Praise Doesn’t Feels Supportive to People in Eating Disorder Recovery

The last post about listening to people with eating disorders applies to family and friends as much as it does to clinicians and treatment.

Families often feel like their job is to monitor and assess food intake and adherence to a meal plan. Similarly, families want to reward following the treatment plan with praise. Yet this praise almost always backfires and actually strengthens the eating disorder—a fact hard for most people to understand.

The conundrum of how to support people in eating disorder recovery stems from the nature of the illness itself. The eating disorder thoughts are powerful and hard to resist. They bring comfort and a sense of accomplishment, no matter how destructive they are at the same time.

If family or friends praise progress in recovery, people with eating disorders struggle to hear the positive reinforcement as it’s intended. Instead, the praise betrays the eating disorder thoughts by reinforcing the idea that that eating normally is a failure. Other people recognize the changes and reveal the person is normal, like everyone else, something abhorrent to eating disorder thoughts. Moreover, the praise stirs up the frustration and sadness at leaving the eating disorder behind.

If instead families ask how to help or offer the opportunity to listen, people with eating disorders will likely be able to speak about how they actually feel. After being buried under eating disorder thoughts, it may take time before they feel safe to start to talk about how they’re feeling. However, without the pressure to perform and the feeling of being watched, exposed or even praised, they will feel more able to make their own decisions and not react to outside intrusions.

Of course, these thoughts don’t apply to people who are in medical danger, and the distinction between health risk and psychological stability is often not as clear as it would seem. In addition, different clinicians and families may be willing to accept more instability to provide a safe environment to start recovery. No matter the situation, an open, warm, loving environment is necessary for any successful recovery.