Week 2 Eating Disorder Recovery Update (Wendy)

Goals for this week 2 were:

• Slightly increase food intake.

• Explore cognitive behavioral therapy (CBT-E)

• Work on Body Image

• Tackle 1 fear food

• Make a decision about inpatient treatment

Slight food increase and fear food

We started by using our week 1 plan as a template for developing our schedule for week 2. Updating our schedule with meetings and activities we needed to tackle. Then looking at our meal/snack plan. We did make some small changes by adding toast and jam to 2 breakfast and increasing our milk with our morning snack by a small agreeable amount. I held off pushing anymore until we could meet with the dietitian. My fullness feeling is getting better, I guess my body is adjusting to getting food in the morning and my hunger/full cues are changing.

Yoga and meditation

We continued doing yoga and meditation in the mornings. My favourite meditation this week was Mindfulness Meditation: Spirit of the Meadow (Grounding, cleansing, energising, sleep) by the Honest Guys I very much enjoyed being a tree and then in the stream with the river rocks and minnows.

I have been unsure about doing yoga in the morning as part of Sam’s treatment plan. This has led me to go back to the internet and look at research on yoga and eating disorders. I have found a few scientific articles and studies on this topic. Articles do state there are benefits of yoga for preventing ED. Also yoga is helpful for treating anxiety and depression and improves the mind set in ED. However In my opinion there seems to be concerns about yoga taking on a form of exercise that can be harmful to some ED individuals using this form of exercise to burn calories and developing an over exercise routine. In my opinion, for Sam it is helping to develop the attunement with mind, body and spirit. Furthermore, the breathing and relaxation part of yoga are good skills to develop for any individual. Therefore, we will continue for now. An ED recovery plan really needs to be customized for the individual. What is good for one may be harmful to others. The trick is finding the right approach. In some cases it is a trial and error situation and I do expect we will make some errors along the way. For now I am going with my gut. (Here is the link to the article I read). Along with our yoga and meditation routine we continued watching videos from Morning Chat and we added in Meet and Eat Together videos from Columbus Park. Another excellent site for information on ED recovery.

About CBT-E

I found easy to understand information on the Columbus Park’s (USA) website (https://columbuspark.com/2018/08/01/what-is-cbt-e/). Also, I found a more detailed pdf on Center for Integrated Health ’s (Australia) website (CBT-E-for-Eating-Disorders.pdf). I realized that we had a good chunk of step 1 and 2 on the go already. Next I gave Sam the EDE-Q questionnaire to complete. The EDE-Q test can be found in many areas of the internet. I am sure Sam has done this test several times as some of the questions are very familiar to me. Having her do this at home gave me better insight as to the Sam's problem areas and gave me a insight to a path of behavioral issues to concentrate on. Also, it provided me with a benchmark to go by when it comes time to evaluate efforts.

During my search on CBT-E on the Columbus Park website, I also came across information on DBT skills. There are 5 Skills to master. Here again, I was reassured that we are on the right track on our recovery plan.

Body Image

We did not spend days and days on this subject but I did a couple of things. First I found images on the natural age progression of the female body. And pointed out to her where Sam's body is stuck. In my opinion the human body is not a beautiful thing that has smooth exotic curves and proportions as amplified in media. It is what it is. There is a time in ones life where the body is in a more attractive, healthy state. Like any animal they is a time when one is at their prime for mating and reproductions. I think that one of the biggest and hardest time to except our body's changes is when we go through puberty and menopause. As well as physical body changes there are hormone changes. These big changes can cause either or both physical and mental health complications. Which is altogether another topic.

image from https://www.citizenwolf.com/blogs/news/why-does-magic-fit-need-my-birthday

We also watched a few podcasts that spoke on the genetics of our bodies. These podcasts stated that along with the encoding of the colour of our hair, eyes, our height that our natural weight is also encoded. This is one of the reasons that “fad” diets do not work. We need to learn to love the skin we are in and treat it with the care and respect it deserves.

Other activities

This week included a shopping day that didn’t go quite as planned but worked out ok. Sam and I had a sushi lunch at a park in Guelph on a nice sunny day and we picked up some of our favourite chocolate from Purdy's (yum, yum). Also, we (or in reality, I) made the decision not to send Sam to UHN for inpatient treatment. She was willing to go if everyone else wanted her to. But our trip to UHN for a tour of the facility made me uneasy about the environment she would be in for the duration (around 2 months). The program is a refeeding one, and due to some of Sam’s autistic traits, I felt it was very unsuitable. They did ask if there was anything that they could do to accommodate her. Unfortunately, some small changes would not be enough for me to feel the program would be helpful for Sam. So, we continue on. Lastly, I too now have therapy sessions (yeah). As the main caregiver this is so beneficial as I also need support. So this week Sam and I had our sections and now have therapy scheduled for once a week as we continue our at home ED recovery program.

Week 3 goals:

• Add a dietitian to our team

• Meal intake increase

• Work on control issues

• Work on ACT worksheets