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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cm72
Our daughter has been weight restored for about 4-6 months. I can't remember, it's all a blur. Now we are waiting to see what the brain recovery will do and what are actual mental health issues. She acts out at time and can be very cruel to her sister. Anytime we try to discipline her she just keeps saying I'm sorry, i'm sorry over and over. She also will cry and completely freak out. Even over the simplest discipline like me calmly asking her to pick up her clothes. You would think i'm beating her with how much she carries on! Obviously right now she is super sensitive. I certainly hope she gets a thicker skin with brain recovery but in the meantime, how do I discipline her? It's not fair to her sister that she gets away with murder just because she has emotional issues. 
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debra18
I stick to simple phrases like "I don't tolerate this behavior (hitting, yelling, whatever it is). 
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sk8r31
How old is your d?  Is this newer behavior, or has it been going on for most of the time that you have been refeeding? Giving us a little more info on your situation may help us to share strategies and suggestions better suited to your individual situation.  As debra18 mentions, you can reiterate that you don't tolerate the behavior. But it would be good to also try to help your d with tools and strategies to help her manage her emotions at this stage.  
Sending 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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cm72
She is 11. This is newer behavior. She’s going through a lot. She believes she is a boy (this happened about Three months into the eating disorder) and her anxiety is sky high. 
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sk8r31
If she didn't have pre-existing anxiety prior to ED, it could be extinction burst if you are getting closer to getting her back onto her historical weight/height curve.  There are others on the forum who have had similar experiences as regards questioning sexual orientation as well.  This may be related to being ill, and it may not.  You should have a better idea of where things stand overall 6-12 months after nutritional rehabilitation.  It may be worthwhile to discuss with your medical provider whether meds might help with the extreme anxiety.  We used both meds and an individual therapist to help our d with anxiety issues during refeeding and beyond.  This was in addition to the FBT-trained provider who worked with us as a family.

It is not easy to sort out these challenges and to figure out what way forward is the best next step.  It may be a case of 'feedback, not failure' as you determine what is the best course of action.

Sending warm support to you, and a reminder to take the best care of your own physical and mental health as you can.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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cm72
I'm not quite sure that it's an extinction burst as she's been weight restored for awhile. She is on a small dose of medication and had a year's worth of therapy (we are taking a bit of a break). 
As far as the sexual orientation, I've heard others say that people have spoke about it on here but i've never been able to find any posts regarding it. So if anyone has any similar experience, please message me privately as i'd be interested to hear your story.
Thank you sk8r31 and debra18
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sk8r31
Here is one post about sexual orientation from momon, who is no longer active on the forum.  But if you do a search on sexual orientation, you should come up with other threads/posts.
https://www.aroundthedinnertable.org/post/asd-and-gender-7897782?highlight=sexual+orientation&pid=1290628146
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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Anne_D
Gender identity and sexual orientation are two very different things. Eating disorders are not uncommon in kids/teens grappling with their gender identity. At 11, your daughter is also entering puberty, a very crucial and difficult time for kids who believe they are transgender. If these issues were not explored with the previous therapist, perhaps a new therapist experienced with gender identity issues can be of help?
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cm72
Hi Anne. I have to be honest, I’m nervous about getting to a therapist now specializing in gender identity because I don’t want them to put thoughts in her head. When she was first diagnosed with the eating disorder, all kinds of doctors asked her if she wanted to be a boy, etc multiple times and she always said no. I felt like she never thought this way until they put it into her head. Maybe I’m totally native with this. 
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cm72
I mean naive not native.
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Anne_D
That makes sense to me. It’s so overwhelming to deal with all these issues - like a game of whack-a-mole. I simply raised it because while you said your daughter was expressing a gender identity issue, the term “sexual orientation” was then raised by other posters. I checked out the thread above and there appears to be some good discussion about both sexual orientation and gender identity.
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cm72
Yup. I’m seeing all the posts now by putting that in the search thread.  I wish some of these people were still on so I can find out updates. 
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debra18
I think this is common with ED and seems like a symptom, not a cause, like the many other symptoms. My daughter also wanted to dress like a boy and would take my son's clothes. With brain healing she stopped talking about it. I would give it more time that her brain is healed before addressing it.
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sk8r31
You can always try to send an email & see if there is a response.  Sometimes forum members have just 'moved on', but they may be willing to share an update if you contact them directly.  Momon is a neighbor & friend of mine, & I know that gender identity is no longer an issue for her kid.  You can definitely give it time to see if gender identity is still something to address after a few more months of brain healing and nutritional rehabilitation.
However, if the extreme anxiety continues much longer, it would be good to try to manage that with therapy or meds or both.  
Sending warm support to you.
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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ValentinaGermania
My d also was super sensitive in the first year after WR. If I would have said to her "it is raining outside" she would have answered "but that is not my fault!". She took everything we said personally. She could not stand the simplest bit of criticism (or better said she understood everything we said as criticism). It was very difficult to make her not feel a fault and a loser because she got everything wrong.
We had no siblings here so could try to let some things simply go and give her time to cope with it. But looking back I would say that she had to learn to hear the correct things that we really said. I often tried to say things different, in a positive way. For example I did not say "you need to clean up your room" but "can you help me to clean up your room later?". But it was walking on eggshells most of the time.

I also hoped that she would get a thicker skin with time and here that happened about a year after WR. Slowly but with steady progress. It was not possible to have a good discussion about something with her last summer but it is now. She can even stand to argue with us about something.

