The basket hold and refeeding

So much of what parents talk about in the later phases of re-feeding and the recovery process for eating disorders involves undoing the odd things we had to DO during the early phases. There are rituals and odd boundaries and interventions that are necessary during the initiation of re-feeding that are not only unnecessary later but must be unlearned.

I thought about this as I read The Basket Hold and Other Things Learnt That Need Unlearning by one of my favorite bloggers, autismvox.

After the crisis we also take on the task of working through 'unintended consequences.' So many of the critiques of treatment approaches are about this dynamic: "Well, you can't feed her when she's in college" or "a meal plan isn't going to work forever..." This also goes for the medical interventions like naso-gastric tube feeding and anti-psychotic drugs that are sometimes necessary to get from one place to the next in recovery. But these are akin to the plaster cast over a broken bone that causes itching and atrophied muscles - not a mask over the real problem.

Let's not confuse short-term necessities with permanent concessions. Nor should we flinch from or dismiss the unintended but unavoidable complications. We often worry more about the intervention's effects than the failure to take effective action. We're afraid to do what may be necessary to stop the damage and get going toward safety. This is not to advocate any particular "basket hold" but to say that I see far more damage and regret from failure to act than anything. Delay is damage. Under-responding is damage.

Reserve time to undo and heal and unlearn what had to be done, but still: do what needs to be done.

Comments

  1. Could you retitle this "Learning to Trust again"?
    The hardest thing for us all has been learning to begin to trust each other and not just with food.
    And I hate it.

    xx

    Charlotte

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  2. That IS a good title for this, you're right. And I hate it, too. But I can say from the other side of that difficult place that the reward is... WONDERFUL.

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  3. Laura would you be willing to put out a description of what a recovering anorectic can expect during the phases of refeeding along with what to watch out for, etc? I haven't found proper information and the more time passes with out proper treatment the more my cognitive functions decline so im asking if you would help me with this one task because maybe you might have better access to those resources? If not I understand but would really appreciate it because i am still trying to recover alone. (long story short, my husbands insurance only covers 100 dollars a day for 30 days of minimal behavioral health care, with in and outpatient care not covered)

    Be Well

    Deanna

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  4. Also love this article and thank you for writing it.

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  5. Deanna,

    Please have your husband contact me?

    Laura

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  6. Laura a very good point! I always think that it is a bit crazy to avoid something with a definite benefit in the here and now (read: good nutrition) because of theoretical future risks (they have to feed themselves in college in three years)

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  7. laura,

    My husband is not well enough to help me as a support. He has a job with basic insurance, but has me making the selection for the plan, and doing all the footwork. Im pretty much in this alone i hate to say it. I have reached out to every family member i know but none of them are mentally well enough to be my support, or help me in any major way. They all basically say, "hey try this" I try it, it doesn't work, i keep trying, they say "dont give up" but they never actually help me. They ask me how ive been eating, but they dont know if im exaggerating how much ive eaten or not, no one really keeps much of an eye out on me. Sometimes my husband says im slipping, and as im gagging and trying not to lose my food, he will try tto help me distract myself so i can swallow the food, or he will help me not to psych myself out further. Unfortunately though, The major foot work i have to do alone, and i cannot say that my husbands insurance plan is going to do me much good, but im trying.

    I just wanted to know what to watch out for as i do this on my own.

    D

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  8. D,

    We've discussed this and I'm sorry but I don't believe in helping patients virtually. I can only help caregivers locate resources and information.

    I want to help, but the only way I can do it is through others. Have your husband or other family members or friend contact me or NEDA or FREED Foundation or someone. You may be right that the people around you don't understand, so what have you got to lose? Prove yourself right - have them contact me.

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  9. Ive already asked my aunt and sister and husband to contact you and they declined. Thank you Laura, I'll just try not to give up hope I guess. Ill find someone new to reach out to who will provide me with some tools despite the fact that i dont have support. Its kind of an interesting catch 22, because i dont have support, you cant help me but ok. I do understand this isn't your area, there are too many girls with this disorder, you cant save them all. I just dont know why i bother anymore though.

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  10. sorry for my passive aggressive nature. I wouldn't reach out if i wasn't still trying. Im hurting so much. I dont expect you to have some magic answer,and I do recognize you have tried to help me. I just dont have the support you would require for your process. I dont mean to make it out like your not willing to help me because you clearly are provided that i have a support team. But I do not. So i will not comment again or bother you anymore. I will however say thank you for caring as much as you have. Be Well and i wish you the very best of luck.

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  11. Deanna,

    I wonder if you are treating the people in your real life like you are treating me?

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  12. Laura, I haven't been reaching out to the people in my life in the same way as I reach out to you, because they aren't educated on the condition, they aren't able to handle the situation well, and I admired you. Im sorry for the ways I have reacted but ive been getting desperate. Ive deleted my blog not because Im trying to be passive aggressive but because someone posted a cruel comment on Medusas blog. I dont know how to respond to your comment further because i dont know exactly how to feel. I know my first reaction was to feel hurt. Im sorry for upsetting you if I have. I dont know what to do anymore, and you were someone I respected so I reached out to you more than most. I again really am sorry for treating you in a way that caused you any kind of distress, I just lash out sometimes its not personal, and I didn't mean to offend you.

    Be Well

    D

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  13. Deanna, you haven't hurt or offended me. The reason I asked that is because the way you are treating me is probably how you are treating those around you: as if they don't understand, can't help, and then rejecting them when the help they offer is something you fear. When you treat people that way they BECOME that way.

    Reaching out to me is not really seeking help. It is avoiding help, because you know absolutely that I can't do anything useful, that any information I can give you is readily available elsewhere, and that you can reject what I say without any real consequences.

    You need assistance on the ground, Deanna. That's just true. You do know what to do but you haven't been able to do it. Telling me that my help is special, getting frustrated with me, lashing out at me, even implying that I'm uncaring and part of the problem because I won't help.... You're probably doing that to those in your real life, too.

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  14. Laura,

    I appreciate all the help you have offered me, I never thought you were uncaring.

    I have issues, that is quite clear however those issues have nothing to do with you, and I didn't mean to react towards you in frustration.

    I have reacted a lot out of fear, and desperation, however this chapter has come to a close. I realize how unhealthy these types of interactions really are.

    I wanted a care taker, someone to come in and help me figure out what to do, how to do this, but I realize how unfair it was to put pressure on you for help. I really never expected anything of you, though i know it must seem that I did. I didn't mean to. Im just desperate and reacting. Im looking for someone to save me, but i have to save myself.

    I appreciate all you have tried to do, and im sorry if you felt like i rejected any of your help.

    Be Well

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  15. Yes, save yourself BY LETTING SOMEONE HELP. Someone in your real life. I will help - and there are others as well - who will help find you on the ground resources but not directly. Give your husband or aunt or someone in your life my contact information, or NEDA's, or the FREED foundation. Please?

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  16. Ill give it to them again and tell then what you said. I hope they will help me. I know they want to try to help me, but none of them can really handle a crisis like me right now. They try to, however I cant blame them. Everyone in my family is dealing with some kind of personal crisis.

    Anyway thank you again, I will keep trying to do what I can. I wish you and your family all of the best! I hope that you save many lives through educating parents of minors about the maudsley method. May you hear more stories of hope and recovery, than of devastation and loss. That is the best thing i could think of to wish for you considering your journey to educate and help.

    Be Well

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