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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seaglass
Hi. My 13 yr old daughter has anorexia and after struggling to get help we are a few weeks into FBT (maudsley). She is following the meal plan and very slowly gaining weight but I'm struggling with the weekly sessions. It seems tough and unsupportive. We manage the eating but the sessions are hell. She hates them (maybe to be expected?) but so do I. I need help and support but feel judged and undermined. She is so low and admits suicidal thoughts which are ignored in sessions but which I have to deal with daily. My ex husband is with us in sessions and so I feel I can't talk freely. I am struggling to cope and feel our 'help' is far from helpful. What do I do? I feel like I can't cope and need help. I am not sleeping (as she can't sleep), I can't get support (as am always with her) and hate the FBT as it doesn't support me or my daughter. I feel like there's no hope or help and don't know how we can both go on
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Kali
HI seaglass

So sorry you have to go through this. Is it possible for you to schedule an appointment with the FBT therapist without your d. and x and discuss how you think the therapy can best support you and your d? Let the therapist know how you are feeling and how difficult it is at home at the moment and see whether you can brainstorm some ways in which the therapist can really help you and d. while you go through the very difficult refeeding.

Let her know that you feel judged and undermined and see if you can have a constructive conversation about how to change things.

Therapy is not always pleasant—and sometimes very difficult—especially during anorexia treatment. But it is good that your d. is following the meal plan and has gained a little weight.

Kali


Food=Love
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seaglass
Thanks for replying Kali. I do really feel there's a lot to discuss without my daughter there and might see if I can talk to the doc privately.

I feel hopeless and as if I can't help my daughter but am expected to be skilled and able to so without any support.

We can both follow the meal plan but it's the rest that is hard. My daughter tells me night after night that she just wants to end it all. I don't know how to help her.

I hate FBT. But they told me there's no support for me or her.
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Francie
Hi Seaglass, welcome to the forum, and I am sorry your situation is such that you have to be here. You are saying you need support and you have found a good place for that on this forum. I am sure my reply will be joined by others' soon so please hang in there, you are not alone. 

It sounds as though you are doing a good job of feeding your d and getting her to gain weight. Hooray for you! That is so difficult and you are managing it beautifully at this point. Pat yourself on the back for the success you are having with your beginning efforts at weight restoration. Some of us are not able to handle refeeding (myself included).

Others on this forum will surely weigh in but it sounds like it's a bad fit between you, your d and the T. And if he/she is making you feel judged and undermined that is a big red flag that this person is not the right one for your family. Therapy should make you feel good/better/supported or what is the point? How can you help your d heal if you feel you are not supported and your d's suicidal tendencies are not addressed? 

It would be worth seeking another therapist who will be a better fit for you and your d. My d and our family have had experiences with different therapists and their talents and capabilities really run along the scale from being very, very good to being very, very bad, even harmful. See if you can find a new therapist who can support you. This is a tough battle and you will need good support as you have seen already.

On this forum there is a listing called 'Feedback on Specific Providers'. I think it mostly lists and recommends (or not) places for ED therapy, but it may be helpful: http://www.aroundthedinnertable.org/?forum=189312#gsc.tab=0 . You can also connect with others on the forum who may be in your geographic area who might be able to recommend another therapist here, in the section called "Connect with Local Members": http://www.aroundthedinnertable.org/?forum=185061#gsc.tab=0

All best to you! Keep asking questions and read around the forum. We have all found it very helpful and supportive.

Francie

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sahmmy
seaglass, I agree with the others, if your FBT is no help for anybody, you may be better off going alone. We've had more than our fair share of uneducated providers. Hind site - like everybody on this forum says, it's the consistent food going down over a long period of time that works.If you've got that going for you and your d, you just might make it out of this without the hassle of outsiders.
I truly WISH that providers were more helpful. I think we all agree that there is definitely a need!

We actually tried a new therapist today. My d mentioned being fed for the last 3 years. She also struggles with anxiety. The (non-ED) therapist actually said "You can't REALLY force somebody to eat if they don't want to." I think she was trying to imply that maybe I was the cause of my d's anxiety, by being an over-controlling parent.
I had to explain that the ED world is different.
Not sure if we'll continue with her. She may be great for other issues, but the last thing I, or you, need is for our paid help to undermine our efforts.

