Damned if you do. Damned if you don’t. That is often what it can feel like when talking to a loved one with an eating disorder. If you bring something up, will they feel attacked, will they scream at you, will it get worse? It is always seductive to think, Maybe it’s just this once. Maybe it will go away if we just show him/her we believe they can do it.

I am recovered from an eating disorder, and in my own treatment program parents were almost encouraged to “walk on egg shells.” I remember my parents sitting in a family group where my fellow cohort and I were creating a list of don’ts: don’t talk about food, weight, appearance, exercise, don’t ask how her day was, don’t talk to her when she’s eating, don’t ask about food, don’t ask about the future, don’t ask about school, etc. It almost felt like no topics were safe to bring up without triggering someone. The list of don’ts could easily go on and on… and on, depending on whom you ask.

There is an illusion of safety behind the don’ts, but is it realistic? Coming home from treatment can feel incredibly vulnerable and overwhelming. Measures should certainly be made to ensure a successful transition, but hiding from every possible trigger for the rest of your life isn’t realistic. So how do we find a middle ground?

When I started working at Monte Nido Philadelphia, our clinical director, Emily, said in one of our first family groups together, “stomp on the egg shells” and she created a stomping motion with her feet. In that moment I had a flashback to a similar moment in my own treatment where the eggshells were alive and well and felt like the only thing protecting me from sudden doom. As my supervisor and someone I admire in the field, I had to give this some more thought. Should the eggshells be squashed?

In therapy we have to crack some eggshells and break down some walls in order to grow and heal. In order to strengthen our skills we need to be challenged, and, in order to master our skills, we need practice! I suggest having a conversation with your family member who has an eating disorder about their triggers. Everyone has a few things that are incredibly challenging for them personally. You and your loved one can request one or two thing(s) that are not up for discussion, but every other topic is fair game. Each client I’ve met has something (if not more than one thing) that is just incredibly triggering to them, whether that is their weight, dieting, or comments about appearance. Most clients know that one thing that always sets them back. Having my clients explore those triggers in therapy, and then share them with their supports, can be incredibly helpful.

Ask your loved one about their triggers; they can rank them from most challenging to least, and then agree which ones are off limits. Asking about how your family member would like triggers and challenging situations to be dealt with would also be helpful. Mistakes are going to happen. Those topics will accidentally be brought up, but set the expectation that those one or two topics will be avoided as much as possible. Those topics can then be left to work on in therapy (with and without supports present) and should be communicated to your loved one’s treatment team. Taking the pressure off the client and the family will help both client and supports feel that they know what’s expected of them.

Being a support of someone with an eating disorder is incredibly difficult. Constantly second guessing yourself about what to say and what not to say is exhausting. If you don’t already have a family therapist who is well versed in eating disorders, I would highly recommend it. Having a professional with whom supports and parents can discuss their concerns and worries will be a great relief. When struggling with bringing up a difficult topic, I recommend clients and parents alike to bring their loved one in for a family session. That way, everyone can feel supported in the conversation.

Talking about triggers and understanding how they affect your loved one can help you be mindful and sensitive of their needs during recovery. Understanding that we are human and will make mistakes, and then giving yourself the time to learn from those mistakes and move forward is paramount.