I have been doing this work- supporting teens, young adults and individuals with eating disorders alongside their parents and caregivers for over 11 years now- and I often think about my very first case. Like any eager intern, I couldn’t wait for my first case and I didn’t have to wait long. 

 

I met “A” (let’s call her) and her family on a fall night. She was diagnosed with anorexia nervosa and our goal was to use Family-Based Treatment to keep her at home while getting her well. Her parents were tasked with refeeding her at home, having 6 trying meals and snacks each day through screaming matches about pasta, a food that had previously been her favorite, as they endeavored to help her gain all the weight she had lost. 

 

As part of her treatment, she was expected to see her doctor weekly for vitals and labs. 3 weeks in, her older brother, 17 at the time, tagged along and also had labs done. A week later the parents let me know: he had been diagnosed with a type of childhood cancer. The labs he had done while accompanying his sister had alerted his pediatrician to an extremely alarming white blood cell count that was indicative of the illness in his body. 

 

Before I go on, I need you to know that both of these kids battled their illnesses and went on to lead happy, healthy lives. They both did so with their parents, by their side every step of the way. 

 

As you can imagine, that case stuck with me, and has remained with me, in some way, in every room I enter with parents, but there was something that the Mom shared with me that I will never, ever forget. 

 

We found ourselves alone, just the two of us in a session one evening and she looked at me, after a deep sigh, and said, “The cancer is so much easier”. She went on to explain the website that friends had created for her son where people left messages of encouragement and posted pictures of him during healthier times. She told me about all the casseroles and food deliveries friends had dropped off, unasked, while he was going through procedures at the hospital. She spoke of a medical system built to handle this illness and wrap around families while they navigated the unimaginable. 

 

Then Mom spoke about how, not only did her daughter not have a website, she had told no one about her daughter’s anorexia diagnosis. This decision was based on a mix of feeling unsure how to respect her daughter’s privacy and knowing, probably accurately, that even close friends wouldn’t know what to say, or worse, offer unhelpful advice like “Just let her eat cheeseburgers!” . She talked about how confusing it was to know what to do and how no one knew how to support them. It was scary, but even more than that it was also painfully lonely. 

 

She said it again, “Bryn, the cancer is so much easier.”

 

This is often the unfortunate reality for families struggling through this illness. But there is another reality of this illness. The other reality is, that with the right support, people, like my very first client, can get better and go on to lead vibrant and meaningful lives. One of the best shots they have at recovery is through the support from parents, families, friends and loved ones. 

 

You would think after a first case like that one, I would have run for the hills. Set-up camp in some other sub-speciality in psychology, but it was just the opposite. I was hooked and I have done this work every single day since. You want to know why?

 

 

Watching how these parents showed up in my office week after week, meal after grueling meal, moment by moment, not just for their daughter but also for their son, not just logistically but also emotionally, with their whole hearts, absolutely blew my mind. I felt like I was helping them wield a force that was bigger and more powerful than all of us, as if we were corralling a hurricane and using it for good. 

 

Years later when my first son was born, I understood. That miracle I witnessed was the love of a parent to a child, in action, directed toward the goal of saving their life. In that internship therapist office, it felt like watching magic happen and it still does. 

 

Parents are a force of nature, and their impact is hard to overstate because they sit upstream of their child. But parents, like the Mom I worked with, and every family I have worked with since, need someone upstream of them too. Parents also need to also be supported, believed in and championed in order to translate their love for their child into effective, life-saving action instead of it becoming a paralyzing fear. 

 

The great news is that there are incredible ways to support these parents. Research repeatedly shows that caregiver involvement leads to better and faster outcomes (Levoy et al., 2022). There are parent-based interventions for mental health issues that have proven to be as effective as individual treatment (Lebowitz et al., 2019). This phenomenon is even seen in the NICU, where parents holding their infants leads to faster recovery and earlier discharge (North, Bass, Edmond, & Lee, 2022).

 

By supporting parents, we harness the incredible power of their love- and neurobiological connection- to help their loved ones thrive.

 

There is something else that happens when we support caregivers. I call it Whole Family Healing. When we can include caregivers in the process, we help these families use this horrific illness as a catalyst for change and transformation. 

 

When a family says at the end of their work, “We are different than we were before this illness, but we are better, stronger, more open and honest, more real with each other. Closer.” I know they have been changed forever, not just by this struggle, but by this work.

 

You've got this,

PS: I started a group practice called Interlace Mental Health 

and I am working with the amazing Jamie Manwaring, PhD.

She is accepting new clients in Colorado and over 40 PSYCHPACT States.

Reach out if you or your loved ones need support.

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References 

 

Lebowitz, E. R., Omer, H., Silverman, W. K., Kirshenbaum, K. G., Göbel, K., Scahill, L., & Scharfstein, L. (2019). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of Supportive Parenting for Anxious Childhood Emotions. Journal of the American Academy of Child and Adolescent Psychiatry, 58(7), 650–657. https://doi.org/10.1016/j.jaac.2018.11.009

 

Levoy, K., Rivera, E., & Szaflarski, M. (2022). Caregiver Engagement Enhances Outcomes Among Randomized Control Trials of Transitional Care Interventions: A Systematic Review and Meta-analysis. Medical Care, 60(7), 519–529.

 

North, K., Bass, K., Edmond, K., & Lee, A. C. C. (2022). Family involvement in the routine care of hospitalized preterm or low birth weight infants: A systematic review and meta-analysis. Pediatrics, 150(Supplement 1), e2022057092O. https://publications.aap.org/pediatrics/article/150/Supplement%201/e2022057092O/188641/Family-Involvement-in-the-Routine-Care-of