We are grateful to Ginny Jones for this phenomenal guest blog post! Ginny is the founder of More-Love.org, an online resource that supports parents who have kids with eating disorders. She’s also a parent coach who helps parents who have kids with eating disorders.
Feeding a child who has a restrictive eating disorder can be a harrowing experience for even the most confident parents. When kids with eating disorders have tantrums about eating, parents tend to argue with them and try to negotiate or give into kids’ demands. But these approaches, while completely understandable, don’t typically help kids do what they need to do, which is eat!
Worse, this pattern of tantrums and arguments can become a negative family dynamic in which the child’s demands and tantrums affect everyone and effectively “run the show.” Many parents feel completely overwhelmed and hopeless because every meal is a battle.
As an eating disorder dietitian, you might find it difficult to make an impact because of this family dynamic. It’s not that you aren’t giving great advice; it’s just that the family is stuck in a relational dynamic that’s getting in between your advice and the behavior you’re hoping to see at home.
A dynamic looks something like this: the parent does something, the child does something, the parent does something, etc. In other words, it’s a predictable pattern of interpersonal behavior. It’s easy to focus on the details like, “Last night she wouldn’t eat the bread because she said it tasted stale.” But, instead, we want to focus on the pattern, which is “every night she refuses food, and every night, I try to convince her that she needs to eat, and then we argue and argue, but, ultimately, she doesn’t eat.”
Here’s how you can help parents change negative feeding dynamics and get through difficult tantrums. It takes time and effort to change negative dynamics, but it’s definitely possible.
1. Name the relational dynamic.
Many parents who are stuck in a negative feeding dynamic see the problem as their child’s refusal to eat and explosive tantrums. You can kindly but assertively point out that the child certainly is struggling to eat, but there’s also a relational dynamic, and the parent plays a role.
This is a little tricky because parents may become defensive. To defuse tension, I’ll describe the dynamic they’re involved in at the table and ask whether it shows up in other areas (it often does). I let them know that we all get into dynamics with our kids, but there are ways to change negative dynamics, and it’s better for everyone if we can. The goal is to empower parents to take action within the part of the dynamic that’s within their control without shaming them or triggering defensiveness.
2. Validate the parent’s fears.
Parents who are stuck in a negative feeding dynamic are terrified. They’re worried that if they push too hard, their child will get worse. But they also worry that if they don’t make demands, their child will get worse. They feel frozen and don’t know what to do. Their fears are valid, and they strike right at the heart of every parent’s worst nightmare. Often, we jump quickly to telling parents what to do, but that skips the important part of making the parent feel seen, heard, and understood.
There is no greater therapeutic tool than validating someone who is in pain and helping them feel seen, heard, and understood. You can say things like “It sounds like _____,” or “I imagine you worry that _____,” or “It makes sense that _____.” This is how you validate the parents’ fears without making the fears worse. You’re not saying, “You’re right; if you don’t feed him, he’ll get sicker.” Just reflect back what you heard them say and hold space for their fears to exist. This alone will reduce their intensity.
3. Reassure the parent that feeding is challenging but possible.
Once the parent feels seen, heard, and understood, you can move to reassure them that feeding their child is challenging but possible. You want to model confidence and strength. The main goal is to assure them that feeding a child with an eating disorder is a difficult job, but it’s a job they can handle. They’re up for this! When you normalize both the difficulty and the possibility, parents will feel stronger and more confident about their feeding assignment.
4. Provide a simple script.
The script I use most often when kids throw tantrums is from SPACE (Supportive Parenting for Anxious Childhood Emotions), a parent-based treatment program for children and adolescents with anxiety, OCD, and related problems. It’s called a “supportive statement” and has two parts: 1) provide acceptance/validation, and 2) provide confidence/assurance.
When a child is having a tantrum, parents deliver a simple sentence that sounds something like this “I get it; this is hard, but I know you can handle it.” Another option is “We understand; you don’t want to do this, but we know you can get through it.” This script is essential because it validates the child while also setting an expectation. It’s much more likely to succeed in the long term than trying to negotiate, convince, threaten, or command the child.
5. Role-play so the parent can practice.
The supportive statement is simple but not easy. Almost every parent immediately intuits how their child will respond to the supportive statement, and they’re usually correct: many children will increase their tantrums, getting louder and more dramatic in an attempt to get their way. This is when it becomes clear that the real issue at hand is the relational dynamic.
A classic example is the parent says something, the child explodes or refuses, an argument ensues, and the child doesn’t eat. The supportive statement changes this dynamic by giving the parent a solid message to stand behind rather than resorting to arguments or their old way of responding to tantrums.
This is really hard! To help, you can role-play with parents. Let them practice staying steady when their child tantrums, rather than returning to the old dynamic. Model for them how they can use the supportive statement at meals with firm compassion.
Parents are an essential part of eating disorder recovery, but they can easily get pulled into old, familiar relational dynamics that get in the way of feeding their child. Teaching parents new skills to help them get through tense and difficult feeding situations can go a long way toward recovery.
Ginny Jones is the founder of More-Love.org, an online resource that supports parents who have kids with eating disorders. She’s also a parent coach who helps parents who have kids with eating disorders.