Archive for November, 2015

Video: Post-Traumatic Stress (Step 4)

Below is a video from the presentation of “Post-Traumatic Stress.” For the various counseling options available from this material visit www.summitrdu.com/counseling.

NOTE: Many people have asked how they can get a copy of the seminar notebook referenced in this verbal presentation. You can request a copy from Summit’s admin over counseling at counseling@summitrdu.com (please note this is an administrative account; no individual or family counsel is provided through e-mail).

“God Is Dead, Life Is Meaningless, or I Am Crazy”
LEARN MY SUFFERING STORY which I use to make sense of my experience.

Trauma: Step Four, Brad Hambrick from The Sam James Institute on Vimeo.

Memorize: Psalm 88:13-18 (ESV), “But I, O Lord, cry to you; in the morning my prayer comes before you. O Lord, why do you cast my soul away? Why do you hide your face from me? Afflicted and close to death from my youth up, I suffer your terrors; I am helpless. Your wrath has swept over me; your dreadful assaults destroy me. They surround me like a flood all day long; they close in on me together. You have caused my beloved and my friend to shun me; my companions have become darkness.” As you memorize this passage, reflect upon these key points:

  • Psalm 88 – This is the darkest of all the psalms. God knew we would need words like this and he gives them to us.
  • “Close to death” – The psalmist’s experience was so intense he believed he might die.
  • “Suffer your terrors” – The psalmist made sense of his experience by attributing it as being God’s punishment.
  • “I am helpless” – The psalmist was so overwhelmed that whatever strength or influence he had felt meaningless.
  • “Surround me like a flood” – The experience was so encompassing that the psalmist felt like he was drowning in it.

Teaching Notes

“This side of heaven, no one can offer a fully satisfactory answer for why God continues to allow evil and suffering (p. 20).” Steven R. Tracy in Mending the Soul

“One of the things that will be so important as you move through this book is trying to separate out your voice, the abuser’s voice, and God’s voice. Often times they will seem as if they all run together. Or yours gets completely squashed, and you can’t tell the abuser’s words from God’s (p. 41)… Until you state what you know, you cannot find out what is a lie and what is the truth. And as long as the lies remain hidden, they will exert a powerful influence over your life (p. 72). .. If the prior knowledge is a lie, then all incoming information will get filtered through that lie, and the lie will stand. This is especially so if the lie was repeated many times and accompanied by high emotional intensity (p. 122).” Diane Langberg in On the Threshold of Hope

“Traumatic events destroy the victim’s fundamental assumptions about the safety of the world, the positive value of the self, and the meaningful order of creation… They violate the victim’s faith in a natural or divine order and cast the victim into a state of existential crisis (p. 51)… Traumatized people feel utterly abandoned, utterly alone, cast out of the human and divine systems of care and protection that sustain life. Thereafter, the sense of alienation, of disconnection, pervades every relationship, from the most intimate familial bonds to the most abstract affiliations of community and religion. When trust is lost, traumatized people feel that they belong more to the dead than to the living (p. 52).” Judith Hermann in Trauma and Recovery

“The traumatic event challenges an ordinary person to become a theologian, philosopher, and a jurist. The survivor is called upon to articulate the values and beliefs that she once held and that the trauma destroyed. She stands mute before the emptiness of evil, feeling the insufficiency of any known system of explanation (p. 178)… It appears, then, that the ‘action of telling a story’ in the safety of a protected relationship can actually produce a change in the abnormal processing of the traumatic memory (p. 183).” Judith Hermann in Trauma and Recovery

“The greater the wrong suffered, the more it gets ingrained into the identity of the person who endured it. Such a person sometimes comes to view himself – and others also come to view him – primarily as a sufferer of that particular role… It is as though the wrong suffered is the most defining event of his life – an event that prompts creative accomplishments, friendships, joyful events, whether old or new, and all else. When wrongdoing defines us, we take on ‘distorted identities, frozen in time enclosed to growth’ (p. 79).” Miroslav Volf in The End of Memory

Tweets of the Week 11.18.15

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.

