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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fogandfern
Hello, amazing caregivers - 
I'm new to the forum, and wanted to extend huge gratitude to you all, as this has been a lifeline in the months since our 14 year-old daughter has been diagnosed with RAN. Thanks to all of the guidance I've received here and from books, research, etc, we are refeeding her at home. She has gained 9 pounds in 2 months, and after many battles and countless circular conversations, she is eating between 2700-3000 calories a day and making cautious progress toward healthier behaviors around food choices - though we have a long way to go.

She currently has a treatment team (therapist, physician, dietician), but because we live in an isolated community in Alaska, they have limited experience with eating disorders, and it's been a struggle to get everyone on the same page. The question I have for you all is, do you know anything about the use of Somatic Experiencing Therapy to treat eating disorders? This is the approach her therapist is using, and I've found very little about it; most of the research I've found recommends Cognitive Behavioral Therapy or Dialectical Behavior Therapy (my daughter says it's a waste of time and money). Any insights you have to share would be most appreciated!

So much thanks-
fogandfern

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tina72
Hi and a veyr warm welcome from Germany! Sorry that you need to be here with us...

I found some articles about it and even in German. It seems to be a stress therapy for trauma patients and a bit esoterical 🙂.
As long it is only to help to cope with stress and the food goes in and there is no search for underlying family issues or that a trauma must have happened that caused ED I would think it is worth a try to help to cope with the ED stress.

Only thing I would be a little concerned about is that it is very body-related and ED patients already focus on their bodys too much.

You find more if you search for the founder of that therapy Peter A. Levine. Or ask your therapist for more information.

Here ALL psychotherapy was lost time and money (including CBT and music therapy and art therapy and whatever). Best therapy for my d was food, food and food.

Come back with all your questions, we are here to help if we can!
Keep feeding. There is light at the end of the tunnel.
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fogandfern
Thanks so much for your response - you've gotten me thinking that maybe I should have broadened my initial question to what kinds, if any, psychotherapy people have found helpful? 
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sk8r31
Hi and welcome fogandfern.  Amazing progress in terms of nutritional rehabilitation in such a short time!  It's hard work and a steep learning curve, and you are well on your way to helping your d into strong recovery.  As you are not doubt aware, it's still early days for your d and family traveling this path.  General rule of thumb is to focus on getting your d back onto her historical growth curve, and likely a bit higher for the next little while.  Your d is heading into puberty, or already there, and a great deal of physical growth should be happening over the next few years.  In fact, weight should be going on into the early 20's.

Many leave any therapeutic support for later down the road if needed.  While we were in refeeding mode with our then-17-year-old, we had an individual therapist for our d in addition to the family-based-treatment trained therapist that we all saw.  The individual T was able to help our d with her anxiety issues alongside our treatment plan, and it was helpful for her.

However, in the 'bad old days' before we found good-evidence-based treatment, our d saw a therapist in our small town.  It was less than helpful.  The T thought our d's ED was caused by her dad's anxiety.  So I would be cautious about whatever therapeutic support you are seeking at present and trust your gut if you think it is not helpful or is even harmful.  I am a proponent of 'no therapy is better than bad therapy' and sadly have the experience to support that. 

Sending warm support to you,
sk8r31
It is good to not only hope to be successful, but to expect it and accept it--Maya Angelou
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tina72
fogandfern wrote:
Thanks so much for your response - you've gotten me thinking that maybe I should have broadened my initial question to what kinds, if any, psychotherapy people have found helpful? 


As this is a biochemical brain disease like for example diabetes there is no ONE psychotherapy that helps them to be able to eat again.
In some cases CBT therapy helped against body dysmorphia. Here that got better just with weight gain and refeeding.
In some cases therapy helped with high anxiety. Here it did not help and when we started to treat anxiety the same way as fear food (with calm and increasing exposition) the anxiety got less.

You can only treat some SYMPTOMS of the disease with therapy, the main issue of the disease is the malnurished brain and that can only be treated with food and a high caloric intake. Good nurtition helps the brain to heal and then slowly the symptoms dicrease in most cases.
Keep feeding. There is light at the end of the tunnel.
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tina72
A friend who is an adult recovered AN patient read your post here and send me some information about that therapy.

Here is what she wrote:
"That is the therapy modality that made me choose the therapist that I adore. The technique would be the total opposite of 'blame the parents.' It is definitely geared toward anxiety and trauma therapy but I can actually see benefits in terms of stress tolerance with the ED. So the big picture idea is that when in nature an animal is threatened, they have this adrenaline rush which causes that fright or flight reaction. However when the danger goes away, there is a system that tells the body 'everything is now ok. you can relax.' If you have experienced developmental trauma where you lived in an unsafe environment or had repeated experiences that you weren't safe, your body is frozen in that heightened state and never relaxes. There's also the experience of feeling totally detached from your body and so you aren't aware of basic signals like hunger and need for sleep. The idea of the therapy is helping a client to notice sensations in the body and experiment with what you can do to shift things. So for example, does it feel better to sit or lay down? Does it feel better to have a weighted blanket or a stress ball? Part of it is also recognizing that whatever distress we are feeling doesn't stay that heightened forever. A lot of the things that parents talk about doing such as hot water bottles could be part of it. Knowing that there may not be a 'quick fix' to feeling great but that there are things we can do that can shift things positively. It would start with even paying attention to breath. It helped me a lot. and Peter Levine would say that it is TOTALLY unhelpful to talk about the trauma as that would lead to the body reexperiencing it neurologically. My only thing would be that in order for this therapy to work, the patient would have to be out of an acute or crisis state and have some level of maturity/self awareness. Honestly, the work I did as a teenager in theater using method acting had some similarities to somatic experiencing. It is empowering to recognize that there are things we can do to shift the feelings of intense discomfort. I would think it would be helpful for parents who experience PTSD after their children are further along in recovery."

Maybe that helps you.
Keep feeding. There is light at the end of the tunnel.
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fogandfern
That is really helpful, Tina. Much thanks to you and your friend for taking the time to share this with me! I worry that my daughter doesn't have the level of maturity and self-awareness that might be necessary for this kind of therapy to be productive. I think we will look into alternatives and just keep feeding the the meantime. Again, I truly appreciate your responses!!!
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tina72
This might be the cases as there is some insight and maturity needed for it but at least it will do no harm 🙂.
Keep feeding and maybe most of the problems will be solved just by food like here.
Keep feeding. There is light at the end of the tunnel.
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bluerain
Hi there :-)
I just want to add that as the parent of a child with an anorexia and subsequent medication mismanagement resulting in intense and constant suicidal ideations for many months, Somatic Experiencing therapy has been very instrumental in moving ME out of a constant fight/flight/freeze state, which is in turn helpful to my child and family. 
This video is a good explanation:

We can do hard things well...
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