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For Bulimics and Anorexics, Mom Uses Maudsley Method and Succeeds

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If you are a parent of an anorexic or bulimic and thinking about pursuing the Maudsley approach, reading Harriet Brown’s account of her experience will help you understand how much participation is involved. Harriet Brown is an author, teacher and co-chair of the Maudsley Parents, and her article, “One Spoonful at a Time,” was in the New York Times.

Brown writes, “That summer, Kitty was 14. She was 4-foot-11 and weighed 71 pounds. I could see the angles and curves of each bone under her skin. Her hair, once shiny, was lank and falling out in clumps. Her breath carried the odor of ketosis, the sour smell of the starving body digesting itself.” This is what anorexia looks and smells like. There is nothing stylish or sexy about it.

Anorexia is a killer. And what does a mother do when a killer wants to obliterate one of her children? She battles “the demon,” as Harriet calls anorexia. And Harriet and her husband waged an heroic battle against this deadly disorder.

Harriet’s daughter became anorexic when the Maudsley approach wasn’t well-known in the United States. So while researching the Maudsley method, Harriet writes that “…two studies showed that 90 percent of the adolescents recovered or made significant gains; five years later, 90 percent had fully recovered. (Two other studies confirmed these results.)” She wanted to find a treatment option that didn’t include the hospital, feeding tubes and as Harriet writes, “a parentectomy,” and she did: the Maudsley approach.

Using this approach was controversial, and as parents, they had no idea if it was right. It just felt better than the other options. But it was challenging, Harriet writes, “She [Harriet’s daughter] sat in front of the cake, crying. She put down the fork, said her throat was closing, said that she was a horrible person, that she couldn't eat it, she just couldn't. We told her it was not a choice to starve. We told her she could do nothing until she ate — no TV, books, showers, phone, sleep.”

I like another insistent remark that Harriet used when her daughter was being particularly difficult, she writes, “Food is your medicine and you’ve got to take it.” Amen. Re-feed the body and the brain starts to function properly: that is the main tenet of the Maudsley approach. This approach is not for the weak or impatient. Imagine the stress on a family repeating this routine for three meals and two snacks a day, Maudsley’s required meal plan.

After about sixteen months, the approach did work, but Harriet explains that it works best when there are two parents to share the burden. These devoted parents even brought their child to work to see that she ate her lunch and took turns being the enforcer at dinner. Of course not every family is in a position to do this. But if you are and believe you are strong enough, this approach is definitely worth a try.


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EmpowHER Guest

When I was 14, my parents used the Maudsley Method to try to coax me out of a stubborn eating disorder. Like Harriet’s daughter, I was not allowed to sleep, shower, or maintain any level of hygiene. I did not eat or sleep for 3 days. This stress on an already severely underweight body took a brutal toll. I was admitted to the hospital and quickly transferred to the ICU, when it was found that my heart was beating irregularly. However, after about a week I was discharged, having reached a daily caloric intake of about 1200. When I got home, the Maudsley method was re-implemented, this time attacking “fear foods” or foods that I had avoided for years. When I tried to leave the table, I was “restrained”. My dad and I would wrestle for hours until finally he was literally on top of me, pushing my pressure points to deter me from doing leg lifts. I was kicked, hit, and strangled by my father, a man who had never laid a hand on me before. So before you choose Maudsley, please consider the possibility that the fear involved in watching your child starve is sometimes a stressor that leads to terrible situations. Also consider that parents simply do not have the equipment or expertise of a hospital setting. After my parents realized Maudsley was not working, they admitted me to Alexian Brothers Behavioral Health Hospital where I worked with nutritionists, therapists, and doctors. Thanks to them, I have been fully recovered for three years.

October 15, 2010 - 10:46am
EmpowHER Guest
Anonymous (reply to Anonymous)

Anonymous - I too am sorry that you and your parents had such a hard time during your illness, and very relieved that you found more suitable help and have recovered. As you have said, and indeed as Harriet Brown describes so exquisitely in her book, AN is terrifying for parents. That fear can either be chanelled for good, or, as in your case, and indeed in mine (I am a parent) allowed to spiral out of control and damage all around it. One of the main aims of Family Based Treatment (which is a highly manualised, researched and supervised approach, NOT just letting parents get on with it the best they can) is to chanel that fear and to make it a force for good and for recovery. I am sorry that you and your parents did not get the help you needed during the process. Many, many centres throughout the world are now giving both parent and child that extra help and thus making sure that no-one is left to flounder. For example the Westmead Clinic in Australia provides space for whole families to live near the hospital and to learn the practical and therapeutic skills neccessary to help their child post-discharge. In London Ivan Eisler, one of the fathers of "Maudlsey" works with teams of families so that each can learn from others and no one is left with the aching feeling of lonliness which comes from inadequate help.
What you and I got wasn't good enough. Neither was it "proper" FBT which should empower the family to be the best agents of recovery for the patient. We shouldn't let that detract from the stories of those like Brown who manage with only limited help, or from those who ARE being given true Family Based Treatment and are conquering this horrible disease.

November 23, 2010 - 7:26am
(reply to Anonymous)

Thank you for sharing this, Anonymous. I'm sorry you had to go through that with your parents.

Therapy is only therapy if it is guided by professionals. As you found, parents are just people and often not equipped to deal with a serious eating disorder. That's why therapy exists. Any treatment should be guided by professionals to help ensure safety and efficacy.

I'm so glad to hear you have recovered. That is something to be very proud of. It takes hard work, and you have clearly done your share!

Good luck to you.

October 15, 2010 - 6:36pm
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