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CAREFULLY SUPERVISING ALL MEALS

It goes without saying that close supervision of every meal lies at the heart of the recovery of any anorexic and there was no disagreement here between us and the experts. Helen, as an anorexic, was not the daughter that we had lovingly raised - but a creature of a different ilk altogether. Had we not accepted this, we would have lost her. We had to resist the natural temptation to want to trust her and believe all her protestations that she had seen the light and had now embraced the road to recovery. These were, by and large, a subterfuge created by the anorexia to trick us into believing her so that it could continue on its quest to destroy her. As working parents, we were not in a position to supervise every meal and , therefore, had to rely heavily on the support of Fiona’s mother, Audrey, and Fiona’s uncle, Meredith, to supervise Helen’s eating while we were at work. Helen was not attending school at this period (March - June 2003) due to her mental and emotional instability. At first, Helen would not eat for anyone apart from Fiona and myself. Fortunately, I work a few minutes walk away from Audrey’s house and my employers were kind enough to allow me to take extended breaks at times when Helen needed to be fed. However, if this had not been possible, I would simply have taken a leave of absence. Had this involved any loss of income, then so be it. Such a very high level of supervision was only necessary during the first three months of Helen’s illness (although she still needed to be supervised for a further three months) and any loss of income would have been a welcome sacrifice considering the alternative.

One example of the type of anorexic counter-strategies developed by Helen which we had to continually confront involved reluctantly eating the first breakfast Weetabix but plastering the second one on to the roof of her mouth and in between her gums and the sides of her mouth. We detected this because she had difficulty speaking clearly after breakfast. And, very suspiciously as far as we were concerned, she would go to the toilet immediately after eating. We listened for retching but there were no tell-tale sounds. In order to spot exactly why her speech was constrained in this manner, I had to shine a torch in her mouth in order to locate the hidden food. Once alone in the bathroom, her practice was to spit this secreted mush into the toilet. Another practice was to eat certain food items infuriatingly slowly - especially Kendal mint cake. It could take up to an hour to consume one of these. Helen argued that it was because she wanted to savour it - and there was an element of truth in this - but it was equally true that Helen also could not resist the temptation to cheat, even if she was beginning to enjoy food again. By breaking her food into such small pieces, it was much easier to ‘lose’ some of those pieces in her pocket or on the floor. This was made easier by the inevitable lapses in concentration of the by-now very bored observer. Helen’s dietician was particularly against the continuance of this practice because it was part and parcel of the anorexic thought process. The inordinate amount of time she was taking was also impractical from the observer’s point of view and so we had to put a time limit on how long she would be allowed to eat one of these bars.

By June 2003, Helen was able to return to school and her body weight was about 6 stone (up 8 pounds and 10 pounds short of her target.) By this time, Helen had made the crucial decision herself that she wanted to recover. The anorexia had been severely weakened and was definitely on the run - but it was still there. We were still a good three months away from totally unsupervised eating and therefore, Helen was still required to go to Audrey’s house for her lunch. We still operated the policy that if either Fiona, Audrey, Meredith or myself had not actually seen the food being consumed, then it had not been eaten and would not be counted towards the calorie total for that day. And, if in any doubt, we would still check her mouth after a meal for any hidden food deposits. But this time, Helen had learnt that it was in her interests to ensure that one of us had observed her eating her meal. Besides which, she was really beginning to enjoy the freedom to eat as a result of no longer being entirely ruled by the iron will of the anorexia. Helen’s lunches were prepared by either Fiona or myself and were put into a lunch box which one of us would personally deliver to either Audrey or Meredith. We treated this box as if it were a briefcase full of state secrets and Helen was not allowed unauthorised access to it. Inside the lunch box was a dated handwritten list of the contents which Audrey or Meredith would use to check that nothing had gone astray. Earlier on in Helen’s recovery - the end of April/ beginning of May - Helen had tried to convince us that she could be trusted to make her own lunches. She would, for example, make a sandwich and weigh out the bread and cheese herself. I had my doubts about this and so after a few days, took her lunchtime sandwich apart and weighed the various items. Helen had greatly over-estimated the respective weights and, therefore, the real number of calories that she would have consumed! On being gently but firmly confronted with the fact that she would no longer be making her own lunches, she became hysterical - yet again! She was terrified of the mental tortures that would be wreaked upon her by the anorexia. But this was par for the course during March to June 2003 and so we all just had to ride the storm. Helen simply had to accept that our decision was final.

By being so vigilant and meticulous in our approach, we caused Helen considerable stress and really did put her between a rock and a hard place. As Helen was mentally ill - insane even - we instinctively wanted to create a peaceful environment for her so that the manic pace of her thoughts could slow down, therefore promoting her recovery. Unfortunately, Helen’s anorexia confounded such a softly, softly approach. If we hadn’t challenged it, thereby causing her intense distress, it would have continued to starve her to death. Furthermore, according to Helen’s psychiatrist, her prolonged weight loss could induce disorientation and, therefore, perpetuate her pattern of disturbed and unrealistic thinking. As a result, Helen became deeply depressed. The anorexia really punished her for allowing herself to be forced into eating. She was suddenly filled with feelings of self-loathing, self-disgust and suicidal despair for a period of about 3 months (March to June 2003). Life was so unpleasant for her that she took to cutting herself with a knife, banging her head against walls and writing notes expressing her desire to die. She even took to trying not to wear a seat belt when in the car in the hope that the car would crash and the impact might kill her, thus ending her misery. To gain an insight into the agonies she suffered, we have included Helen’s essay “THE SIX WORDS THAT ARE ABOUT ME” in which she graphically describes her despair.

But the reality is that it was something that she just had to go through in order to recover. She had to be forced to face up to her worst fears in order to realise that there really was nothing to be frightened of after all. However, until the point she realised that for herself, we needed to protect her by ensuring that she was closely supervised and kept away, as far as possible, from all means of self-harm. By June 2003, we had crossed this particular bridge and the depressions became much less severe, far more infrequent and finally disappeared by the end of July 2003.


supervision of every meal
anorexic counter-strategies
food deposits
anorexic thought process