all of a sudden you go in the pantry and they’re missing things

 

in the garbage that you wouldn’t normally see.

 

Like just wrappers things like that, not eating in front of others.

 

So, you will notice maybe them saying I’ve already eaten or I had a big lunch or just

 

coming up with covers for actually eating a meal.

 

So those are just some of the behaviors to just be mindful of.

 

Now we’re going to go to just food rules

 

that you might start to see happening with your child.

 

So, some of the things that may show up

 

a common one would be wanting to become vegan or vegetarian.

 

So, lots of rules around eating things like not eating after 07:00 p.m. Or I’m not

 

eating carbs or I’m no longer eating sugar.

 

So, any hard definites in terms of what

 

they will or will not eat, some kind of odd behaviors with their food.

 

So, cutting things into very small pieces,

 

not allowing foods to touch, shuffling food around the table.

 

So, if you’re noticing that there’s not much going in but there’s a lot

 

of behaviors happening with the plate type thing.

 

Eating too rigidly, are too clean.

 

So, we spoke about that in terms of orthorexia.

 

So only eating low fat or no fat or only

 

eat whole foods that are not processed, that sort of thing.

 

Food ritual,

 

that kind of in line with the cutting and whatnot, but not letting food touch or

 

I can only eat this color of food or that sort of thing or any kind of negotiating.

 

So, if you hear them either making

 

negotiations with themselves or with you no, I can’t eat dessert today because I

 

didn’t get my workout in or no mum, I’m not eating your chocolate cake because

 

I haven’t run my ten KS or what not that sort of or.

 

I will eat the chocolate cake if I run ten K.

 

Yeah. And then we’ll get into the last one.

 

No, second last one.

 

Just hyper focusing on food nutrition, obsessing over food labels,

 

reading every cookbook that they can get their hands on.

 

So just noticing this hyper focus on weight, shape and appearance,

 

spending excessive amounts of brain time thinking about food.

 

What am I going to eat? What am I not going to eat?

 

We’re going to a restaurant.

 

Can I see the menu beforehand?

 

Compulsively counting calories, like looking at food labels, weighing food.

 

So, if you have a scale there for your

 

coffee beans but they’re starting to use it for I can only have so many ounces

 

of yogurt in the morning, which is really hyper.

 

Focusing on numbers on weight, just anything related to dieting,

 

the influencers they might have on their Instagram.

 

If you’re looking through their social

 

media use, if it’s all clean eating influencers on Snapchat or whatever kids

 

are using these days, then that’s just the hyper focus on weight

 

shape of parents that are some things to pay attention to.

 

And the last one is exercise.

 

So, what we always look at with exercise, is your child using exercise for joy,

 

for play, for fun, for positive reasons, or are they using exercise because it’s

 

eating disorder driven like Lindsay was saying?

 

Are they using it to negotiate with themselves?

 

Like I am going to be able to go to that party with my friends if I do 27

 

burpees before that’s random 27 burpees before school.

 

So just looking at exercise as how they’re using it and what purpose is it serving?

 

Could they stop?

 

If they were asked if they sprained an ankle, would they be okay?

 

Because they have a whole bunch of other

 

mechanisms to kind of calm themselves and to sue themselves.

 

So do they have rest days.

 

We know that you need one or two rest days for muscle repair in a week.

 

And if they are going two workouts a day,

 

just needing to move, needing to be physical is a flag.

 

Yeah.

 

And just paying attention to, again, some of the things that they might be doing.

 

So, exercising in their room at night.

 

So, if you’re hearing bedtime,

 

they said they were going to read a book and you hear the floor kind

 

of with jumping Jacks or whatever, it’s like, why are they doing that?

 

Now?

 

I remember the secrecy, like just to tag onto Lindsay’s mom’s onto me.

 

So, I’m going to pace in my room over and over again or things like that.

 

We might not even think of standing

 

instead of sitting because that’s going to use more calories or wanting to be

 

cold, which again, they could pick up on that.

 

That’s going to burn more calories or fidgeting.

 

So, I have one client that is constantly

 

moving her legs up and down and doing plyometrics or whatever it’s called.

 

So, she’s constantly exercising.

 

So, pay attention to some of these

 

behaviors that you might see in the odd things.

 

I know Lindsay laughs at this, but planking, you’re just in the middle

 

of watching your favorite show and they’re planking or they’re doing sit ups or

 

they’re like doing yoga poses and say, okay, that’s a little bit odd.

 

What is the purpose this is serving?

 

So, asking the difficult questions

 

and being really curious as to what some of these things are is really important.

 

So, some of you may have already noticed

 

some of these markers or these flags in your loved one,

 

or if you’re just starting your journey with this and you’ve now watched this

 

video and you’re seeing these things or paying attention to them,

 

you might have some reactions to these things that you’re noticing.

 

So, we just wanted to talk about some

 

really common reactions to the symptoms of an eating disorder.

 

And then we’re going to move into why these might not be the most helpful

 

and help you develop some more skills to really attend to these symptoms

 

in a different way that are going to be more effective in helping move.

 

Through the stuff, because it is very difficult stuff.

 

When we recognize that,

 

we recognize that you’re probably really scared, you’re overwhelmed.

 

You’re like, Holy, Holy man, how do I do this?

 

How do I help my child not go down?

 

that eating disorder route or get out of that eating disorder behavior?

 

So, this is Maudsley.

 

So, you probably have seen some resources

 

on what to do if your child suffers from an eating disorder.

 

And we love this. And its really kind of weird to have

 

these animal metaphors, but I’m going to put them up again.

 

If I know how to do that, I’ll let Lindsay begin.

 

Yeah. So, it’s categorized into these four

 

different common animal models that may come up here as reactions to symptoms.