We need support and encouragement to keep our kids nourished. Who can argue with that?





d=18, R-AN, Generalized Anxiety Disorder. Refed at home with information gathered from this forum and lots of books. Relapsed. Refed. Relapsed. Refed. 17 sessions with an excellent individual therapist. 19 sessions with unhelpful dietician. 3 sessions of DBT (didn't like it). Psychiatrist available if needed. Prozac - fail. Lexapro - fail. 5HTP - fail. Clorazepam/Klonopin = major improvement, only used when necessary. Genomind SLC6A4 short/short - not able to process SSRI's.
d=15, lost 14 lbs in 8 months, Ped [nono]diagnosed as a crystal on a hair in the ear canal
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Torie
Hi Seaglass - So sorry you needed to join us here.  This vile illness is the pits.

It's great that you are managing to get your d to gain some weight.  That's really the only thing that matters ... well, other than suicidal ideation of course.  More on that in a bit.  We were among the many who found mostly unhelpful "help" and ended up mostly on our own - no help at all is better than bad help.  So that's a real option - maybe you could even frame it as a motivator for your d?  If she eats all you feed her - every bite, sip, crumb - she can skip FBT meeting for the week?

That might be a really dumb idea.  But for sure, what is needed is weight gain, the more and the sooner the better.  What many here have found helpful:

1. Keep her out of the kitchen.  It is your job to plan meals, prepare and plate them - your d's only job is to eat.
2. Have her use the bathroom before each meal so that she can stay with you for at least an hour afterwards.  Trust me, you really don't want to deal with purging.
3. Up the calories and fats in her meals as much as you can.  The brain is made largely of fats so needs plenty to heal.  Plus, additional fats will help increase calories without increasing the size of the meal too much.  You can add butter, cream, and canola/rapeseed oil to countless dishes without changing the flavor or texture much.  (I was amazed that if you vigorously stir it in, you can add a T or two of canola/rapeseed oil to a cup of soup, dish of yogurt, etc.)  I had no idea that premium ice cream is so much more caloric than regular and have been really impressed by the calorie count of some of the breads forum members report finding.  Sucks that it takes so long in the grocery store to read all the labels looking for maximum calories but oh well.
4. Consider sleeping in your d's room or at least outside the door.  Some have been surprised to find their kids exercising in the middle of the night, and that seems to be a difficult time of day for them.  I know I slept better when I slept with my d because I knew she was ok (she was suicidal, like yours), and I think it gave her comfort, too.
5. Visit the forum often and please feel free to ask all the questions you like.  

Hang in there.  You're off to a good start and it does get better.  Really. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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seaglass
Thank you. It feels great just to have found a place to talk to others who understand.

I do need to find the best therapy/ist that will help not hinder. I think I have felt powerless to have a say in that. There seem to be so many
Different battles to face with this horrible illness.

Does anyone have any advice on helping my daughter deal with dark thoughts and moments? Sometimes I feel I can't reach her at all. It terrifies me. At the moment I am with her day and night and sometimes just being there is all I can do. It's hard though as my eldest daughter and husband barely get enough of my time or attention.

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ooKoo
Hi Seaglass,

Welcome x

Our experience with the FBT was pretty disasterous.  We are UK, so under CAMHS, where Maudsley was mentioned a lot. My D refused to engage, to the point where she totally stopped eating for days and days and ended up in  hospital and ultimately as an in-patient in Psychiatric unit for children.  We tried and tried to get it to work, but my D would storm out, or sit silently in the sessions. (before being ill, she was always super compliant/polite etc). 

Last Summer, my D discharged herself from all services (she was 16, and was simply allowed to do so) although my husband and I attended some therapy sessions and became my Ds spokesperson so that information was fed back into the team.  All quite unorthodox, but it did work.  My D was able to gain weight and engage in normal life when the tortuous sessions, weighing, lectures and general rollockings were removed from the equation.  She continued to do very well.  We didn't weigh her, we went by sight.

