Tuesday 13 December 2016

Triangulation - the eating disorder's favourite state of affairs

Back in 2010, as we neared the point where my son was given control of his breakfast, lunch and snacks and 'Mum's Eating Plan' was dumped, there was some super-triangulation going on. By this I mean that different people were saying different things. Eating disorders love this. What eating disorders find tricky is when everyone - both parents and everyone in the treatment team - is 'on the same page', presenting a united front against the eating disorder.

Another thing that eating disorders love is for people to argue with the patient - to try and rationalise, explain, bribe, bargain, reason, etc. An argument with someone entrenched in eating disordered thinking is an argument you are never going to win. As a parent or carer you need to demonstrate that you are in complete control. You are the boss.

As the wonderful mum Charlotte Bevan advised in her reply to my forum post below, don't argue, just sit there until he eats, saying things like: "Food is your medecine, I love you more than the eating disorder, Hmmmmmmmmmm - repeated endlessly!" One mum said she tended to "blank out" what the eating disorder was saying, treating it as "white noise".

But back then, I was terrified of where my son's eating disorder was heading - and not 100% confident in CAMHS which was kind of scary seeing as they were responsible for potentially saving my son's life.

We were triangulating. On one hand, our psychiatrist was keen to pass food control over to my son, but the dietitian (who we saw separately) wasn't. My husband was kind of floating between the two much of the time. Then there was me, wielding the 'dreaded' Eating Plan, keen for my son to put on weight and get back to where he was before the eating disorder struck.

This edited version of a thread I posted on the Around The Dinner Table forum in May 2010 describes what was going on at the time and is an example of both triangulation and trying to reason / bargain with the eating disorder:

Last week, after 6 very successful days sticking to the eating plan, my son refused to eat the meals and snacks I put in front of him. The only way I could get him to eat was to allow him to take back some control over his intake and strike a deal that if he LOSES weight by his weigh-in next week, then I take back total control. The psych has been 100% behind my son's desire to take back some of the control whereas I've been 100% sure my son isn't ready to do so. Triangulation, with me as the 'baddy'.

Anyway, we saw psych on Fri followed by the dietitian. Psych is still behind my son's desire to take control despite the fact he had LOST 0.7 of a kg on Friday (which must have happened during the 'pear shaped' days when my son was refusing to do the eating plan). Meanwhile the dietitian is completely on my side, unhappy about my son taking this control and reinforcing why this diet plan was prescribed and needs to be followed. Reluctantly however after my son's protests, she agreed that he could continue with the 'deal' with the caveat that if he hasn't put back the lost weight by Friday's weigh-in, then I take back control and the strict eating plan kicks in with a vengeance.

It all started well, with my son mirroring the eating plan on Friday. But then on Sat he went on his camping trip with his friends - great from a social point of view, but terrible from a food point of view. When he got back, he was just like any other boy who'd had a fun weekend with his mates which was good... initially... but then things quickly spiralled out of control as he started to tot up his calorie intake, checking calories on the Web, etc - and he went into total panic, convinced he'd been 'bingeing', disgusted at himself and generally beating himself up about this so-called 'binge' and refusing to eat any more food today, also refusing to let me take back control and reinstate the eating plan which all my instincts scream that I should be doing. I can't clamp his mouth open and force-feed him - and the eating disorder just spits back at me that I can't go against what the psych has instructed. So what can I do?

Things have gone totally pear shaped and very, very messy. It's not come as a surprise and I'm mad at the way the treatment team have been handling this with, on one hand, the pscyh telling my son that yes it's great he's taking more control and, on the other, the dietitian insisting he isn't ready (which I agree with). Plus, because of this, my son is getting some pretty dreadful mixed messages. So much for 'all singing from the same hymn sheet'...

We have a weigh-in with the nurse this week, but we don't have a pscyh or dietitian appointment for another fortnight. And if my son hasn't put on the lost weight, then who's to say he will stick to his side of the 'deal' and allow me to reinstate the eating plan. Help!!!

I've had a very stressful week. My son continues with his version of the eating plan and screams at me if I make so much as a whimper about what he's eating. Meanwhile I am sure he isn't eating enough (to put it mildly...) (He is trying quite hard, but he really isn't eating enough, but I guess Friday's weigh-in will be the telling time.)

I've had massive arguments with my husband who keeps accusing me of "Going against all the professional advice" (which is to let my son get on with things his own way) over and over again while my son accuses me of being a control freak because I can't handle losing control of the eating.

Meanwhile I can't get hold of the CAMHS team or the dietitian, having emailed, phoned, arranged for the nurse to leave messages in pigeon holes, etc. No-one is getting back to me.

And I know on Fri when we see the psych she will whisk my son off to be weighed followed by a session between her and him while H and I see the nurse (who never seems to pass our concerns on to the psych, or at least it never seems that way). By the time we see them at the end of the session, she'll have said something like: "He's lost a little weight, but I feel he's doing SO WELL we'll let him carry on as he is... I've told him to try a little harder to eat more..." sort of stuff.

I feel as if it's just me, surrounded by my son, husband and a divided CAMHS team and I am very, very depressed about it all.

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