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Torie

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Reply with quote  #26 
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Originally Posted by melstevUK
Rosa and all those not in the UK!

It is very difficult for anyone not in the UK to understand how not getting qualifications in school is a huge obstacle to moving on later - education is another area where there is not the same flexibility as in other countries. 
 

I'm not in the UK, and it's true that I don't understand your education system so this might not apply.  But here in the US, my d was rejected from her dream universities and ended up at her "safety" school.   There's a huge silver lining in that -  it's less competitive and less stressful. A case of be careful what you wish for, I think.  xx

-Torie

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melstevUK

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Reply with quote  #27 
Rosa,

'but when she is unwell the relationship deteriorates, she becomes suspicious, irritable and untrusting so the situation spirals down.'  Keep remembering that this is not really your d but the illness which is putting up barriers between you and her.  Try not to let it stop you finding ways to take action.

Who is responsible for your d's welfare in school?  Could you speak to that teacher and ask him/her to raise their concerns?  If noone at school is speaking out while she is clearly going downhill, that does not help the situation either.  

Torie - I didn't make myself very clear, I am aware of that.  Rosa's daughter's motivation right now is her education and if they can turn things round and get the weight going back on and keep her going until the end of May, then she will have the qualifications she needs for the next step of university.  She can take a gap year or more after that.  If she doesn't get through this stage - then her options are more limited and they will be options which she is unlikely to be motivated by, which in the long term is not good for her recovery.  The drive and willpower required thereafter and the possible belief that she has missed opportunities may well discourage her even more, that is my fear. I know I am not making sense to many but I believe I will be making sense to Rosa.  The important thing right now is to turn things around and get the weight going back on.  The service will, in any case, hospitalise her if the weight loss doesn't stop, and she will have to be taken out of school.  (Rosa - reminding her that hospitalisation will be the next step if she doesn't pull things back may be an incentive to eat more)  



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rosa

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Reply with quote  #28 

Thank you all again for so much wise advice.

Foodsupport_AUS
I agree that there is never a good time to recover and that the situation is urgent and that waiting allows the illness to gain in strength. I also agree that having clear rules and boundaries is important. However we have found that punitive measures or taking away things doesnt work well for our D (her self esteem/ self hatred are serious problems due to the illness); so we have found that goals- like university or days trips or special treats- are more effective motivators. The specific threat of hospital has also been motivating.
So we try and drop in positive thoughts eg "you will be able to perform better in exams and interviews if your brain is better nourished and healthy" and "Imagine if you are offered a place at uni, you could have a wonderful summer/ gap year if you are healthy/ well/ recovered" I try to get her to imagine the future herself- "How would you like to spend the summer if you were healthy?" etc

mjkz
Yes, you are absolutely right that health is most important and I am clear that I dont want my D to start uni until she is well recovered- ideally 6 months recovered with normal eating and socialising- as someone here advised. She is already 1 year "behind" her peers due to having to stop school for 9 months. It was absolutely necessary to stop school but is hard for her to feel "behind" and it seems to have affected her self esteem. She often feels that she is a "failure". It may be that she is not offered a place at uni and that she doesnt achieve her grades- in which case hospitalisation may occur- but I would fear that she would feel less motivated to recover in that situation.

melstevUK
Thank you so much, again. You are absolutely right that school qualifications are key for my D and certainly in the community in which we live. So, I am very keen to push on if possible and try and get my D through the next 6 months of exams and uni interviews. We would prefer that she continues at school so we dont want to threaten to stop school as we think that school will help her get her grades and we also think that it is positive for her to mix with healthy teenagers. She would actually quite like to work at home rather than go to school but we dont think it's healthy as the anorexic behaviours increase when she is at home, isolated and free to spend the days as she chooses.
It is a good idea to find barriers to behaviours but I am not sure how to stop the running. I removed her trainers so she ran in unsuitable shoes and damaged her toenails and feet- compounding her lack of self care generally. 
Yes we now have a meal plan but without times. She just gets angry with me if I mention it so my H tends to do that side of things. She often asks me if she should eat- she needs my reassurance- which I give.
She seems to like the dietician and psychologist at the adult ED service, she has mentioned them and quoted them. However, she did not attend the last appointment before Christmas and I dont know when the next one is. I am allowed to email one clinician so the team is fully aware of my concerns. They seem to listen and respect my concerns but are not able to comment on my D.

