The Pros and Cons of Friendships in Eating Disorder Treatment
It’s impossible to fully emphasize the value of a positive support system for those faced with eating disorders like anorexia and bulimia. Clinicians and therapists provide the skills training and techniques to reshape thoughts and behaviors. Parents, family and friends lend the guidance and helping hands to then apply these skills and transfer them to life outside of treatment. Sometimes, even friendships and relationships formed in treatment can play a productive role in one’s journey toward recovery.
The latter is an area many parents and families ask about. Since group therapy is a large component of treatment, their loved ones will inevitably meet and befriend others in similar situations. Are these relationships in the best interest of a patient? And when treatment is over, is it beneficial to remain in touch with them?
First off, it varies case-by-case, and depends on the level of treatment and specific type of setting. But generally, it’s a double-edged sword. These interpersonal relationships can be healthy – yet at the same time, detrimental and problematic to a patient’s progress in treatment.
One scenario that brings concern is when personal boundaries are crossed. It’s not uncommon to see “friends” in treatment become enmeshed and hyper-focused on each other’s appearances, behaviors, food consumption and specifics to treatment. This external focus can easily distract someone from what matters most: the internal thoughts on how they’re doing and attending to their own personal care and treatment goals.
Believe it or not, these relationships can also lead to even more distorted thinking or negative behaviors. Patients may sometimes “solidify” the bond of their friendship through unhealthy eating disorder actions like restricting calories together, bingeing together and/or encouraging each other to purge. Competition can arise too: Who has the more “severe” disorder? Who can lose more weight? Who can go the longest without eating? These mindsets often manipulate individuals into deeper engagement with harmful behaviors.
But “treatment friends” can be positive too, as long as the behaviors above are avoided. The bond of a shared experience – especially something as serious as an eating disorder – can be difficult to find elsewhere within their support system. There is often a strong sense of trust and understanding with each other. It’s easier to empathize with the thoughts, feelings and problematic symptoms that accompany this illness. These types of friends can also encourage each other in a productive light. In fact, I often see patients help each other prepare meals, share their thoughts in treatment and practice good self-care.
As in any type of relationship, healthy behaviors and interactions are key to making it work. Friendships which develop through treatment are no different, yet can be more challenging to reach a truly beneficial point.
If you have a loved who acknowledges a new friendship through treatment, it’s important to explore with them whether this relationship is healthy and/or has the potential to do harm. Keep your inquiry general in nature and nonjudgmental and remain open to their feedback. Open ended and supportive questions are going to provide the most helpful insight. Suggestions might include:
What are the three most positive qualities that attracted you to this friendship?
How do your friend’s strengths help to support your progress in recovery?
How are you balancing your own self- care with caring for your friend?
How will you know if the relationship begins to have a negative impact on your recovery process?
What are the similarities and differences of your friends in and out of treatment?