I may be able to speak to both Wendy's and leanonme's comments sort of at once.
Seems like just about everything is fundamentally based on being aware and being able to assess realistically (which we can of course only do when we are aware).
So, first off, Wendy, the thing we can do to do tend our relationships is be aware that the relationships exist in the first place (sometimes easier said than done!) and be aware that the nature of an eating disorder is to isolate someone from his/her connections and to cause huge wear and tear on any connections (especially close ones).
Being aware and acknowledging what's true is such good protection for us (all of us humans, and not just relating to eating disorders either- relating to virtually everything :)
We can also make some possible predictions based on what we know from being aware, and these help protect us also by making things a bit more predictable and stable-feeling. I often say to families that the presence of an eating disorder has an enormous capacity to wreak havoc on relationships and cause huge amounts of exhaustion, and that I'm not saying that scare them, only to help them understand the possibilities that can potentially occur, and to remind them that they're normal people if these things do happen (then the family can say to themselves: it's so normal that wear and tear would occur that we could even predict it. ok, if it's normal for this to be happening, we can probably get through it and we can probably find ways to help it).
After being aware and acknowledging what's real, the next most important thing is to talk. To say what's real for us, and to ask questions. It's not even important that we know what we want to say, or the "perfect" way to say it. And it's not important to have everything figured out before we say anything.
What's important is to connect. And one of the ways we connect as humans is to talk to each other. You know the family I was talking about the other day? One of the things that was getting in way of their communication was that the parents very much wanted to be involved with their daughter and her thoughts and feelings. The daughter had a tendency to feel the parents could be overbearing and she felt intruded upon and as if the parents wanted to have control of her life. But that wasn't the case. The parents simply wanted to know how the daughter was doing- how she was feeling, what she was thinking about various things in her life, how certain decisions she was in the process of making were going for her...
They didn't have any particular investment in an agenda, and they weren't trying to dictate an agenda. They only wanted to get to come along for the ride with their daughter- to be a part of her day to day life.
You can imagine the difficulties this misunderstanding causes. The daughter clams up, worrying that if she says anything at all her parents will "take it and run with it." But then, in the face of silence from their daughter, the parents feel completely in the dark, worry like crazy about what she might be experiencing, and then feel mad and sad. Yikes... a mess... and it doesn't need to be.
The simple act of talking solves this one. And we practiced this in my office- you know, to give the daughter direct evidence that her parents want only to be connected to her, not control her. And to give her direct evidence that she doesn't have to have her life "figured out totally" in order to get to talk to her folks.
Sometimes people think that in order to tend relationships you should go off on a trip to Tahiti for a couple weeks and be with the other person/s. Trips to Tahiti are fine, and can be a lot of fun probably. But it's the day to day, seemingly small, things that make or break connections.
Here's where leanonme's comment comes in. Leanonme, the distinction between tending a relationship and becoming hypervigilant about the process is very important. Here's the thing- all the things I wrote about above are kind of the antithesis of hypervigilant! Hypervigilance is rigid and hyper-alert. It's ok in a crisis or for a very brief period of time (that has a clear end point). It's terrible for ongoing living.
Not only does it wear us out badly, as we become more and more exhausted and fatigued, we lose the flexibility and endurance needed to be aware and to use our observational skills. So, prolonged hyper-vigilance ends up backfiring- we do the hypervigilance thing because we are trying to protect ourselves by keeping a close, close watch.
But the opposite actually happens- we become so fatigued we can't stay aware. And then we are less protected! Paradoxical, huh?! And a bummer, because usually people's response to this state is to think they need to be even more hypervigilant, to "step it up" and "be better" at hypervigilance, in order to protect themselves. You can see where this ends up... not good.
It seems, as usual, the best solution is to use our "basic elements of a workable life." Amazing how things always seem to end up with these few, crucial elements: awareness, flexibility, scrupulous honesty, gentleness and compassion, and patience and a broad perspective while staying right in the moment.