Torie
Yes, I appreciate that we need to careful for what we wish for. I recognise that my D's high achieving goals may not be the best in the long term.

MelstevUK
Thank you again. I keep trying to remind myself that it is the ED that is putting up barriers and making my D behave in such a difficult way- however I also try and request civil/ pleasant interactions.
I communicate with my D's teacher at school, she is keen to help but as yet I am not clear what we want her to do.
You are absolutely right that her motivation is her education so we are trying to support her through the next 6 months. In my opinion the best/ dream scenario is that she is offered a place at uni and achieves the grades- this would help her self esteem- then she can pause and we can focus on full recovery during a gap year- or even 2 if that is needed. I think that we could be totally clear and firm about recovery at that stage. Universities do not want to take students who are unwell.
During CAMHS treatment we were encouraged to help our D have interests and aims beyond anorexia eg hobbies and social life- and I think this is helpful.
The threat of hospital motivated her when she was previously very ill and low in weight. However, this is tricky as hospital then became a terrifying prospect rather than a therapeutic, positive sanctuary.

Thanks again to everyone.
Rosa

 

AUSSIEedfamily

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Reply with quote  #29 
Dear rosa,

While I understand that going to university is an incentive, there is the situation that university study is a lot of work and effort which can be and often is stressful and anxiety creating for all students. For our D I think it was that stress/anxiety that inhibited her recovery and had quite a bit to do with her relapse as she finished her bachelor of commerce Industrial Relations Human Relations (HR/IR) degree (with distinction and nearly honors).

Her chosen occupation of HR/IR proved to be a hugely negative experience as nearly all HR/IR work is mostly centred around managing workplace problems. Our D now runs her own business doing personal fitness work but in an oh so different way and her HR/IR degree is now parked and she uses her Certificate IV qualification (gained during her recovery from relapse) for her personal fitness work.

University study is for those with sustained and well established recovery. I have had long conversations with Professor Cynthia Bulik about University/College being a huge trigger for relapse especially in the US of A where so many travel long distances to live away from their family & home to study. Many on this forum have discovered that university/college created the ideal triggers for relapse.

If I had an opportunity to revisit our D's entry into university study with what I know now, I would have encouraged for a sustained period of life without ED before starting University and for at least 12 to 18 months with lots of work on relapse planning and prevention.

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frazzledmum

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Reply with quote  #30 
I have been reading this thread with interest as I am in the same situation with my D. The only difference being that my D does not want to go to uni and so we don't have that pressure, which also means she has not a lot of motivation to do any school work.

Melstev, thank you for your replies as they are as applicable to me as to Rosa, especially with your insight into the UK health and education systems. It's a fine line to tread here as it is so important that our kids finish their A levels as otherwise so many paths are closed to them and it is so difficult to for them to catch up - I would go as far as to say nearly impossible(which may also affect their recovery from ED as there is not a lot for them to motivate them to recover and aim for). That's why we feel that in a way it is better for them to finish school before really fighting ED, I totally understand Rosa's situation, whilst also realising that health always comes first and ED D will not be able to perform in exams as well as she would if she were healthy. Here in the UK, we are stuck between a rock and a hard place. 
However, I would like to add that it is possible to resit A level exams (often in November) if the results are not what you had hoped for. This would have to be done privately and you would have to apply through an independent exam centre (usually a private 6th form college) as an external candidate. Failing this, if you speak to the school and have a good relationship with them, they may, in some rare cases allow students to resit year 13, but this is solely at their discretion (they are more likely to allow this if the student is a high achiever as this will help their exam results statistics). For my d, she says this is not an option as she will not spend a minute longer in school than necessary, never mind a whole year. Apart from these options it is very very difficult for anyone to finish or resit A levels and these options need to be explored very soon after results come out in August as there is not much time to put them into practise. Rosa, I hope this information helps.
I would totally not allow ED D to go away to uni without being completely recovered, even if this means taking a gap year or 2 and feel lucky that we do not have this to deal with as well.
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Reply with quote  #31 
Hi frazzledmum,

