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.

Monday, March 28, 2011

Helping Your Loved One Manage Change

In an earlier post about Borderline Personality Disorder (BPD), I tucked away a link to some very important guidelines that are especially helpful to families whose loved one has been diagnosed with BPD but also, I think, to any family that is trying to cope with the frightening development of an eating disorder or other brain disorder in their midst and wanting to help their loved one get well.   Note that these guidelines were originally developed to assist the family in the treatment of schizophrenia and many of these points are echoed in Dr. Xavier Amador's book, I Am Not Sick, I Don't Need Help.

These Guidelines were written by John G. Gunderson, M.D. and Cynthia Berkowitz, M.D. for the Multiple Family Group Program at McLean Hospital in Massachusetts.  The guidelines were published by The New England Personality Disorder Association and can be found at this link.  

The document indicates that the "Guidelines were adapted from a chapter by the authors,  "Family Psychoeducation and Multi-Family Groups in the Treatment of Schizophrenia," McFarlane A. and Dunne B., eds, Directions in Psychiatry 11:20:1991. "   Note that you can print these by clicking on specific options on your screen on the first page of the document.  This yields an easy to read print size and an 11-page terrific document.

The Table of Contents reveals five themes and 15 sections:
"Goals: Go Slowly
1) Change is Difficult
2) Lower Expectations
Family Environment
3) Keep things Cool and Calm
4) Maintain Family Routines
5) Find Time to Talk
Managing Crises (pay attention but stay calm)
6) Don't Get Defensive
7) Self-Destructive Acts...Require Attention
8) Listen
Addressing Problems (Collaborate and Be Consistent)
 9) Three "Musts" for Solving Family Problems
10) Family Members: Act in Concert
11) Communications with Therapist/Doctor
Limit Setting (Be Direct but Careful)
12) Set Limits...Limits of Your Tolerance
13) Don't Protect from Natural Consequences
14) Don't tolerate Abusive Treatment
15) Threats and Ultimatums"

All this on eleven pages!

Again, these themes and this document would seem useful for any family, particularly one with teens and especially for one with a family member diagnosed with a brain disorder/mental illness.

As Harriet Brown and others write of their loved one's recovery(ies) and the process of getting there, there are phases during which behaviors become totally unrecognizable and even frightening.  Habits die hard.  The eating disordered part of the personality becomes terribly threatened and proceeds to try to sabotage the entire process.  My loved one is at this place.   She needs to walk through it to get to the other side; something she has been unable to do during previous treatments.  Hopefully this time will be different.   These guidelines are an effective reminder.
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