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

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Lexi123
Hi all,

it’s been a while since I’ve posted. D has been doing “okay” but we still have no weight gain and in fact some weight loss. Purging has still been decreased and she is still coming home most weekends and letting me feed her. Her boyfriend is helpful, but doesn’t understand the seriousness of ED. My d has been telling me she needs to process her trauma and that is what is keeping her from fully recovering from her anorexia. Says if she can process the trauma she can get past ED. What do you all think? She says she wants to stop seeing her ED treatment team because they aren’t helping her and she doesn’t find it useful. She wants to do trauma work with an EMDR therapist and then see how she is doing. Any insight is appreciated. 
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
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Enn
My feeling is this: until her body and brain are nutritionally stabilized would any ‘therapy’ or EMDR, really be helpful?
I am not sure. There is evidence that EMDR can help if there was trauma as part of developing ED. Now there is a recent thread  .Teecee’s d has been quite successful
https://www.aroundthedinnertable.org/post/emdr-for-anorexia-10377497?pid=1310732626
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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Enn
https://anorexiafamily.com/psychotherapy-eating-disorders-anorexia/?v=79cba1185463
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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Kali

Hi Lexi123,

It is great that she is coming home most weekends and you are able to feed her and eat with her. That is a big step forward. Has she been in to see her MD and how are her labs and heart? I know you said in an earlier post that you were concerned about that. Has she been able to follow up and is she stable at the moment or is that still an issue?

I'm wondering if she can see a trauma specialist in addition to the ED team and have the therapists cooperate around her care? Or find an eating disorder therapist who is also trained in EMDR to work with? Has she articulated WHY she thinks that the team and what they are suggesting she do is not helping her? Could it be that they are asking her to eat more and weight restore and that conversation becomes unpleasant for her? Have you ever attended one of her therapy sessions with them? I did go to my daughter's therapist a couple of times with my d. just to see how things were going and to talk about what I could do to support her. Is it possible to work out some sort of plan with the team and your daughter for (as I called it when in therapy) full nutrition? (AKA weight restoration but full nutrition didn't seem quite as scary to my d.) Does her boyfriend make meals at home sometimes and do they eat together? I don't think it is an either or question about treating the trauma or the eating disorder first...I can't think of any reasons why they cannot be treated simultaneously. If your daughter feels that the EMDR can be helpful then she should explore that. But her eating also needs to be adequate and the question is how can that happen?

Just curious, has she tried any DBT, FBT or CBT? What kind of therapy modalities does her current team work on with her? 

We did just about anything which I thought could be helpful. Lots of different therapies. But honestly, what disrupted the purging was that she spent 3 months on a locked eating disorders unit and was not allowed to visit the bathroom after eating while she was being weight restored. Making it impossible for her to carry out the behavior was very effective. 

warmly,

Kali







 

 

Food=Love
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Barberton

Hi Lexi123,

I too think it's great that she appears to want help and is letting you feed her on weekends. However, I wonder if there isn't a hint of ED manipulation in there? Why can't she eat AND do trauma counselling at the same time? I think the ED tries to find these small loopholes that try to look like compliance but are just an excuse to avoid what really has to happen - eating. Perhaps you can bargain with her and say 'sure you can process your trauma, but you need to weight restore at the same time'?

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.
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MKR
Hi @Lexi123 ,

Some families have changed therapists until they found the one that simply "clicked". I am not saying that your daughter should keep changing them to avoid dealing with her trauma or avoid refeeding.  From what you are saying, she sounds eager to get over it.

I also don't know how possible it is to change providers. Perhaps you can help her find another team, especially if she had made an effort with the current one for some time. 