Thank you for that reminder.  I am in Scotland and we do not have re-sit possibilities in November.  That does give Rosa's d more options, that's for sure.  It also gives the possibility of improving her grades if she feels she wants to do that, and is in a better place healthwise at that time, which can take a bit of the pressure off too.

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mjkz

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Reply with quote  #32 
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However, I would like to add that it is possible to resit A level exams (often in November) if the results are not what you had hoped for. This would have to be done privately and you would have to apply through an independent exam centre (usually a private 6th form college) as an external candidate.


Rosa, I would put all the things we talked about that worked into place now knowing that she can take the levels in November rather than June.  I think it would send a very clear message to her that health comes first overall and she would be in a much better place to do the exams, etc. once she is weight restored and can concentrate better.  You could still use the taking exams in June as a goal but you wouldn't have to be so focused on treading a fine line to get things done by June.  With this as leverage, maybe she could do it in June but at least you would have another option if she balks at stopping exercise, etc. 

I truly do know how exhausting this is but you are not powerless.  If FBT worked in the past, then by all means go back to it.  You do have options!!
rosa

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Reply with quote  #33 
AussieEDfamily
Thank you for the advice that university is for those with an established and sustained recovery of 12-18 months. This makes absolute sense to me as I can see that the uni environment can be an ideal environment for a relapse. I will definitely bear this in mind- I plan/ hope for my D to be fully recovered for as long as possible before uni.

frazzledmum
so sorry to hear that you are in a similar position to us. I did not know that it is possible to resit exams in November so I will research this option locally.

mjkz
thank you for your suggestions- I realise that I need to make it clear that health comes first. Recognising that I have options is very heartening. I understand that FBT approach may be the best option.

So our current situation is that my D has A level 'mock' exams next week. My heart is aching for her as she is so stressed. She is stressed about the exams and trying to recover. My compassion is greater than it has been at times and I find that this improves our relationship and she therefore feels more strength to try and recover. For her some of the anorexic behaviour is like self harm due to self hatred so when we are loving and supportive this helps her to 'allow' herself to eat and reduces the duration/ intensity of exercise.

We are trying to be supportive at the moment- just gently encouraging her to follow the meal plan and reduce exercise. After the exams in 5 days time we will be more firm/ tough.

I went to the monthly parents support group run by our ED service. There was around 14 parents there and 2 therapists. Both therapists are excellent- experienced, reflective, not defensive, good at listening, good at managing the group. My H came too and we were able to discuss some of our concerns. The professionals recognised the limitations of CBT and agreed that it was partly due to being cost effective in an underfunded service. They also agreed that therapies have phases/ fashions. Our experience with FBT was that my D was able to get 90% weight restored and this happened numerous times over 4 years- she just couldnt seem to get above a certain weight (56kg) which was clearly not a high enough wt for a full recovery. I think that she need to reach at least 60kg and to do this she needs psychological motivation which CBT can help with. So I think that she needs a combination of both FBT/ serious weight restoration/ with CBT style support.

Rosa
Torie

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Reply with quote  #34 
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Originally Posted by frazzledmum
 It's a fine line to tread here as it is so important that our kids finish their A levels as otherwise so many paths are closed to them and it is so difficult to for them to catch up - I would go as far as to say nearly impossible(which may also affect their recovery from ED as there is not a lot for them to motivate them to recover and aim for).


