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

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lovemum
I just wondered if anyone could give some examples of what is actually talked about / how therapy sessions are focused. 
I know this will probably be different for any family but I am not really clear about what a "good" FT session should look like.

D (13) has been IP for six months with RAN - now goes in to IP unit 3 days a week for day-patient services and the rest of time she's at home.
They say she's weight restored at 45kg (154cm height)  She never had periods before she got ill and still hasn't but she's starting to get boobs and looks way better. having been unable to be in the same room as me and treat me as if I was infected, I now sleep in her room and spend pretty much every minute with her when she is home. 

She has super rigid thinking, has never opened up to ANYONE about her inner struggle. Resists therapy on every front. She complies with meal plan but is very rigid in thinking checks portion sizes, doesn't see friends, wears the same clothes every day, doesn't see herself getting better EVER, has some OCD behaviours, self harm a big issue.

She's on Olanzapine and fluoxetine. 

She has never said much at all in our FT sessions - we have a systemic family practitioner who has tried alot of different approaches - but at the moment we seem stuck in playing word games and jenga, Any direct discussion of AN or food - she walks out. 
We'll be going back to CAMHS soon and I'd really like to start afresh with FT - what kind of discussions did you have? how far did you push them to open up? 
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tina72
Just a short answer as I need to prepare lunch now 🙂.
My d never opened up because she did not know what to say. There were no underlying issues and she did not know why she started that diet that made her go down the rabbit hole. She just wanted to eat more "healthy" like many others do.
The behaviour of your d that you describe makes me think she is not truely WR as it is very much ED behaviour and that should disappear slowly after WR + some months x. How did they get to that number? A child of that age is never WR as she must still grow and develop a female body and get her periods. Do you have historical weight growth charts?
To answer your question above, here FBT was starting with a talk about last week and what worked and what not and mostly WE had these sessions without our d as it did not help her at the start and we needed the therapist more to tell us that we are doing great 🙂. The last about 5-6 sessions we had together but then she was compliant and we could talk about future and next changes in MP.
Keep feeding. There is light at the end of the tunnel.
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Ellesmum
Our first session was basically a getting to know you session, as many family members we wanted there were welcome.  They asked what I wanted from them and we discussed what daily life looked like and how we were all affected.

over the next few weeks we were asked what was going well and how difficulties (school, arguments) could be resolved. Now d and I are in separate sessions, I get the chance to talk about how I’m feeling and so does d.

I don’t agree with much of their approach to refeeding and they are well aware of that, they respect my wishes if I say no to weigh or request blind weighing.  They know their meal plan went in the bin. And that  I felt it was very wrong for d to be given a copy of the meal plan with its 100ml of juice or 3 spoons of vegetables.  

We talk well though and I feel respected, I worry a lot for the parents who follow the meal advice (they should be able to trust the experts but...) my d would still be very underweight and plagued by ED on their plan. 

The sessions at first did shake d up for a while after. Separate to the team we see a CAMHs psychiatrist who prescribed meds, I like him and it was him who told her that her most important medication is food and plenty of it, no limits.  A message I kept reminding her of and also told the team this is what I wanted them to say.  I don’t find the sessions particularly helpful or educational but they liaise with school for me and are good that way.   I feel too they are scared of too much weight gain and in this I feel I educate them. 
Ellesmum
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scaredmom
For us FBT seesions were more focussed on my struggles to get weight on and how to tackle behaviours.
d was weighed by the team but I spoke alone with the therapist most of the time.
It has been two years and d’s brain is doing well. Therapist only discusses school or social struggles with d and then we discuss food issues- if there are concerns.
mu d is 50 kg at 151 cm. I wonder if your d needs more weight.
Give it time. Keep at it. She may or may not open up but if you give her opportunities to discuss then she may take them over time.
XXX
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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Mamaroo
My d never opened up and to this day does not want to discuss it. The only thing I can tell her is that her body needs more calories than her peers and that is why she needs to eat more. And she accepts that. No underlying issues for us as well. During our sessions at the hospital, we discussed how to add more calories into her meal plan ("do you want to add an extra snack at morning or afternoon tea", for example) or how to tackle fear food. Several months after WR she was offered a couple of individual sessions with the psychologist, who concluded that she was now much better. When was she WR? The brain takes a long time to heal and you'll only START to see improvement after 6 -12 months. In the meantime keep on feeding.
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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deenl
Hi Lovemum,

We did not have FBT available but my son, too, did not have any therapy. There is no chance whatsoever of him telling a 'stranger'what he is thinking or feeling. But he seems to be doing fine so I'm not pushing it.