 

So, the first one is the Kangaroo.

 

So, this is where we smother with protection.

 

So, we’re safeguarding everything and we’re

 

treating our loved ones as if they’re incapable of handling everything.

 

So of course, with this image here, it’s like Mama Kangaroo is putting baby

 

in her pouch and just protecting them from anything.

 

No, you can’t go to that party.

 

You won’t know how to handle it.

 

Those kinds of things,

 

the rhino would be charging in with anger, irritation, or control.

 

So, what that would look like is just very strong.

 

Just eat one more. It’s so simple, why can’t you do this?

 

Just eat that sort of type reaction,

 

because parents are so lost, and they don’t know what to do.

 

So, this can be kind of a common reaction to that.

 

An ostrich parent would be the parent

 

that sticks their head in the sand and wants to just ignore the situation

 

because it’s too painful or too confusing or overwhelming to acknowledge.

 

A jellyfish parent is a parent who’s

 

really overwhelmed with their own feelings about it.

 

So, whether that be their own guilt or shame,

 

blaming themselves, all those kinds of things,

 

so, their emotional reactions can become kind of spilling out everywhere.

 

So those are common but not very helpful.

 

I guess it depends too, because I know as you’re listening

 

to this, you’re like, oh my gosh, I’m a total ostrich.

 

Like, I saw and noticed some things and I

 

never said anything because I didn’t want to make it worse.

 

Or you may just be feeling guilt and shame.

 

You shouldn’t, because it’s not about blame, ever.

 

But just paying attention to where you’re

 

gravitating to and knowing that there are sometimes for rhino as an example,

 

that take charge in some of the early phases of trying to get your child

 

to restore their weight and become healthier physically.

 

You may have to rhino it up and just be like, no, you’re eating this.

 

But we want to help you.

 

And that’s the next few slides to help you

 

become really calm, firm, loving, and connected so that you can do what you

 

need to for your child, even if you’re freaking out,

 

even if you’re really overwhelmed, even if you feel jellyfish like,

 

but just knowing that you want to be loving and connected

 

and understanding and trying to remove the eating disorder from your child,

 

because this is something that has taken hold of your child and it’s not your child

 

wanting to be, like we said at the beginning, stubborn or difficult.

 

So going on to the next little bit is

 

about why we need to build our child’s emotional competency.

 

So, it’s really important to understand

 

that in recovery they are avoiding feelings and your child is trying

 

to figure out, what do I do with these negative emotions that I might be having?

 

So, as you can see here,

 

an eating disorder can serve as a maladaptive way of managing unwanted

 

negative emotions, they may not know, what am I feeling?

 

What am I feeling? And what do I need to do with my feelings?

 

Because we know that emotions need action.

 

When I’m sad, I need to cry.

 

When I’m fearful, I need reassurance. We know this.

 

We know that when we build emotional competency, and we get good with our

 

emotions, then we don’t need a maladaptive behavior like an eating disorder.

 

Like, we don’t need to latch

 

on to overthinking about food or like, on the slide.

 

Starving. Numbs.

 

Starving is putting a lid on unwanted and undesirable emotions.

 

Binging actually soothes the nervous system.

 

Purging actually floods when a child throws up.

 

It’s like it’s a wave of melatonin.

 

That’s the sleep hormone, not melatonin.

 

It’s a wave of neurotransmitters. Yeah.

 

Like it’s blood of serotonin.

 

And it actually is very soothing, and it offers them a sense of relief.

 

So, it’s just imperative that there is

 

a focus on not only the behavioral ships and the refeeding and making sure

 

that they have that health component contributed to their recovery,

 

but they also need to work on the emotional component.

 

So, as we move into helping you guys as

 

parents and loved ones, develop your own emotional competency

 

with this stuff, this is where it links together from.

 

Okay, well, how do I stop being jellyfish?

 

How do I stop being rhino?

 

Is we’re going to help you guys name some of these emotional components and then

 

help use that knowledge to become your children’s emotion coach.

 

So, this next segment is just going to tell you how to actually

 

do that because it’s tricky, but it really actually isn’t as tricky as you think.

 

And we really believe that’s.

 

What I guess Lindsay and I really believe

 

in our whole heart is that we believe in parents, and we believe in parents

 

capacity to be that person that your child brings their emotional stuff to.

 

And that is really key to recovery.

 

So, we’ll start with, how do you be your child’s emotion coach?

 

So, you’ve heard us use the term emotion

 

coaching, and you’re probably thinking, what is that?

 

So here are the steps to emotion coaching.

 

So, one attend to the emotion.

 

So, what we mean by attend to the motion is

 

you’re going to pay attention to anything that your child is showing you,

 

whether that be slamming a door, whether that be rolling an eye,

 

whether that be minute, little flicker of a look away.

 

But what you’re doing is you’re noticing this thing.

 

So, emotions are not always big and bold.

 

They can be very minuscule.

 

And you almost have to be a Detective to look for some of these things.

 

But it’s really important to pay attention to it.

 

And by attending to it, what you’re saying is I see this.

 

I see that you look sad, you look confused.

 

You’re noticing them once you have attended to it.

 

So, hey, what’s up?

 

What was that eye roll about or how come you Slam the door there?

 

You’re going to label and express the emotion.

 

So, what we mean by labeling and expressing

 

it is you’re going to say something like, hey, you slammed the door there.

 

Seems like you’re probably pretty angry

 

right now, because that would be an obvious one.

 

So, this is not always obvious.

 

So, I’m making it sound very easy.

 

You know, a door slammed, that must be anger.

 

But we’re going to get it wrong sometimes.

 

So, you may say something like,

 

you look really sad if they’re showing tears or whatnot.

