ANZAED conference blog posts to follow

Based on the recent presentations I attended at the ANZAED conference these are the topics* that I plan to cover in some upcoming posts:

• Specific foods to optimise recovery
  
• June Alexander's 'Evidence from Experience' presentation
  
• Why clinicians should research their own practices (see June Alexander's blog for this one!)
  
• Compulsive exercise in eating disorders  (still to come...)
  
• Are Maudsley skill-builder workshops for carers effective? (still to come...)

if there are any other topics you'd like me to cover from this conference please let me know and I'll see what I can do.

*note: these will be my interpretations of the information presented at these sessions. I will do my best to be as accurate and unbiased as possible in my accounts but, you know, all care no responsibility okay :)

sound bites from the ANZAED conference

I had the most amazing experience at the ANZAED* conference! In all my years of uni lectures and scientific/medical conferences and even blogging conferences I have always been the quiet one. Never raised my hand. Never asked a question. So imagine my surprise in a conference room filled with highly experienced ED clinicians to suddenly find my voice. And it didn't just happen once either - seriously, you couldn't shut me up! And interestingly I had quite a few people coming up to me at the end of sessions saying things like "I'm so glad you asked that question, I was wondering the same thing" - honestly, don't encourage me people, heavens knows where it will lead...

But this post is supposed to be about some sound bites I gleaned from the wonderful presenters on the first day**. So here are a few little gems that really stuck in my mind - and the bigger gems I will blog about in some follow up posts:

1. The majority of people in the community with an eating disorder do not access evidence-based treatment. Far more people access treatment for weight loss. (1)

2. Compulsive exercise is predictive of relapse and poor long-term outcome. (2)

3. Specific foods can optimise the process of recovery. (3) (don't worry, I won't leave it there - I will do a post on this one!)

4. All clinicians should research their own practice...[because] patients have the right to know your success rates. (4)

5. when clinicians give feedback on a patient's progress [good and bad] it improves outcomes - just knowing and discussing progress improves outcomes.(4)


Over all I was incredibly impressed with the level of professionalism, empathy and passion shown by the clinicians whose presentations I attended.

By far the highlight was June Alexander's presentation!!!

But I also met some amazing, inspiring, generous, kind and wonderful people such as Carolin Gray and Bridget Bonnin from FEAST, Christine Morgan from the Butterfly Foundation, Claire Diffey from CEED, and the extremely affable Rod McClymot.

I can't tell you how scary it was going to the conference. It felt like my first real 'public outing'. But I'm so glad I went. And I feel stronger and braver for the experience.




*Australian and New Zealand Academy for Eating Disorders
** sadly I could only go for the first day (friday 26Aug)
(1.Phillipa Hay, 2. Caroline Meyer 3. Leanne Barron 4. Anthea Fursland)

parenting through an anxiety attack

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A lot of my ED habits are an attempt to keep my anxiety under control. And for me this is surprising, as I never knew I had a problem with anxiety before. Yes, my eating disorder has been that successful in keeping anxiety under control that I have only started having anxiety attacks this year, now that I am working to eliminate my ED.

So now that I know, I need to learn how to reduce the symptoms of the anxiety without resorting to my dangerous habits. Returning to ED habits will simply prolong my recovery, it will not cure the anxiety, so that's not an option.

So what is an option?

Well, being able to walk away from parenting, certainly isn't.  But so much of the information I have read on how to deal with anxiety attacks assumes that you are able to just disappear for a few hours to recover.

But 99% of the time I can't. There's still a house-full of small people who need to be fed, washed, dressed and driven around - and I have no family here to help me.

So here's what I find helpful.

1. stay away from the caffeine

I like coffee and tea, a lot. It is warm and comforting. But a really bad idea if my heart rate is already through the roof. So I switch to peppermint tea for the duration.

2. prioritise

What can I just skip it today? The swimming lessons? The supermarket? Am I ok with letting them just watch tv or play at the park for an hour instead of rushing around?
I like to work out what I have to do immediately and what can just be 'let go' this time.

3. break it down

If I'm having an anxiety attack I'm not myself.
Normally I'm a can-do-anything type person. In the middle of an attack everything is a struggle and completely overwhelming. But breaking down my evening and my tasks into 15 minute intervals is helpful for me.
eg: here's what my anxiety evening might look like in my head.
(Note, I'm going to 'let go' of reading to the kids and doing the dishes that night because nothing terrible will happen if I don't do those things.)

**Any time I have left over in each 15min block I can have to sit down and breathe. That is then my time as each task doesn't need to start until the next 15min block**
No rushing.

4. breathe

It's that simple. Slow deep, eyes shut, breathing. Slow everything down. No rushing.

5. block it out

If need be I will also put my ipod on quietly in my ears to block out a lot of the chatter that I don't need to hear right away. I can still hear them perfectly well if I need to, but I don't need to hear all the "don't push" "shut up" "give it me" "I was here first" "That's my chair" "don't!" "stop it!" "muuuuuuuuuum I wanted that first" "why can't I have one" "everyone else's mum said yes"
Alright, you get the idea. And you don't need to hear all of that on your anxiety night!

And once I've got them all to bed I go and take a nice hot shower.

And breathe.

And then go to bed...

and remember, I'm new to all this, so if you have some great suggestions of what works for you I'd love you to share! Thanks :)

words to live for

"Mum, when I grow up can I live next door to you? And then when I go to work, you can look after my baby."

Every minute of every day might be a struggle. Sometimes it's a struggle just to breathe. But who could pass up an offer like that?