Counseling In Your Local Church: Understanding the Liabilities and Possibilities — Workshop Schedule

We want you to know the scope of what we hope to accomplish in this workshop. Divergent expectations are a primary contributor to the dissatisfaction that sometimes exists with counseling-related resources (i.e., books, conferences, or personal counseling). We want to model the level of informed consent that should be present in a counseling ministry not only by “what” we say, but “how” we present-promote this workshop.

COUNSELING IN YOUR LOCAL CHURCH:
Understanding the Liabilities & Possibilities of Lay Care Ministries
Date: Friday February 19, 2016
Time: 9am to 5pm
Location: The Summit Church, Brier Creek Campus
Address: 2335 Presidential Drive; Durham, NC 27703
Cost: $99 / person (lunch provided)
RSVP Here

At the end of this event you should…

… be able to identify the functional differences between counseling and discipleship
… understand the advantages and disadvantages that emerge across a spectrum from informal one-another care to formal counseling
… be able to assess your church’s, leadership’s, and communities’ readiness to launch / receive a counseling ministry
… know the kind of leadership and supervision necessary to care well for lay counseling leaders
… grasp how to structure components of lay-led counseling ministries in a way that

1. is liability safe,
2. allows for growth into a more robust counseling ministry, and
3. cooperates well with other resources in your community

This event will not attempt to…

… teach you how to re-create the counseling ministries that exist at The Summit Church (your context likely calls for something different)
… how to create a formal lay counseling ministry utilizing certified lay counselors (this can be good, but it outside the focus of this workshop)
… how to create a parachurch counseling ministry (this would require more time than a one-day conference)

Here is our intended schedule.

9:00 to 9:30
What Is Counseling? Helping Relationships from Discipleship to Counseling

Counseling and discipleship overlap significantly and, any church-based counseling ministry that serves a church well, should have a strong discipleship ministry as its long-term care outlet. Otherwise you would be creating something that was long-term unsustainable and privatized discipleship in a way that detracts from the community life of your church.

In order to determine if your church wants a formal counseling ministry and, if so, how to best develop one, there must be an agreed upon definition of “counseling.” If counseling is simply “every helping conversation” then your church already has a counseling ministry.

In this session you will receive key markers to differentiate the changes in relationship and liability that occur across the spectrum from discipleship to counseling.

9:30 to 10:30
Who Does Counseling? Competency from Friends to Professionals

What level of training is necessary to warrant calling a given interaction counseling? What liabilities and responsibilities emerge as these more formal and artificial relationships facilitated by a church? What advantages and disadvantages emerge as counseling becomes more formal?

How can the early stages of an informal, lay counseling ministry be developed in such a way that (a) it does not create undue liability for the church, and (b) allows for growth into more formal aspects, if those aspects are desirable latter?

In this session we will define five levels of counseling competence across a spectrum from informal to formal counseling that allows you to answer these kinds of questions. The remainder of this event will prepare you to maximally launch and utilize the first two levels on this spectrum.

11:00 to 11:30
Why Wouldn’t Our Church Want This?  

What are the challenges that having a formal counseling ministry presents? What are the character qualities needed in our pastors, congregation, and community in order for a counseling ministry to thrive?

What are common things a church wants from a counseling ministry that are not possible which result in a sense of disappointment about initiating this type of ministry? Conversely, what are the advantages of having a formal counseling ministry which make it “worth it” to face these challenges?

11:30 to 1:00
Lunch // Q&A About Morning Topics

1:00 to 1:50
How to build a church-based counseling ministry from the bottom up?

Based on the definitions and models being presented, how would a church (pastoral team) or individual within a church (lay initiative) begin to develop a counseling ministry?

What existing programs and resources are there and how do they fit within the framework that has been presented?

What supervisory considerations should a church provide for a lay counseling ministry even in its earliest stages of development?