Thanks for the information about the importance of A levels.  I'm trying to understand what the specific impact is - apparently very different from the US as Melstev has said.  We have a lot of different post-high school options, ranging from community college (low stress and low prestige) to highly selective universities that offer high stress and high prestige.  If a student does well in a community college, s/he can transfer to a more selective school after a year or two.  Pretty much any subject can be studied in any of the colleges / universities so if the student chooses classes wisely, the credits will transfer to the new university. Community college is much cheaper, but whatever the expense, the family is responsible for paying (with scholarship and grant options a possibility for many). I think university is paid with public funds in Germany and Denmark, but I don't know how funding works elsewhere.

I'm curious to hear how it works in the rest of the world.  xx

-Torie




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melstevUK

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Reply with quote  #35 
Hi Torie,

I know, it can seem strange to anyone outside the UK.  There are options of course, for moving on - you can get A levels or other vocational qualifications at further education colleges which will lead to credits, which you can then use to apply for university afterwards.  So there are other paths and the flexibility to do that.  This works well for young people who hated school but find that they want to get back into education at a later date in their lives.

If you want to do medicine or veterinary medicine, though - you could never achieve that at a later date. Both disciplines require grade As in all subjects and passed at the same time, as the competition is huge.  So if someone was ill and missed sitting their A levels, their chances of ever getting into these professions at a later date would be virtually impossible, however brilliant they were.  

Most pupils, if they are reasonably academic, expect to pass their A levels and then move on to university, unless they have a different kind of career in mind. They might take a gap year and they might not get their first choice of university but there will be other universities offering places.  

Most of the department stores would require young people to have A levels these days, so you would have limited choices even if you wanted to work in a shop.

My concern for Rosa's d is that, if she cannot take her A levels in May or November - she will find it incredibly difficult to have to go to college, with a new peer group, a new environment, and likely with a huge sense of failure because this is so far removed from her dreams in life.  I think it will be very hard to accept that as a compromise route if she has anxiety issues already and is fighting her illness.  If she can push through this period and keep getting weight on - she can sit back and take time to recover and mature and gain in confidence afterwards.  Having dreams in life is a big motivator for recovery, and if those dreams are dashed, recovery could prove even more difficult in the longer term, and it is the long-term picture here which I am looking at here.  

Rosa: if your gentler approach is working, stick with it if it is getting results.  I am glad you have a support group to attend too.  Support on the ground makes a big difference.  I am so sorry for what your d is going through.  I always found it difficult to imagine what the worst thing that could happen if I failed any exam was taking.  If I could accept that worst thing, then I found exams less stressful.  I wish her luck and hope she gets the results she wants.
 

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frazzledmum

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Reply with quote  #36 
It's as Melstev says and also it is important to know that not all colleges are the same and not all offer the chance to do A levels if that's what you want (certainly where I live, these are mainly taught in schools). Mostly you would need A levels to go to uni, but there are other routes, though not to the top universities or the best courses (where most of our ED children will have been planning to go). Many colleges now offer very piece meal courses as well, making it difficult to actually choose the right one for your needs. Another thing to bear in mind is that at 18 the government funding for education runs out and you have to fund courses yourself (generally through loans from the government). As Melstev says, many employers now ask for A levels even for the most junior staff.

I totally agree with Melstev about college not being the best place for Rosa's D, my D too would find it too stressful, which is why she has stayed at school, which is familiar and importantly her peer group.
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Reply with quote  #37 
frazzled mum melstevUK Torie
Thank you so much for your support and concern. My D stopped school January 16 for 9 months as she was so seriously ill- we have prioritised her health many times. It may be that she will need to stop school again but we are desperately trying to support her to continue her studies as A levels are important as discussed here and retakes are not straightforward.

melstev- my 'gentle' approach is not working in that my D is continuing to lose weight and run too much. A firmer approach just seems impossible this week with her exams. We continue to try and appeal to the small part of her that is motivated to get better. However this feels so wrong as I feel that I am watching her disappearing again down the anorexia vortex. As advised by our team, we try and be kind and compassionate and trusting of the process (just agony for me). With my 'gentle, compassionate' approach one positive is that my D is communicating with me, asking for hugs etc. I like to think that this is valuable?

