In this reflection’s post I have summarised some of the key points and both Megan and and her father Martin have kindly agreed that anyone who has any further questions can email them directly. Please be respectful of this generous offer and there may be things that they can’t answer. Nobody has all the answers in this complex world of eating disorders as we know!
They had prepared a short brief with background information (below) and brought it to life with such openness, honesty and trust. We could have listened to them both for many more hours. It was our busiest ever Zoom meeting with 40 screens equating to over 50 attendees.
Meg Phelps: firstname.lastname@example.org
Martin Phelps: email@example.com
Megan described four phases of her recovery
- Unconscious – I really didn’t know I had an issue. I didn’t see my restriction, use of laxatives or exercise levels as problematic
- Awareness Phase 1 – When I was an inpatient at the Cygnet, I still thought my weight was OK and my identity was very wrapped up in my eating disorder behaviours. My thinking was very black and white: thin = good, fat = bad. I knew I was there for a reason but didn’t want to let it go. My idea of a good day was no breakfast, a run, an apple and a chocolate bar. At this stage I never thought I would or could get better.
- Awareness Phase 2 – The first shift was being able to eat dinner and then things started to shift very quickly. I became aware that I had lost out on things and I would continue to lose out on things (friends, life experiences)
- Insight – This phase has been really really hard with the daily conflict of Meg vs Annie (ED voice). This is where I have learnt to recognise and connect with my emotions, to be both mindful and vulnerable through the SPEAKS programme (see below). I am still on the road to recovery and this might always be a part of me but I am more rounded and much stronger. Chair work has been really powerful in this process. Transformational Chairwork – Transformational Chairwork Megan might have a dialogue with her eating disorder (Annie), or her younger self (little Megan) or a family member, swapping places to experience both sides. This practice is often used in therapy. In addition it was the consistency of therapy and a psychodynamic approach which have been the two constants that have really driven the change alongside SPEAKS.
Key Factors for Megan
- I started to realise the effect the eating disorder was having on my quality of life and future. The breakdown of a five year relationship. Diagnosis of osteopenia. My doctor telling me I probably couldn’t have children at this very low weight. This helped my motivation to improve my health and gain a significant amount of weight.
- My Dad came along side me and learnt to stop pushing for change and to stop judging my behaviours. He learnt to process and communicate his emotions and to also show his vulnerabilities. For example, rather than saying “Eat the food” he would say “I am worried because……” If your carer can be vulnerable, you can learn to be stronger together.
- Having someone I could trust and be completely honest with about my eating disorder. I could phone my Dad and say “I think I am going to be sick” and he could communicate with me without judgement and share my vulnerability.
- My Dad genuinely being proud of me, this was a really really important thing.
Key Factors for Martin (Megan’s Dad)
- Sue (Mum) and I both came to the New Maudsley Carer Skills Workshops about six years ago. At the time we thought this was just teenage behaviour that we could fix. We quickly realised the complexities and that there were so many positive sides to our daughter that we could focus on and help her to use these strengths in her battle with her eating disorder.
- We learnt that if something wasn’t working we could always try something different.
- Megan and her therapist allowed me to sit in on around a dozen sessions which gave me so much insight into her illness and recovery process. This enabled me also to be more open with Megan if I am struggling. Now I can ask Megan for her thoughts when I am struggling.
- Megan’s relationship with her younger sister Rebecca was really affected by the illness. This has now improved greatly, partly due to the fact we realised we needed to let them make their own decisions and we couldn’t force a bond. (note that teenage sisters also often have a period in which they really don’t get on, only to be best friends again as they emerge into adulthood)
- Me being able to tell Megan how genuinely proud I am of her determination, tenacity and courage!
Extracts from the Q&A
1. More about SPEAKS
Specialist Psychotherapy with Emotion for Anorexia in Kent and Sussex (SPEAKS) is a research study led by Dr Anna Oldershaw which aims to develop a psychological intervention with a focus on working with emotion. Link – NELFT Sponsored studies | NELFT NHS Foundation Trust You need to scroll down the page. You can get in touch by emailing R&D@nelft.nhs.uk.
2. Coping with bingeing and purging
Parents are often terrified to confront these behaviours for fear of making things worse. Megan and Martin agreed that it was all about trust and communication. The more Martin understood about the emotions behind the bingeing and purging, the more Megan trusted him to be able to support her without any hint of criticism or judgement. Megan could talk more openly if she felt she was not going to be attacked.
3. My daughter hates being an in patient
So many of our families have loved ones either in a general (non ED specialist ward) or in a specialist ED clinic. At the beginning and at key points in treatment the ED voice can really kick back and usual family celebration times can be particularly difficult (post Christmas, Easter, Thanksgiving, family anniversaries or birthdays etc). Our message to families is to stick with it through these difficult times. The ED voice might try to blackmail you to withdraw your loved one from treatment. Talk to the treatment team and trust that they know what they are doing in the best interests of your loved one.