WIBU to remove my DD from an eating disorder unit?

[triper]

DD is 16 and in an eating disorder unit.

They think she should stay. However, she never joins in on group therapy (they have it twice a day) she has social anxiety. She is really good at talking during her 1-1 therapy, but really hates talking in a group. She says it's to the point that people laugh at her for not talking. I feel like this atmosphere will surely crush her self esteem even more?

Thanks.

I've been hospitalised in the past. MH rather then ED but all the wards were linked if that makes sense.

I hated the place, I still think looking back some of the care in that place was seriously lacking but it probably save my life.

How long as she been in for Trip?

Distance learning is a great idea actually. Especially as her treatment seems like it's going to be a while. She might be happier if I suggest this.

12 is so young really hope things improve. WRT the eating part, the definitely do eat more when there than at home. Food is always supplemented. See, if she almost all the plate when at home, in my head I'd be so happy and proud and accept the couple of spoonfuls left on the plate. You have none of that there, if there's 2 spoonfuls and you don't want it, it gets replaced with a drink that has the same calories. Also being around people the same age all eating, I think it becomes more 'normal' in their minds and they do it. Eating is definitely achieved at her unit, barely any children get tube fed, as it's a big fear in her clinic.

She has been in since just before Christmas. It is such a slow process.

Can imagine how tough this is for you but I also think you need to leave her there.

I was in an EDU at 16 too. And I used every excuse under the sun with my parents to try and get out: group therapy was cringey; the other girls were mean; the nurses were creepy; the food was disgusting and I'd eat at home, promise!; there was nothing to do and I'd get better faster if I was busy with friends and school.

All those things sound reasonable but I was clutching at straws. My weight was critically low and I had to be somewhere where I could be monitored and forced to eat. And that's all there was to it.

IF you are in a practical, financial and emotional position to be able to cope with Maudsley style treatment then maybe you could consider bringing your daughter home. But, presumably, she is at a very low bmi and seriously ill. Anxiety in sessions and frustration at lack of educational process are very minor sacrifices to make to help save her life.

She's got an eating disorder, she's not mad.. Why is she being locked away in a place she doesn't like? What good is that? Surely she would benefit from being in a loving family environment

Zafod I can assure you that the thing I would love most is for her to be at home, hence this thread!!

She's locked away because she had a dangerously low BMI, her heart was so weak. She would collapse if she went up the stairs. No matter how much I tried, how much I begged, she was not going to eat food. She began to stop drinking water. Didn't like the idea of calories in her toothpaste, etc. she was in such an awful state. She even began to get anxiety at the idea of smelling food in case that made her put on weight. She was going to die.

Zafod unfortunately, in the very severe stage of an eating disorder, 'mad' is a fairly accurate description of the mental state. Lack of nutrition and psychological problems combined can render a person completely unrecognisable, out of control and incapable of rational thought or action. At the lowest weights, hallucinations and psychosis can even happen.

Please know that you don't need to worry about her education.

Generally, it's extremely difficult to learn whilst at a very low weight or taking in very few calories. But the ability to concentrate and take in information goes back to normal once weight and diet are healthily stabilized.

Long term, taking a year or even two out of education is a small price to pay for getting well again.

Two pupils I taught who were hospitalized for a number of months with Anorexia are now on track to get 1sts at top universities, in spite of having to effectively stop education for a year. And - more importantly - they're both healthy and genuinely happy.

Op I'm sorry for my ignorance. I really feel for her and yourself. It's just as a veteran of a semi-institutional upbringing, and from working in such environments, I know it's your last resort but would not recommend it. There is not the human touch that you get from being with true family and friends. Love is indispensable when trying to rehabilitate a lost soul. I realise it is a very difficult situation. Maybe there is one person who she looks up to and will listen to.

First I am so sorry that your DD is facing such issues, I worked in CAMHS day unit for young people with severe mental health issues this included those with eating disorders. Patients whose BMI dropped into the danger ..... that is life threatening, range were referred onto specialist ED residential providers.
As has already been said, it is a very slow process and group therapy is just one aspect of the therapy and treatment usually offered. It often takes time for a person to be able to 'join in' but that does not necessarily mean that the patient is gaining nothing.
On the education side, being able to continue with academic work can itself be part of the overall therapy and is maintaining an important element of normality in the student's life. If she is on a school or college role then they should be able to supply work in conjunction with teachers at the centre.
Too late at night to write more so very happy to say more tomorrow but I hope I've given a few helpful thoughts.

Would it be possible for her school (if she's still enrolled) to send her any work? It would give her something to do, even if she wasn't able to take in all the information. Alternatively, could she focus on learning something like a language or music theory so that she stays occupied while taking a break from "official" studies. Does she have internet access?

I agree with others that it's probably best for her to stay in the unit, but I would ask her keyworker about what treatment she's receiving for her social anxiety.

I second the advice not to worry about here education. It really would not be possible for her to progress in the physical state she is in.

Part of the concern about this on her part is denial that she is in very poor physical shape due to her abnormal relationship with eating and food.

I suspect denial is also why she is baulking about the group therapy but getting on well with the individual therapist. There can be a bit of special snowflakery involved in ED units that is associated with denial - 'I'm not like the rest of them/ I really don't have a problem like hers/ Why do I have to do this since my problem is XYZ, not ABC?' And etc..

Please don't enable her denial. She needs to stick with the programme she is in.

