Saturday 28 May 2011

1.2kg weight gain since our last scales session... BMI now 19.7

Mixed messages at our CAMHS session yesterday with the psych's assistant. Some of it was absolutely OK, but my gut instinct wasn't too sure about other bits - unless it was the assistant's clever way of making Ben react in a positive way to yet more weight gain... It might be... so the jury, as they say, is out on that... But the Very Good News is that, 10 weeks into the Contract, and over the past 8 weeks, Ben has averaged out at a weekly weight gain of 0.4kg which is almost what the NICE Guidelines recommend. Considering that for MONTHS, he'd lost and then maintained (after an initial fast gain right at the start of our CAMHS treatment last spring), I think that's well worth celebrating!

Initially at our CAMHS session yesterday a fly on the wall might have thought Ben was reacting extremely badly to this news. But, as often happens, I think it's just Ben's way of coming to terms with it. By the time we arrived home, he was OK and readily agreeing to continue on his current daily calories rather than being tempted to cut back. We also agreed to update the Contract so it's addressing whatever areas we need to address now.

What niggled me, however, was the assistant implying that Ben is now "Weight Restored" - something that Ben picked up on immediately - as if that was it, finished, sorted, Job Done. She said that CAMHS would be quite happy to discharge Ben on the basis of his current BMI if that's what he wanted (but she did add that it might help to do some work on his relationship with food which isn't good...). "So what if he started to spiral downwards again?" I asked, playing devil's advocate and voicing my natural concern as a mum who's spent almost 2 years battling with Ben's eating disorder.

"You'd have to go back through the GP route," she said.

"So we'd have to wait 6 months or so for a first CAMHS appointment following a GP referral?" I asked horrified, "Just like we did at the start?"

She didn't answer.

Yet again, it was all about Ben "choosing" to stay at his current weight - at it being OK for Ben to pick a weight out of the ether "he feels comfortable with" and stay there. If this isn't recovery level, then maybe he will never recover fully, but that's what happens with some patients. It is his choice, especially at his age. Or, at least, that's the message I was clearly getting from her...

So my hackles began to rise. And then Ben started spitting venom at me in his "Big Bad Mum" hatred voice when he refers to me as "SHE". ("SHE insists...") So it felt as if Mum was the "baddie" and Ben and the assistant were the "goodies". Nice triangulation, that. And we all know the ED loves triangulation...

Yes I admit that Ben has done splendidly over the past couple of months, sticking to the Recovery Contract like glue with great results. Yes I admit he is now what experts consider to be a healthy BMI and could possibly have arrived at his natural weight. But he is definitely still entrenched in the eating disorder as regards his relationship with food and certain other aspects - although he has improved immeasurably on those counts, too.

However I know for a fact that, before Ben started to lose weight as a result of the eating disorder, he was a much fitter, healthier looking, muscular, "strapping lad". Perfect physically, really, and so handsome! The kind of boy that girls would stare at admiringly while I swelled with maternal pride. He hasn't got back to that stage yet and is still much thinner. Also, in those days, he naturally did a great deal of sport. If he did the same amount of sport now, I believe his weight would plummet very quickly.

So, as Ben's Mum, my instinct says that, no, Ben is not "Weight Restored". He isn't a million miles off it, but he's not there yet. And, in my opinion, the assistant shouldn't have implied Ben is - because ED latches onto that kind of thing immediately; it's the perfect ammo for ED in the war against Big Bad Mum & Dad...

However, as I said above, it may be an extremely clever way to get Ben to feel OK about his weight and be happy to hover around that level... So the jury is out on that, as they say...

But I'm not happy with it. I'm happy with Ben for having done so well, but I'm not happy with the way CAMHS are handling these last few kg and all the ED-related thinking that is still entrenched in Ben's head. They shouldn't be jumping in so quickly and readily with conclusions about being Weight Restored.

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