Releasing Self-Blame

Parenting Teens with Mental Health Challenges

The last place I wanted to spend Friday night was in the veterinary emergency room.

Yet here I was with my fourteen-year-old daughter Leah and a dog who couldn’t stop barking. He also showed an embarrassing lack of respect for mourning pet owners who walked the halls in tears. Leah and I waited for a technician to try to solve the reality that we had just inadvertently poisoned our dog. 

Henry at Christmas

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When a Crisis Hits

“How could you do this?” I yelled at Leah two hours earlier. “What were you thinking?”

“I don’t know,” she whispered, wiping tears. We stared at a ripped ziplock bag on her bed that once held trail mix.  Then we looked at our dog, who had just ingested his own worst enemy: raisins. 

I pushed my fingers against my temples. “How could you leave that on your bed?” I asked helplessly. “You know it sent Henry to the ER last time!”

There was no answer that would have felt satisfying. No explanation could change the fact that we had to call Poison Control. It didn’t help that I felt depleted from the stress of Ellie’s health challenges. 

I sat down and buried my face in my hands. Think, I told myself. Yelling at Leah doesn’t help anything. What’s the next right thing to do?

I said a prayer. I hugged Leah. We talked about how scared we felt. Then we packed Henry into the car, along with an arsenal of treats that we hoped might keep him from screeching. But there is only so much you can hope for with an anxious dog who hates the car.

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When Blame Comes to Visit

“Want to play hangman?” Leah asked. We sat in padded chairs in a secluded area. She grabbed a printed hospital brochure and found a section of white space. “Got a pen?”

I shrugged. “Sure.” 

As Leah sketched out a word, carefully counting the letters, I thought about the technician’s report. Your dog threw up four large raisins. But you think he ingested seven? We can’t get everything by inducing vomiting. You’ll have to decide if you want to leave him here overnight. Raisins can cause kidney failure in some dogs, but we don’t know how it will affect yours.

“Ready, Mom?” Leah raised her eyebrows, grinning. “Betcha can’t guess this one.”

 “A,” I said, which landed me one letter in the word. “E, I, O, U.” Leah drew the hangman’s head, body and an arm. 

I thought about how Leah seemed to have already let go of the self-reproach that I would have carried. Throughout Ellie’s mental health crises, I endlessly analyzed my mistakes. Could I have caused her depression or anxiety? Even though I had thirty years of recovery, how might I have contributed to her eating disorder beyond genetics? I told my daughters that they were beautiful inside and out, and avoided commenting on their bodies, but was that the right approach? I taught principles of healthy eating, such as choosing something from each part of the food pyramid, eating whole grains rather than highly processed foods, and enjoying sugar in moderation.  But when Ellie went into treatment, I wondered if I had been too controlling. When Ellie sunk deeper into an eating disorder relapse, she blamed me for allowing her to get away with unhealthy behaviors. Because I had rearranged my work and parenting schedule to supervise Ellie’s eating according to the direction of her therapist,¹ this criticism hit a tender spot.  In family therapy, Ellie gradually confronted her father about his parenting mistakes which hurt her.

The Benefit of Admitting Mistakes

Don’t get me wrong: I’m grateful for Ellie’s willingness to talk about how our parenting affected her. Every parent, no matter how skilled or well-meaning, makes mistakes that affect our children in ways that we don’t necessarily intend and don’t always realize. Part of becoming a healthy adult means that our teens need to face those wounds, discuss them honestly, and move to the other side. The best thing we can do as parents is to listen without getting defensive, to validate our child’s feelings (whether or not we agree with their interpretation of events), and to apologize where appropriate. After years of counseling, I took similar brave steps with my parents, which has led to healing and greater intimacy. 

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When Responsibility Turns Dark

But the down side to my vigilance is that I was left with a crushing weight of responsibility and guilt. Those same words that I asked Leah, “How could you do this?” are the ones I have asked myself and my husband too many times. How could you do this to Ellie? I’ve demanded relentlessly. How could we create an environment in which our oldest child developed debilitating mental health conditions?

Sadly, these feelings have a historical basis. There were times when medical professionals inaccurately and unfairly blamed parents for their child’s mental health challenges. About fifty years ago, some psychodynamic theories, now debunked, attributed mental illness to a failure of childhood development due to inadequate parenting.² Early treatment for eating disorders insisted on separating patients from their parents (who were seen as the problem). Today, organizations like F.E.A.S.T.³ affirm that parents do not cause their child’s illness.⁴ In contrast, F.E.A.S.T. says that “guilt and blame are distractions from the work of supporting recovery,” and “parents are needed as part of the solution.”⁵ As Family-Based Treatment (FBT) has become one of the leading paths of recovery for teens with a variety of eating disorders, the focus has shifted from discerning causes to focusing on what the family can do, in partnership with professionals, to help a child recover.

Even though Ellie’s eating disorder has stabilized, I still have some of the same reactions, like a perpetual limp, from the most intense times of her mental health crises. I still expect myself to be vigilant in my parenting choices. I still struggle to give myself grace for my mistakes. I jump too quickly into worst-case scenarios, because I once lived in a prolonged state of terror, watching my daughter’s illness progress into a desperate state. It’s still hard for me to trust and hope.

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Releasing Self-Blame

On that Friday night, I watched Leah try to stump me with words like “luminescence,” and wished that I could hold mistakes with more lightness like she did. As she winked, I thought, What a good model she is. How can I find the joyful moments when I feel scared and weary? How can I release the heaviness of my mistakes and instead focus on connecting with others? How do I embrace my humanness with more grace? 

In the end,  I decided to enjoy one-on-one time with my daughter in that waiting room. We cheered when the receptionist offered us markers and coloring books. We prayed for our dog. We raided the snack bar and greeted other animals. And eventually, we brought our barking dog home.

I’d love to hear how you’ve released fear and unhelpful guilt to embrace moments of joy. What have you learned along the way?

P.s. In case you’re wondering: I wish I could say that all was well for Henry after that Friday night, but three days later, Henry got sick enough to need hospitalization. He’s still recovering, but he’s pretty happy with the gourmet meals (chicken and rice) that have replaced his Kibble.

It’s never fun to go to the hospital, especially if the doctors shave your fur to stick you with needles.

1. We used Family-Based Treatment (FBT), which is a method in which a therapist trains the child’s parents to re-feed and support the child’s recovery at home. You can read more about that method here.

2. Read more about the progression of psychotherapy around mental health here.

3. F.E.A.S.T. is an amazing global community which supports and empowers parents to help their children recover from eating disorders. Find resources on their website. 

4. https://www.feast-ed.org/parents-do-not-cause-eating-disorders/ - F.E.A.S.T. acknowledges that abusive, neglectful or otherwise harmful parenting does exist and does cause harm.

5. Ibid