Unfortunately, as there was no input from any medical team, eventually, she did relapse quite specactualy this year - but was very quickly and carefully engaged by a different team, with a different approach. Because my D wasnt underweight at the time, her treatment was based around her anxiety and depression and not about weight gain.  She engaged very well with a new Psychiatrist who seemed to "get her" and she was put onto medication to treat the anxiety and depression.  She has been on the medication since March 2016 and has engaged in normal life and normal eating since.  She is back at (and enjoying) college, has a boyfriend, has learnt to drive and has a nice part-time job.  She eats three meals a day and snacks when she wants to and she keeps in good shape by going to gym occasionally, which she enjoys, but not to excess.  Life isn't always perfect, but she is doing very well.

So, in our experience, it can be done without the team (it is hard work, but actually my D trusted me and my decisions).  We made our expectations of her abundantly clear (some parents on here draw up a "contract" with their child in these situations).   It is also very very important that all ties with the team are not cut, so that if you need to get back into the system quickly, it can be done.

You say that your D is slowly gaining weight - how far does she have to go?  Do you feel she should be gaining faster?  We normally say around 2lbs a week minimum, and this is very doable.  Do you have to follow a set mealplan?  Does your D eat all her meals and snacks?  You may be chasing growth too, and you would be surprised at just how many calories some parents have had to feed their children each day in order to keep a steady weight gain.

Dark moods are frightening.  Being with her is the best thing that you could do, and although your D may not show it now, she will know and appreciate it that you are there for her.  Keep a tight watch on her, and be patient and consistent.  The only way out of this is through it, and the only way through it is with food, love and patience. 

Kx

UK - South East

19 yo D

Dx AN Feb 2015 (Aged 15). Pre-existing low self-esteen and high anxiety. 

2015: 3 x medical hospital admissions. 1 month in IP which she self discharged from [eek].
2016: 3 x hospital admissions. 
2017: CAMHS CBT. WR, dropped out of 2 different colleges and started an apprenticeship.  Started having grand mal seizures and was diagnosed with epilepsy in Nov 2017. Sacked from job because of this.  Tribunal ensued.
2018 - doing a Psychology degree through Open University and working in retail to pay her way in life. Relapses with eating disorder in June 18 and Nov 18 😢. 

On particularly rough days when I am sure I can't possibly endure, I like to remind myself that my track record for getting through bad days so far is 100% and that's pretty good. [Author Unknown]
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Foodsupport_AUS
Welcome to the forum. As others have said getting some weight on your D is the number one issue at present. Her dark thoughts and moods however are also very important. One of the downsides of FBT is that it does not address other issues until weight restoration, it is primarily focused on weight restoration in stage one and how you can best achieve this. There has been some studies which show the child does not even need to be there for it to work. This however does not help your concerns about D's mood. Suicide is a real and present danger in those with eating disorders. You know your D better than anyone. Although low mood and depression is common in association with starvation for some the distress of weight gain can tip them further over the edge. This is not a reason to not gain weight- there is no recovery without it, but it is a reason to make sure that you are able to keep your daughter safe. Some will need mental health admission for this. I can only emphasise that if you have strong concerns, please find someone to help you, but it may not be FBT. 
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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seaglass
Thank you all for replying. It helps to hear all the different experiences and to not feel alone.

I think that although my daughter is gaining weight it perhaps needs to be more (she is gaining a pound a week only). I have been reading the threads on refeeding and am going to start a new approach and make each bite count as much as possible. I feel empowered and supported for the first time since finding this forum! She is eating all I give her and I honestly am so glad she's doing so and not fighting that (externally I mean). It's hard to recognise and hold onto any positives so I will remind myself that is a huge one.

I am determined to talk honestly and openly with the therapists without my daughter there and see where that leads. I need help to support me so I can support her and it is so frustrating that that isn't happening. It took so long to get help in the first place. I find the fight to access it so tiring. I feel like I am turning into a warrior mum! Maybe that feisty warrior side is what will get us through? It's just that when I get tired or scared for her safety that it fades and I feel desperate. It is so helpful to hear such strong brave empowering voices here!

Quick question. When my d has a nice time in her day (for example we went to theatre the other night) she then hits a huge down afterwards as she forgets her ed for a while and after she feels she will never get her old happy life back. Is this just to be expected?



