Maudsley Approach | Holes In The Sky

Anorexia…….. The Maudsley Approach.

I never cease to be amazed at the internet and all the information which comes my way via it. Today, I was reading NHS Blog Doctor (a must for any Brit concerned about the state of our health service) and he had a link to an article in the New York Times by Harriet Brown, the mother of an anorexic girl. You can access the article *here (that’s if the NYT will let you – I had to register to access the article, but when I tried a second time it told me I had to pay!).
Anyway, I was very interested to read in there about the Maudsley approach. It was the Maudsley that we attended when our daughter (then a 15-year-old) wasn’t eating (I see that Dr. Christopher Dare who is mentioned in the article and who led the team which worked with us has written a book on the subject, together with other experts). I wote my story in a previous blog MY DAUGHTER. It is interesting to learn that the Maudsley approach is now widely used in other countries as well as the UK. I see there is now a web site for Maudsley Parents.
I repeat what I said before about the Maudsley. Although my husband did not like much about the place, I believed that their basic approach was correct. I hated the horrible room we were in (physically hot, but very cold in atmosphere) and the fact that we were not only being viewed by a room-full of experts in the room next door via a two-way mirror but were being videoed at the same time. It was hard to talk under those circumstances, especially as we were under such stress anyway. Nevertheless, I felt that their basic philosophy was very good.

I wonder if the Maudsley still has the same system for payment, i.e. the patient’s surgery had to pay if the patient attended more than a certain number of times (I think it was 3 times). As I mentiioned in my previous post on this subject, this prompted my (horrible, horrible!) doctor at the time to complain at us for costing the surgery something like £3000 because we attended just long enough to incur the charge and then stopped (we knew nothing about this until our doctor chided us about it). I personally felt very aggrieved about this as I really wanted to carry on going there; but it is very hard to make a 15-year-old go somewhere when she is determined not to!

A few weeks ago I drafted out a post about anorexia which was sadly eaten up by blogger. I was prompted by a post on anorexia on NHS Blog Doctor to go and look at the web site for the UK Eating Disorders Association. They were a great help to me when my daughter had her problems and I bought several books that they recommended. Anorexia & Bulimia Care (a Christian organisation) were very helpful too.

Anyway, when I visited the EDA website I noticed that there wasn’t a lot of advice for parents on there, so I e-mailed them about this. They replied that it is an area that they will be improving on in the near future, but they asked me to let them know the kind of things that I think should be included. I really have no idea how to reply to them and (very naughtily) I still haven’t done so. I feel that my experiences as the parent of an anorexic child are very indivual to myself and my daughter and may not be helpful to anyone else. I must try to draft something out though.
* If you have trouble accessing the NYT article, e-mail me and I will send you a copy.

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The music track now playing on my computer is: –

Sisters Of Mercy from The Songs Of Leonard Cohen by Leonard Cohen

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My daughter is very precious to me – a shining light in this dark, unfriendlly world! I thank God for giving her to me.

Unfortunately though, she has had many problems in her 25 years. When she was 15, she experienced some verbal bullying at school and it stressed her out. She was anorexic for a while – there were many days when we would be grateful if we were able to get her to eat as much as an apple throughout the whole day.

It was a terrible time for my daughter. She was obviously very unhappy. For my husband and I, it was an incredibly worrying time. It still makes me cry every time I think about the events of that period, even though it is now over 10 years ago.

As a mother, I felt as if I must somehow be to blame for what was happening to my daughter. Many of the doctors etc we came up against at the time did not help, in fact they made us feel worse. There was one old doctor (he looked at least one hundred years old!) who tried to put her on a dose of drugs we were later told was far too high! They wanted us to put her into hospital, where they were undoubtedly going to force-feed her – but everything we had read said that we should not force her to eat. We just did not know what to do.

Eventually, we agreed to take her, as an out-patient, to a London hospital. It was a family-therapy based centre. To get there, we had to travel up to London from our home on the south coast. And our daughter most definitely did not want to go. It was hard.