 

And they may say, I’m not sad, I’m mad and great.

 

Okay, now they’ve helped you out and you know what the real emotion is?

 

They’re feeling it’s very tricky with some

 

of this population because they don’t often know what they’re feeling.

 

Right.

 

So, a common thing is they are not great with their feelings.

 

So, they are going to miss queue things. Right.

 

They might be sad, but they’re showing anger or vice versa.

 

So just know that you’re helping be kind of a coach and a guide for this stuff.

 

But it’s a learning process.

 

It’s a co creation that’s happening there.

 

And it’s not, again, as simple as I’m making it sound.

 

And I want to remind people we have an accommodating handbook of information.

 

And one of the resources is Daniel Siegel.

 

And he always says name it to tame it.

 

So as Lindsay was saying, like, hey, you’re angry.

 

I see you’re angry. Even just that sense of, hey,

 

my mom is seeing me, or my dad is trying to understand me.

 

Even if you don’t necessarily understand

 

what is going on, it’s that name it to tame it.

 

So, labeling like the step two here, labeling and saying, I see you, I get you.

 

I’m trying to understand your emotional world is just really important.

 

But the most important I’ll let Lindsay. Yeah.

 

Continue.

 

As you see, we’ve underlined it and put important there.

 

So, validating the emotion.

 

If you take one thing away, please take this away.

 

Validation is a critical skill to have, not only with your loved one that’s

 

struggling with a mental health concern, but just any relationship.

 

So, validation is about putting yourself

 

in the other person’s shoes and understanding it from their perspective.

 

So, where this can be really tricky again

 

are they’re going to bring some feelings or emotions that don’t make sense, right?

 

I’m fat, I’m disgusting.

 

Where you see this beautiful, thin child in front of you.

 

So, it’s very hard to validate something that you don’t agree with and don’t see,

 

however, the breadth and the importance of validating it from their perspective.

 

So, what that would look like is something

 

like, I see how hard it is for you to accept yourself.

 

So, something like that, that’s going to capture it from their perspective.

 

So, validating anything they see.

 

I get why you’re mad right now.

 

I get why you’re upset that you can’t go to that party because it’s mealtime

 

and you need to be supervised for meals right now.

 

I understand that must be really hard.

 

So, validating.

 

And what we’re doing there is we’re

 

helping them normalize their experience and helping them recognize that their

 

feelings are important and they matter and they’re real.

 

So, they don’t need to dismiss it, hide it, wash it or not feel it.

 

We want these things coming up.

 

The next one is it’s not always possible,

 

but meeting the need is if you’re able to land on okay, you’re sad.

 

Can I give you some comfort?

 

Can I give you a hug?

 

Can I bring you some tea?

 

So, you meet the emotional need there.

 

If they’re mad, they need a boundary.

 

So, you’re going to meet the need of. Okay, I get it.

 

You need some alone time.

 

I’m going to come back in ten minutes and check on you.

 

And please know again, this is a quick summary of this stuff.

 

But in the handout that comes along

 

with this, there’s a lot of resources out there, lots of access to videos

 

and handouts that are really going to expand on what we’re talking about here

 

and helping you get more familiar with these steps.

 

How do I validate that when it’s nonsensical?

 

And how do I meet the need when I don’t really even know what is happening there?

 

So just please know that this is a summary.

 

Well, in this handout,

 

just to refer again, oh, my goodness, it’s a little ridiculous.

 

But there’s script, we put pages, I think, scripts for how to help with meals.

 

But then mostly with this emotion coaching, like, say this, don’t say this.

 

And we will get into that a bit at the end of this seminar.

 

But the most important thing is not to go to step five all the time.

 

I think we as a society want to fix and problem solve, and we like that.

 

We don’t want to happy with emotional dysregulation.

 

So, we often just jump to let’s figure out a problem.

 

Let’s solve this.

 

What can I do about this?

 

And we jump to step five

 

and we need to at times, we definitely don’t want to ignore

 

that our child might not have the capacity to problem solve on their own.

 

And we need to jump in and rhino it up.

 

But it’s really important to only do that if necessary.

 

And it’s staying in those first three

 

steps of attending, expressing the emotion, naming it,

 

and then the validation of I see you, I get you.

 

I understand you, even if you don’t totally understand.

 

I’m here with you and I’m trying

 

to understand and muck around in your emotional world so they don’t feel alone.

 

Now one of the important things here is

 

that if we do accidentally put the slide back up, if you accidentally jump

 

to number five too quickly, a concern with this is that they are not

 

getting the competency of developing emotional regulation skills.

 

So, one, two, three, and somewhat four as well for helping

 

model ways to meet the emotional need is helping them figure out for themselves.

 

Okay, I’ve got feelings.

 

It’s telling me something that’s valuable and important.

 

I need to attend to that.

 

My feelings matter.

 

Once I know what I’m feeling,

 

I can start to access what I might need in order to help tend to that emotion.

 

So, this is development of emotional regulation.

 

If we as parents accidentally jump to number five too quickly,

 

we are missing that opportunity to help them develop these really critical things.

 

So again, I know as a parent myself,

 

it is so easy, and you want to jump to number five sometimes and it’s not

 

always problem solving or fixing it’s things like, oh, I don’t feel that.

 

That’s silly.

 

They don’t hate you, that kind of thing. You’re not fat.

 

Yeah, like it’s jumping, like wanting to take their pain away.

 

But even if your daughter is saying, oh, I’m so fat, I’m so grotesque people can’t

 

stand to look at me the minute you go to but are you kidding me?

 

You have a cute little body.

 

It’s like that’s not what sad is not a feeling.

 

That’s not where they’re going.