So, today D was meant to have 2 exams at school. Last night she said she was too anxious to go to school so arranged for the exams to be done at home today. She is now running. I believe that the exercise compulsion is so great that it dominates many decisions. As the weight drops, the anorexic voices are louder, the compulsion to run and do many other OCD type rituals increases- so the vicious cycle continues. Aarrgh.

I have emailed the Eating Disorder team and have a carer's appointment this week. I believe that they understand the situation. What shall I ask for/ discuss/ demand?

I am drowning here...
Rosa
Torie

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Reply with quote  #38 
Rosa, when is her last exam? 


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rosa

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Reply with quote  #39 
Torie
The last exam is on Friday this week. These are 'mock' A level exams. She will then continue with studying at school then the actual exams are in June 2018.
dc

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Reply with quote  #40 
Hi! Rosa,

Thanks melstevUK for the explanation of UK education system. It is different from the one in US. I understand that your D needs to take A level exams in June 2018, however she is suffering from ED. It is really hard for her to focus on studying and gain weight at the same time. Like your daughter, my D is a runner. During the last 5 years of fighting with ED, there were only two times we fully stopped her running and helped her to gain weight: One was we dropped her out of middle school in 2012 and kept her at home to do re-feeding. Another was she took PHP therapy at UCSD in 2017. Basically only in an restricted and monitored environment, her running was stopped completely.

In your case, if you really couldn't stop her from running, can you try to do the following things:

1. Running is really bad for AN because it not only consume too much calories, but also enforce the rigid thinking and perfectism. Is it possible to convince her to switch to other sports like table tennis which are less energy consuming?

2. I remembered that one day D told me that the reason she wanted to run was to release her anxiety and stress. Is there any other ways to help your D to achieve that instead of running? For example, watching sitcoms or playing with pets. D and I watched Fresh Prince of Bel-Air, The Complete Series during the re-feeding phrase.

3. If 1 & 2 are not working (most likely), you need to add Ensure or Boost on her food.

4. I suggest you to measure her heart rate and blood pressure at least once a week. When my daughter's weight was really low and she was still running, we found out that her heart rate was only 48. At that time, she also complained us that she felt pain on her chest when she was running.

5. You may also need to check her bone density. 

If both heart rate and bone density are not good, ask her doctor to use those medical report as scientific evidence to prove that her health condition is bad, she should stop or reduce her running immediately. I heard that some excessive runners with ED eventually got injured on their legs or hearts, their body forced them to stop running. Check out the following links for more details:  Confessions Of An Anorexic Runner The Role of Running in Eating Disorders , Eating Disorders and RunningTraining On Empty: A Runner’s Struggle With Anorexia and the book Running in Silence.

If her health is in danger, it doesn't matter what tests or exams she has to take, she has to restore her health first.

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19 yr old d Dx Feb 2012. WR June 2012. Now she is in Phase III and enjoy her study and activities. Try to give the control back to her but still keep vigilant. 
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Reply with quote  #41 
Hi Rosa,

I really am sorry for the hell you are all going through.  

Was your d sectioned last time or did she go into hospital willingly?  I think I would get through this week but ask her team about the possibility of her being taken into hospital next week.  I know beds are in short supply but the situation is desperate again.  If you cannot stop the running, but more importantly the weight loss, then it needs to be stopped in hospital.  She could still do some studying in hospital, the school would give her some assignments but motivation in itself is not going to work from what you are saying.  Unless you can stop the running there is going to be no progress and the spiral down will continue.

We all have to find the one stand we think we can make to bring about a change in the dynamic.  How do you feel you can best stand up to this illness, or does hospital feel like the best option?  

