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

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rdeb175
My 17 year old d, (diagnosed at 14 with An), is generally coping ok with food these days.  After a 6 month inpatient stay, she has pretty much stayed healthy weight restored, and eats independently and unsupervised when at school.  She is still on a meal plan, though is able to swap things round when needed and cope when we go out for dinner etc.  That said, I have felt that I constantly have to push her to eat everything required at times, and that I'm managing to keep her at her weight through sheer persistence and nagging, which at times leads to conflict, though she nearly always complies.  There's still plenty of anxiety around over food.

Well, we're just looking at universities for her to go to next year in September 2016 and she is telling me that she wants to be independent and that she thinks it's time for her to be discharged from CAMHS.  Camhs are saying to me, look, she's been weight restored for two years, things seem to be going ok, we will look to wind down support over the next 6 months.

So, what I've decided to do is to back off completely, not nag her about having enough, and wait and watch and see what happens.  She's in charge of her food, serving herself, responsible for making sure she has meals when I'm not around.  It feels like the right time to test this out.

Disappointingly, I can see she's having less than needed, not much less, but as we know it will show in the end.  And this is so hard, watching.  She will be weighed in two weeks time so I will see the damage then.  But this is the right thing to do yes?  If she can't swim by herself, I need CAMHS to step back into the picture, before she reaches 18, and to step up the support and not back off.  Anything else I can do?  Anyone else have this experience and any advice?



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sk8r31
This is a tough phase to go through...handing over the reins of independence.  There will likely be a period of up-and-down, as your d tries to feed herself appropriately without input from you.  It is a trial and error process, and it seems like this is the right time to do it....but still.  It's hard.

Have you read any of Psycho_Mom's posts recently?  She is also struggling in the same way, giving more independence, and then from time to time needing to step in with more support.  I think your d's illness timelines and ages are similar as well.

Sending warm support,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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Charbonie
Yes I would say you are handling it the right way. Sometimes it looks like it is not enough, but it actually is. That is the case with my d. She eats so many meals unsupervised, with friends etc. that sometimes when she eats with us it looks as though it is not enough, however, she is still weighed every 2 weeks and stays in her zone (in fact has increased) and looks and acts good so......the weigh-in is key!

Any 'failure' is feedback that she needs in order to learn what is and isn't enough food for when she will live on her own. Going to school is a great motivator. If you see a downward trend in weight after a couple of weigh-ins, she should know it and be able to increase on her own. If not, you will need to step in. Make sure she knows that in order to go away to school, she will need to be at a certain phase in her recovery where she is able to do it on her own. If she can't, it is not her fault and not a failure, she is just not yet quite to the point in her recovery where it is possible.

Good luck!

Best wishes,
Charbonie
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18 yr old d Dx Mar 25/14. WR June 2014. FBT/EFFT, Individual Therapy. In Phase III, eating intuitively, letting her plan ahead on her own re her nutritional needs for the day and how they fit into her schedule. Teaching her how to cook more for herself. Still watchful. Thankful every single day.

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Foodsupport_AUS
This is a difficult phase. We went through this 18 months ago. We know how much they need. They are often quite clueless. My D was convinced I was a crazy woman constantly over feeding her.  I could see straight away that D was not eating enough, she was convinced it was plenty. 

The big difference though was the response to weight loss. Every time she lost weight as she took over control, she increased her intake. She was often shocked about the results. Interestingly we found that we were better to weigh slightly less often to see a trend rather than pick up any fluctuations. 

Fast forward D is now able to feed herself at university without problem. She makes sure she eats regularly, picks up snacks to take with her without prompting. 


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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OneToughMomma
redeb, good question! 

We are kind of in the same spot in the Tough house and I think you are doing the right thing.  Right now H and I are also doing what my mom calls, 'Hide and Watch.'

Constant vigilance, and constant notes to self to not interfere.

We do have to let go sometimes, and better that we do it now when we have their backs, as you say.

Do keep us posted--many of us are in the same boat and it's wonderful to compare notes.

xoOTM
D in and out of EDNOS since age 8. dx RAN 2013. WR Aug '14. Graduated FBT June 2015 at 18 yrs old. [thumb]
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YogurtParfait_US
Sink or swim ... methinks that's a false choice. I think about my daughter's swim lessons as an itty bitty one with floats on her back, that were removed one by one, until she could swim on her own.

That's what we've gotta do with our kids with ED in order for them to recover ...

Sending warm support!
"Hope is a wonderful thing ... but hope by itself is not enough. Hope is the reason to take action, to make a plan and then to change the plan when it isn’t working - over and over and over again if necessary." Hannah Joseph (Let's Feast Friday Reflection, "Just Keep Going," Friday, March 3rd, 2015)
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rdeb175
Hello everyone, it's a while since I posted.  Last time I posted (see below) I was going to try the experiment of handing full control of food back to my daughter, back in September.  She lost a little bit of weight and CAMHS weren't too concerned as she still seemed to have a responsible attitude towards maintaining weight.  She even managed to put a bit back on with some encouragement.  But then she began to find it harder and harder and I started to wave the red flag.  CAMHS weren't that interested as they want to transfer her to adult services (she reaches 18 in July), but now we have hit a full blown crisis.  CAMHS woke up and said back on full meal plan, no negotiation. 

However, it's too late - my d says she no longer wants to eat, she doesn't care if she goes into hospital, she doesn't care if she misses college.  We seem to be back where we were nearly 3 years ago and my d seems unreachable, angry and aggressive and entrenched.  She hasn't eaten since tea last night and has refused her medication.