2:00 to 2:50
Understanding the Interface of Different Kinds of Helping Relationships

Not all helping relationships are created equal, nor should they be; one size does not fit all. Consider the differences you experience in your relationships with a friend, pastor, doctor, mentor, coach, professor, or personal trainer. Each plays by a different set of rules and each, when those principles are followed, is good. In this session we want to help you identify how locating a given helping relationship on three spectrums can ensure you help effectively and ethically: (1) formality, (2) expertise, and (3) authority.

3:00 to 3:50
Ethical Issues in Church-Based Counseling Ministry

Counseling ethics are not just about avoiding lawsuits. Too often this is the unintentionally low bar for how churches think about counseling ethics. The purpose of counseling ethics is to ensure that we can care well for people; that is, to ensure that how we care (i.e., method) does not detract from the care we want to provide (i.e., intentions).

There two realities that will help us think more clearly about the material in this section:

  1. Ethics are not a set of abstract principles; ethics are wise decisions in difficult situations.
  2. Counseling is a concentrated collection of difficult situations where various moral-relational priorities are, or at least appear to be, at odds with one another.

4:00 to 5:00
Q&A about Afternoon Topics

COUNSELING IN YOUR LOCAL CHURCH:
Understanding the Liabilities & Possibilities of Lay Care Ministries
Date: Friday February 19, 2016
Time: 9am to 5pm
Location: The Summit Church, Brier Creek Campus
Address: 2335 Presidential Drive; Durham, NC 27703
Cost: $99 / person (lunch provided)
RSVP Here

My Favorite Posts on Grief

The “My Favorite Posts” series on my blog is how I catalog posts I’ve written to help my readers find the material that is the best-fit for their interest or need. I hope this series creates a more user-friendly experience for my readers and allows this site to become a trusted resource hub for the church.

Seminar Resource:

Evaluation:

Blog Resources:

Book Recommendations:

Tweets of the Week 11.18.15

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.

Video: Post-Traumatic Stress (Step 3)

Below is a video from the presentation of “Post-Traumatic Stress.” For the various counseling options available from this material visit www.summitrdu.com/counseling.

NOTE: Many people have asked how they can get a copy of the seminar notebook referenced in this verbal presentation. You can request a copy from Summit’s admin over counseling at counseling@summitrdu.com (please note this is an administrative account; no individual or family counsel is provided through e-mail).

“What Are the ‘Invisible Injuries’ I’ve Suffered?”
UNDERSTAND the impact of my suffering.

Trauma: Step Three, Brad Hambrick from The Sam James Institute on Vimeo.

Memorize: Isaiah 21:3-4 (ESV), “At this my body is racked with pain, pangs seize me, like those of a woman in labor; I am staggered by what I hear, I am bewildered by what I see. My heart falters, fear makes me tremble; the twilight I longed for has become a horror to me” As you memorize this passage reflect upon these key points:

  • “At this” – Isaiah is responding to the vision of an attack that would have been as traumatic as any battle experience.
  • “Body is racked” – Physically, Isaiah is affected with pain reactions that are as intense as anything he could imagine.
  • “Staggered” – Cognitively, Isaiah is disoriented to the point that he is “bewildered” by what he sees.
  • “My heart falters” – Emotionally, Isaiah is disturbed to the point that his hands and arms tremble in response.
  • “Become a horror” – Narratively, Isaiah has come to the point that hope (twilight) no longer rejuvenates him.

Teaching Notes

“Any treatment approach that is not predicated on a basic comprehension of the nature of trauma in what it does to human beings will be ineffective and possibly harmful (p. 45)… Too often the survivor is seen by herself and others as ‘nuts,’ ‘crazy,’ or ‘weird,’ unless her responses are understood within the context of trauma (p. 68).” Diane Langberg in Counseling Survivors of Sexual Abuse

“Abuse feels like an experience that has stamped you and has the final word on your identity. But the truth is God gives you a different identity… Your identity as God’s child is far deeper than the abuse you suffered (p. 4).” David Powlison in Recovering from Child Abuse

