Almost two weeks ago, as I was sitting in a Crisis Center Emergency Room, a peer counselor started a conversation with me and introduced me to a program I'd not heard about before called the Wellness Recovery Action Plan. I have since learned that this program is being used in other countries and is gaining traction in the United States as well as in my own community's mental health teams.
Here is the link: http://www.mentalhealthrecovery.com/wrap/
The peer counselor handed me his copy of the manual (can be ordered on line) so I could browse through it while I was waiting. My brief cursory review told me three things:
first, that the program actually is quite simple, straight-forward,and relevant;
second, that I might even be able to use it for myself, as a parent; and
third, that the forms included in the manual can be copied and used.
I ordered the manual and will write further, have adopted some of the practices, and wanted to provide another avenue to get this information "out there." The acronym KISS comes to mind in a good way.
Information is provided about eating disorders, particularly of adults, to parents and other loved ones written by a parent who is in recovery from an eating disorder.
Welcome
When I created this blog, I was "getting on" in my early sixties, hence the blog name. However, my adult daughter's eating disorder and co-occurring emotional dysregulation disorder and other co-morbidities - ongoing for about 33 years - became and was our focus as we attempted to help her get into recovery. By learning about, reflecting on, reading about, attending conferences and writing about eating and brain disorders, I created a place to blog what I've learned. I hope this blog will be of use to others, especially families of and adult sufferers themselves to help them get into recovery. I update posts from time and the update date will be present at the top of the post.
Sadly, my daughter passed away in early October 2021 mainly because her body became so malnourished that she was immunocompromised, contracted a severe infection that was not properly addressed during an earlier hospital stay the month before, and developed an overwhelming non-covid pneumonia following surgery to save her life. I believe she should have been able to receive palliative care but Arizona, our country, and even the professionals trained in the treatment of eating disorders, particularly anorexia, are not "there" yet. I address the issue of palliative care in a recent post below, initially written in November 2021. I am not a certified eating disorder specialist. I am an Expert by Experience and college-educated with a BA in Community Work with an additional certificate in a one-year program in Business Administration from the same institution.
I am passionate about all of this because, as Shakespeare wrote in The Taming of the Shrew, Act 4, Scene 3: "My tongue will tell the anger [and sadness] of my heart or else my heart, concealing it, will break. And, rather than it shall, I will be free even to the uttermost, as I please in words."[2016]
Travel Guide
If you're new to my blog, I recommend you begin on the right side and take a look at the "Of Note" offerings. Read Dr. Cynthia Bulik's recent published interview (5/4/22) "Rethinking Eating Disorders" if you want to print an easy-to-understand professional's expert opinion about anorexia for your family doctor or the therapist. [Early intervention is absolutely critical. For those whose eating disorder is categorized as entrenched or severe and enduring, read the editorial comment by Stephen Touyz and Philipa Hay for a new approach about treatment. It is possible for your loved one to recover! I have also attached a link here for additional papers on the subject of severe and entrenched eating disorders. If you are a family member or friend of an adult with an eating disorder and have been at this for awhile, I refer you to the posts within the title "Adult Eating Disorders and Recovery Tools" found in the Index on the right hand side of this site. As well, in the "Of Note" section take a look at those posts with an asterisk. If you're a parent and need support, look for posts in the Index about parent support or parent toolbox.
In my opinion, the best book to buy, to refer to constantly and to share with members of the medical/psychiatric profession is "Sick Enough: A Guide to the Medical Complications of Eating Disorders" by Jennifer L. Gaudiani MD, CEDS, FAED. "Dr. Gaudiani aims to improve medical diagnosis and treatment, motivate recovery, and validate the lived experiences of individuals of all body shapes and sizes, while firmly rejecting dieting culture."
I recommend two groups who will support you on your journey - F.E.A.S.T and the National Alliance for Eating Disorders. Both maintain websites and Facebook private groups.
Tuesday, January 28, 2014
Wednesday, January 22, 2014
Back to Basics
I haven't been inclined to post lately, mostly because I've had nothing new to write about and have set an intention that I'll share new information here rather than rehash old stuff.
However, this past week I was again reminded that people who are not fully versed in eating disorders (by fully versed I mean eating disorders are their main focus rather than a subset of, for example, brain disorders/mental illness) forget a basic principle. I'll get to the principle in a moment.
I thought of this principle in frustration the last few days and know that behind this basic idea is the message that the film Someday Melissa and other media continue to remind us of: bulimia can be invisible except to the person who has this eating disorder. (The blog linked within the site for Someday Melissa includes this post revealing that well known people like Lady Gaga, Katie Couric, Sally Field, Jane Fonda and Jessica Alba have fought this, as well.) I know it was for my parents; they didn't have any idea. I know it was for me when my family member seemed to be better for six or seven years before the relapse. I know the seriousness of bulimia can become less visible to a treatment team when they are looking mainly for weight loss. Why? because often, those with bulimia maintain a steady weight and appear okay; because often, those with bulimia carry on their binging and purging in secret and the effects can be invisible except to those who know what to look for. The side effects of bulimia can and do kill.
The National Eating Disorder Association provides a helpful/informative summary here. Re the effects of bulimia on teeth, I believe destruction of teeth not just staining would be important to add.
Years ago at the Grand Canyon I remember noticing a sign posted somewhere (I think at the South Rim) that says, "Water is Life." Without water one can die on the trails of the Grand Canyon. Without water, one can die.
