Inside Family Based Treatment for eating disorders: One mother’s experience
By Diana Beaudet
I’ve written before about my own eating disorder experience – realizing in mid-life that I had spent decades living with anorexia, confronting the realities of recovery as a working mother, and pushing away my feelings of shame by slowly sharing my story with family, friends, and a wider eating disorder community found online. But in the past year, I’ve also become the primary caregiver to my teen-aged daughter, who like me developed avoidant restrictive food intake disorder (ARFID) at a very young age, and then anorexia.
Recognizing the signs and finding the right care
My daughter’s ARFID first developed at 8 years-old. She stopped eating all solid foods – completely. We consulted our pediatrician and a few therapists, and though her diagnosis at this time was not ARFID or another eating disorder, we developed a plan to work with her as a family to encourage her to eat while she worked with a therapist specializing in childhood anxiety. This plan worked for a time. She slowly regained the weight she had lost and she developed a great relationship with her therapist to work on the anxiety that she was feeling. But less than five years later, the ARFID was back and again became all-consuming.
This time around I was aware of my own eating disorder and in therapy, so I was able to recognize for the first time the similarities between my daughter’s illness and my own. My therapist was instrumental in recommending and paving the way for my daughter to be seen in a clinic where they were researching and treating ARFID and other eating disorders. Using a combination of exposure-based and family-based therapy – each week my daughter would stare down her fear of a particular food by forcing herself to eat it, no matter how uncomfortable it became.
Recovering from ARFID, developing anorexia
Her recovery from ARFID was inspirational – both in how fast it was (a matter of months) and how complete. It uncovered a happiness (and relief) in my daughter that I realized we had not seen in many years. Tackling this fear gave her strength in so many other areas of her life as well. But, ARFID also taught her how to restrict, and suddenly the ARFID voice of fear and restriction was replaced with an eating disorder voice. Now, together each week, we tackle the eating disorder in family based treatment.
Recovery from anorexia
I can tell that my daughter’s recovery from anorexia will not be as swift and straight-forward as her recovery from ARFID, but after reading the recent post “The tale of two mothers and the illness that starves children and families,” by June Alexander, Ann Gardiner and Judy Krasna, I’m grateful for the advancements that have been made in treatment options for eating disorders. I was both shocked and sad as I read Ann and Judy’s stories of their daughters’ eating disorder recovery – at their exclusion from the process of their treatment.
Gratitude for family based treatment
Whether your child or teen is in out-patient or in-patient treatment, they will ultimately be home with you and we’ve witnessed first-hand how critical it is that parents’ understand exactly what the treatment plan is, in order to uphold it and support your child through it when they are in your care. A child in the midst of an all-consuming illness cannot be solely responsible for their recovery when they are away from their medical treatment team. Family based treatment works because it gives the child a full-time team, a constant support network, with constant guidance. A parent’s involvement in therapy is also critical because no one – no matter how exceptional and caring the treatment team – loves and cares for a child as much as a parent does.
Accessibility to family based treatment
It is my hope that accessibility to family based treatment will continue to expand in countries throughout the world, allowing families and their loved ones that struggle with eating disorder recovery to form a valuable and essential core support network. No medical provider should leave the parents of a child recovering from an eating disorder uninformed of the treatment plan, and all medical providers should realize the importance of family participation in the child’s treatment.
Let’s skip blame and focus on quality care
I’ve read many stories where blame for a child’s eating disorder is placed on the parents, providing justification for excluding them from the treatment process. As I’ve struggled with the role that I’ve played in my daughter’s nearly identical path towards her eating disorder (what has she learned from me, what is genetic, etc.), our family therapy sessions have never focused on placing blame, but instead the focus has been on educating me on how to step out of my own disorder to better support my daughter’s recovery. Without this education and focus, my daughter’s therapy would have no hope of being successful.
To learn more about Family Based Treatment…
Please read My Kid is Back – Empowering Parents to Beat Anorexia Nervosa, by June Alexander and Daniel Le Grange, and visit: http://www.feast-ed.org/?page=FBT_MaudsleyApproach. For health professionals, please refer to this anorexia nervosa treatment manual by James Locke and Daniel Le Grange, and go to the Training Institute for Child and Adolescent Eating Disorders.
For more information about Avoidant Restrictive Food Intake Disorder (ARFID)…
Please visit: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/arfid/overview and http://www.massgeneral.org/psychiatry/services/eating_disorders_about.aspx. For professionals, please find more information here: https://www.ncbi.nlm.nih.gov/m/pubmed/28644568/.
Diana Beaudet is the proud mother of two daughters, a mental health awareness advocate, and a senior marketing professional. At age 40, Diana learned that her increasing health concerns were due to an underlying, decades-long, eating disorder. She immersed herself in recovery and quickly found her way towards advocacy, participating in the first World Eating Disorders Action Day in 2016, a global movement to create greater awareness of eating disorders. Through this movement and its incredible community, Diana met her friend and mentor, June Alexander. Diana has collaborated with June to create and manage www.thediaryhealer.com to help others find a safe, supportive and healing environment to stay actively and creatively engaged in recovery.