Why "see your doctor" just won't cut it

You realize a family member is showing signs of illness. You do a quick bit of Internet searching and quickly determine what illness it is, and how serious it is. You immediately call the doctor.

Works for most illnesses, right?

Not with eating disorders.

Your primary care doctor will have had little or no training in eating disorders, and will probably refer you to the first mental health professional in the phone book.

The first professional you contact will not be taking new patients. The next two will not take your insurance. The third will queasily tell you they don't feel prepared to deal with eating disorders. The fourth will be hours away. The fifth will tell you they can cure it, immediately, but won't tell you how until you come in for a 3-hour pre-paid consultation. Sixth, seventh, eighth: can't see you for two months. Ninth says there is no hope, this illness never goes away, detach yourself. The tenth agrees with #9, but scolds you for being over-involved. Number 11 strongly suggests you send your child immediately to a treatment center far away. And after you do, and your child is released without a treatment plan you can enforce, number 12 tells you it is your fault for sending your innocent child away.

See a "Mental health professional" is like saying "be a good person." It is not specific enough to be of any help.

The truth is, qualified, experienced clinicians are overworked and over scheduled. Short of interviews, it is very difficult to pre-qualify or distinguish one from another. Many clinicians put out a shingle with dubious qualifications, treat people for decades without staying up to date on research, or bring dubious personal biases into the treatment room.

Most therapists, doctors, nutritionists, and other mental health professionals I've encountered have been well-meaning, dedicated, and hard-working. But only a minority have been current on the rapidly developing research on the causes and treatment of eating disorders. Most remain uncomfortable with parents, unschooled in the physiology of malnutrition, and confused about the distinction between correlation and causation.

Here is what I've learned in my years observing the extreme psychiatry of children:
* Do your homework. It is your job to learn what the treatment options are, and ask good questions.
* How much time would you invest in purchasing a car or real estate? Why would you spend less on finding life and family-saving care?
* Yes, some of the people you contact will be incompetent, inexperienced, and potentially damaging to your child. Just say no.
* Interview the clinician as a possible resource, not an authority figure who will cure your child, repair your psyche, and cure malaria.
* Family-based treatment is the gold standard for treatment of dependent children - it isn't about fixing you or blaming you or making your child behave - it is about keeping everyone on the same page, with the same goals. (Eating disorders hate that!)
* Prepare for hard work, careful observation, patience, and for the long haul.
* Meet with the clinician alone before bringing your child in, and every time you need to make sure the adults are sending the same message.
* When you've found the right fit: listen. Be humble. Learn. Dig deep. Isn't that what you want your child to do?
* Insight is a by-product of recovery, not the tool to get it. It is okay if your kid doesn't want to go, doesn't believe in it, doesn't believe it helps, doesn't understand the illness. Feed them anyway. Bring them to family therapy anyway. Say annoying things like "I love you" anyway.
* I'm sorry, but there is uncertainty and risk and not even the best clinician knows everything.
* You are still the parent, and your child's best ally. Trust your fiercest, bravest instincts.


  1. Thank you Laura. Perfectly timed just for me.

  2. If you are British you will have neither the agonies OR the opportunities of choice outlined here. Your GP will probably be your first port of call and may be great or totally hopeless but as a guide this http://www.nice.org.uk/guidance/CG9/niceguidance/pdf/English is very helpful (there's a paper designed for adolescents and their parents too but I find it rather condescending and prefer the full guideline)

  3. Too familiar from the annals of Autismland---thanks so much.

  4. Honestly, you can't get somebody with an eating disorder help. Especially a teen.

    I've been to treatment, it doesn't help. It just gets on my nerves being asked to draw myself and look in a mirror. The hospital sticks a tube in you, which you can use to suck things out too.

    There's no fixing somebody who doesn't believe they need it.

  5. Oh, Dee, I wish I could give you a hug. And a sandwich.

    You can help someone even if they don't want help - and you can get help even if you are ambivalent about recovery.

    There is a part of you that wants to be well.


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