At the hospital, we were put in the most inhospitable of rooms – cold, clinical and very hot. We were interviewed by a young therapist and sometimes a doctor too – but were informed that there was a two-way mirror and that we were being both videoed and observed by some other people in the room next door. At my husband’s request, we were taken to briefly meet these people. The room was full of doctors etc. Being interviewed under such circumstances is hard – I promptly burst into tears.

Still, we went ahead. The young therapist (from Thailand, I think) was very nice and sympathetic. Once we had got past the interrogation – why didn’t we want our daughter to go onto drugs, why hadn’t we agreed to her being admitted to hospital – they were actually pretty much in our way of thinking. The environment though was still bad. My husband did not like it, he did not want to be there. Our daughter, of course, hated it too. The whole thing was really bad. We only managed to take our daughter up there 4 times, then she wouldn’t go any more. I wanted to carry on, it seemed the only option – unpleasant though it was.

Fortunately though, by then it was now about 6 or 7 months since the problems had started and thankfully our daughter was gradually beginning to eat again. We achieved this by not forcing her to eat, by just saying it was up to her if she wanted to eat or not. It was not an easy thing to do, especially for me. But that was what the self-help books that I had bought told us to do – and it worked. Thank God.

We still had regular visits from a phsychiatric nurse for a while. After a time, it became clear that he thought mothers were always to blame for such problems! He never liked me – though he never tried to really get to know me. I don’t open up as easily as some people, it just takes a little extra effort. He never tried. I was the one who wanted to agree to our daugher taking the drugs and to continue going to the hospital. Yet, I was the one somehow taking all the stick.

Our doctor – a rather hard Scots woman with daughters of her own around the same age as ours – was unsupportive throughout the experience. She started by telling our daughter to basically just snap out of it! She finished by getting very annoyed with us for not continuing the hospital visits. This was because the surgery apparently had to pay for the visits as we had attended more than 3 times. We had not known about this before and to this day I cannot believe that that woman ever mentioned it to me! I was so upset, that I sent her a long letter explaining everything that had happened. She never answered my letter. We changed our doctor as a result. The one and only time I have seen her since is when she arrived by accident on my doorstep when she should have been at another address. At least she did have the grace to look embarrassed when she saw it was me!

Forward ten years…………… and our daughter still has problems. Thankfully, she now accepts that she was anorexic before and can talk about what happened. Her confidence is still very low though. And she still gets depressed and has lots of anxieties – mainly still concerning the way she looks. When she is going out, she will ask me – not once, not twice but over and over again – whether her skirt is alright, whether her shoes look dirty…….. any little thing will do it.

Finding a career has been a problem. She was unemployed for some time at first, filling in with one or two casual jobs. Then in October 2003 she started work at a local children’s nursery. It was not without its problems, but she stuck it out. Until February this year, when she left. She did not have another job to go to, although she decided she liked the idea of training guide dogs for the blind. The idea is still in the pipeline, in fact she is just about to apply for a job – if she can pluck up the courage to do it!

My daughter is so precious to me, but having her home has been hard for me. I knew that a long period of unemployment would make her depressed – and it has. It is then harder for her to get going again. Plus having to constantly reassure her about her anxieties – sometimes all day long – takes a toll on my patience. My husband tells me that I am very patient with her, but it makes me very stresssed inside! My blood pressure is up at the moment- and it really is not at all surprising. I feel weary and in need of a rest! (Thank God I have a holiday in my beloved Kefalonia coming up very soon!)

My daughters’s problems have helped though to shape the person she is. She is sensitive and thinks deeply about things. She has become a very spiritual person too and has got very involved with a local church. She shares my love of poetry and music. We have spent so much time together and have become very close.

Having said that……….. my husband and I do get the worst side of her character too. She takes a lot of her anger and frustrations out on us. I don’t think anybody outside this house would really believe just how difficult she can be to live with at times. If you met her, you would think she was the friendliest, loveliest of people. So I usually keep my own frustrations to myself. Until today, when I am sharing them with you………….