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Turkey

 

Yes, it’s already December and I’m still concocting a various array of T-Day leftover meals. The latest- and hopefully the last turkey creation!- curried turkey potpie was a hit, but with one plate empty at the table.

Life for our family, once again, is on temporary halt to regroup, realign, and reaffirm former, as well as new recovery priorities-goals; and up the ante a bit to get beyond the bump-in-the-road our daughter is experiencing wrestling free (though as of late, resembling more acquiescence) from the dangerous clutches of anorexia.

Leftovers…

Ironically we were in this familiar territory the same time last year. And as a parent, when you’ve seen how far your child has come through his/her ED recovery, how hard the fight gets fought, seeing and knowing they can do it; it feels like suddenly your footing on that long arduous climb is becoming loose and weak. You’ve been tossed back down, the wind has been knocked clean out — “GASP!” Some confusion sets in, frustration, even some anger– “Damn you friggin’ (I use a word with a bit more gusto and power) ED!” It’s time to take action, as most of us know, eating disorders love the waiting-game, the delay, the postponing… we’ve already been there too.

Adolescence is a time of rapid growth and development, and a body taxed with an eating disorder at this time cannot do fully what it was meant to do normally unhindered. The reports regarding bone density and calcium loss within eating disorder sufferers are not new but it is a necessary reminder of the severity of this illness and why treatment should not be delayed, since significant changes do take place before decreases in bone structure become evident, and some of these changes can be permanent after a certain age.

Leftovers in this scenario can also be remembered as requiring 100% full nutritional support and adherence- without question, without exception. This time of year brings forth both a welcoming joy towards celebration with family and friends, but as well an unwelcome increase of stressors and worries that pose some unique challenges for those with eating disorders.

There has been a wide variety of posts and informational resources in this regard which is fantastic. One incredibly busy and committed individual interviewing as of late is Dr Cynthia Bulik, who is the director of the UNC Eating Disorder Program prompting:



Keep your support team on speed dial and call them at any time during or after a party. Talking relieves the pressure. You’re not overburdening them. They will undoubtedly have stories to share, too.– Potlucks are your friends. Don’t hesitate to take a food you prepared that feels safe enough to you so that you will have at least one manageable entrée.– Lavish holiday spreads don’t have to be the enemy. If faced with one, channel your inner Boy Scout or Girl Scout skills and be prepared! Before stepping in line, and before getting a plate, evaluate the options. Mindfully consider which foods you’ll sample, portion sizes and whether you feel comfortable trying a “feared food.” Make a decision and stick with it!– If your treatment team has given you a meal plan stay on track so you aren’t starving when you get there.– Listen with your heart, not your head. Hear the happiness and caring in a person’s tone when they tell you that you look “so much better.” They are saying they care about you. Don’t let the eating disorder lead you to misinterpret those words in a way that deprives you of hearing that people really care about you.— Get Real! People too often have a fantasy about how “perfect” the holidays are going to be. When family members fail to live up to unrealistic expectations, it might be tempting to restrict or overeat in an effort to feel better temporarily. Try to anticipate some of the possible emotional traps in advance so you can cope (and maybe even laugh) when you encounter them.– The well-known HALT slogan works for any type of recovery. Don’t let yourself get too hungry, angry, lonely or tired. This is especially important over the holidays.– ‘Tis the Season to Forgive, so forgive yourself if you have an eating slip.– Try your best not to skip appointments with your treatment team. It’s an important time to stay in touch with people who can help.

 

Dr Bulik also continued with an “Eating Pressure” interview recently conducted by CNN worth viewing.

And there is an equally interesting qualitative study: “Total Control? Eating Disorders and Emotional Responses to Food” conducted by the University of Adelaide in Australia with the result podcast and interview available from CQ University’s International Program of Psych-Social Health Research Dept that looks at emotional responses to images of food presented to adults with eating disorders, and using the qualitative methodology to further measure and explore issues of self-control, food fears/responses, CBT-cognitive behavior therapy as a means to help adjust maladaptive ways of thinking and behaving. I think this could also be extremely beneficial to younger ED sufferers as well, and crucial for helping them deal more cohesively with their “fear” foods that many times get downplayed or ignored within many treatment programs by only having the patients eat the foods, or avoid them altogether in their meal plans.

And yet more leftovers, as lastly I found BBC’s-Radio4 All In The Mind Segment by Claudia Hammond insightful in regards to the variations in some residential programs and getting additional perspectives from patients who are going through the program, their personal thoughts and views. The “partnership” message from the Phoenix ED program in the UK director, Dr Thompson was also welcoming to hear in having patients play a significant role in their treatment and recovery process along with more collaborative and balanced strategies. The numbered tables that residents eat at are something quite interesting as well, with Table 1 being a level requiring most support and moving towards Table 3 with more independence, and thusly Table 2 being 50/50. I think to me what stands out is the ability to remain open to making changes and being creative in strategies, and not simply applying practices to ED care and treatment that simply don’t always work for the individual patient.

