[VERONICA]: Empowered and Unapologetic is part of the Practice of the Practice Podcast Network, a family of podcasts that changed the world. To hear other podcasts like the Bomb Mom podcast, Beta Male Revolution, or Imperfect Thriving, go to practiceofthepractice.com/network. Have you ever thought, how did I manage to lose myself? Being a mom is so hard, especially when we’re feeling stressed and disconnected. We exhaust ourselves trying to create this perfect life for our family. You deserve to enjoy your marriage and your kids, without the stress perfectionism brings. I am going to teach you how to identify who you are, outside of all of the roles you play. Hi, I’m Veronica Cisneros. I’m a wife, mother of three, and a Licensed Marriage and Family Therapist. I am on a mission to teach women, just like you, how to become empowered and unapologetic. Welcome to our girl gang. Hey ladies. So, we are back with Dr. Foster. And like I mentioned in the last episode, we’re going to talk about all the things with regards to, okay, now we know our child has an eating disorder. Now, what do we do? How do we talk to them? What are the do’s and don’ts? What is available to me? Do I go to a therapist? Do I go to a partial hospitalization program? What the hell is the partial hospitalization program? Do I have to go to residential? What does this look like? So, Dr. Foster is going to go ahead and teach us. So, without further ado, let’s go ahead and get to it. Dr. Foster, welcome again. Hey, girl. [DR. FOSTER]: Hey. [VERONICA]: All right. So, we now discovered our child has an eating disorder, right? And we now recognize that we’re not at fault. However, maybe some of the things we modeled for her, or for him, might have led to this in some way, shape or form. So now, what do we do? So, if I discover my child has an eating disorder, what do I say? How do I have this conversation? Do involve the entire family? Does my husband have to be a part of this conversation? Or is it just one on one, like, what do we do? [DR. FOSTER]: Yeah, that’s a great question. First, I want to highlight, again, we talked a lot in the last episode about how parents modeling their behavior impacts the behavior of their children, especially around food and body image. I do want to say, though, that, again, going back to not blaming, it’s no one’s fault that this developed. Can we model bad habits? Absolutely. But also the development of an eating disorder is sort of a perfect storm; there’s other factors involved, you know, some of it might be genetic, some of it might be related to anxiety, some of it might be related to difficulty regulating emotions, and that might have to do with, you know, temperament or kind of how we’re born. So, all of those factors have to be in play. Can we model healthy behaviors? Absolutely. But is it solely the responsibility of a parent who modeled unhealthy behaviors that their child developed an eating disorder? Absolutely not. So, I just want to make sure that that’s clear. [VERONICA]: Yes. [DR. FOSTER]: And in terms of treatment, you know, I think that the first step is to have a conversation. When you notice growing concern or when you notice that there’s some behavior developing that maybe seems to be crossing the line into unhealthy or, you know, all of the parents have that kind of intuition. Like, I’m not sure that that we’re moving in the right direction here. This doesn’t feel right. I think go with your gut and have a conversation. I think it’s important to let your child or teenager know, I’m concerned. I know it’s natural and common to have some worry about your body, or how you look, your appearance and all of that, but this seems to have taken kind of a turn or be progressing in an unhealthy way. So, just confronting the issue. I would never advise a parent to avoid it or put your child straight into therapy without letting them know what you’re thinking or how you’re feeling and kind of opening up those doors for communication. And then, based on what comes out of that conversation, I think then it’s important to pursue treatment. And I’ll talk a little bit about those options, but going back to your question like does the family need to be involved? Absolutely. So, this is the time, you know, when you find out that your child is suffering from an eating disorder, this is absolutely the time to kind of circle the wagons, like the more accountability, the better. Having all household members involved is actually part of treatment and can be really helpful. Everybody needs to be aware of what’s going on and how we’re monitoring this and how we’re treating it and kind of the do’s and don’ts, like, how can we help and be supportive? And what’s harmful, even if we didn’t realize it before? What’s potentially harmful in this situation? So, I think it is important to kind of circle those wagons. [VERONICA]: I appreciate that you said