SGH Eating Disorders Programme
Department of Psychiatry
Conversation Tips:
How To Talk To Someone
With An Eating Disorder
Eating Disorders Clinic
SGH LIFE Centre
Bowyer Block, Block A, Level 1
Outram Road
Singapore 169608
www.sgh.com.sg
For more information: 6321 4377
Opening Hours:
Mondays to Fridays (8.00am to 5.30pm)
Closed on Saturdays, Sundays and Public Holidays
Reg. No: 198703907Z
Information correct as at February 2012.
Conversation Tips:
How To Talk To Someone With
An Eating Disorder (ED)
Tone of Voice
DON’Ts
• Don’t speak too loudly
• Don’t speak too fast
• Don’t say too much – ‘less is more’
DOs
• Say a little and wait for a response
• Talk slowly and calmly
• Be caring and matter-of-fact in your tone
• Convey warmth and a non-judgemental attitude
Eye Contact
DON’Ts
• Don’t read or multi-task when speaking to him or her
DOs
• Maintain eye contact to show your respect towards him or her
• Note the expression in your eyes. He or she will subconsciously
know if you are angry, fearful, sincere, uncomfortable, trusting,
patronising etc, or meeting them halfway
Body Language
DON’Ts
• Don’t turn your body away from him or her
• Don’t lean over or cross your arms or legs
• Don’t roll your eyes, sneer or make long sighs. These actions
convey negative meanings that undercut what we really
want to communicate
DOs
• Turn your body to face him or her. Put warmth and expectancy
in your voice and keep the rest of your body language open to
convey your interest and support
• If you are sure that he or she is comfortable, sometimes
touching their hand, arm or shoulder can help you connect
and convey that you care
Learn to Listen
DON’Ts
• Don’t interrupt when he or she is talking
• Don’t get overwhelmed by strong feelings
• Don’t say “I understand” without explaining what it is that
you understand
DOs
• Give him or her your full attention
• Be aware of your own feelings and learn to recognise when
they might distort what you hear, e.g. when you are angry, you
are more likely to listen for things that will justify your anger
That makes it harder to hear important things that run counter
to your expectations
• Try to check what you hear by paraphrasing or ‘mirroring’ what
you heard. It helps to clarify your perceptions and affirm with
him or her that you have understood them correctly
Timing is Key
DON’Ts
Don’t approach a difficult topic when he or she is:
- Tired
- Doing something important and likely to be distracted
- Not in the mood to talk right now
- Just getting up in the morning
- Going to bed at night
- In front of other people
DOs
Pick a better time to talk when:
- He or she says they are ready to talk
- He or she is rested, comfortable and undistracted
- You have some privacy
- You won’t be interrupted
- You have adequate time
- You are certain and clear about what to say
- You are aware that not discussing these matters will affect
the quality of your relationship
Consider writing down your concerns instead, so as to give
him or her the opportunity to react in private.
Extracted from:
Heaton, J.A., & Strauss, C.J. 2005. Talking to Eating Disorders:
Simple ways to support someone with Anorexia, Bulimia, Binge Eating,
or Body image issues. NY: New American Library.
Advanced Conversation Tips
1. Check your assumptions
Thinking you know exactly what another person is going to say
creates a mindset that can distort what you hear. These
distortions can lead you to misinterpret motives and intentions.
We often assume we know how others are feeling when we have
gone through something similar in our own lives. It’s easy to
imagine that someone who is going through what we went
through will react the same way we reacted.
Unfortunately, this can significantly interfere with hearing that
their experiences and feelings are different from yours. It’s better
to assume that no two experiences are ever identical.
2. Listening for differences
This can help you communicate your understanding of another’s
unique circumstances and emotions. Many people develop
automatic thoughts in response to someone else’s eating
problems, such as:
•
•
•
•
•
•
She always blows her diets
He’ll never change
She’s going to the bathroom; she must be vomiting again
He won’t wear that because he thinks he’s fat
She won‘t go out for meals with us
He’s trying to kill himself with food
3. Don’t let assumptions made by the other party stay hidden
The people we are concerned about who have EDs may also
misinterpret our actions. They often assume we aren’t telling
them the truth, especially when we say things like, “You’re not
fat” or “I love all of you” or “it doesn’t’ matter to me what we eat”
or “I think you’re beautiful inside and out”. People with EDs
assume we say these things because we have to, not because we
really mean them.
Don’t let such assumptions stay hidden. Bring them out into the
open by asking questions. For example, “I get the feeling you
assume I’m not telling you the truth, is that right?” This gives
you the opportunity to discuss the fact that you see them in a
different way than they might see themselves.
4. Agree to disagree
Agreeing to disagree is an essential strategy when talking about
eating problems. Conversation can continue even when people
disagree. Bringing this up directly can help make a difficult
conversation go better. You could say:
• “I want to continue talking about these matters, and it’s okay
with me if we don’t agree.”
