F.E.A.S.T's Around The Dinner Table forum

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

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RachelM
Hello

I am new to this forum but so grateful for it!  My daughter was diagnosed with atypical anorexia in April this year.  She has lost weight since and the NHS eating disorder service last week diagnosed her as anorexic.  Sadly, there is a waiting list so she is receiving no treatment from the Eating Disorder Clinic for now.  She sees a psychologist once a week privately but this to be honest has had little effect on anything.   We are basically re-feeding without support from anywhere other than books and the internet!  I'd be grateful for your thoughts on the following ..

- Affection.  My daughter finds it very difficult to accept any sort of affection.  She can not stand any physical affection usually.  Is this common?   If so, why?  She never used to be that way.  What has lead to her eating more is less and less freedom e.g. no sports, no school unless she eats breakfast, the threat of supervised lunch at school.  This doesn't seem to be to be the compassionate approach that Eva Musby suggests in her book...😧  

- Emotions.  She can go from yelling loud enough for the street to hear to singing in her room in a very small space of time.  Do your children have these severe mood swings over a short period of time?  She is also self-harming.  My ears are still ringing from her outburst on Saturday although I can't remember much about it.  I am increasingly finding I can't remember short periods of time that have been intensively stressful - is that normal?  

- Treatment.  She's said that she wants a flat stomach as she associates this with being happy and confident.  She checks herself in the mirror A LOT.  Where in the treatment process is this addressed?

- School. I emailed all of her teachers directly last week, detailing her diagnosis asking them to let me know of any suspicions regarding purging/self-harm, asking for a supportive approach when teaching her.  3 out of 11 replied.  I have heard nothing from 8.  What do you think about this?  As a teacher myself I think that's pretty poor but maybe I'm over sensitive???
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ValentinaGermania
Hi and a very warm welcome from Germany. I am sorry that you need to be here.

Affection: AN and the malnutrition of the brain affects the emotional parts a lot. They are feeling dumb. They do not feel any compassion or sympathy. That is normal and gets better with weight gain. It is common that working with incentives and threats works best. Try to say it in a positive way to make it an incentive and not a threat. "You can go to school as soon as you have finished breakfast" instead of "no breakfast no school".

Emotions: see above. Mood swings are normal in that period. Many parenst experienced more mood swings when they are on low blood sugar. Is she already eating every 3-4 hours and having 3 meals and 2-3 snacks? The mood swings get better with weight gain and time. I marked my calendar in red for bad days. yellow for normal ED days and green for good days to see the very slow progress. Without that I would have thought that all days were red...
Self harm: we had a punching bag for my d to help her to get rid of all the anger and frustration and that helped to stop self harm here. Take away all sharp things she can use for self harm. Sleep with her if needed. She will hate it but if you can make self harm impossible it is easier to stop it for her.

Treatment/body dismorphia: The body checking gets less with weight gain and brain recovery. It is adressed in treatment if it does not fade then. I would suggest you take away all full size mirrors in the house for some time x. That helps to keep her from body checking all the time.

School: I think most of the teachers are not prepared for that and do not know how to help. I would go and see them 1:1 and ask for help and what you want them to do. There are great infos for schools on Eva Musbys homepage (https://anorexiafamily.com/eating-disorder-policy-guidance-school/)
I do not know the legal rights in UK but in most countries kids with cronic illnesses (and EDs normally are because they last more than 3 months normally) have special legal rights in school (no PE, no tests, lunch breaks at home and so on).

It is great that you already have started refeeding at home and do not wait for the system to get into action. Can we help with something more?
Keep feeding. There is light at the end of the tunnel.
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Stubby_USA

First - welcome!  I'm sorry you need to be here but I'm sure you'll be very grateful for the support.       You are doing heroic work with your re-feeding on your own.   

