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Begining the Dialogue with Your Child
The script below is an excerpt taken from
When Your Child Has an Eating Disorder: A Step-by-Step Workbook
for Parents and Other Caregivers (Natenshon, pgs. 83-85)
Mentally rehearsing a confrontation with your
child can help you get ready to intervene by mapping out major
points and goals for your dialogue. You may want to anticipate
making active listening responses, recognizing and responding
to resistance, and offering effective rebuttals. The following
section is a sample script, or discussion outline, for a parent
who sees symptoms of an eating disorder in her child that
the child is refusing to acknowledge. It incorporates many
of the ideas discussed in this chapter. Think about which
aspects of the script might work for you. If some parts of
the discussion feel less comfortable to you than others, try
to understand why. You may use the script as a model for preparing
your own outline of what you might say and how you might respond
to your child’s predictable display of resistance.
Sample Script for an Intervention
PARENT: I’m concerned about you. Here is what
I’ve observed [describes his or her observations]. My hunch
is that you may be needing some help now. What’s your take
on this?
CHILD: There’s nothing wrong [or, You’re imagining
it, exaggerating; or, It’s really none of your business; or,
If there’s ever anything to be concerned about, I’ll let you
know].
PARENT: I understand what you think, but it
would be helpful for me to know more about how you’ve arrived
at this conclusion. Because we see things differently, and
because this might possibly be a matter of your health, maybe
a professional should help us determine what, if anything,
might be going on here.
CHILD: I’m not going to see anyone. I don’t
want to, and I don’t need to [or, I can fix things myself
whenever I choose].
PARENT: It’s only natural to feel reluctant
to investigate a situation that scares you or makes you feel
out of control. A lot of people who don’t understand eating
disorders think all kinds of scary things about them, like
once you have a disorder you’ve got it “for life” or that
you have to be “psycho” to have an eating disorder or to go
into therapy. You know that these notions aren’t true, don’t
you?
CHILD: Of course. I also know there’s nothing
wrong with me. I’m just trying to keep my weight down so I
can look good. All I want to do is lose ten pounds.
PARENT: What is so confusing about eating disorders
is that they appear to be about food and weight, but they
are actually devices that help people solve problems, cope
with anxiety, and take control—not only of food, but of life.
The odds are that if you are out of control with food and
frightened about gaining weight, you are probably feeling
out of control and fearful about other things in life as well.
Eating disorders reflect how a person thinks, acts, and feels
in general. By the way, have you thought about why you feel
you must engage in such extreme behaviors in order to lose
weight? And are you absolutely certain that you’d be content
to stop losing weight once you lost the initial ten pounds?
CHILD: OK, so let’s say I have a problem and
I went for help. What if things didn’t get better for me even
then?
PARENT: It’s understandable that you might be
concerned about that, because eating disorder recovery can
be a real challenge and can take time. But you’re up to it,
and I’m behind you. You’ve done a lot of tough things in your
life—you’ll do this one, too. The changes you will need to
make won’t require you to totally revamp who you are; they
will simply be a matter of fine-tuning some of the strengths
and resources that you already have in place.
CHILD: What if I have to leave college [or,
school]?
PARENT: There’s a good chance that you could
work on your recovery while in school, through various supports
on campus. If the problem is too intense for you to stay at
school, it will make sense for you to take a semester off,
because there’s not a lot of learning that can go on anyway
when all you can think about is food.
CHILD: I’m not ready to get help now. I’ll take
care of this next week. Just give me a little time.
PARENT: Do you believe that waiting will help
the situation go away? Initially, an eating disorder helps
a person feel better, but the longer the disease goes on,
the greater the damage it does to the body and the harder
it is to fix. If you’d like to try to make a few changes on
your own for a week or so and then see what happens, that’s
OK with me. But let’s plan to talk about it again in a week’s
time to see how things are going.
CHILD: I promise, I can do this myself. I don’t
need anybody’s help.
PARENT: If you had diabetes and needed insulin,
I’d be responsible, as your parent, to make sure you got the
medical attention you needed. This situation leaves me no
choice either. Why not take the week you are looking for,
and let’s say that if you haven’t been able to make sufficient
changes in that time, then I’ll step in at that point to find
help for you. That’s the deal. I will offer you a hand temporarily,
just until you are free to take control of things on your
own again. So, what do you think?
CHILD: I guess that sounds fair. I just wish
I could be good enough the way I am.
PARENT: You are certainly good enough. My intention
is to help you stay that way. Achieving an open exchange is
the most important goal as you begin to dialogue with your
child. Don’t expect results immediately, but remain focused,
confident that you are doing what needs to be done, and persistent.
Getting Started
By now, you have the essential information you
need to confront your child. Think of an appropriate time
to bring up the necessary conversation with your child, or
resolve to take advantage of the next opportunity that presents
itself. Decide whether you want to be with or without your
partner when you talk with your child. If the two of you are
to do this together, determine the things you and your partner
should discuss prior to the dialogue with your child. Be sure
that you are both of the same mind and that your child
does not feel ambushed.
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About the Author:
Psychotherapist Abigail H. Natenshon has specialized in the
treatment of eating disorders with individuals, families,
and groups for the past 31years. She is the author of When
Your Child Has An Eating Disorder, A Step-by-Step Workbook
For Parents And Other Caregivers, Jossey-Bass, 1999. Based
on hundreds of successful outcomes, this book shepherds concerned
parents step-by-step through the processes of eating disorder
recognition, confronting the child, finding the most effective
treatment for patient and family, and evaluating and insuring
a timely recovery. A guide to eating disorder prevention,
this book is useful to parents, health professionals and school
personnel alike in countering the pervasive epidemic of unhealthy
eating and body image concerns, and destructive media and
peer influences. Her work can be reviewed further at www.empoweredparents.com
and www.empoweredkidZ.com
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