July 19, 2018

Boundaries in Eating Disorder Recovery: An Act of Love – Dr. Angela Derrick

how to set boundaries with childrenMom: (speaking tentatively to her daughter) “Dear, I’m so sorry but you have to see the nutritionist today even though it conflicts with the concert you want to attend.”

Daughter:“No! It’s not fair! I never get to do anything I want! Just let me go to the concert this one time, mom! I’ll go to the appointment next time. My eating is okay; I promise. Why would you do this to me? You are so unfair! I hate you! 

Mom:“Well, just this once… I suppose it wouldn’t hurt…”

The scenario described above is common. Parents often tell me how hard it can be to set boundaries with their children. Parents report feeling worried about offending, angering or distancing the child. They even feel guilty, as if they are doing something wrong. In fact, it is just the opposite, I tell them. 

Setting boundaries can be an act of love. 

The Role of Boundaries

Instead of ruining relationships, boundaries help us preserve and maintain connections. This is because, with the right boundaries, both parties understand what the other needs. Both parties know how to keep the relationship healthy and harmonious. Instead of heading towards a rupture, with the right boundaries, relationships can strengthen and endure. 

In a family setting, boundaries are meant to create and maintain the safety and structure of the household, provide guidelines for how family members interact, and make household norms explicit. These types of rules are considered external boundaries.

Examples of external household boundaries include the following: 

  • When family members are angry, we all take a time out to calm down before trying to resolve the conflict.
  • In our house, we don’t raise our voices or criticize one another.
  • We have dinner together every night.
  • Everyone is responsible for cleaning their own room.

I like to think of boundaries as flexible constructs; they can tighten or loosen as appropriate to fit the person and situation. 

External boundaries that are too loose in the household— mean that children don’t have enough structure, they might not feel cared about and might have more independence than is appropriate for their age. 

External boundaries that are too tight— are restrictive and don’t give children the space to make reasonable mistakes and learn from age-appropriate challenges; the rules often feel “smothering” or “rigid” to the child, who then may feel pushed to rebel.

Boundaries in eating disorder recovery

Here is an example of how boundaries might be applied to setting limits with a child in treatment for an eating disorder

A parent who is setting a loose boundary might say: “If you keep losing weight, you might not be able to play soccer.”

A parent who is setting a rigid boundary might say: “You can’t play soccer this year.”

A parent who is setting a flexible boundary might say: “When your weight reaches the safe limit set by your dietitian, you can participate in soccer practice again as long as your weight remains stable.”

How to set appropriate boundaries

Let your child know you have thought about ways to support their recovery and want to be clear about what they can expect from you. Tell them your job is not to be their friend, but to be a resource and advocate in their recovery. With the soccer situation, you might say I know how important soccer is to you and here are the things that need to happen in order for you to practice with the team again. Then, lay out the parameters decided upon with the treatment team and help your child identify what he/she needs in order to be able to meet those standards. 

Boundaries are best when they are:

  • Clear
  • Fair 
  • Fit the situation
  • Able to be anticipated or are expected and not a surprise
  • Directly benefit the child, meaning they aren’t just a power play by the parents or an effort to gain control over the child

It certainly can be challenging to set boundaries-even those that are flexible and fair. And, your child may not respond well to boundaries of any kind. If your child responds with anger to boundaries you set, try the following:

  1. Review the bullet points above regarding reasonable boundaries. If you feel that your boundary meets these criteria, you can feel more confident that you are doing the right thing to support your child, even though they might not appreciate it at the time. 
  2. Remember to deliver boundaries in calm, kind and even tones with minimal negotiation. Don’t yell or get overly emotional, which will turn an important conversation into an argument in which the intention is lost. 
  3. Expect that your child may react negatively at first and give them some time to process their reactions. Know that they may be scared, sad or shameful underneath the anger, and try to find compassion even when it is hard. 
  4. Get support from your child’s treatment team and other parents who have set similar boundaries. One great resource is the Eating Disorders Family Connection Facebook page

Please know that you aren’t the first parent to struggle or to set limits like this; you don’t have to go at it alone. Take a deep breath and remember this:

Boundaries are an act of love.

Angela Picot Derrick is a clinical psychologist and Senior Clinical Advisor at Eating Recovery Center of Chicago and Insight Behavioral Health Centers. Insight Behavioral Health Centers provides specialized treatment for mood and anxiety disorders at five Chicago, Illinois treatment centers and one center located north of Austin, Texas in Round Rock. Dr. Derrick has studied and treated eating and mood disorders for over 15 years and is honored to help her clients build hope, self-compassion and resilience as they work towards recovery. 
 
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