- Affection.   I think this is fairly common for adolescents in general, but especially for those with anorexia or other types of illnesses.    The goal is for us, as parents or caregivers, to be as compassionate as possible.   It isn't often reciprocated.  Compassion doesn't mean we are not firm in our expectations.    The "LSUYE" (Life stops until you eat) IS compassionate.    It sets priorities that our children are having difficulty setting for themselves.    They need loving consistency.     It sounds like you are right on track with that.     

- Emotions.    Again, a very age appropriate situation, amplified by the illness.       What is more concerning is the self-harming.    It is quite common in people with eating disorders and it is important not to over-react, but it does need to be addressed.       Your life being intensively stressful is, sadly, quite normal.     That is why it is so important for caregivers to practice self-care and have support through this process.  ED is an incredibly isolating illness both for the individual with the ED, but also for the family.     This forum helped me keep my sanity more than once.    If you can find a local support group for caregivers, that can also be immensely helpful.    

-treatment.     The "flat stomach" things is going to need to be addressed, especially because so many with ED also have Body Dysmorphia, which means they'll probably never see themselves with a "flat enough" stomach.     The body-checking should be discouraged.    We took mirrors out of her room.     I would suggest addressing this as early as possible in the treatment process, but it may require an outside source.    

- School.   I, too, am a teacher.    (31 years!)    I have taught mostly in the US, but did a stint years ago in the UK.    I'm not sure what current procedures are for getting a meeting where all of the teachers gather to discuss a particular student, but I'd request such a meeting.    The more you can make teachers your allies, the better.    Your daughter won't like it.       Speaking of teaching - I have a class about to start.    This final advice.  Remember - this is not a sprint.     It will take time to recover, but recovery does happen!    

 

----    "Parenting is not for cowards."
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sk8r31
Welcome to the forum, though sorry you have a need to be here.  There is such a steep learning curve with this illness, and I applaud you for learning as much as you have done already and being proactive with teachers at school.  Hopefully, there will be those in the UK along shortly to share their thoughts on school support and what they have found useful.  Eva Musby has some very good resources regarding communication with schools, and it would be worthwhile checking out those out.

As far as affection goes...our d was a very happy, cuddly child before ED, but we had a pretty long period of time where she wouldn't let me touch her at all.  It was very distressing for me, and I wasn't sure what to do.  The only time there would be physical contact was during the evening when d would drink her shake, and we would watch a short comedy show together for distraction.  Then she would sort of lean into me a bit.  I had to be content with that minimal level of contact for quite some time...so practicing distress tolerance for myself and making self-care a priority were what got me through.  Happily, our d is once again physically affectionate & thoughtful.

Sending warm support to you, & well done on getting going with refeeding.  
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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Hendrixt
Hi Rachel,

Very sorry you've found yourself seeking help on this site but it really is a wonderful place to get advice. My D was diagnosed AN in may this year so I dont have anywhere near the experience of other members on the site, save to say all the subject areas you mention are very common problems. I could just pick up on a couple of things, being from the UK myself.

Treatment - being stuck on a waiting list. Are you in CAHMS? All CAHMS should have a Community Eating Disorder service (CEDS) and NICE guidelines specify that all adolescent patients should be referred to a CED. The NHS Waiting Standards are very specific in setting out waiting times for referrals. If your D is diagnosed as an urgent case the maximum time should be no more than one week to getting an appointment and the clock starts from when your GP submits the referral. (Even the GP practice is on a timer and required to make the referral within 24hrs of the consultation with the patient.) In non-urgent cases the waiting time is four weeks. Our D had only lost 10lbs over 5 months and was classed as urgent. I have heard many stories of patients who have been left languishing in general CAHMs services for months before they have been referred to the CED, on the verge of a hospital admission. A lot of people dont realise that a parent can refer their own child to the CED. If you search up on your CAHMS website there should be a referral form for parents - but it's not always well advertised. NHS waiting standards are on the below link. My GP referred us into general CAHMS and we ended up on a waiting list. After I sent the waiting standards document to the practice and pointed out their responsibilities I got an urgent appointment at CEDS within a few days. Once you are in CEDS you will be placed on FBT which is the best treatment for AN

https://www.england.nhs.uk/wp-content/uploads/2015/07/cyp-eating-disorders-access-waiting-time-standard-comm-guid.pdf