“The most powerful determinant of psychological harm is the character of the traumatic event itself. Individual personality characteristics count for little in the face of overwhelming events. There is a simple, direct relationship between the severity of the trauma and its psychological impact, whether that impact is measured in terms of the number of people affected or the intensity and duration of harm (p. 57)… Trauma appears to amplify the common gender stereotypes: men with histories of childhood abuse are more likely to take out their aggressions on others, while women are more likely to be victimized by others or to injure themselves (p. 113).” Judith Hermann in Trauma and Recovery

“We must be very careful to avoid blaming abuse victims for their traumatic symptoms… Effects of trauma are not consciously chosen by the victim. Abuse victims do not choose to have amnesia, nightmares, flashbacks, panic attacks, or increased heart rates. At the same time, as adults, we all must come to the point of taking responsibility for our unhealthy patterns of behavior. Abuse victims often do choose to deaden themselves in response to their pain instead of turning to God for strength and healing (p. 104).” Steven R. Tracy in Mending the Soul

“A child is emotionally unable to refuse, modify, or detoxify a parent’s abusive projections. The power differential is too great and the projections too toxic and overwhelming. Furthermore, the child actually lives in the emotional world and fantasy life of the parent. This is the child’s reality (p. 322).” Richard T Frazier in “The Subtle Violations—Abuse and the Projection of Shame” in Pastoral Psychology

“The image of being without talent, mediocre, average, or worse is a self-serving, self-protective evaluation used for a purpose: it provides the victim with a contemptuous explanation for not being able to halt the pain (p. 116)…. Many times the chronic patterns of lying or deceit, and to abused persons arise because of a forsaken history that forces them to concoct a past and a present that has no connection to their abused soul (p. 113).” Dan Allender in Wounded Heart

 

Gaining a Healthy Relationship with Food (Seminar Videos)

Below are the videos from the presentation of “Gaining a Healthy Relationship with Food.” For the various counseling options available from this material visit www.summitrdu.com/counseling.

NOTE: Many people have asked how they can get a copy of the seminar notebook referenced in this verbal presentation. You can request a copy from Summit’s admin over counseling at counseling@summitrdu.com (please note this is an administrative account; no individual or family counsel is provided through e-mail).

STEP 1.
ADMIT I have a struggle I cannot overcome without God.

Ganing A Healthy Relationship With Food — Step 1 from The Sam James Institute on Vimeo.

 

STEP 2.
ACKNOWLEDGE the breadth and impact of my sin.

Ganing A Healthy Relationship With Food — Step 2 from The Sam James Institute on Vimeo.


Resource: Daily Food Planning Sheet

STEP 3.
UNDERSTAND the origin, motive, and history of my sin.

Ganing A Healthy Relationship With Food — Step 3 from The Sam James Institute on Vimeo.

Resource: Disordered Eating Journaling Tool

STEP 4.
REPENT TO GOD for how my sin replaced and misrepresented Him.

Ganing A Healthy Relationship With Food — Step 4 from The Sam James Institute on Vimeo.

STEP 5.
CONFESS TO THOSE AFFECTED for harm done and seek to make amends.

Ganing A Healthy Relationship With Food — Step 5 from The Sam James Institute on Vimeo.

For the “Confession Guide” click here: Confession Guide

STEP 6.
RESTRUCTURE MY LIFE to rely on God’s grace and Word to transform my life.

Ganing A Healthy Relationship With Food — Step 6 from The Sam James Institute on Vimeo.

Resource: Healthy Food Thoughts Journaling Tool

STEP 7.
IMPLEMENT the new structure pervasively with humility and flexibility.

Ganing A Healthy Relationship With Food — Step 7 from The Sam James Institute on Vimeo.

Resource: Implementation Evaluation Tool

STEP 8.
PERSEVERE in the new life and identity to which God has called me.

Ganing A Healthy Relationship With Food — Step 8 from The Sam James Institute on Vimeo.

STEP 9.
STEWARD all of my life for God’s glory.

Ganing A Healthy Relationship With Food — Step 9 from The Sam James Institute on Vimeo.