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HateEDwithApassion
Hi,
I just wanted to echo others on the site and also mention that there are many therapists out there who are not great and others who are fine but not a good fit for your particular family. If you are not feeling like you are being supported and guided, it's ok to consider looking into others - even if you just go to talk about your own needs. I have just started seeing a therapist as needed, and I can't tell you how helpful it's been. Of course, you are with your D 24/7 and all of this is costly, so it may not be possible, but if it is, it can be a life saver for you. 

I know this feels long and hard. Come here and talk with us - we are here for you!

19 yo D. AN - since about 15 years old. WR quickly - but the last four years have been tough. Since Sept. 2017, two residential stays, now in IOP, fighting a relapse. ED is hanging on, mental state not great, can't get her to remain at a weight long enough or high enough to see mental healing. She's on a gap year that will likely now turn into two.
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ooKoo
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Quick question. When my d has a nice time in her day (for example we went to theatre the other night) she then hits a huge down afterwards as she forgets her ed for a while and after she feels she will never get her old happy life back. Is this just to be expected?


I think this is quite normal.  We had similar.  The ED would give my D a hard time for relaxing and enjoying herself.  Almost as a punshment for paying attention to something else other than ED.  She will get her happy life back.  She is doing so well by eating her meals/snacks (don't tell her that, ED will really give her a hard time, then) and you are working so hard with her.    Use this forum for as much support as you need, that is what we are here for.

Take care x
UK - South East

19 yo D

Dx AN Feb 2015 (Aged 15). Pre-existing low self-esteen and high anxiety. 

2015: 3 x medical hospital admissions. 1 month in IP which she self discharged from [eek].
2016: 3 x hospital admissions. 
2017: CAMHS CBT. WR, dropped out of 2 different colleges and started an apprenticeship.  Started having grand mal seizures and was diagnosed with epilepsy in Nov 2017. Sacked from job because of this.  Tribunal ensued.
2018 - doing a Psychology degree through Open University and working in retail to pay her way in life. Relapses with eating disorder in June 18 and Nov 18 😢. 

On particularly rough days when I am sure I can't possibly endure, I like to remind myself that my track record for getting through bad days so far is 100% and that's pretty good. [Author Unknown]
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Torie
Does anyone have any advice on helping my daughter deal with dark thoughts and moments? Sometimes I feel I can't reach her at all. It terrifies me. At the moment I am with her day and night and sometimes just being there is all I can do.

The best advice I received on
 this (other than staying with her day and night as you are already doing) was to be very clear and consistent is telling your d that it will get better.  It's as though your d is adrift in a stormy sea, and you are standing on the shore waving a banner that reads "It Will Get Better."  I can't tell you how many times we had the conversation about it will get better, no it won't get better it just gets worse, yes it WILL get better, no you always say that but it doesn't, yes it will and I will always be here for you, how long does it take, there's no way to know how long it will take but I will be here always, etc.

The more she doubts that she will get better, the more important it is for you to be her rock and keep insisting that it will. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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LauraCollins_US
I want to cheer for your growing courage! When I read your first post I thought: "This is a loving and scared parent." When I read about your growing resolve I thought "This is a parent who is gathering the strength to overcome fear and find her inner strength!"

It's SO HARD to see our loved ones struggle and suffer. Harder still to be told that you as a parent need to find the solutions that will work for your family. But the reality is, it is that individualized and deeply connected parenting instinct that makes what you do work. The therapist can't give you the answers, specifically, because that would not only disempower you but it sends a message to your daughter that you can't handle it. FBT is all about giving parents the responsibility and the empowerment to choose how to get the job done. And when you own it, there is no power on earth stronger than a parent protecting and supporting their children.

It's a different kind of parenting, truly, than we are usually expected to do. In some ways it is a very traditional and old school role. But it is temporary, necessary, and incredibly powerful.

15 years ago the treatment you would have gotten would be to keep you out of the room, blame you, and tell you the best case scenario was eventual improvement. Now, you are not only in the room you are TOTALLY succeeding. You are achieving what years ago no one believed parents could do: feeding your child successfully and every day moving closer to getting her back to her healthy self. Her brain is healing. YOU DID THAT.

