Parents Do Not Cause Eating Disorders

Believe it or not, there are eating disorder professionals out there who know nothing about me, yet they would postulate that I am the cause of my daughter’s anorexia solely by virtue of being her mother. They categorically believe that parents cause anorexia. Well, they should know better. Not because I say so, but because the research and literature say so. The Academy for Eating Disorders says so. Science, specifically neurobiology, says so.

Over the past 21 years, I am sure that I have made my fair share of parenting mistakes. Trust me, I am my own vicious Monday morning quarterback. I have replayed my daughter’s childhood and early adolescence in my mind in an endless loop, looking for how I should have parented her differently, trying to figure out what I could have done to save her from falling into the quicksand of anorexia. There is no greater torture for a parent than thinking that you failed to keep your child safe.

What I keep seeing over and over in that loop is normalcy. I see playdates and birthday parties, I see family celebrations and school events, I see homework, tests, and book reports, I see ballet and flute recitals, and I see my daughter both fighting with her sisters and playing with them. I see her basking in the love of her grandparents, enjoying family vacations, caring for her younger brother, and interacting with her friends. I see a child with sparkling blue eyes who was adored, cherished, respected, cared for, and loved. I see room for improvement in myself, but mostly I just see years of normal.

Along with that, I also clearly see the perfectionism, over-achievement, selflessness, and anxiety that are classic personality markers for anorexia. They have been present all along. A 95 instead of 100 was a tragedy. We never pushed our daughter; if anything, we tried to get her to lower her impossibly high standards. Everything our daughter did had to be absolutely perfect or she would scrap it and start all over again. Her willingness to defer to others and give up things that she wanted so someone else could have them seemed noble; I had no way of knowing that it was actually harmful. I wish that I could have known then what I know now, but life doesn’t work that way.

I would never let my pride or hurt feelings stand in the way of my daughter’s recovery; if blaming parents had a shred of therapeutic purpose, I would be in full favor of it. I would take out a full page ad in the New York Times blaming myself for her anorexia if it would help her in any way at all. However, not only is parent blaming indicative of an outdated approach, it is also harmful.

When my daughter was hospitalized at age 15, the hospital was so focused on how and why she developed anorexia (the answer, of course, was us) that they all but ignored actually treating her. It’s like looking for cause in a cancer patient instead of administering radiation or chemotherapy to treat the growth; all the while when you are looking for cause without giving any treatment, the tumor is growing and the patient is getting sicker.

In addition, the blind presumption of parent blame pretty much requires distancing patients from their parents, which is usually a mistake; and yes, of course there are exceptions. If parents are viewed as the problem, they cannot be part of the solution. This negates the possibility of using what is considered to be the most effective method of treating anorexia in adolescents, family based therapy. In fact, later on, we participated in family based therapy and found it to be the only form of treatment that was able to propel my daughter forward.

I attended an eating disorder conference in NY last year, and I was gratified to see that so many eating disorder professionals are using a therapeutic approach that is inclusive of parents. However, for the most part, the eating disorder community in Israel has not yet boarded this train; and as such, we parents suffer not only with the pain of our child’s illness, but with the knowledge that our children have no access to the treatment that is most inclined to help them. Statistics for recovery from anorexia aren’t that great to being with; I want my daughter to have the best possible care, and I want it to be standard.

Parent blaming is the equivalent of using 30 year old treatment methods for cancer. No one would consider an oncologist with an outdated approach to treatment knowing that their loved one’s chance of recovery would be compromised.

Family based therapy is practically impossible to find here in Israel. Why? My take is that if professionals won’t let go of their blanket parent blaming theories and accept that anorexia is a brain-based biological illness with genetic components (and environmental triggers), they won’t ever be able to include parents in treatment. In the end, the person who suffers most is the patient.

Once upon a time not so long ago, disorders such as autism and schizophrenia were thought to be caused by bad parenting. Thankfully, the psychiatric community has changed its opinion and is now focusing on research relating to genetics and neuroscience.  I am praying for the day when parent blaming in the eating disorder world will be a thing of the past; and that instead of wasting precious treatment resources on outdated theories, these resources will be more effectively dedicated to improving care for anorexia sufferers and their families.