Treatment Fatigue

I feel so weary writing this, I almost can’t start. And I am not talking about provider fatigue, for that is a different subject altogether, and an important one. No, I mean the fatigue I have watched parents feel over all these years of treating children with eating disorders.

Parents are human, even when they can do inhumanly difficult things for the sake of their children. None are saints, of course, but they can come close to sainthood when circumstances require. At least, some of them can (and do).

Do you remember the myth of Sisyphus from school? The Greek myth where King Sisyphus was condemned repeatedly to roll a boulder up hill with great effort, only to have it roll back as he nearly reached the top? This must be what it feels like to have one’s child briefly returned to health, only to have the illness come tiptoeing back, seducing the child into first one small eating disorder behavior and then another until the sum total adds up to weight loss and relapse.

At first, you might not see it coming. Then you may see something, but you just can’t bear to acknowledge that it’s back. Maybe if you ignore it, it will resolve? Maybe you’re too tired to jump on every little behavior that seems suspicious. Maybe your other kids have you distracted and it only seems right to allot them their share of your time and attention. Maybe you’re trying to start a new job, get a promotion, learn a new skill. The constant drip-drip-drip of close attention to the details of food intake that are necessary to keep your child safe take their toll. Can’t someone else do this for me for a while? Can I lay this burden down for a week or two and pick it back up when I’m stronger?

The fact is, we parents are unlikely to find someone who can care as much as we do, who has been through the training we have, who “knows the illness.”  Even doctors who care for our children may not really know all we have been through and the effort, the daily effort, it has required.

So, treatment fatigue: what can we do about it? It seems simplistic to say “take care of yourself,” though it’s true. Scrounge time alone from your friends and family, ask them to help you with the shopping, clean-up, errands — but not the meal supervision unless you or your team have trained them very well. Sometimes you just need an hour to take a walk, take a nap, get a pedicure, plant some carrots, sniff some lilacs, take a bath, have a coffee with a friend or — blissfully — alone.

When I first wrote a version of this blog about three years ago, I immediately received a comment advocating the use of grandparents in the respite-providing role. Of course, for some people this is a sound possibility; for others, involving their parents or parents-in-law is a complicating rather than a simplifying act. We vary as adults in our relationships with our parents, and they vary in resilience as they get older. Meal supervision is exhausting. It’s hard to know what to say; it’s even harder to know when to say nothing. It is far simpler to have them help you with the transportation of other children, the grocery shopping, the laundry than the actual supervision of a child who struggles to eat.

But grab that help where you can get it. Talk to others who have been through it. If you are a Kartini parent, attend those parent support groups! Check out the F.E.A.S.T. forum for ideas and support. Put that oxygen mask on yourself first, for without you, your child will not thrive.