One More Bite

Readers' Choice

First, Happy New Year from One More Bite!  I hope this year brings you and your families health, peace, and triumph over adversity.

I started this blog with the purpose of serving an unmet need-- providing guidance, feedback, and a forum for families struggling with eating disorders and support for family-based treatment.  In that spirit, I would like you to share with me what your current needs are.  What would you like to learn more about? What issues do you feel you need more guidance on? What struggles do you face that you would like me to write about? This blog is YOURS, and I need your help to serve you best. 

Thank you for your readership!!
Joy

The Happiest Time of the Year?

If your child is in the grip of an eating disorder, holiday time—and the accompanying centrality of food, presence of extended family and friends, and changes in normal routines and schedules—can be a difficult time for the entire family.  Now is the time to think ahead and strategize how you can manage these many changes and maximize the chances that you and your family can enjoy this time of year as much as possible.  

Talk to your spouse and/or other family members about ground rules for the family, decide what you think will be helpful and remember to be proactive, communicating ahead of anticipated challenges.  If you know that there will be challenges ahead but cannot anticipate precisely what they will be, it can be helpful to develop a game plan for problem resolution.  Having a process in place will allow you to think more rationally and effectively when faced with unexpected situations and quickly figure out the appropriate course of action.

Remember, the skills you build in successfully navigating holiday challenges can benefit your child and family not only during the holidays but all year long.  Good luck and let me know how it goes!

Fighting ED: Priceless Stress Relief Tips for Your Child

As wildly stressful as refeeding can be for parents, it can be even moreso for your child.   Some kids liken refeeding in particular to torture.  As more objective observers, we know that anorexia or “ED” is the tormentor.  In the meantime, it is vital for your child to have safe ways to relieve stress during the recovery process. 

I am lucky enough to get to work with incredibly talented and creative kids and am thrilled when ED has abated enough to let those qualities shine through.  One of my brave teenage clients brought in the list below—an incredibly thoughtful and creative list of things she can do when she is feeling stressed, angry, or needing to vent.  She produced this list instead of listening to ED’s command to exercise compulsively and generously agreed to let me share it with you, as did her parents.  I am confident this list will be a tremendous resource for many of you, truly a gift that keeps on giving.  Keep in mind that this lift was approved by my client’s parents; you may or may not feel all are appropriate for your house/child.  Nevertheless, I hope that this will be a useful starting point for you.

Food can indeed be medicine in many ways (hint: see tip #1 and more below)!    

 

The “Help!! I have no control!!” List

 

If you need to THROW something:

Throw eggs at approved area

Throw water balloons at approved area

Chuck tennis balls

Paint your feelings on large newspaper canvas (i.e. throw paint on

canvas= splatter paint)

Throw clothes onto bedroom floor

Throw old plates on the ground

Throw small stuffed animals at a target (i.e. a soccer goal)

 

If you need to BITE something:

Bite a pillow

Bite a stuffed animal

Suck on an ice cube

Bite toothbrush

 

If you need to RIP something:

Rip pages out of an unused diary/old book

Rip up old newspaper

Rip up Silly Putty

Cut up paper scraps

Rip old rags

Unshell peanuts

Rip up old cardboard boxes

Rip out weeds :)

 

If you need to KICK/JUMP on something:

Kick a soccer ball (in juggling net)

Kick sand or water

Jump on bubble wrap

Jump rope as fast as you can

Jump on crackers (something crunchy)

 

If you need to HIT something:

Hammer a nail into wood

Punch a pillow

Hit tennis balls (with racket)

Press unused keyboard keys

Hit rotten apples/empty soda cans with a baseball bat

 

If you need to SQUEEZE something:

Click an old computer mouse

Pop bubble wrap with fingers

Squeeze a stress ball (blanket/wad of toilet paper will work)

Bend wire hangers

Unscrew old tomato sauce jars

Fold paper into a million pieces

Grip a zipper and “Zip” it up and down

Squeeze peanut butter or Jell-O between your fingers (over the sink if necessary)

Tie really tight knots in a string

Squeeze a water bottle

Squeeze a broken remote really hard and press every button

 

 

If you need to MAKE NOISE:

Scream as loud as you can into a pillow

Suck on a lollipop for a distraction

Chew gum for a distraction

Shake maracas or hit them on bed

Slam a textbook closed (NOTE: It is UNACCEPTABLE to slam doors)

 

When you need to VOICE YOUR FEELINGS:

Scream at a stuffed animal

Write an angry letter to “Bob” or “Sue” about how you feel, and then recycle it

Type, “I hate this” a hundred times on the computer

Draw faces on old magazines

 

 

 

The Pitfalls of Compromise

One of the biggest challenges faced by families in the midst of refeeding is the issue of compromise.  Time and again parents—seeking to appease their very stressed out child whose eating disorder is struggling to survive in the face of refeeding—end up conceding to the eating disorder and ultimately reinforcing it.  Making concessions can lead to many unfortunate results, including:

food ruts (for example, providing the same foods/meals over and over again in order to avoid conflict at meal time)

continued avoidance of certain kinds of foods (e.g., carbs, desserts, fried foods, meat, etc.)

ongoing rigidity related to the circumstances around eating (for example, conceding to a refusal to eat before bed is a common pitfall)

These are just a few of the many ways in which compromise can reinforce eating disordered behavior.