Maybe she has a particular person in mind? 
Mum's Kitchen

14-y-o "healthy living" led to AN in 2017 and WR at 16. Current muscle dysmorphia.
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Foodsupport_AUS
I agree with the thought there may be a bit of ED in the plan to stop seeing ED therapists with a view to doing trauma therapy. At the same time I am not a great believer in "therapy for ED" . My D has seen a psychiatrist for going on to 10 years, he has been very useful for many things but I am still not sure he has helped her "ED". He has helped her learn coping strategies for anxiety, he has helped her suicidal thoughts and self harming, he has helped her with her poor self esteem, perfectionism etc.. Although he has challenged her eating and her fear of weight gain I am not sure that the therapy ever achieved much of that happening. 
I would be fine about not seeing a therapist as such for the ED but would suggest that there is an agreement for a food intake that will and should lead to weight gain - a starved brain doesn't adapt well to anything. 
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.
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ValentinaGermania
Please check that. Normally I am also against therapy before refeeding is done but teecees d has made a huge progress with EMDR.
https://www.aroundthedinnertable.org/post/emdr-for-anorexia-10377497?pid=1310737436

But food must go in as well so treating that is important.
Keep feeding. There is light at the end of the tunnel.
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Torie
II don't know much about dealing with trauma, so I would go with whatever you and she think might help at whatever time you want to do that.

I do, however, know a fair bit about dealing with ED.  One of the most counter-intuitive things I have learned is that the LAST person you want to accept advice from regarding ED treatment is the sufferer.  Their brains are not (not NOT) rational about anything related to food, calories, AN, etc.  That is what anorexia IS.  So whatever she says about food, eating, ED treatment, etc. is very likely the opposite of what she needs.

My advice to you is to keep doing whatever you can to get her weight up. xx

-Torie
"We are angels of hope, of healing, and of light. Darkness flees from us." -YP 
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Lexi123
Enn wrote:
My feeling is this: until her body and brain are nutritionally stabilized would any ‘therapy’ or EMDR, really be helpful?
I am not sure. There is evidence that EMDR can help if there was trauma as part of developing ED. Now there is a recent thread  .Teecee’s d has been quite successful
https://www.aroundthedinnertable.org/post/emdr-for-anorexia-10377497?pid=1310732626


good point. I also believe that proper nutrition and weight restoration would help her more than therapy. Thanks for the EMDR thread link!
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
Quote
Lexi123
Kali wrote:

Hi Lexi123,

It is great that she is coming home most weekends and you are able to feed her and eat with her. That is a big step forward. Has she been in to see her MD and how are her labs and heart? I know you said in an earlier post that you were concerned about that. Has she been able to follow up and is she stable at the moment or is that still an issue?

I'm wondering if she can see a trauma specialist in addition to the ED team and have the therapists cooperate around her care? Or find an eating disorder therapist who is also trained in EMDR to work with? Has she articulated WHY she thinks that the team and what they are suggesting she do is not helping her? Could it be that they are asking her to eat more and weight restore and that conversation becomes unpleasant for her? Have you ever attended one of her therapy sessions with them? I did go to my daughter's therapist a couple of times with my d. just to see how things were going and to talk about what I could do to support her. Is it possible to work out some sort of plan with the team and your daughter for (as I called it when in therapy) full nutrition? (AKA weight restoration but full nutrition didn't seem quite as scary to my d.) Does her boyfriend make meals at home sometimes and do they eat together? I don't think it is an either or question about treating the trauma or the eating disorder first...I can't think of any reasons why they cannot be treated simultaneously. If your daughter feels that the EMDR can be helpful then she should explore that. But her eating also needs to be adequate and the question is how can that happen?

Just curious, has she tried any DBT, FBT or CBT? What kind of therapy modalities does her current team work on with her? 

We did just about anything which I thought could be helpful. Lots of different therapies. But honestly, what disrupted the purging was that she spent 3 months on a locked eating disorders unit and was not allowed to visit the bathroom after eating while she was being weight restored. Making it impossible for her to carry out the behavior was very effective. 

warmly,

Kali







 

 



hi Kali,

thanks for this thoughtful reply. She is seeing her MD for monthly EKGs and labs. How we, I know that things have been about the same regarding bloodwork and her abnormal EKG and she has not gained weight. I would love to go to an appointment with my D. How were you able to get your d to agree to that? My daughter has been very resistant to me attending any of her appointments, although I’ve been able to go to some doctors appts as well as a few nutrition appts. My feeling is that when things start to get really hard with food (ie her doctor is wanting her to gain weight) she tends to want to switch therapists and therefore stall/buy more time. I am going to look for a trauma therapist and tell my d that I’d prefer she see that therapist alongside her team. Her current team uses a combination of CBT and DBT with a heavy emphasis on DBT. I appreciate this because they are firm that brain healing cannot happen until she is eating adequately and not purging. 
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
Quote
Lexi123
Barberton wrote:

Hi Lexi123,

I too think it's great that she appears to want help and is letting you feed her on weekends. However, I wonder if there isn't a hint of ED manipulation in there? Why can't she eat AND do trauma counselling at the same time? I think the ED tries to find these small loopholes that try to look like compliance but are just an excuse to avoid what really has to happen - eating. Perhaps you can bargain with her and say 'sure you can process your trauma, but you need to weight restore at the same time'?

Barberton wrote:

Hi Lexi123,

I too think it's great that she appears to want help and is letting you feed her on weekends. However, I wonder if there isn't a hint of ED manipulation in there? Why can't she eat AND do trauma counselling at the same time? I think the ED tries to find these small loopholes that try to look like compliance but are just an excuse to avoid what really has to happen - eating. Perhaps you can bargain with her and say 'sure you can process your trauma, but you need to weight restore at the same time'?



This makes a lot of sense. It’s so hard to know what to believe with ED. My d can be so convincing and I’ve often found myself agreeing to something only to realize later the ED voice was who I agreed with. I think I can try to bargain by helping her find a trauma therapist as long as she continues seeing her ED team
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
Quote
Lexi123
I agree with the thought there may be a bit of ED in the plan to stop seeing ED therapists with a view to doing trauma therapy. At the same time I am not a great believer in "therapy for ED" . My D has seen a psychiatrist for going on to 10 years, he has been very useful for many things but I am still not sure he has helped her "ED". He has helped her learn coping strategies for anxiety, he has helped her suicidal thoughts and self harming, he has helped her with her poor self esteem, perfectionism etc.. Although he has challenged her eating and her fear of weight gain I am not sure that the therapy ever achieved much of that happening. 
I would be fine about not seeing a therapist as such for the ED but would suggest that there is an agreement for a food intake that will and should lead to weight gain - a starved brain doesn't adapt well to anything. 


I’ve been reading a lot more about how unhelpful therapy can be when the person with the ED is not eating adequately. It makes a lot of sense, as weight restoration should be the primary goal. 
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
Quote
Lexi123
Please check that. Normally I am also against therapy before refeeding is done but teecees d has made a huge progress with EMDR.
https://www.aroundthedinnertable.org/post/emdr-for-anorexia-10377497?pid=1310737436

But food must go in as well so treating that is important.


thank you for this! Very helpful. 
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
Quote
Lexi123
Torie wrote:
II don't know much about dealing with trauma, so I would go with whatever you and she think might help at whatever time you want to do that.

I do, however, know a fair bit about dealing with ED.  One of the most counter-intuitive things I have learned is that the LAST person you want to accept advice from regarding ED treatment is the sufferer.  Their brains are not (not NOT) rational about anything related to food, calories, AN, etc.  That is what anorexia IS.  So whatever she says about food, eating, ED treatment, etc. is very likely the opposite of what she needs.

My advice to you is to keep doing whatever you can to get her weight up. xx

-Torie


thank you Torie. I always get such great advice on here! I am going to talk to her this weekend when she comes home. Hopefully after a day of feeding her adequately we can have a conversation. I would really like for her to weight restore before considering stopping seeing her ED therapist and beginning trauma therapy. 
D is 23 with restrictive anorexia since age 13. Purging tendencies shortly there after. Currently underweight and struggling with restricting as well as purging. 
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Kali

Hi Lexi123,

Quote:
I would love to go to an appointment with my D. How were you able to get your d to agree to that? 


I told my daughter that I wanted to talk with her and her therapist about the best way to support her and set up a time to do that. It might help you move forward. 

Which was the truth, but I also wanted to get a sense of the dynamics in therapy and what the therapist was working on with her.

Kali

Food=Love
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