Meanwhile my ex says he no longer has the stamina to stand up to her and has said to her and me that now she's practically an adult it's her responsibility whether she eats or not, but he's not going to force her.  He can't handle the conflict, and the anorexia is raging ferociously at the moment.

What do the wise people here suggest - full blown non -negotiation (though my bargaining tools are severely limited at the moment due to school holidays), or a more softly softly approach.  But whenever I try and be sympathetic and say I realise she must be so anxious, she tells me to go take a running jump.

Frightened and stuck and on my own with this.  My d returns from my ex this evening...



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Psycho_Mom
Hi,


She has to eat enough to regain.

So do whatever it takes to make that happen.

I'd suggest that "non-negotiation" or a "soft touch" are not opposites, but both necessary and completely compatible in getting your girl to eat. Be completely firm and clear in what needs to happen and what the consequences will be if it does not. But at the same time, of course you are being firm because you love her and want her health. Staying calm and supportive and remind her often that you respect her and know her behavior is a result of illness. 

I'd also say, try to ignore nearly everything she says, if it's mealtime. IF she thinks it will get her out of eating, she will say or do anything. Anything at all. She'll say she doesn't care about school or having a life and she hates you etc etc etc , because maybe you'll give up and go away with that plate of food. SO. Your best chance of talking with your real girl is when there is no food in sight. But at this point, it sounds like you're still likely to get ed and not your girl.

That your ex says he doens't have the stamina to go through this again, is understandable and honest. BUT that he says it's d's responsibility now shows he unfortunately still lacks understanding of the basic nature of anorexia and mental illness. Would he read one chapter from Decoding Anorexia, or even a one page explanation of anosognosia? (Anosognosia being of course the symptom common to eds and some other mental illnesses, of the sufferer being unable to realize they are ill and therefore unable to help themselves.)

Can you get support, emotional or practical, from anyone else? Family, friends, coworkers, church? IT sounds like you're facing refeeding, and the good thing here is you've been through it before and you know what you're facing, and what you need. You also know you can do it.

OK? You can do this.

best wishes,



D diagnosed with EDNOS May 2013 at age 15, refed at home Aug 2013, since then symptoms gradually lessened and we retaught her how to feed and care for herself, including individual therapy, family skills DBT class, SSRI medication and relapse-prevention strategies. Anxiety was pre-existing and I believe she was sporadically restricting since about age 9. She now eats and behaves like any normal older teen, and is enjoying school, friends, sports, music and thinking about the future.
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Torie
Oh dang, rdeb, sucks that Ed is visiting again, and also sucks that it's going to take some work to get your ex back on board. Those who have done the heroic work of battling Ed deserve a life of milk and honey from there on out, and certainly NOT a repeat of Act I and also certainly NOT a need to find all that strength again and also strength to drag one's ex back onto the ED battlefield.

So it sure as heck isn't fair, but as PsychoMom said, your d needs to regain the weight so you will need to do whatever you need to do to make that happen.  Do you think it might help get your ex on board to stress htat since she will be 18 soon, ("adult"), you both need to jump on this asap while you still have leverage and adolescent services?

You're a fab mum, and you can do this.

xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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rdeb175
Thanks Psycho Mum and Torie - I know in my heart of hearts that I've got to get on with refeeding but I'm not quite sure how to do it given the last time I did it she was much younger and I could just demand it.  Now she's older I need a bit more of an adult approach and am worried that my tendency towards belligerent insistence isn't very helpful.  

  My d arrived back last night from ex in terrible state, hollow eyed and wild.  After a bit I got her to start taking her medication and a couple of hours later she made up the missed food she'd not had that day (she ate a bar of chocolate and half a jar of peanut butter but who cares!).  We went for a short walk and had a chat.  She did get very anxious about what she'd just eaten and went to bed in her clothes as couldn't face getting changed, but at least she didn't get rid of the food.  She told me that my ex had said I was too controlling and this wasn't helping her.  I agree I'm controlling but what's the alternative?

This morning she's complied with all food but off to work with a sandwich for lunch that I just know she's not going to eat.  I'm going to say to myself don't get hung up on everything, just try and win most of the battles and of course it will all tell in the weight - weigh day tomorrow...


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momon
hi rdeb 175

Wish I had wisdom to share but I just want to cheer you on. I can sympathize, I am trying to deal with a dip and my h is also unable to cope and thus undermining.

You made me smile  with  "belligerent insistence." That pretty well sums up my refeeding posture, so much for zen!

You know what to do and you will manage it. Somehow.  I wonder if someone else in her team can talk to your ex? It sure would be great if you had his help but if not, wonder if she could stay at your house only?
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rdeb175
Hello all - I thought I would give an update on what's been happening because it's something that I would never have predicted.  My d has spent the last 4 months restricting bit by bit, losing weight and then starting to spiral out of control.  We were on high alert with CAMHS and I was preparing for another possible hospital admission.  But then she suddenly decided to eat.  Back to her full meal plan without any confrontation, some encouragement at times, but she's decided to do it.  Now she talks about "when she's regained weight" and seems in a really good mood.  What's going on??  She's regained nearly a kilo in the last week (5 more kilos to go) so we're not there yet, but I didn't expect this at all.  She's also said that she's decided she doesn't want to vomit any more if she feels too full.  Whether she'll be able to stick to it I don't know, but she's certainly never said anything like that before.   Is it a honeymoon period before we go backwards again?  Who knows with this wretched illness.  
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Sotired
No matter what it is,just enjoy it.[smile]it may be that for now your d feels strong enough to fight.enjoy that,encourage it.even if it is just temporary,make the most of it.
Sotired42
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