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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Alwaysthere
Now that I have a better sense of how serious this disease is and after hearing from my sibling that the next step will need to be a treatment center for a month... I'm finding it hard to find the right words to help her stay positive. She's not stupid, she knows going away isn't going to be great. Her and I both know it's going to be scary, lonely, awkward, etc... To tell her to try and think positive just sounds disingenuous and hollow. If I were her, I wouldn't want to hear the false upbeat, "actually this is going to be good!"

I just don't know what to say to make it better/easier to face....
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kazi67
Not sure if this helps as it was all a bit of a blur when my d was admitted and she was VERY ill and medically unstable at the time 
but our mantra was “to trust the process” when I didn’t know what else to say that is what I said 
My understanding of your post is that your sibling wants the help? Is that right? 
if so that is a really good sign

i would also tell my d on the very tough days how fortunate she actually was to have a bed and to be getting the help she needed
(just a pity she didn’t get it before she got so ill)

its not easy but your sibling is very fortunate to have you, your support is so important to her
i found being loving and positive no matter what mood either of us was in was really important too

i did a lot of crying driving back and forth to the hospital but not in front of d, I put on my happy face in front of her 
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scaredmom
It is awful and I don’t think there is one thing to say that makes the feelings better, tbh.
i think reframing that this is an illness that needs more supportive and specialized care and that inpatient or more intensive therapies are part of the journey. I wonder if you tell her this is a necessary step to move forward it could help? 
I want you not to lose hope. It will really help her keep as positive as she can.
all the best
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Alwaysthere
Thank you scaredmom and kazi67.

I know I need to stay positive for her. I'll be honest though... my thoughts go to places like, "what if this new treatment doesn't work?" "what if she can't have children because it would be unsafe?" (she's in her thirties and just starting to tackle this). It makes me sick to my stomach to think about these things. Maybe that's why my positivity about the situation sounds forced? I really don't know if she's going to be ok. Reading all these different stories with different endings... makes me afraid of which one she will be.
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sk8r31
I don't know if it's been suggested to you before, but there is an excellent resource for siblings that you may find hopeful and helpful.  Here is the link to Kymadvocates, where there are some wonderful, supportive stories that are most definitely positive.

Sending you warm support.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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scaredmom

Alwaysthere, I know you are worried, anxious and scared. Who wouldn't be?  I wish to point out some huge positives here:

She is getting care for her ED, she does not seem to be refusing that  care and walking away from you and others wishing to help her. She knows it is going to be hard work and still wishes to get help! That is a big one! 
She has you every step of the way. If you have not done it already, please go to the link for siblings that sk8r31 has posted. You can find support for yourself too that can keep you strong for your sister. This illness takes a lot out of all of us. You need to be in the best health and mindset to help her. There is a huge learning curve and hearing from other siblings may be really helpful. 
There is always hope, there is always a way out. She is starting on this scary journey with you alongside of her!She is very lucky, she has you! It may not be a smooth easy road, but it is an important life altering journey you are both embarking on to make her healthy! That is positive, positive, positive!! And if this part needs some tweaking you will tweak and figure another way forward. I used to be so black and white in my thinking about ED, that if A did not work that there was no plan B, now I know there are so many plans and roads to Rome! You try something now and see how it goes. It may be so much better than you both could have imagined. If not you take a new different path. No matter what the Education will serve you well on your ED travels. You cannot help but learn and it will empower you.

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

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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mjkz
I think it is positive she is willing to take that step.
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kazi67
Alwaysthere
its totally normal for you to feel anxious and worried about everything 
there are lots of stories of adult sufferers who have recovered so please don’t give up hope
recovery is definately possible no matter the age or how ill they are
my d and many others are living proof of this

i too worried about wether  the damage ED had done to her body and if it was beyond repair (her period had stopped for 2 years) when I sat with her in hospital and she cried and SH and had no will no live it was very difficult to see her like that and I’m only now slowly recovering from the trauma of it all

but honestly she is living life, socialising, working, laughing (omg I love it when I hear her laughing) and her health is good 
she tires easily and rests her body more these days instead of running around like a maniac 
my guess is her body is still doing a lot of interior repairing (her periods returned too)

my councillor said to me (when we were in the thick of it and having very difficult days) to take one day at a time and not to think too far into the future as this caused anxiety (as like you I would start worrying about her health and the damage to her body) also she told me not to look back as that caused depression, so that’s what I did and that helped a lot

we lived in the moment, right now, not looking back  or forwards - this minute,  right now 
maybe you can try this too it really did calm down not only mine but my d anxiety as well

now as she is recovering, we can look to the future and feel excited and happy about the future instead of fearful and worried but this did take time it is unfortunately a slow road to recovery but so worth it!

try to take time to do something nice (self care) its very hard to think of yourself when very worried about a loved one but important to look after yourself too so you can be the best version of yourself for you sister
a cuppa with a friend, a movie, massage, enjoying nature/outdoors or even listen to some nice music can help to lift your spirits 
 how lucky your sister is to have you!
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Kali

Alwaysthere,

I hope that residential will be the beginning of recovery for your sister. 
If you are close enough to visit her I'm sure she will appreciate it. And sending her off with some small gifts:  giving her some music playlists and/or journals to write in or art supplies/craft supplies if she likes to express herself like that might be a way you can show that you care.