School - The school has a legal responsibility to respond to your request for support with eating at school as it is a medical condition, just the same as they would if she had diabetes  The best thing to do is to request your school to draw up a Health Care plan. The school may also be able to access funding from the local authority (this is not SEN funding - we got 5 hours per week for medical care in the school). We had the same problems with our school until I researched Health Care plans, Medical Care funding and then wrote to the Head requesting a meeting with him, the head of pastoral care and the SEN coordinator. Since then the school have been very good and have allocated support workers to supervise my D eating in school. There is plenty of guidance on Eva Musby's website on the below link. I am the "dad in England who discovered ......."  If you want to message me privately I am happy to assist you with this.

https://anorexiafamily.com/legal-school-plan-eating-disorder/ 


I really do wish you the best
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Enn
Welcome to the forum! We are glad that you found us but so sorry that you needed to. 
Please read around the forum, there are so many wonderful resources. (feast-ed.org)

I am pleased you are feeding her! That is the treatment at this time. 

I will give my point of view on your questions:
Affection: Although it is common, I think understanding that your d is feeling "unlovable" at this time may help. They deny themselves care from nutrition and it can spill to denying themselves  the affection. Also as said above the malnourished brain/body is very strange. Just keep feeding. We found that we just had to wait it out over time it does get better.  By all means, keep being compassionate and use loving words. Right now ED has taken her hostage and your real d inside needs to hear the love and kindness you have for her. She can hear it, it is working, but ED won't let her respond in kind. I hope that makes sense. I agree with sk8r31 about learning to tolerate her distress. It comes, I just want to let you know, that to get through it they WILL feel pain. That is part of the process and we cannot take that pain away from them. It goes when it is time to go, proper nutrition and other supports as required. I am so sorry it is so hard. 

Yup the emotional upheaval is real and common. Again, she is frightened and she is anxious and upset. There is a lot of guilt with eating and self loathing. They take it out on themselves. (Just my take on some of this.) Please ensure you keep things away from her that she could use to self harm. (sharps, poisons, pills, detergents, scissors and other things)

The checking of the body is common and taking away mirrors and/or distracting her during those moments may be helpful. It can get better over time. It is just so hard to witness though, at the beginning.
"School. I emailed all of her teachers directly last week, detailing her diagnosis asking them to let me know of any suspicions regarding purging/self-harm, asking for a supportive approach when teaching her.  3 out of 11 replied.  I have heard nothing from 8.  What do you think about this?  As a teacher myself I think that's pretty poor but maybe I'm over sensitive???"
No you are not over sensitive. I actually demanded in a nice way to meet with them individually. Would you feel comfortable asking via email, when you could meet with each of them. They do need to hear from you, they need to take this seriously and know that it cannot be dismissed. 

Please ask all the questions you have. We do wish to help.

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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RachelM
Hello

Thank for your responses.  I have felt less alone today having posted this.  I don't think anyone who has not been through this can understand at all the horrendousness of it all. 

Hendrixt - you are the famous dad!  Well done to you.  I read about you on Eva's site.  I referred my daughter to our local CAHMS eating disorder service (the GP I originally saw with my daughter obviously did not know about this service or the treatment times so advised us to go private...).  She was seen within 4 weeks and I assumed treatment would commence within 4 weeks as per guidelines but at the end of the assessment, we were told there's a waiting list for treatment.  I was totally crushed.  Daughter was assessed on the Junior Marsipan as being mostly green in spite of some suicidal ideation and self harm and blood biochemstry low and abnormal.  As she is mostly green, she is just being monitored - two weeks from this first appointment and then once a month.  They were apologetic...  But not as sorry as I was!