Blog Post: 9 Questions to Help You Steward All of Your Life for God’s Glory

Appendix B: How to Start a Conversation with a Loved One You Believe Has an Eating Disorder

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Disordered Eating” post which address other facets of this subject.

Responding to Relapse in an Unhealthy Relationship with Food

This post is an excerpt from the study guide which accompanies the “Gaining a Healthy Relationship with Food” seminar. This portion is one element from “STEP 7: IMPLEMENT the new structure pervasively with humility and flexibility.”

To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

Is every slip a relapse? Does every bad food choice mean I’m “starting over”? How can I not expect myself to be perfect for the rest of my life without making excuses for myself that will make it easier to slip back into destructive behaviors? You can see why relapse is such a difficult subject in a recovery program.

On one hand, you can expect to relapse many times in the journey of recovery. If we don’t relapse, then our struggle was probably not “life dominating” and didn’t warrant the level of attention this study provides.

On the other hand, we don’t want to expect to fail. We want to face every moment with the expectation that we’ll rely on God to make healthy, God-honoring choices.

With that said, here are the expectations of this study:

  • We will face relapse.
  • Relapse is the recurrence of self-destructive behaviors related to our desired change.
  • More dangerous than relapse are dishonesty and hiding.
  • Dishonesty and hiding are the difference between a relapse slip (short) and relapse slide (long).
  • Relapse begins to end when honesty begins.
  • We are more likely to be honest about something we’ve openly discussed.
  • We include this section, not to excuse or predict relapse, but to place ourselves in position for a healthy response.

In their book Lose It for Life, Stephen Arterburn and Linda Mintle lay out four phases of a relapse (p. 228-230; bold text only). The presence of an early step does not make the latter steps inevitable. Rather we will look at each in order to help you prevent moving further into relapse when you realize you’re in a vulnerable condition.

1. Complacency:

“I just want a break from being good.” This is the mild, passive-aggressive defiance of fatigue. It likely means we’ve been trying to change too fast (perfectionistic approach to change) or that we’ve got too much in our schedule. Early honesty with people in your support network is the best response to this fatigue. Don’t try to press through in private. Evaluate what would be a sustainable approach to change with people who care about you. That is what this chapter is all about.

2. Confusion:

It has been said by many, “Worldliness is what makes sin look normal and righteousness look strange.” The further we get into temptation, the more this dynamic effects our thinking. You begin to view “healthy choices” as an “unhealthy burden.” You begin to view “unhealthy choices” as “moments of freedom.” You begin to view “supportive friends” as “people who don’t understand and expect too much.” When this disorientation begins to emerge be honest ASAP. This is the pattern of thought that will extend a relapse. Even if you don’t know what to disclose at this point, call a member of your support team and say, “I’m struggling. I don’t think I’m thinking well right now. Can we talk?”

3. Compromise:

This step can be fueled by self-pity, denial, or defiance. But we begin to think, “I deserve my self-destructive behavior,” as if it were a form of relief. The duration of time that has passed since we last engaged these patterns allow the sense of high or relief to be greater and the physical effects not to be as immediately felt. It is as if our bad friend really has learned to be good like they promised. We also know those who care about us will be disappointed and hurt, so we are more prone to remain secretive about what we’re doing. Frequent warning signs at this stage of a relapse are:

  • More frequent weighing yourself and preoccupation with your weight
  • Comparing yourself to others and a growing sense of insecurity
  • Resuming some of the food rituals or food rules that were part of your disordered eating
  • Preoccupation with calorie counting or reading food labels
  • Preoccupation with clothes you used to wear or want to be able to wear
  • Each of these distract you from being content being a good steward of your God-given body

4. Catastrophe:

Destructive choices destroy. There is no way around that. When we fail to acknowledge compromise (stage three), catastrophe (stage four) will get our attention. While our goal is to interrupt a potential relapse before it reaches catastrophe phase, the earlier in the deterioration of health and relationships we acknowledge what is happening, the better. Don’t allow shame or pride to prevent you from reversing the impact of your choices.

