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Companion Guide for A Season in Hell

QUESTION 9: WHAT CAN THE FAMILY DO?

A Season in Hell leaves no doubt that eating disorders pose a very difficult problem for family members. In the final analysis, no one can make a person like Regina get help. Nevertheless, there are some things the family can do which will help a person with an eating disorder to acknowledge the severity of the problem and to get proper treatment. These suggestions will also aid family members in protecting their own rights.

(1) Become educated about eating disorders and about the nearest resources offering professional and expert treatment. If possible, consult with professionals about the best ways to confront the eating disordered person and to initiate treatment.

(2) Get support and advice from trusted friends and professionals&emdash;clergy, the family physician, social workers. Converting the problem into a "special family secret" may reduce embarrassment for a while, but in the long run it only creates confusion, isolation, and guilt. Families should not cut themselves off from people who care and can help.

(3) Before confronting the person strongly suspected of having an eating disorder, have all concerned persons write down specific instances of the person's problematic behavior or attitudes. Then arrange for the family to speak confidentially with the person about the specific details and the consequences of disordered eating and weight management practices. Try to remain calm, caring, and non-judgmental. Avoid simplistic suggestions about nutrition of self-control, as well as fatuous statements like "You know, your weight is fine where it's at now."

(4) Communicate directly to the person the family's concern and its conviction that treatment is necessary. Let the person know there is financial, emotional, and other practical support available.

(5) Exercise responsibility and authority in obtaining treatment for people who are suicidal, very sick, and/or out of control.

(6) Reaffirm the importance of each family member and the family as a whole. Do not allow the family to be disrupted by emotional upheaval&emdash;arguments, threats, blame,resentment&emdash;concerning issues of food, weight, and eating.

(7) Sustain the person's sense of dignity and importance in the family by requiring decision-making and personal responsibility. Do not be manipulated into shielding the person from the consequences of the disorder, including separation from the family. That is, do not lie, take over work or school responsibilities, allow food or money to be stolen, allow the bathroom to be fouled with food or vomit, etc. In this same vein do not protect the person from anticipated hardships in overcoming the problem. Compassion is "bearing with" a person who is out of control and in distress. Compassion is not suffering unduly because of that person's irresponsibility and unwillingness to get help.

(8) Love the person for herself or himself, not for appearances, body weight, or achievements. Encourage healthy feelings (even if they are unpleasant), and avoid talking about body shape, weight, eating habits, calories, etc.

(9) Remember that families neither cause nor cure eating disorders, but they can make a major contribution to recovery and future development. Dwelling on guilt may interfere with the process of arranging for an participating in treatment.

(10) Be patient: Recovery is a long and complex process because of the various dimensions which must be addressed.