When my d. was in residential—she was there for 3 months—I honestly felt that she was doing the best thing for herself even though I was horrified that she was so ill she needed to be there. It is not easy to be confronted with the thing you are most frightened of—eating—3 times a day, and then gaining weight, but I hope that your sister will be in a center where they take weight restoration very seriously and then help her to create a step down plan upon discharge to get the treatment she needs. There may be family sessions as part of her treatment (it was required where my d. was)

At the point at which your sister has been through some treatment and returns home perhaps it would be helpful to attend one of the adult weeklong sessions where family/partners also attend as supports and you can all work on figuring out how to best support her as she moves through learning how to nourish herself both with food and with life.They have one out in San Diego at UCSD, for example. 

I think that this is really great news that she is willing to go! 
warmly,

Kali

Food=Love
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deenl
Hi Alwaysthere,

My son's two brothers were younger than you are but I think there are some principles that still apply. 

I encouraged them to be his brother, to distract him with conversation about common interests, to play games and do crafts and hobbies, to touch him in a normal way when he wouldn't let us (his parents) touch him. My idea was that they could show and guide him in normal, everyday life. He was so caught up in his illness and own thoughts that he needed their example to guide him back. I think you could do this for your sister too.

I also think that your name gives you a tip - alwaysthere - to listen, to acknowledge her fears and pain, to let her know she is loved. Just listening and validating will be much appreciated, I think. I don't think you have to fake a forced positivity. A realistic view that this is very challenging but you stand with her during the tough times will be both honest and help her through. And is a much more helpful word than but for this purpose. Just to give a rough example "I can hear a lot of emotion in your voice.(making the conversation about the person) It sounds like you are very stressed. Is that right? (Naming the emotion, people with ED often find this hard. But with humility that you might have gotten it wrong. Provides opportunity for them to say what they do feel)... It is indeed very tough to follow the rules day in, day out (acknowleding the difficulty) and (but invalidates her difficulties while and acknowledges the two sides of the coin - it's tough and it what she needs) even given that, I see improvement in .... (name a specific benefit, preferrable one that is important to her and not weight/health related, like reminding her of some days she felt emotionally more stable, or extra freedoms she was allowed because of following treatment plans. For my son it was the ability to think and learn again and his sense of humour coming back) If appropriate, encourage them to hang in there. And then change the subject - I used to sometimes jot down bits of family news, funny headlines, a joke I'd heard and surreptitiously look at it so I would always have a change of topic. This used to help my son get back onto an even keel. At other times, a 'What can I do to help make this process easier?' can be helpful. You are not offering to get her out of the situation but to do what you can to make it easier. 

Many loved ones of older teens and adults have found it motivating to talk about the future they are hoping for and how being unwell is making that more difficult to achieve. Listening and encouraging her dreams, reminding her of them at times helps them focus on the big picture when the nitty gritty of eating day in, day out is wearing them down.

Much of what we as parents have to learn is to tolerate our distress and their distress. This applies to siblings and partners too. From our point of view it is horrible to see our loved ones sick and in pain, it is very upsetting to feel so overwhelmed with fears and so unable to rescue them. If you search for distress tolerance on the forum, you will find resources to help you learn what is an extra skill over and above what is needed for normal life.

It is possible that your sister may get more upset while inpatient and call you in distress, my son did. It helped me to think of the treatment in a similar way to chemotherapy - it makes the patient feel very much worse but it is essential for a full, long and happier life. I used mantras to calm my own sadness so that I could validate how hard this was for him AND provide encouragement (as a parent, I could insist but a sister will be encouraging) to stick with it. The mantras I used were 'Short term pain for long term gain' 'You have to be cruel to be kind' and 'When you are going through hell, keep going'.  The mantra's were just my own thoughts to help me be brave and strong. I don't think my son would have been helped by them. There  may be times when you have to take your courage in your hands and say something like 'I love you to bits and I hear/see/acknowledge how very challenging recovery is. Because I love you so much I am sorry but I cannot ... agree with you leaving treatment / you hiding this behaviour from your treatment team / come and collect you or whatever.

The other aspect to learn to tolerate is your sister's distress. It is very, very sad that recovering from this illness is so tough. It is heart wrenching for us to see but at the same time very important that we are honest that they need to get through it. We cannot and should not rescue or relieve this distress. They need us to surround them with as much love and kindness as possible, yes and also be strong for them when they are at their lowest. It is in your sister's long term interest to continue in treatment and making it through the really rough times is empowering for any human being and gives us the strength to fight future battles. If we are 'saved' from the tough times we come to believe that we are not strong enough.

