Compassion Fatigue: Parents of Children with Eating Disorders

As any parent who has a child with an eating disorder knows, it can be difficult to balance caring for their child while also acknowledging and attending to their own needs.
 
Many parents, in an attempt to make sure their child is safe, receiving the right treatment, and making progress in recovery, may under-emphasize their own needs. While it makes sense that the child will require more attention and support than usual for some time, it also is true that parents need to be adequately cared for in order to be a present and helpful ally in the fight against the eating disorder.
 
The role of the caregiver is a stressful one
 
It is not uncommon for parents to experience what is commonly referred to as compassion fatigue.
 
Compassion fatigue is a form of burnout which “is caused by empathy” and “is the natural consequence of stress resulting from caring for and helping traumatized or suffering people” according to psychologist Dennis Portnoy.
 
Portnoy authored a seminal article on the subject, called Burnout and Compassion Fatigue: Watch for the Signs, in which he lays out cognitive, emotional, behavioral, spiritual and somatic dimensions to compassion fatigue.
 
When applied specifically to parents caring for children with eating disorders, there are several unique ways in which compassion fatigue might manifest:

• Having difficulty maintaining an empathic perspective, or seeing your child as manipulative, uncaring, or selfish
• Misattributing the eating disorder symptoms to something negative about your child’s behavior, such as feeling like your child is “doing this on purpose” or “doing it to you” or “just wants attention”
• Feeling perpetually tired, withdrawn, hopeless or having a desire to give up or give in to the eating disorder
• Feeling angry and irritable and having difficulty managing your own emotions

 
Risk factors for compassion fatigue
 
Not every parent caring for a child with an eating disorder suffers from compassion fatigue. So, what are the risk factors for developing this type of burn-out?
 

• Inadequate support system and/or lack of connection with informed others
• Insufficient resources, misinformation, or lack of understanding about the causes and symptoms of your child’s eating disorder and the treatment plan for their care
• Feeling overly responsible for every up and down in the process of your child’s recovery and placing too high an expectation on what is possible for you in your role as a support person
• Uncertainty about how to manage your emotions in general, but specifically in situations in which you might feel scared, overwhelmed, or have a lack of control
• Lack of attention to basics of self-care such as rest, exercise, and proper nutrition

 
Ways to reduce compassion fatigue
 
What are some strategies that parents can use to prevent and/or treat compassion fatigue?
 

• Find acceptance. Reduce your attachment to previous expectations and face the current circumstances directly. You may need to accept that your child will not be able to play on the volleyball team this year because her weight is still too low. You may need to accept that meal times are going to be stressful for everyone at this point in recovery. When you face these realities directly, you reduce the struggling around wanting things to be different in this moment.
• With realistic expectations, you can better identify the small wins. Maybe your child was willing to try a challenge food, or able to use a set of skills prior to purging. While these things might seem too small to celebrate, they are the building blocks towards recovery and should be recognized as such.
• Reduce perfectionistic thinking. Take the pressure off yourself to know how to handle every situation a certain way or have the right response. Recognize your own humanity and know that you are trying your best and will sometimes make mistakes.
• Enjoy the relationship you have with your child without the entire focus being on the eating disorder.
• Consider joining your child in family therapy sessions and/or having more contact with your child’s therapist or treatment team.
• Increase your support by seeking your own therapy or support group. There are free ANAD support groups that welcome parents and caregivers. There are also excellent groups and organizations specifically for parents of children with eating disorders, including Families Empowered and Supporting Treatment of Eating Disorders, the Academy for Eating Disorder’s Patient-Carer Special Interest Group, National Eating Disorder Association conferences, and Anorexia Nervosa and Associated Disorders conferences.
• Consider joining ERC’s new closed family Facebook page, Eating Disorder Family Connection, in order to interact with parents who share similar struggles.
• Take advice from parents with similar challenges. For instance, there might be a lot to learn from parents who have children with developmental delays/difficulties who manage challenging mental and physical health concerns on a daily basis. A NY Times article “When the Caregivers Need Healing” highlights ways some parents have found to better manage their emotions related to caring for their child, specifically through “parent training” and mindfulness classes or exercises.

 
Importantly, have the expectation that eating disorders are treatable illnesses and full recovery is possible. Know that your involvement as a carer, advocate, ally and supporter for your child are essential in supporting their recovery. And be kind to yourself as you learn to navigate this difficult role better and better over time.
 
Resources for Compassion Fatigue
Compassion Fatigue Awareness Project
The American Institute of Stress
National Association of Anorexia Nervosa and Associated Disorders

• Angela Derrick, PHD, CEDS-S