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

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We are 2.5 years into our journey with AN that began when our d was 11. She has never engaged with therapy. If anything, sitting through a session with a psychologist made her angrier than sitting down for a meal. So my question is, assuming we can continue to make progress with weight restoration (slow, but steady), is therapy (CBT or whatever) essential to recovery at this age? Is it possible to "grow out of" ED behaviours without psychological counselling?

I have been told by her school that therapy is 'absolutely necessary' to recovery. I just don't believe it. I think it's a big ask to assume that she would have the self-reflection required for effective therapy. In our case, my d and I have developed a very close relationship. It's been a very steep learning curve for each of us and we don't always get it right. There is no straight path in recovery. So when I'm told that therapy is necessary, I feel that I am being told that her recovery is beyond my expertise. There are days when I want nothing more than to outsource her recovery to a professional, but it's been unrealistic.

I would love to know what you think. Stay safe!

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.
There are plenty of children who have recovered without therapy, whereas others like my D have required extensive therapy. I know that @mamabear 's daughter did not have therapy, and she got sick at 10. I am not sure what the school is likely to know about ED's. Good therapists are age appropriate, so her ability to "process things" will be different at different ages and stages. 

Where my own D has benefited from therapy is in learning new skills to deal with stress and anxiety, learning new tools to deal with her own values and using those values to help her fight her ED, along with being helped with her severe depression when at her most ill. She herself is now keen to continue for support. 
D diagnosed restrictive AN June 2010 age 13. Initially weight restored 2012. Relapse and continuously edging towards recovery. Treatment: multiple hospitalisations and individual and family therapy.
I have never been convinced that my d's therapist was a help.  If she was a help, I think that help was minimal.  The bigger help - by far - was when CHOP told her she needed to eat whatever I served her.  Keep feeding. xx

"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
Hi Barberton,

There are few good options for therapy where we live. In the early days, my son absolutely rejected therapy of any sort. No wonder because his BMI was so low that there were pauses in conversations because his brain was processing so slowly. Later, they wanted to send him to a group CBT class for people with ED. He was still very young (13) and I was concerned that most would older than him and also all girls. I also did not like what I read in the book they used. So there was no choice for us even though I do think that he would benefit from a little bit of therapy.

What I think is important is the nutritional rehabilitation. Personally, I think it is not just the calories but all the vitamins, minerals, proteins etc that bring the body and mind back to proper functioning. I do like Tabitha Farrar's idea that there are actually two aspects of recovery - the weight/nutrition and then the fading of the habits of whatever eating disorder you have. That is the stage that we are at. My son is well, healthy and happy but left to himself the unconscious habits of taking smaller amounts than required or the lighter option or not seeing how essential it is not to miss a snack. The habits are still lurking. Damn it! But luckily younger kids are at home for a long time and we can consciously work to eliminate those bad habits over the years. I do think it might be easier for him to hear some things from someone else because he always thinks I am over exaggerating!

Remember, too, that the question of therapy is one that you can revisit if your daughter is feeling better, if the option of a therapy that is a good fit arises or if your daughter's subsequent behaviour seems to warrant it.

Warm wishes,

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.

deenl wrote:

Remember, too, that the question of therapy is one that you can revisit if your daughter is feeling better, if the option of a therapy that is a good fit arises or if your daughter's subsequent behaviour seems to warrant it.


There may be a time where therapy could help. It is not an all or none thing.
For the first two years I don’t think therapy would have helped my d  but now i think she could be taught skills to manage anxiety. I actually feel that CRT cognitive remediation therapy may help my d, if and when she is willing to go. 

I would just recommend keeping your options open and continue to evaluate and reevaluate her needs over time. You never know what amazing treatment may come up that she could tap into. 

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)

My ears were burning... 

We tried therapy when my D ( then 10.5) was diagnosed. It was a complete waste of time. The therapist was awesome ( via Skype) and agreed that it was not useful. FOOD and gain and time were the most important priority. Engaging in any formalized therapy was not going to happen. 

We ended up never needing any therapy. Once her brain righted itself we were able to work through everything together over the following years . 

She is now almost 20 and has seen an EMDR therapist on her own for PTSD from some major traumas ( won’t get into it here) and has some anxiety but is able to deal with it via her music, artwork, going outside  etc. 

I like the above advice. It can always be revisited.
But yes- my daughter fully recovered without formal therapy . Tons if mom and dad therapy 😘

Persistent, consistent vigilance!
I have wondered this exact question so many times. My 15 year old D has never engaged in therapy. If anything, the days we saw our therapist were the worst days of all. She was angry and we were upset with her lack of participation. We are approaching 1 year from diagnosis day and we are doing better. We haven’t seen our therapist since January because it really felt pointless since D would just sit there. We haven’t pushed to go and just done the hard work at home on getting our D to open up. We have made a lot of progress in the last 3 months. D is weight restored, happy, eating adequate nutrition everyday and now we are trying to break the ED behaviors that continue. It is good to hear that others have succeeded in helping their kids without it. 

Thank you, everyone, your reassurance has lightened my heart. I agree with what everyone has written and I appreciate that we all seem to have accepted the need for flexibility in our approach to recovery. 

As far as the school is concerned, I've been very hesitant to criticise because I need and want their support for my d. Their intension is well-meaning but I will stick with my gut feeling that external therapy is not 'essential' at this stage. I am trying to encourage more interaction with the school's counsellor and promoting more group development sessions (discussions about friendships, coping with feelings, etc).

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.

Hi Barberton,
I just wanted to share with you that my D was exactly the same, never engaged, with anyone, once, ever.  We too have a really close relationship, but this is one thing she just couldn’t (or wasn’t allowed) to talk about, apart from the odd rare moment with me. We got to the point last November when her lack of interaction led to therapy being withdrawn. An Ed specialist once told me that some people go through this without ever sharing anything and come out the other side recovered and I’m really pleased to say that I think my daughter is shaping up to be one of those people.  

3.5 yrs in and she’s back, eating things that haven’t been eaten for years, not so regimented, open to trying new things and eating out regularly, sociable, loving life and looking forward. We still have some behaviours but I know together we can continue working on those.

I guess we will never know how beneficial the therapy she had was, but I do know that not having it hasn’t impacted her recovery at all.