that, you know, we come together as a family. And it’s important to have that conversation with your child before walking into a therapist’s office. I’ve had clients come in, and they’re with their parents and we’re sitting down and we’re all together. And then the mom will say, yes, on the phone, I had mentioned that my daughter’s suffering from depression and anxiety, but the one thing that I left out is she’s also suffering from an eating disorder. And the little girl just looked at me with wide eyes, like, completely embarrassed, full of shame. And it was like, wait a minute, timeout. Timeout, like, yes, it’s important, it is extremely important to… I know you want to go and see a professional right away, however, have this conversation with your child first. I can’t stress that enough. So, I’m so glad you mentioned that. [DR. FOSTER]: Yeah. And I think a lot of times, for people suffering from eating disorders, it plays the role of kind of a security blanket. There’s this fear that if I go to treatment, or my mom makes me go talk about this, they’re going to make me stop. And there’s this anxiety around, you know, not monitoring their food, not excessively exercising, not binging and purging. Like, I can’t live without these things right now; I can’t imagine not having access to these things. And so, if I’m having to go to treatment, that’s kind of anxiety provoking, because they’re going to take that away from me. So just having a conversation about the fact that we just want to get some advice and some help with this and make sure that you’re healthy, as opposed to… we never want to approach this as, like, if you don’t stop this, this is what’s going to happen, right? We don’t want to approach this with fear or potential punishment. I’ve had parents like, you have to eat or I’m taking your phone away. You don’t want to get into a power struggle around food because part of… for a lot of people, part of an eating disorder has to do with control, and so if you get into that power struggle, it’s just going to kind of increase the behavior or, depending on the child, they’re really going to dig their heels in. So, really having an open conversation about, look, I get that you have ownership over your body, you decide what you put in your mouth, and ultimately you decide what comes out, too; at the same time I’m really concerned about your health and I would just like to get another perspective and maybe some advice from a professional about where to go from here, somebody that you can talk to. So, kind of keeping the doors open for communication as opposed to saying, do this or else. I think that’s dangerous territory. [VERONICA]: Yes. [DR. FOSTER]: My first piece of advice, in terms of treatment, would absolutely be get a medical professional on board. And any therapist that works with a client suffering from an eating disorder is going to say the same thing: we need a medical professional on board; I need you to go to your PCP, I need a release to speak with your PCP. I need the PCP to know what we’re dealing with here, what the food intake is or what the eating disorder behavior is. We need labs drawn and we need regular monitoring. I mean, absolutely, because of, you know, there’s two pieces really to an eating disorder; there’s that kind of mental and emotional aspect, or behavioral aspect, and then there’s the physical, medical aspect. And so, we need to make sure that the child is medically stable, that these behaviors haven’t negatively impacted their physical state in a way that puts them at higher risk. So that’s first step, absolutely necessary. And as long as they’re medically stable, then we can work with them on an outpatient level of care, so getting them into seeing an individual therapist for weekly or twice weekly sessions. [VERONICA]: Is that any therapist? [DR. FOSTER]: I would definitely recommend somebody with eating disorder experience – some kind of training in the treatment of eating disorders. Again, I think if you’re going to somebody who doesn’t know, then you’ll run the risk of perpetuating the eating disorder language, like, well, instead of restricting your food to 1000 calories a day, what if you just restricted it to 1100 calories a day? [VERONICA]: Oh, God, yes. [DR. FOSTER]: Or [unclear] that are not necessarily helpful. Or things like, you’re not fat – look at me. If you think you’re fat, [unclear]. Those things are not helpful, but people who don’t know might say some of those things. And so, I think it is important to seek treatment from somebody who is educated and trained in this area. [VERONICA]: And I think it’s also important to know that although we’re therapists, that does not mean that we’re trained in everything, and we specialize in everything. We’re given maybe a book, you know, in grad school, about eating disorders. However, that might be the extent of a therapist’s training. Now, if they’ve, you