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:

1. because it is biological
2. because there isn’t one thing
3. 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.

In the meantime though, I want to highlight a quote from Laura Collins’ article, “The size of the trigger or the speed of the bullet?”

An eating disorder is not a sign of deep wounds, but some people do have deep wounds, and it makes recovery harder.

I’m curious — this this a “duh” statement for everyone treated with the Maudsley Method? Because it basically goes against all of my inpatient and outpatient treatment, formal education, and research. Just to quote a few of the institutions, professionals, and resources I’ve had experience with:

“Eating disorders are serious health- and life-threatening physical disorders that usually stem from some underlying emotional cause.” – The Renfrew Center

“Genetics make the gun, environment loads it, and that an experience of unbearable trauma is what actually pulls the trigger.” – Lui, Aimee. Gaining: The Truth About Life After Eating Disorders.

“Eating disorders are real, treatable medical illnesses with complex underlying psychological and biological causes.” – National Institute of Mental Health

If you don’t see my point by now… it’s that I have always been told, eating disorders are not about the food. They’re a symptom, coping mechanism, etc. of something else.

That said, I don’t think that everyone has trauma… I’m not a fan of repressed memory therapy, because I think a lot of it is made up (or generated in the process).  Ruminating on traumatic events prolongs mental illness.  You can’t change what happened to you when you were three.  This is all true… but I also think that some people are using food to subconsciously avoid feelings/situations related to previous trauma, and in those cases, they need to be resolved in therapy.

I like Aimee Lui’s perspective on the matter.  You NEED the genetic component to develop and eating disorder.  They don’t really just happen to people.  Even if you have the genetic component, though, growing up in a wonderful environment can be protective.  I refuse to believe that you just inherit the anorexia gene and you’re doomed for a life haunted by an eating disorder (and if that’s the case, then I should never have children given my family history).  There IS a strong genetic component… but in all these genetic studies, you also have to consider environment!  Chances are, these kids are growing up with semi-similar relationships as their parents did.  There are just too many variables.

Anyway, I think that given genetics, environment CAN be enough… but for many people, it’s the unbearable stressing event that pushes them over the edge.  Those are the people with the trauma history.  So, regardless of whether or not you have a history of trauma, you at least have underlying relationship/environment issues to address