You are an amazing parent. You are doing wonderful parenting.
Laura (Collins) Lyster-Mensh
F.E.A.S.T. Executive Director
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seaglass
Thank you to all the amazing people who have replied. I feel like finding this forum might be the thing that helps me through and keeps me strong to help my daughter fight this awful illness.

We live in Edinburgh, Scotland and I do know I am lucky because there are specialist centres for eating disorders here.

With Maudsley we are in phase 1 and I do know it is focused on refeeding. What concerns and frustrates me is how easily they dismiss my daughter's suicidal thoughts as 'something we will deal with when she is weight restored' but I have to deal with them day to day with no support. And it terrifies me. ALL the care is in my hands but I am scared as I feel unqualified to help her in her darkest times. And I need her to be here and alive.

I have found a wonderful therapist to see me once a week to help me stay strong. I think that will help.

My New Years resolution is to insist upon the best help for my little girl. And to fight fight fight to beat this.

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Foodsupport_AUS
Suicidal thoughts are extremely common with this illness. So common as to be expected. It is incredibly frightening for all of us to here our children to express a desire to no longer be here. That being said they should not be being dismissed by your team unless they have assessed them sufficiently to be a non immediate threat. There are different degrees of severity for suicidal thoughts from having the odd thoughts of dying through to having an active plan in place. They need to know the strength and severity of your D's thoughts. Perhaps they have already assessed them, I don't know, but having had a D who went through all these stages and had several suicide attempts I would encourage you to take this up with them until you feel that you know where things are. I had a D at home who had daily thoughts or more about dying, not wanting to be here for over three years, she required someone with her 24 hours a day seven days a week for more than 2 of those years. She only spent less than a week in a mental health ward, in the end feeding her at home worked better. 
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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seaglass
Hi everyone. So we got through Christmas. Eating has maybe been a little more erratic with the stress of it all but it has been so nice to have a break from all the medical appointments and therapy. Tomorrow is our next FBT session and alreasy d is anxious and feeling down. I want to ask to speak to the therapists without her there and ask for something to change.

Part of me is scared I am doing the wrong thing but the weekly meetings push us backwards each week. I am also dealing with my ex (her dad) who is telling me I'm wrong to think I'm an expert in ED and should just accept the help were given.

In all of this she's eating three meals and three snacks a day with little resistance (I don't underestimate her battle to do so) and she's been sleeping better after a nightly battle to calm her enough.

I'm with her 24/7 and sleeping by her side to give her continued support and help with her dark episodes (and also because of her suicidal thoughts).

I just need whatever support we get to be just that - helpful and supportive.

I do worry though that when I get tired and stressed I say the wrong thing. She constantly tells me she just wants to give up and she wishes she's never told me about her Ed. I feel I just say the same thing over and over again- telling her that we are safe, that this is the way and that it will get easier. She doesn't believe me and when I am most down I lose faith too. I can't see the way.

I don't even know what I am asking for. Maybe just understanding from others who may have felt the same?
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Foodsupport_AUS
You are doing wonderfully, even though it doesn't seem it. Three meals and three snacks in with weight gain is slowly but surely edging her back towards good health. 

You are indeed an expert on your daughter. You have read up on ED and understand what she needs. Wide reading tells you that good treatment is far from certain. It sounds as though the FBT is helping you work towards weight restoration but as you say there is anxiety in your D. Ironically there has been some trials in FBT where the patient received therapy/counselling on their own whilst the parents alone saw the FBT therapist. It may be a slightly better fit for you, if it could be offered this way? https://www.mcri.edu.au/sites/default/files/media/documents/media_release-_parent-focused_treatment_effective_in_combatting_anorexia_nervosa.pdf
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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Torie
So we got through Christmas.

Yay!!!  Cross that challenge of the list, and award yourself a basket of gold stars.

Tomorrow is our next FBT session and alreasy d is anxious and feeling down.

Unfortunately, I think that's pretty typical.  FBT is hard.  But so, so worth it.

I am also dealing with my ex (her dad) who is telling me I'm wrong to think I'm an expert in ED and should just accept the help were given.