know, worked… at the extent of how far you went, you know, now you’re an expert, which is completely different then a therapist who specializes in depression, different to a therapist who specializes in anxiety. So really making sure that your therapist is familiar, or even specializes, that would be even better, you know, specializes in eating disorders, because I don’t know how many times I’ve heard a client say, well, you know, that exact same thing that you just said – you’re not skinny, look at me. And it’s like, dude, really? Really? Like, why would you say that? But it does happen. It does happen. [DR. FOSTER]: Absolutely. Yes. I think the specialty education and training is really important. You know, there are evidence-based treatments for eating disorders. So, if you’re going to a therapist who doesn’t know necessarily what those are, they’re kind of walking in blind like, you would not go to a psychiatrist for a heart problem. It’s important to make sure that you’re seeking the advice from a professional who knows what the research says in this area. [VERONICA]: Absolutely. Another question I ask, and I think this is also important. What should I avoid doing or saying around someone with an eating disorder? Because the minute you’ve had this conversation, okay, well, now the eating disorder’s exposed, and this is a very sensitive and vulnerable time. And it’s not that we have to walk on eggshells by any means; you’re still family, you can still go about your day. However, what are things that we should say, or we should not say? Or we should do, or we should not do? [DR. FOSTER]: Yeah. I think it’s really important… again, we’ve talked a lot about modeling and how we can model behavior. It’s really important not to comment on food, weight, or body. So, for example, your child is in eating disorder treatment. Let’s say they go to a higher level of care; let’s just say for example, they start seeing an individual therapist who specializes in eating disorder, and at some point, that therapist says, hey, look, I think that this needs more containment and I think we need to step you up to maybe a partial hospital program that involves a dietitian, and a psychiatrist, and a mental health professional, all those other things. Well, it’s important that you’re avoiding any… as they’re in the treatment, they’re possibly restoring weight, cos they’re eating more and they’re under more strict monitoring, and they’re coming home, you don’t want to say things like, it looks like you are gaining weight. That’s great. [VERONICA]: Yes. [DR. FOSTER]: Because that is extremely triggering. In our minds, we’re like, yes, you’re gaining your health back, right? That weight gain is a signal that maybe you’re progressing or you’re moving in the right direction, but somebody with an eating disorder hears that and thinks, holy shit, this is terrifying. And so, you want to avoid any conversations around that, even if it doesn’t look like you’re restoring weight. That could be triggering in a different way. Or, you don’t want to hyper focus on the food, so let’s say they’re in treatment and, as they’re progressing through treatment you notice that they are eating dinner now, or let’s say, for example, last night at dinner they went back and got seconds. You don’t want to say things like, you got seconds. Good job. [VERONICA]: High five. [DR. FOSTER]: Okay, well, you might be internally noticing the progress and saying that’s a sign that maybe they’re overcoming their fear of food, that could be very triggering for somebody who’s in treatment with an eating disorder, who are still struggling. Most people who are recovering from an eating disorder don’t want people to notice; they don’t want people to notice that they’re eating more, that they’ve gained weight. They want to fly under the radar. So, you want to stay away from those types of things and focus more on health. Like, I’ve noticed that your smile’s back, I really missed that. You know, you look happy again; I love watching you spend time with your friends again, that’s just so energizing. All of those things that that are coming as a result of them feeding themselves and being in treatment and all those other things that are hugely beneficial but not focused on weight and food. [VERONICA]: Yes. Beautiful, beautiful. I love that. I love the examples that you gave as well. So, you already explained the difference between a therapist, a partial hospitalization program. We’ve already covered what to say what, not to say, and why it’s important to get help, because we’ve talked about how lethal an eating disorder can be. So, one question that I ask everyone that’s on the podcast is, what advice would you give to the mom who is feeling stressed and disconnected? And I’m carrying this question to this topic because you’re gonna want to take it away. You know, this is our baby, we’re gonna want to take