After the appointment, I drove straight to her school to talk with her form tutor, agreed with my College to take a sabbatical, spoke to a private specialist dietitian via Skype (didn't know that was possible!) about meals and snacks (she said a multivitamin should be non-negotiable so we're doing that) and started efforts to restore her weight.   I would not have allowed her to loose any weight if the support from the private clinic she went to in April had been better. This is something Eva mentions in her book and I think she's right, private treatment in our case without a multi-disciplinary team and without FBT is not the best for recovery.  You live and learn...

I will get in touch with all those teachers who have not replied to me (0 of 3 PE teachers! she was obsessively exercising for a long time) and ask for a meeting.  I'm trying to give them the benefit of the doubt and a little more time to reply... Interestingly, the lessons she talks most enthusiastically are those with the teachers who have replied.  

Thank you again.
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HopeNZ
Hi RachelM

I feel these are all quite normal experiences for you, unfortunately.  I don't have much to add to what the others have said, but for what it's worth...

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 ... This doesn't seem to be to be the compassionate approach that Eva Musby suggests in her book...😧 

As a huge Eva Musby fan, my understanding of her compassionate approach is more along the lines of you, as the parent, being completely clear that your d taking her medication (food) is utterly non-negotiable, but you understand how very difficult things are for your d right now.  So while you're insisting on structuring your d's life so that she has the best chance of getting better (ie gaining weight), you're doing it with love and empathy and acknowledging her suffering.  Perhaps you could reframe it for yourself so that you're not thinking in terms of her losing her freedom, or having the threat of supervised lunches, but rather that you're putting supports into her day to enable her to do what she needs to do to recover.

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- Emotions.  She can go from yelling loud enough for the street to hear to singing in her room in a very small space of time.  Do your children have these severe mood swings over a short period of time?  She is also self-harming.  My ears are still ringing from her outburst on Saturday although I can't remember much about it.  I am increasingly finding I can't remember short periods of time that have been intensively stressful - is that normal?  

It helps me to think of the effects of starvation as a kind of reversible brain damage.  And with brain damage goes emotional dysregulation, volatility etc.  One of the things that horrified me the most while my d was so ill initially was her cruelty.  My previously sensitive, thoughtful, kind d was capable of laughing at people and animals in pain, enjoying cruel jokes at the expense of the rest of us.  Thankfully this passed with brain healing.

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- Treatment.  She's said that she wants a flat stomach as she associates this with being happy and confident.  She checks herself in the mirror A LOT.  Where in the treatment process is this addressed?

We sellotaped sheets of baking paper over the large mirror in the family bathroom, so that the rest of us could see our faces over the top but no full-body reflection!  I'm afraid she's going to body check her reflection in shop windows etc anyway.  My d did lots of bodychecking all the way through, and now that she is into tentative stage 3 she still does, but the difference is that now she seems ok with what she sees.  We've never addressed this in treatment.

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- School. I emailed all of her teachers directly last week, detailing her diagnosis asking them to let me know of any suspicions regarding purging/self-harm, asking for a supportive approach when teaching her.  3 out of 11 replied.  I have heard nothing from 8.  What do you think about this?  As a teacher myself I think that's pretty poor but maybe I'm over sensitive???

I'm sorry to say this mirrors our disappointing experience with school.  We discovered that a few wonderful individual teachers moved heaven and earth to support our d and to learn what she needed from them, but others simply did not want to engage with us.  I recommend advocating for what the school is legally obliged to offer your d, and on a personal level cultivate the teachers who are supportive.

Please let us know how it goes.

Warmly
Hope
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Mamaroo
RachelM wrote:

spoke to a private specialist dietitian via Skype (didn't know that was possible!) about meals and snacks (she said a multivitamin should be non-negotiable so we're doing that) and started efforts to restore her weight. 


