Wanting to be Well

Today, we meet at the unit to discuss L’s progress. Or lack of progress. I am told they believe she is ambivalent about being there and that I am ambivalent too. The unit manager is there, as is a key worker from her last stay. I sense I am being managed. I meet L’s new case co-ordinator. We settle down and I am asked about my ambivalence about her stay here.

So, I describe her journey since her last stay. Her weight loss as soon as any choices and freedom of food was allowed. How I hoped that her new college life would pull her away from anorexia. And the reality that what made L happy was to lose weight. Which she did and all attempts to help her eat were rebuffed. I try to explain what worries me about their methods; essentially it depends on L wanting to be well and choosing to eat. If she does not eat a meal, there are no alternatives offered. She just sits it out for half an hour and then gets to go to bed. Surely, I ask, if her CAMHS team thought she lacked any capacity to make decisions, how can they believe she can make this choice, to want to be well? I ask them if they accept that there are other treatment models and indeed they do. In fact they used to run a programme based on insisting that patients eat. But they believe this works better. L’s case coordinator says she thinks that L can make the choice and I tell her politely that as she has only met L this morning. No changes will be made to the programme to assist L. So, we are asked to make a decision, should she stay or go? All eyes turn to L and I protest, that it is unfair to ask her to choose, right here and now. I tell them it may well be their approach works for most patients, but it doesn’t work for L. And as they can’t tell me that the approach of insisting on eating and then helping her mind to heal once she is weight restored, won’t work for L, then I refuse to let her stay unwell. She can’t want to be well, because she thinks she already is.

We agree she will stay until Monday, for thinking time and for her to keep trying. She worries that the Boyfriend will hate her if she doesn’t come home. But nor does she want to stay. She doesn’t want either of the options, she just wants everyone to leave her alone. Because she’s fine, just fine. She tells me this as she sobs.

If she completes all meals she will get leave. But tonight, a text from her hints she hasn’t eaten tea. My heart sinks. I can’t wait for her to want to be well.

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6 responses to “Wanting to be Well

  1. I seriously don’t understand what the unit is doing. Would L need to be in hospital if she were able to eat without being ‘forced’? Of course you are ambivalent about her being there if she’s not eating and is losing weight! When I was in hospital if I had had ‘choice’ about whether or not to eat there’s no way I would have eaten. I assume most AN patients in an acute stage would be the same…hence the need for hospitalisation. This isn’t what happened last time she was in the unit, is it? Is there nowhere else she can go?

  2. (I mean, I do think there is definitely a place for choice and wanting to be well after a certain stage of health and stability has been reached. But it doesn’t at all sound like L is at that stage).

  3. arrrrrggghhh which like ambivalence, and anosognosia and alexythemia begins with “a” and is a pertinent word to eating disorders. How can the hospital expect her to make choices. If she could she could have chosen to eat enough to stay out.

  4. I am unsure of what pointer you are living in, but I am a really big fan if Peggy Claude-Pierre. She is one of the most amazing experts in eating disorders and probably is the only one who truly understands these complex diseases. She wrote the book The Secret Language of Eating Disorders. My parents read it and with her techniques, my parents are helping me destroy my anorexia. She also has a treatment center in Portugal called cigona retreat. It is probably one of the best treatment centers around and I would highly recommend you look into it because the treatment center your daughter is at is obviously oblivious on how to properly treat a starved anorexic.

  5. The unit I was in had a 100% rule, there was no negotiating. You had to eat 100% of what was on your plate including crumbs within half an hour and if you didn’t the entire meals calorific value was replaced by fortisip. Even if you’d eaten half the meal, the FULL amount of calories were replaced. It left no room for anorexia to have a say.

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