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Carer’s Blog 4: Making rules and setting clear boundaries when caring for a loved one with an eating disorder

By Madalyn Oliver

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Typically, families need rules in order to define what is expected of each family member, clarify what behaviours are considered acceptable vs. unacceptable and to ensure the smooth functioning of a household. Often, when a family member has an eating disorder, parents might notice boundaries being broken or that they have inadvertently begun to cater to the eating disorder by letting family rules slide for the sufferer. This can have devastating effects; both by enabling eating disorder behaviour in the sufferer, as well as facilitating additional challenges for other family members such as siblings. In our experience, we have found this to be particularly true for parents of sufferers who are adults and/or still living at home.

Examples of rules that might be appropriate to establish as a family are:

  1. The sufferer must replace food that has been binged on
  2. Ensuring “mess” from purging is cleaned up completely; or plumbing bills for clogged pipes are financed by the sufferer
  3. Not adhering to eating disorder demands around meal times (e.g. everyone leaves the kitchen so the sufferer can prepare food)

It is completely normal for parents to worry about their loved one and a common reaction is to slip into the Kangaroo role. That is, parents may feel as though they need to protect their loved one from any additional upset or stress. Often, they do so by meeting all of their loved ones demands, even if it means maintaining the eating disorder behaviours at times.

The guidelines for making rules and setting boundaries described below aim to support parents to have the confidence to effectively balance being caring, loving and empathetic, while at the same time, having clear boundaries and rules that enable everyone in the family (including the sufferer) to cope with the demands of the illness.

Guidelines for making rules and setting boundaries:

  • Rules and boundaries should be discussed with all family members using a collaborative approach. Existing rules and boundaries may need to be reviewed and if necessary, new ones can be developed.
  • When setting rules and boundaries, try to be firm, clear and consistent about your expectations.
  • If your loved one shows resistance towards the new rules or boundaries, it is helpful to sidestep a potential argument by stating the reasons for your thoughts and feelings calmly and clearly. Remind your loved one of what was planned and discussed as a family. You may find that you need to repeat this a few times.
  • When discussing rules and boundaries, it is important to show respect for each other and to remain calm. Your loved one may need to be reminded that they are worthy of love, support and respect and that they are expected to treat others the same way.
  • It may be necessary to coach your loved one on how to take up the new behaviours using encouragement and positive reinforcement.
  • Any progress and positive efforts towards following the rules should be acknowledged and praised.
  • If rules are broken, calmly acknowledge it, plan for any possible future difficulties and encourage your loved one to try again.
  • Allow time for family members to provide feedback, review rules and boundaries and plan for the future.

If you would like more support in making rules and setting clear boundaries with your loved one please contact us at BodyMatters Australasia. We can provide one off consultations and ongoing consultations for parents and partners. In addition, we offer parent and partner support groups on the first Saturday of each month.

Stay tuned for our final installment of our parent and carers blog series on self-care strategies for carers and family members.

References:

Treasure, J., Schmidt, U., & McDonald, P. (2010). The clinicians guide to collaborative caring in eating disorders. London: Routledge

Treasure, J., Smith, G., & Crane, A. (2007). Skills-based learning for caring for a loved one with an eating disorder: The new Maudsley method. London: Routledge.