Dr J gets to the heart of the matter

So far I like everything about Dr Joanne (except the fact she is so expensive!). Her background is CAMHS - not from our city but from a neighbouring town. I only wish we'd had her as Ben's therapist from Day One. Within 20 minutes or so of our (second) session with her today she'd got right to the heart of the matter i.e. the key problems that still remain from the eating disorder.


Although Ben has been moving forward on so many fronts - and we all give him credit for this - there are still these niggly issues and they are things that could prevent him from complete recovery, or at least make complete recovery far far slower than it needs to be which risks messing up even more of his life than the eating disorder has messed up already.

These are sticking points that came to light when Ben dropped out of university last month. Mind you, they are things I am aware of which is why I always say that Ben is 'almost' recovered rather than 'completely' recovered.

Today I was reminded of the day when CAMHS said "I'm happy to settle for 'good enough' if you are, Ben" as we approached discharge from their services because of Ben's age and the fact our psych was leaving.

Big Smiles all round. Except for me, that is. As I said to Dr Joanne last week, "'Good enough' isn't 'good enough'. 'Fully recovered' is."

Subject to Ben agreeing to continue treatment with Dr Joanne they will be working on the eating issues that are preventing Ben from resuming a full life - the way he still needs to structure his evening eating in a certain way i.e. main course of the main meal at 7pm, pudding at 8pm and snack at 9pm. Okay these days it's not as rigid as that, time-wise. But it still makes it difficult for him to go out in the evening or alter his evening routine too much. And it got heavily in the way during those few days at university.

They will also be working on the way Ben still thinks about food pretty much all the time, over and above most other things. Also the way he is worried about putting on any more weight. "I have a wardrobe of clothes I can't get into now," he told her. "Also, when I went out for a run the other day someone shouted 'Run fat boy run!' to me. Why would they do that if I wasn't putting on weight? I think about food all the time. I keep wanting to eat i.e. snack over and above my calorie limit [he still counts calories which is another sticking point...] and then I feel greedy." He used the word 'greedy' a few times.

He is worried that his weight will spiral upwards out of control. Yet at the same time he is worried that if he cuts back on food it will do the opposite and risk dragging him back down into the eating disorder. "So I feel as if I'm between a rock and a hard place," he said.

"Can you tell in advance if you've put on a kilo?" she asked.

"Oh yes," he replied. "And I feel cr*p. I have a naturally big frame, you see, and so a little bit of weight makes me look far bigger than I actually am. I also have a round face which looks worse if I put on a bit of weight. When I was a few kilo lighter my features were much sharper and I preferred that."

Hmn, I could see Dr Joanne thinking. "Do you think I would be able to notice if you put on a kilo?" she asked followed by: "What we need to do is to work on getting you from 'here' to 'there', from where you are now in terms of rigid thinking, food and weight worries, etc to a position where you don't worry and are sufficiently free of the anxiety and restrictions to allow you to resume the kind of life you want to lead - and the kind of life you would need to lead to have a successful time at university. We don't expect change to happen overnight, it needs to be achieved in small manageable steps - like you did before, with CAMHS, where you made a small change and then adjusted to it before making another small change. Although you might think you haven't come on very far over the past few months and feel in a bit of a rut I suspect that if you compared where you are now with where you are then you would see quite a big change - a positive change. And you are already doing so many positive things, like the voluntary work, Phab and so on."

I nodded my head in agreement.

Don't get me wrong, these aren't massive sticking points. Not massive when you compare them to the enormous sticking points we've had to overcome in the past, and I believe Ben is completely able to accept what she says rather than rebel against it as he would have done in the Bad Old Days. We are at a very different place, a much better place. It's just that I am aware that there are still several sticking points - issues that need ironing out so that one day soon we will all know in our hearts that Ben is 'completely recovered'. And when Ben is completely recovered he will be able to resume a normal life again, like the life he led before the eating disorder struck.

Fingers crossed Dr Joanne will be able to help tidy up these loose ends and lead Ben towards full and permanent recovery.

If the money doesn't run out before then. And if Ben agrees to continue seeing her.