that âinvolving adolescentsâ parents in treatment might be necessary, particularly for adolescents who describe the greatest resistance to treatmentâ¦. Adolescents who perceived their relationship with their parents more positively also reported greater motivation to change their eating disorder.â) *
That numberâ90 percentâis the one that catches my eye. It represents the best news Iâve gotten since Kitty was diagnosed. Why wouldnât we try a treatment with such a high recovery rateâespecially if the alternative is treatment with only a one in three chance for full recovery?
And thereâs another reason to try it: chronic anorexia is notoriously tough to treat. Years of malnutrition, restricting, and altered social interactions set up a potent and self-reinforcing pattern that becomes part of an adultâs identity and physiology. After five or ten or fifteen years of anorexia, recovery is far less likely.
All the more reason to take this on aggressively and fast. If we can help Kitty recover now, while sheâs still a teenager,while she hasnât been sick for very long, her chances are way better.
We can do this, I know we canâif Jamie gets behind it too. One of the key criteria for the success of FBT is that parents present a united front. Consistency and persistence, as Le Grange told me. That makes sense; all child-rearing efforts, whether they involve potty training or curfew setting or eating disorders, require that parents be on the same page. I know from our experiences so far how hard it is to keep at Kitty to eat another bite, have another sip, finish the milk shake or pasta or cheese. You feel like youâre torturing your child by pushing, pressing, insisting. And you are, in the short term. But the long-term stakes are so high. It seems to me a fair trade-off: X number of days, weeks, months of hell, in exchange for a lifetime of recovery. I know what I want to do. What we need to do.
For the next several days, Jamie and I talk and argue and grieve together. âI canât understand it,â he says, over and over. âWhy wonât she just eat?â I canât understand it either. But my gut tells me that weâre asking the wrong question. The question isnât why but what: What do we do now?
What it boils down to is that we have three choices: Send Kitty away. Keep doing what weâre doing. Or try some version of FBT, the Maudsley approach.
In the end the decision is easy.
Â
The next morning I call Dr. Beth and Ms. Susan and tell them our plan to begin family-based treatment with Kitty. Ms. Susan has heard of FBT and thinks it could be a good option for Kitty because sheâs young and hasnât been sick for long. (How long is long, I wonder? Because I feel as though Kittyâs already been sick a long time. Too long.) Dr. Beth has never heard of it but promises to do some reading and call me.
FBT comprises three phases: Phase 1 is weight restoration, Phase 2 is returning control over eating to the adolescent, and Phase 3 is resuming normal adolescent development. Phase 2 seems a long way off; thereâs no way weâre letting Kitty control her eating anytime soon. I have no idea what âresuming normal adolescent developmentâ means, and frankly, at the moment, I donât care. We are solidly in Phase 1.
Kitty has lost only six or seven pounds since June, but itâs painfully clear that sheâll need to gain a lot more than that to recover. Dr. Beth graphs Kittyâs height and weight from birth, plotting her natural growth curve, and gives us a number to start with: twenty-five pounds. Thatâs how much Kitty needs to gain, at least for now.
In true FBT, I read, a therapist meets weekly with a family, supporting them as they figure out how to get their child to eat. The therapist doesnât tell the parents how to do this but rather empowers them to find strategies that work. I
That numberâ90 percentâis the one that catches my eye. It represents the best news Iâve gotten since Kitty was diagnosed. Why wouldnât we try a treatment with such a high recovery rateâespecially if the alternative is treatment with only a one in three chance for full recovery?
And thereâs another reason to try it: chronic anorexia is notoriously tough to treat. Years of malnutrition, restricting, and altered social interactions set up a potent and self-reinforcing pattern that becomes part of an adultâs identity and physiology. After five or ten or fifteen years of anorexia, recovery is far less likely.
All the more reason to take this on aggressively and fast. If we can help Kitty recover now, while sheâs still a teenager,while she hasnât been sick for very long, her chances are way better.
We can do this, I know we canâif Jamie gets behind it too. One of the key criteria for the success of FBT is that parents present a united front. Consistency and persistence, as Le Grange told me. That makes sense; all child-rearing efforts, whether they involve potty training or curfew setting or eating disorders, require that parents be on the same page. I know from our experiences so far how hard it is to keep at Kitty to eat another bite, have another sip, finish the milk shake or pasta or cheese. You feel like youâre torturing your child by pushing, pressing, insisting. And you are, in the short term. But the long-term stakes are so high. It seems to me a fair trade-off: X number of days, weeks, months of hell, in exchange for a lifetime of recovery. I know what I want to do. What we need to do.
For the next several days, Jamie and I talk and argue and grieve together. âI canât understand it,â he says, over and over. âWhy wonât she just eat?â I canât understand it either. But my gut tells me that weâre asking the wrong question. The question isnât why but what: What do we do now?
What it boils down to is that we have three choices: Send Kitty away. Keep doing what weâre doing. Or try some version of FBT, the Maudsley approach.
In the end the decision is easy.
Â
The next morning I call Dr. Beth and Ms. Susan and tell them our plan to begin family-based treatment with Kitty. Ms. Susan has heard of FBT and thinks it could be a good option for Kitty because sheâs young and hasnât been sick for long. (How long is long, I wonder? Because I feel as though Kittyâs already been sick a long time. Too long.) Dr. Beth has never heard of it but promises to do some reading and call me.
FBT comprises three phases: Phase 1 is weight restoration, Phase 2 is returning control over eating to the adolescent, and Phase 3 is resuming normal adolescent development. Phase 2 seems a long way off; thereâs no way weâre letting Kitty control her eating anytime soon. I have no idea what âresuming normal adolescent developmentâ means, and frankly, at the moment, I donât care. We are solidly in Phase 1.
Kitty has lost only six or seven pounds since June, but itâs painfully clear that sheâll need to gain a lot more than that to recover. Dr. Beth graphs Kittyâs height and weight from birth, plotting her natural growth curve, and gives us a number to start with: twenty-five pounds. Thatâs how much Kitty needs to gain, at least for now.
In true FBT, I read, a therapist meets weekly with a family, supporting them as they figure out how to get their child to eat. The therapist doesnât tell the parents how to do this but rather empowers them to find strategies that work. I
Similar Books