Do you think it might help to let him know that since AN is a complex illness, you're reading what a variety of experts have found?  Offer to lend him some reading materials?  Maybe if you offer reading materials he'll stop ragging on you because he probably won't like to keep being offered them.  Or maybe just ignore ignore ignore.  Dealing with this vile illness is hard enough under the best of circumstances and for sure you don't need people getting in your way.

In all of this she's eating three meals and three snacks a day with little resistance

Yay!!

I do worry though that when I get tired and stressed I say the wrong thing. 

Yeah, we all are flawed and make mistakes.  Please try not to beat yourself up when that happens - doesn't help you, doesn't help your d, just helps ED to beat yourself up.  That's the last thing you want.

She constantly tells me she just wants to give up and she wishes she's never told me about her Ed. I feel I just say the same thing over and over again- telling her that we are safe, that this is the way and that it will get easier. She doesn't believe me and when I am most down I lose faith too. I can't see the way. I don't even know what I am asking for. Maybe just understanding from others who may have felt the same?

It's so hard to hear those things, yes indeed it is.  Sounds like you're doing all the right things and "just" need to keep on keeping on.  By all means keep telling her it will get better, even if you secretly have your doubts.

It will get better.  It will.  Your d is really lucky to have you. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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EDAction
seaglass,

As others have said, YOU are an expert on your D and YOU are becoming an expert on EDs as you read widely and educate yourself.  Soon you will know more than most doctors outside of specialty ED treatment centers.  And once you've read widely you will disagree with a number of the ED specialists (the ones who subscribe to treatments that you determine are unproven). Do NOT sell yourself short and follow any professional blindly.

I understand the worry about saying the wrong things when you are tired and stressed.  I share it.  But, my friend, at this stage you must be tired and stressed almost all of the time.  I know you are with your D almost 24/7, reassuring her many times a day that you are there and things WILL get better.  Trust that your actions - just being there - speak to your D as well as your words.

I am glad that you found a therapist to see for yourself.  That is wonderful self-care!

It is so good that you are successfully refeeding your D bit by bit.  If you haven't come across it yet, I recommend the Center for Balanced Living's website to you.  You'll find an explanation of the neurobiology of ED.  It explains how refeeding will let the brain heal and the psychological torment lessen.  

Thinking of you and supporting you . . .
DD diagnosed with anorexia at 14; FBT at home with the help of psychologist and medical dr; 3+ years later and doing well (knock on wood)
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Busylizzie_UK
Hi Seagrass,
I am not so far away from Edinburgh though in a different health board area. I can relate to much you say. My D is now wt restored nearly 2 years, after diagnosis at start of Nov 2014. Still quite a few issues going on , but at least she is at a safe weight and has a reasonably ' normal' eating pattern much of the time now. My D had times initially when she had suicidal thoughts and could scream in distress. It was very difficult, and I didn't get any much direct help from CAHMS, sometimes I really just wanted someone competent to be able to offload to in times of acute distress. I would say that I came to realise that good can come of distress, quite often my D would take a step forward a couple of days after she was acutely distressed, I found that keeping this in mind was helpful . Also I would often have 'lightbulb' moments after the distress had settled, and over time I moved forward and learnt to react in a more constructive manner- thought certainly not always ! - but have become better at not beating myself up , and remembering to say sorry to my D and acknowledging that I could have acted in a more helpful manner.
In moments of acute severe distress there isn't much you can do other than keep her safe, then offer some lighthearted distraction afterwards. Once my D had started to improve, but still had very dark moments, I found it helpful to compare a passing low mood to a passing weather storm- it will pass in time. I could ask her ' how 's your weather' rather than 'how are you '-was really useful at getting her to communicate openly . Your D may need more weight restoration though before this approach might help.
Also, I agree that FBT at the CAMHS appointments can be stressful , but they are probably necessary at this stage. Having someone neutral to record weekly weights is helpful, and also if D tried to enter debates with me eg about nutrition etc I found it helped to be able to say ' I ' m not discussing this but we can ask CAMHS about it at the next appointment,' it was a good way of ending the conversation , because it is very important not to get drawn into debates with D about what food you are presenting to her. Hope this helps, and I am thinking of you.

busylizzie
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