First Steps

Aims of Carer Skill Sharing

• To ensure that supporters are offered the knowledge and skills to facilitate their participation in the triangle of care (the three-way collaboration between patients, professionals and lay supporters).
• To be aware of obstacles to effective collaborative connection because of automatic emotional reactions (overprotection, accommodating and enabling behaviours or criticism and frustration).

It can be surprising to be told that one of the first steps as a supporter is to consider your own emotional reaction to the illness. It is important that you do not think we are pointing a blaming finger at families. Indeed this approach developed because we observed that unhelpful patterns of interpersonal reactions were common in both inpatient and outpatient settings.

Consider these questions professionals ask themselves.

1. Have you been drawn into making allowances for the person with an eating disorder possibly joining in with some “safety” behaviours i.e. methods to cope or compensate with the fear?
2. How often have you become frustrated, lost your temper and become critical?
3. Have you been drawn into disagreements with other team/family members about the best way to help?
4. Have you thought that no matter what you do it goes wrong, and you have withdrawn to focus onto something you can do right!

If you have answered yes to any of these it is probable that you have got caught in some of these interpersonal traps. These are automatic responses to the signs and symptoms of an eating disorder.

Adjustments to your own reactions not only have direct benefits in managing symptoms, but they have indirect effects by modelling emotional regulation strategies. It takes high emotional intelligence to manage these automatic responses triggered by illness behaviours. Professionals set aside time for reflection and supervision to consider these traps. We suggest that you do something similar at home.

Key learning points

• Role model change. Changing your own behaviour is hard but it is easier than trying to change the behaviour of other people.
• Change is always possible, no matter how long or how severe the illness.
• Change takes time (at least two months of engaging in new behaviours).
• “Every mistake is a treasure”. Mistakes are important learning opportunities. You will have taught the person you care for a critical lesson – it’s ok to fail! Remember, “if nothing changes, nothing changes”.
• Role model reflective self-compassion. Creativity, a key part of being human, involves trial and error. It takes courage but remember “Nothing ventured nothing gained”.
• It might appear to get worse before it gets better.
• A Mr Fix It approach is not helpful in the long term. Eating disorders have their onset during the formation of identity. It is essential for the individual themselves to develop a connected form of autonomy with her own values and meaning in life.