With siblings it is hard not to be equal to both. And I think you should not let her get through with everything just because of AN. But maybe you can try to change the way you say things for both of them. If you can ask for things in a more nice and positive way maybe both would appreciate that. For example you could say "please try to keep the milk in the glass" instead of "be aware not to drop the milk in the glass". Do you know what I mean? It is a bit difficult to explain that for me in English...
Keep feeding. There is light at the end of the tunnel.
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Enn
cm72,
It sounds quite challenging to know what to do at the moment. When I hear about the emotional dysregulation  and hypersensitivity to anything meant as parental correction of behaviour, I start thinking about DBT. I think she is too young for it, but learning DBT for yourself  may give you some tools to help her manage her emotions better.  My eldest d was very similar to what you describe when she was young and I did not know how to handle it at all tbh.  She grew up, now 21, and has done some DBT for herself and I must say I have learned a few things too through her experience. She has found it helpful and a lot of work. She is of course older and her brain is much more mature now. It has given her tools to help manage the high emotions that she can still have at times.  I am doing some reading for myself  in this regard. This is in order to help me communicate better with all of my kids and others and learn some tools for myself. 
Just throwing out ideas. 
Well done  with WR!
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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debra18
Does she have interests or hobbies? I found the most important thing for my daughter has been to engage in positive activities when she is anxious. I consider her music lessons to be her therapy. When you stop allowing negative coping mechanisms (restrictive eating, tantrums, etc) these have to be replaced with positive ones. As parents we are there with our kids on a daily basis and can help them figure this out when they are experiencing the anxiety. I also deal with my own anxiety from ED in the same way and can disconnect through painting or other hobbies.
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Mamaroo
Children with ED regress in age, so she's acting a bit like a toddler. When she attacks her sister, you can send her to her room for a half an hour or so, or use any other consequence. My d used to cry a lot and nothing we could do, could calm her. Our team suggested we leave her in her room to calm down herself and it worked. The screaming sessions became shorter and shorter until she learned to calm herself. My d was also over sensitive for things we said, even our facial expressions could send her into tears. So most sentences I started with "I'm not angry with you" then continued with "please pick up your clothes", which helped.
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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chester

My children don't have eating disorders, I just have a wife with anorexia and I'm a dad and special ed teacher.

 

what exactly do you mean by discipline?  are you using that word as a synonym for punishment?  discipline comes from the word "disciple" which means "to teach."  you don't have to use punishment in order to teach your child how to behave around others, build character and have healthy boundaries.  I would recommend the book "how to talk so kids will listen and how to listen so kids will talk" by Faber & Mazlish and also "the explosive child" by dr. ross greene.  Dr. greene is excellent as he specializes in respectful discipline for children/teens with emotional/behavioral problems.  his collaborative problem solving model is the most evidenced based approach out there IMHO.

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chester
also what kind of therapy is she doing?  i have heard that there are versions of dialectical behavioral therapy that are more geared toward tweens & teens so that might be helpful because it stresses self regulation rather than relying on others to regulate your intense emotions.  ultimately with kids, there will be a time they don't have adults around to validate their feelings and regulate their behavior so it's important to learn self validation and self regulation so you can be fully emotionally independent later in life
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chester

debra18 wrote:
Does she have interests or hobbies? I found the most important thing for my daughter has been to engage in positive activities when she is anxious. I consider her music lessons to be her therapy. When you stop allowing negative coping mechanisms (restrictive eating, tantrums, etc) these have to be replaced with positive ones. As parents we are there with our kids on a daily basis and can help them figure this out when they are experiencing the anxiety. I also deal with my own anxiety from ED in the same way and can disconnect through painting or other hobbies.

 

I always say that my piano was my first therapist.  Boys weren't allowed to have feelings in my household so that was my primary emotional outlet.  i'm forever grateful for "dr. steinway" for hearing all of my angst for all those years when no one else could.

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mjkz

They do regress.  We are going through this again right now since my daughter is finally back to where she was prior to the crash around Christmas.  One thing I have had to do is get used to her distress and work on my own tolerance for her level of distress.  I looked out at the lawn last night and remarked I should mow this weekend and she burst into tears claiming it wasn't her fault.  I told her I was just planning my weekend and left it at that.  She cried a bit more and I didn't make a big deal of it or do anything else.  She calmed herself down and life went on.  It is so hard not to jump in there and try to comfort her but it is the same as when she was distressed about eating. Any comfort I gave simply fed her distress.

I too will tell her I won't tolerate that behavior when she gets nasty (and boy does she know what buttons to push).  If it continues I send her to her room to calm herself down and come back out when she can be civil.  She too apologizes and I accept it but I still send her out to calm herself down.

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Foodsupport_AUS
Reading about this reminds me of one of my daughter's friends when she was younger. If her friend had anything negative said to her she would curl up in a corner and cry. Her need to be seen as good and perfect was much worse than even that of my daughter who also was very averse to any negative or aversive feedback. For my daughter the lack of approval of her behaviour from me was always all that was required. Our kids with AN are often particularly punishment sensitive and not reward sensitive. Keeping that in mind then it then determines how are you going to manage her behaviour. You certainly should not let her do as she likes just because she gets distressed when corrected - however how you do that correction and getting her to do those behaviours you want is more the crux of the matter. So not being mean to her sister, having to pick her clothes up are all reasonable and expected behaviours. If she is doing them and not doing other things she shouldn't then all is well. She may just need reminding that her behaviour needs to be redirected, and then let her deal with the consequences of the distress caused. 
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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HopeNZ
This discussion reminds me of some research I had the privilege of hearing Janet Treasure talk about.  She found that people with eds tend to read neutral faces as negative or disapproving.  Learning this was an epiphany for me and helped to explain so many of my d's behaviours and those tortuous interactions where she is convinced we're being 'mean' or 'angry' or disapproving, when we are simply stating a fact or expressing an opinion.  Well into wr they still happen and they drive me completely bonkers.  But they also give me insight into the world she inhabits.
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sandie
Same here. My D complains about the way I look at her all the time and often perceives me as mean and angry.
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