On Monday, I did a question and answer session with a load of health care professionals based in the East of England. There were (I think) a good mixture of nurses, GPs, psychologists, CAMHS, crisis teams, treatment centre managers…That kind of thing.
Because the week was rapidly sucked into a whirlpool and I have spent most of it trying to catch up with myself, I have only just started to process what we said; and, interestingly – although probably unsurprisingly – the question that arose in each of the groups I talked with was: “what are the things that really helped?”
I have talked, extensively, about what doesn’t help.
I have identified the things that motivated my recovery and started to unpick some of the notions that got me stuck. Have explored sections through to self help – and taken responsibility for my recovery – and focused on the positives, and the positive people, that made a difference along the way –
But I found it really hard to describe the particular things that helped.
So, I talked about taking different bits of help at different times, and learning that things that didn’t help at one stage might still help at another – and vice versa. And, I found myself describing my lovely GP, and the amazing care I received in rehab, and some key messages I’d taken from nutritionists.
I emphasised the individuality and variation inherent in eating disorders; and the impossibility, therefore, of a one-size-fits-all approach. And, I talked about the importance of someone who would keep believing, even when I had totally given up hope -
We talked about pace – and who took responsibility – and how to engage through resistance – and the many different dimensions of recovery -
And, whilst the complexity of eating disorders was certainly clear, I’m not sure about the extent to which my rambling really helped.
So, because it’s all subjective, and as we know that there’s no quick-fix-solution or silver bullet approach, I thought it would be helpful to open out the question and bring some other people’s ideas in by asking:
What are the things – in terms of types of treatment, and approaches, and qualities – that really helped?
Tags: discussion, inpatient, recovery, things that help, Treatment
Having someone actually empathize. Having someone understand that DID wasn’t just a “bad choice”. Not getting flooded. Being a real person. Calling me on my shit. And by the way–morning ! Great post
That is certainly a difficult question, but a fundamentally important one. I think that you answered correctly there there is no one-size-fits-all approach.
I guess I can only speak of what helped for me, having been treated as OP only in CAMHS and now in adult services.
What helped:
1) My psychiatrist could not be fooled as easily as other mental health providers that I dealt with in the past and really questioned my motives to a deep level. She knew when I was doing this for myself, or when I was saying things to please her or others. I respected her because I knew I could not play games with her, and she could be firm and took the approach of “I’m not arguing with your ED. This is it, full stop.” I was partly scared of her and rarely failed to miss any snacks a few days before I saw her. I was scared that she would restrict my life, give me a level or care I did not want (adult psych hospital as a child), and so on. She was a very nice person, don’t get me wrong. She was truthful with me, and always went straight to the point without any fluffy language. She occasionally made jokes, and tried to get me to laugh at my ED — not to undermine the severity but to make me realise how ridiculous some of my behaviours were.
2) Turning up to CAMHS and the staff seeing the AN as separate to myself so the identity of an ED did not ingrain itself too deeply. Also, just being treated my professionals allowed me to give myself “permission” to eat (ie it was not my decision but something that was forced on me).
3) CAMHS did not give up on me when I was on the brink of IP, when I ended up at a lower weight then when I came in, when I failed to comply with treatment at times or when I did not want to really recover. I could only truly want to recover at a higher weight; cognition is not immune to the effects of starvation.
4) CAHMS liaised closely with school in order to give me support: I was watched eating by student support/guidance workers, I was in the school library being watched to prevent me exercising (as an alternative to going IP and being watched there), I had extensions to deadlines and school agreed to extend my studies by a year only after CAMHS spoke to them.
5) Teachers supported me with studies — they dropped off work to my home, or when I lost my school diary they also dropped it off, allowing me to e-mail them, one teacher drove to another school closer to home (as I was too weak to walk to lessons which were on a different site a mile away) to give me some one-on-one time. On teacher told me he empathised with me — his daughter recovered from the same illness as me.
6) CAMHS put me in touch with a social group which has literally changed my life around. Feeling accepted and seeing what social events I was missing helped me to get motivated to recover, and helped me have fun and gain confidence. It showed me a glimpse of a life that I was longing for — a life without an ED: a LIFE.
7) e-mail support with my psychologist helped massively as I am not the best of talkers!
All in all, the fact that my treatment at CAMHS involved so many people, and that it involved all aspects of my life: educations, social, nutritional and so on was an integral part of my recovery. My family have been every so helpful to me too; I would not have sought help without my mum and certainly could not have managed meal times without her (even if I resented all the monitoring at the time).
I think if I went IP I could have recovered, or at least gained weight, much more quickly; I was gaining weight for a 8/9 months to my minimum as OP… but I think I would have become very isolated from real life and not been able to continue with my education, as much as I struggled.
I hope this answers your questions. I’m willing to hear others’ responses too.
Wow – thanks for this and education is another question on it’s own (and one I was also asked). For me, the return to school was quite tricky…so I might actually look at this into this issue another post.
I think your last point is really interesting too – the extent to which recovery takes place within the context of life and how to manage the different aspects of recovery seems such a delicate and important balance.
Thank you so much for sharing these.
I’d like to think that every little thing adds up and helps in some way. Just to add a few things that have really helped me lately, I think it’s being in daycare with the support of objective professionals – not people necessarily who are too emotionally involved with you but not completed uninvolved – with the fact that you can’t escape. Talking to other people and getting outside yourself – that lonely place where the eating disorder reigns supreme – is definitely effective for me personally.
I guess that there is no ‘one-size-fits-all’ answer and recovery has got to involve numerous approaches to be truly effective and sustainable. All I’ll say otherwise is that by making sure that my blogroll and Twitter-feed bombards me every time I sit at a PC, I keep resolved to push on instead of giving in. What definitely doesn’t help is being surrounded by self-centred people who don’t empathise or show compassion – and that goes for both ‘regular people’ and medical staff.
I honestly don’t know what really helps. The closest I’ve heard to anyone describing what people call ‘recovery’ is like taking a bunch of little steps. It was little steps that led to the ED and it is unrealistic to think that ‘recovery’ would be anything but that, too.
It really annoys me because I want to get my relationship with food to be healthy, but when I think really, really far back I’ve always had a funny relationship with food so it isn’t as surprising that I’m still struggling with it now.
Self-help books. I am a huge fan of these for a few reasons. First, that they’re cheap, easily accessible and something you can dip in and out of. Also, they are things that I’m learning to absorb and take bits out of, rather than going for the all-or-nothing, choose it and stick to it kind of thing. I figure all this information I’m absorbing will help me at some point, and be working on my subconscience in the meanwhile.
Counselling. Don’t ask me how; it just does something. Even if it only keeps you plodding on from week to week (like my first counsellor). Or maybe, if you’re lucky, things will start to move forward.
James, I think you’re right: there’s certainly something in there around cumulative effect and using a mixture of things. I also think the distance question is really interesting, and where those support relationships are positioned. After having healthy – and less healthy – therapeutic relationships, it’s good to get a real balance; and also stay in touch with “normal life”.
girlundiscovered – the little steps is a similar theme and something I can relate to. Thanks for mentioning self help books too – it’s really important to have things that are accessible and you can take ownership of, I think. I hope you win the struggle – I think you can!