Wednesday 8 February 2012

"I'm happy to settle for 'good enough'"

... said the psychiatrist at CAMHS yesterday afternoon. Ben's mood was very low and he was extremely anxious. He admitted to being tempted to give in to the ED thoughts. "My mum told me that when I was recovered I'd feel better emotionally", he said with an accusing look, going on to imply that - because he felt cr*p - he might as well give in to the eating disorder. After all, he felt 'safe' there.

They say that you hurt the ones you love most, and Ben certainly succeeded in hurting me. The session was full of accusations along the lines of "My mum insists that xxxx is right" kind of thing and "I don't know who's right: the NHS for telling me it's OK to stick with 'good enough' and stay as I am - or the rest of the world that's telling me I must be properly 'weight restored' in order to recover".

"Well I'm more than happy to settle for 'good enough'", said the psychiatrist. "In an ideal world we'd love you to return to the weight and physique you were before the anorexia. But in many people this just isn't possible. They simply can't handle it. So we need to come to some sort of compromise and I'm happy for you to stay where you are. Yes, if you got freshers' flu or something else that results in weight loss you would be underweight because you don't have any 'buffer zone' at the moment. But I'm happy to settle for 'good enough' if you are."

Daggers look from Ben at Big Bad Mom who, I guess in his eyes, is trying to make him fat whereas the nice psychiatrist isn't. "My mum says if I lose weight I'd end up hospital and die" he said accusingly.

"No, I did not", I said. "I said that because you don't have any buffer zone, if you lost weight you could risk heading back into the 'danger zone' if you went too far. You and I have fought tooth and nail to get you to the stage you are now and I refuse to let you relapse. I refuse to go through all this again. Relapse does happen because I've seen it happen." I was referring to the various families I know who are having to deal with the eating disorder for a second or even third time - and the recovered anorexia sufferers I know who have had relapses and are well aware of the risks.

Ben feels "uncomfortable" now he's "put all this weight on". He feels like he "did before the anorexia" when he carried more weight. He talked as if he'd put on a tonne of weight recently rather than a couple of kilos.

And I could feel the eating disorder beckoning with Siren-like lures of comfort and security in its 'arms'.

Ben felt cr*p and he felt 'recovery' wasn't handing him the happiness and contentment he thought it would. He felt betrayed, and it was as if he was saying he might as well have stayed with theED.

So that kind of set the tone for the session and I came out of the session feeling horrified and defeated.

We didn't speak to each other on the way home.


  1. I don't blame you. I wouldn't be speaking to the psych either. For goodness sake, this is just dreadful - poor care.

    I would suggest that the psych listens to the Dasha Nicolls/Adrienne Key interview yesterday on Radio 4, where they talk about anorexia being an anxiety disorder.

    Sigh. Poor Ben. What a terrible thing for the "specialist" to give up on him.

    Batty, you know more than them. Don't doubt yourself. xx

    1. Just as I thought we were 'singing from the same hymn sheet...' I will check out that Radio 4 interview.

    2. Of course you know, but recovery and the feelings of contentment or at least being ok take a long time, possibly even years. I have been in active recovery from bulimia for about five years and I still struggle with my body image, how to exercise safely (as in not trigger myself) and food/nutrition management. I still panic over cooking food for anyone other than my immediate family and on a bad day find eating with others difficult. It is a management process, if not forever, for a long time.

      Over the past week I have read your whole blog and I just wantd to say wow! You, yourself have come such a long way in managing and understanding Ben's illness and obviously he has too. Don't give up on trying to push his weight up those few extra pounds, it will be so worth it.

  2. I'm so sorry you had such a difficult time yesterday, Batty :(

    It does take time, after weight gain, for the person to feel better about themselves and their life again. It has taken me ages.

    My psychiatrist said something to me a couple of years ago that stuck in my mind and has made a lot of sense. He said "you need to find something to replace the anorexia with; something that feels to 'work' equally well".

    I was struggling to understand who I am, what I 'should' be, what I wanted to be etc. I was confused about my identity. And for me that identity confusion started pre-AN, because I felt I was fundamentally 'wrong' in some way; that I didn't 'fit in' with my peers and that I was crap. I don't think it is unusual for all teens to struggle to 'find themselves' - and having AN certainly doesn't help, because it delays development in some many ways. Yet, for the person who has AN, the AN 'feels' to 'work'. It can feel like 'a solution to a problem', even though that is an illusion. AN creates porblems; it doesn't solve them in reality.

