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Judith Brisman, Ph.D. Headshot

Children with Eating Disorders: Are Parents to Blame?

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Recently, my blogs were responded to by supporters of F.E.A.S.T. and the Maudsley approach to re-feeding anorexic children or teens.

It is interesting to me how much fire these advocates of family-based treatment inspire. Their responses almost always result in an an outcry of protest and inflamed feelings. That's a shame because F.E.A.S.T. and the supporters of family-based treatment have something critically important to say. As a result of their work, we now know to include families in treatment and we know that there is an important genetic component to anorexia. We also know that it is extremely harmful to blame parents for their child's eating disorder.

But blame and curiosity are two different things and I think it is important to question the role of the family with any symptom that arises, be it genetically based or not. Every family should take a look at itself and see what is working and what isn't, to allow for growth, independence, intimacy and exchange with all family members. We often take better care of our cars than we do our families. I would posit that even in a family with a schizophrenic child or an autistic child, there are many things that can be done to help the family operate more effectively. I would say that of any family, including my own. This isn't a mandate to blame. It's an opportunity to help families consider what might need to change to better meet the needs of all of its members.

So in that spirit, and in total agreement with F.E.A.S.T., parental involvement is critical when any child, adolescent -- or for that matter -- young adult has an eating disorder. But the goal is to look at what is going wrong and what can be fixed -- even if what is going wrong is difficulties handling a very severe illness. The goal is NOT to assess blame.

What inflames many people about the F.E.A.S.T. push for no family blame is that this leaves no room for any curiosity about the family. Since when is talking to one's kids about problems in the culture a completely ineffective means of prevention?

I still believe that parents should talk to their children about eating disorders. For some children or adolescents, this will have no effect on the development of an eating disorder. For others, it will allow for an open dialogue which may indeed influence their relationship with food. If that isn't the case, why are we talking to kids about drugs and alcohol? Alcoholism is now proven to have a genetic base. Does that mean that parents shouldn't talk to their kids about drinking because talking won't stop someone from being an alcoholic?

So, after all is said and done, I (thoughtless parent and author that i apparently am) still think that parents should talk to their kids about eating disorders, and about developing ways to listen to and attend to one's needs without turning to food or starving oneself. Will this help everyone? Absolutely not. But, I would like to think that parents can be actively and thoughtfully involved in the lives of their children, guiding, directing, encouraging. That has nothing to do with blame. That's just good parenting.

Talking to one's kids doesn't prevent a disorder from developing. Life is rough and many things way beyond our control occur. However, trying to have an open dialogue with our kids is one way we can try parent as best possible. In a world where just about anything can happen, that's the best we can do.