I was looking at your daughters weight and height. Do you have records from before she was 11 or so? These would be the best guide of whether she is at the correct weight FOR HER. In most cases, to allow brain healing, she needs to be brought back to her historical height curve and the weight curve she was on about 2 years prior to the onset of ED. All of her symptoms were the similar to my son and all disappeared when he got to a good weight and we waited a few months for brain healing to occur.

Warm wishes,

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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mid73
Hi 
Is it FBT or family therapy you are getting? The two are different. 

We started with FBT and the sessions were mainly about finding strategies to successfully refeed our daughter. My daughter would not engage in anyway and with the benefit of hindsight it would have been more useful if she hadn’t been in the room as I think it only heightened her distress and anxiety. It was however useful for us but would have been more so without daughter and AN listening!!!!

FBT didn’t work for us and she ended up in an ED unit for a couple of months . Her response and experience of AN sounds very similar to Tina’s daughter.  She has never properly engaged with anyone around her illness but 2.5 years in she maintains a reasonable BMI and most behaviours have gone. She still will not discuss AN and gets angry if I try. 

I hope you make some progress towards recovery. There really is no one approach that works for everyone. The beauty of this forum is that you can read real life experience and learn. 
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Ronson
We don’t include my d in sessions - we tried the typical way but honestly it was awful, it didn’t work for her, I felt guilty speaking about her when she was there and she hated it.

so we do weigh in for d every fortnight.  And I see FBT therapist every 6 weeks to discuss what is happening and get some tips - although to be honest I learn more here.

D is doing well - she is wr+ and most behaviours gone.  She actually opened up to me last night and said Ed voice sometimes still there but not nearly as much.  She now realises she was really ill.  I asked her if she wanted to see FBT therapist again with this increased ‘insight’ but she said no - it makes it worse - you and dad are the ones who help.  

So just by feeding her and making that safe for her we have helped 
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tina72
Ronson wrote:
you and dad are the ones who help. 
So just by feeding her and making that safe for her we have helped 


This goes out to all that in the dark days that are blamed by their children and that get all the hate at the moment - they will see that you helped them and that what you did was right afterwards. They will thank you although they might call you all bad words they know at the moment!
Keep feeding. There is light at the end of the tunnel.
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Suzanne
We see a FBT therapist weekly and it focuses on strategies.  And weigh-ins.  identifing what works, and suggesting new things to try.  Very concrete.  Therapest is not warm and fuzzy- on the contrary, she’s really a hard A**!  Keeps us grounded and focused.  She is not “ a good fit” for my son; she’s an expert at ED and recovery.  I have to remind myself that each week.  It’s hard not to feel like we are ganging up on him. I try to stay on “ his side” validating his feelings while following her directions.  It’s a tricky balancing  act... 
At about about 6 months in, my son ( he’s 18 1/2) has just started seeing a talk therapist on his own. I feel strongly, that he needs a private place to begging to process this experience for himself. But two months ago, I don’t think his brain was ready.  (PS I made it clear to new therapist our goals! ) 
We shall see...
we see our FBT as a Coach!!!
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Elibean1
Hi, another one with Camhs here...my D(12) was diagnosed with ARFID but has some AN traits/symptoms. We don’t have FBT as such - we had family CBT (CBT for her, with us parents in for some of the time to talk about the week, what helped, how school was going etc).  She was weighed weekly, and worked on strategies to help deal with anxiety. 

After a a few weeks, now well above her original growth curve (40kgs at 147 cms), she is only going monthly to check in and be weighed. She likes her psychologist and will talk a little, but opens up much more to me at home so now it’s us parents who go weekly and the CBT works ‘through’ us! 

I’ve had to do what Ellesmum did and insist on higher weight than they saw as ‘enough’ or ‘healthy’, and they have listened - i feel respected too. It’s weird how scared of going over they seem to be! But it was clear to us that D’s anxiety and body worries dropped as soon as we upped her weight beyond her old curve. 

This group, and another FB one, have taught me more than Camhs - but I do really appreciate the connection with medical support and it carries authority with D! 
Elibean
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