By Dr. Theresa Fassihi, PhD, FAED, CEDS
What is a trauma? An OpEd in the New York Times on Saturday, February 4, raises the question, “If Everything is trauma, is anything?” The author expresses concern that the term “Trauma” is being used too loosely to describe any “disagreement or hardship.”
In my work as a therapist, I have found that the common understanding of trauma is usually too narrow, limited to war, violence, rape, extreme danger. I know this because when I ask my new patients if they have had trauma, most people initially say they haven’t. It is only after we have discussed what it means that they recognize that they have had traumatic experiences.
This holds true for parents of patients with eating disorders. They are usually unaware that having a child with an eating disorder is traumatic.
The Substance Abuse and Mental Health Services Administration (SAMHSA) describes individual trauma as resulting from “an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being.” This definition is known as the three E’s – Event, Experience and Effect. Let’s look at the three E’s of an eating disorder’s impact on parents:
Event – eating disorders are life-threatening illnesses. They are physically and emotionally harmful and dangerous.
Experience – although their children may not be able to recognize the illness, most parents can and are overwhelmed with fear and helplessness. The only thing scarier to a parent than having their own life in danger is having their child’s life in danger.
Effect – parents often exhibit extreme emotions when they bring their children to treatment. They are anxious, frantic, fearful, or angry at their child and treatment providers, or avoidant of the issue, in denial. These responses are consistent with the automatic fear responses of Fight, Flight or Freeze.
One wise clinician once said that the eating disorder puts a magnifying glass on our vulnerabilities. Whatever difficulties we may have with coping are intensified by the trauma of having a loved one with an eating disorder.
It is helpful to recognize that the responses families are having to the illness are NORMAL responses to an abnormally difficult situation.
Fortunately, the most effective treatment we have for eating disorders, Family Based Treatment or FBT, can also be effective in healing parents’ trauma. As parents learn to nourish their child back to health, they regain their confidence that they can make a difference and use support to get through the challenges.
One thing we are learning, though, is that before we can teach skills for addressing the eating disorder, we need to address parents’ trauma. A common symptom of trauma is self-blame and shame, and parents often blame themselves for their child’s illness or for not recognizing it sooner. Not too long ago, the medical field was also blaming parents.
Addressing parents’ self-blame and fear is the first step to helping them support their child’s recovery, so that instead of feeling “afraid and alone,” parents can feel empowered and supported by their treatment team and the FEAST community.
