I DECIDE TO START AT THE top and go for a private psychiatrist. Psychiatrists seem to be the most expensive so, logic implies, their treatment must be the most effective. This means Ben will get better faster. Or at least that’s the way my mind is working in the run up to Christmas in 2009. Eventually I find a psychiatrist that can see us over the busy festive season.
Friday afternoon sees us sitting opposite a rather stern, smartly dressed gentleman as the clock ticks away on the first £250 of our insurance money. But, after asking a lot of questions, it appears he’ll simply be supervising the treatment. He hands me a list of suitable therapists to contact - the people that will do the real work. “Then, in a few weeks’ time, you can come back and tell me how you got on.” Not at £250 a shot, we won’t, I mutter under my breath. I take the expensive list home.
These are the notes I took along with me:
HISTORY
- Started to notice a difference in the summer when Ben cut himself off from his friends a lot. He didn’t have them round as much as he used to and spent a lot of time in the gym exercising, but not actually enjoying it. It was as if he felt compelled to exercise. On holiday, he didn’t eat the usual ice creams, etc.
- By October, Ben was getting very thin. He’d grown from being a strapping rugby-playing, healthy eating boy to a thin, gaunt, pale boy who was well below the minimum for his build and height.
- His eating became increasingly obsessive and ritualistic, sticking to certain foods e.g. salads, fruit and dried fruit, spending ages chopping them into small bits before eating. All ‘bad’ foods were completely cut out of his diet.
- Meanwhile he was frantically exercising to burn off the food. He’d frequently look at himself in the mirror, hating what he saw, and claiming that the rolls of skin on his stomach when he sat down were fat. All we were seeing was an almost skeletal, gaunt, pale, ill-looking boy. Everyone from the family commented on the change.
- It got to the stage where we couldn’t eat normally as a family – rowing about food, etc. Ben was ‘policing’ the fridge and everything I cooked. He’d scour recipe books for zero fat recipes. Anything containing oils, butter or cheese was off bounds. He also reduced his carbs intake to virtually nothing.
- I took him to the doctor who explained the dangers of under-eating. She said he must increase his weight before a second visit, but on the second visit he was very depressed at the slight increase in weight, immediately exercising like mad to lose it – yet hating the exercising.
- As he got thinner, he withdrew more into himself. He’s always been a fairly quiet and shy boy, but his self esteem and confidence plummeted to an all-time low. He also lost his sense of fun, becoming very serious and morose. As he distanced himself from his friends and became increasingly miserable, his peers began to distance themselves from him – it became a downward spiral. The more he tried to do things which, in his eyes, should make him more popular, the more they did the exact opposite. As a result, he became very distressed and depressed, and more obsessive than ever about food and exercising.
- Increasingly, I was picking him up from school and he was in a terrible state, extremely distressed and depressed, convinced everyone was ignoring him – in an extremely ‘black’ mood which would take AGES for us to get him out of. Very distressing for us as he’d often take it out on us too.
- The staff at school mentioned it to me. The Head of Year mentioned that the sports staff had commented on Ben losing the ‘bulk’ he needed to be in the rugby team. Other sports staff were concerned at the way he was ‘punishing himself’ in the gym.
- Around mid November, things came to a head after two particularly bad weeks. In desperation I had a talk with the school nurse who had a long talk with Ben which seemed to do some good.
- For the first time, he actually admitted there was a problem and explained how trapped he felt by it all – and how it wasn’t actually achieving what he had set out to achieve, and that it was a ‘control’ issue. He felt almost imprisoned by it all. But he felt he didn’t have the personal strength to get out of this alone. We decided he needed professional help and the doctor referred him to CAMHS (eating disorders), however the waiting list is 18-22 weeks. This is why we have gone private.
- After lots of long talks and support from us, his eating began to improve, although it’s still far from perfect as he still cuts out the ‘bad’ foods from his diet. He is so afraid that he’ll get out of control with eating that he will become fat (like his ‘puppy fat’ days at primary school). In my mind, he is still under-eating – but it HAS improved but he needs to lose this need for control, this fear of eating the ‘wrong’ things. He needs to lose his obsession with food.
- His self confidence and self esteem seem a bit better; there are less ‘bad’ days at school. However I believe that the slightest ‘You’re fat’ accusation or peer pressure could undo all the good that’s been done… We are not out of the wood yet.
- I believe that it’s the self confidence and self esteem that needs working on. He needs to see beauty from within as being far more important than the physical image. If his self confidence and esteem grow, hopefully the attitude to food will follow. I feel we are treading on eggshells a bit and the improvement he’s undergone is fragile.
QUESTIONS
- What kind of therapy does he need and with whom?
- How long will it take / how many sessions?
- Obviously Ben’s well being is uppermost in our minds but because this is private, we need an idea of how much it may cost.
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