I am on a train heading to London and smiling ironically as I write this post. Because I am hopeless at getting L to eat. Always have been. At first I didn’t even know whether I should make her eat. I agreed 1800 calorie a day meal plans with her just to get her to be used to 3 meals and 3 snacks. I didn’t know that when she asked for a certain food, it was Ed speaking, not her.
It is hard for me to insist a child eats. I was brought up by a mother who was obsessive about food – when we were to eat, what we were to eat and who would insist every mouthful was eaten. I was a fussy child and this enraged her. And I mean enraged. She would scream and shout, slap me or bang the table while I sat in tears. One mealtime she enlisted one brother to hold my arms behind my back, while she held my nose and shovelled food in. Another time her rage made her push my face into the food. I feel shaky when I think of those times, but angry too and I promised myself I would make mealtimes calm and would never, ever force a child to eat. But anorexia changes that and while I would never contemplate the abusive behaviours I experienced, she needs to eat.
One of my mantras is the only behaviour you can change is your own and this is never more true than when helping an anorexic to eat. So on the basis that this is the advice of someone who has really struggled with refeeding these may work for you.
1. Start with you. Do you really want her to eat? Yes I know you do, but I mean, really, really want her to eat. So much so, that you can stand her tears? So much so that you can clear up a thrown meal, replate if clean, replace if not, put it back on the table and start again? Can you hear your child say, “Mum, please, please don’t make me, please, I can’t.” With tears rolling down their face and perhaps yours too? Can you hear that, see it and resist the urge to hug them and say Don’t Worry, we’ll try again tomorrow? Can you do that up to six times a day? Seven days a week and if you’re not there, will someone else do this? The biggest lesson I learned about being a parent of an anorexic was that it wasn’t her emotions that needed to change; it was mine. I needed steely resolve, and I needed calm and I needed warmth. All at the same time. While being exhausted. These tips are as much about my survival as hers.
2. Keep her out of the way until the meal is ready. I am hopeless at this, partly as it is open plan downstairs and I do wonder that if I chase her away, the meal will have more threat to it. So, if butter or large portions are needed, I add them, calmly. On bad days, a little more defiantly perhaps. Practice the teenage ‘talk to the hand’ gesture as you hear the gasp at the sight of you plating a meal.
3. Have a phrase and a gesture. I stroke her forearm and say, please finish. Only when she flags. Use the broken record technique, use the same words again.
4. If, like me, you have been less than strict in the past, tell her that this time is different. Say out loud, “I have given in in the past and anorexia won. I’ve changed now. I won’t give in, we will stay here until this is eaten. I am stronger now. I can do this and so can you”.
5. If you planned pudding and the main course is really tough, don’t back down on pudding. Remember this is about your child, not your exhaustion. Every compromise teaches her that Anorexia is In Charge. It is a terrorist. You are The Government.
6. Distract, distract, distract. All of you need this – the traumatised siblings as well as you. Chat about the day, tell jokes. Once others have finished, let them leave if they want.
7. When it’s down to you and her, distract yourself. I browse the internet on my iPad, stroking her forearm and repeating Please Finish. The Internet stops me giving in and gives the message that we’re staying until she eats. But ban her phone from the table.
8. Make fun of anorexia. This works best with a sibling. Ways we have tried are:
a) Impromptu renditions of Fighter or Stronger with accompanying dance routines
b) Boxer soliloquy in manner of Ed being in the ring. “You’re going DOWN! I’m gonna whip your sorry ass!
c) Big Deep Voice for L, squeaky voice for Ed. Act out dialogue in comic book heroes style with L being Batman and Ed being pathetic villain. But you have to do both voices. L can’t, she’s crying.
These last three are best for keeping you sane. Your child won’t laugh. But you might and your other child might and this will give you breathing space to avoid yelling, “For beep sake, will you just beeping eat your beeping dinner before I go beeping mad”. Not only does this not beeping work, you will feel so guilty you will give in. And beeping Ed wins.
9. Hug her frequently, tell her you love her and that you won’t give in because she deserves better.
10. Put food on a spoon and raise to her lips, while placing an arm around her. The arm is principally to avoid unbalancing as the spoon is knocked away.
11. Tell her all what life will be like when she is well. Remind her every mouthful is a step towards it. Tell her she can do this, she will do this and when she eats, tell her she is doing this. Tell her she is strong, tell her you are strong too and together you’re going to do this.
12. Try the personal trainer approach. You know,,the sadists who growl Come On at a client when they are red faced and sweating on a treadmill. Like a drill sergeant and gospel preacher had a baby. Motivational and directional. Avoid the logic voice that says this is toast, not the Olympics. Actually, it’s harder.
And when it’s done, run away, far away from the table. To the sofa, back to bed and hold her as tight as you can, rest and relax. Because you’re going to need to do this all over again. Very soon. And again. This isn’t a sprint, nor a marathon. This is a war of attrition and only one side can win. It must not be Ed.