In addition to the multi vitamin, our treatment team added a calcium tablet and I added a couple of omega 3 fish oil capsules (I told my d it was for her joints). I also added zinc and a pro biotic. 

I'm sorry to hear that you got such few responses from school. We had to pull our d out of pe classes for the rest of the year as the teachers constantly gave her 'something' to do (walking etc). Some teachers just don't get it, sigh. I gave her teacher "Brave girls eating" and it helped a bit.

Good luck and please come back with more questions!
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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deenl
Hi and welcome RachelM,

You have likely seen Eva's school resources on her website.

Here is a booklet for sport professionals and clubs. It is Australian but the information is still relevant for the UK. Just in case you feel you need to bring info for the PE teachers.

Warm wishes,

D
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, stable but no progress. Medical hosp to kick start recovery Feb 2016. Slowly and cautiously gaining weight at home and seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
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RachelM
thank you for your replies.  I've just been into school to talk to the safe guarding lead after one of d's teachers replied (after prompting) to my email saying d seems fine and does not feel at this point a meeting is required.  I was fairly livid.  I have the impression she thinks I'm an overprotective, over-worrying ED obsessed mother.  
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ValentinaGermania
You are certainly not overprotective or over-worrying.
NO AN kid is "fine" in the first year of recovery.
And school is one of the big stress factors for ALL of them.
To be alert is one of the best relapse preventions you can do.

Listen to your gut and do not listen to teachers that do not know anything about EDs.
You are the expert. You know your d best. She needs you to stand up for your rights at the moment and you have all the right to do that.
Keep feeding. There is light at the end of the tunnel.
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Enn
I do hope you meet personally with that said teacher! Those are the people who may be difficult at the beginning but may be your best allies in the end. That is what I found here. Or meeting with that teacher and another one or two at the same time to discuss your concerns? I find having a group meeting so that we can all be on the same page and come up with very specific goals/targets at the end that are documented for all, may force them to stick to the plan no matter what. 
I had to remind the gym teacher here after I posted to you ,a couple of days ago, that even if she had spoken to the guidance counsellor and may think she knows what is going on, that it was imperative to talk to me as i needed to understand the curriculum and she had to understand what I would not allow in terms of health/ nutrition talk and exercise. 
Power to you! 
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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RachelM
Thanks for the power.  I feel utterly powerless.

I am now trying to register at a GP a few miles away in another county as the eating disorder service in that county does not have a waiting list.  I am literally pleading on the phone.

D is eating more but has upped exercise.  She started back at school last Weds so this is a new routine.   She walks to school - 1.8 miles /2.9 km each way everyday.  She does 30 mins of swimming on Sunday, Tuesday netball at after school club, Weds is circuits at after school club, Thursday is basketball at after school club (all 1 hour).  On Friday she dances 45 mins.  When she gets home from school at 5.00pm, she's maybe in for 30 mins then walks (it was biking) until 7pm when she comes home for dinner.  

My alarm bells should be ringing right?  She says it's just because she doesn't want to be in the house and she enjoys sports/walking.  She self-harms, if I take away exercise, will this get worse?  Do I protect her calorie intake and risk self-harm?

I called the 'duty clinician' at the eating disorder service yesterday at 4pm.  They were busy and never called back.  I called again this morning 9.30.  They were busy and haven't called back.  

Much sadness.
 





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Enn

It does seem as if you have a few road blocks in the way right now. 
May I offer some advice: STOP all non essential physical activity. It looks as if that is ED right there. She is doing so much exercise that I fear that it will thwart all your efforts to kick ED out.
Things may get worse and you will need to think of plans for those scenarios. This is ED, it has to be tackled. I know how difficult it is as you may feel you are boxing a ghost. 
Ed is sneaky and will give you "logic"  that really does make sense for a healthy child. But that logic for ED is a trick and I know you know that. That spidey sense you have about your alarm bells are on target! We had standing all the time and wanting to go for walks that became runs. It was really a difficult time.