Apologies for 'special snowflakery' - I didn't mean it to come across as scathing.

Love is indispensable when trying to rehabilitate a lost soul.

Nope. Food is indispensable. Food.

I'm sorry she's in
I have also been admitted for mh (not ed). At first I would think other patients were talking about me, laughing at me, hated me. I would take comments very badly that were actually well-intentioned teasing. Might that be what's happening? That said, good-natured but shall I say robust joking isn't the way to interact with a socially anxious person you barely know, and drawing attention to her not participating especially is really counter-productive. I'm socially anxious. Attempts to jolly me into talking more result in the opposite.
Staff response sounds a bit dismissive. They don't, as most people don't, get social anxiety. I had the same about group therapy, 'everyone else will be anxious too' um They do need to address this, try to make it easier for her to take part. If some girls are crossing the line with their comments that also needs addressing. I would try going back and discussing that first.

Online courses are a great idea. She might not be at her sharpest but it's better for her to keep her mind occupied. Books are also good. I would just research something that caught my interest sometimes, anything I felt like - no pressure to get it quickly, pass exams etc but something to do.

I used every excuse under the sun with my parents to try and get out: group therapy was cringey; the other girls were mean; the nurses were creepy; the food was disgusting

To be fair I did all this 2 years ago. Aged 26.

I'm not an ED specialist by a long shot but I do think with ED being a MH disorder her being at risk of hurting herself that hospital is the right call.

I'm sorry your families going through this, MH runs in my family especially with women and I'm terrified my DD's may struggle when older.

The sitting and eating (for an hour or more if needed) is really important.

It must be so hard for both you and her, but the eating is so so important and as her weight hopefully returns more to normal her mental state should improve.

Are you able to go and talk to the staff? Is family therapy available?

If not study, is there anything else you can take her to help keep her mind off things? Art stuff? Adult colouring books? Reading books?

Sorry if stupid suggestion.

I recommend Open University when she's feeling up to it. Bypass needing A levels... Also, they do short courses as well, rather than having to do a whole year. Think they do taster type (free) online things too.

to you both

At home, she'll be able to go back to her old eating habits and deteriorate. EDs work in isolation.

At the EDU, she's not isolated, she's with people who know every avoidance technique in the business, she's 'challenged' every day with what's wrong (when her ED is telling her it's right) and she's forced to confront other patients with the same or similar disorder.

She's not as unique and special as she wants to believe she is (or wants you to believe she is) and she's forced to see that every day.

Getting her to group therapy would be a big step forward. Giving her an excuse to isolate herself ("Sorry, I can't go. I've got my studies to get on with") may not be a good idea, especially as it would be distance learning when she would effectively be in a class of one. You can't get more isolated.

Getting her fed, stable and on the road to recovery is the main priority. Anything else can come later.

She's not as unique and special as she wants to believe she is (or wants you to believe she is) and she's forced to see that every day

YYY to this^^
This is why the staff will not pander to the social anxiety. She has to learn that she is not an exception to the expectations. She may well thus understand that her life is lived under the same biological rules as everyone else's life.

This is not meant to be soul crushing - it is affirming her place in society and reminding her that her value is equal to everyone else's.

I agree completely with Gingernut that the DD must muck in with the other patients, because it is denial that she needs to learn from everyone else in the same boat as her that is making her resist what the centre is asking her to do.

The focus on her A levels is pure denial of her current situation. You should not enable this denial by allowing her to put her mind on anything that is not the here and now and the tasks that the centre wishes her to engage in. She wants to believe that she is special and that she can motor on towards A levels regardless of the trifling problem everyone else is insisting she has.

*Gingernaut, excuse me..

Actually... WRT the studying. They don't have facilities for her.

She is at a disadvantage to the others, who have 3 classes a day. She has to go along to the GCSE ones (that she has completed) she would still go to these but do her A-levels. She also couldn't use that excuse to not go to therapy, how would that work? It's not like she would be having extra to the other children. It's also not about getting the right grades. It's about that being a part of recovery and the comments about the education on the unit are really positive about how it helps the children keep motivated.

Has she been quite a perfectionist about her schooling?

I think the idea of her having something is good as if nothing else it keeps her busy and not in room alone thinking about ED stuff, however a risk would be that she becomes obsessed and anxious about keeping up with her work and uses ED to help those feelings.

Also what she is being asked to do is such hard work, she needs to evaluate her life, her attachments, her feelings etc and that - when properly explored - is exhausting.

So yes you could speak to them about some work at her level but be weary of how much and the pressure she might put on herself to achieve it.

EDs are so difficult on the whole family.

I feel for both you and your dd op, I was on an ed unit at 18 and it is so tough.
What is the current plan re discharge? Does she have a date? Is she at TW yet? How are her obs? Does she have any compensatory behaviours to contend with?
To be honest I would leave her there.
I begged to be discharged but that was because it was so hard being there, because I had to take on the AN and challenge it everyday. The reason I wanted to be at home was because it was easier, I could get away with more.
I think the education thing is a bit of an excuse. It really doesn't matter in the grand scale of things, a levels are pretty useless when you're dead. At 17 time is on her side, it's easy enough just to repeat the year. That's not to say that sorting out the work wouldn't help her, I think it would but it wouldn't be a deciding factor for me when it came to stay or go. Do you know what the post discharge plans are? Is there any intense outpatient support? Can you say whereabouts in the country you are?