What if your child were ill?
Everyone should go and read the discussion about this post — so many interesting things have been said from people with very different beliefs about the cause and treatment of eating disorders. One question stood out to me, though:
Who would you go to if your child was ill?
I’m going to change the question a little bit: What would you do if your child were ill?
I’ve thought about this a lot since “discovering” the Maudsley Method (I had never heard of it until a couple of years ago). Maudsley contradicts many of the beliefs that I was taught in treatment — it’s not about the food, there are lots of issues to work through, family therapy is necessary, etc. I’ve been to residential treatment centers a couple of times and seen a dozen (or two) professionals outpatient. Everyone has a different thought on what “caused” (or contributed) to my eating disorder. My parents have both been blamed at times (each individually — either my mom OR my dad), sure. My ex-boyfriend has been blamed. I’ve been told that I’m just perfectionistic and that I feel out of control in my life. I don’t even remember half the things that I’ve been told.
Honestly, I think that discussing what “caused” my eating disorder is a waste of time:
- because it is biological
- because there isn’t one thing
- because my childhood was 15 years ago and I am tired of rehashing it
In therapy, I’m dealing with what’s going on now. Just as an example, I’m afraid of wrecking relationships. Maybe this is because I didn’t feel like my mother cared, or because I feel unlovable, or because I wrecked a relationship with a guy — I don’t know. I can’t change any of that and I’m not sure that identifying the source would make a difference. I can, however, explore how this issue is affecting my life now. I’m afraid to be open with friends because I don’t want to be a burden and screw things up. I hate emailing my therapist because I don’t want her to think that I’m needy and unreasonable. I feel like a lot of my work right now is exposure therapy. It’s taking that step and emailing my therapist when I’m having a bad night, and then talking about it at our next session and realizing that I didn’t wreck anything. I’m trying to be more “real” with friends and trusting / hoping / praying that they can be there for me and don’t mind listening. You get the point.
I know that I seem way off-topic, but I have a purpose for all of this. When I was an adolescent, I would have probably responded well to the Maudsley Method — especially since I so badly wanted my parents to care and to notice and to tell me that my health was important. That didn’t happen, but I did get that support and education from residential treatment. My parents wouldn’t have done family-based treatment if they had known about it. I don’t really care to elaborate on that, but trust me, they would not have.
If I had a daughter, though, I’d use the Maudsley Method. Well, if I had a daughter, she would never GET to a point where she needed inpatient treatment because I would have her in therapy so fast. But yes, I would be the adult and I would tell her that this is important and I would make her sit at the table for two hours or however long until she finished her meal. Of course I would have her in therapy, too…
Not all families are willing to make the investment that FBT requires. If you are on this blog and are reading this, then that’s probably not you. One reason that I think Maudsley is effective is because it addresses so many of the underlying issues and concerns — whether you realize it or not. You’re telling your child that you love them, that you are the adult, that their health is important, that it’s okay (and necessary) to take time out for themselves, that you support them, that you notice and care, that they matter, etc. That’s not something that my parents would do, so I got those messages in residential treatment. It’s not the same, for sure. I still think that I would have needed years of therapy, just because there is / was a lot of stuff to process. But yes, I would use FBT with my daughter. It’s not an option for everyone, but if you are educated and knowledgeable about the illness, then you know how important your role is as a loved one.
I agree with you that there’s a lot going on in FBTeven in the earliest stage. Sometimes it’s talked about as if it were simple “refeeding” but non-critical supoprt and externalizing the illness are important psychological factors even in the nutritional restoration phase. And of course in the later two parts of treatment revolve around managing independently and dealing with any issues that get in the way of healthy adolescent development. FBT isn’t a rejection of therapy, but a TYPE of therapy.
If you ever have a daughter with AN I’m sure you’d do a great job helping her recover (but I truly hope you never find yourself in that situation!)
Jane – Thanks
That’s a valuable point that FBT is a type of therapy. I guess I’ve always looked at FBT as incorporating therapy, but it makes sense that it is in fact its own kind.
I’ve thought a lot about maudsley stuff lately too. Like you, I know my family never would have gone for this sort of treatment. In fact, they were in deep enough denial to argue against doctors,teachers & camp counselors for years. When I was wanting treatment, my mother told me not to believe that I was crazy, tried to assure me I was fine etc.
I really do not think there was any malice– they wanted me to be well, badly enough to fail to see the problem.
I think maudsley has some great ideas & has brought about a wealth of research. I hate the parent blogs/comments that refuse to understand that not all patients could have this therapy, that some patients *do* benefit from individual/traditional therapy.
I think it’s occassionally useful to reference my past, because it sometimes helps to understand my present tense patterns & problems. I don’t think it would be useful to focus on that exclusively though, and the therapist I’ve seen for six years has helped me a lot with focus on my current values/goals, cbt, etc.
I think maudsley has helped me think about the ed as external, and appreciate the importance of nutrition. I’m a science geek, so I like seeing these things laid out in studies. it’s reassuring!
and like you, I feel like I’ve used my treatment team to take on that sorta refeeding job. I joke that I outsource my food & exercise decision making. It’s true though.
I’d like to see traditional therapy/residential centers try to adapt some of the most successful aspects of maudsley & incorporate them.
I kinda freak out when I read comments from parents etc saying not to trust what a sick person is saying etc– dehumanizing much?! I know (now) when I stop making sense, and even then, I never make up stories about my childhood/twist family relationships. when I’m food deprived, I come up with all sorts of absurd justifications & I shut people out. I don’t stop being a person though, and I wanted to strangle some of those mothers!
What synchronicity! I stumbled upon your blog in my musings about the very same article and the differing opinions in response!
I really appreciate your perspective, it is helping me continue to think through my reactions and the response I am in the midst of crafting for my Blog.
I too was concerned about the depiction of clients’ stories of their past lives as not believable. That has not been my experience, but rather, like you say, that many people go to great lengths to blame themselves and justify the behavior of their loved ones.
Thank you for this post. I am glad I found it when I did.
I stumbled onto this site and I am so glad that I did.
My daughter was in traditional treatment for Anorexia for years.
It wasn’t until I pushed the professionals to the side and used my motherly instincts, took her to a neutral place and we put together a plan, which parallels the Family-Based Treatment.
She is in Recovery for the longest by far period in years. She is 25 with a college education and lots of scars from the eating disorder.
I write at http://AnorexiaTreatmentExposed.com
Facebook: Caron Kasey
Facebook public link: http://www.facebook/pages/FoodIsMedicine
Twitter: @AnorexiaExposed
Thank you!!!!!!!