One thing I did learn is that my son cannot tolerate heavy discussions so little and often is a better strategy for him. 5 minutes of heavy talk and then on to lighter topics. Another thing that worked well with us once he was had started to recover was using humour. For example, 'This food looks gross' Me: hamming it up, clutching my heart and putting on a thick accent "Jaysus, I'm wounded. How could you say such a thing to your poor oul mom?" Or me with a laugh and a mocking finger wag "Good try but that trick isn't going to work - its in the mom's handbook so I know all about it. Eat up" and I would go about my business showing him that I expected him to eat. He wouldn't want me to see that he thought it was funny but the corner of his mouth would twitch as he desperately tried not to smile. My humourous reaction stopped it becoming a big deal and skipped over the fight and got him eating.

Have you read/listened to Tabitha Farrar's blogs and podcasts? They may help you to understand what your sister is going through and also to have faith that recovery is always possible.

Wishing you continued strength,

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

May 2017 Hovering around WR. Mood great, mostly. Building up hour by hour at school after 18 months at home. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. [thumb] 2018 growing so fast hard to keep pace with weight
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.
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Foodsupport_AUS
Your sister is choosing to do this for her own health and well being after having been ill for some time. It will be tough and challenging for her and I think it is important to acknowledge that. Not going however means that she continues to suffer and struggle as she has done for some years. So there is a chance at recovery, or even improved outcomes, or continuing in the same misery she is in. If it doesn't work this time, it doesn't mean it won't in the future, this is why sometimes it is worth repeating treatments that have not worked in the past. So it is not about being positive, telling her it will be easy.  It is about being behind her, letting her know that you will be there when she is struggling, to help her move forward. 
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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Alwaysthere
[QUOTE username=scaredmom userid=4930637 postid=1309668463]

Alwaysthere, I know you are worried, anxious and scared. Who wouldn't be?  I wish to point out some huge positives here:

Thank you so much... I always appreciate your comments. They are thoughtful and well spoken.

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mommiful
I took a little while thinking this over. I hope my thoughts are still relevant. I'm addressing them to your sister. 

  • A residential program can make it easier for you to restore weight. This alone won't cure you; you will still need to do the hard work of making the choice, day in day out, to eat without restriction yourself, without someone making you do it. Still, many people find that when they're at a higher weight, their thinking is more flexible and it feels less overwhelming to make it the rest of the way to full recovery. You'll be more able to make the choices you need to in order to get better once your brain is better nourished.
  • For many people with anorexia, it can be very hard to break out of a pattern of behaviors that has been set for years. The restriction is interwoven with routines that have built up over the years, so it can be easier to break the pattern of restriction if you are breaking habits and changing routines in other areas of your life as well. A residential program provides the structure that makes that happen. 
  • A residential program introduces you to skills for dealing with the challenging times when you are on your own. A lot of people find DBT helpful, and this is very commonly taught as part of the group therapy. CBT, ERP, and ACT are also common and can be helpful. The various therapy groups will give you more chances to learn and practice these kinds of skills than you would have in just weekly sessions.
  • What you're going through is hard and scary, but at least you're not going through it alone. One of the most helpful things for my daughter has been the community of peers. She has become very close to some of the people she met in residential, and they have continued to support each other in their recovery since discharge. Of course, not everyone is in a good place when they come to residential, and not all will be positive influences on your life. It is up to you to decide who to associate with who will be helpful to you in your recovery. It can also be rewarding and boost your confidence to find ways to be a positive force in your peers' lives. You have unique experiences, and you will find ways to bring this to bear to help others.
  • It can feel like you are giving up your autonomy when you go into residential, but that isn’t really true. Even within a strict structure, you still have it in your power to choose how you respond to that structure. That is how you take little steps, day by day, to beat the ED—not just by being compliant and following the rules, but by making the harder choice. You will have the choice of opening up with your treatment team and your peers or shutting down. There will probably be situations where you get to make food selections, and you can choose to pick the harder option. You can choose to recognize when small movements are driven by an exercise compulsion or to pretend that you aren’t exercising. You can choose not to engage in arguments with the ED or to make up mental excuses to placate the ED (“Everyone else is eating, so I can, too,” or “They’re making me”). You don’t need to beat yourself up if you don’t make the most helpful choice. You have made a big step if you start recognizing when you make a choice that will harm you in the long run. That’s a skill that will help you throughout your recovery.
  • As others have said, by choosing to go into residential, you are making a commitment to recovery. The stronger that commitment is, the more you will benefit from residential. You may see people in residential who have resigned themselves to a life of cycling in and out of treatment, never really facing the eating disorder and getting better. By choosing to go into treatment, first outpatient and now residential, you have made the choice not to continue allowing the ED to rule your thoughts, limit your freedom, and curtail your life. Remember that. You are in it for full recovery. You are fighting to regain a full life.
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Torie
1. It WILL get better
2. I will always be there for you.

Please keep us posted.
-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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