I discharged a family from FBT last week. Their daughter, who we’ll call Tina, was fully recovered from anorexia (AN), a healthy teen, after 22 sessions, and just under a year of treatment. So why write about that? Indeed, if we are using effective treatment methods, recovery in itself is not news. Well, the journey for this family didn’t always look so good, and it struck me that families in the trenches stand to learn and to feel comforted by the struggles of other families early in treatment, especially when that treatment has a good outcome.
So what did it look like at the beginning for this family? Well, their daughter was dangerously underweight, with AN having reduced her daily intake to little more than green juices. Consisting of varying combinations of “super foods” such as kale, fruits, chia seeds and health-fads-everywhere’s-new-fave, coconut water, the family described them as “pond scum”. She was weak, her skin somehow greyed, cold all the time, irritable, socially withdrawn and struggling to concentrate at school. At the start of treatment the family couldn’t see a time when their daughter and sister would be able to return to eating muesli, chicken schnitzel, chocolate, or any of her previously enjoyed foods; at that point, just returning to solids seemed like reaching for the moon.
During our 12 months working together, Tina, described by her family has formerly a happy, somewhat shy, certainly compliant young girl, sat through sessions with dread and even refused attendance on one occasion. Anorexia had her throw food out, lie about what she was eating and her weight, and cry in distress through the reintroduction initially of chicken breasts, but then a range of foods including that chicken schnitzel, pasta, red meat, ice cream and chocolate. Throughout this period her parents held fast, on what must have been a roller coaster of their own. Tina’s father broke down in a session telling me he wanted to give up, but that he loved his daughter too much to give that thought air time; her mother fought to stand tall not only above the AN, but to back her own gut feelings on when it was okay to support Tina to have more independence around food, sometimes in the face of her own family questioning her decisions.
And despite those extremely trying experiences, 12 months on, Tina has a full circle of friends, can eat a wide range of foods, and feels confident enough in her body to tell me that if she could interview her former self at the start of treatment, she would tell herself she didn’t need to lose weight, she was strong and capable and good as she was. Her words, along with her (this time good) tears. Most humbling, Tina knew she couldn’t do it alone, and expressed relief that her parents were able to take charge, even though that didn’t stop her fighting for her freedom again when she was well enough to. Her parents on telling me about what was helpful and not about therapy have said it was one of the hardest journeys of their lives to figure out how to stay so united AN could never win, and how to flirt with wanting to give up without giving in; but that knowing there was a treatment that they could believe in and a treatment team they could trust held them steadfast to their sole goal of getting their daughter to full recovery. Once again, families’ courage humbles me, but I share this story to remind those in the trenches not to give in. As hard as the fight against AN is, if you can win it, you’ll give your daughter a gift money can’t buy.
So what did it look like at the beginning for this family? Well, their daughter was dangerously underweight, with AN having reduced her daily intake to little more than green juices. Consisting of varying combinations of “super foods” such as kale, fruits, chia seeds and health-fads-everywhere’s-new-fave, coconut water, the family described them as “pond scum”. She was weak, her skin somehow greyed, cold all the time, irritable, socially withdrawn and struggling to concentrate at school. At the start of treatment the family couldn’t see a time when their daughter and sister would be able to return to eating muesli, chicken schnitzel, chocolate, or any of her previously enjoyed foods; at that point, just returning to solids seemed like reaching for the moon.
During our 12 months working together, Tina, described by her family has formerly a happy, somewhat shy, certainly compliant young girl, sat through sessions with dread and even refused attendance on one occasion. Anorexia had her throw food out, lie about what she was eating and her weight, and cry in distress through the reintroduction initially of chicken breasts, but then a range of foods including that chicken schnitzel, pasta, red meat, ice cream and chocolate. Throughout this period her parents held fast, on what must have been a roller coaster of their own. Tina’s father broke down in a session telling me he wanted to give up, but that he loved his daughter too much to give that thought air time; her mother fought to stand tall not only above the AN, but to back her own gut feelings on when it was okay to support Tina to have more independence around food, sometimes in the face of her own family questioning her decisions.
And despite those extremely trying experiences, 12 months on, Tina has a full circle of friends, can eat a wide range of foods, and feels confident enough in her body to tell me that if she could interview her former self at the start of treatment, she would tell herself she didn’t need to lose weight, she was strong and capable and good as she was. Her words, along with her (this time good) tears. Most humbling, Tina knew she couldn’t do it alone, and expressed relief that her parents were able to take charge, even though that didn’t stop her fighting for her freedom again when she was well enough to. Her parents on telling me about what was helpful and not about therapy have said it was one of the hardest journeys of their lives to figure out how to stay so united AN could never win, and how to flirt with wanting to give up without giving in; but that knowing there was a treatment that they could believe in and a treatment team they could trust held them steadfast to their sole goal of getting their daughter to full recovery. Once again, families’ courage humbles me, but I share this story to remind those in the trenches not to give in. As hard as the fight against AN is, if you can win it, you’ll give your daughter a gift money can’t buy.