Not me.

my armour

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The new therapist, J, asked me if I would like to do some writing activities to help me get my thoughts out - which I thought was probably a good starting point given my general reluctance to talk too much during sessions. So when we last met J brought along some writing prompts, one of which was to do with discussing how I use armour to protect myself in daily life - how this helps and how this restricts me.

At first I interpreted this to mean how does ED act as my armour - which I thought was interesting since I had never thought of ED as protecting me. But try as I might I couldn't make this model fit. The best I could come up with was 'tissue paper' armour that dissolved at the first sign of rain.

In actuality ED is more that frenemy we all had in high school that would talk us into doing something stupid or dangerous and promise they'd be 'right behind you'. But of course as soon as there was trouble they were not there to back you up.

But as I re-read the writing prompt it didn't actually mention ED at all. It simply says talk about 'your armour'. Which is really more the front I put on for others. Which I definitely do - all the time. K (the old therapist) once commented that I had turned 'fake it 'till you make it' into some sort of olympic sport. But I suspect I'm not the only one who does this??

So who am I protecting with all this armour? Me? My reputation? My kids? My husband? Take your pick. ED will tell me that all of these are in terrible danger if the truth were to get out. I think my biggest fears would be losing my job and my kids getting bullied for having a 'mental mum'.


But I'm starting to let go of this. Firstly I think there are worse things in life that your mum having an eating disorder. And since I'm planning on beating this thing I hope I will raise them to be proud of me. And secondly I'm not really sure I care if I lose my job. Yes I love love love my job - but if anyone thinks I'm any different once they know about my eating disorder than I was 10 secs before they knew, well I'm not sure I want to know them.

But I guess my armour does restrict me. It stops me from finding out who my true friends really are for a start. And that is something I have decided needs to go pretty high on my list of priorities. I am not going to bother socialising with anyone who doesn't support me (in any sense of that word). Life is too short for fair-weather friends.

Have you ever thought about your armour? Does it really protect you? 

Do you think you will always wear it?

those damn scales again

I’ve been pushing my dietician to find out my weight from my gp. I know my gp won’t tell me and I thought I would have a better chance of getting this information out of M, so that’s where I’ve been focusing my efforts. But truthfully I think deep down I didn’t expect her to tell me. So although she didn’t tell me the numbers, I was still very caught off guard on thurs night when she told me the trend of my weight over the last three or four months. Basically it went up slightly originally and has then been stable for the last two months.

Right.

How do I feel about this?

How about, completely confused.

M did spend quite a long time explaining what would have caused the initial weight gain. Firstly all starved people are dehydrated, even if they are drinking. And since 1L of water weighs 1kg, fluid alone will account for quite a large percentage of that initial increase. Then there’s the GI tract. Initially, of course this would have been pretty empty, but now that I am eating again normal changes here will add to the numbers on the scale. And neither of these factors will affect how ‘big’ I am. Just the number on the scale.

Okay. So I’m a scientific thinker. This all sounds reasonable to me, doesn’t it? Well, no. It must be wrong. I have always questioned Dr C’s scales anyway – they are so imprecise. So her scales must be wrong.

But is that me thinking that, or ED?

Like I said completely confused.

It’s not that I don’t trust Dr C or M, or that I think they are lying to me. It’s just that I think they must be mistaken. My weight simply could not be stable.

So I weighed myself.

And to say that I’m more confused now would be a gross understatement. My weight is where they said it was. It hasn’t increased that much. In fact I am okay about it.

But I’m not oblivious to how dangerous that decision was. What if they had been wrong? What if my weight had gone up more than I expected? What would I have done?

Don’t get me wrong – I’m fine. In fact I’m really pretty good. But that in itself concerns me as I think I’ve let those damn scales determine my mood again. Arrgghhh, so confused…

thanks for the support

nothing quite like tea and a good chat :)

Dear Readers,

I had a post all lined up ready to go about how worthless I feel at the moment...

But I'm not going to publish it.

I have had time to reflect and breathe. And I've been back to talk to my gp again (twice in two days is never good!) but it has helped me make some big life-altering changes which I am still too scared to talk about here yet.

So instead of wallowing in self-pity - not a hobby I am comfortable with - I have re read the comments people have left for me here on my blog. And the support of people going through what I am going through as well as those who care and understand, have meant the world to me. I am so blessed to have discovered the power of blogging - both for communicating my feelings, and for the support it has given me.

So thank you to everyone who has talked to me; here, by email, on twitter and in real life.

It has made a enormous difference to my outlook and to my recovery.
Thank you
:)PJ

why I hate the term 'mental illness'

One word; stigma

I had a great conversation with my dietician the other day and it clarified a few things for me. I told my dietician that she (meaning the ED professional community) needs to come up with a better term than 'mental illness'. The stigma attached to that terminology is too damaging. It really makes no difference what it actually describes - the general community associate the term with psychotic behaviour. It immediately conjures up an image of someone who is a danger to the community and therefore cannot be trusted. True that someone with an ED is inherently (and seriously) a danger to themselves - but I resent the implication that I must be 'mental' to have a 'mental illness'.

My dietician made the comment 'but you don't have to be the one to fix it'. But quite frankly I think I do. I have a voice and I have experience that I think is worth something.

And I find it frustrating when people who are not personally affected by anorexia tell me how I should feel about the term. I find it condescendingly paternalistic that I should be told to accept a label simply because some professional came up with it. It is like an explorer naming a country without asking the current inhabitants what the country is actually called.

It may be a perfectly exactly descriptive name - but the stigma is too damaging. And stigma is everything. It is what the uninformed use as fact to pass judgement. The media encourage it and the masses repeat it and retweet it.

I'm not mental, or even unintelligent. I refuse to be categorised, pigeon-holed and labelled. I don't like the name someone else chose for my country. So I'm not going to call it that.