I would insist that she sees her GP straight after school tomorrow, if you can get an urgent appointment, so that her heart and blood pressure can be checked.  You need to be able to get through to her just how seriously ill she is again, if nothing else.  It is so not easy.   I really feel for you.


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Doitagain

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Reply with quote  #42 
Hello Rosa - I am so sorry things are so tough. But Rosa I am also so sorry I did not see your post earlier. Please slow right down now, pause, regroup , and cancel all of these exams. Your daughter does not NEED to do these mock exams at all! They do not count towards, and have no bearing whatsoever ,towards her final A level result or her future. One thing I did do was simply tell, not ask, the school/college that we would not be doing any mock exams whatsoever. It created stress at GCSE that I was not prepared to repeat at A level and there is no reason at all other than being swept along with the panic hype our education system throws at us.

Better she spends those mock days tucked up in bed with a hot water bottle, loads of tlc, and a CGP guide - If she insists! Do not panic. Save your efforts for the real exams in the summer . My D was two years out and ended up with a very honest personal statement and unconditional offers from some top universities for an academic degree course.! Send me a private message if you would like to and I would be happy to chat as have been there and worn this t-shirt. It is good to tell your education provider that this is what you are doing and it is for indisputable medical reasons. If you really want to dot the i's and cross the t's , then get a copy of the mock later.

Most importantly, tell your D that you have sorted this, it is in hand, it is all agreed, everyone is very happy with the arrangement and wishes her well , and that she doesn't need to think about any of this now until the real thing. Tell her you are proud of how well she has done with her studies but she is smart enough, and Ill enough, to only do what is 100% necessary now (and mocks are 100% irrelevant ) and that she absolutely deserves a break now. Go to the emotion, empathise, and take the pressure off for her as she won't be capable of doing this herself and might feel she is letting people down - anorexia as we know, loves to create self loathing and guilt. It is key that you tell your D, who is undoubtedly like all of our D's , a perfectionist - that everyone has agreed and is very happy with this plan for her. She can look at the paper next week at home but only if she wants to.
Please remember that there are many many self-study or independent /home schooled children who end up exactly where they need to be including Oxbridge etc. Fighting for recovery from an illness does not deter universities at all - quite the contrary in my experience. I feel for you - it's horrible but know that we are here for you x
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Reply with quote  #43 
Great reply doitagain,

Sounds like a personal exchange between you and Rosa is the way forward.

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rosa

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Reply with quote  #44 
Apologies for slow response- I have been wanting to reply but work and life is hectic and I have very little privacy...

dc
Thank you so much for your extremely useful advice and insights about running and the excellent links. I am taking it all in and trying to work out a way forward.
My D has had bone density done twice and she has osteoporosis and has been prescribed oestrogen to help her bones but she has not taken a single pill due to fear of weight gain which is not at all likely as it is a very low dose. Sadly she is not rational due to the anorexia so I am not ale to reason with her.

melstevUK
My D has never been admitted. She has not wanted to go voluntarily. She was close to being sectioned numerous times in 2016. I would love her to go to the GP for weight BP pulse etc, but she is so focussed on studying, running and anorexia, that it will be hard to persuade her but I will try. The illness is so strong/ severe that it is hard for me to stand up to it.
I had a very supportive meeting for myself at the Adult ED  Service today. I was able to raise all my concerns. I think they are aware of the issues and familiar and experienced. They could not give me any information at all- as I knew. They are waiting for my D to recognise that she will only be able to get through interviews and exams if she is well. This may happen soon or may happen later.. 
I think that my D may be reading my posts here- she is so smart, and so anxious, it is very hard for me to have any privacy. She manages to look at my phone and my emails, she listens to conversations standing outside rooms, she quietly walks around the house and comes into the room suddenly...

doitagain
Thank you so much for your kind support and advice. It seems that you have been in a similar situation- and your D is now well- this is so exciting and hopeful for me. I would very much like to private message you- how do I do that?