Read I Corinthians 10:13. “God will not let you be tempted beyond your ability” doesn’t just mean the type or intensity of temptation, but also means at any point in the temptation cycle. Too often we conceptualize a fictional “point of no return” in our battle with disordered eating. If a “point of no return” exists, it is the point at which we decide not to be honest with God, ourselves, and others. The grace of God means there is always hope in honesty about our sin and struggles. When God promises to provide “a way of escape” that refers, not to some secret passage way (hidden is never free), but to the context of grace and support which the gospel provides that allows us to be honest.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Disordered Eating” post which address other facets of this subject.

Tweets of the Week 11.12.15

There is great value in saying something in a memorable, concise manner. Twitter has caused us to make this a near spiritual discipline. For my own growth (as a generally verbose individual… that’s a long way of saying “wordy”) and for the benefit of others, I highlight tweets each week that deliver a big message in a few words.

How to Start a Conversation with a Loved One You Believe Has an Eating Disorder

This post is an excerpt from the study guide which accompanies the “Gaining a Healthy Relationship with Food” seminar. This portion is one element from the appendices section of this seminar.

To RSVP for this and other Summit counseling seminars visit bradhambrick.com/events.

You may have come to this study out of concern for a friend or family member more than your own unhealthy relationship with food. If that is the case, then you are likely thinking, “I would love to have conversations like the ones in this study, but I don’t know how to get them started. When I’ve tried, my friend has gotten defensive and the conversations went nowhere.”

This challenge is real. You are not the only concerned friend or family member to have this experience. By the time an eating disorder has become severe enough to be noticed by others, it has usually generated a set of beliefs that result in thinking, “If you don’t support how I eat, then you don’t support-love me.” That makes starting a meaningful conversation on this subject very difficult, but vitally important.

We will start with some general guidance and then examine differences in approach that exist when you’re the parent of a minor who struggles with an eating disorder. The authority a parent has over a child allows for more options, but it does not negate the importance of the matters we’ll discuss first.

 Generally Relevant Principles

Seek to Understand: You don’t have to “get it” to be understanding. Starving, binging, excessive exercise, or comfort eating may not make sense to you. That’s okay. You’re frame of reference for an experience is not the standard your friend has to meet. You can gently and patiently ask questions that show you want to understand. Realize, until you show yourself willing to try to understand you firmly establish yourself as an “outsider” to their struggle.

Of the resources referenced in this study, the one (in my opinion) best-suited to help you understand the thinking process of someone with anorexia and bulimia is Life without Ed by Jenni Schaefer. Jenni writes in a transparent and humorous first-person style that is very relatable.

Don’t Personalize: Parents can be tempted to ask, “What have we done?” out of guilt or as a means to be less confrontational. Friends can phrase things in similar ways. This is unhelpful in three ways. First, it promotes a form of blame-shifting from the beginning that has a propensity to sabotage the likelihood of completing the full journey of recovery. Second, if the rationale is acceptable, it also becomes a criticism of you. This kind of emotional-relational risk is not likely to be engaged in the early stages of recovery. Third, the relational awkwardness created adds to the emotions of the conversation and makes it less likely your friend will engage.

Identify Qualified Care Options: When your friend says “yes” to help, you want to already know who the most qualified individuals are in your area. Often the window of willing cooperation can be short, so you don’t want to waste that time seeking a good referral. Begin now compiling that list.

You can offer to be a counseling advocate; someone who goes with the individual to counseling for support. Some counselors are more open to this than others. One reason for getting information about the best eating disorder counselors in your area is to know whether this is something they would be open to. That way you don’t offer something that is not viable.

Identify Healthy Recovered Individuals: Do you know people who have experienced an eating disorder similar to your friend and are now living a healthy life? Don’t set up a “blind date.” That doesn’t honor your friend’s autonomy. But offer to coordinate an opportunity for them to talk. A conversation with a “real person” who has struggled like they’re struggling can be an important part of becoming willing to seek help.

