I was very slow to warm up to Family Based Treatment, known in some circles as the Maudsley approach. The Maudsley approach was not well known or well received in the U.S. during the early days of my child's eating disorder, so I knew little about it. I was utterly exhausted and defeated by the eating disorder by the time I heard of this model, and it went against pretty much everything I had been taught as a parent about what caused eating disorders and what my role should be.
You see, back in the day, parents were assured that eating disorders were diseases of control. We were encouraged to stop paying so much attention to what our kids ate and let the kid, the therapist, and the nutritionist handle it. This helped a lot with the level of tension in the house. Things certainly felt better. The only problem is, our kid continued to get sicker and sicker, so that inpatient and residential care became necessary to save her life. So we entered a pattern over a number of years where we would limp along, under the control of the eating disorder, until things would get so bad that we would send our child off to treatment again. Back then there was little treatment available for kids on the East Coast. So, our child went to Denver, to Phoenix, to Tucson. Each treatment program did a fantastic job, and our child was able to weight restore while in the program. However, whenever she returned home, the cycle began again. My husband and I felt so helpless and inadequate, and sometimes so angry. This cycle essentially continued through early adulthood. Finally, something clicked in our child's early twenties; that "something" was most likely the development of the pre-frontal cortex of her brain. She was finally able to make her own commitment to recovery, and she is now "right as rain," as she puts it.
But I have to wonder, what if our family had been seen as a resource instead of part of the problem? Would my child have had to suffer for so long? What if we had been taught how to help her eat until she could do it on her own?
MInd you, I am not blaming her treatment providers. Every outpatient, inpatient, and residential therapist, nurse, residential assistant and psychiatrist gave their best to her treatment. The thing is, my husband and I did not have the skills to help her when she came home. We understood eating disorders pretty well, but we didn't know how to help her stay on track. Plus, we did not have access to information we have now, which indicates that parents and the family are the best resources for helping a child recover from an eating disorder.
We just didn't know.... But now we do. We are learning more all the time about how to put together the pieces of Family Based Treatment and other forms of therapy to mount the best fight against this brain disorder that can take over, and sometimes take, the lives of our children. Our children do not have the strength to fight an eating disorder by themselves. The disorder is just too strong. They need us to stand between them and the unrelenting demands of the eating disorder. That is why I offer and believe in Family Based Treatment.