
My boy Sinbad…
The internet has been cutting in and out at my house these last couple of days, thus breaking the “More tomorrow” promise I signed off with last time. I know you’ve all been salivating to the point of drowning in your own spit waiting for my second installment of the Eat, Play, Live Eating Disorder of Canada Conference recap. Hopefully your floatation devices of stuffed animals and pillows have kept you afloat…and yes, it did take me this 48 hours to finally put on my biking gear and head to Coburg Coffee – my old flame and favourtie hub-bub in the Halifax area – to share my thoughts of Keynote Speaker Dr. Janet Treasure. Without further adieu, I give you my perspective on Dr. Janet Treasures presentation titled – Collaboration in Care: Sharing skills and mobilizing motivation with a focus on working collaborations with caregivers.
So there I was freaking out internally at my little table as Dr. Janet Treasure took her place at the podium to roars of enthusiastic applause. Ladies and gentlemen, this is THE woman who has pioneered many new approaches to working with caregivers and helping them to learn the coping tools as well as the essential knowledge on how to grapple living with someone who has an eating disorder. I have been a fan of hers for sometime now having first heard about her through a friend on one of my online support groups. Professor Treasure ( how can you not be jealous at that title as it rolls of your tongue into sheer radness? ) has been specializing in eating disorder research at the South London and Maudsley Hospital and Kings College in London ( Jolly Old Enlgalnd, yes, that very one ) for roughly the span of her clinical career. Her CV of accomplishments in the field is rather daunting so I am just going to attach a little link here in the text for you to follow up on your own and dive in. Onto the talk… Right off the bat I knew I was in the presence of a mind who was genuinely fascinated by the neurological construct of our brains; the eating disorder patient.We must confess that we as the illness never do go into the curiosity of what is happening up there all the time, and why our minds are so adept at telling us these peculiar notions of our body, habits, and why we are so entwined with the world around us that we often take things to the whole other level of palatability. You say jump, we try and jump higher, farther, faster than anyone ever has before. If we can’t do it, then the negative repercussions are more like “Well, that’s it, my life is over because I couldn’t do more than was asked of me…” We often live our lives in either of the polar extremes – hate or love. She described how fascinating the mind of an ED patient is, how we are genetically different than those around us, how we are hypersensitive to information or situations around us. So there is Dr. Treasure at her podium speaking so beautifully in such a tasteful, calming British tone ( no wonder she is able to connect so soothingly to her patients and colleagues ) about the construct of what eating disorders are and there varying categories – anorexia nervosa, bulimia nervosa, EDNOS, binge eating disorder, etc – but not in too much detail. After All it should have been assumed that a conference for eating disorders would have an audience of those who are already proficient in the realm of who, what, why (somewhat). Her main focus was to describe the varying levels of categories for CAREGIVERS ( parents, often, or friends, teachers or peers closely associated to the patient ). From my own experience the only type I had really encountered was the “Tough Love” approach. Never had I considered there were varying levels of how parents treat the illness. The role of caregivers is to “provide an escape route” for the eating disordered patient, to “pull them out of the hole they have dug themselves into” according to Dr. Treasures research. Essentially many parents often feel that if they are not bearing the responsibility of the patient fully during the critical time of their lives, then the long term relationship may be damaged or perhaps severed, with fear that relapses or failure to “Recover” will be theirs to hold as their own. On with the slideshow of her work, which was incredibly adorable seeing as her husband who is not an artist answered his wife’s request and drew each slide for her…have to say that if he ever decides to illustrate a children’s book, he would do quite well on the market. Her work has produced the following animal characteristics of care: The Jellyfish, The Ostrich, The Terrier, The Rhino, The Kangaroo, and The Dolphin. Colourful method to label our love to a sick family member, is it not? A method that is rather easy to understand and certainly had members of the audience bobbing their heads when she began talking about the animal which best described our own method of care. I, apparently am a hybrid of Jellyfish and Kangaroo…probably with a hint of Terrier too…

I chose the most insane image of a jellyfish…look at the size of that thing…
Jellyfish are often much like the animal themselves; prone to lash out and sting when threatened. Often this type of caregiver will become anxious or angry losing the ability to regulate their emotions. Often they peak the level of clinical anxiety becoming depressed, shutting down, and lash out at the patient in a loss of how to deal with the problem at hand.
Ostriches like to bury their heads in the sand, so to speak. Even though real ostriches don’t do this, fact. Here we see caregivers avoided all emotional reaction to the patient, channeling their energy into supporting the family as a whole as if there is nothing out of the ordinary. Perhaps the most vicious method of care in that the patient usually will mimic their parent in their caring ways and choose to not acknowledge that what they are doing is dangerous, and wrong. As well it leads to an exaggeration of the parents emotions in the patients own life, not being able to regulate emotions as they happen. Nothing is wrong if we can’t see it…

Border Terrier…much better
Terriers ( Confession: Yes, I was kinda miffed that she used a pit-bull terrier for this…seeing as the breed is nothing like how she describes ) are “Nagging, micro-managing caregivers who won’t let up”. Always on the patients heels exhibiting an often aggressive manner to berate the patient into an emotional collapse. Rather than providing a sympathetic tone or listening, Terriers will attack until the patient breaks to their will or demands, or losses all self-confidence breaking down. Personally having experienced this type of “care” before, I have to say, it’s the most terrifying for myself to have ever experienced, having left me feel like there was no hope for my life, that I was a burden on others, and that my life was better off dead. After all it is easier to grieve than to help…

Rhinos, the controlling caregiver who is often fueled with an overwhelming sense of authority, constantly giving advice and choosing to cause arguments in the effort to communicate, “Charging the eating disorder patient in coercive circles and ultimately provoking defiance from the patient.”

