Research is looking at into the very early stages of recovery with the thought there may be very little ability on the part of the sufferer to respond to psychological treatment. This train of thought has also been voiced by others. Some of those raising this point of view are hospitals and medical centres – it always comes down to dollars. If an eating disorder sufferer is not suitably nourished enough for the brain to work, why bother spending money on giving psychological therapy to them at this stage.
Fair point. BUT. I have watched our team from the onset of hospitalisation with many girls start the full process right from day one. Most in-patient treatment centres do too. Our team didn’t and still doesn’t consider it too early to start psychological therapy, when both body and brain are malnourished. Within the depths of the eating disorder, the person is still there. And that is who they are trying to reach. You get glimpses of the person during early treatment. The constant, drip-feed and small seeds of thought laid by either a psychiatrist or psychologist (even a social welfare worker) are incredibly invaluable. Each little seed takes root and very slowly knowledge about the eating disorder illness prepares the sufferer for deeper treatment later. I watched my daughter and others, slowly see a light turn on – even though their brains and body were still malnourished and weak. They could start to understand a little that this wasn’t normal, that this illness was something bigger than them, and that it would destroy them if left alone.
Also just as invaluable, is the trust groundwork that is laid. Though the girls didn’t make great leaps in recovery in hospital (apart from weight gain), they learned to start slowly trusting the medical team. The team didn’t give up. They didn’t run away when the girls were sneaky, rude, defiant etc. The team kept turning up and believing in them. This constant show of belief and strength started the building of trust for an ongoing relationship.
By the time Sophie was released from hospital she knew enough the team wasn’t going anywhere in the short-term. She continued to test the teams ability to stay with her, and accept her as she was, to save her even when she didn’t want to save herself. It took 18mths on average with each team member for her to finally trust. But the seeds of trust and knowing her team took place in hospital – again while she was still malnourished. Even those following Maudsley or FBT have therapists, dietitians etc on board from the very start of the recovery period.
Unless there is trust in the relationship of therapist and patient, there will never be any real openness, honesty and intimacy. To gain recovery you have to believe and trust your team.
It is never too early to start therapy with an eating disorder sufferer. Early intervention is not just about weight restoration. It is about bringing the whole person back, slowly, carefully, and wholly.