 

That’s what they’ve latched on to.

 

That’s what they’re hyper focusing on.

 

So, pausing and going, tell me more what’s going on for you.

 

Like, I can see how distressed you are.

 

You seem really overwhelmed right now.

 

Help me understand because remember, the whole point of a lot of this is

 

that we want to render the eating disorder as we don’t want it needed.

 

Not needed. Yeah.

 

And right now, the eating disorder is soothing numbing.

 

It’s helping them avoid emotional content.

 

So, the more you muck around with their emotional stuff, then the eating disorder

 

will slowly it’s a lot, I know, but it will slowly go away and not be

 

needed as much to soothe their emotional sells.

 

I’m just going to put this one up. We love this.

 

This is Gordon Newfield, and he wrote the book hold on to your kids

 

and we have that in their resource list, but we cannot parent parts we do not have.

 

There’s lots of science that says

 

the nurturing, connected relationships that we have with our children have really

 

shown to activate really healthy brain chemistry.

 

So, this means that when caregivers connect in this emotionally attuned matter,

 

it really creates this calming effect on their nervous system.

 

It promotes more emotional regulation.

 

Kids feel seen, felt and understood.

 

It gives them this flood of endorphins

 

and neurotransmitters that would otherwise eyes be creative.

 

It from purging or restricting.

 

So, it really is important to pay attention

 

to the relationship you have with your child and build your competency

 

with emotional competency so that they can bring their emotional stuff to you do.

 

And that’s why therapy is really

 

important, not just for the child, because we often hear that like, okay,

 

my twelve-year-old is struggling to see her, but Lindsay and I never work

 

with a child in isolation, especially related to I mean,

 

we do sometimes, but when it was related to eating disorders,

 

we need to bring in parents so that you can be available to them to do this

 

emotion coaching stuff as well as getting them to eat.

 

Because back to this slide, we cannot parents hearts we do not have if

 

you’re trying to meal support them and make them eat breakfast because they

 

are underweight or in an unhealthy medical place, they’re going to be far more likely

 

to do this work with you as a support if they feel emotionally connected to you.

 

And as parents, we don’t expect or at least us as

 

clinicians don’t expect parents to know how to do this stuff.

 

Right. There’s a very emotionally avoidant

 

culture out there that we live in, and most of us have not been modeled or

 

taught how to emotionally attend to this stuff.

 

Right.

 

So, what we’re asking parents to do is very hard.

 

We’re asking you to be emotion coaches

 

when you might not have those skills developed for yourself.

 

So that’s where it’s really critical that you have support from a therapist as

 

well so that your own stuff can be processed through.

 

And you can figure out how to do this because how can you coach someone to do

 

something that you don’t even know how to do yourself?

 

So just we really want to reiterate

 

the importance always of having support for parents.

 

And you need a team around you to help

 

support and guide you and resource you so that you’re able to take on this really

 

big task of supporting your loved one who is suffering in this.

 

I know that was a lot Lindsay and I do five day,

 

five evening seminars on emotion coaching, but the resources in our handbook will

 

provide you some books to look into, to dive deeper into the emotion coaching

 

and the importance of emotional competency.

 

But now we’re going to get into some more

 

granular stuff of things to do, more of things to do less of.

 

So, the do’s and don’ts in supporting your child with an eating disorder.

 

So, we’re just kind of we’re going to go through this quite quickly, actually.

 

Yeah. And some of them

 

it kind of meshed together in terms of some of the emotional stuff,

 

but also, some of the behavioral and tangible pieces here.

 

So, it’s across the boards.

 

So, if you do is just

 

remembering that you want to understand what the feeling is under the words,

 

under the pushback or the arguing or some of the behavioral stuff.

 

It’s like really mucking around and what

 

the feelings are under that try to be as warm and loving as possible,

 

even if you’re super frustrated or scared or overwhelmed yourself.

 

Try not to blame shame or cause pain because this is not about blame.

 

This is not about why can’t you just do this?

 

Like, it’s just really important to watch your language in, especially saying things

 

like, you’re ruining our family or Why are you doing this to me?

 

It’s just because we know that guilt

 

and shame are really active eating disorder behavior.

 

So being really mindful of what you’re saying.

 

So do reflect, pause,

 

take care of yourself so that you can I know it sounds rude,

 

but kind of check yourself so that you can be available to your child and try

 

to refer to and think about the eating disorder as a separate entity.

 

And I know it is your child, but remember, this is your child in pain.

 

This is your child struggling, not being well in their emotional world.

 

And really illness.

 

Yeah, it’s a significant illness.

 

So, knowing that, okay, this is just my child’s suffering and this

 

isn’t my child being a real treat and just do offer comforting gestures.

 

So, rubbing her back or saying to him, I’m here for you.

 

So just really the comfort of just being present and offering a hug when needed.

 

And that reassurance.

 

And just also do recognize that recovery is not linear.

 

So, there will be setbacks.

 

You’ll be like, okay, we got this, we got this.

 

And then the next week it’ll be all falling to pieces and it’s really okay

 

and important for you to remember that it’s not going to be linear.

 

There’s going to be ebbs and flows in the treatment.

 

And you’ll think it’s a relapse.

 

I don’t even like that word.

 

We call them setbacks because it’s not A plus.

 

B equals C. There’s no.

 

We expect that. Yeah.

 

Actually. And they’re learning opportunities.

 

We know that’s hard to think of it like that.

 

And really emphasize, do emphasize success when they are

 

struggling, not throwing up, and they do it, you have to celebrate

 

that like crazy easy and just be like, oh, my God, I’m so proud of you.

 

You’re so strong. That was so difficult.

 

And you did it anyway.

