Week 4 Eating Disorder Recovery Update (Wendy)

Week 4 goals/events were:

• Meeting with the Dietitian

• Time for Sam to visit with her friend

• Meeting regarding autism

• Weigh-in

• Work on control and self esteem

• ACT worksheets

How it went

Meeting With The Dietitian

Monday morning we met with our Dietitian. We reviewed what went well and what was challenging. Sam had some challenging days where she was not able to complete the additions to the lunch meal plan. We made no changes to morning or lunch meals. We did discussed super issues and our goal this week was to work on carbs being 1/2 cup.

Sam’s Visit With Her Friend

So my thought about doing this was a positive one. I figured having a break would be good for both of us. Right after lunch we got ready and I brought Sam to her friends and had a nice visit with her friend's dad. They were informed ahead of time about Sam’s eating disorder and I had no doubt that Sam would be well taken care of. Also in regards to Sam’s selective mutism, the only person outside of therapy and her parents, Sam can talk to is her friend. While Sam was gone I enjoyed having a break. I did yoga in the morning then I got caught up in more research and recapping information I had collected on control.

Meeting Regarding Autism

After struggling with anxiety and selective mutism (SM) through highschool and the beginning of university, as well as a few years of therapy to help with these problems, Sam was diagnosed with autism. We did some exploring regarding autism but did not do anything different. Now with ED in the picture I figured it was important to get an autistic profile done so that we could understand how autism played a part in her ED and the best way to help her now.

Besides having an autistic profile done, we also had a few objectives for our meeting. One was how to learn if and how Sam could overcome the SM and we wanted to learn about the relationship autism has with the eating disorder. In our 90 minute appointment we did learn a lot. The biggest take away for me was the way an autistic brain processes information on self and others. In a "normal" brain there are two separate areas that are active, one dealing with self and one dealing with others. In autistic individuals, these two different parts of the brain have an overlapping so when areas of self is triggered the area of others is also triggered. For Sam, this intertwines the self with others, creating the need to not disappoint others and being sensitive to others thoughtsdriving her to make decisions based on what others think best for her. There can also be a loss of identity of oneself and a not understanding of one's own thoughts and feelings or lack of self awareness. What does this mean? As I see it, a slight change in our focus. First step is for Sam to find herself by first learning to identify her thoughts and feelings (which right now are all crazy ED thoughts).

We got a lot of info from this meeting but there is more for us to learn, so we will work on the self and have a follow up appointment in early November.

Weigh-in

This was an important weigh-in as it is the first one in which we could gauge how we are doing. To put things in perspective. Our meal plan was based on an agreement between Sam and I. It was a starting point for us to build on. Our meal plan did not contain any protein or calorie boosting supplements. I did not know how it would affect her weight. The end result was a small increase. I was a bit disappointed at first as I was hoping for a larger increase as we have a ways to go. But, I do look at this as a win as we are headed in the right direction.

Work On Control, ACT Worksheets, and Self Esteem

These 3 things are ongoing areas that are being done through activities at home and in therapy. The work we are doing on control as it pertains to thoughts and feelings has changed to being able to recognize thoughts and feelings. Also, to align more with our goals we switched our source of meditation. We are now listening to guided meditations from https://www.youtube.com/c/DeclutterTheMind. These meditation concentrate more on mindfulness. I like them as it is a different type of meditation that focuses more on connecting with yourself and that is what we need.

Week 5 Goals/Activities

• Recognizing thoughts and feelings

• ACT worksheets

• Building positive thinking skills

• Take time for play

• Stabilising food intake