Tuesday, 31 May 2011

Dr Sarah Ravin speaks sense....

Thank you to my dear friend, Mamame from the ATDT Forum and FEAST, for this link to Dr Sarah Ravin's latest article. (She is a really clued-up US expert on eating disorders.) The content is particularly relevant to us at the moment as it becomes increasingly clear that at least one half of our treatment team is, unfortunately, living in the past, adhering to outdated theories rather than modern evidence-based eating disorders treatment.

The number of times I've heard how the treatment won't work until and / or unless "Ben chooses to get better" and, lately, why it's important to "let Ben choose a final weight he feels comfortable with" rather than, as I and many others believe, enforcing a higher and almost certainly more realistic and relapse-resisting goal.

Ultimately we are told that the choices are "Ben's choices", not ours. We can't inflict our own will on him - he has to "want to get better". On the contrary, as Dr Ravin points out in her article: "The problem with emphasizing insight and motivation early in treatment is the presumption that the patient must 'choose' to get well and that, if she does not make that 'choice,' no one else can make it for her. Precious weeks, months, even years are wasted trying to form an alliance, cultivate motivation, and develop insight."

I understand from our treatment team that we are also about to embark on a few sessions exploring the reasons "why" Ben might have developed the eating disorder... looking back at his early life, etc. However Dr Ravin says: "In reality, childhood experiences are generally irrelevant to the patient’s eating disorder ... there is no evidence that an ill patient can overcome her eating disorder 'exploring' or 'processing' such experiences."

I am still angry at how the psych's assistant led Ben to believe on Friday that his current weight is fine and that he is, to all intents and purposes, Weight Restored.

We've had a weekend of "Xxxxxxx says I'm Weight Restored and she's a professional; you are not, so what do you know?" shouted at us by Ben (or, rather, ED...)

Meanwhile my dear contacts on the ATDT Forum who are incredibly clued up on the latest evidence-based treatment for eating disorders, throw up their hands in frustration, wondering how on earth we, Ben's parents, are going to undo the harm that has been done.

I know that we shouldn't look religiously at "numbers" but no way is 17 year old Ben Weight Restored at 1.7m and 57kg (BMI just under 20) which puts him at under 9 stones. He needs at least another half stone on top... at least...

This is a former "strapping" rugby player, cyclist and athlete we are talking about, not a 7 stone weakling...

He can't be allowed to "choose" to stay where he is or he may never recover.

Sorry, but I won't settle for anything below what is obviously Ben's natural weight.

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