it away, and all of those feelings of guilt are going to [unclear] every time she walked into my room, I just so happened to be on the damn scale, or I was in my closet, or wrestling with my jeans, you know. That might happen. And so, you know, there’s an emotional component that happens to us too and us wanting to take it away so badly so this doesn’t exist in our family anymore. Right? What would you tell her? The mom who just feels completely stressed, completely disconnected. If you were talking to her, she was like standing right in front of you, what would you say? [DR. FOSTER]: I think my first piece of advice would be, you need to have your own space to talk to somebody and process this. You don’t have to go this alone. It’s not your fault. At the same time, I understand where the guilt comes from and you need a place to process that. I would recommend any parent who’s dealing with a child struggling with an eating disorder to seek their own therapy. I mean, much like we would tell any family member who has a relationship with an addict to go to Al Anon and get their own treatment as well – I think it’s important in the same way for any family member who has a loved one struggling with an eating disorder to seek their own treatment as well. Again, you need a place to… we all need a place to kind of process those feelings, those thoughts. And especially when you’re trying to monitor what you’re saying and what you’re doing around your child, that can even add pressure and stress to the situation like, how do I know if I’m doing it right? When am I doing it wrong? There’s so much pressure, I feel like I’m walking on eggshells. You need a place to have those questions answered. And to kind of unload and unpack what you’re thinking, because it’s not always going to be helpful to do that in front of your child anymore, right? So, having that own safe haven where you can debrief, you can unpack, you can process all that you’re feeling and experiencing, is so important. You don’t have to go this alone and in fact you shouldn’t. So, seek your own therapy at the same time. [VERONICA]: And last and final question: you personally, what are you doing right now to live the life you want to live? [DR. FOSTER]: Oh my. So much. I’m in a career that I love. I am active. I love hiking, I’m outdoors. I got a new puppy. I’m spending time with my new puppy. I’m reading, I’m growing, I’m challenging myself. I mean, I’m one of those people who, you know, I love my career and I love to work. I also love a lot of other things like crafting and being outside and all of those fun things. So, I make sure to carve out time daily to engage that side of me. [VERONICA]: Absolutely, absolutely. I think that’s one thing that I absolutely love about you, is just how you embrace life. Don’t get me wrong, I miss you and Spencer down that Soul Train line, so tell him I said hi. [DR. FOSTER]: I will. I’ll let him know. [VERONICA]: How can we find you? So, for those women that have some questions or just want to reach out to you and say thank you, how can we find you? [DR. FOSTER]: Yeah. So, I mean, I know I let you know this, Veronica and you were shocked, and I think a lot of people are shocked too. I don’t have a professional social media platform. But feel free to email me. I mean, anybody can email me with any questions. I’m happy to provide consultation and referrals as needed. So, my email address is dr.aimee.foster@gmail.com. [VERONICA]: Aimee, Dr. Foster, thank you so much. Thank you so, so much. You have given us so much information. And I’m just so thankful. I’m just so thankful. We haven’t seen each other in a minute, girl. We haven’t seen each other in a minute. [DR. FOSTER]: I know it’s been a long time, but no, I appreciate it. I’m happy to help. [VERONICA]: Thank you so much again. [DR. FOSTER]: Yeah, of course. [VERONICA]: Alright, girl, well you go about your day cuz I know you have another client, and I will talk to you soon. [DR. FOSTER]: All right, thanks. [VERONICA]: Absolutely. [VERONICA]: What’s up, ladies? Just want to let you guys know that your ratings and reviews for this podcast are greatly appreciated. If you love this podcast, please go to iTunes right now and rate and review. Thank you, guys. Many women lose their own identity in the shadow of being a mom and a wife. We are a community of women who support each other. We leave perfectionism behind to become empowered and unapologetic. I know you’re ready for the next steps. If you want to become empowered and unapologetic, get my free course, “Unapologetically Me,” over at empoweredandunapologetic.com/course. This podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. This is given with the understanding that neither the host, Practice of the Practice, or the guests, are providing legal, mental health, or other professional information. If you need a professional, you should find one.