One thing you quickly learn as the parent of a teenager with anorexia or another eating disorder is that the most obvious and logical solutions to problems aren't workable. For one thing, at what I call the High Anorexia stages, anorexia changes the mindset from normal logical to totally illogical and irrational. Anorexics will swear that black is white - and believe it. Logic tells you this is not true and never will be - so what do you do? That's just one of the 'impossible' problems you regularly get with anorexia...
An example of this might be the #1 Problem which is: child is losing weight fast... they need to eat more to put the weight back on... so the logical solution would be to ensure they eat more food. Sorted, right?
Pah. We've been finding 'creative ways' around this problem for MONTHS and some solutions have proved more successful than others. Also, the WAY you approach things is key. I've found a very subtle and discreet approach often works better than an enforced approach and over the months I've developed a range of little 'tricks' that I bring into play whenever I need to.
One of the most obvious 'tricks' has been the Recovery Contract. The idea is that Ben and I agree this together rather than it be seen as me 'imposing my will' on him. But, of course, it's been me that's instigated the Contract and I wanted to test it out no matter what. Thankfully he thought it was a Good Idea first time round. No need for 'Plan B', 'C', 'D' or whatever.
Another major problem you'll come across is of the "as a parent I can't stand this any longer... I can't handle this... let him / her get stick-thin and end up in hospital for all I care..." variety. With me, this kind of thinking was usually accompanied by me in floods of tears, curling up in bed or in some corner - usually following an almighty 'scene' with Ben or just when the stress got to me.
Now, we all know that, unfortunately, caring for an anorexic teenager isn't something you can opt out of. You have to go on. You have no choice. No matter how impossible or hard it may seem, basically you have no choice.
So you have to think of yet another 'creative' solution to an 'impossible' problem with various Plan Bs, Cs, Ds, etc just in case.
I always smile when I think of the standard question in job interviews i.e. "Do you see yourself as a problem solver?" Ha ha ha ha ha - they should try solving OUR problems as parents of anorexic teenagers!
Now, that's what I call a REAL 'problem solver'.
Here's an example of some problem-solving / personal brain-storming I did back in September 2010 (oh, yeh, and back then I'd already made the decision to take a couple of months off work while I focused on getting Ben's recovery on track. Again, I had no choice; your priorities completely change.):
Problem: Some evenings, Ben can’t handle the thought of school next day.
Solution: Be a 'dolphin' [see Janet Treasure's book] and ask him if he’d like to take a morning or day off to ease the pressure.
Problem: Ben can’t sleep on school days.
Solution: Lessen the pressure by letting him sleep in the next day and taking him into school late. Hopefully once he gets into the swing of things, sleep will improve.
Problem: Ben has missed a lot of school and needs to catch up.
Solution: Talk to the Head about solutions – bring work home, etc. If the worst comes to the worst and he just can’t keep up, will need to take him out of school and get private tutors for the rest of the year.
Problem: Ben can’t handle school full stop and is missing loads, like in Jan/Feb.
Solution: Think about taking him out of school for a period until he’s ready. Arrange to collect work from school, as before.
Problem: Ben can’t handle school and it’s still the case at Christmas – or he ends up an in-patient.
Solution: Take him out of school for a term or longer but before that, get info from school re what he’ll miss so we can arrange private tutors. Saving on a term’s fees should pay for tutoring (100 lessons!) (25 lessons per subject – find out about how to take exams in this situation) Also explore the situation if Ben ends up IP.
Problem: Ben doesn’t go back to school.
Solution: Keep alternative state school application open and continue with tutoring. Get some voluntary work underway as well.
Problem: State school doesn’t have a place.
Solution: Apply for other state schools in the area.
Problem: Keeping Ben occupied / stimulated whilst away from school.
Solution: Walks, museum visits, voluntary work, tutoring, helping Granny, keeping in touch with friends, college courses (?), learning html & copywriting, cooking, Sky TV, decorate the house.
Problem: Ben can’t handle inactivity at school or home.
Solution: CAMHS will need to find a solution!
Problem: Ben won’t put on weight by eating more – or is cutting down more (e.g. too tired to eat).
Solution: CAMHS will need to find a solution!
Which solution worked in our case?
For Ben to go into school when he felt able to - and when he had had a reasonable night's sleep. This was either a full morning or a part morning. Because of the school dinners problem (food, social and 'inactivity' for the full day) I picked him up at lunchtime every day. Some days he didn't go at all.
I set up a system with school staff whereby Ben took work or lesson notes home. I would also email staff on problem days and they'd email work to me for him to do.
Meanwhile, to overcome the potential problem of Ben not completing the year or 'flunking' it, we applied to the local state school sixth form to re-do the year, starting September 2011. We got a place and the school has agreed to keep our application open until Ben gets his AS Level exam results in August. Hopefully we won't need to take them up on this offer, but it's there just in case.
Throughout the term, I constantly tested the water to see if Ben was ready to do full days. Then, after Christmas, when Ben ended up in a bit of a rut and didn't seem to be making any progress on any front, I introduced the Contract.
It's achieved several things including making Ben more relaxed because everything is agreed and written down, including food and exercise, so he's not worrying about it in the middle of the night. So he started sleeping much better (before this he was a total insomniac).
Because he gets points for being in school part or full mornings, it's encouraged him to be in school more - so much so that by the start of this term he was doing full mornings every day.
By adjusting the Contract yesterday to encourage full days and adequate school dinners, we're hoping that Ben will start full days at school.
But, as we parents know, with anorexia it's often a case of 'the best laid plans'... so I accept that he may not succeed right away.
However, at this stage in the recovery, I'm less inclined to make it 'easy' for Ben to opt out of school, so I will need to be a little stricter - a case of being a teeny weeny bit 'cruel to be kind'. But I'll cross that bridge if or when I come to it.
Another thing with anorexia is that you can't rush recovery. Solutions take a long time to yield results or show you need to bring an alternative solution into play.
Unfortunately that's just the way it is, but there you go.