With the eating disorder clinic, I wonder if you could talk to anyone there to get a message to that clinician and let them know you are very concerned and really would like to speak to someone, anyone to see how to get moving forward.  I usually preface it with, " I understand how busy you are. But this is my child and I am fearful for her life, I really would appreciate a call back today. Would it be OK if I were to come in today to discuss my concerns in person first?" I have done this many times for d, and my other kids with different issues. It has worked for me overall, but I understand if that approach may make someone uncomfortable.
Remember, you are her parent for a reason. You were picked to help her get back to health.
XXX

When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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mjkz
I agree with Scaredmom.  No more exercise. While I wish you had a better response from her teachers, I'm not surprised.  Teachers just don't have the time with so many kids to personally supervise one. While an ED is a medical condition like diabetes, the school nurse deals with that kind of issue rather than teachers (at least over here on this side of the pond). Stubby had some great ideas.  I would focus on the teachers who did respond and get more supervision through the school counselors and nurse.

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Do I protect her calorie intake and risk self-harm?


She is already self-harming through exercise so I'd stop it and keep a close eye on her.  Protect her calorie intake at this point and supervise as much as possible to keep the other forms of self-harm to a minimum.
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RachelM
I'd forgotten she's also doing workouts 3x a week in her room - planks, crunches.  She does them super quietly...

Long conversation the Eating Disorder Service when the duty clinician eventually called this afternoon.  Basically they've 'empowered' us to decide what is appropriate and they will back me.  We now need to decide...

Thankyou mjkz and scaredmom.  I hear you.  Just wondering though, is anyone of the opinion that I should be more lenient?  


   
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ValentinaGermania
RachelM wrote:
I hear you.  Just wondering though, is anyone of the opinion that I should be more lenient?  


No. 🙂 ED is a terrorist and we do not negotiate with terrorists.
Keep feeding. There is light at the end of the tunnel.
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Enn
RachelM,
at the beginning you are learning the Ed in your home. It is like learning at school. You see and learn a little bit then more and more comes to light. That is the part  of treating ED that I feel the teams don’t discuss with us properly. It takes us time to figure the ins and outs of our ED in our home and how it responds. Either a gentle touch or a very strict approach. 
Here when the team said that parents were in charge and they stood with me no matter what. It took the negotiating down a big notch.
it was helpful for me.
sending warm support.
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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teecee
Please heed the wise words of those who have responded. 
We did LSUYE (life stops until you eat) and it worked for us. Our D was suicidal so we battened down the hatches - which literally meant that. We supervised her 24/7, stopped all exercise (good job as she was dangerously ill and when we did this we found she didn’t have the energy to walk upstairs on her own despite convincingly enduring 20 hours plus a week high performance tennis training and circuit training ‘for fitness’.) We locked all poisons, sharps medicines etc in a locked store cupboard and hid the key. Life was like this for months (I had to take sick leave from work). Luckily my hubby is retired. 

