Caring for the siblings of people with an eating disorder
When a family has to cope with a situation as painful and complex as an eating disorder , they very often feel confused and overwhelmed. A great deal of information about the disorder and significant support and guidance from professionals are needed to overcome it.
Anxiety, fear, feelings of helplessness, and uncertainty about what to do typically disrupt family dynamics. Routines break down, conflict increases, and the disorder takes center stage in family life. It is at this point that parents often, and quite naturally and understandably, focus on helping the person affected by the disorder. To concentrate on such a difficult challenge, they often reduce their attention and availability to other family members, very often siblings.
At this point, what should we keep in mind? The best thing we can do is be aware of the needs of our brothers and sisters and support them throughout the treatment and recovery process.
Guidelines for supporting brothers and sisters
We need to explain to them what an eating disorder is.
It's necessary to provide them with information about the disorder, adapting the language and vocabulary to their age and level of understanding. Overprotecting them—that is, hiding the disorder from them, deceiving them about it, or trying to minimize the obvious seriousness of certain situations—will only make them feel more distress and frustration. It's also important to explain that certain reactions of sadness or anger from the affected sibling are typical of the eating disorder and that, although it's normal and natural to feel bad when this happens, it's important that they don't interpret these reactions as a personal attack, but rather as part of the disorder's manifestations. You can tell them, for example, that sometimes it's the eating disorder that speaks and acts, instead of their sibling.
To involve them in what we are doing to overcome eating disorders
As much as possible, it's advisable to prepare them for what will happen throughout the treatment and recovery process. For example, explain that for a while their sibling won't eat at home, but will eat at the hospital, or that they won't be able to go to school at the usual time. It's important to make it clear that all these actions aren't a punishment, but rather aimed at their sibling's recovery, and that they are temporary because as they overcome the eating disorder, the treatment will become less and less invasive.
Let them know what they can do to help their sister or brother
It is necessary to help them support their affected sibling with understanding and affection . It is good to make them aware of the different guidelines and recommendations established by the therapeutic team; this way, we will prevent them from feeling confused by these guidelines and help them understand why they are useful. We will also prevent siblings with eating disorders from using strategies to "escape" treatment, such as asking for their cell phone or computer to access the internet during periods of treatment when they are not yet allowed to do so.
It is very important for the family to understand that under no circumstances should siblings be responsible for the care of the affected person, as this requires the maturity and management skills of an adult. However, siblings can be very active in showing affection and support to the affected person, for example, by expressing their love, spending time talking, playing board games or video games, watching movies and TV series together, and so on.
Give them space to express themselves and validate their emotions
Siblings will most likely feel compassion and motivation to help the affected person, but, as is also natural and understandable, they will feel anger, frustration, and resentment. These emotions may be directed toward the affected person. It is important that we validate their emotions and support them with understanding and affection . We must allow them to express themselves freely without judgment, listening to them with empathy and helping them manage all these emotions in a healthy way, ensuring that the sibling relationship is not harmed by the disorder. Let us also keep in mind that our example, as adults who support and help a son or daughter with an eating disorder, will be key in teaching siblings what to do and what not to do, what to say and what not to say to the affected person.
Preserve your routine and your particular life
The less the eating disorder disrupts the lives of individual siblings and the family as a whole, the better. Let's not forget that the ultimate goal of treatment is for the individual to lead a completely normal life. For this reason, the more normalized everything can be from the outset, the better. This means that, although the entire family, including siblings, will have to adapt to the guidelines and recommendations provided by the therapeutic team, the more the siblings' daily routines can be preserved, the better. This means maintaining meals, conversations, and family time despite the disorder, so that siblings perceive that the family structure and dynamics remain intact and that they are also available to them. Along these lines, it is also important that, to the extent the situation allows, siblings maintain extracurricular activities, leisure activities, friendships, and get-togethers with friends, etc.
Managing an eating disorder at home, with all that it entails—helping the affected person, attending to the needs of other family members, maintaining work, and managing daily life—can be a monumental challenge. For this reason, organizations for families and individuals with eating disorders, such as the Association Against Anorexia and Bulimia , can provide guidance and support to families throughout this process.
Featuring