 

So, remembering that emotion, coaching, connect, then redirect.

 

Right.

 

Connect emotionally and then offer suggestions.

 

So do emphasize the celebration, the positives.

 

I’m so proud of you.

 

You did that.

 

Now can you eat the next part?

 

So just remembering, we will get into more

 

details on the meal support and scripts, but just celebrate the small success.

 

So, the don’ts, the don’ts would be.

 

So, we want to encourage emotional expressions.

 

But of course, we don’t want to tolerate any sort of abuse.

 

Right. So, if they’re really angry or protesting

 

or whatnot, it’s again, making space for that feeling.

 

But knowing that there’s also a line

 

of you can’t throw a plate at my head or you can’t call me the F word or whatnot.

 

I recognize this is really hard for you

 

and very frustrating, but I’m not going to tolerate you treating me that way.

 

Don’t do most of the talking.

 

So really, this is a time

 

in your family’s life where it’s really about increasing your capacity to listen

 

really wholeheartedly and less knowledge here, listening more.

 

Don’t set unrealistic goals for yourself or for your loved ones.

 

So, something like gaining £5 in a week,

 

that’s really unrealistic or even for the family of like,

 

we’re going to beat this thing within three months and then life is going

 

to take off again and we’ll be able to go to Hawaii as planned, blah, blah, blah.

 

So don’t set unrealistic goals because dependent on the severity of where your

 

loved one is showing up in, this can be a very long journey and

 

that it’s not helpful for them or for you to have these goals that may not be met

 

on time because there’s no timeline on how this is going to go.

 

This is really important.

 

Don’t always go to the silver lining place.

 

So, what we mean by that is, don’t worry,

 

kiddo, you’ll get this next time and you’ll

 

figure this out or everything’s going to be just fine.

 

I know you can do this.

 

I know you can get through this.

 

You’re strong, you’re brave or always

 

being the light of joy and being Pollyanna of like, it’s okay.

 

I know this sucks, but we’re good.

 

Our level get us through that kind of thing.

 

We have to go into some of these dark places you need.

 

Disorders are dark and deep, and they bring up a lot of really nasty stuff.

 

Nasty like existential kind of self worth stuff.

 

So, we have to be able to go into those places with our children and explore.

 

It so dependent on where you’re at in your

 

journey and the severity of your loved one who is struggling.

 

It may be recommended to you,

 

whether that be through your doctor or maybe you’ve enlisted a dietician already

 

and we will talk more about dietitian support in a bit.

 

But you may be tasked with really taking

 

over responsibility of meals in the early stages of treatment and recovery.

 

So, this slide is in relation to if you are taking that responsibility over.

 

So, what we suggest is really looking

 

at a very structured approach in the beginning.

 

So, what we want to do is eliminate any of these high stress moments where,

 

oh gosh, I don’t have a snack prepared for you, I got to pull something together

 

and your loved one is getting increasingly anxious as that’s happening.

 

So, we want a lot of structured around

 

the planning, the preparation, deciding what that is.

 

Day of so structure, structure, structure.

 

Timing is really important in the beginning.

 

So again, we’ll talk about this with dietitian when we move into that.

 

But really the recommendation, depending again on severity,

 

is often three meals and three snacks a day if you’re needing to gain weight.

 

So, looking at how that’s going to work

 

for your family, where is the best likelihood of success?

 

Those sorts of things stick to grocery lists, don’t check ingredients.

 

So simple.

 

Keep it as simple as you can.

 

This is my food plan.

 

These are the things that we need.

 

Don’t go off the list.

 

We talk about introducing fierce foods early on.

 

So, what we mean by that is if your loved one is absolutely against all sugars,

 

I will not eat any sugary food, any desserts.

 

You don’t want to let that go on too long. I’m an ex-teacher.

 

So, I think of scaffolding,

 

like starting really slow and going, okay, right now I need to own this.

 

I need to take this on and take control of this.

 

But then as treatment, things get a little bit better and they’re

 

like, okay, now you can come with me to the grocery store because you can help.

 

But don’t obviously look at labels, don’t look at calories.

 

Just remind you of is in this handbook

 

that’s accommodating this video is a whole bunch of scripts on how to do the emotion

 

coaching, how to talk about emotions and redirect and help with meal support.

 

But some of them are I can see this is overwhelming for you.

 

I’m here to help.

 

It sounds like you have a lot of fear right now.

 

Can you tell me about it so that I know?

 

that’s what a lot of parents need is like, okay, I get it.

 

But just give me what do I actually say?

 

And then even we got some more specifics around meal support here.

 

So, it depends.

 

I know some of your loved ones may not they might be living on their own.

 

So, you can’t be available to do this, meal support.

 

Some of you, they won’t even let you help with meal support.

 

But we just wanted to put this in there too, because it’s really important.

 

Especially at the early phases of an eating disorder.

 

They need structure and routine around getting the nutrition into their bodies.

 

So, what we have discovered, what does work is the first two.

 

So, using direct eating prompts and being

 

that firm, strong, warm, if you can do the combo of that.

 

But being really direct and saying things

 

like, you have to eat all your eggs, you got to eat this.

 

You’re eating this and this is what you need.

 

This is what you need.

 

This is what I know because I know how to do this.

 

I’m the expert here, even if it feels like

 

you’re not the expert, just being direct and just I’ve got this.

 

I’ve got you. I’m capable because remember,

 

they’re scared and they know if you’re scared, then they’re scared.

 

And that perpetuates an eating disorder.

 

So direct eating prompts are super helpful.

 

The next one using physical prompts.

 

It’s kind of ridiculous.

 

But handing them the food, eat this, pushing the plate in front of them like

 

we’re eating breakfast, we’re sitting as a family.

