Parents in denial

I hear a lot about parents "in denial" about the seriousness of a child's eating disorder.

And I do see parents who appear to be denying how ill their child is. I meet parents seeming to enable the illness by settling for low weights or resisting high calorie meal plans. I talk with parents who don't want to drive any further, pay any more, sit through any more disheartening meals, attend any more sessions, or just want it to be over.

But I don't call it denial. I call it fear exacerbated by incoherence in the treatment world.

It is too easy to call a parent "in denial" when they don't know which - of all the contradictory, ineffective, unquantifiable options available - treatment direction to pursue.

It is too convenient to say a parent is "in denial" when they do what a seemingly competent and well-meaning professional says to do and when it doesn't work the next professional upbraids them for listening to the first idea.

It is inhumane to observe a parent in distress and fear and worry - this is their child, after all - and assume the parent is choosing the "easier" of the options.

And it is impossible to know, looking at a family new to an eating disorder diagnosis, what that family was like before the illness or what miracles they can perform if offered tools and support and the benefit of the doubt.

The inertia of normal, healthy parenting isn't swept away in a day, a week, or a month of living in the new world we enter when our child is gravely ill. It takes time, training, and compassion.

Let's learn from the tragic history of blaming the parents of autistic children, schizophrenic offspring, asthmatics, and tuberculosis patients. It's an illness, and parents are the best asset a child has.


  1. And those of us who are not "In Denial" are "Controlling", "pushy" or "over-anxious" - we can't win!

  2. I recall when a parent in a forum which offered support to parents wrote me and told me I was in denial! It's an offensive remark but I knew my own mind. You were one of the few parents who treated us all like we were intelligent Laura. And you are still doing it!

  3. It's true- the eating disorder community has, for so long, put parents in an almost impossible position.

    I think some of the "denial" is in the form of love. If I saw that my child was very distressed by eating, it would be hard for me to encourage or request that she eat. I'm trying to fit my cat in a harness/leash for when we move, and she hates it. Aside from the fact that a squirming, yowling cat is sort of funny, I felt bad for the little dear. If I didn't have to have her wear the darn thing, I wouldn't. But I want her to be safe and healthy- thus the harness/leash. I did promise her a tiara if she behaved. ;)

    Another problem is that, up until FBT, the treatments out there were lousy, so there was really nothing to do. It's not like cancer, where there's a diagnosis and a course of action.

    Sucks, really.

  4. Marcella,
    You are so right: they've got us coming and going.

    Mary, you've always been a champion of both parents and patients - and I know I'm not the only one who appreciates it!

    I will now forever see home refeeding with cat leashes!

  5. I have a friend who is a nurse practitioner and I have all but stopped discussing my son's illness with her. She is sympathetic to the health risks of starvation but sees no reason why he shouldn't just pick up a fork and get over it. When I used to try to get professional advice from her I felt I was being tut-tutted for enabling his behavior. She does care about him and asks how he is but I won't go into detail with her anymore.

    It's very hard to make him eat. I'm trying. He's trying. I'm celebrating today because he ate all his snacks last night including a half jar of organic peanut butter. Trying to shovel in 5000 Cal a day is really, really, really hard.

  6. Karen,

    It is hard, and you are doing a great job.

    Half a jar of PB? Yikes! Have you checked out the "High Calorie Recipes" discussion at Maudsley Parents? Some good ideas there for mixing it up.

  7. Karen,

    As someone who has gone through home refeeding from Jan to March of this year, I can say that PB was one of my helpful foods. PB on bagels, several tablespoons on each side, eaten openface with a banana sliced on top. It's really versatile. Other kinds of nuts were a favorite (cashews, macadamia, etc). Cheese and butter are easy add-ons. And shakes! I like coffee flavored premium ice cream, milk and chocolate Carnation Instant Breakfast.

    But that thread is very useful.

    Good luck! All you moms are amazing.

  8. I just posted about mother blame today and this post really hits home. Can one be a parent and not get a bad rap?

  9. i, a purging type anorexic, albeit years late, feel compelled to chime in, if for not other reason than to vent and (hopefully)inform.
    I've considered my mom to be in denial for my whole life, ive always been a nervous child, anxious as a perfectionist from the start. I remember biting my finger skin til they bled and my mom would grab my hands and lick my fingers so id stop or try to shame me out of it. later came the pickier and pickier eating habits, cutting out entire food groups for apparently no reason. then the crash diets and raging mood swings, which she wrote off as 'just a phase' or 'it must be pms' or its 'middle child syndrome' when all i needed and still hope for, was a listening, non judgmental ear and some support, or just kind words, but instead felt dismissed as if my pain, nor myself existed. I've been like this my whole life and am stuck in the trap of trying to fix past wounds, but she and her *denial* trigger me on a daily basis. I told her the gruesome truth a few times and she couldnt bear it. What i believe fuels her denial is the thought that she failed me as a mother. After i pour my heart out she responds with a teary eyed 'where did i go wrong?', forcing me to swallow back what id just said, rewind and reword it in order to appease her and ameliorate things, leaving me with a terrible guilt that only purging seems to relieve. I suppose im still just a baby crying for milk from dried up mammaries.

  10. Anonymous, that is tragic and deeply sad. With or without your mother's help, you deserve health and hope and recovery. Please don't let ANYTHING keep you from that!

  11. What about parents who can obviously see their child is sick and dying and won't so much as take them to a doctor?

  12. How then does a sick kid get help? Say parents have pushed away relatives, school nurses,CPS, and other, is it simply a matter of waiting for kid to collapse?

  13. I have seen a number of scenarios. Parents may misunderstand, may not believe there is a solution, may be divided between the two, there may be other competing illness, parents may themselves be ill, and, very common, the kid says their parents don't want to help but they do. (I can't tell you how many parents tell me their son or daughter tells people they won't help but they are actively involved.)

    But the bottom line is that mental illness is treatable and all sufferers deserve support. If the family won't or can't then others need to step up. Yes, report to authorities. Yes, gather school and other relatives. If the parents can't do their job as protectors and caregivers then others must help.


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