Believing is seeing yourself as effective

Confidence is tremendously difficult when a parent is faced with:
  • A frightening prognosis
  • Perplexing symptoms
  • Confusion about what is their child and what is the illness
  • No clear understanding of the illness from friends, family, media, literature, or clinicians
  • Being asked to do things that distress one's child
  • Parenting that seems inappropriate for the loved one's age
  • Actions that others have told you explicitly NOT to do
  • Other adults, even spouses, pulling in different directions
  • A situation that requires throwing out nearly everything pleasant and normal
  • Challenging, often long-distance, appointments where you will be given homework, not a magic wand.
  • The prospect of doing these things for a long time
Those are what parents are being asked to do when they begin Family-Based Maudsley. They don't sound good. Sending the kid to a nice ranch or even a stay with Nurse Ratched may easily strike a family as a better and more effective idea: after all, what do WE know about treating mental illness?

But here's why this unappealing scenario is still the first thing a family should consider: getting your kid back. If you want to double your chances of getting your dear son or daughter back to health and on to normal development then it bears consideration. It's the hardest parenting and caregiving and marriage-relationship work you'll ever do, but consider the alternatives.

But if you do it, know that your confidence is part of the calculation. Find it, nurture it, protect it, spread it - fake it when necessary - but confidence is one of the greatest medicines you can offer.

'I Know I Can Help You': Parental Self-efficacy Predicts Adolescent Outcomes in Family-based Therapy for Eating Disorders.

This doesn't just go for FBT/Maudsley. It doesn't matter what "approach" or combination of tools your loved one needs: confidence is key. And HARD.


  1. Boy Laura , you really hit the nail on the head for me. This was a long changing process for me. I think the first really hard thing to earn was learning to tolerate my daughters distress and realize that I could not take it away or even make it better. When I learned to stay calm, listen and comfort her without engaging in advise or discussion, the distress did dissipate. I began to develop mre confidence in my ability to recognize and respond effectively to my daughters disordered thinking and behavior. We really have had more than our share of perplexing symptoms. Learning how to navigate the professional treatment providers was essential to finding the best treatment for these symptoms.
    The absolute key to the set outcome was having a united team. My husband, and our treatment providers standing shoulder to shoulder, sharing our observations and plans continue to be the best chance our daughter has for complete recovery.
    I know there's no magic wand or wonder drug. Behavioral therapy that teaches our daughter and us how to most effectively respond to these maladaptive responses to stressors and restore her to full nutritional state seems to be
    to be our best choice for recovery.
    Confidence rises and wanes. It's comes with the territory.regaining confidence when it does wane is crucial. Even if it's a temporary or sometimes even fake it to you make state of mind.

  2. I expect you can tell who I am - Ms Guilt Trip signing in!

    I agree with every word of this post and with the comment, but boy is it difficult. It doesn't help if you haven't seen One Flew Over the Cuckoo's Nest and actually have largely good experience of hospital care and fear of (lack of) Care in the Community when you start and when pre-existing struggles make it rather less easy to state that you want your child "back" rather than "well" and "happy" which is what the magic wand wavers promise.

  3. Honestly, I thought of you when I was writing this and considered how impossible it is to exhort people to do things without stirring unfair criticism for those with more complex situations. Please know that I hope to bolster the confidence of those for whom it is the missing and available piece, not to further depress others.

  4. I know! Love you!

  5. and I must watch One Flew Over The Cuckoos Nest one day just for the sake of my education.


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