10 Apr Why we do what we do.
“I’m so sorry for crying” she said, “but you are the first person to recognise there is a genuine problem”. Diane grabbed a tissue, and told me her story.
Diane had become very worried about her 12-year-old daughter Sarah. Sarah was rapidly losing weight and had become secretive and moody. Sarah was an only child and the close relationship she had with both her parents had changed recently. Diane thought she heard her daughter vomiting in the toilet a couple of months ago, and had mentioned it, but Sarah had denied anything was wrong.
Diane was worried enough to ask for a referral from her doctor to a local psychologist; who told her the moodiness was just normal adolescent behaviour and not to worry.
She sought a second opinion and had a few sessions with another psychologist who then told Diane that she was being overbearing and was part of the problem. Her advice was “leave the child alone”.
With Diane’s permission I spent 90 minutes with Sarah and discovered she was purging at least twice a day, usually in the shower as the water hid the sound of her vomiting. She had been bingeing in her bedroom and hiding food wrappers under the bed and in her school bag. Sarah loved to dance but felt under a lot of pressure to be slim. Everyone at dance class had complimented her on her weight loss, even the teacher, and this motivated her to lose more and more weight by increasing the frequency of the binge and purge cycle. Sarah liked the psychologists she saw previously, but neither of them asked directly about her bingeing and purging behaviour, and neither seemed to understand her mindset, which meant she didn’t disclose vital information about her eating disorder. She believed her life was out of control and felt ready to accept help.
I spent a total of 6 months seeing Sarah and her parents together, and separately. We worked on behavioural interventions and explored the cognitive emotional side of her eating disorder. We built relapse prevention into the treatment program and agreed a ‘contract’ between us outlining the actions she would take if she began to slip back into certain behaviours. We discussed body image and where the pressure comes from the look a certain way. We discovered a mutual love of Converse shoes and modern art!
Sarah gained confidence and understood how she used the binge/purge cycle to regulate or block some emotions. We worked together to include her parents as a ‘resource’ when she had concerns about school and her changing relationships with her friends. Diane and Paul agreed to make time to actively listen to Sarah’s needs and not to punish her for eating disorder behaviours. Instead they collaborated with her and supported all efforts to try different ways to overcome the need to binge and purge.
Sarah was in recovery, but it bugged me that many health professionals lacked the required knowledge and skills to be able to effectively assess and treat eating disorders.
The Australian Centre for Eating Disorders (ACFED) was born, and it became our mission to bridge the knowledge gap and establish a minimum standard of eating disorder education in Australia, making it safer for sufferers and their families to receive effective help towards recovery. ACFED are affiliated to The National Centre for Eating Disorders (UK) and use the same evidence-based treatments models.
In just our first year we trained 130 counsellors, psychologists, psychiatrists, and dietitians and started to build an ACFED Approved Practitioner network that is accessible through our website at www.acfed.com.au.
Our network makes it easy for medical practitioners and the general public to be able to find someone local who can offer effective help.
In November 2016, we will present our first course in Auckland and we are looking even further afield in 2017.
If you are a health professional who recognises the need to expand your knowledge in this area, we would love to welcome you to the ACFED family.
The Australian Centre for Eating Disorders.