Do parents affect mental health? Of course

If you don't know me, I can understand that without that background my posts may seem "needlessly angry" or that I am on a "high horse."

I have blogged on this topic before:
Yes, some parents suck
"my personal experiences diminished and trivialized"

...and many other times to say very clearly and without reservation that parents very, very, very (save a few of these for later because if you read my blog you'll need them) much affect the mental health of our children. If we neglect or abuse our children we cause enormous and often irreparable harm. Sometimes we do things that are not overtly damaging but do cause harm anyway -- in ways we may never know.

But a person with an eating disorder isn't JUST an eating disorder, and an eating disorder isn't the sum total of that person's mental health. I'm not arguing that parents don't cause harm or make it more likely that an eating disorder be triggered or that we don't sometimes exacerbate and perpetuate the illness once in place. ALL I'm saying is that an eating disorder is not a sign that the patient has been neglected, abused, mistreated, bullied, teased, pressured, or influenced. All an eating disorder diagnosis tells us is just that. No matter how serious the symptoms, how severe the behaviors and the thoughts, this tells you nothing about the family or the life experience of the patient.

This is important because unless we separate the issues we risk harming the patient more:

If there is NO environmental problem then we cannot afford to put energy into that angle - the patient needs a confident, calm, loving family and treatment team even in the best of circumstances to save this person's life and future. This is most families.

If there ARE problems in the patient's history or present then those must be addressed FOR THEIR OWN SAKE and not based on the eating disorder. By linking the two we actually risk making the patient use the eating disorder behaviors as a distress signal -- and a default. An eating disorder only makes one's overall mental health worse.

Believe it or not, I'm not DOWNPLAYING parenting, I'm EMPHASIZING it. We parents need to step up and do some of the hardest, scariest, most personally challenging parenting we've ever had to do - and most parents never need to do -  if our child has an eating disorder.

Let's not give abuse or poor parenting a pass, and lets stop putting all parents under that suspicion.


  1. One particular problem with the parenting hypotheses is that life is messy, unfair and downright cruel sometimes, parents are only human, and gosh darn it, when you come right down to it, there is very little research on methods of effective parenting to prevent particular mental illnesses. I think it's very likely that people who are predisposed to particular mental illnesses could benefit, if identified in infancy, with specific types of parenting that help the brain develop in specific ways to provide resilience against mental illness. Yes, I think this is a good idea! BUT, let's be realistic. A. There is no way to identify future mental illness in infants B. There have not been any studies that I know of that have resulted in specific parenting techniques to be used across infancy and childhood to protect a child.

    And, can all of this prevent a parent from losing a job, developing cancer, getting divorced or anything else bad in life?

    And #2, there have now been studies showing even children raised by drug addicts have better outcomes when raised by their parents rather than foster parents. What!!! So how to fit that all in there??

    So how can we be putting parents under suspicion, when we don't even know what they are to be accused of???

  2. I am the anonymous who replied to your post a few days ago (the one you deleted). Thank you for this post. I know I was harsh in my reply earlier this week, but it was only because I too am tired of feeling misunderstood. I know that not all eating disorders are rooted in trauma, but some are (like mine) so you can see why some of your posts may strike a nerve with people like me. When you explain it like this, I get it and I agree. But sometimes, often times, you seem very polarized in your stance that eating disorders are "brain disorders" and nothing more-- all nature and no nurture. Getting people to see the biological and/or genetic basis of EDs is crucial in reducing stigma and having them taken seriously, but there is often more to the story.

    I've been through years of family therapy. I know how hard it is on parents, especially when they feel responsible for their kid's illness. My parents had little to do with my trauma, which occurred outside of my family, but they still felt blamed much of the time. I can see how upsetting it must be for parents, but I also fear the "EDs are brain disorders and nothing more" stance gives parents a free pass to say "this is not my problem, why do I have to be in therapy?" As difficult as family therapy is, I think it is (often) an important part of recovery.

    I appreciate you reading and taking the comments you get into consideration. I apologize for my attack the other day. I really respect what you aim to do, I just think the message is sometimes lost on people (like me) who feel like we don't fit into your intended audience.

  3. Anonymous, I've spent the past 8 years PROMOTING family therapy, family stepping up, family doing the difficult and often personally challenging work of engaging in the treatment process. I'm doing the opposite of giving parents a pass!

    When I say that eating disorders are a "brain disorder" I'm not saying that the patient's mental health is ONLY about their brain disorder. The patient has experiences and a life and a personality that are shaped by more than just the eating disorder - and that includes nurture. I think what is getting missed here is that I'm only talking about the eating disorder part - not the whole person's mental state and health. When someone has an eating disorder AND trauma, they need treatment and a home environment that takes all of that into consideration. If they have an eating disorder AND abuse then the treatment and that person's recovery will take a very different trajectory and needs.

    Parents SHOULD be blamed for what they actually DO that is damaging. Abuse, neglect, poor decisions - they can't be swept under the rug. We don't have to use the eating disorder as the reason for the person to be protected and healed -- everyone deserves a safe and loving environment.

    I appreciate you coming back to comment again, Anonymous. Even without a name or a way to reach you directly, your opinion matters to me and anyone who reads your words - how can they not? I care about every word I put out there, and although I may mess up sometimes I take the responsibility seriously and the process is interactive.

  4. I never thought this is a question, its so obvious!


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