So while I’m still musing over Thanksgiving tidbits and at the same time putting up the Christmas lights and bringing out the boxes of holiday decorations, we’ll keep fighting and rallying behind our daughter to continue to move forward within her next level of recovery. Regaining some ground lost with deeper learning and strength gained (we all make mistakes and have setbacks- with or without an eating disorder!) We know we’ll get through this together and once again her place at the table will be filled when she is ready… until then leftovers may be on the menu for awhile.

 

Vrishabha- the sacred bull of Lord Shiva… or more widely known- Taurus, the Bull reigns this month of May.  Our daughter turns 14 on this May 20th, and she definitely characterizes the nature of the bold, loyal, and very stubborn Taurus!

Before being diagnosed with Anorexia, birthday’s had always been a festive and richly tasting  affair.  And while we’ll continue partaking in this annual delight, it’s still a bit difficult for her to freely enjoy what never took a second guess years past.  She’s committed to challenging herself, though there are days she’s not too happy to do so, and will boldly (envision the Taurus with plumes of smoke flaring from nostrils!) make that clear– well, what were you like at 14, minus an eating disorder? 

I’m forever grateful to those who also remain equally, if not at times more, committed to helping support our daughter in keeping focus upon her recovery.  Recovery is not easy for sufferers, and parents still get  bawked a’ plenty and treated with disdain, misjudgment, and left to the side when there requires a much more encompassing circle to complete for true healing and whole-ness to take place.  And dualistically, sufferers also need their own space, their own pace to regain their true Selves back once nutritionally and weight stabilized– this requires alot of Love, patience, perseverance and sometimes a compassionately coordinated “team” all working together.  It makes me think of the Buddhist practice of mindfulness and the use of “a two-handed practice”:

_____

I can sit in my predicament as a witness, not as a plaintiff or judge: ‘Here I am in this situation and I sit squarely in it and breathe into it.  At the same time, I am aware that I can handle this and get through it without becoming devastated.  I can trust my competence neither to become dramatically overwhelmed nor to be stoically untouched.  This sense of competence frees me from fear, since fear thrives on powerlessness.  I imagine myself holding my predicament in one hand and my power to work with it in the other.  One hand is serenely mindful; one is courageously working.  When I hold both realities this way, I am agreeable to things as they are, and I am doing all I can to change them for the better as well.”   -D. Richo 

_____

This resonates with me deeply as a parent and the complexities illnesses like eating disorders present to us.  Now if only we can collectively and universally have provided the very best in evidence-based, highest standard of quality care of treating eating disorders and supporting families in such a comprehensively and equally accessible manner– that would be my wish!

Our daughter has many “wishes” and dreams she wants to pursue.  We simply want to wish her a very Happy Birthday, happy 14th Year, to continued Health and vitality… and to a courageous healthy-stubborn side that can be an anchor for her when difficulties and stress arise.  Knowing she can reach out and ask for help, she’s worth every ounce of her hard work on the road to recovery she has traveled thus far, and that we Love her very, very much!

-XOXO Mom*Dad*Big’Sis

 

This is a day of promise –
Of hopefulness, laughter, and cheer,
For this is a day of remembering
The good things that happened all year –
A day for reflecting on memories
Shared with friends and with family, too,
Who were so much a part
of the joys in your heart
And the love that you felt
all year through-
This is a day of promise
Of the beauty and warmth life can hold,
And of new dreams to dream
and more love to share
Through a year that’s about to unfold.

-Emily Matthews

Continued studies, most recently published by Dr Mark Zimmerman for Methods to Improve Diagnostic Assessment and Services (MIDAS), and additional colleagues of both Rhode Island Hospital and Brown University, indicate that the current DSM-IV lacks adequate “diagnostic criteria for eating disorders”, and that “researchers recommend a broadening of the criteria” since currently only anorexia and bulimia are “officially recognized and formally defined”.

Makes definite sense.  Especially since DSM-IV was published back in 1994, and in reading the current DSM-V “white papers” , “DSM definitions are virtually devoid of biology, despite a large body of research that indicates a neurological basis for most mental disorders”.  And that for over the past ten to fifteen years, there has been a steady increase of research and findings developed within eating disorders expanding beyond just AN and BN, but also EDNOS (Eating Disorder Not Otherwise Specified) which counts for “more than half of the patients in treatment centers”, as well as Binge Eating, COE (Compulsive Over-Eating), and other “subthreshold variants” that clearly expand the scope of eating disorder symptoms and diagnosis.

From what the DSM-V timeline indicates, this much needed and updated manual will be published sometime in 2011, which seems like an eternity for many of us already too familiar with the complexity of eating disorders and more often inadequate care/treatment of our loved ones. 

So it’s encouraging to see the continued efforts and commitment of researchers and clinicians in the trenches (along with the rest of us!) collecting the data, and analyzing the results for peer review, publication, and improved teaching/training- which ultimately leads to better treatment and recovery options for those in need.

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