Well, food is life, too. Without food, life dies.
A drug addict or an alcoholic can quit the drug or quit the alcohol and continue to live. This decision can be more difficult for some than others, but they can quit. Those who have managed to quell these addictions and maintain recovery sometimes believe that those with eating disorders should be able to quit, too. Straight forward thought but misguided.
One cannot quit eating food and continue to live.
Overcoming anorexia is hugely difficult but can be done, especially if the family of the person allies with their relative to seek assistance to overcome it early. Overcoming anorexia subtype bulimia is also hugely difficult because the anxiety and the fear of food is still there but in addition the person has developed an addiction to binging and purging that leads the person to eat the very food(s) s/he is afraid of. A vicious cycle. But not insurmountable.
Recovery is possible. Habits can be broken and these diseases can be overcome. How?
To quote Sarah Ravin in her excellent post "Expanding Our Minds: Towards a Biologically-Based Understanding of Eating Disorders" of January 18, 2014:
".... behaviorally-based psychological treatments focused on symptom management and skills building can be very effective, in large part because they change the brain [emphasis mine]."
One effective treatment for bulimia is dialectical behavioral therapy (DBT). Dr. Ravin writes,
".... CBT and DBT are forms of psychotherapy which involve a relationship with a therapist who instills hope, provides support and feedback and accountability, promotes awareness of thoughts and feelings, and teaches adaptive skills for managing life’s challenges."
I encourage adults and older teens who are fighting bulimia to take a look at Kathryn Hansen's book, Brain Over Binge. I reviewed this book here on my blog. Again, one can change the pathways in their brain and learn new healthy behaviors.
Family members can be allies here, too.
I again refer the reader to Dr. Shari Manning's book, Loving Someone with Borderline Personality Disorder. Although the book is written for family members and friends of those with BPD, in fact the information and skills provided helps family members ally with their loved one against bulimia.
My closing question is this: how does one solve the "food thing" as a transition for an adult who lives independently?
Food is life.
However, this past week I was again reminded that people who are not fully versed in eating disorders (by fully versed I mean eating disorders are their main focus rather than a subset of, for example, brain disorders/mental illness) forget a basic principle. I'll get to the principle in a moment.
I thought of this principle in frustration the last few days and know that behind this basic idea is the message that the film Someday Melissa and other media continue to remind us of: bulimia can be invisible except to the person who has this eating disorder. (The blog linked within the site for Someday Melissa includes this post revealing that well known people like Lady Gaga, Katie Couric, Sally Field, Jane Fonda and Jessica Alba have fought this, as well.) I know it was for my parents; they didn't have any idea. I know it was for me when my family member seemed to be better for six or seven years before the relapse. I know the seriousness of bulimia can become less visible to a treatment team when they are looking mainly for weight loss. Why? because often, those with bulimia maintain a steady weight and appear okay; because often, those with bulimia carry on their binging and purging in secret and the effects can be invisible except to those who know what to look for. The side effects of bulimia can and do kill.
The National Eating Disorder Association provides a helpful/informative summary here. Re the effects of bulimia on teeth, I believe destruction of teeth not just staining would be important to add.
Years ago at the Grand Canyon I remember noticing a sign posted somewhere (I think at the South Rim) that says, "Water is Life." Without water one can die on the trails of the Grand Canyon. Without water, one can die.
Well, food is life, too. Without food, life dies.
A drug addict or an alcoholic can quit the drug or quit the alcohol and continue to live. This decision can be more difficult for some than others, but they can quit. Those who have managed to quell these addictions and maintain recovery sometimes believe that those with eating disorders should be able to quit, too. Straight forward thought but misguided.
One cannot quit eating food and continue to live.
Overcoming anorexia is hugely difficult but can be done, especially if the family of the person allies with their relative to seek assistance to overcome it early. Overcoming anorexia subtype bulimia is also hugely difficult because the anxiety and the fear of food is still there but in addition the person has developed an addiction to binging and purging that leads the person to eat the very food(s) s/he is afraid of. A vicious cycle. But not insurmountable.
Recovery is possible. Habits can be broken and these diseases can be overcome. How?
To quote Sarah Ravin in her excellent post "Expanding Our Minds: Towards a Biologically-Based Understanding of Eating Disorders" of January 18, 2014:
".... behaviorally-based psychological treatments focused on symptom management and skills building can be very effective, in large part because they change the brain [emphasis mine]."
One effective treatment for bulimia is dialectical behavioral therapy (DBT). Dr. Ravin writes,
".... CBT and DBT are forms of psychotherapy which involve a relationship with a therapist who instills hope, provides support and feedback and accountability, promotes awareness of thoughts and feelings, and teaches adaptive skills for managing life’s challenges."
I encourage adults and older teens who are fighting bulimia to take a look at Kathryn Hansen's book, Brain Over Binge. I reviewed this book here on my blog. Again, one can change the pathways in their brain and learn new healthy behaviors.
Family members can be allies here, too.
I again refer the reader to Dr. Shari Manning's book, Loving Someone with Borderline Personality Disorder. Although the book is written for family members and friends of those with BPD, in fact the information and skills provided helps family members ally with their loved one against bulimia.
My closing question is this: how does one solve the "food thing" as a transition for an adult who lives independently?
Food is life.
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