Friday 20 April 2012

Would our Contract have worked earlier in the treatment?

Probably not. Because, at that stage, Ben - egged on by the Anorexia 'Demon' - was actively working against us. Like many people with anorexia, he was also a dab hand at pulling the wool over people's eyes. As I grew to know the Anorexia Demon's sneaky tricks, I could usually tell when Ben was lying to us, hiding food or throwing it away 'in secret'.

In those days, it was all about deception - leading people to think you are absolutely fine when, in fact, you're being dragged down the rabbit hole by the ED Demon at a rate of knots. In those days, Ben would argue that black was white. At its worst, anorexia makes you completely irrational and logic and common sense go out of the window.

The Contract relies on trust - on both parties knowing that the other is telling the truth and not deceiving them. This is probably why it wouldn't have worked during the 'dark days'.

Also, in those 'dark days', I used to promise to reward Ben with all sorts of things 'if only he would try to get better'. And of course it never worked, because he was completely trapped in the eating disorder and couldn't escape.

It wasn't until Ben turned a corner in October 2010 that I gradually learned that I could trust him. I could trust him to eat the calories he was claiming to be eating. I could trust him to cook meals in the correct way, without any 'bad' ingredients being left out. I could trust him when he insisted he was working with us and was determined to recover. At that stage what I couldn't trust was when Ben claimed to be doing no exercise, or only a little bit.

When you've been deceived for so long, trusting your child is difficult. It's a slow process and more than once I mistook 'the real Ben' for the 'Anorexia demon' - and it's something he often picks up on now.

But gradually trust developed. Also, on the whole (with the exception of the odd blip), Ben was working with us towards recovery. So much so that, by the early spring of 2011, it was exactly the right time to introduce something like the Contract.

The main reason it was introduced was because, although Ben had turned a corner, his weight hadn't really increased. In fact it had continued to go down or maintain at a very low level. He found it very hard to fight the 'demon' to put the weight back on again. It was exhausting and he often felt like giving up.

By the late spring of 2011 he had reached a plateau. We called it 'Limboland', and he just couldn't go any further. It was like being stuck on a little island in the middle of a bog which threatened to suck you down again if you moved in any direction.

The other reason was that he was trapped in a vicious circle of compulsive exercise. He was unable to stop exercising or stay still for too long. This meant he was unable to 'sit around doing nothing' in school lessons. It took up loads of his time, planning or worrying about exercise kept him awake at night and it was preventing him from putting on weight.

He was frustrated. He was losing motivation. He had run out of energy. He needed some help.

This is when I came across the concept of a Contract - the 'Mountain Rescue Team' which would help him to safety, in the right direction.

He took to it like a duck to water. And the rest, as they say, is history.

But, no, the Contract I don't think the contract would have worked in the 'bad old days' of High Anorexia.

Or at least not in the form we developed.

I have come across similar things - not written Contracts, but things along the same lines; 'carrots' to the donkey if you like - which have worked at earlier stages in the illness and pushed the young person in the right direction.

So a carefully put together version of the Contract might just work earlier on in the illness. Providing that the parent finds some way of overcoming the fact that the eating disorder lies and deceives because, as I know only too well, "I've had 2500 calories today" can, in fact, mean "I've had a heck of a lot less than 2500 calories today, and the day before, and the day before that..." and "Yes I've eaten it all" can mean "I ate half of it and the rest is in a piece of kitchen paper in the kitchen bin".

And, of course, back in the Bad Old Days "sitting around all day doing nothing" didn't include the fact that we'd gone on a 5 mile walk or whatever...

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