 

We are eating breakfast and putting a plate right in front of them.

 

That direct firmness is really important, especially in meal support.

 

Things that don’t work are the other four.

 

So, offering choice, promoting autonomy and nondirected eating prompts.

 

So, saying things like, why don’t you eat just a little bit more pasta.

 

Or could you or could you have one more? Yeah.

 

Do you want another one? Yeah.

 

Okay.

 

Do you think it would be okay if you could eat breakfast today?

 

Which one would you like?

 

Would you like this one or this one?

 

So, you’re really taking control, especially at the beginning stages.

 

So being really direct and not offering

 

them options because that’s just super overwhelming as well for them.

 

So, they need to see that you have control of this.

 

And oftentimes what Lindsay and I’ve discovered is that it is really like

 

meal prep and meal sitting and eating a meal is really overwhelming for a lot.

 

So, distraction can be quite helpful.

 

So not talking about an eating disorder

 

related topic necessarily but having the TV on or playing a board game.

 

And we would never really promote multitasking at meals.

 

Yeah. But for an eating disorder,

 

it can be really helpful to put on a video or their favorite show just to distract

 

themselves from the discomfort and the pain that they might be feeling.

 

Yeah.

 

And this would be again in the early phases of refeeding and whatnot.

 

So, as you progress through that, then you would look at removing some

 

of those distractions and being more mindful of how we’re eating.

 

But again, we’re really targeting kind

 

of those early places where we know it’s really, really difficult.

 

So, whatever you can do to help them get

 

that in and then some things, even some behavioral things afterwards.

 

I know lots of families speak about going and laying down afterwards

 

and having like a nice warm hot water bottle or something on the tummy.

 

Just because people do experience a lot

 

of discomfort afterwards if they’re used to not having much food at all.

 

And now they’re tasked with eating regular

 

meals, three meals, three snacks, their bodies literally will be uncomfortable.

 

So going for a gentle walk as a family afterwards or letting them lay down while

 

you clean up anything that we can do to help support these.

 

Tough places,

 

the next little bit of the presentation is going to feel a little bit one off.

 

So, we’re going to be talking about dietitian support and medical support.

 

But the one additional piece

 

of body image concerns your child may say, I don’t like how I fit in my clothes or

 

when I look in the mirror, I feel fat, or I look.

 

Fat and I hate my body. Yeah.

 

And a lot of parents will say, what do we say?

 

Like, do we go shopping and buy clothes that will fit better?

 

The thing we want you to understand is

 

that this is the last thing to often settle in and to improve.

 

So, it often goes from tolerating we want your child to begin to tolerate their

 

body, and then it will go to accepting their body and then feeling good about

 

their body and then eventually loving their body.

 

But it is often the last thing to feel good about.

 

So just paying attention to that and not

 

arguing like, oh, you got a beautiful little body,

 

or don’t worry, we’ll go shopping and we’ll get you some new pants.

 

It’s not about that necessarily.

 

It’s just what can you do to support them

 

as they are being overwhelmed or not comfortable in their bodies?

 

So, some of those things are to remove scales.

 

If you have

 

a lot of individuals will weigh themselves in the morning and then that will set

 

the tone for their nutritional intake throughout the day.

 

So not even having a scale available to activate that need and that compulsion

 

mirrors paying attention to the body checking and how much time they’re

 

spending in front of the mirror and pulling their body apart.

 

Like, oh, I hate this, I hate this, I hate this.

 

And so just really having them be aware and conscious of how much body checking

 

they’re doing, having a gratitude Journal and writing down things that they like

 

about their bodies and how their bodies are used to move them up a mountain,

 

how they have strong arms to help them play volleyball.

 

And so, looking at the positives that their

 

body provide, rather than just hyper focusing on what it looks like and.

 

What it appears like, another important thing is to be really

 

cognizant of what kind of influences they’re having.

 

So, if your child is willing and hopefully you’re able to encourage this.

 

But going on their social media threads or

 

streams or whatever it’s called and seeing what kind of influencers that they are

 

following, helping them be kind of critical,

 

critical viewers of what they’re taking in and helping them maybe cleanse out some

 

of these followers that aren’t going to be helpful if they’re doing a lot

 

of comparing and a lot of Why don’t I look like this?

 

It’s like, why don’t we take that off there for now?

 

Or even social media cleanse.

 

Another thing as well that we really want

 

to put the importance on here is our own relationships with our bodies.

 

So as parents or aunts or loved ones, whatnot watching how we discuss.

 

Our. Bodies and oh, I can’t fit into a bikini

 

this season, or I’ve got to lay off on this until I can get back

 

into my skinny jeans or what kind of stuff that we’re encouraging there.

 

Because of course,

 

that’s going to be modeling sense to them of value and importance on bodies.

 

So really checking ourselves in that area.

 

And even if you don’t think you’re doing it, they pick a lot of girls or guys will

 

pick up on the atmosphere and the environment.

 

And if you’re not feeling good about you,

 

then they’ll be like, okay, well, that’s something I have to focus on as well.

 

So just be mindful of that stuff.

 

So, we’re going to move into treatment options here.

 

So, it’s really important that you do look

 

into what’s available in your provinces here.

 

So, what I’m discussing is in relation to Calgary, Alberta,

 

and this will look a little different depending on where you are.

 

So here are the options that at least in Calgary we have.

 

We have private care,

 

hospital day treatment program inpatient hospitalization and residential treatment

 

centers, which we actually don’t have here, but we will speak to them.

 

So private care is really important that you have a team of skilled

 

professionals that are collaborating together.

 

So, we always suggest having a dietitian and a physician and then obviously

 

a therapist and a therapist for your loved one.