Accept Your Limits: You can offer help. You cannot force your friend to seek help. As soon as you forget this, and you will be tempted to, the dynamics of the conversation will change radically. Avoid power struggles where you try to leverage emotions or facts to coerce change. You will lose. Avoid being a food detective. When evidence is gathered in an intrusive manner it becomes a reason not to change. Don’t debate “thin enough” or “too thin.” Even if you “win” the debate, you will have damaged the relationship and reduced the likelihood your friend will engage with the help you’re encouraging.

Don’t Ignore Lying or Stealing: “My eating habits don’t affect you,” can become a Teflon statement when raising concerns to your friend. While it is not completely true, it is true-enough to disarm you in conversation. But when you notice lying or stealing food, that line of offending relationship has been crossed in a way that invites a different type of conversation. These are not “gotcha moments,” because the health of your friend is more important than the offense. But your friend has crossed a line (indicating the struggle is getting worse) that gives you a more legitimate reason (even in their constricted thinking) to talk.

Avoid Criticism or Shaming Language: We want to avoid anything that says, “What’s wrong with you?” Instead, we would rather know, “What’s going on?” Even if their school, work, or social performance is declining, that is not the issue and we need to be careful not to frame the conversation in a “you need to be more productive-engaged” way. Our concern is their well-being, not their performance, and that needs to be very clear.

Be Concrete and Don’t Use Weak Examples: This is as close as we’ll get to a debate strategy. When presenting your concern, don’t use speculative examples. If you use five solid examples of things that are significantly unhealthy and one speculative example, where is your friend going to focus if they’d rather avoid the issue? The evaluation tool from chapter one and forms of impact in chapter three should help you formulate concrete reasons for concern. Health examples tend to be more concrete than emotional or relational changes.

Sympathize that Recovery Would be Hard: Make sure your “you can do it” attitude doesn’t come across as “this will be easy.” When that happens, your hope reveals how little you understand. A demeanor that emphasizes “it is worth it” and “we will support you all the way” are much better at communicating realistic hope.

Don’t Under-Estimate Loving Persistence: Often the person knows they’re being unreasonable. They’re afraid the people who care are going to give up on them because they’re being so difficult. Even if you’re being tuned out, realize that your patient-loving persistence proves to your friend that they’re not “too far gone” yet. Even if a conversation gets shut down, try to end it with, “I love you. I’m praying for you and I’m here for you. I’ll give you space, but I’m still available.”

Additional Guidance for Parents of Minors

Get Professional Medical Help: You have the legal authority and moral responsibility to seek and require help when your child’s health is in danger. Your child will punish you with painful words (e.g., “I hate you”), tantrums, and threats (e.g., “I’ll run away” or “I’ll never talk to you again”). You need to be strong enough to require help while your child is at an age these interventions can be required. However, this should be towards the end of efforts described above and not an ultimatum early in the discussion of this subject. Voluntary engagement with recovery is a large factor in whether recovery will be successful.

If Hospitalization Is Recommended, Do It: If a physician or counselor is recommending hospitalization, it is likely because they see physical changes that could be life-threatening. The malnourishment and extreme fatigue from excessive exercise of eating disorders can result in death. Therefore, you should heed these recommendations even if it means upsetting your child. Ask the physician to sit down with you and your child to explain their rationale for their recommendation, so that it is clear why this is happening and that the doctor is not merely serving as your mouthpiece.

Be Willing to Participate in Family Counseling If Recommended: If there is any defensiveness in you towards this recommendation, it may be your first point of identifying with the mindset of your child. Being part of the process might mean we were part of the problem. Being part of the problem might mean changing things we don’t want to. But being healthy individuals and a healthy family must take precedence over our preferences. If we want our loved one to seek the help they need, we must model the same humility to seek help that we might also benefit from.

Conclusion

This appendix is not a “full proof method” for ensuring your friend or family member will engage with the concerns you have for them. But it is intended to provide guidance on how to allow your concerns to have the best opportunity to be heard. Bathe your efforts in prayer and seek the guidance of people who know you well as apply these materials.

If this post was beneficial for you, then considering reading other blogs from my “Favorite Posts on Disordered Eating” post which address other facets of this subject.