• “How is it for you when we don’t agree about these matters?”
• “Can we keep talking even though we don’t agree?”
• “It means a lot to me to feel safe enough with you to continue
talking about things we don’t agree on.”
• “I learn from our disagreements. I’d like to keep talking.
Is this okay with you?”
• “I want you to know that I respect your views even when
I don’t agree.”
• “I like hearing what you are really thinking, even when I have
different ideas.”
• “It seems healthy to me that we can agree to disagree and
still keep talking, that seems like a sign of our respect for
each other.”
After a disagreement, it’s helpful to remind the person you are
arguing with that you’re really okay with not agreeing and that
you are still there for him or her:
• “You know, I don’t think that being thin is the only thing of
value, but that doesn’t mean I don’t want to talk about how we
feel about dieting.”
• “We agree on some of these matters, but not others. I’m glad
we can respect each other’s opinions.”
• “I appreciate telling you about things that are different from
what you think, it means so much to me that we can agree
to disagree.”
• “Our relationship is strong enough to withstand differences
of opinion. That means a lot to me.”
Arguing never helps. If you can stop the conflict quickly and give
yourself and the person you care about time to cool down, you’ll
create a safer environment for difficult tasks. Consider that the
more you argue your point of view, the more likely the person
you are trying to help will want to hold on to his own beliefs.
6. Let an angry person walk away
5. Don’t let tears throw you
7. Avoid using “should” and “must” statements
When someone is upset and emotional, they are often more
accessible, because their pain may open doors that lectures
can’t. Let the person who is upset know that you can see how
difficult things are:
You will be tempted to tell the person you care about what she
or he should do. You may want to urge them to follow your plan.
But nobody takes it well when someone tries to tell us what to
do. Even if someone asks for your advice, avoid using the words
“should” and “must”. Here are some things you can say instead:
• “What you are telling me sounds so hard. I’m sorry this is so
difficult for you.”
• “I’ve read about what you are describing and I can only guess
that these problems are different for each person. Can you tell
me more about what this is like for you?”
• “I can see that you are having a hard time. You aren’t alone.
I’m willing to listen.”
Don’t offer false reassurance or deny that they have a problem.
Sitting with a person in pain without trying to fix that pain is a
great gift. It conveys that you care and that, no matter what, you
are willing to go through the ups and downs of trying to
understand the other person’s unique experience.
Conversations always go poorly unless both people want to
continue. Recognise that your pushing is likely to lead to a
horrible exchange of words that will only make him or her less
willing to talk the next time.
• “Use “I” statements – “I feel scared that you will hurt yourself
when I see you exercising so much.” Or, “I feel hurt that you
don’t call me.”
• State your preferences rather than making demands.
Say, “I would prefer it if we could spend more time together,”
rather than “You should spend more time with me.” Or try,
“I prefer talking to you when you are calmer,” rather than,
“Stop yelling at me!”
• Ask him or her to consider an idea rather than arguing your
views: “Have you thought about___?” or “have you considered
___?” If they argue, you can say, “Just think about it; maybe we can
talk more about it later.” Instead of saying, “You have to eat with me
at least once a week,“ try “Do you think we could get together
once a week?” or “Think about it, I’d love to see you next week.”
8. Avoid generalisations such as “never”, “always”,
“all the time” and “constantly”
Give someone the benefit of the doubt. Entertain the possibility
that the other person never does anything always. Say, “The last
time you told me you’d call, you didn’t. What’s up?” instead of
saying, “ You always don’t turn up”. Or, “Recently you don’t seem
interested in going out to eat, do I have that right?”
9. Don’t give advice until you are asked
(even if asked – be careful)
• “You can do it.”
• “I’ll see you through this because I know you’ll do just
fine in time.”
• “Give yourself some time, you’ve got a good head on
your shoulders.”
Most people actually know what they need to do, they just can’t
make themselves do it. So reminding them of your faith in their
ability to cope is a great gift.
It’s hard to listen to a problem without feeling like you should fix
it, but jumping in is not what the person really wants most of
the time. The key to handling others’ complaints is to wait until
the person you are worried about has clearly asked you to offer
advice or solutions such as by saying, “What do you think I
should do?” Even then, it’s better to ask them what they had
thought of doing before offering your own ideas.
Instead, try using minimal encouragers. It is important for a
person struggling with an ED to feel your confidence in his or
her ability to improve. Even when you aren’t feeling so confident,
it helps to express faith that he or she will eventually figure out
how to manage better. You can do that with brief encouraging
comments like these:
• “You’ll figure that out.”
• “You’ve handled tough things in the past.”
• “You can decide what’s best for you.”
Extracted from:
Heaton, J.A., & Strauss, C.J. 2005. Talking to Eating Disorders:
Simple ways to support someone with Anorexia, Bulimia, Binge Eating,
or Body image issues. NY: New American Library.