I’ve always wanted to ride in a kangaroo pouch…
Kangaroo caregivers internalize the patients illness choosing to carry them in their “pouch”. They infantilizes the patient offering “No opportunities for self-care”. Essentially the caregiver would rather caudal the child and attempt to live their woes as their own rather than letting them explore self-help on their own terms, or even allowing them to engage in the opportunity. Which seems hard to not understand given the often strong bond between a mother and child…

Dolphins are the key animal to adopt when your thrust into the spotlight of eating disorder patient caregiver, according to Dr. Treasure. Here we see the caregiver giving “Gentle guidance” operating in a safe, calm, composed manner. Often they have excellent coping behaviors in stressful situations and “Go easy on the rest”.
Her patterns arise from the observation of patients who are in the early stages of the disorder, still believing this is the healing tool to help them overcome many of life’s issues, emotional conflicts with themselves and society, and the positive reinforcement they have been searching for from loved ones and peers. While the patient is usually rather proud and elated with their accomplishments of strong wills and excellent work ethic ( the mind of an anorexic to willingly condition their bodies to operate on no solid foods is remarkable, and something I think we too often don’t observe with sheer amazement of strength and courage. Yes, the disorder is dangerous, but the mentality to condition yourself in such a manner exudes incredible strength. Applied correctly that mind will excel in such heightened performances in an area to which they find a connection to. For myself the less I concentrated on my physical appearance of the process of starving, the more my art work and writing excelled, simply because the resources of concentrating so fully on my illness were now applied to my passions: creativity. That was the essential rundown of her talk. Her program in the UK offers workshops to educate caregivers on The Dolphin method of caring, helps to educate them on the actual illness to which their child / loved one has, and encourages them to be present in the lives of the patients without overstepping their boundaries of self-care. Which I can’t disagree with at all. I have been practically screaming for more workshops and advocacy in the same vein as Dr. Treasures for years, really emphasizing on the need for Canadian clinicians to work closely with their patients in learning how / what is needed to better produce programs for those in recovery; families and patients. It just makes sense to incorporate the mind of the sick into the practice of healing not only themselves, but those around them.
Here’s where I had difficulty in her talk. Right off the bat I was upset that when she referred to eating disorders, she meant strictly anorexia nervosa. While she touched on bulimia, EDNOS and binge eating, her outline and research focused on the anorexic. Case studies were only of anorexics, and even the method of counseling and educating caregivers in her workshop was to work primarily with anorexic situations. Now, the mind of a bulimic and an anorexic are incredibly different, as well are the disorders. One method will not always work for the other. Several times Dr. Treasure even stated that there is not enough information about bulimia to continue concentrating resources to look deeper into how to treat the illness. Which, as you can imagine, was shocking and disheartening. This theme continued throughout the conference with varying clinicians who routinely spoke of papers that only focused on anorexia nervosa. For myself as an anorexic who recovered only to adopt bulimia; one is not the same. Bulimia by far has been the more traumatic – physically and emotionally – as well as more controlling of the two disorders, one which I continue to struggle with every day. Knowing that one of the top minds in the field is rather defeatist regarding bulimia has me rather heartbroken, yet, uplifted knowing that so long as we talk openly about our dealings with bulimia we will encourage others to come forward in the medical field to *hopefully* want to explore deeper into the recovery methods for this illness. So yes, it was hard to not raise my hand several times and ask why she kept saying eating disorders when she was speaking specifically about only one, the more predominant.
Secondly her talk was directed towards adolescents only, in the approach that it’s easier to treat an illness before it becomes a “problem”. No adult case studies were shared and often it was mentioned that once the illness as transcended into adulthood that the recovery rates drop dramatically. End of discussion. Didn’t leave much hope for those who first experience their eating disorders well into adulthood…finally, this was an all girls talk. Men were not mentioned, nor was it even alluded to that young boys are prone to experiencing eating disorder behavior in their adolescents. Perhaps it was the time constraints and I am trying to give Dr. Treasure the benefit of the doubt, but reading her literature online ( I have not read her books yet and am hoping to be proven wrong in this…) there is little to no discussion on boys, or men, with eating disorders. Shook my head on that one…clearly we still have a long way to go in this community….despite my disappointment with parts of her talk, I have to say that it was an incredible learning experience in that as an eating disorder patient myself, I have never considered the illness from the perspective of my family or clinicians who did their best to help me in the manners they knew how. I came home that night and told Jonathan that I felt a heavy weight of guilt, and this longing to apologize for my behavior to everyone I had ever encountered over the years that simply had my best interest at heart. Dr. Treasure even mentioned that often we are bullies to those around us, manipulating our illness to the advantage of our demands, pushing those around us to feel a burden or guilt that is not theirs to experience. We attack placing blame on their love, pushing everyone to the point of madness. It’s cruel not only to the host but to those around them; eating disorders cripple lives without remorse.
More tomorrow guys. I hope. I will probably be down here at Coburg Coffee once more in Halifax, so if you’re in the neighborhood you should swing on by and keep me company. I will be the chick in the back with green hair talking to myself and waving my hands around…promise it will be a good time.