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Friday Reflection: Does ‘Refeeding’ Change Relationship?

I worried refeeding would do lasting damage to our relationship.

I went from instinctually working to make the world a safe and easy place for my daughter to actively creating highly distressing circumstances that she was required to suffer through.  It felt horrible.   I was able to put it in context and think of the long game but, nothing about it feels right. Our days were fraught and tense. Sitting for meals took up most of our time and I would steel myself and murmur ‘another bite…just one more…nope, you can’t stop…. keep going” through raging and heartbreaking tears.  I struggled mightily to summon up ‘compassionate drill sergeant’ but, more often than not, during meals I veered away from compassion and more towards automaton taskmaster.  I didn’t talk much.  I didn’t touch her other than to still a jiggling leg or stop a hand from flicking food off the plate.  I wanted to comfort her but that raised her ire and she lashed out physically. I couldn’t really look at her and take it all in for fear of bursting into tears,  so I just sat close prompting through the pain.   It felt at times like we were adversaries in battle. I tried to create points of closeness and connection to offset all the rest but nothing made things better. She was closed and gone.  She said she hated me.  Weird.  After 10 years of intense little kid love it was weird. weird. weird.

I wanted her alive more than I wanted her to like me so I did not back down but I spent many a night lying awake thinking: What does it do to a kid when home doesn’t feel like a safe place anymore?  What does it do to a kid when the people they love and trust most in the world are making them face their biggest fear….6x a day.  Does it leave a mark?   How can it not?

These two studies, one from the International Journal of Law and Psychiatry and one from the International Journal of Eating Disorders, suggest that taking control and coaching them through the difficulty of eating will benefit our children and that we should not fear it will damage our relationships.

1.  How do parents of adolescent patients with anorexia nervosa interact with their child at mealtimes? A study of parental strategies used in the family meal session of family-based treatment
Findings: Despite associations with negativity from the adolescent, the use of food-related prompts (both verbal and physical) seems to be associated with increased eating. This indicates the potentially important role of parental control of eating. 

2.  Attitudes of patients with anorexia nervosa to compulsory treatment and coercion
Findings: The perception of coercion was moderated by relationships.  A striking result was that what mattered most to participants was not whether they had experienced restriction of freedom or choice, but the nature of their relationship with parents and mental health professionals.  Indeed, within a trusting relationship compulsion may be experienced as care.   

Our experience bears this out.  At then end of the day the bad stuff was left on the field and we ended with the same relationship we had before she became ill (albeit the teenage version which seems to include considerably more eye rolling).  She loved me before; she loves me now.  She trusted me before; she trusts me now.  The world felt safe before; it feels safe now.

Refeeding didn’t ‘change’ our relationship; the ‘illness’ changed our relationship.  If anything it was refeeding that got us on the road back to the start.

Parents, what is your experience? How is your relationship now?

References:

1. White, H. J., Haycraft, E., Madden, S., Rhodes, P., Miskovic-Wheatley, J., Wallis, A., Kohn, M. and Meyer, C. (2014), How do parents of adolescent patients with anorexia nervosa interact with their child at mealtimes? A study of parental strategies used in the family meal session of family-based treatment. Int. J. Eat. Disord.. doi: 10.1002/eat.22328
2. Jacinta O.A. Tan, Anne Stewart, Raymond Fitzpatrick, Tony Hope, Int J Law Psychiatry. 2010 January; 33(1): 13-19. doi: 10.1016/j.ijlp.2009.10.003 
 
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