We quickly found that LSUYE was motivation for her to refeed quickly to regain her independence. We reintroduced gentle exercise when weight restored and maintaining but no competitive tennis. This helped with depression (rather than medication - we were worried the effects may exacerbate the suicidal ideation).
 We are 18 months past diagnosis and only in recent weeks has she chosen to do one competitive doubles competition. 
She has an independent life back with us still monitoring and encouraging/supporting her through recovery. She lives a full life and just passed her driving test this week! Let me tell you that 18 months ago I did not envisage her being able to continue her education let alone be well enough to study for GCSEs, A levels, driving test, volunteer at a stroke unit and hold Dow a Saturday job coaching tennis for little kids !!!! We are in such a different place but it did take a lot out of us. 
Please treat this vile illness with the seriousness it deserves...it is a serious (life threatening sometimes) illness. Please don’t underestimate it and be aware that the quicker we act the less likely it is to become embedded (which makes it harder to untangle from) 
please come back here to ask away...there are amazing carers on this forum who have been there and get it...they wish you didn’t have to walk their shoes however you will overcome this and your D will be forever grateful. You are doing life saving work!!!!! 
Virtual hugs. Xxx
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Enn
RachelM,
lenient is such a subjective word.
i know for me I had to do a 180 with my parenting. I really had to change my collaborative and inclusive approach to loving and firm and no nonsense. 
It depends what you mean by that I guess. The main rules are food, weight gain and tacking Ed behaviour however best it occurs on your home. The fights are normal and expected and hard and awful. Many can attest to that. 
Please ask away. How can we support you? 
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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sandie
Hi, we found it too difficult to gain weight needed with exercise. We had to stop all including shopping trips and walking for several months. I drove D to and from school and we worked with school to see how walking in school coud be minimised, eg use of lift, skip some classes to avoid too much walking. When D failed to make progress, she had to stay off school for 6 weeks and even walking up and downstairs was limited. I did not understand what was needed at the start of treatment and felt that bringing D for a walk helped to relax her and if I was at the start again, i would definitely really restrict activity. We found once we even let D walk around the block that weight gain was tricky and exercise inexorably creeps up.

wishing you the very best. Xx
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Foodsupport_AUS
It depends what you mean by lenient. As has been mentioned there is no negotiation with terrorists. 
Her illness needs to be treated with firmness and persistence, with a view to eliminating all ED behaviours and thoughts. How this looks is very variable from family to family. Some have found LSUYE (life stops until you eat) very helpful in getting things moving, the thing about this is that life starts again after eating. If life just stops it may not be the best way forward. Some of us have had to find other ways to move forward, have a look at the super resistors thread. Most of us have had to change how we cared for our children, my daughter was such an easy going well behaved child that I never really had to manage any behavioural issues before ED came along. My previously extremely compliant child was suddenly very resistant. Her only previous ever resistance was when needed to do something she found scary or worrying. We need to learn to get them over those hurdles as their lives depend on it, but there is no one way to achieve it. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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HopeNZ
RachelM, my advice is: 'be a wall'.  A wall cushioned in empathy, compassion, kind words and understanding, but a wall no less.  

If you can't manage kind words and understanding, then a non-committal, 'I'm so sorry it's so hard for you, darling,' followed by a 'we love you and want the best for you and this is what you need right now' will do.

Easier said than done, I know.  But ed is an expert manipulator, a master negotiator.  Be a wall.
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Barberton
Hello from Western Australia and I'm sorry to hear what you are going through. We have had a similar journey with our daughter. 

Affection: In the beginning my d was numb to affection, but now she is on the path to recovery she gives me long, deep hugs. 

Emotions: All I can say is brace yourself, don't take it personally. I like HopeNZ's comment above about being the 'wall'. 

Also, I covered all the mirrors in our house for the first two months after diagnosis. My husband thought I was insane, but I think it was important to do. 

Treatment: We found the appointments with the psychologist to be pointless. That was our experience. I would recommend listening to all of Tabitha Farrar's podcasts. They have helped give me a perspective and language for working with my d. The ability to talk to her about 'mental hunger' rather than saying "stop listening to a voice in your head" was enough of a subtle difference that has pushed her recovery further ahead for us.

School: I agree with you that you had a poor response from the school. The most trouble I have had at my d's school is with the physical education teachers! They know she has AN but still ask her in front of her classmates why she can't join in sport! Crazy mad! I found that the shame around EDs means that some people are so afraid that they don't know how to respond. I think we parents need to educate those who need to be. "Hey teacher, my child has an ED and this is what she may do and this is what I need you to do." Is this unrealistic?

Good luck. It sounds like you are on the right track.
D fell down the rabbit hole of AN at age 11 after difficulty swallowing followed by rapid weight loss. Progressing well through recovery, but still climbing our way out of the hole.
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