Even the most seemingly minor compromise on these and similar issues can reinforce the existence and illogic of the eating disorder. 

If this post is ringing any alarm bells, sit down and write a list of the compromises you may have unwittingly made and develop a plan for addressing each one.  If your list is long, it may help to prioritize the order in which you address your action items.  Do your best to work your way through the entire list.

It can be difficult—and downright scary—to face down an eating disorder.  Use all of your family teamwork and resources to do it….it might just save you much more difficult and painful attempts at correction down the road. 

Back To School

This time of year poses unique challenges for Maudsley families.  Trying to squeeze in breakfast before school, snacks and lunch at school, homework and dinner can create additional pressure for families already struggling to pack as much nutrition into the day as possible.  If you are feeling stressed or pressured as you get into the groove of your new routine, try to refocus on your long-term goal: full recovery.  Make decisions that will get you there the fastest way possible.  If it means a few classes are missed, activities postponed, or school needs to be put on hold until refeeding has progressed further, make the decision, even if it is a hard one.  Homework can be made up and schools these days are becoming more accommodating than ever.  Years from now you won’t regret sacrifices made for the sake of full recovery . 

And Then There Was Ice Cream….

I recently received an email that reminded me of the pure joy that successful completion of FBT can bring to parents and therapists.  A mom wrote me to share her happiness that her child asked, of his own free will, for a bowl of ice cream with his siblings.  This simple request was a reflection of months of effort, endurance, patience, and persistence.  Anorexia would not have let this child consume any extra calorie a year ago, much less a “fun” food like dessert.  Weight restored, and sanity restored, life can become normal again.  And it’s just a scoop away….

Summer “Vacation”

Believe it or not, for most kids summer break is almost halfway over!  Parents, if you are refeeding your child, use the remaining time you have this summer to really dig in to the refeeding process.  Try to use this break from the rigors of school and activity schedules to your maximum advantage.  Refeeding  is much more challenging when you’re trying to work around the stresses of school schedules, homework and other academic and extracurricular commitments that your child may have.  Summer is an ideal time to put everything else aside and truly focus on restoring your child to full health.  Come September you might be very pleased with the results of this investment.  Go for it!!

Anger

One of the biggest struggles of parents implementing FBT is the anger they face when confronting the eating disorder head on.  The fury of an ED confronted with potential extinction is like none other.  If you’re a parent who has lived through this, the experience can be unforgettable. 

Parents currently in the thick of refeeding could use your wisdom and experience.  How did you manage when faced with an ED induced rage?  Did you ever make concessions, hoping it would make things “easier”?  If so, what did you learn from doing this?

If you were able to stand firm in the face of an ED rage, what kept you on track?  How did doing this influence the success of the refeeding goals for your child?

Please share.

A Pregnant Pause

If you have not heard about “pregorexia,” you might be shocked by the account you read here.

http://www.momlogic.com/2009/06/pregorexia_starving_for_two.php

Pregorexia is not a diagnostic term but a clinical one, referring to the failure to gain adequate weight during pregnancy due to eating disordered behavior.  

This compelling and heartbreaking story reaffirms the life altering stakes of anorexia…with implications for future generations.

FBT offers a cure for this; addressing your teen’s ED now may save her life as well as your future grandchild’s.

Getting on the same page

If you are part of a parent team trying to refeed your child, chances are that you’ve faced conflict with your spouse—over appropriate strategies, contingencies, meal schedules, foods, amounts…and the list goes on.   Regardless of the content of the conflict, the eating disorder loves to divide and conquer, to exploit parental conflict and take advantage of it.

Don’t let conflict with your spouse distract you from the long term goal—saving your child’s life.  If you feel that you and your spouse are in conflict too often, pick a calm time to sit down and privately discuss it.  By reviewing your areas of conflict (and agreement), you can develop an action plan for improving your teamwork and making you a truly united team.  This will maximize your chances for successful refeeding and hopefully help boot the eating disorder out of your family’s life for good.