By Susan E Hickman, PhD, PsyD
This is a question that is always on the minds of families or loved ones when having to face the presence of an eating disorder. And it is an understandable question, particularly given that humans are in the business of "making meaning." That is, we really want to understand the causes, assign the proper blame and then figure out how to deal with the situation. The real answer to this question, though, is more about recognizing the fact that trying to place blame on yourself or others is totally the wrong approach and is not only unhelpful, but destructive. So do yourself and your loved one a favor and toss the question aside as completely irrelevant.
That being said, though, you will need to be open to considering your own attitudes and behaviors toward food, dieting or your body, which may be a contributing factor in supporting the presence of an eating disorder, though not the cause. One way to look at this is to consider that excessive concern by parents, spouses or other important authority figures (e.g., coaches) regarding healthy eating, calorie consumption or size/weight does not cause an eating disorder, but may support the development of disordered eating because the person has been exposed to those particular thoughts and behaviors. The same would be true for alcohol use or pornography use. Whatever a person is exposed to will bring awareness to this particular form of coping and will make it a possible coping choice, even if it is a negative one.
You may also need to be open to considering the relational or family dynamics that may be contributing to emotional stress in the individual who has turned to controlling food intake as a means of coping with emotional or environmental stressors. For example, parents who tend to over-control their adolescent's behavior, emotional reactions and social interactions, may be inadvertently contributing to the stress that is triggering the onset of an eating disorder. Family crises, sudden death of a family member, divorce or separation, or other major life changes can also overwhelm a person's coping resources. Similarly, overly critical or controlling spouses (or partners) may have a correspondingly negative impact. Thus, it is important to examine your own parenting behavior, coping skills and interpersonal style for areas than need improvement. For example, if you have problems regulating your own emotions, examine how you cope with the problem. Do you tend to self-medicate in some way, blame others, or throw tantrums? How can you learn better, healthier coping skills so that you can model these for your loved one? In these cases, seeking family or individual therapy to correct unhealthy patterns and support the development of good boundaries, healthy coping skills and mutual respect may be in order.
If this still sounds like you are to blame, consider this additional, very important detail: not everyone who is exposed to these environmental factors will develop an eating disorder. Thus, researchers are concluding that a person has to be predisposed to developing the disorder (e.g., possess particular genetic markers) in order for the environmental stressors or triggers to be influential in the onset of an eating disorder.
In summary, rather than thinking about whether or how much you are to blame and incurring the overwhelming guilt and frustration that accompanies the belief that you have caused harm, focus on learning what unhealthy behaviors you may need to eliminate or what new skills or interaction patterns you may need to learn in order to fully support a balanced and healthy attitude toward food and body image while modeling good relational and emotional health that are accompanied by solid coping skills of your own. Just as you can be part of an environment that contributes to the development of an eating disorder, you can also help create an environment that fully supports recovery.
For more information on how involved parents should be during treatment and recovery, see "Eating Disorders in Teens: Parenting Tips for the Recovery Process."
Susan E. Hickman, PhD, PsyD, is a Clinical Psychologist, entrepreneur, speaker and writer. Dr. Hickman writes extensively in the field of psychology and enjoys producing self-help guides and materials. For more resources and to receive your free "Top Tips for Mastering Anxiety," visit http://www.MindoftheMatter.com. To learn more about Dr. Hickman, you may also visit http://www.DrSusanHickman.com.
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