    What my psychiatrist was telling me to do was to find things I enjoy doing; things that make me feel better about myself and that life is worth living. It can take time to find those things. For some it is a relationship; for some it is a career; for some it is volunteering; for some it is a passion - like photography/art/music etc.

    Not sure if this helps...


  3. Argh, how frustrating for you! Nothing like a good bit of triangulation, hmm?

    I really wish the professionals wouldn't side with the eating disorder. Of COURSE Ben is scared of putting on more weight, and of course he feels uncomfortable at his current weight. He feels uncomfortable because he's not had enough time to get used to it, and quite possibly because it's below his set point and therefore his brain can't recover properly in his current state. I used to think I was doing myself a favour by keeping my weight at the very low end of healthy too - I thought that appeasing the anorexic thoughts would stop me from becoming overwhelmed and relapsing. In reality I just perpetuated my state of slight malnutrition which kept the eating disordered thoughts going and eventually lead to more relapses. Keeping myself too low made the eating disorder worse, not better.

    How exactly does the psych expect Ben to EVER be okay with getting back to a truly healthy weight for him if he doesn't a) get there and b) stay there for an extended period of time? While he's still not at the correct weight his brain is just getting the message over and over that there is something to be scared of and a good reason to stay there. It's basic behavioural principles...

    Gah, this is making ME want to rant, so I can't imagine how you must feel. I can imagine how Ben must feel - terrified and confused, most likely, worried that he will always feel this bad and will just be an anorexic brain trapped in a "fat" body, and wanting to trust the person who says he can stay at a lower weight and make his ED happy but still recognising that there is logic and sense in what you say as well. It's a horrible conflict to be in, and he needs consistent messages. I would be spitting nails at that psych...

  4. Thanks everyone for your feedback. I am spitting nails! Psych leaves in a few weeks' time on maternity leave, so after that I'll be in charge: Big Bad Mum, lol!!!!! And first I need to undo all the damage that's been done. I won't rush into this. I'll give it a little time...

  5. I don't know if this would help at all and it might be a bit too confrontative, but could you try framing it to Ben that he might not *want* to be one of the people that "simply can't handle it"? Like trying to get him to see that it's almost insulting that the psych thinks that he isn't up to full recovery?

    Hmm now that I've written that it sounds awful, and obviously you don't want to vilify the psych, but if a doctor/psych said that to me, although the ED part of me would use it as an excuse to stay where I was, I think the healthy part of me would find some motivation in it - to show them, in a way, even if that's childish. (It's part of how I'm motivating myself to keep going with weight restoration at home when all the docs have told me it's "not possible" and I'll "definitely fail and end up back in hospital.") Anyway I'm glad Ben has you in his corner and that you at least aren't prepared to settle for second best! :)

    1. Hmn.... food for thought there, Anon, definitely food for thought - and I could actually see that angle appealing to him, especially the perfectionist side of him. I get a gut feeling it's best to wait a tiny little while before I start drip-feeding this concept so he doesn't smell a rat, keeping a close eye on him of course in the meantime. Excellent idea. xx

    2. I agree with Anon, the psych has basically given your son permission to remain "not fully recovered" which will place him at greater risk of relapse.
      If your son is anything like my daughter (perfectionist, high achiever, athlete...) then a compromise is always a better offer but alos a guarantee that their brain will never be given the chance to fully recover.
      It's not just about weight restoration but also about brain restoration and that requires the body to be weight restored to the persons "ideal" based on their growth and development when they were healthy. That's my opinion anyway.
      Keep fighting BM... and don't allow any "specialist" to tell you or your son that near enough is good enough!

    3. That's actually a really good idea. One of the things which kept me motivated after the initial rush of the first couple of weeks of recovery wore off was that my contact at the local EDU quite clearly did not believe I could manage to gain weight in the community. She was such a patronising cow that I took great pleasure in proving her wrong :P

  6. So frightening.. so discouraging. Good enough is more than a little insane. I wonder, if she had a patient who was suicidal, would good enough be sufficient? How about a host of other issues.. cancer? Well it's just *little* cancer, that's good enough. I'm so irritated right now I can't even respond the way I wish to.

  7. I can understand your frustration. I found that when my own son was recovering from his eating disorder years ago, that the recovery process was almost as difficult, if not more difficult, than when he was fully immersed in it. It's hard not to see results right away, so I can understand what he's feeling. But you must not give up! My son didn't, and he is so much better today. I know your son can do this too. If you're interested, has some great advice there for dealing with ED. It really helped me through the whole ordeal. I'll be keeping you and your son in my thoughts.