When eating disorder behaviors or thoughts are challenged, patients can suffer violent peaks of emotional turmoil that may result in food throwing, flying plates and distressing anger explosions involving kicking, biting, destruction, etc. Self harm, suicidal thoughts, and running away are associated with this period of recovery. This is particularly pronounced in Stage 2 of the recovery process. Violent explosions can be very distressing for families especially when the child was previously calm and collected. The turmoil and conflict can have a huge impact on everyone in the family leading to anger, confusion, resentment and pain. In attempts to prevent escalation of conflict one strategy is to avoid arguing with the eating disorder (see externalization of eating disorder). Many therapists counsel parents not to tolerate behaviors that they would not otherwise tolerate from their child. Standing firm, they counsel, helps empower the child against the eating disorder. It is essential that families have plans in place to avoid or respond to violence - even for patients who have never displayed such behaviors. Ensuring the safety of the patient and other family members must be a priority, without compromising treatment progress.

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