 

And that might be the same therapist that you’re working together with as

 

a family or you may have your own that’s collaborating again.

 

So, we really want that team approach.

 

We want dietitians to be familiar with eating disorder clients.

 

So really setting out who’s capable of doing those things.

 

We will talk a little bit more about the physician in the next one there.

 

But ensuring that your physician has

 

a good understanding of this population and if not, they’re referring out

 

to someone who does the hospital day treatment program is

 

something that’s available to both under 18 and over 18.

 

They’re in different places, but this would be sort of structure

 

of like 07:00 A.m. To 07:00 P.m. Where all meals are being supervised and there is

 

an element of therapeutic support, some group stuff, that sort of thing.

 

During the day, they do come home at night,

 

but they are getting all their meals supervised monitored.

 

So, it’s really helpful in terms of weight restoration inpatient hospitalization

 

would be when someone is really medically unstable.

 

So, they need to be fed through an IV,

 

they need to be monitored 24/7 type thing for their vitals.

 

And whatnot often what happens is you’ll move from the inpatient and once you’re

 

stabilized, they would Segway you into the hospital day treatment program.

 

And then the last thing that we speak

 

about here is residential treatment centers.

 

So again, in Calgary, we don’t have any of those available,

 

but in other provinces in Canada, they do have some options for that.

 

And we make note of that in the resource booklet at the end.

 

Yes.

 

And of course, the States, they have a bunch of them available.

 

However, that does come at a really high cost.

 

So just things to consider in terms of treatment.

 

I think there’s a lot of things happening behind the scenes to get some day

 

treatment programs in Alberta, so that’s a positive.

 

So, in regard to medical support, there are a lot of physicians that feel

 

they are not qualified or have the expertise in eating disorders.

 

So, we know that in Calgary specifically,

 

that the eating disorder program will support and offer lab works and lab work

 

requisitions and stuff to consult with a doctor if needed,

 

if your family physician just feels like they’re in over their heads.

 

But the one thing we really want to remind parents is you have to go in with your

 

doctor with telling them specifically the changes you’ve noticed in your child

 

because it is that early identification that’s super critical in recovery.

 

So going in and going, I’m noticing this,

 

I’m really worried, be confident, be specific in what you’re seeing

 

and ensure that you’re taken seriously and not have someone say, oh,

 

it’s just a phase or, oh, well, teenagers make me seem like physician care,

 

but just making sure that you’re like, hey, listen, I’m really noticing this.

 

And being the expert of your child, when you walk in there, your doctor,

 

especially if you have a long-standing relationship with your family,

 

can potentially compare earlier weights that they’ve had on there as they were

 

developing and then compare it with the new weight to see how their

 

growth is and then can figure out how to support based on that.

 

And then just to segue into the next specifics of the medical tests that your

 

doctor should and could perform if they felt like it was appropriate is just

 

making sure that their height and their weight is being measured.

 

And a BMI less than 19 is a concern, depending though.

 

So, it’s very specific to your child.

 

But you may have to book with your doctor weekly and then getting blood work taken,

 

making sure levels are appropriate, electrolytes, potassium, iron.

 

And if your child is purging more than two

 

times a week, you might want to be going in every week as well.

 

And then, of course, heart rate and blood pressure.

 

So those orthostatic vital signs,

 

standing, sitting, blood pressure and just getting the whole battery complete so

 

that you are making sure that they’re medically not compromised.

 

And depending, your doctor may want

 

to refer them to one of the treatments plans that Lindsay was speaking to.

 

It can be really helpful to enlist

 

a dietitian to come in to support you and your child.

 

They can become the expert in all thing’s food related.

 

There’s a couple of different benefits to this, but one of them being they become

 

kind of the food police and you can delegate, we’re doing this because

 

the dietician told us this is what we need to do.

 

So, pulling in a dietician to help create

 

food plans, helping you understand what’s going to be the best nutrition guide

 

to get your child through what stage they’re in, those sorts of things.

 

Well, I just want to add to that,

 

like having a dietitian explain why we need carbs and what they do for our

 

bodies, why we need a protein and what they do for our bodies.

 

And it’s that education that a lot

 

of children that we find they really appreciate it.

 

They go, okay, I have to have good fats.

 

I can’t have a fat free diet.

 

And the reason for it is because it helps

 

with my brain health and my ability to focus.

 

And so having a dietitian explain the science of food and nutrition,

 

we have found to be extremely helpful in the treatment plan.

 

Yeah.

 

And help debunk a lot of those food myths and help them really challenge

 

that from a very knowledgeable and scientific approach.

 

Exactly. And then to create a plan of

 

getting to that intuitive place, but with the structure of the support

 

and the education and the three meals and the three snacks,

 

as we have mentioned before, so that they build their confidence so

 

that they can become an intuitive and mindful eater.

 

Like that last point.

 

And then if they are feeling really competent

 

in how they’re nurturing their bodies, then they feel a lot more competence

 

and competency in other things like body image and just that sense of control

 

and that sense of self efficacy and inner resourcing that is just good for overall

 

confidence that we want for all of our children.

 

Someone is struggling.

 

Depending on the age of your child,

 

you may need to enlist the support of the school,

 

mostly because of appointments and they may have to miss school,

 

and then they get behind and then that adds more stress and then

 

that activates more disordered eating behavior.

 

So, enlisting someone in the school to know what’s going on,

 

whether that be a counselor or an assistant principal or a teacher

 

that you trust just to inform them that this is what’s going on and having

 

a safe place for your child to go if needed.

 

So, teachers may need to be informed, having that point person at the school

 

to be available if your child just needs to sit and eat lunch possibly,

 

and or is feeling quite overwhelmed that they have a place they can go

 

and there might be some learning accommodations that might be needed.

