In 2012 I was privileged to present at the Mind and its Potential Conference. Below is the video of my presentation. It has been on our Facebook page for a while and got shared around the viral world with really good feedback for which I am grateful. I thought I should put it up on our webpage.
Can I share, with permission, the story of a patient of mine. She has had an eating disorder for some time, a long time. At times she wants to keep it, at times she wants to be free from it. Many of these times happen at the same time.
She had being doing as well as she had done for a long time. She had not needed intensive treatment in an eating disorders unit or a day program or a medical unit for over a year. This was the first time she had been able to do this for some years. She was able to reconnect in a deep and meaningful way with her children and husband. Life was becoming meaningful and worth living. I have a lot of time for this patient. I have learnt much from her about how to be a better therapist and, in a lot of ways, how to be a better person.
Then she got sick again, very sick, life threateningly sick. It took a while, but she agreed that eating by herself, even with her husbands support, was being made too hard by the anorexia. She needed to go to hospital. At times she could see that the anorexia was so in control she would not be able to eat in hospital (this has happened before). Together we decided that we needed to admit her to a hospital to be tube fed so that she could again restart the process of nutritional recovery.
The hospital where we had done this before had been closed. It was a private unit and didn’t make shareholders enough money. Another private unit had a long waiting list and had a policy of not using tube feeding. They seemed to think that patients should not “cop out” and require a tube. This confused us.
So despite having private health cover, the private health system was not able to help. So we turned to the public system, as all those without private health cover need to. In NSW there are two adult beds designated for patients with eating disorders. These beds are in a general psychiatric unit within a medical hospital. Perhaps not surprisingly, these beds were occupied and there was a long waiting list.
There was another option. There is an excellent hospital in Sydney’s West. It is internationally renowned for its treatment of children and adolescent with eating disorders. They also have access to some beds for adults with eating disorders. They have a great team with great people with high levels of expertise and experience in helping patients just like mine.
One of the first questions the intake officer asks you is your post code. If you don’t have the right post code, you don’t get access to adult treatment.
Working with the GP and my patient talked to a consultant psychiatrist who was willing to accept the patient and treat with the intensity needed to save a life. There was a bed available. However, there was that post code problem. We were told however, that we could probably gain access to a bed if we wrote to the Minister for Health explaining the clinical need.
Three letters were written.
One response received.
“I understand that the patient is very unwell and is likely to need artificial feeding and a full physical assessment. Given the clinical situation described.. I would strongly recommend the patient attend the closest Emergency Department as soon as possible”.
Well, thats a no then. We had thought of the option of a medical admission at the local hospital, but our experience is that the response has been rehydration (with the risk of refeeding syndrome) and discharge. The response ignored that anorexia is a mental illness with severe and life threatening physical complications. It requires specialist treatment.
All patients deserve access to the best possible treatments irrespective of their post code.
If you don’t think the above scenario is acceptable. The I ask you to sign the petition that you can get to via the link below.
A Discharge Letter to Anorexia
MFBT can be challenging for many families, who in implementing the required interventions to guide their child to recovery, may experience distress at how the necessary firmness of interventions may impact upon familial relationships. A family I recently worked with repeatedly raised concerns over whether the course of treatment would damage their relationship with their daughter. In this particular instance, the anorexia coerced their daughter Mary to repeatedly threaten their relationship, stating that if her parents didn’t back off she would forever hate them and never speak with them again. This understandably caused considerable distress for Mary’s parents, who decided to make some tough decisions which their daughter might not like, but which ultimately would save her life.
At the end of treatment, this is the discharge letter Mary wrote to the anorexia.
GOODBYE! All you did to me was push away my loved ones and loose my true self. I was beautiful inside and out, but with you in my life I had doubt. You were one of the worst things that have ever happened to me. I know to never be your friend again. I lost myself, I just wasn’t me. But now that you are no longer a part of my fantastic life, and I realize the strength of love and life, and how anorexia tears people apart and love brings them together.
The pain I experienced is indescribable, I had no control and it was scary. I have been so unlucky to experience anorexia, but there have also been some of life’s lessons learned. I have learned to always look at the positive side of things. I have learnt that you only live once, so live life to the full. I have learnt family is what will save you any day and every day. I have learnt that sometimes you may feel like giving up, but giving up is never an option. I have learnt that in life you should try smile every minute of the day, laugh until you wet yourself, and love like there’s no tomorrow. I have learnt that life’s journey is tough but with friends and family beside you it is possible to pull through it. Having YOU ANOREXIA RUIN MY LIFE has made me realise how important it to live everyday.
I have learned that nobody is perfect, everyone is individual and beautiful in their own way so don’t judge yourself against others, because you’re as perfect as it gets. I’d like to say I hate you for everything you damaged! I don’t ever want to see your ugly face again. I suggest you NEVER EVER come back to visit me or my beautiful family, because it is bloody proven that my family can beat anything in life no matter how difficult, we just put our hearts and minds to it. So I ban you from coming anywhere near me, my family or friends. Life without you is worth living. You made me hurt so so much that I am scarred. Although the memories are painful, I don’t mind looking back on them to say I will never go there again! GOODBYE ANOREXIA you are ugly, selfish, hurtful, painful, and damaging and you make me feel sick! I am Mary and I am cured, I choose to love my family, friends and myself. You’re no longer present in my life. You do not exist! That’s right I said you do no longer fucking exist!
I am now stronger more beautiful and happy. I love my life! I love my family. Without my family I would also not exist. You kept me going. You kept my heart beating. You are irreplaceable. I cannot thank you enough for understanding. I know I have hurt you but I am deeply sorry. Because when you hurt, I hurt. When you cry, I cry. When you laugh, I laugh. When you smile, I smile. So I say lets smile because life is a treasure, but the biggest gift of all is that we have each other. Thank you for being my family!
To finish this letter my last statement will be GOODBYE, GOODBYE Anorexia! YOU ARE NO LONGER A PART OF ME.
From Mary (Officially cured from Anofuckingrexia)