Rosa
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Reply with quote  #45 
Rereading my posts, I fear that I come across as a weak, over kind parent- not being tough or firm enough on this tyrant anorexia.

This is the approach of our ED service.. but it seems so different to many other services..
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Reply with quote  #46 
rosa we are all doing the best we can with the resources we can. The question is can we tweak things to get a better result when we have more information. 

ED is a tyrant, and most of us have experienced that ED rage, which can be very difficult to manage. My D was particularly good at making me doubt everything I thought or was doing. Her reasoning sounded so rational at the time, and I would really have to take three steps back just to get my own head in order. I found it useful to make some non-negotiables in my own head. Things like going for regular check ups were one of those, as was insisting on continuing treatment and management of her ED. Making a few small important things then not trying to reason but insisting it happened made it much easier. 

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mjkz

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Reply with quote  #47 
Quote:
Rereading my posts, I fear that I come across as a weak, over kind parent- not being tough or firm enough on this tyrant anorexia.

This is the approach of our ED service.. but it seems so different to many other services..


Sadly you got a bad ED service which is not your fault in any way.  You do the best with what you have.  We did every other kind of treatment including what you are doing for over 10 years before I finally said enough and went with my priorities of health above all and realized my sacrificing my short-term relationship would pay off i the future.  You want to help and keep the boat steady during high stress times.  Now that you don't have exams to worry about, I say you go Mom.  Go back to FBT and get her where she needs to be to be successful on the real exams come June.  A lot can change in a little under six months.
rosa

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Reply with quote  #48 
FoodsupportAUS
Thank you for your support. I can see that it is vital to have some non negotiables written down so that the anorexia tyrant is limited. I am trying to work out which battles to fight- trying to prioritise..

mjkz
Thank you for your support. I find it very encouraging to think that you made progress with FBT when your D was in her 20s. I am trying to keep the boat steady in high stress times. The exams are out of the way but D has an important uni interview in 10d time. If she was successful in this, whatever happens next, she may not have to go through the incredibly demanding uni application process again. So I am trying to keep her going for the interview then pause and plan. This interview is an incredible motivator for her- though clearly not enough to counteract the anorexia bully. 

The stress levels in our house are so high. The exams are over but it is 10d to the interview. My D is so anxious as she really wants to succeed in the interview yet is aware of how ill she is. I feel so sorry for her. She is very hostile and irritable. She is trying so hard to fight anorexia, alone, using the CBT-E approach- trying to eat. But I think she is losing the battle and recognising that she is exhausted and needs help. She says she is going to see the ED team this week...

Rosa
mjkz

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Reply with quote  #49 
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This interview is an incredible motivator for her- though clearly not enough to counteract the anorexia bully.


If you are seeing how clearly she is going downhill, then maybe the interview will have to wait.  She could really blow it and then you've lost that motivation.  I can see positive both ways.  If even the interview is not enough motivation at this point, that tells you how sick she is and how much help she needs.

If you are set on getting her through this interview, I'd start making changes now and couch them in terms of getting her mind clear nutritionally so she can think and do her best at the interview.  Make eating required and don't let her off without eating three meals and snacks.  At this point it sounds like she needs help and is starting to recognize that.  Make sure the interview is really something she wants to do and not something she thinks is just expected.  If she does, then I would step in and help her turn this around.  If not, then get a hold of the ED services and see what can be arranged. 

As much as she might know what she needs to do, I doubt she is able to do it at this point and needs someone to sit her down with food and coach her through the meals and snacks.
rosa

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Reply with quote  #50 
mjkz
Thank you- my D is fixed on doing this interview as she sees it as a goal to get her out of the anorexia hole she is in. I agree that I am not sure she is able to manage 'alone' - I think she needs intensive support. I am frequently reminding her that her brain needs nutrition but she just gets so hostile and angry if we try and help her. I feel frightened for her- all options seems so hard..

Rosa
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