 

You would have to obviously talk to your

 

school counselor or an administrator to see what accommodations could be

 

created for your child, whether that be exempting them from exams

 

or offering some extensions on deadlines or a quiet place to write a test if

 

they’re feeling a lot of anxiety and overwhelmed.

 

So, checking in with your schools and not

 

trying to do this in isolation because we need a team of people to support,

 

especially if you’re really enmeshed in some eating disorder behavior.

 

Yes.

 

And Dell had touched on this here, but in terms of some meal support as well.

 

So, I know I’ve had clients before that had to have their snacks during a time where

 

they’re in a class that they’re not allowed to be eating.

 

So, they worked with the teacher.

 

This is hush hush.

 

So, the teacher helped them kind of figure

 

out a way to always excuse themselves to go down to the office and take

 

the attendance so that they could quickly have their snack there.

 

And other kids wouldn’t know what was

 

going on if they didn’t want other people to be involved at that point.

 

And we often get asked if medication would help the treatment plan.

 

And we say, yes, it can.

 

But there also isn’t any specific

 

medication that can cure an eating disorder.

 

Some can help with symptoms, and it can perhaps treat some cooccurring

 

disorders because as we mentioned at the beginning, there can be a higher

 

level of anxiety and depression diagnoses as well.

 

So, a medication that can help support

 

that would then help support the eating disorder.

 

We also know that nutritional support is

 

really important at the beginning phases of an eating disorder.

 

So, food is the medicine.

 

However,

 

SSRI So, a selective serotonin reuptake inhibitor, specifically have shown

 

to improve some of the disturbances that come along with an eating disorder.

 

It helps with some bulimia and binge eating.

 

There are more studies related to that,

 

but it’s something to explore with your doctor and see if that is something

 

that could help while you’re doing the nutritional support as well.

 

So, what do you do if your child thinks nothing is wrong?

 

Malnutrition can impair the brain self perception.

 

So, a person with an eating disorder may

 

not be able to recognize that they even have an illness.

 

With teens and children, it’s really important that the caregiver

 

take on that responsibility to bring their loved ones to the appointments and get

 

help and appointments really shouldn’t be optional at this point.

 

It’s just the impairment and judgment that we see.

 

We often get clients that are mandated or forced to come,

 

and we are okay with that because we have to get them in the office,

 

get them saying that there are some costs and benefits, and that sounds awful.

 

But the benefits of an eating disorder are that it’s trying to take care of them

 

and they’re using their eating disorder to settle and soothe their emotional selves.

 

So, bringing them in, helping them understand where this is

 

coming from and the costs and the things that they are losing or that are hindered

 

in the world, how we work with clients right

 

at the beginning, if they feel like they are being forced or mandated

 

for counseling, at least getting them in the door and saying, you got to go.

 

And oftentimes we are doing a lot more of the work at the forefront of sessions,

 

but it’s just really important to know that their judgment is hindered.

 

So, if they don’t feel like anything’s

 

wrong, then you just have to be the one to say, yes, I’m concerned about this.

 

We’re going it’s your responsibility as

 

a parent to take care of their emotional needs.

 

There. This would be a really great place

 

to weave in Some of that emotional support and coaching that we’ve been discussing

 

previously, as this would be an opportunity for you

 

to be that very loving, warm, but firm parent who’s saying, I know this is hard.

 

I know you’re scared.

 

I know you might not want to go talk to somebody, and we’re going.

 

I’m worried about you.

 

There’s something going on, and we need help, and that’s my job.

 

So that minimizing the negotiations.

 

You are the parents.

 

I know this is tough, but we’re going.

 

And so that connects and redirect stuff that we keep repeating.

 

This final slide here is really important.

 

So, it’s about modeling self care and healthy relationships.

 

During this really tough time in your family, you may need a lot of.

 

Support, and that not only

 

from the professionals, but also from your family members,

 

your partner, a friend, your own personal counselor.

 

But it’s really important that you’re not falling to pieces in front of your child.

 

You just don’t want your child to feel

 

like, oh, I’m messing up my family or look what I’m doing to my dad.

 

You really want to be able to take your

 

emotional frustration, anger, fear to someone that can help you process this.

 

So, the better you are,

 

the better you are feeling about where you are emotionally and confidence wise.

 

Although I know there’s going to be a lack

 

of confidence in figuring out, what do I do?

 

I’m at this weird stage, I’m not sure,

 

but you have to take that insurance to someone other than your

 

child, and it is okay to say to your child, you know what?

 

This is new for me, too.

 

I’m not sure because you want to also show

 

your child that you’re human and you’re in this together.

 

That’s the essence.

 

You can’t force your child to get better.

 

You can only support them during the recovery.

 

And so just saying, I’m here, we’ll figure this out.

 

I don’t know what we’re doing,

 

but I’m strong and I’m capable, so they just really need your strength.

 

So, bring in your people and ask for help.

 

Personally, we just want to end with the fact we have this handbook.

 

We might even.

 

Shown it a few times that this will be alongside the video.

 

We’ll have access to this resource, and.

 

That resource has videos, YouTube, I guess YouTube videos,

 

some books to read, articles, websites, podcasts, A whole page full of.

 

Resources so that you can expand on any

 

of these areas that we’ve touched on because even though it probably felt

 

overwhelming, this is just kind of a summary of some of the work.

 

So please refer to the resources for more in-depth material, and we wish you well.

 

Thank you. Thank you.

 

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About the Author

Danelle Spence

Danelle Spence is a Registered Psychologist with a passion for helping teens effectively manage emotional distress and helping their parents’ understand the complex and developing teenage brain.

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